Feasibility of intrainfusion exercise in a regional chemotherapy day unit.

Abstract

Background: The benefits of exercise during cancer treatment are well documented, however exercising through systemic anti-cancer treatment (SACT) infusion remains relatively novel. Patients are sedentary for lengthy periods while receiving SACT infusion and this time could be used to increase physical activity (PA) and a patients’ confidence that it is safe to engage in, even with a cancer diagnosis. Research question/aim: This mixed methods approach aimed to determine the feasibility and acceptability of nursing-supervised low-intensity exercise during SACT in a regional health service. Methods: Phase 1: Exercise Physiologists provided education to CDU nursing staff on intra-infusion exercise prior to project commencement. Nurses were surveyed on their confidence to assist with intra-infusion exercise at baseline, and will be completed at regular intervals throughout the project. Phase 2: Education and low-intensity exercise in the form of seated cycling was offered by EP’s to patients receiving SACT. EP staff implemented the intervention initially, and CDU nursing staff supervised exercise during subsequent sessions. Patients completed surveys each session providing data on: PA levels (Godin), quality of life (EORTC QLQ30), levels of boredom, fatigue, confidence to exercise, duration of intra-infusion exercise, and their subjective feedback. Phase 3: Following a 3-month pilot, nursing staff will participate in focus groups to provide feedback on the intervention and patient uptake. Data from the focus groups will be thematically analysed. Patients will also be interviewed on their experience. Phase 4: Repeat patient intake. Results: Phase 1 has now been completed with preliminary results of 12 nursing staff demonstrated a confidence rating of 5.6 out of 10 (10 = most confident) at baseline. Barriers were identified, such as COVID related staff shortages, and therefore modifications to protocol were required prior to phase 2 commencing. Phase 2 has commenced with 6 patients commenced to date. Data collection is anticipated to be completed by September 2022. Translational impact/implications: Intra-infusion exercise was well received by both staff and patients however staff shortages delayed commencement. Nursing staff initially reported mid-range confidence in assisting with intrainfusion exercise.