A qualitative study exploring weight management support for people living with and beyond cancer in Scotland. The patient perspective.


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Karen Barnett, Meena Bhagat, Robert Steele, Annie Anderson

Abstract

Background

For people living with and beyond cancer who have excess body fat, intentional changes in body weight, diet and physical activity offer significant opportunities to reduce future morbidity, including risk of recurrence and second primary cancers, and can improve quality of life and mental wellbeing.  Current international guidelines on cancer survivorship highlight the importance of weight management (WM) as a priority, but support is largely omitted from rehabilitation programmes in Scotland.  The aim of this study is to explore the provision of WM services in the context of cancer survivorship.

Method

Ten focus groups/Interviews (FG/I) were conducted with people living with and beyond cancer (LWABC) who identified as being overweight or obese.  Local cancer charities assisted with recruitment.  Four key areas were explored: perceptions of the relationship between WM and health conditions; beliefs and attitudes towards maintaining a healthy weight and lifestyle; experiences and sensitivities around discussing WM and desirable approaches to improve WM services. FG/I were audio recorded, transcribed verbatim and thematically analysed.

Results

Twenty-nine people participated in a FG/I. Knowledge regarding the association between WM and cancer was limited compared to other weight-related conditions, with cancer commonly associated with weight loss.  A healthy lifestyle was considered important and many were interested in receiving lifestyle advice or WM support.  Treatment side-effects including lack of motivation, fatigue and physical decline were key barriers to active engagement.  Participants reported limited or ‘non-specific’ WM advice from health care providers and a lack of clear sign-posting to WM services. Those who proactively sought help did so through cancer charities.

Conclusion

WM is outlined as a priority within international cancer survivorship guidelines, however results from the present study suggest there are significant ‘gaps’ in the provision of WM support within the health service. Further work is needed to align services, to provide a standardised cross-organisational approach to support patients LWABC with excess WM.

Impact statement

This study identifies an important ‘gap’ in the provision of WM services for people living with and beyond cancer and highlights an urgent need for the alignment of services to ensure that the appropriate help is available to those seeking WM support.