Udviklingen af et flerstrenget interventionsprogram med formålet om at øge deltagelsen blandt og fastholdelsen af senfølgeramte i rehabilitering

Abstract

Resume Problemfelt: Mandlige kræftoverlevere med senfølger, har en lav tilslutning til den danske rehabiliteringsindsats. Det estimeres at det blot er hver fjerde der deltager i rehabilitering, som er en mand. Dette gør mandlige senfølgeramte, mere eksponeret overfor udviklingen af senfølger, og skaber ulighed i sundhed og senfølgeforekomst imellem kønnene. Der ses visse barrierer i forhold til rehabiliteringsdeltagelse og, risikofaktorer for senfølgeudvikling hos mænd. Der findes derfor grundlag for forandring på området. Formål: Formålet med specialet er derfor at undersøge, motivation for og barrierer til rehabiliteringsdeltagelse, samt fastlæggelsen af et beslutningsgrundlag, til at udvikle en intervention, Interventionerne har det formål at højne deltagelse til og fastholdelsen i rehabilitering for mandlige kræftoverlevere med senfølger. Metode: Til besvarelse af specialets problemformuleringer, er der udført en systematisk litteratursøgning mhp. at afsøge evidensgrundlaget, for hvilke elementer der er en barriere for deltagelse blandt mandlige senfølgeramte, samt hvad der er motivationer herfor. Dernæst blev der indhentet kvalitative data gennem en interviewundersøgelse, baseret på et fokusgruppeinterview. Dette med mhp. at udvikle et flerstrenget interventionsprogram, som danner rammen for interventionsudvikling, til at øge deltagelsen og fastholdelsen i rehabiliteringsindsatser. Resultat: På baggrund af resultaterne fra den systematiske litteratursøgning og interviewundersøgelsen, er der udviklet to interventioner. disse skal bidrage til at øge deltagelsen i rehabilitering for mandlige senfølgeramte, samt reducere senfølger. Intervention 1, består af informering og rådgivende samtaler ved udskrivelse efter endt kræftbehandling, samt at flytte kræftkontrol, hvor det er muligt til intervention 2, der foregår i kommunernes sundhedscentre. Intervention 2 består superviserede gruppebaserede og individuelle fysiske træningsaktiviteter kun for mænd. Samt dannelsen af netværksgrupper og inddragelsen af sociale relationer. Konklusion: Udviklingen af et flerstrenget interventionsprogram, målrettet mandlige kræftoverlevere med senfølger, som har til formål at øge deltagelsen til og fastholdelsen i rehabilitering. Kan tilrettelægges udefra specialets hovedresultater; oplevelse af rehabiliteringens tilgængelighed, mestringsevne, og høj self-efficacy, den mandlige kønsrolles indflydelse, betydningen af fysisk og psykisk rehabilitering samt netværkets indflydelse. Ved at implementere det flerstrengede interventionsprogram, vil det øge sandsynligheden for at mandlige kræftoverlevere med senfølger deltager og fastholdes i rehabilitering. Dette vil på sigt kunne reducere senfølger og senfølgers konsekvenser efterfølgende en kræftsygdom

Abstract Problem field: Male cancer survivors with late effects have a low uptake to the Danish rehabilitation. It is estimated that it is just every fourth participant in rehabilitation, which is a man. This makes male cancer survivors with late effects, more exposed to the development of late effects, and creates inequality in late effect occurrence in between genders. Some barriers are seen in relation to rehabilitation participation , and risk factors for late effects development in men. There is therefore a basis for change in this area. Purpose: The purpose of the thesis, is therefore to investigate, motivation for and barriers to rehabilitation participation, and to determine a basis for decision-making, to develop an intervention. The purpose of the interventions is to increase participation and continued participation to rehabilitation, for male cancer survivors with late effects. Method: To answer the thesis's problems, a systematic literature search has been carried out. to investigate the evidence base for which elements there is a barrier to participation among male cancer survivors with late effects, and what are motivations for participation. Qualitative data was obtained through an interview study, based on a focus group interview. This with the purposes to develop a multi-strain intervention program, that provides the framework for intervention development, to increase participation and continued participation in rehabilitation. Result: Based on the results of the systematic literature search and the interview study, two interventions have been developed. these should help increase participation in rehabilitation for male cancer survivors with late effects and reduce late effects. Intervention 1 consists of information and advisory talks on discharge after the end of cancer treatment, and to move cancer control, where it is possible, to intervention 2 which takes place in the municipal’s health centers. Intervention 2 consists of supervised group-based and individual physical training activities for men only. As well as the formation of networking groups and the involvement of social relations. Conclusion: The development of a multi-strain intervention program, targeting male cancer survivors with late effects, aimed at increasing participation and continued participation in rehabilitation. The interventions can be organized from the main results; experience of the accessibility of rehabilitation, coping ability and high self-efficacy, the influence of male gender roles, the importance of physical and mental rehabilitation, and the influence of the network. By implementing the multi-strain intervention program, it will increase the likelihood that male cancer survivors with late effects will participate and maintain the participation in rehabilitation. In the long term, these interventions will be able to reduce the consequences of late effects following cancer.

A master thesis from Aalborg University

Udviklingen af et flerstrenget interventionsprogram med formålet om at øge deltagelsen blandt og fastholdelsen af senfølgeramte i rehabilitering

[The development of a multi-stranded intervention program with the aim of increasing participation among and maintain participation in male cancer survivors with late effects in rehabilitation.]