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Shivakumar N, King AA, Lyons KD, L'Hotta AJ. "If I have a limited amount of time left, this is not how I want to spend it": A qualitative descriptive study of factors influencing daily life participation following a cancer diagnosis. Psychooncology 2024; 33:e6366. [PMID: 38880761 DOI: 10.1002/pon.6366] [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: 01/18/2024] [Revised: 05/29/2024] [Accepted: 06/09/2024] [Indexed: 06/18/2024]
Abstract
OBJECTIVE Following a cancer diagnosis, restricted participation in daily life is common. Restricted participation can be temporary or long lasting. The aim of this study was to characterize how daily life participation is impacted following a cancer diagnosis. METHODS Eligible individuals included adults (>18 years) with any stage/grade brain, breast, colorectal, or lung cancer in any phase of treatment or post-treatment. Participants completed a semi-structured interview about how their life participation was impacted following their cancer diagnosis. Data were analyzed through team-based thematic analysis. RESULTS Forty adults, 10 per disease category, participated. Four themes were identified that supported or hindered daily life participation: (1) self-expectations, (2) expectations of others, (3) awareness of mortality, and (4) symptoms and side effects of cancer. Participants discussed how their cancer experience resulted in a reprioritization of what they valued doing in their life. However, many survivors struggled to adapt and described a tension between their need to adapt to their current life circumstances and their contrasting desire to stay connected with their pre-cancer selves through daily life participation. The mental health challenges associated with decreased participation were also outlined by participants. CONCLUSIONS Cancer survivors' daily life participation is influenced by expectations from themselves and others, awareness of mortality, and disease symptoms/side effects. Future interventions can target these domains to supports survivors' life participation.
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Affiliation(s)
- Nirmala Shivakumar
- Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
| | - Allison A King
- Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
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Adler RF, Baez K, Morales P, Sotelo J, Victorson D, Magasi S. Evaluating the Usability of an mHealth App for Empowering Cancer Survivors With Disabilities: Heuristic Evaluation and Usability Testing. JMIR Hum Factors 2024; 11:e51522. [PMID: 38564261 PMCID: PMC11022134 DOI: 10.2196/51522] [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: 08/03/2023] [Revised: 11/07/2023] [Accepted: 11/11/2023] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND More than 18 million cancer survivors are living in the United States. The effects of cancer and its treatments can have cognitive, psychological, physical, and social consequences that many survivors find incredibly disabling. Posttreatment support is often unavailable or underused, especially for survivors living with disabilities. This leaves them to deal with new obstacles and struggles on their own, oftentimes feeling lost during this transition. Mobile health (mHealth) interventions have been shown to effectively aid cancer survivors in dealing with many of the aftereffects of cancer and its treatments; these interventions hold immense potential for survivors living with disabilities. We developed a prototype for WeCanManage, an mHealth-delivered self-management intervention to empower cancer survivors living with disabilities through problem-solving, mindfulness, and self-advocacy training. OBJECTIVE Our study conducted a heuristic evaluation of the WeCanManage high-fidelity prototype and assessed its usability among cancer survivors with known disabilities. METHODS We evaluated the prototype using Nielsen's 10 principles of heuristic evaluation with 22 human-computer interaction university students. On the basis of the heuristic evaluation findings, we modified the prototype and conducted usability testing on 10 cancer survivors with a variety of known disabilities, examining effectiveness, efficiency, usability, and satisfaction, including a completion of the modified System Usability Scale (SUS). RESULTS The findings from the heuristic evaluation were mostly favorable, highlighting the need for a help guide, addressing accessibility concerns, and enhancing the navigation experience. After usability testing, the average SUS score was 81, indicating a good-excellent design. The participants in the usability testing sample expressed positive reactions toward the app's design, educational content and videos, and the available means of connecting with others. They identified areas for improvement, such as improving accessibility, simplifying navigation within the community forums, and providing a more convenient method to access the help guide. CONCLUSIONS Overall, usability testing showed positive results for the design of WeCanManage. The course content and features helped participants feel heard, understood, and less alone.
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Affiliation(s)
- Rachel F Adler
- Department of Computer Science, Northeastern Illinois University, Chicago, IL, United States
- School of Information Sciences, University of Illinois Urbana-Champaign, Champaign, IL, United States
| | - Kevin Baez
- Department of Computer Science, Northeastern Illinois University, Chicago, IL, United States
| | - Paulina Morales
- Department of Computer Science, Northeastern Illinois University, Chicago, IL, United States
| | - Jocelyn Sotelo
- Department of Computer Science, Northeastern Illinois University, Chicago, IL, United States
| | - David Victorson
- Department of Medical Social Sciences, Northwestern University, Evanston, IL, United States
| | - Susan Magasi
- Department of Occupational Therapy, University of Illinois Chicago, Chicago, IL, United States
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Winters CA, Marshall HK, Victorson DE, Adler RF, Magasi S. Does the Canadian Occupational Performance Measure (COPM) Capture the Complex Experiences of Cancer Survivors? A Mixed Methods Approach. Occup Ther Health Care 2024; 38:347-363. [PMID: 37302410 PMCID: PMC10711147 DOI: 10.1080/07380577.2023.2215875] [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: 12/23/2022] [Accepted: 05/14/2023] [Indexed: 06/13/2023]
Abstract
Occupational therapy practitioners are uniquely positioned to address the needs of cancer survivors. This study aimed to understand the complex needs of survivors using The Canadian Occupational Performance Measure and in-depth interviewing. A convergent, mixed methods approach was utilized with a purposive sample of 30 cancer survivors. The results indicate that while the COPM can be a practical tool to address basic occupational performance problems, the in-depth interviews exposed these challenges are intricately connected to identity, relationships, and roles. Implications for occupational therapy practitioners include a critical approach to evaluation and interventions to capture the complex needs of survivors.
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Affiliation(s)
- Cassandra A Winters
- Department of Disability Studies, University of Illinois Chicago, Chicago, Illinois, USA
| | - Hilary K Marshall
- Department of Occupational Therapy, University of Illinois Chicago, Chicago, Illinois, USA
| | - David E Victorson
- Northwestern University Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Rachel F Adler
- Department of Computer Science, Northeastern Illinois University, Chicago, Illinois, USA
| | - Susan Magasi
- Department of Disability Studies, University of Illinois Chicago, Chicago, Illinois, USA
- Department of Occupational Therapy, University of Illinois Chicago, Chicago, Illinois, USA
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L’Hotta AJ, Varughese TE, Lyons KD, Trebelhorn A, Manohar A, King AA. Preferences for Participation Measurement Among Individuals Diagnosed With Cancer: A Qualitative Content Analysis. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2024; 44:244-254. [PMID: 37354019 PMCID: PMC10748790 DOI: 10.1177/15394492231181104] [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] [Indexed: 06/25/2023]
Abstract
Individuals with cancer experience occupational participation restrictions, but there is no consensus on how to measure this construct. The objective of this study is to describe the perspectives and preferences of individuals with cancer regarding participation measurement. Forty individuals with brain, breast, colorectal, and lung cancer provided feedback on three participation measures in semi-structured interviews. Through an iterative, team-based content analysis approach, interview text was coded using the study codebook and organized into themes. Core themes included (a) participation measures highlighted occupational priorities, (b) measuring participation can identify supportive care needs, (c) measures must balance thoroughness with speed of completion, (d) measurement timeframe varies by treatment phase, and (e) evaluating community engagement is not a priority for some individuals with cancer. Integrating participation measures into cancer care can support referrals to occupational therapy and supportive services. It is essential to consider time since cancer diagnosis and client priorities when selecting participation measures.
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Affiliation(s)
| | | | | | | | | | - Allison A. King
- Washington University, St. Louis, MO, USA
- St. Louis Children’s Hospital, MO, USA
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Steuer A, Polo KM, Little L, Madrigrano A, Taylor SJ. Occupational Therapy After Breast Cancer Reconstructive Surgery: A Predictor for Opioid Prescriptions. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2024; 44:236-243. [PMID: 37438948 DOI: 10.1177/15394492231182626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
Abstract
Occupational therapy practitioners have a unique and vital role among interprofessional health care teams toward facilitating occupational participation among breast cancer survivors. This study investigated the relationship between acute medicine occupational therapy services after breast cancer reconstructive surgeries (BCRS) and a number of prescription refills 90 days after surgery. This retrospective study ran binary logistic regression analyses on 562 women after BCRS for refills of opioid and non-opioid medication. Both models were statistically significant, χ2(7df) = 23.001, p = .002; χ2(7df) = 32.312, p < .001, indicating the ability to distinguish who received opioid or non-opioid refills, respectively. While younger age was a significant predictor across both models, occupational therapy was only significant for opioid refills; each was associated with fewer refills. Early occupational therapy treatment after BCRS is associated with fewer opioid prescriptions 90 days after surgery, therefore enhancing occupation throughout this timeframe is beneficial.
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Brick R, Natori A, Moreno PI, Molinares D, Koru-Sengul T, Penedo FJ. Predictors of cancer rehabilitation medicine referral and utilization based on the Moving Through Cancer physical activity screening assessment. Support Care Cancer 2023; 31:216. [PMID: 36928440 PMCID: PMC10281047 DOI: 10.1007/s00520-023-07679-6] [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: 10/03/2022] [Accepted: 03/07/2023] [Indexed: 03/18/2023]
Abstract
PURPOSE Cancer survivors experience high rates of physical inactivity that often go unaddressed. The My Wellness Check program (MWC) is an EHR-integrated screening and referral system that includes surveillance of physical activity and triage to cancer rehabilitation medicine services. This study examined assessment of physical activity and subsequent referrals to cancer rehabilitation medicine. METHODS A secondary analysis was performed for survivors who completed the MWC between April 2021 and January 2022. Univariable and multivariable logistic regression modeled determinants of qualification for a physical activity referral and provider completion of referral to cancer rehabilitation medicine. Referral was based on responses to the Moving Through Cancer questionnaire. Adjusted odds ratios (aOR) and corresponding 95% confidence intervals (95% CI) were calculated. RESULTS There were 1,174 survivors who completed the assessment, of which 46% (n = 540) reported physical inactivity. After controlling for group differences, individuals with moderate-severe physical dysfunction (aOR: 1.750; 95% CI: 1.137, 2.693) had higher odds, and self-reporting Hispanic or Latino ethnicity (aOR: 0.720; CI: 0.556, 0.932) had lower odds of physical inactivity. Only 31% (n = 168) received a completed physician referral to cancer rehabilitation medicine following identification of physical inactivity. No patient-level factors were associated with receiving a physician referral. Following referral, 8% (n = 13) utilized cancer rehabilitation medicine services. CONCLUSIONS Patient-level and clinical factors may predict qualification for physical activity referrals; however, they don't appear to predict referral completion to cancer rehabilitation medicine. Future research should focus on potential provider- and organization-level factors that interact and influence access to cancer rehabilitation medicine services.
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Affiliation(s)
- Rachelle Brick
- Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, Rockville, MD, USA.
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA.
| | - Akina Natori
- Division of Medical Oncology, Department of Medicine, Miller School of Medicine, FL, Miami, USA
| | - Patricia I Moreno
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Diana Molinares
- Department of Physical Medicine and Rehabilitation, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Tulay Koru-Sengul
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA
- Sylvster Comprehensive Cancer Center, Miami, FL, USA
| | - Frank J Penedo
- Division of Medical Oncology, Department of Medicine, Miller School of Medicine, FL, Miami, USA
- Department of Psychology, University of Miami, Miami, FL, USA
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Kaya C, Chan F, Iwanaga K, Wu JR, Bezyak J. A Psychometric Validation of the Impact on Participation and Autonomy Questionnaire in a Sample of Turkish Cancer Survivors. REHABILITATION COUNSELING BULLETIN 2023. [DOI: 10.1177/00343552221146160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Community participation and autonomy are two of the vital treatments and rehabilitation outcomes for people with chronic health conditions and disabilities, including people with cancer. The purpose of this study is to investigate psychometric properties of the Impact on Participation and Autonomy Scale (IPA) in a sample of Turkish cancer survivors. An exploratory factor analysis was used to analyze data collected from 186 cancer survivors who completed the IPA, Health Care Climate Questionnaire, Satisfaction with Life Scale, and the Role Functioning subscale of the EORTC Core Quality of Life Questionnaire. In contrast to the original five-factor solution, the results provided a better fit for a three-factor correlated model ( Activities of Daily Living [ADL]/ Instrumental ADL, social relations, and employment and education). The IPA factors were significantly associated with supportive healthcare climate, role functioning, and life satisfaction in the theoretically expected directions, providing support for the nomological construct validity of the Turkish version of the IPA. Overall, the Turkish version of the IPA is a psychometrically sound measure of participation and autonomy that can be used to assess cancer survivors’ levels of community participation for treatment planning and selection of evidence-based healthcare and psychosocial interventions for cancer survivors.
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Affiliation(s)
- Cahit Kaya
- University of Texas Rio Grande Valley, Edinburg, TX, USA
- Harran University, Sanliurfa, Turkey
| | - Fong Chan
- University of Wisconsin-Madison, USA
| | | | - Jia Rung Wu
- Northern Illinois University, DeKalb, IL, USA
| | - Jill Bezyak
- University of Northern Colorado, Greeley, USA
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Adler RF, Morales P, Sotelo J, Magasi S. Developing an mHealth App for Empowering Cancer Survivors With Disabilities: Co-design Study. JMIR Form Res 2022; 6:e37706. [PMID: 35881439 PMCID: PMC9364172 DOI: 10.2196/37706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 06/02/2022] [Accepted: 06/23/2022] [Indexed: 11/27/2022] Open
Abstract
Background The transition from active treatment to long-term cancer survivorship leaves the needs of many cancer survivors unaddressed as they struggle with physical, cognitive, psychological, and social consequences of cancer and its treatment. The lack of guidance after treatment has forced cancer survivors to manage long-term effects on their own, which has an impact on their overall health, quality of life, and social participation. Mobile health (mHealth) interventions can be used to promote self-management and evidence-informed education. Objective This study aims to design an mHealth app for cancer survivors with disabilities that will offer interventions to improve their quality of life and increase their self-efficacy to manage cancer as a chronic condition. Methods We organized 3 co-design workshops with cancer survivors (n=5). These workshops included persona development based on data from 25 interviews with cancer survivors with disabilities; prototype ideation, where we sketched ideas for the prototype; and prototype development, where participants critiqued, and suggested improvements for, the wireframes. Results These workshops helped us to define the challenges that cancer survivors with disabilities face as well as important considerations when designing an mHealth app for cancer survivors with disabilities, such as the need for including flexibility, engagement, socialization, and a minimalistic design. We also outline guidelines for other researchers to follow when planning their own co-design workshops, which include allowing more time for discussion among participants, having small participant groups, keeping workshops engaging and inclusive, and letting participants dream big. Conclusions Using a co-design process aided us in developing a prototype of an mHealth app for cancer survivors with disabilities as well as a list of guidelines that other researchers can use to develop their own co-design workshops and design their app. Furthermore, working together with cancer survivors ensured that the design team had a deeper sense of empathy toward the target users and kept the focus on our ultimate goal: creating something that cancer survivors would want to use and benefit from. Future work will include usability testing of a high-fidelity prototype based on the results of these workshops.
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Affiliation(s)
- Rachel F Adler
- Department of Computer Science, Northeastern Illinois University, Chicago, IL, United States
| | - Paulina Morales
- Department of Computer Science, Northeastern Illinois University, Chicago, IL, United States
| | - Jocelyn Sotelo
- Department of Computer Science, Northeastern Illinois University, Chicago, IL, United States
| | - Susan Magasi
- Department of Occupational Therapy, University of Illinois Chicago, Chicago, IL, United States
- Department of Disability and Human Development, University of Illinois Chicago, Chicago, IL, United States
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Lyons K, Murphy L. Introduction to the Special Issue on Cancer Rehabilitation. Occup Ther Health Care 2022; 36:113-115. [PMID: 35133948 DOI: 10.1080/07380577.2022.2033423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
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10
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Cancer Survivors’ Disability Experiences and Identities: A Qualitative Exploration to Advance the Cancer Equity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19053112. [PMID: 35270802 PMCID: PMC8910238 DOI: 10.3390/ijerph19053112] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 02/25/2022] [Accepted: 03/02/2022] [Indexed: 12/10/2022]
Abstract
Eliminating cancer-related disparities is a global public health priority. Approximately 40% of cancer survivors experience long-term effects of cancer which can lead to activity limitations and participation restrictions; yet discussions of disability are largely absent from clinical and research cancer health equity agendas. The purpose of this study was to explore how cancer survivors experience and make sense of the long-term disabling effects of cancer and its treatments. In this qualitative study, data were collected via in-depth semi-structured interviews with survivors of breast cancer, head and neck cancer, and sarcoma (n = 30). Data were analyzed thematically using a 2-phase iterative process proceeding from descriptive to conceptual coding. Survivors experienced a wide range of long-term physical, sensory, cognitive, and emotional effects, that intertwined to restrict their participation in self-care, work, leisure, and social roles. While the interaction between impairments and participation restrictions meets the definition of disability; participants articulated a range of responses when asked about their disability identity, including (1) rejecting, (2) othering, (3) acknowledging, and (4) affirming. Findings may be indicative of structural and internalized ableism which can impede cancer care and survivorship. To support cancer survivors’ transition to post-treatment life, cancer care providers should implement anti-ableist practices and engage in frank discussions about cancer’s long-term impacts.
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Anampa-Guzmán A, Acevedo F, Partridge AH, Alfano CM, Nekhlyudov L. Cancer Survivorship in Latin America: Current Status and Opportunities. JCO Glob Oncol 2021; 7:1472-1479. [PMID: 34648386 PMCID: PMC8791813 DOI: 10.1200/go.21.00223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
PURPOSE The number of cancer survivors is increasing globally although the status of cancer survivorship care provision and research in developing countries is limited. This study aimed to review published literature and available guidelines and/or recommendations to inform cancer survivorship care in Latin America. METHODS Embase, Web of Science, Scopus, PubMed, and SciELO were systematically searched for articles and guidelines and/or recommendations published through December 31, 2020. Our search terms included cancer, survivors, neoplasm, cancer, survivorship, survivor, follow-up studies, and the name of the countries. We categorized the articles by country, year, cancer type(s), language, and domain of cancer survivorship care. We also searched governmental health agencies websites in all Latin American countries. RESULTS Our literature review found 664 articles for inclusion. The number of publications increased over time. Brazil had most of the survivorship research (n = 483, 72.7%). The most common topics included surveillance and management of psychosocial effects (n = 237, 35.7%) and physical effects (n = 230, 34.6%). Prevention and surveillance for recurrences and health promotion and disease prevention were each addressed by about 10% (n = 71) of the publications. Although close to half of the publications included more than one cancer, 28.9% (n = 192) focused solely on breast cancer. We found no guidelines and/or recommendations explicitly focusing on Latin America in the reviews of the literature or the national governmental institutions' websites. CONCLUSION We found a growing body of cancer survivorship publications, mainly focusing on psychosocial and physical effects, although no cancer survivorship guidance and/or recommendations focused on Latin America were identified. Expanding research across Latin American countries and covering a broader spectrum of cancer survivorship care is needed. Development of guidelines may further promote provision of quality care for this growing population of cancer survivors. There is a steady growth in papers focusing on cancer survivorship care published in Latin America![]()
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Affiliation(s)
- Andrea Anampa-Guzmán
- San Fernando Medical School, Faculty of Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru.,Lymphoma Section, Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - Francisco Acevedo
- Department of Hematology and Oncology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Ann H Partridge
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.,Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Catherine M Alfano
- Northwell Health Cancer Institute, Center for Personalized Health, New York, NY.,Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY
| | - Larissa Nekhlyudov
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.,Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
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Distress among cancer patients attending rehabilitation in the community. Support Care Cancer 2021; 30:279-287. [PMID: 34273033 PMCID: PMC8636420 DOI: 10.1007/s00520-021-06422-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 07/06/2021] [Indexed: 01/30/2023]
Abstract
Purpose The aim of this study is to identify sources of distress among cancer patients attending rehabilitation in the community. Methods Participants were 430 patients recruited from a cancer rehabilitation center in Singapore between 2017 and 2018, who had rated their distress using the distress thermometer (DT) and indicated associated problems on the problem list. Chi-square tests were used to detect differences in the reported symptoms among three age groups. Exploratory factor analysis was used to identify symptom clusters. Partial correlational analysis was then performed to examine the relationship between distress, symptom clusters, and age controlling for gender and cancer type. Results About 30% of the participants reported distress ≥ 5 on the DT (mean 3.3 ± 2.5), and the mean number of problems endorsed was 8 ± 6. A higher total number of reported problems (r = .63) and younger age (r = − .21) were associated with increased distress. The younger age group also reported more problems surrounding emotions, finance, work/school, children-related issues, and physical symptoms such as sleep and nausea. Of the 12 factors identified, 9 psychosocial and physical symptom clusters correlated with distress (r ranging from .12 to .41). All results were statistically significant after adjustment (p ≤ 0.05). Conclusion Younger survivors are more at risk of distress and report greater role functioning concerns related to childcare, partner relationship, and work participation. Age-tailored and multimodal interventions may be necessary to adequately address age-related differences and help coordinate management of multiple symptom clusters across physical and psychosocial concerns.
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Brick R, Skidmore ER, Al Snih S, Terhorst L. Examination of Cancer and Aging Through Activities of Daily Living: A National Health and Aging Trends Study Analysis. J Aging Health 2021; 33:877-885. [PMID: 33961520 DOI: 10.1177/08982643211017656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives: This study longitudinally examined how older adult cancer survivors perceive disability in activities of daily living over time compared to older adults who have not had cancer. Methods: This was a secondary analysis of the National Health and Aging Trends Study examining participants with a new cancer diagnosis and age-, gender-, and comorbidity-matched comparison participants without a history of cancer. Generalized linear mixed models examined time and group interaction and main effects in disability. Results: There was a significant main effect of time (F4,771 = 12.81; p < .0001) demonstrating increasing disability levels for both groups. There were significant group differences, with higher disability in the cancer group than the comparison group (β = 0.628, SE = 0.263; t = 2.39, p = 0.017). Discussion: Although perceived disability was greater immediately following cancer diagnosis, older adult cancer survivors and comparison participants appear to have similar perceived disability over time.
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Affiliation(s)
- Rachelle Brick
- Department of Occupational Therapy, 6614University of Pittsburgh, Pittsburgh, PA, USA
| | - Elizabeth R Skidmore
- Department of Occupational Therapy, 6614University of Pittsburgh, Pittsburgh, PA, USA
| | - Soham Al Snih
- Division of Rehabilitation Sciences, Division of Geriatrics/Department of Internal Medicine, 12338University of Texas Medical Branch, Galveston, TX, USA
| | - Lauren Terhorst
- Department of Occupational Therapy, 6614University of Pittsburgh, Pittsburgh, PA, USA
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Lyons K. Introduction to the special issue on cancer rehabilitation. Br J Occup Ther 2021. [DOI: 10.1177/0308022621991773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Kathleen Lyons
- Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, USA
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Polo KM, Ingram G, Mather T, Ragle A, Scholl N, Welch T. “It takes a village to get through cancer,” A photo-elicitation study exploring lived experiences of community cancer survivors. Br J Occup Ther 2020. [DOI: 10.1177/0308022620953002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction Cancer survivors continue to experience complications that last months to years following diagnosis and treatment, which can impact daily life. The purpose of this study was to explore the lived experiences of adult community cancer survivors related to daily activities and occupational performance. Method Phenomenology study design and photo-elicitation were utilized to blend photos and words. Thirteen adult survivors were recruited from a community-based cancer support organization. Open coding, axial and in vivo coding, and constant comparative analysis were utilized to analyze data and achieve conceptual saturation. Results Participants experienced a shift in cultural context, wherein they took on a new context defined by their cancer survivorship. This context shift is dynamic and interconnected to the sub-themes of distress, changes in perspectives, and side effects that all ultimately influence occupational performance and engagement. The cultural context shift supported participants’ ability to engage in new, meaningful occupations, supported their new identity, and ultimately created a sense of support and belonging. Conclusion Occupational therapists have a unique position to assist with the adjustment process during this cultural context shift and provide interventions in cancer support communities to assure cancer survivors’ continued performance and engagement in meaningful activities.
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Affiliation(s)
- Katie M Polo
- School of Occupational Therapy, University of Indianapolis, Indianapolis, USA
| | - Gabrielle Ingram
- School of Occupational Therapy, University of Indianapolis, Indianapolis, USA
| | - Tamzyn Mather
- School of Occupational Therapy, University of Indianapolis, Indianapolis, USA
| | - Amy Ragle
- School of Occupational Therapy, University of Indianapolis, Indianapolis, USA
| | - Nicole Scholl
- School of Occupational Therapy, University of Indianapolis, Indianapolis, USA
| | - Taylor Welch
- School of Occupational Therapy, University of Indianapolis, Indianapolis, USA
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16
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Brick R, Bender C, Skidmore E. Impact of cancer and cancer-related treatments on participation restrictions. Br J Occup Ther 2020. [DOI: 10.1177/0308022620923858] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Introduction The purpose of this research was to describe participation restrictions in younger and older adult cancer survivors post treatment. Method Younger adult cancer survivors ( n = 20) and older adult cancer survivors ( n = 21) completed questionnaires and a semi-structured interview of satisfaction with daily life activities and self-reported health outcomes in a single visit. Reports were based on recall during treatment and current perspectives post treatment. Results Despite general health short forms revealing health within normal limits, semi-structured interview approaches revealed dissatisfaction with occupational performance in both younger and older adult cancer survivors. Older adults reported persistent dissatisfaction with instrumental activities from diagnosis through post treatment compared to younger adult cancer survivors. Older adults received fewer referrals for cancer rehabilitation services (19%) compared to younger adult cancer survivors (50%). Conclusion Dissatisfaction with daily life activities persists several years post cancer diagnosis in older and younger adult cancer survivors, despite self-reported health within normal limits. Impairment-based short forms may lack sensitivity to detect activity limitations and participation restrictions conveyed through in-depth assessment. Adoption of more comprehensive screening methods may be needed for timely referral to cancer-based occupational therapy services.
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Affiliation(s)
- Rachelle Brick
- Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, USA
| | | | - Elizabeth Skidmore
- Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, USA
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L'Hotta AJ, Varughese TE, Lyons KD, Simon L, King AA. Assessments used to measure participation in life activities in individuals with cancer: a scoping review. Support Care Cancer 2020; 28:3581-3592. [PMID: 32285262 DOI: 10.1007/s00520-020-05441-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 03/27/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Individuals with cancer are at high risk for restricted participation in meaningful life activities such as work, school, and social activities. Evaluating participation in life activities is identified as a critical component of rehabilitation referral and triage systems. This scoping review investigates what assessments are used to measure participation in life activities in individuals with cancer. METHODS Six databases were systematically searched using keywords and controlled vocabulary through February 2020. Eligible studies used the term participation in the context of life situations and had an assessment with at least 5 participation-specific questions. RESULTS A total of 4604 unique articles were identified and screened for eligibility. Thirty-two studies were included; 20 unique assessments of participation were identified. Assessments were developed with the primary purpose of measuring participation (n = 8); global or physical function (n = 9); community integration (n = 1); social activity (n = 1); or occupational gaps (n = 1). Most assessments (12/20) were not developed with the purpose of measuring participation and only 4 assessments measured key components of participation other than frequency. CONCLUSION Measuring participation in life activities is a developing area in oncology research. Most studies do not accurately or comprehensively measure this construct. The heterogeneity in assessments used indicates no clear consensus on a gold-standard participation measure for use among cancer survivors. Comprehensively measuring participation will help identify individuals in need of rehabilitation services and is an essential first step to inform the development of targeted interventions to enhance participation.
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Affiliation(s)
| | | | - Kathleen D Lyons
- Dartmouth-Hitchcock Medical Center, Norris Cotton Cancer Center, Lebanon, NH, USA
| | - Laura Simon
- Washington University School of Medicine, St. Louis, MO, USA
| | - Allison A King
- Washington University School of Medicine, St. Louis, MO, USA.,St. Louis Children's Hospital, One Children's Place, St. Louis, MO, USA
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