Supportive Care in Cancer

, Volume 26, Issue 1, pp 305–312 | Cite as

Barriers and enablers to implementing scalp cooling in Australia: a qualitative study of health professionals’ attitudes to and experience with scalp cooling

  • Joanne M. ShawEmail author
  • Jane O’Brien
  • Susan Chua
  • Richard De Boer
  • Rachel Dear
  • Nicholas Murray
  • Fran Boyle
Original Article



Chemotherapy-induced alopecia is a common and distressing adverse event for patients. Scalp cooling to reduce this alopecia has been available in Europe for more than a decade, but only recently introduced in Australia. The aim of this study was to qualitatively explore health professionals’ perceptions of the barriers and enablers to the implementation of scalp cooling in Australian cancer centres.


Using a qualitative methodology, telephone interviews were conducted with 21 health professionals working in a tumour stream where chemotherapy-induced alopecia is an adverse event of treatment. Participants were recruited from five centres in Australia where scalp cooling is currently available and one centre without access to the technology.


Four interrelated themes were identified: (1) health professional attitudes, (2) concerns for patient equity, (3) logistical considerations and (4) organisational support.


This qualitative study provides the first methodological exploration of Australian health professionals’ perceptions of barriers and enablers to scalp cooling uptake. The results highlighted health professional support drives the introduction of scalp cooling. Integration of the technology requires adjustments to nursing practice to manage the increased time, workload and change in patient flow. Strategies to manage the change in practice and organisational support for change in work flow are essential for successful implementation into routine care.


Breast cancer Scalp cooling Qualitative Health professionals Interviews 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interest.

Data access

The authors have full control of all primary data and agree to allow the journal to review data if requested.


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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • Joanne M. Shaw
    • 1
    Email author
  • Jane O’Brien
    • 2
  • Susan Chua
    • 3
  • Richard De Boer
    • 2
  • Rachel Dear
    • 4
  • Nicholas Murray
    • 5
  • Fran Boyle
    • 6
    • 7
  1. 1.Psycho-oncology Co-operative Research Group (PoCoG), School of PsychologyThe University of SydneySydneyAustralia
  2. 2.Epworth Breast Service, Epworth CentreRichmondAustralia
  3. 3.Epworth Eastern Breast Service, Epworth EasternBox HillAustralia
  4. 4.The Kinghorn Cancer Centre, St Vincent’s HospitalDarlinghurstAustralia
  5. 5.Medical Oncology, Royal Adelaide HospitalAdelaideAustralia
  6. 6.The Patricia Ritchie Centre for Cancer Care and Research, The Mater HospitalNorth SydneyAustralia
  7. 7.Sydney Medical SchoolThe University of SydneySydneyAustralia

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