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“My patient is looking for some guidance, can I send her to you?”

Folkersma, F.
Vrije Universiteit (VU)
24 p. bijl. fig. tab. Met lit. opg.

“My patient is looking for some guidance, can I send her to you?”, a qualitative study on active referral of breast cancer patients and collaboration between oncology physiotherapists, care sport connectors and the physical activity sector, masterscriptie


The survival chances of cancer patients are slowly increasing; however, survival causes consequences such as pain and mental issues. Physical activity (PA) has been found effective in reducing these negative effects.

Unfortunately, cancer survivors often do not meet the recommended PA guidelines. Therefore, active referral to physical activities may be a solution. The Care Sport Connector (in Dutch: Buurtsportcoach) can be a facilitator in this chain from primary care to PA. As breast cancer is highly prevalent the research question of this master thesis (masterscriptie) is as follows: “Which barriers, facilitators and needs of oncology physiotherapists play a role in active referral of adult female breast cancer survivors by oncology physiotherapists to physical activity outside the health setting after or during rehabilitation?”

Semi-structured interviews with 13 oncology physiotherapists were held. Purposive selection was done via Onconet in the regions Amsterdam and Nijmegen. Topics were based on the Healthy ALLiances (HALL) framework which conceptualizes the necessary factors for successful (intersectoral) collaboration. Additionally, the study was focused on the community and organizations level of the Social Ecological Model.

Results from the thematic content analysis indicated that participants were not in collaboration with the sports sector or a CSC yet. Major themes of the results consisted of; the need for communication, visibility, and an overview of sports options; barriers being motivation and dependence of the patients, funding, and policies; facilitators being capacities and knowledge; personal relationships, attitude and beliefs being mixed.

Referral seems to be an intricately linked mechanism with the patients, the participant’s (inter)personal factors, institutional factors, and organizational factors at its core. It is suggested that the initiation of collaboration is in the hands of the sports facilities and CSCs, because their low visibility hinders the oncology physiotherapists from connecting with them.

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Mulier Instituut

Kenniscentrum Sport & Bewegen