Facilitators and barriers to the implementation of traditional Chinese exercises in cancer patients: a mixed-methods systematic review
Clinical Snapshot
PICO Framework
| P — Population | Cancer patients of any age, stage, or treatment status |
| I — Intervention | Traditional Chinese exercises (Tai Chi, Qigong, Baduanjin, etc.) |
| C — Comparator | Not applicable - implementation study examining facilitators and barriers |
| O — Outcomes | Implementation determinants (facilitators and barriers) categorized using CFIR framework |
Bottom Line
This mixed-methods systematic review identifies key implementation determinants for traditional Chinese exercises in cancer care. The study found 43 factors across five domains, with major facilitators including perceived benefits and social support, while barriers included symptom burden and resource constraints. The findings suggest implementation success depends on aligning intervention characteristics with patient capacity and contextual conditions. However, the abstract lacks crucial methodological details including search strategy, quality assessment, and evidence certainty ratings. While the CFIR framework provides a robust theoretical foundation, clinicians should await full publication to assess study quality and applicability. The identified determinants could inform implementation strategies for complementary exercise programs in oncology settings, but context-specific adaptation would be essential for Australian practice.
Key Findings
P Value: Not applicable for implementation research
Effect Size: 25 facilitators and 18 barriers identified
Primary Outcome: 43 implementation determinants identified across 5 CFIR domains
Nnt Or Sensitivity: Key facilitators: perceived benefits, simplicity, social support, flexible delivery; Key barriers: symptom burden, resource constraints, competing demands, limited organizational support
Confidence Interval: Not applicable for qualitative synthesis
Clinical Application
Requires consideration of patient capacity, symptom burden, and organizational support systems Relevant to Australian cancer care given growing interest in integrative oncology; would need adaptation for Australian healthcare settings and consideration of Medicare/PBS coverage for allied health services Cancer patients across various stages and treatment phases interested in complementary exercise interventions
Abstract
PURPOSE: To identify barriers and facilitators to the implementation of traditional Chinese exercises in cancer patients. METHODS: This was a mixed-methods systematic review. It searched for published studies from nine different sources. Data synthesis followed a convergent integrated approach according to the Joanna Briggs Institute methodology for mixed-methods systematic reviews. Quantitative data were qualitized using thematic analysis and synthesized with qualitative data using thematic synthesis. RESULTS: Twenty-one studies were included. Forty-three implementation determinants were identified across five domains of the Consolidated Framework for Implementation Research (CFIR), including 25 facilitators and 18 barriers. Key facilitators included perceived benefits, simplicity, social support, and flexible delivery, whereas major barriers involved symptom burden, resource constraints, competing life demands, and limited organizational support. CONCLUSIONS: The implementation of traditional Chinese exercises in cancer patients is shaped by multilevel determinants across CFIR domains. Implementation outcomes depend on the alignment between intervention characteristics, patient capacity, and contextual conditions. Context-sensitive and tailored strategies are required to improve uptake and long-term sustainability.
References
- 1.Gao, L., Zhang, L., Liu, Y., Zhang, N., Li, Y., & Chen, L. (2026). Facilitators and barriers to the implementation of traditional Chinese exercises in cancer patients: a mixed-methods systematic review. Supportive Care in Cancer. https://doi.org/10.1002/jcop.22354
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