Rehabilitation for cancer patients at Black Lion hospital, Addis Ababa, Ethiopia: a cross-sectional study

Background

In Ethiopia, there were greater than 2000 adult and 200 pediatric cancer patients annually in 2010, but the estimated number of cancer patients were increasing. Oncologic rehabilitation treatment may result in improved physical and mental impairment. There is a paucity of information about rehabilitation service utilization among cancer patients in Ethiopia. Hence, the purpose of this study was to assess the rehabilitation service for cancer patient and associated factors at Black Lion hospital, Addis Ababa, Ethiopia.

Methods

A hospital-based cross-sectional quantitative study was conducted from March to April 2014. Convenient sampling method was employed to recruit the study participants. Interviewer administered questionnaire was used to collect data. Data were entered into EPI data version 3.1 and exported to SPSS (16.0) software for analysis. Descriptive analysis, binary and multiple logistic regression were carried out. Significance association was interpreted using adjusted odds ratio at 95% confidence interval and p-value less than 0.05.

Result

A sample of 423 patients aged 18 years and older were involved in the study. Breast cancer (25%), colorectal cancer (20.6%), cervical cancer (14.7%), lymphoma (7.7%), lung (7.2%), leukemia (5.4%), kidney (3.6%) and prostate cancer (2.6%) were the common forms of cancer diagnosed at cancer unit of the Black Lion Hospital. Twenty six percent of cancer patients received rehabilitation service at least once. The main rehabilitation services given were nutritional and psychological support. Unavailability of supplies, lack of professionals and cost of service were among the barriers to receiving rehabilitation services.

Conclusion

Only a few cancer patients received cancer rehabilitation services. Increasing the knowledge of the professionals, stocking cancer units with necessary supplies, and other comprehensive programs are needed.

Rehabilitation of people with spinal cord damage due to tumor: literature review, international survey and practical recommendations for optimizing their rehabilitation

BACKGROUND/OBJECTIVES

People with spinal cord dysfunction (SCDys) due to tumor (benign and malignant) pose enormous rehabilitation challenges. Objectives were: conduct literature search regarding epidemiology, clinical features and outcomes for SCDys due to tumor following rehabilitation, the ideal setting for rehabilitation and practical considerations for rehabilitation; and propose framework and practical considerations for managing people with SCDys due to tumor in spinal rehabilitation units (SRUs).

DESIGN

Survey of rehabilitation health care professionals, consensus opinion from experts and literature search.

SETTING

Workshop at International Spinal Cord Society and American Spinal Injury Association combined annual meeting, May 16, 2015, Montréal, Canada.

PARTICIPANTS

Workshop attendees and experts in the rehabilitation of people with SCDys due to tumor.

OUTCOMES MEASURES

Reports of services offered to people with SCDys due to tumor, including whether those with benign and malignant tumors are admitted into rehabilitation, any admission criteria used and the rational for declining admission.

RESULTS

Most respondents (n = 33, 83%) reported that people with benign tumors were routinely admitted for rehabilitation but only 18 (45%) reported that people with malignant tumors were routinely admitted. A range of criteria and reasons for declining admission were given. Evidence from the literature and the opinion of experts support the admission of people with SCDys due to tumor into specialist SRUs.

CONCLUSIONS

A framework and practical considerations for managing people with SCDys due to tumor in SRUs are proposed. Patients with tumor causing SCDys should be given greater access to specialist SRU in order to achieve the best outcomes.

Metastatic paraplegia and functional outcomes: perspectives and limitations for rehabilitation care. Part 2

OBJECTIVE

To identify functional outcomes that could justify the need for a rehabilitation care program for patients with metastatic epidural spinal cord compression (MESCC) and paraplegia.

DATA SOURCES

Publications from 1950 to January 2010 selected from 3 databases.

STUDY SELECTION

Original articles dealing with outcome data for functional status, pain, and bladder dysfunction.

DATA EXTRACTION

Standardized reading grid.

DATA SYNTHESIS

The data are dominated by retrospective studies for even functional-related data, and studies from rehabilitation teams are rare. They report a functional evolution similar to a population with traumatic spinal cord injury for the first 3 months. Patients who were ambulatory before treatment retained their ability to walk, and patients who were nonambulatory before treatment could regain gait abilities. Data also showed a positive impact on pain and bladder and/or bowel dysfunction.

CONCLUSIONS

By restricting physical medicine and rehabilitation therapeutic care to a short time (1-2mo), the progression margin is possible in the short term and implies a voluntary and active therapeutic care approach for patients with paraplegia after MESCC on the basis of a codified and standardized program with clinical indicators, as well as patients' comfort indicators.

Survival after rehabilitation for spinal cord injury due to tumor: a 12-year retrospective study

Metastatic spinal cord compression occurs in 2.5% of cancer patients in the last 5 years of life. Spinal cord injury (SCI) due to tumors accounts for 26-45% of non-traumatic SCI. With the aging population and improving survival, the number of patients with SCI due to tumor who have the capacity to benefit from rehabilitation is increasing. This study planned to document survival in patients with primary and secondary tumors causing SCI admitted to a spinal rehabilitation unit over a 12-year period. This is a retrospective open-cohort case series of patients admitted to a Spinal Rehabilitation Unit between 1 July 1996 and 30 June 2008 with a diagnosis of tumor causing SCI. Linkage to the Registry of Births, Deaths and Marriages (Victoria) was used to calculate survival in months following discharge from inpatient rehabilitation. 108 patients were included in the study cohort of which 62% (n = 67) were male. The median age was 61.5 years (IQR 53.6-74). The majority of patients had paraplegia (n = 97, 89.8%) and a metastatic tumor (n = 71, 65.7%) causing their SCI. Most (n = 78, 72%) patients died during the study period. The median survival for primary tumors was significantly greater (Cox regression HR = 1.8, P = 0.03) 9.5 months (IQR 2.8-34.4 months) than that for metastatic tumors (median 2.8, IQR 1.2-9.0 months).

CONCLUSION

Patients with longer survival are appropriate for rehabilitation programs targeting longer-term goals whilst patients with shorter survival are more suitable for short, directed rehabilitation programs.