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Current Practice and Barriers in Cancer Rehabilitation: Perspectives of Korean Physiatrists

Identifieur interne : 000325 ( Pmc/Curation ); précédent : 000324; suivant : 000326

Current Practice and Barriers in Cancer Rehabilitation: Perspectives of Korean Physiatrists

Auteurs : Eun Joo Yang [Corée du Sud] ; Seung Hyun Chung [Corée du Sud] ; Jae-Yong Jeon [Corée du Sud] ; Kwan Sik Seo [Corée du Sud] ; Hyung-Ik Shin [Corée du Sud] ; Ji Hye Hwang [Corée du Sud] ; Jae-Young Lim [Corée du Sud]

Source :

RBID : PMC:4506115

Abstract

Purpose

The purpose of this study was to assess clinical practice and barriers associated with cancer rehabilitation from the perspective of Korean physiatrists.

Materials and Methods

All active members of the Korean Academy of Rehabilitation Medicine were invited to complete an online survey developed after focus group discussions.

Results

A total of 97 physiatrists (72 males and 25 females) in Korea completed the survey. Of these, 77% reported familiarity with the term 'cancer survivors.' More than 50% of respondents reported that they provided rehabilitation services for patients with breast cancer (61.9%), brain tumors (64.9%), and spinal tumors (63.9%), whereas 86.6% of respondents reported that they had never or rarely provided rehabilitation programs for patients with gynecological, colorectal, or prostate cancer. Physiatrists who received referrals from a well-organized cooperative referral system reported providing services such as exercise programs for patients with gynecological cancer (odds ratio [OR], 2.16; p=0.044) as well as education regarding lymphedema (OR, 1.81; p=0.047) and neuropathic pain (OR, 1.96; p=0.026).

Conclusion

Although most of the physiatrists surveyed believed that they should contribute to the management of cancer patients, they considered themselves ill equipped to provide appropriate rehabilitation services. This lack of understanding of the effectiveness of rehabilitation services for cancer patients and absence of a cooperative referral system are the major barriers to providing rehabilitation services to cancer survivors in Korea.


Url:
DOI: 10.4143/crt.2014.084
PubMed: 25672583
PubMed Central: 4506115

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PMC:4506115

Le document en format XML

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<title>Purpose</title>
<p>The purpose of this study was to assess clinical practice and barriers associated with cancer rehabilitation from the perspective of Korean physiatrists.</p>
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<sec>
<title>Materials and Methods</title>
<p>All active members of the Korean Academy of Rehabilitation Medicine were invited to complete an online survey developed after focus group discussions.</p>
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<sec>
<title>Results</title>
<p>A total of 97 physiatrists (72 males and 25 females) in Korea completed the survey. Of these, 77% reported familiarity with the term 'cancer survivors.' More than 50% of respondents reported that they provided rehabilitation services for patients with breast cancer (61.9%), brain tumors (64.9%), and spinal tumors (63.9%), whereas 86.6% of respondents reported that they had never or rarely provided rehabilitation programs for patients with gynecological, colorectal, or prostate cancer. Physiatrists who received referrals from a well-organized cooperative referral system reported providing services such as exercise programs for patients with gynecological cancer (odds ratio [OR], 2.16; p=0.044) as well as education regarding lymphedema (OR, 1.81; p=0.047) and neuropathic pain (OR, 1.96; p=0.026).</p>
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<p>Although most of the physiatrists surveyed believed that they should contribute to the management of cancer patients, they considered themselves ill equipped to provide appropriate rehabilitation services. This lack of understanding of the effectiveness of rehabilitation services for cancer patients and absence of a cooperative referral system are the major barriers to providing rehabilitation services to cancer survivors in Korea.</p>
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<pmc article-type="research-article">
<pmc-dir>properties open_access</pmc-dir>
<front>
<journal-meta>
<journal-id journal-id-type="nlm-ta">Cancer Res Treat</journal-id>
<journal-id journal-id-type="iso-abbrev">Cancer Res Treat</journal-id>
<journal-id journal-id-type="publisher-id">CRT</journal-id>
<journal-title-group>
<journal-title>Cancer Research and Treatment : Official Journal of Korean Cancer Association</journal-title>
</journal-title-group>
<issn pub-type="ppub">1598-2998</issn>
<issn pub-type="epub">2005-9256</issn>
<publisher>
<publisher-name>Korean Cancer Association</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="pmid">25672583</article-id>
<article-id pub-id-type="pmc">4506115</article-id>
<article-id pub-id-type="doi">10.4143/crt.2014.084</article-id>
<article-id pub-id-type="publisher-id">crt-2014-084</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Original Article</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Current Practice and Barriers in Cancer Rehabilitation: Perspectives of Korean Physiatrists</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname>Yang</surname>
<given-names>Eun Joo</given-names>
</name>
<degrees>MD</degrees>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="af1-crt-2014-084">
<sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Chung</surname>
<given-names>Seung Hyun</given-names>
</name>
<degrees>MD</degrees>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="af2-crt-2014-084">
<sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Jeon</surname>
<given-names>Jae-Yong</given-names>
</name>
<degrees>MD</degrees>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="af3-crt-2014-084">
<sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Seo</surname>
<given-names>Kwan Sik</given-names>
</name>
<degrees>MD</degrees>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="af4-crt-2014-084">
<sup>4</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Shin</surname>
<given-names>Hyung-Ik</given-names>
</name>
<degrees>MD</degrees>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="af1-crt-2014-084">
<sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Hwang</surname>
<given-names>Ji Hye</given-names>
</name>
<degrees>MD</degrees>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="af5-crt-2014-084">
<sup>5</sup>
</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Lim</surname>
<given-names>Jae-Young</given-names>
</name>
<degrees>MD</degrees>
<degrees>PhD</degrees>
<xref ref-type="corresp" rid="c1-crt-2014-084"></xref>
<xref ref-type="aff" rid="af1-crt-2014-084">
<sup>1</sup>
</xref>
</contrib>
<aff id="af1-crt-2014-084">
<label>1</label>
Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University, College of Medicine, Seongnam,
<country>Korea</country>
</aff>
<aff id="af2-crt-2014-084">
<label>2</label>
Department of Physical Medicine and Rehabilitation, National Cancer Center, Goyang,
<country>Korea</country>
</aff>
<aff id="af3-crt-2014-084">
<label>3</label>
Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
<country>Korea</country>
</aff>
<aff id="af4-crt-2014-084">
<label>4</label>
Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul,
<country>Korea</country>
</aff>
<aff id="af5-crt-2014-084">
<label>5</label>
Department of Physical Medicine and Rehabilitation, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
<country>Korea</country>
</aff>
</contrib-group>
<author-notes>
<corresp id="c1-crt-2014-084">Correspondence: Jae-Young Lim, MD, PhD  Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam 463-707, Korea  Tel: 82-31-787-7739 Fax: 82-31-787-4056 E-mail:
<email>drlim1@snu.ac.kr</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub">
<month>7</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="epub">
<day>7</day>
<month>1</month>
<year>2015</year>
</pub-date>
<volume>47</volume>
<issue>3</issue>
<fpage>370</fpage>
<lpage>378</lpage>
<history>
<date date-type="received">
<day>1</day>
<month>4</month>
<year>2014</year>
</date>
<date date-type="accepted">
<day>13</day>
<month>6</month>
<year>2014</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright © 2015 by the Korean Cancer Association</copyright-statement>
<copyright-year>2015</copyright-year>
<license>
<license-p>This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (
<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/">http://creativecommons.org/licenses/by-nc/3.0/</ext-link>
) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<abstract>
<sec>
<title>Purpose</title>
<p>The purpose of this study was to assess clinical practice and barriers associated with cancer rehabilitation from the perspective of Korean physiatrists.</p>
</sec>
<sec>
<title>Materials and Methods</title>
<p>All active members of the Korean Academy of Rehabilitation Medicine were invited to complete an online survey developed after focus group discussions.</p>
</sec>
<sec>
<title>Results</title>
<p>A total of 97 physiatrists (72 males and 25 females) in Korea completed the survey. Of these, 77% reported familiarity with the term 'cancer survivors.' More than 50% of respondents reported that they provided rehabilitation services for patients with breast cancer (61.9%), brain tumors (64.9%), and spinal tumors (63.9%), whereas 86.6% of respondents reported that they had never or rarely provided rehabilitation programs for patients with gynecological, colorectal, or prostate cancer. Physiatrists who received referrals from a well-organized cooperative referral system reported providing services such as exercise programs for patients with gynecological cancer (odds ratio [OR], 2.16; p=0.044) as well as education regarding lymphedema (OR, 1.81; p=0.047) and neuropathic pain (OR, 1.96; p=0.026).</p>
</sec>
<sec>
<title>Conclusion</title>
<p>Although most of the physiatrists surveyed believed that they should contribute to the management of cancer patients, they considered themselves ill equipped to provide appropriate rehabilitation services. This lack of understanding of the effectiveness of rehabilitation services for cancer patients and absence of a cooperative referral system are the major barriers to providing rehabilitation services to cancer survivors in Korea.</p>
</sec>
</abstract>
<kwd-group>
<kwd>Physical and rehabilitation medicine</kwd>
<kwd>Data collection</kwd>
<kwd>Professional practice</kwd>
</kwd-group>
</article-meta>
</front>
<floats-group>
<table-wrap id="t1-crt-2014-084" orientation="portrait" position="float">
<label>Table 1.</label>
<caption>
<p>Characteristics of participants</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th valign="top" align="left" rowspan="1" colspan="1">Characteristic</th>
<th valign="top" align="center" rowspan="1" colspan="1">No. (%)</th>
</tr>
</thead>
<tbody>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">Gender (male)</td>
<td valign="top" align="center" rowspan="1" colspan="1">72 (74.3)</td>
</tr>
<tr>
<td colspan="2" valign="top" align="left" rowspan="1">Age (yr)</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1"> 20-29</td>
<td valign="top" align="center" rowspan="1" colspan="1">2 (2.1)</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1"> 30-39</td>
<td valign="top" align="center" rowspan="1" colspan="1">59 (60.8)</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1"> 40-49</td>
<td valign="top" align="center" rowspan="1" colspan="1">34 (35.1)</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1"> 50-60</td>
<td valign="top" align="center" rowspan="1" colspan="1">2 (2.1)</td>
</tr>
<tr>
<td colspan="2" valign="top" align="left" rowspan="1">Proportion of cancer patients (%)</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1"> < 10</td>
<td valign="top" align="center" rowspan="1" colspan="1">84 (86.5)</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1"> 10-29</td>
<td valign="top" align="center" rowspan="1" colspan="1">11 (11.3)</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1"> 30-50</td>
<td valign="top" align="center" rowspan="1" colspan="1">1 (1.1)</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1"> > 50</td>
<td valign="top" align="center" rowspan="1" colspan="1">1 (1.1)</td>
</tr>
<tr>
<td colspan="2" valign="top" align="left" rowspan="1">Institution</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1"> Primary and secondary hospital</td>
<td valign="top" align="center" rowspan="1" colspan="1">39 (40.3)</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1"> Tertiary general hospitals</td>
<td valign="top" align="center" rowspan="1" colspan="1">58 (59.7)</td>
</tr>
<tr>
<td colspan="2" valign="top" align="left" rowspan="1">Cooperative referral system with primary oncologists</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1"> Yes</td>
<td valign="top" align="center" rowspan="1" colspan="1">65 (67.0)</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1"> No</td>
<td valign="top" align="center" rowspan="1" colspan="1">32 (33.0)</td>
</tr>
</tbody>
</table>
</table-wrap>
<table-wrap id="t2-crt-2014-084" orientation="portrait" position="float">
<label>Table 2.</label>
<caption>
<p>Delivery of rehabilitation service components</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th valign="top" align="left" rowspan="1" colspan="1">Variable</th>
<th valign="top" align="center" rowspan="1" colspan="1">Overall (%) (n=97)</th>
<th valign="top" align="center" rowspan="1" colspan="1">Primary and secondary hospitals (n=39)</th>
<th valign="top" align="center" rowspan="1" colspan="1">Tertiary general hospitals (n=58)</th>
<th valign="top" align="center" rowspan="1" colspan="1">p-value</th>
</tr>
</thead>
<tbody>
<tr>
<td colspan="5" valign="top" align="left" rowspan="1">Cancer-specific dysfunction</td>
</tr>
<tr>
<td colspan="5" valign="top" align="left" rowspan="1"> Lymphedema</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">  Never or rarely</td>
<td valign="top" align="center" rowspan="1" colspan="1">50.5</td>
<td valign="top" align="center" rowspan="1" colspan="1">30</td>
<td valign="top" align="center" rowspan="1" colspan="1">19</td>
<td valign="top" align="center" rowspan="1" colspan="1">< 0.001</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">  Usually or always</td>
<td valign="top" align="center" rowspan="1" colspan="1">49.5</td>
<td valign="top" align="center" rowspan="1" colspan="1">9</td>
<td valign="top" align="center" rowspan="1" colspan="1">39</td>
<td valign="top" align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td colspan="5" valign="top" align="left" rowspan="1"> Upper limb dysfunction for breast cancer</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">  Never or rarely</td>
<td valign="top" align="center" rowspan="1" colspan="1">38.1</td>
<td valign="top" align="center" rowspan="1" colspan="1">24</td>
<td valign="top" align="center" rowspan="1" colspan="1">13</td>
<td valign="top" align="center" rowspan="1" colspan="1">< 0.001</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">  Usually or always</td>
<td valign="top" align="center" rowspan="1" colspan="1">61.9</td>
<td valign="top" align="center" rowspan="1" colspan="1">15</td>
<td valign="top" align="center" rowspan="1" colspan="1">45</td>
<td valign="top" align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td colspan="5" valign="top" align="left" rowspan="1"> Pelvic floor dysfunction for gynecological cancer</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">  Never or rarely</td>
<td valign="top" align="center" rowspan="1" colspan="1">86.6</td>
<td valign="top" align="center" rowspan="1" colspan="1">34</td>
<td valign="top" align="center" rowspan="1" colspan="1">50</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.571</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">  Usually or always</td>
<td valign="top" align="center" rowspan="1" colspan="1">13.4</td>
<td valign="top" align="center" rowspan="1" colspan="1">5</td>
<td valign="top" align="center" rowspan="1" colspan="1">8</td>
<td valign="top" align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td colspan="5" valign="top" align="left" rowspan="1"> Dysphagia for head and neck cancer</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">  Never or rarely</td>
<td valign="top" align="center" rowspan="1" colspan="1">54.6</td>
<td valign="top" align="center" rowspan="1" colspan="1">26</td>
<td valign="top" align="center" rowspan="1" colspan="1">27</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.040</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">  Usually or always</td>
<td valign="top" align="center" rowspan="1" colspan="1">45.4</td>
<td valign="top" align="center" rowspan="1" colspan="1">13</td>
<td valign="top" align="center" rowspan="1" colspan="1">31</td>
<td valign="top" align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td colspan="5" valign="top" align="left" rowspan="1"> Brain tumor</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">  Never or rarely</td>
<td valign="top" align="center" rowspan="1" colspan="1">35.1</td>
<td valign="top" align="center" rowspan="1" colspan="1">18</td>
<td valign="top" align="center" rowspan="1" colspan="1">16</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.049</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">  Usually or always</td>
<td valign="top" align="center" rowspan="1" colspan="1">64.9</td>
<td valign="top" align="center" rowspan="1" colspan="1">21</td>
<td valign="top" align="center" rowspan="1" colspan="1">42</td>
<td valign="top" align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td colspan="5" valign="top" align="left" rowspan="1"> Spinal tumor</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">  Never or rarely</td>
<td valign="top" align="center" rowspan="1" colspan="1">36.1</td>
<td valign="top" align="center" rowspan="1" colspan="1">19</td>
<td valign="top" align="center" rowspan="1" colspan="1">16</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.028</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">  Usually or always</td>
<td valign="top" align="center" rowspan="1" colspan="1">63.9</td>
<td valign="top" align="center" rowspan="1" colspan="1">20</td>
<td valign="top" align="center" rowspan="1" colspan="1">42</td>
<td valign="top" align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td colspan="5" valign="top" align="left" rowspan="1">Cancer-common dysfunction</td>
</tr>
<tr>
<td colspan="5" valign="top" align="left" rowspan="1"> Immobilization</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">  Never or rarely</td>
<td valign="top" align="center" rowspan="1" colspan="1">72.2</td>
<td valign="top" align="center" rowspan="1" colspan="1">33</td>
<td valign="top" align="center" rowspan="1" colspan="1">37</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.020</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">  Usually or always</td>
<td valign="top" align="center" rowspan="1" colspan="1">27.8</td>
<td valign="top" align="center" rowspan="1" colspan="1">6</td>
<td valign="top" align="center" rowspan="1" colspan="1">21</td>
<td valign="top" align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td colspan="5" valign="top" align="left" rowspan="1"> Exercise during treatment</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">  Never or rarely</td>
<td valign="top" align="center" rowspan="1" colspan="1">86.6</td>
<td valign="top" align="center" rowspan="1" colspan="1">37</td>
<td valign="top" align="center" rowspan="1" colspan="1">47</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.044</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">  Usually or always</td>
<td valign="top" align="center" rowspan="1" colspan="1">13.4</td>
<td valign="top" align="center" rowspan="1" colspan="1">2</td>
<td valign="top" align="center" rowspan="1" colspan="1">11</td>
</tr>
<tr>
<td colspan="5" valign="top" align="left" rowspan="1"> Neuropathic pain</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">  Never or rarely</td>
<td valign="top" align="center" rowspan="1" colspan="1">51.5</td>
<td valign="top" align="center" rowspan="1" colspan="1">22</td>
<td valign="top" align="center" rowspan="1" colspan="1">28</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.282</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">  Usually or always</td>
<td valign="top" align="center" rowspan="1" colspan="1">48.5</td>
<td valign="top" align="center" rowspan="1" colspan="1">17</td>
<td valign="top" align="center" rowspan="1" colspan="1">30</td>
</tr>
<tr>
<td colspan="5" valign="top" align="left" rowspan="1"> Orthosis</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">  Never or rarely</td>
<td valign="top" align="center" rowspan="1" colspan="1">63.9</td>
<td valign="top" align="center" rowspan="1" colspan="1">30</td>
<td valign="top" align="center" rowspan="1" colspan="1">32</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.023</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">  Usually or always</td>
<td valign="top" align="center" rowspan="1" colspan="1">36.1</td>
<td valign="top" align="center" rowspan="1" colspan="1">9</td>
<td valign="top" align="center" rowspan="1" colspan="1">26</td>
</tr>
<tr>
<td colspan="5" valign="top" align="left" rowspan="1"> Weight control</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">  Never or rarely</td>
<td valign="top" align="center" rowspan="1" colspan="1">89.7</td>
<td valign="top" align="center" rowspan="1" colspan="1">37</td>
<td valign="top" align="center" rowspan="1" colspan="1">50</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.150</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">  Usually or always</td>
<td valign="top" align="center" rowspan="1" colspan="1">10.3</td>
<td valign="top" align="center" rowspan="1" colspan="1">2</td>
<td valign="top" align="center" rowspan="1" colspan="1">8</td>
<td valign="top" align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td colspan="5" valign="top" align="left" rowspan="1"> Osteoarthritis</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">  Never or rarely</td>
<td valign="top" align="center" rowspan="1" colspan="1">45.4</td>
<td valign="top" align="center" rowspan="1" colspan="1">21</td>
<td valign="top" align="center" rowspan="1" colspan="1">23</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.121</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">  Usually or always</td>
<td valign="top" align="center" rowspan="1" colspan="1">54.6</td>
<td valign="top" align="center" rowspan="1" colspan="1">18</td>
<td valign="top" align="center" rowspan="1" colspan="1">35</td>
<td valign="top" align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td colspan="5" valign="top" align="left" rowspan="1"> Gait training</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">  Never or rarely</td>
<td valign="top" align="center" rowspan="1" colspan="1">50.5</td>
<td valign="top" align="center" rowspan="1" colspan="1">18</td>
<td valign="top" align="center" rowspan="1" colspan="1">31</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.310</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">  Usually or always</td>
<td valign="top" align="center" rowspan="1" colspan="1">49.5</td>
<td valign="top" align="center" rowspan="1" colspan="1">21</td>
<td valign="top" align="center" rowspan="1" colspan="1">27</td>
<td valign="top" align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td colspan="5" valign="top" align="left" rowspan="1"> Body image</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">  Never or rarely</td>
<td valign="top" align="center" rowspan="1" colspan="1">95.9</td>
<td valign="top" align="center" rowspan="1" colspan="1">38</td>
<td valign="top" align="center" rowspan="1" colspan="1">55</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.470</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">  Usually or always</td>
<td valign="top" align="center" rowspan="1" colspan="1">4.1</td>
<td valign="top" align="center" rowspan="1" colspan="1">1</td>
<td valign="top" align="center" rowspan="1" colspan="1">3</td>
<td valign="top" align="center" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td colspan="5" valign="top" align="left" rowspan="1"> Sexual problem</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">  Never or rarely</td>
<td valign="top" align="center" rowspan="1" colspan="1">97.9</td>
<td valign="top" align="center" rowspan="1" colspan="1">38</td>
<td valign="top" align="center" rowspan="1" colspan="1">57</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.645</td>
</tr>
<tr>
<td valign="top" align="left" rowspan="1" colspan="1">  Usually or always</td>
<td valign="top" align="center" rowspan="1" colspan="1">2.1</td>
<td valign="top" align="center" rowspan="1" colspan="1">1</td>
<td valign="top" align="center" rowspan="1" colspan="1">1</td>
<td valign="top" align="center" rowspan="1" colspan="1"></td>
</tr>
</tbody>
</table>
</table-wrap>
<table-wrap id="t3-crt-2014-084" orientation="portrait" position="float">
<label>Table 3.</label>
<caption>
<p>Multivariate analysis of perception of cancer rehabilitation and likelihood of providing rehabilitation services (odds ratios)</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th valign="middle" align="center" rowspan="1" colspan="1"></th>
<th valign="middle" align="center" rowspan="1" colspan="1">Lymphedema</th>
<th valign="middle" align="center" rowspan="1" colspan="1">Upper limb dysfunction in breast cancer</th>
<th valign="middle" align="center" rowspan="1" colspan="1">Pelvic floor dysfunction in gynecological cancer</th>
<th valign="middle" align="center" rowspan="1" colspan="1">Brain tumor</th>
<th valign="middle" align="center" rowspan="1" colspan="1">Spinal tumor</th>
<th valign="middle" align="center" rowspan="1" colspan="1">Mobilization</th>
<th valign="middle" align="center" rowspan="1" colspan="1">Prevention of lymphedema</th>
<th valign="middle" align="center" rowspan="1" colspan="1">Neuropathic pain</th>
</tr>
</thead>
<tbody>
<tr>
<td valign="top" rowspan="1" colspan="1">Knowledge about the benefits of rehabilitation services for cancer patients</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.67</td>
<td valign="top" align="center" rowspan="1" colspan="1">1.2</td>
<td valign="top" align="center" rowspan="1" colspan="1">1.35</td>
<td valign="top" align="center" rowspan="1" colspan="1">3.01</td>
<td valign="top" align="center" rowspan="1" colspan="1">1.31</td>
<td valign="top" align="center" rowspan="1" colspan="1">2.04</td>
<td valign="top" align="center" rowspan="1" colspan="1">2.03</td>
<td valign="top" align="center" rowspan="1" colspan="1">1.07</td>
</tr>
<tr>
<td valign="top" rowspan="1" colspan="1">Referrals for cancer rehabilitation services by oncologists</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.73</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.4</td>
<td valign="top" align="center" rowspan="1" colspan="1">2.19</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.48</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.71</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.96</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.48</td>
<td valign="top" align="center" rowspan="1" colspan="1">0.93</td>
</tr>
<tr>
<td valign="top" rowspan="1" colspan="1">Available physiatrist services</td>
<td valign="top" align="center" rowspan="1" colspan="1">1.86</td>
<td valign="top" align="center" rowspan="1" colspan="1">2.4
<xref rid="tfn2-crt-2014-084" ref-type="table-fn">
<sup>a)</sup>
</xref>
</td>
<td valign="top" align="center" rowspan="1" colspan="1">1.28</td>
<td valign="top" align="center" rowspan="1" colspan="1">1.89</td>
<td valign="top" align="center" rowspan="1" colspan="1">1.42</td>
<td valign="top" align="center" rowspan="1" colspan="1">1.48</td>
<td valign="top" align="center" rowspan="1" colspan="1">1.58</td>
<td valign="top" align="center" rowspan="1" colspan="1">1.45</td>
</tr>
<tr>
<td valign="top" rowspan="1" colspan="1">Oncologist referral system for cancer survivors</td>
<td valign="middle" align="center" rowspan="1" colspan="1">1.61</td>
<td valign="middle" align="center" rowspan="1" colspan="1">1.8</td>
<td valign="middle" align="center" rowspan="1" colspan="1">2.16
<xref rid="tfn2-crt-2014-084" ref-type="table-fn">
<sup>a)</sup>
</xref>
</td>
<td valign="middle" align="center" rowspan="1" colspan="1">1.16</td>
<td valign="middle" align="center" rowspan="1" colspan="1">1.54</td>
<td valign="middle" align="center" rowspan="1" colspan="1">1.76</td>
<td valign="middle" align="center" rowspan="1" colspan="1">1.81
<xref rid="tfn2-crt-2014-084" ref-type="table-fn">
<sup>a)</sup>
</xref>
</td>
<td valign="middle" align="center" rowspan="1" colspan="1">1.96
<xref rid="tfn2-crt-2014-084" ref-type="table-fn">
<sup>a)</sup>
</xref>
</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn id="tfn1-crt-2014-084">
<p>Values are presented as odds ratios.</p>
</fn>
<fn id="tfn2-crt-2014-084">
<label>a)</label>
<p>p < 0.05.</p>
</fn>
</table-wrap-foot>
</table-wrap>
</floats-group>
</pmc>
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