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Tennison JM, Fu JB, Hui D. Palliative Rehabilitation in Patients with Cancer: Definitions, Structures, Processes and Outcomes. Curr Oncol Rep 2024:10.1007/s11912-024-01585-8. [PMID: 39102013 DOI: 10.1007/s11912-024-01585-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2024] [Indexed: 08/06/2024]
Abstract
PURPOSEOF REVIEW This review examines the literature on palliative rehabilitation for patients with advanced cancer, focusing on definitions, structures, processes, and outcomes. RECENT FINDINGS Palliative cancer rehabilitation targets comfort and functional improvement for patients with limited rehabilitation potential across various settings. The palliative cancer rehabilitation team, typically led by a physician, coordinates symptom management and referrals to rehabilitation and other allied healthcare professionals as needed. The outcomes of palliative cancer rehabilitation varied widely by goals, settings, and interventions. Studies in hospice settings generally reported improved symptom control; inpatient rehabilitation had mixed functional outcomes; and outpatient palliative rehabilitation may contribute to enhanced functional and symptom outcomes, especially among patients with higher baseline function. Palliative cancer rehabilitation emphasizes a collaborative approach that integrates palliative care with rehabilitation interventions, aiming to enhance quality of life and address diverse patient needs. Further research and standardization are necessary to realize its full potential.
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Affiliation(s)
- Jegy M Tennison
- Department of Palliative, Rehabilitation, and Integrative Medicine, Section of Physical Medicine & Rehabilitation, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1414, Houston, TX, 77030, USA.
| | - Jack B Fu
- Department of Palliative, Rehabilitation, and Integrative Medicine, Section of Physical Medicine & Rehabilitation, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1414, Houston, TX, 77030, USA
| | - David Hui
- Department of Palliative, Rehabilitation, and Integrative Medicine, Section of Palliative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of General Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Bakhsh A, Abudari G, Alhaidar S, Shamsy S, Alqahtani A, Haddadi R, Almsaud M, Callaghan S, Ahmad F. Prevalence of Anxiety, Depression, and Distress and Their Association With Problems Encountered by Advanced Cancer Patients in a Tertiary Hospital in Saudi Arabia. Cureus 2024; 16:e66219. [PMID: 39233933 PMCID: PMC11374431 DOI: 10.7759/cureus.66219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2024] [Indexed: 09/06/2024] Open
Abstract
BACKGROUND Patients with advanced cancer often suffer from significant psychological distress, anxiety, and depression, which can profoundly influence their quality of life. This study aimed to evaluate the prevalence and severity of these psychological factors in advanced cancer patients. Additionally, it sought to identify related psychosocial, practical, emotional, and physical problems and their association with the psychological factors. Furthermore, this study provides interventions and strategies to help mitigate the psychological burden experienced by these patients. METHODS A cross-sectional survey involving 180 patients with advanced cancer was conducted at a tertiary hospital in Saudi Arabia. Participants were assessed using the Distress Thermometer (DT) and the Hospital Anxiety and Depression Scale (HADS). Data analysis included descriptive statistics, chi-square tests for categorical variables, and multivariate regression to explore the factors associated with distress, anxiety, and depression. RESULTS The prevalence of distress, anxiety, and depression among patients was 40.6%, 46.1%, and 52.2%, respectively. Patients who experienced 'changes in urination' which is an item in DT had a 2.86 times higher risk of developing distress. Patients experiencing sadness (item in DT) and fatigue (item in DT) were at a 3.91 and 2.29 times higher risk of developing anxiety, respectively. Practical problems, such as childcare and treatment decisions, emotional problems, and physical problems, such as appearance, bathing/dressing, and eating difficulties, were significantly associated with distress. There was no significant association between patients' demographics and psychological factors. CONCLUSION The findings underscore the complex interplay of psychosocial, practical, emotional, and physical problems faced by advanced cancer patients receiving palliative care. These patients exhibit a high percentage of distress, anxiety, and depression. Addressing these multifaceted problems through targeted psychological and social interventions can significantly enhance the overall care and quality of life for this vulnerable population. This study advocates routine psychological screenings and tailored interventions to mitigate the psychological burden in this group.
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Affiliation(s)
- Abdulaziz Bakhsh
- Oncology Center, King Faisal Specialist Hospital and Research Centre, Riyadh, SAU
| | - Gassan Abudari
- Oncology Nursing, King Faisal Specialist Hospital and Research Centre, Riyadh, SAU
| | - Saud Alhaidar
- Oncology Center, King Faisal Specialist Hospital and Research Centre, Riyadh, SAU
| | - Saad Shamsy
- Oncology Center, King Faisal Specialist Hospital and Research Centre, Riyadh, SAU
| | - Ahlam Alqahtani
- Oncology Nursing, King Faisal Specialist Hospital and Research Centre, Riyadh, SAU
| | - Rania Haddadi
- Oncology Nursing, King Faisal Specialist Hospital and Research Centre, Riyadh, SAU
| | - Maiadh Almsaud
- Department of Social Services, King Faisal Specialist Hospital and Research Centre, Riyadh, SAU
| | - Steven Callaghan
- Oncology Nursing, King Faisal Specialist Hospital and Research Centre, Riyadh, SAU
| | - Fawad Ahmad
- Oncology Center, King Faisal Specialist Hospital and Research Centre, Riyadh, SAU
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Dolgoy N, Bernard S, Huang F, Driga A, Hall-Lavoie D, Brown A, Pituskin E, Fairchild A, McNeely ML. Determining the destination: a co-designed chronic advanced cancer rehabilitation conceptual framework for engagement of individuals with lived experience in rehabilitation research. RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:35. [PMID: 38528573 DOI: 10.1186/s40900-024-00566-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 03/19/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND Individuals living with chronic advanced cancer (CAC) often face distinct physical, functional, and cognitive issues. Their rehabilitation needs are not yet routinely met, warranting further CAC-specific rehabilitation-based research. Given the complexity of functional and symptom presentations, engagement of individuals living with CAC as partners in the research process is encouraged to better understand the lived perspective. Formal engagement requires both structured approaches and iterative processes. The aim was to co-design a conceptual framework to develop and integrate engagement strategies into rehabilitation research focused on CAC populations. METHODS A multidisciplinary team of authors, including two individuals with lived experience, conducted an implementation-focused descriptive study to inform future research design, including: interviews and follow-up, review of current models and approaches, and development of a co-designed conceptual framework for engaging individuals with lived experience into CAC-specific rehabilitation research. RESULTS Emergent themes include shared understanding, transparent appreciation, iterative processes and unique partnership needs. A definition, guiding principles and tools for engagement were identified. In consultation with individuals with lived experience, and application of the emergent themes in context, a conceptual framework to guide the engagement process was developed. CONCLUSION A novel conceptual framework for engaging individuals with lived experience with CAC as partners in rehabilitation research is proposed to facilitate implementation-focused team-based approaches for this population.
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Affiliation(s)
- Naomi Dolgoy
- Department of Occupational Therapy, University of Alberta, Edmonton, AB, Canada.
- Cancer Rehabilitation Clinic, University of Alberta, Edmonton, AB, Canada.
| | - Stephanie Bernard
- École des sciences de la réadaptation, Faculté de Médecine, Université Laval, Quebec City, Canada
| | - Fleur Huang
- Department of Radiation Oncology, Cross Cancer Institute, Edmonton, AB, Canada
- Faculty of Medicine and Dentistry, Department of Oncology, University of Alberta, Edmonton, AB, Canada
| | - Amy Driga
- Alberta Health Services, Edmonton, AB, Canada
| | | | - Adam Brown
- Individuals With Lived Experience, Edmonton, AB, Canada
| | - Edith Pituskin
- Faculty of Nursing, Department of Oncology, Cross Cancer Institute and University of Alberta, Edmonton, AB, Canada
| | - Alysa Fairchild
- Faculty of Medicine and Dentistry, Department of Oncology, University of Alberta, Edmonton, AB, Canada
| | - Margaret L McNeely
- Department of Physical Therapy, Department of Oncology, Cross Cancer Institute and University of Alberta, Edmonton, AB, Canada
- Cancer Rehabilitation Clinic, University of Alberta, Edmonton, AB, Canada
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Brose JM, Willis E, Morgan DD. Occupational adaptation for adults living with advanced cancer: A phenomenological longitudinal study. Aust Occup Ther J 2024; 71:52-63. [PMID: 37806961 DOI: 10.1111/1440-1630.12908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 09/14/2023] [Accepted: 09/19/2023] [Indexed: 10/10/2023]
Abstract
INTRODUCTION People living with advanced cancer want to continue participating in their valued occupations amid cancer progression. However, increasing dependence and bodily deterioration challenge a person's ability to do so, thus requiring adaptation to how they engage in their occupations. Theoretical frameworks on the process of occupational adaptation often do not address the implications of progressive functional decline. METHODS A longitudinal phenomenological design was used to understand the lived experience of occupational engagement for working-aged adults living with advanced cancer. A semi-structured interview series explored participants' experience of occupational engagement and how this changed over time. Data were analysed thematically and mapped against the Model of Human Occupation (MOHO). FINDINGS Eight adults (40-64 years old) participated in 33 interviews over 19 months. Three themes were constructed from the data: ongoing adaptation through doing, the significance of volition in adaptation, and everyday life is contingent on my environment. Study findings demonstrate that the process of adaptation occurs through occupational engagement, is motivated by volition, and is affected by the environment. Volition and the environment play a more central role in occupational adaptation than occupational competency for the advanced cancer cohort. CONCLUSION Study findings further MOHO's theoretical conceptualisation of occupational adaptation by identifying the centrality of volition and the environment in the process of adaptation. For people living with advanced cancer, disease progression results in unremitting functional decline, thus rendering competency an unstable and untenable construct. Rather, this paper argues that occupational adaptation is facilitated by volition (i.e., the motivation behind the doing) and the environment, thus fostering a sense of identity and meaning at the end of life. Occupational therapists' awareness of the significance of volition and the environment can thus foster continued occupational engagement and meaning at the end of life for people living with advanced cancer.
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Affiliation(s)
- Julie M Brose
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- Research Centre for Palliative Care Death and Dying (RePaDD), College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Eileen Willis
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Rockhampton, Queensland, Australia
| | - Deidre D Morgan
- Research Centre for Palliative Care Death and Dying (RePaDD), College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
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