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

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Abstract

Background

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.

Methods

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.

Results

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

Conclusions

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.

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Authors and Affiliations

  1. Psycho-oncology Co-operative Research Group (PoCoG), School of Psychology, The University of Sydney, Chris O’Brien Lifehouse (C39Z), Missenden Road, Sydney, NSW, 2006, Australia

    Joanne M. Shaw

  2. Epworth Breast Service, Epworth Centre, Richmond, VIC, Australia

    Jane O’Brien & Richard De Boer

  3. Epworth Eastern Breast Service, Epworth Eastern, Box Hill, VIC, Australia

    Susan Chua

  4. The Kinghorn Cancer Centre, St Vincent’s Hospital, Darlinghurst, NSW, Australia

    Rachel Dear

  5. Medical Oncology, Royal Adelaide Hospital, Adelaide, SA, Australia

    Nicholas Murray

  6. The Patricia Ritchie Centre for Cancer Care and Research, The Mater Hospital, North Sydney, NSW, Australia

    Fran Boyle

  7. Sydney Medical School, The University of Sydney, Sydney, Australia

    Fran Boyle

Authors
  1. Joanne M. Shaw
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  2. Jane O’Brien
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  3. Susan Chua
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  4. Richard De Boer
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  5. Rachel Dear
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  6. Nicholas Murray
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  7. Fran Boyle
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Corresponding author

Correspondence to Joanne M. Shaw.

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The authors declare that they have no competing interest.

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Shaw, J.M., O’Brien, J., Chua, S. et al. Barriers and enablers to implementing scalp cooling in Australia: a qualitative study of health professionals’ attitudes to and experience with scalp cooling. Support Care Cancer 26, 305–312 (2018). https://doi.org/10.1007/s00520-017-3849-7

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  • DOI: https://doi.org/10.1007/s00520-017-3849-7

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