Patient‐Level Barriers and Facilitators to Inpatient Physical Therapy in Adolescents and Young Adults With a Hematological Malignancy: A Qualitative Study

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BACKGROUND: Despite their increased risk for functional impairment resulting from cancer and its treatments, few adolescents and young adults (AYAs) with a hematological malignancy receive the recommended or therapeutic dose of exercise per week during inpatient hospitalizations. Physical therapy (PT) plays a critical role in promoting and supporting exercise in the hospital setting; however, little is known about the factors that influence AYA engagement in PT. This qualitative study aimed to explore barriers and facilitators to inpatient PT through the perspectives of AYAs and healthcare providers. PROCEDURE: AYAs with cancer (n = 14) and healthcare providers (n = 9) were recruited at a pediatric academic medical center. Participants completed a semi-structured interview assessing barriers and facilitators to inpatient PT adherence. Interviews were video/audio-recorded, transcribed, and coded. Codes and themes were developed iteratively using reflexive thematic analysis. RESULTS: AYAs (15-29 years, M = 18.95, SD = 3.68) and healthcare providers discussed four primary themes affecting inpatient PT engagement. The themes suggested that social support from family and friends, AYAs' individual goals, and individualized PT programs improved motivation to participate. In contrast, treatment side effects and treatment demands limited AYA inpatient PT engagement. CONCLUSIONS: AYA engagement and motivation for inpatient PT vary with the individual's circumstances, goals, health, and social support. Evidence-based behavior change techniques may support future intervention efforts in addressing barriers specific to inpatient PT adherence in AYAs with hematological malignancies.

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