Search Results (5)

Purpose: Breast cancer has been recognised as a chronic condition, with survivors experiencing long-term physical and psychosocial effects following treatment. Supporting breast cancer survivors to self-manage their health can optimise health-related quality of life and reduce symptom burden. Self-management education (SME) has been advocated at the policy and programme level in Australian primary care, but its uptake is often limited. This study explores healthcare professionals’ (HCPs) experiences and perceptions of SME in primary care, aiming to identify factors influencing its implementation and to support survivorship care for breast cancer survivors in Australia. Methods: A qualitative descriptive approach was adopted involving in-depth semi-structured interviews. Convenience sampling was used to recruit HCPs across the three primary care clinics in the Greater Brisbane area. The interviews were conducted based on an interview guide. Each interview was audio-recorded and transcribed verbatim. Descriptive content analysis was used to analyse the data. Results: Fourteen participants were interviewed across three primary care settings, including five general practitioners and nine registered nurses. Three categories were synthesised from the data: (1) Meaning and role of SM/SME; (2) Suboptimal SME in current practice; (3) Perceived factors impacting SME delivery in practice. Each category had two to six subcategories for the participants. Conclusions: The findings highlighted the importance and perceived benefits of SME for breast cancer survivors and HCPs in Australian primary care. However, the integration of SME into primary care remained suboptimal due to a combination of systemic, organisational, and healthcare provider factors. Evidence-based resources, particularly guidelines and training, are essential to equip HCPs to effectively integrate SME into routine care for breast cancer survivors. Full article

Background: Cancer survivors frequently experience persistent physical and psychological sequelae, including impaired physical function, fatigue, anxiety/depressive symptoms, and reduced health-related quality of life (HRQoL). Exercise is an effective non-pharmacological intervention; however, comparative evidence between multicomponent training (MCT) and aerobic training (AT) using a multidomain framework remains limited. Methods: In this randomized controlled parallel-group trial, 47 cancer survivors (mean age 63.0 ± 8.9 years) were allocated to a 24-week supervised MCT programme (n = 16), an AT programme (n = 16), or a non-exercise control group (CG; n = 15). Outcomes were assessed at baseline and post-intervention including body composition (BIA), physical performance, fatigue (FSS), anxiety (STAI-Y1/Y2), depressive symptoms (BDI), and HRQoL (EORTC QLQ-C30). Results: Fat mass decreased in both MCT (p = 0.005) and AT (p = 0.034), whereas arm circumference increased only in MCT (p < 0.001). Significant Group × Time interactions were observed for major physical performance outcomes; improvements were broader in MCT, while AT showed its largest change in aerobic endurance. Between-group contrasts indicated greater gains with MCT than AT for chair-stand (p = 0.046), sit-and-reach (p = 0.048), and handgrip strength (p = 0.049). Significant interaction effects were also observed for fatigue and psychological outcomes (FSS: p = 0.003; STAI-Y1 and STAI-Y2: p < 0.001; BDI: p < 0.001) and for HRQoL global health (p = 0.003), with larger improvements in MCT than AT for fatigue, state anxiety, and depressive symptoms (all p < 0.05), but not for trait anxiety (p > 0.05). Conclusions: A 24-week supervised MCT programme produced broader benefits than AT alone across physical function and selected psychological outcomes in cancer survivors. These findings support the incorporation of multicomponent exercise into survivorship care as a feasible and effective strategy for addressing multidimensional treatment sequelae. Full article

Background/Objectives: Breast cancer is the most common malignancy among women globally, with survival rates improving due to earlier detection and better treatment. As a result, cancer survivors now constitute a growing segment of the population, and addressing their long-term health and well-being is a public health priority. Diet and nutrition represent modifiable factors that may influence recurrence, comorbidities, and quality of life (QoL), yet clear evidence-based guidance remains limited. This umbrella review thus synthesized evidence from published reviews on the effects of dietary and nutrition interventions among breast cancer survivors. Methods: Following a prospectively registered protocol in PROSPERO (CRD420251185022), six databases (PubMed, EMBASE, Scopus, Cochrane Library, PsycINFO and CINAHL) were systematically searched for systematic reviews/meta-analyses evaluating dietary or nutrition interventions in adult breast cancer survivors. Eligible reviews reported anthropometric, metabolic, psychosocial, or survival outcomes. Methodological quality was appraised using the AMSTAR-2 tool, and findings were narratively synthesized. Results: Nine systematic reviews encompassing more than 10,000 breast cancer survivors were included. Interventions ranged from general dietary counselling and structured weight-management programmes to Mediterranean-style dietary patterns, dietitian-led primary care, multiple health behaviour change interventions, mobile nutrition apps, and broader lifestyle programmes incorporating diet. Across reviews, interventions consistently improved diet quality and fruit–vegetable intake, produced modest but meaningful reductions in weight, body mass index, and body fat, and enhanced several QoL domains (e.g., fatigue, physical functioning, body image). Higher adherence to Mediterranean-style diets was associated with lower all-cause and non–breast cancer mortality, though certainty was limited by observational designs. However, evidence for long-term maintenance, survival endpoints, and ethnically diverse or low- and middle-income populations remains sparse. Conclusions: Dietary and nutrition interventions, particularly structured, dietitian-supported, and Mediterranean-style approaches, contribute to improved diet quality, sustainable weight control, and enhanced QoL among breast cancer survivors. Integrating nutrition care into survivorship pathways should be the focus of future research. Full article

Despite evidence that survivorship support programmes enhance physical and psychosocial wellbeing, cancer patients and survivors often do not use these supportive care services. This study investigated the utility of the Common Sense Model of Self-Regulation for predicting supportive care use following cancer, and the mediating role of coping strategies. Cancer patients and survivors (n = 336 from Australia, n = 61 from the UK; 191 males, 206 females) aged 20–83 years (Mean (M) = 62.73, Standard Deviation (SD) = 13.28) completed an online questionnaire. Predictor variables were cognitive and emotional representations of cancer, as measured by the Illness Perception Questionnaire—Revised (IPQ-R), and problem- and emotion-focused coping strategies, as measured by the Brief-Coping Orientation to Problems Experienced inventory (Brief-COPE). The outcome variable was survivorship support programme use within the preceding month. Perceived personal control over cancer predicted supportive care use, but cancer-related emotional distress did not. Coping was an inconsistent mediator of the relationships. Problem-focused coping mediated the relationship between personal control and supportive care use; emotion-focused coping did not mediate between emotional responses to cancer and the uptake of survivorship support programmes. The Common Sense Model provides a useful framework for understanding survivorship support programme use. However, more clarity around the relationship between illness beliefs and coping is required. Full article

Commonly cited requirements for bridging the “science‑practice divide” between practitioners and scientists include: political support, communication and experimentation. The Subtropical Thicket Restoration Programme was established in 2004 to catalyse investment in large-scale restoration of degraded subtropical thicket in the Eastern Cape, South Africa. Political support has been strong, with the South African government investing more than US$8 million into the programme. Communication occurred regularly among a wide range of stakeholders, and a restoration experiment—comprising 12 treatments and ~300 plots—was established over an area of ~75,000 km². Despite this support, communication and experimentation, many pitfalls were encountered. For example, one restoration protocol became entrenched in the programme’s public as well as private sector operations without continual scrutiny of its efficacy. This was largely because results from the large-scale restoration experiment only emerged a decade after its conceptualization. As the programme enters its second decade there is recognition that a full range of “intelligent tinkering”—from small, rapid experiments to large, long-term experiments—needs to be planned and prescribed. The new working hypothesis is that prescribed innovation will reduce costs of restoration, increase survivorship of plants, increase income streams from restored landscapes, and promote new financing mechanisms for restoration. Full article