How people with cancer experience the ethical dimensions of physiotherapy in cancer rehabilitation: a qualitative interview study.
Gianluca Bertoni, Simone Battista, Valentina Conti and 2 others
Cancer patients in physiotherapy reported feeling excluded from treatment decisions and held back by caution they could not question.
They valued therapists who adapted to their daily state and explained the reasoning behind limits.
Key findings
1Many participants experienced a gap between being formally informed and being genuinely involved in decisions. Treatment plans felt predetermined, and instructions were given without clear rationale, leaving them in a passive role.
2Clinical caution was experienced in two directions: as reassurance and protection, and as a restrictive barrier. Some participants interpreted it as defensive practice driven by liability fear rather than individualized assessment, and internalized the caution even when therapists encouraged progression.
3Access to rehabilitation was shaped by geography, personal finances, and informal networks rather than clinical need. Several participants discovered the service by chance or through a friend, and described regional disparities as structural injustice.
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What it does not show
Twenty participants from one country (Italy), so the findings reflect a specific social and institutional context and cannot be taken as representative of all cancer rehabilitation settings. Recruitment went through professional networks and patient associations, which may have favored people who were more informed or more engaged with rehabilitation pathways. The sample was predominantly from Northern and Central Italy (16 of 20), with limited representation from the South and Islands, so the regional access findings may understate the full range of disparity. All interviews were conducted remotely via Microsoft Teams. The authors note this did not appear to hinder rapport, but it is a different interaction mode from in-person sessions. This is a descriptive qualitative study. It reports what 20 people experienced and how they interpreted it. It does not test whether any particular practice improves or worsens outcomes.
Declared interests
The authors declare no conflict of interest and no funding received for the study.
The easy way to misread this
Do not read the patients' accounts of excessive caution as a verdict on physiotherapists' competence or intentions. The same cautious approach was described by other participants as reassuring and protective, and these are 20 people's perceptions in one country, not a quality audit of cancer rehabilitation.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →