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Support Care Cancer. 2018 Jan;26(1):305-312. doi: 10.1007/s00520-017-3849-7. Epub 2017 Aug 29.

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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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.
Epworth Breast Service, Epworth Centre, Richmond, VIC, Australia.
Epworth Eastern Breast Service, Epworth Eastern, Box Hill, VIC, Australia.
The Kinghorn Cancer Centre, St Vincent's Hospital, Darlinghurst, NSW, Australia.
Medical Oncology, Royal Adelaide Hospital, Adelaide, SA, Australia.
The Patricia Ritchie Centre for Cancer Care and Research, The Mater Hospital, North Sydney, NSW, Australia.
Sydney Medical School, The University of Sydney, Sydney, Australia.



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; Health professionals; Interviews; Qualitative; Scalp cooling

[Indexed for MEDLINE]

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