Challenges in implementing a multidisciplinary integrative oncology intervention for young women with localized breast cancer.
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Fajardo-Espinoza Fernanda Sarahí, Martínez-Palacios Daniela, Rodríguez-Fonseca Yanira E, Pérez-Camargo Dana Aline, Gálvez-Hernández Carmen L, Bejarano-Colina Tavata, Torres-Domínguez Juan A, Rodríguez-Velázquez Ana Laura, Cedillo-Compeán Verónica, López-Bejarano Rosa L, Enríquez-Cárcamo Virginia Isabel, Lopez-Castro Lourdes, Menéndez-Aponte Y Guzmán Raquel María, González-Pérez Alicia, Barranco-Cortés Aline, Madariaga-Cobos Aimée C, Blandón-Hernández Lina M, Cabrera-Nieto Sara Aileen, Labra-Alvarado Lucero I, Mohar Alejandro, Matus-Santos Juan A, Villarreal-Garza Cynthia M, Platas Alejandra, Bargalló-Rocha Juan E, Cruz-Ramos Marlid
Аннотация
METHODS: A qualitative analysis was conducted to identify the challenges and facilitators perceived by patients and providers in implementing a hybrid (on-site and online) integrative oncology multidisciplinary intervention. Women aged 18 to 39 with a recent BC stage I-III diagnosis and providers participated in structured interviews based on the Consolidated Framework for Implementation Research (CFIR) and Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) tools. The data from this framework analysis provided insights for developing an effective intervention and helped identify potential barriers and facilitators.
RESULTS: Patients and providers reported that implementing the intervention was challenging, primarily due to time constraints, follow-up requirements, and the need to sustain patient motivation. The hybrid modality enhances motivation and adherence while addressing limitations such as the distance necessary to attend in-person sessions. However, some patients encountered difficulties related to technology and scheduling virtual sessions. Despite these challenges, the intervention proved feasible in assisting patients in maintaining a healthy lifestyle since their diagnosis and throughout their active BC oncology treatment.
CONCLUSIONS: Integrative oncology interventions emerge as a strategy to maintain a healthy lifestyle, positively impacting quality of life during BC active treatment, and have gained widespread acceptance globally. However, their routine use and inclusion in BC standard treatment at oncology centers remain limited. This study underscores the importance of providing comprehensive care to YWBC from the outset of their treatment. Overcoming barriers such as patient ideologies, healthcare personnel, geographical distances, scheduling constraints, technological limitations, and institutional support is crucial for delivering this level of care.