Lack of Successful Implementation of Cancer Rehabilitation Guidelines: A Mixed-methods Study Highlighting Need for Better Preconditions in Primary Care.
Lindberg M & Efverman A • Integrative cancer therapies • 2026
Primary care practitioners reported limited preconditions for cancer rehabilitation implementation, including lack of knowledge, insufficient time, and organizational barriers, with 95% having not read cancer rehabilitation guidelines.
Key Findings
Results
A minority of primary care practitioners provided cancer rehabilitation or prescribed physical activity to cancer survivors.
20% of rehabilitation practitioners provided some form of cancer rehabilitation, compared to 10% of healthcare center practitioners.
70% of rehabilitation practitioners prescribed physical activity to consulting cancer survivors, compared to only 15% of healthcare center practitioners.
The study included 229 primary care practitioners: 104 rehabilitation practitioners and 125 healthcare center practitioners.
Results
Practitioners reported having no knowledge regarding physical activity advice for cancer survivors.
Both rehabilitation and healthcare center practitioners reported a median score of 0 (on a 0 to 10 scale where 10 = maximum) regarding physical activity advice for cancer survivors.
95% of all participants had not read cancer rehabilitation guidelines.
Knowledge gaps were identified as a primary barrier to implementation.
Results
Rehabilitation practitioners rated the importance of providing cancer rehabilitation and physical activity advice more highly than healthcare center practitioners.
Rehabilitation practitioners gave median ratings of 8 and 9 for the importance of providing cancer rehabilitation and physical activity advice, respectively.
Healthcare center practitioners gave median ratings of 6 and 7 for the same items.
Ratings were collected using 0 to 10 scales where 10 = maximum.
Results
Practitioners reported low workplace preparedness and insufficient time for cancer rehabilitation.
Rehabilitation practitioners gave median ratings of 3 for both workplace preparedness and sufficient time for cancer rehabilitation.
Healthcare center practitioners gave median ratings of 2 for workplace preparedness and 0 (no time at all) for sufficient time for cancer rehabilitation.
Perceived unsatisfactory organizational preconditions were identified as a primary barrier to implementation.
Results
Facilitators for cancer rehabilitation implementation included perceived importance of the work and existing rehabilitation and physical activity counseling experience in non-cancer populations.
Providing cancer rehabilitation was considered important by practitioners, serving as a facilitator.
Practitioners were experienced in rehabilitation and physical activity counseling in non-cancer populations, which facilitated implementation.
Having committed and motivated co-workers facilitated a positive work culture for cancer rehabilitation.
Results
Primary barriers to cancer rehabilitation implementation included limited knowledge and skills, organizational deficiencies, and uncertainty about responsibility.
Limited knowledge and skills were identified as a primary barrier.
Perceived unsatisfactory organizational preconditions shaped uncertainty about whether primary care has any responsibility for cancer rehabilitation.
These barriers were identified through qualitative data from a sub-sample of 120 practitioners.
Results
Interest in answering questions about cancer rehabilitation was substantially higher among rehabilitation practitioners than healthcare center practitioners.
Of 168 rehabilitation practitioners invited, 104 (62%) were interested in answering questions regarding cancer rehabilitation.
Among 1055 invited healthcare center practitioners, only 125 (12%) were interested.
This difference in interest was noted as relevant for tailoring educational interventions and support strategies.
Conclusions
The authors concluded that educational interventions and support strategies tailored to both individuals and organizations appear necessary given the described implementation barriers.
The conclusion was based on the identified limited preconditions, barriers, facilitators, and varying practitioner interest.
The study used a convergent mixed-methods design, collecting both quantitative questionnaire data and written qualitative data.
The authors indicated that both individual-level and organizational-level strategies are needed.
Lindberg M, Efverman A. (2026). Lack of Successful Implementation of Cancer Rehabilitation Guidelines: A Mixed-methods Study Highlighting Need for Better Preconditions in Primary Care.. Integrative cancer therapies. https://doi.org/10.1177/15347354261420179