A qualitative analysis of oncology clinicians' perceptions and barriers for physical activity counselling in breast cancer survivors


Few breast cancer survivors (BCS) engage in sufficient physical activity (PA) to gain physical and mental health benefits. This may be due to a lack of appropriate PA information and support. While key messengers of PA information could be oncology clinicians, many do not consistently counsel their patients on PA. Purpose: To examine factors affecting PA counselling in clinicians and inform future strategies. Methods: Focus groups were conducted with clinicians (N=27) at four cancer hospitals to better understand factors that affect PA counselling. Focus group discussions were transcribed verbatim and analyzed using inductive thematic analysis. Results: Clinicians perceived a lack of training and knowledge related to PA and BCS. Clinicians also discussed being unsure of when to integrate PA counselling into different phases of survivorship. Similarly, clinicians experienced barriers from hospital administration to maintain patient flow in-clinic, which decreased opportunities for PA counselling. Additionally, lack of awareness of community-based programs within large areas served by hospitals also decreased clinicians' self-efficacy for counselling. In order to facilitate PA counselling, clinicians wanted resources that promote patient-managed PA, available on multiple platforms (e.g., printed and online). Continued education, highlighting recent research and effective implementation of PA, was noted as an important facilitator. Conclusions: Researchers are encouraged to develop research agendas and test educational strategies that are integrated into current practice, empirically test barriers that developed from this study with a larger, representative sample to determine salient barriers and develop PA counselling strategies that are clinician-initiated but not dependent on clinicians.

Acknowledgments: Funded by a grant from the Canadian Breast Cancer Foundation