title: Lung cancer and rehabilitation--what are the barriers? Results of a questionnaire survey and the development of regional lung cancer rehabilitation standards and guidelines.
abstract: BACKGROUND
  Evidence supports the role of rehabilitation in the management of lung cancer symptoms. Previous research reports that rehabilitation needs are inadequately recognised and managed, which may adversely affect patients' quality-of-life and create burden for caregivers.
  
  
  OBJECTIVE
  This study aims to explore the perceptions of palliative care and respiratory multidisciplinary team (MDT) members about the role of rehabilitation for lung cancer patients, examine patterns of referral for lung cancer patients to rehabilitation services, and highlight the barriers which prevent the referral of lung cancer patients to rehabilitation services.
  
  
  METHODS
  Questionnaires were completed by MDT members within a regional cancer network during June 2010.
  
  
  RESULTS
  Fifty-nine healthcare professionals participated. Ninety-four per cent of respondents perceived their patients had rehabilitation needs. Referral most commonly occurred during the palliative (29.6 %) and post-treatment (23.7 %) disease phases. Barriers to referral included "lack of knowledge of services or referral mechanisms" (28.8 %), "waiting lists" (28.8 %) and the perception that patients "do not desire rehabilitation" (22 %). Rehabilitation needs were most frequently discussed at palliative in-patient MDT meetings [reported as "often" by 37 (62.7 %) respondents] and least discussed at lung MDTs (half of respondents reporting that rehabilitation was "never" discussed). Rehabilitation services were considered adequate by 39 % of respondents.
  
  
  CONCLUSIONS
  Long waiting times and lack of knowledge of services are among several factors that may prevent lung cancer patients being offered rehabilitation. In order to improve the quality of care delivered to cancer patients, it is important to remove barriers that affect delivery of rehabilitation services.
authors.affiliation: Marie Curie Palliative Care Institute Liverpool, University of Liverpool, Speke Road, Liverpool L25 8QA, UK. amaranwosu@doctors.org.uk
authors.forename: Amara Callistus
authors.initials: AC
authors.lastname: Nwosu
authors.forename: Joanne L
authors.initials: JL
authors.lastname: Bayly
authors.forename: Kathryn E
authors.initials: KE
authors.lastname: Gaunt
authors.forename: Catriona R
authors.initials: CR
authors.lastname: Mayland
mesh_terms: D001291:Attitude of Health Personnel; D006801:Humans; D008175:Lung Neoplasms / Q000534:rehabilitation*; D020380:Needs Assessment / Q000706:statistics & numerical data; D009726:Nurses / Q000706:statistics & numerical data; D010166:Palliative Care / Q000523:psychology / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010820:Physicians / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians'; D012017:Referral and Consultation / Q000706:statistics & numerical data; D014850:Waiting Lists