Introduction

Older breast cancer survivors have difficulty accessing rehabilitation interventions addressing activity limitations. Stakeholder input may improve accessibility of interventions. We sought expert consensus on intervention content and delivery features (e.g., where, mode, duration) to inform development of more accessible interventions for this population.

Materials and methods

We conducted a modified Delphi process with patient, clinical, administrative, and research experts. In Round 1, experts evaluated content and delivery features according to domains of feasibility and prioritization. In Round 2, panelists were asked to re-rank or confer agreement of content and delivery features that met Round 1 consensus. Ranking was based on median score. Consensus was defined as a percentage of panelists that ranked an option within one unit of the median. For nominal data, consensus was defined as percent agreement.

Results

Panelists (n = 20) prioritized physical activity strategies (Median Rank: 2; Consensus: 85%) and adaptive skills training (3; 65%). Panelists also prioritized delivery through outpatient services (1; 100%), post-treatment (1; 100%), combination mode of delivery (100%), duration of three months or less (100%) and occurring one to two days per week (100%).

Discussion

Cancer rehabilitation interventions should be designed with input from stakeholders. The stakeholder intervention priorities identified in this study (e.g., content, setting, and mode) may improve relevance and accessibility of future cancer rehabilitation interventions. Interventions delivered in outpatient clinics and post-treatment using virtual and in-person visits may improve accessibility. Future research should examine the effectiveness and implementation of these intervention characteristics.

中文翻译：

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制定影响老年乳腺癌幸存者活动限制的干预措施：一项改良的德尔福研究

介绍

老年乳腺癌幸存者难以获得解决活动限制的康复干预措施。利益相关者的意见可能会提高干预措施的可及性。我们寻求关于干预内容和实施特征（例如，地点、模式、持续时间）的专家共识，以便为该人群开发更容易获得的干预措施提供信息。

材料和方法

我们与患者、临床、行政和研究专家进行了改良的德尔福流程。在第 1 轮中，专家根据可行性和优先级评估了内容和交付功能。在第 2 轮中，小组成员被要求重新排名或授予符合第 1 轮共识的内容和交付功能的协议。排名基于中位数。共识被定义为在中位数的一个单位内对选项进行排名的小组成员的百分比。对于名义数据，共识被定义为一致性百分比。

结果

小组成员（n  = 20）优先考虑体育活动策略（中位数：2；共识：85%）和适应性技能训练（3；65%）。小组成员还优先考虑通过门诊服务 (1; 100%)、治疗后 (1; 100%)、组合分娩方式 (100%)、持续时间为三个月或更短 (100%) 以及每次发生一到两天周（100%）。

讨论

癌症康复干预措施的设计应参考利益相关者的意见。本研究中确定的利益相关者干预优先事项（例如，内容、环境和模式）可能会提高未来癌症康复干预的相关性和可及性。使用虚拟和面对面访问在门诊诊所和治疗后进行的干预可能会提高可及性。未来的研究应该检查这些干预特征的有效性和实施。