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Developing an integrated rehabilitation model for thoracic cancer services: views of patients, carers and clinicians

Bayly, Joanne; Edwards, Bethany E.; Peat, Nicola; Warwick, Geoffrey; Hennig, Ivo M.; Arora, Arvind; Wilcock, Andrew; Higginson, Irene J.; Maddocks, Matthew


Joanne Bayly

Bethany E. Edwards

Nicola Peat

Geoffrey Warwick

Ivo M. Hennig

Arvind Arora

Andrew Wilcock

Irene J. Higginson

Matthew Maddocks


Background: Access to rehabilitation to prevent disability and optimise function is recommended for patients with cancer, including following cancer diagnosis. Models to integrate rehabilitation within oncology services as cancer treatment commences are required, but must be informed by those they are intended to support. We aimed to identify views of patients, carers and clinicians to develop and refine a rehabilitation model to be tested in a feasibility trial for people newly diagnosed with lung cancer or mesothelioma.
Methods: We conducted a focus group study with people affected by lung cancer or mesothelioma, their carers and clinicians providing their care to identify priorities for rehabilitation in this period. We sought views on core intervention components, processes and outcomes and integration with oncology services. Data were analysed using thematic analysis.
Results: Fifteen clinicians (oncologists, nurse specialists, physiotherapists and occupational therapists), nine patients and five carers participated. A proposed outline rehabilitation model was perceived as highly relevant for this population. Participants recommended prompt and brief rehabilitation input, delivered whilst people attend for hospital appointments or at home to maximise accessibility and acceptability. Participants recognised variation in need and all prioritised tailored support for symptom self-management, daily activities and the involvement of carers. Clinicians also prioritised achieving fitness for oncology treatment. Patients and carers prioritised a sensitive manner of approach, positivity and giving hope for the future. Participant’s recommendations for outcome measurement related to confidence in usual daily activities, symptom control and oncology treatment completion rates over objective measures of cardiorespiratory fitness.
Conclusion: The importance of providing tailored rehabilitation around the time of diagnosis for people with lung cancer or mesothelioma was affirmed by all participants. The refined model of rehabilitation recommended for testing in a feasibility trial is flexible, tailored and short-term. It aims to support people to self-manage symptoms, tolerate cancer treatments and to remain active and independent in daily life. It is delivered alongside scheduled hospital appointments or at home by an expert practitioner sensitive to the psycho-social sequelae that follow a diagnosis of thoracic cancer.


Bayly, J., Edwards, B. E., Peat, N., Warwick, G., Hennig, I. M., Arora, A., …Maddocks, M. (2018). Developing an integrated rehabilitation model for thoracic cancer services: views of patients, carers and clinicians. Pilot and Feasibility Studies, 4, 1-12.

Journal Article Type Article
Acceptance Date Oct 1, 2018
Online Publication Date Oct 18, 2018
Publication Date Oct 18, 2018
Deposit Date Oct 5, 2018
Publicly Available Date Oct 5, 2018
Journal Pilot and Feasibility Studies
Electronic ISSN 2055-5784
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 4
Article Number 160
Pages 1-12
Keywords Lung cancer; Mesothelioma; Focus groups; Rehabilitation; Qualitative; Feasibility trial
Public URL
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