1
|
Gilson S. Deconditioning in Hospitalized Patients with Cancer. Semin Oncol Nurs 2024:151676. [PMID: 38945732 DOI: 10.1016/j.soncn.2024.151676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 05/17/2024] [Accepted: 05/19/2024] [Indexed: 07/02/2024]
Abstract
OBJECTIVES Provide an overview of hospital-associated deconditioning in hospitalized patients with cancer, including risk factors and trajectory of deconditioning. Discuss interdisciplinary roles in preventing deconditioning, best practices, and oncology nursing implications. METHODS A literature search was conducted in PubMed and on Google Scholar using search terms Hospital*, Mobility, Immobility, Deconditioning, Cancer, and Oncology. Peer-reviewed research studies, review articles, and websites of professional organizations were reviewed to provide an overview on mobility concerns in hospitalized patients with cancer. RESULTS Thirty-eight references were included in this overview of hospital-associated deconditioning (HAD) in patients with cancer. HAD is a widespread phenomenon with grave consequences. Patients with cancer are particularly vulnerable to HAD due to their cancer diagnosis and treatment effects. Physical activity in hospitalized patients is one of the most important practices to prevent HAD and is achieved through standardized mobility assessment and interdisciplinary collaboration. CONCLUSIONS Promoting mobility in hospitalized patients with cancer is essential to prevent the complications of HAD. IMPLICATIONS FOR NURSING PRACTICE Nurses are leaders of the interdisciplinary approach to enhance inpatient mobility. As they are most often at the bedside, nurses assess patients' level of mobility, recognize risk factors for HAD, and implement safe mobility interventions. Nurses experience barriers to promoting mobility including workforce shortages, high workloads, and competing priorities.
Collapse
Affiliation(s)
- Savanna Gilson
- PIH Health Whittier Hospital, Clinical Nurse Specialist, Medical Oncology, Whittier, CA.
| |
Collapse
|
2
|
Pergolotti M, Wood KC, Kendig TD, Mayo S. Impact of Real-World Outpatient Cancer Rehabilitation Services on Health-Related Quality of Life of Cancer Survivors across 12 Diagnosis Types in the United States. Cancers (Basel) 2024; 16:1927. [PMID: 38792004 PMCID: PMC11119581 DOI: 10.3390/cancers16101927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 05/06/2024] [Accepted: 05/11/2024] [Indexed: 05/26/2024] Open
Abstract
Compared to adults without cancer, cancer survivors report poorer health-related quality of life (HRQOL), which is associated with negative treatment outcomes and increased healthcare use. Cancer-specialized physical and occupational therapy (PT/OT) could optimize HRQOL; however, the impact among survivors with non-breast malignancies is unknown. This retrospective (2020-2022), observational, study of medical record data of 12 cancer types, examined pre/post-HRQOL among cancer survivors who completed PT/OT. PROMIS® HRQOL measures: Global Health (physical [GPH] and mental [GMH]), Physical Function (PF), and Ability to Participate in Social Roles and Activities (SRA) were evaluated using linear mixed effect models by cancer type, then compared to the minimal important change (MIC, 2 points). Survivors were 65.44 ± 12.84 years old (range: 19-91), male (54%), with a median of 12 visits. Improvements in GPH were significant (p < 0.05) for all cancer types and all achieved MIC. Improvements in GMH were significant for 11/12 cancer types and 8/12 achieved MIC. Improvements in PF were significant for all cancer types and all achieved the MIC. Improvements in SRA were significant for all cancer types and all groups achieved the MIC. We observed statistically and clinically significant improvements in HRQOL domains for each of the 12 cancer types evaluated.
Collapse
Affiliation(s)
- Mackenzi Pergolotti
- ReVital Cancer Rehabilitation, Select Medical, Mechanicsburg, PA 17055, USA; (K.C.W.); (T.D.K.); (S.M.)
- Department of Occupational Therapy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Kelley C. Wood
- ReVital Cancer Rehabilitation, Select Medical, Mechanicsburg, PA 17055, USA; (K.C.W.); (T.D.K.); (S.M.)
| | - Tiffany D. Kendig
- ReVital Cancer Rehabilitation, Select Medical, Mechanicsburg, PA 17055, USA; (K.C.W.); (T.D.K.); (S.M.)
| | - Stacye Mayo
- ReVital Cancer Rehabilitation, Select Medical, Mechanicsburg, PA 17055, USA; (K.C.W.); (T.D.K.); (S.M.)
| |
Collapse
|
3
|
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.
Collapse
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
| |
Collapse
|
4
|
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.
Collapse
|
5
|
Loubani K, Polo KM, Baxter MF, Rand D. Identifying Facilitators of and Barriers to Referrals to Occupational Therapy Services by Israeli Cancer Health Care Professionals: A Qualitative Study. Am J Occup Ther 2024; 78:7801205050. [PMID: 38224354 DOI: 10.5014/ajot.2024.050414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2024] Open
Abstract
IMPORTANCE Persons living with and beyond cancer (PLWBC) are rarely referred to occupational therapy services despite their functional difficulties. An understanding of the barriers to and facilitators of occupational therapy referrals from the perspective of cancer health care professionals could help minimize referral gaps. OBJECTIVE To explore cancer health care professionals' perspectives on and knowledge of occupational therapy's role in cancer care, identify the barriers, and explore solutions to optimize referrals. DESIGN Multiexplanatory qualitative case study. SETTING Community and hospital cancer clinics in Israel. PARTICIPANTS Six in-person focus groups of cancer care Israeli nurses and social workers, totaling 28 participants. RESULTS Two main themes were identified: (1) barriers to occupational therapy referrals and (2) partial facilitators of occupational therapy referrals. The four barriers subthemes were (1) gaps in knowledge about symptoms' effects on daily functioning, (2) gaps in knowledge regarding occupational therapy's role in cancer care, (3) bureaucratic and organizational barriers, and (4) unavailability of occupational therapy services. The two facilitators subthemes were (1) collaborations and communication with occupational therapists and (2) awareness of occupational therapy services. Participants suggested practical solutions for improving occupational therapy referrals, interdisciplinary collaboration and communication, and integrating occupational therapy into cancer care. CONCLUSIONS AND RELEVANCE Barriers to referrals included gaps in participants' knowledge that link side effects to functional difficulties indicating a need for referral to occupational therapy. Participants' suggestions to bolster referrals can be implemented by occupational therapists to reduce patients' unmet needs and bridge existing gaps in cancer care. Plain-Language Summary: This research helped to identify barriers and facilitators regarding insufficient knowledge about occupational therapy's role in cancer care and adds a better understanding of gaps in referrals to occupational therapy. In addition, cancer health care professionals who participated in the study suggested practical solutions for reducing barriers and maximizing support for referral. With these nuances, occupational therapy practitioners can work with medical cancer care units (i.e., acute care hospitals, medical cancer centers, and community health care clinics) to target the use of strategies that work for their units to ensure that persons living with and beyond cancer receive needed occupational therapy services.
Collapse
Affiliation(s)
- Khawla Loubani
- Khawla Loubani, PhD, OT, is Occupational Therapist, Clalit Health Services, Jerusalem, Israel. At the time of the research, Loubani was Postdoctoral Fellow, Department of Occupational Therapy, Stanley Steyer School of Health Professions, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel, and Postdoctoral Fellow, School of Occupational Therapy, College of Health Sciences, University of Indianapolis, Indianapolis, IN;
| | - Katie M Polo
- Katie M. Polo, DHS, OTR, CLT-LANA, is Associate Professor, College of Health Sciences, School of Occupational Therapy, University of Indianapolis, Indianapolis, IN
| | - Mary Frances Baxter
- Mary Frances Baxter, PhD, OT, FAOTA, is Professor and Associate Director, Dr. Sophie Lin Rydin School of Occupational Therapy, Texas Woman's University, Houston
| | - Debbie Rand
- Debbie Rand, PhD, OT, is Associate Professor, Department of Occupational Therapy, Stanley Steyer School of Health Professions, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
6
|
Romero-Ayuso D, García-López R, Lozano-Villena C, Martínez JR, Parga-Amado P, García-Ferreiro P, Gallud JA, Lozano M, Triviño-Juárez JM. Usability of a mobile phone application to enhance activities of daily living in occupational therapy services for breast cancer survivors. Hong Kong J Occup Ther 2023; 36:128-140. [PMID: 38027046 PMCID: PMC10680858 DOI: 10.1177/15691861231206489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 09/23/2023] [Indexed: 12/01/2023] Open
Abstract
Background/Objective: The use of new technologies in rehabilitation to evaluate and improve occupational performance and quality of life is increasing. Technological applications in the health field could help meet the needs of patients, including those of women breast cancer survivors. The main aim of this study was to design a mobile phone application "MAIA" focused on the perceived needs of women who have had breast cancer to achieve optimal performance in their daily lives in a meaningful way. Methods: A cross-sectional usability study using an online questionnaire was designed. Sociodemographic and occupational performance data were collected. System Usability Scale, Engagement in Meaningful Activities Survey, Occupational Balance Questionnaire, General Self-Efficacy Scale, Functional Assessment of Cancer Therapy - General and Disabilities of the Arm, Shoulder and Hand were administered. Descriptive statistics were used to describe categorical (frequencies and percentages) and quantitative variables (mean and standard deviation). Results: The sample was composed of seventy-eight women diagnosed with breast cancer. Nine activities of daily living were affected in more than 20% of women with breast cancer. The most affected were sleep and rest and functional mobility. Conclusions: Women survivors of breast cancer showed difficulties in daily life performance and participation. The MAIA App could be useful as a new online resource in occupational therapy for the rehabilitation of breast cancer survivors.
Collapse
Affiliation(s)
- Dulce Romero-Ayuso
- University of Granada, Spain
- Instituto de Investigación Biosanitaria Ibs, Spain
- CIMCYC, University de Granada, Spain
| | - Raquel García-López
- Hospital Provincial de Conxo, Unidad de Trastornos Alimentarios (UDAL), Servicio Gallego de Salud, Spain
| | - Carmen Lozano-Villena
- Hospital Universitario Ntra. Sra. De La Candelaria, Servicio Canario de Salud, Spain
| | | | | | | | | | | | | |
Collapse
|
7
|
Ozluk AA, Outlaw D, Akce M, Fowler ME, Hess DL, Giri S, Williams GR. Management of Older Adults With Colorectal Cancer: The Role of Geriatric Assessment. Clin Colorectal Cancer 2023; 22:390-401. [PMID: 37949790 PMCID: PMC11065137 DOI: 10.1016/j.clcc.2023.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 08/17/2023] [Accepted: 10/05/2023] [Indexed: 11/12/2023]
Abstract
Older adults share a growing burden of cancer morbidity and mortality. This is present across the spectrum of oncologic diagnoses and is particularly true with colorectal cancer (CRC), where older adults continue to share the burden of diagnoses. However, optimal cancer treatment decision making in older adults remains a significant challenge, as the majority of previous clinical trials shaping the current treatment landscape have focused on younger patients, often with more robust performance status and fewer medical comorbid conditions. The heterogeneous aging process of older adults with CRC necessitates a personalized treatment approach, as approximately three-quarters of older adults with CRC also have a concominant geriatric syndrome and more than half of older adults with CRC are pre-frail or frail. Treatment decisions shoud be multifaceted, including consultation with the patient and their familes regarding their wishes, with consideration of the patient's quality of life, functional status, medical comorbid conditions, social support, and treatment toxicity risk. Geriatric assessment is a systematic and validated approach to assess an older adults's potential strengths and vulnerabilities, which can in turn be used to assist with comprehensive cancer care planning and support. In this review, we will summarize current treatment approaches for older adults with CRC, with a particular focus on the incorporation of the geriatric assessment.
Collapse
Affiliation(s)
- Ahmet Anil Ozluk
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Darryl Outlaw
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Mehmet Akce
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Mackenzie E Fowler
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | - Daniel L Hess
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Smith Giri
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | - Grant R Williams
- Division of Hematology and Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL; Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, AL.
| |
Collapse
|
8
|
Raab GT, Restifo D, Tin AL, Vickers AJ, McBride SM, Wong RJ, Lee NY, Zakeri K, Shahrokni A. Differential use of postoperative psychosocial and physical services among older adults with head and neck cancer. J Geriatr Oncol 2023; 14:101609. [PMID: 37678051 DOI: 10.1016/j.jgo.2023.101609] [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: 12/05/2022] [Revised: 03/06/2023] [Accepted: 08/17/2023] [Indexed: 09/09/2023]
Abstract
INTRODUCTION Older adults undergoing head and neck cancer (HNC) surgery often have significant functional and mental health impairments. We examined use of postoperative physical, nutritional, and psychosocial services among a cohort of older adults with HNC comanaged by geriatricians and surgeons. MATERIALS AND METHODS Our sample consisted of older adults who were referred to the Geriatrics Service at Memorial Sloan Kettering Cancer Center between 2015 and 2019 and took a geriatric assessment (GA) prior to undergoing HNC surgery. Physical, nutritional, and psychosocial service utilization was assessed. Physical services included a physical, occupational, or rehabilitation consult during the patient's stay. Nutritional services consisted of speech and swallow or nutritional consult. Psychosocial services consisted of psychiatry, psychology, or a social work consult. Relationships between each service use, geriatric deficits, demographic, and surgical characteristics were assessed using Wilcoxon rank-sum test or Chi-square test. RESULTS In total, 157 patients were included, with median age of 80 and length of stay of six days. The most common GA impairments were major distress (61%), depression (59%), social activity limitation (SAL) (54%), and deficits in activities of daily living (ADL) (44%). Nutritional and physical services were used much more frequently than psychosocial services (80% and 85% vs 31%, respectively). Receipt of services was associated with longer median length of hospital stay, operation time, and greater deficits in ADLs. SAL was associated with physical and psychosocial consult and lower Timed Up and Go (TUG) score; instrumental ADL (iADL) deficits were associated with physical services; and depression and distress were associated with psychosocial services. DISCUSSION The burden of psychosocial deficits is high among older adults with HNC. Future work is needed to understand the limited utilization of psychosocial services in this population as well as whether referral to psychosocial services can reduce the burden of these deficits.
Collapse
Affiliation(s)
| | | | - Amy L Tin
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Andrew J Vickers
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sean M McBride
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Richard J Wong
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Nancy Y Lee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Kaveh Zakeri
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Armin Shahrokni
- Geriatrics Service, Department of Medicine, Jersey Shore University Medical Center, Neptune, NJ, USA.
| |
Collapse
|
9
|
Le Boutillier C, Jeyasingh-Jacob J, Jones L, King A, Archer S, Urch C. Improving personalised care and support planning for people living with treatable-but-not-curable cancer. BMJ Open Qual 2023; 12:e002322. [PMID: 37666580 PMCID: PMC10481844 DOI: 10.1136/bmjoq-2023-002322] [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: 02/18/2023] [Accepted: 08/15/2023] [Indexed: 09/06/2023] Open
Abstract
People living with treatable-but-not-curable (TbnC) cancer encounter cancer-related needs. While the NHS long-term plan commits to offering a Holistic Needs Assessment (HNA) and care plan to all people diagnosed with cancer, the content, delivery and timing of this intervention differs across practice. Understanding how people make sense of their cancer experience can support personalised care. A conceptual framework based on personal narratives of living with and beyond cancer (across different cancer types and all stages of the disease trajectory), identified three interlinked themes: Adversity, Restoration and Compatibility, resulting in the ARC framework.Our aim was to use the ARC framework to underpin the HNA to improve the experience of personalised care and support planning for people living with TbnC cancer. We used clinical work experience to operationalise the ARC framework and develop the intervention, called the ARC HNA, and service-level structure, called the ARC clinic. We sought expert input on the proposed content and structure from patients and clinicians through involvement and engagement activities. Delivered alongside standard care, the ARC HNA was piloted with patients on the TbnC cancer (myeloma and metastatic breast, prostate or lung) pathway, who were 6-24 months into their treatment. Iterations were made to the content, delivery and timing of the intervention based on user feedback.Fifty-one patients received the intervention. An average of 12 new concerns were identified per patient, and 96% of patients achieved at least one of their goals. Patients valued the space for reflection and follow-up, and clinicians valued the collaborative approach to meeting patients' supportive care needs. Compared with routine initial HNA and care plan completion rates of 13%, ARC clinic achieved 90% with all care plans shared with general practitioners. The ARC clinic adopts a novel and proactive approach to delivering HNAs and care plans in a meaningful and personalised way.
Collapse
Affiliation(s)
- Clair Le Boutillier
- Division of Methodologies, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
- THIS Institute (The Healthcare Improvement Studies Institute), University of Cambridge, Cambridge, UK
| | - Julian Jeyasingh-Jacob
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
- Department of Surgery, Cardiovascular and Cancer, Imperial College Healthcare NHS Trust, London, UK
| | - Lizzie Jones
- Department of Surgery, Cardiovascular and Cancer, Imperial College Healthcare NHS Trust, London, UK
- Maggie's West London, London, UK
| | - Alex King
- Department of Surgery, Cardiovascular and Cancer, Imperial College Healthcare NHS Trust, London, UK
| | - Stephanie Archer
- Department of Psychology, University of Cambridge, Cambridge, UK
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Catherine Urch
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
- Department of Surgery, Cardiovascular and Cancer, Imperial College Healthcare NHS Trust, London, UK
| |
Collapse
|
10
|
He K, Jiang J, Chen M, Wang T, Huang X, Zhu R, Zhang Z, Chen J, Zhao L. Effects of occupational therapy on quality of life in breast cancer patients: A systematic review and meta-analysis. Medicine (Baltimore) 2023; 102:e34484. [PMID: 37543817 PMCID: PMC10403005 DOI: 10.1097/md.0000000000034484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/07/2023] Open
Abstract
BACKGROUND The objective was to discuss the impact of occupational therapy on different domains of quality of life in breast cancer patients. We performed a literature search to identify articles published before June 27, 2023, using the following databases: PubMed, Embase, Web of Science, Cochrane Library, and Scopus. OBJECTIVE The objective was to discuss the impact of occupational therapy on different domains of quality of life in breast cancer patients. DATA SOURCES We performed a literature search to identify articles published before June 27, 2023, using the following databases: PubMed, Embase, Web of Science, Cochrane Library, and Scopus. METHODS This study was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Randomized controlled trials that reported the effects of occupational therapy on quality of life in breast cancer patients were identified. Two reviewers independently assessed eligibility, extracted data, and determined risks of bias. Pooled standardized mean differences (SMDs) with 95% confidence intervals (CIs) were estimated using random-effects meta-analyses. Galbraith plots, meta-regression analysis, subgroup analysis, and sensitivity analysis were used to identify heterogeneity in treatment effects. RESULTS Eight studies were included, with a total of 543 patients. The experimental group exhibited better global health (pooled SMD = 0.640, 95% CI = 0.251-1.028, P = .001), physical health (pooled SMD = 0.640, 95% CI = 0.251-1.028, P = .019), social health (pooled SMD = 0.251, 95% CI = 0.011-0.490, P = .040), and cognitive function (pooled SMD = 0.863, 95% CI = 0.266-1.460, P = .05) and improve fatigue (pooled SMD = -0.389, 95% CI = -0.586 to -0.192, P = .000), and role function (pooled SMD = 0.287, 95% CI = 0.029-0.546, P = .029) than the control group. The 2 groups exhibited comparable emotional health (pooled SMD = 0.243, 95% CI = -0.051 to 0.536, P = .105) and pain (pooled SMD = -0.312, 95% CI = -0.660 to 0.036, P = .079). CONCLUSION The current evidence shows that occupational therapy can improve the quality of life of breast cancer patients, especially their global health, physical health, social health, cognitive function, fatigue, and role function.
Collapse
Affiliation(s)
- Kang He
- Department of Rehabilitation, School of Nursing, Jilin University, Changchun, China
| | - Junjie Jiang
- Department of Rehabilitation, The Second Hospital of Jilin University, Changchun, Jilin, China
| | - Mengmeng Chen
- Department of Rehabilitation, School of Nursing, Jilin University, Changchun, China
| | - Taiwei Wang
- Department of Rehabilitation, School of Nursing, Jilin University, Changchun, China
| | - Xuemiao Huang
- Department of Rehabilitation, School of Nursing, Jilin University, Changchun, China
| | - Ruiting Zhu
- Department of Rehabilitation, School of Nursing, Jilin University, Changchun, China
| | - Zhiyuan Zhang
- Department of Rehabilitation, School of Nursing, Jilin University, Changchun, China
| | - Junyu Chen
- Department of Rehabilitation, School of Nursing, Jilin University, Changchun, China
| | - Lijing Zhao
- Department of Rehabilitation, School of Nursing, Jilin University, Changchun, China
| |
Collapse
|
11
|
Harada T, Tsuji T, Tanaka M, Konishi N, Yanagisawa T, Koishihara Y, Ueno J, Mizutani T, Nishiyama N, Soeda R, Hijikata N, Ishikawa A, Hayashi R. Priority of the basic and instrumental activities of daily living in older patients with cancer prescribed rehabilitation: a cross-sectional survey. Support Care Cancer 2023; 31:503. [PMID: 37526784 DOI: 10.1007/s00520-023-07975-1] [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: 04/01/2023] [Accepted: 07/27/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND There is no information on whether vulnerable older patients with cancer consider basic activities of daily living (BADL) and instrumental activities of daily living (IADL) important outcomes. Our survey aimed to investigate the priority of BADL and IADL in outcomes among vulnerable older patients with cancer. METHODS This was a single-center survey in a Japanese cancer center. Eligible patients were ≥ 65 years of age and were prescribed in-hospital rehabilitation while under cancer treatment. Using original self-administered ranking questionnaires, patients were asked to rank outcomes and subdomain of BADL and IADL. High-priority domains were defined as the highest, second-highest, and third-highest priority domains in individuals. RESULTS A total of 169 patients were analyzed. The mean age was 74.0 years (standard deviation, 5.1 years) and the number of males was 107 (63%). The order of ranking of high-priority outcomes was BADL and IADL (n = 155), cognitive function (n = 91), mental function (n = 82), nutrition (n = 61), social function (n = 51), comorbidity (n = 39), and life span (n = 28). The top three high-priority independence subdomains of BADL and IADL were toilet use (n = 140), feeding (n = 134), and mobility (n = 69) among the BADL and shopping (n = 93), food preparation (n = 88), and ability to handle finances (n = 85) among the IADL. CONCLUSIONS BADL and IADL can be considered the most important health outcomes in clinical trials and in practice among older patients with cancer and physical vulnerabilities.
Collapse
Affiliation(s)
- Tsuyoshi Harada
- Department of Rehabilitation Medicine, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
- Department of Rehabilitation Medicine, Keio University Graduate School, Shinjuku, Tokyo, Japan.
| | - Tetsuya Tsuji
- Department of Rehabilitation Medicine, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
- Department of Rehabilitation Medicine, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Motoki Tanaka
- Department of Rehabilitation Medicine, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Nobuko Konishi
- Department of Rehabilitation Medicine, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Takumi Yanagisawa
- Department of Rehabilitation Medicine, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Yu Koishihara
- Department of Rehabilitation Medicine, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Junya Ueno
- Department of Rehabilitation Medicine, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Tomonori Mizutani
- Department of Medical Oncology, Faculty of Medicine, Kyorin University, Mitaka, Tokyo, Japan
| | - Nanako Nishiyama
- Graduate School of Rehabilitation Science, Osaka Metropolitan University, Habikino, Osaka, Japan
| | - Ryo Soeda
- Department of Rehabilitation Medicine, Keio University Graduate School, Shinjuku, Tokyo, Japan
- Department of Rehabilitation, Tsurumaki Onsen Hospital, Hadano, Kanagawa, Japan
| | - Nanako Hijikata
- Department of Rehabilitation Medicine, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Aiko Ishikawa
- Department of Rehabilitation Medicine, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
- Department of Rehabilitation Medicine, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Ryuichi Hayashi
- Department of Rehabilitation Medicine, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| |
Collapse
|
12
|
Ranger MC, Houle S, Rheault A, Thomas R. Art-Based Workshops for Women: An Opportunity for Reflection on Identity and Transformation following Cancer Treatment. Occup Ther Int 2023; 2023:1828314. [PMID: 37492484 PMCID: PMC10365914 DOI: 10.1155/2023/1828314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 05/25/2023] [Accepted: 06/16/2023] [Indexed: 07/27/2023] Open
Abstract
Individuals experiencing cancer often report feelings of abandonment by the healthcare system after medical treatment has ended. Specifically, women with cancer have expressed the need for support beyond traditional medical and rehabilitation periods, especially with the process of reconstructing the self in the context of enduring illness. Occupational therapists could play a critical role in providing opportunities for self-reflection and transformation through occupation for this population. Art-based occupations may be especially useful for providing space for self-reflection and personal change. This article describes the experiences of women living with cancer who participated in community art-based workshops that focused on the themes of identity and transformation. The project consisted of mixed-media workshops that were held at a community-based facility providing supportive programs for people living with cancer. Eleven women participated in the workshops led by an art-based rehabilitation researcher and a visual artist. Workshops were audio-recorded, and photographs of the participants' artwork were taken. Individual postworkshop interviews were conducted with the participants, within 4 to 6 weeks following the last workshop. Interpretive description was used to capture four themes with implications for personal change, transformation, and occupational therapy: (1) revealing: therapeutic potential; (2) sharing: vulnerability and new perspectives; (3) transforming: the self; and (4) creating: regular practices. The findings point to ways occupational therapists can form new partnerships with other disciplines and professionals to generate positive outcomes for people living with cancer.
Collapse
Affiliation(s)
| | - Sandra Houle
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada K1H 8L1
| | - Alysson Rheault
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada K1H 8L1
| | - Roanne Thomas
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada K1H 8L1
| |
Collapse
|
13
|
Capozzi LC, Daun JT, Francis GJ, de Guzman Wilding M, Urgoiti GR, Langelier D, Culos-Reed N. Feasibility and Implementation of an Oncology Rehabilitation Triage Clinic: Assessing Rehabilitation, Exercise Need, and Triage Pathways within the Alberta Cancer Exercise-Neuro-Oncology Study. Curr Oncol 2023; 30:6220-6245. [PMID: 37504321 PMCID: PMC10377964 DOI: 10.3390/curroncol30070461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/17/2023] [Accepted: 06/20/2023] [Indexed: 07/29/2023] Open
Abstract
Individuals living with and beyond cancer face physical impairment and inactivity in survivorship. Neuro-oncology populations have especially high rates of sedentary behaviour and functional deficits, including impaired balance, motor skills, and cognition. Our purpose was to assess the rehabilitation and exercise needs of patients with brain tumours while examining the feasibility of a rehabilitation triage clinic as a part of the Alberta Cancer Exercise-Neuro-Oncology study, where patients were referred to a triage clinic, where health, neurologic, and functional status was assessed, followed by a referral to one or multiple resources, including exercise, physiotherapy, occupational therapy, or physiatry. Qualitative perception of the triage clinic was collected. Overall, the triage clinic was feasible and safe for participants, facilitating referral into rehabilitation and exercise resources. Pre-determined enrollment and attendance rates were met, but referral rates to the triage clinic were not met. Oncology clinic staff reported forgetting to refer patients or uncertainty of who was appropriate for rehabilitation as barriers. Oncology clinic-based screening may improve the identification of patients who are sedentary or have a physical impairment. A proposed screening tool, the Cancer Rehabilitation and Exercise Screening Tool (CREST), is presented within our Cancer Rehabilitation and Exercise Pathways Model. The CREST can identify patients who are sedentary or have a functional impairment, facilitating referral to appropriate rehabilitation resources and ultimately improving patient recovery and functioning.
Collapse
Affiliation(s)
- Lauren C Capozzi
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Julia T Daun
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - George J Francis
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Marie de Guzman Wilding
- Supportive Care: Psychosocial and Rehabilitation Oncology, Cancer Care Alberta, Alberta Health Services, Calgary, AB T2S 3C3, Canada
| | - Gloria Roldan Urgoiti
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - David Langelier
- Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, ON M5S 1A8, Canada
- Department of Supportive Care, Cancer Rehabilitation and Survivorship, Princess Margaret Hospital, Toronto, ON M5G 2C1, Canada
| | - Nicole Culos-Reed
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
- Supportive Care: Psychosocial and Rehabilitation Oncology, Cancer Care Alberta, Alberta Health Services, Calgary, AB T2S 3C3, Canada
| |
Collapse
|
14
|
Longpré SM, Rader NC, Dougherty KJ, Motai Y, Leinhauser KC. Factors That Influence Occupational Engagement of Young Adults Who Are Cancer Survivors: A Pilot Study. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2023; 43:218-227. [PMID: 36245400 DOI: 10.1177/15394492221128779] [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: 11/16/2022]
Abstract
Cancer and its treatment can impact occupational engagement. However, occupational therapy-specific research studying young adult cancer survivors remains limited. The objective of this study to identify the type of occupations that young adult cancer survivors choose to engage in and to understand their decision-making process when choosing these occupations. A mixed-methods explanatory sequential design was used. Eleven participants, nine females and two males, between the ages of 18 and 35, were included. Several occupations were identified for engagement such as activities of daily living, leisure, work, sleep and rest, and health management. The predominant factor that influenced why occupations were chosen was that individuals purposefully selected occupations that allowed them to choose a path toward a more meaningful life. Information gained from this pilot study can be used to inform occupational therapy practitioners regarding services and interventions that promote occupational engagement for young adult cancer survivors.
Collapse
Affiliation(s)
| | - Nadeya C Rader
- Blanchfield Army Community Hospital, Fort Campbell, KY, USA
| | | | - Yael Motai
- Wellness Beyond Rehab, LLC, Oldsmar, FL, USA
| | | |
Collapse
|
15
|
Welford J, Rafferty R, Short D, Dewhurst F, Greystoke A. Personalised Assessment and Rapid Intervention in Frail Patients with Lung Cancer: The Impact of an Outpatient Occupational Therapy Service. Clin Lung Cancer 2023:S1525-7304(23)00051-7. [PMID: 37068994 DOI: 10.1016/j.cllc.2023.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 03/08/2023] [Accepted: 03/16/2023] [Indexed: 04/09/2023]
Abstract
INTRODUCTION Lung cancer and its treatments cause or accelerate frailty, detrimentally affecting function and quality of life. Occupational therapists (OTs) provide global assessments and interventions, but services are often available for inpatients. The impact of holistic assessment and early intervention in the outpatient setting is unknown. MATERIALS AND METHODS A tertiary cancer center in North East England piloted a Lung Cancer Outpatient OT Service for patients with thoracic malignancy and a Clinical Frailty Scale Score (CFS) ≥ 5. Service effectiveness was evaluated through calculation of admission avoidance, hospital length-of-stay reduction, completion/impact of advance care planning and patient/family feedback. Demographics, frailty level, required interventions, and onward referrals were recorded. RESULTS A total of 153 patients (median age of 71 (range 46-90) received OT assessment and intervention. 48% were in the lowest socioeconomic quintile. Median CFS score was 5 (mildly frail (range: 4-7)) at initial assessment. Total of 918 interventions were delivered (median: 5, IQR: 3-7, Range 0-22). 48% of patients engaged in future planning (national average: 10%-15% P < .0001) and 78.5% achieved preferred place of death (national average 30%). An estimated 37 hospital admissions were avoided. In admitted patients, average inpatient stay when known to the service was 6.5 days less than other frail lung cancer patients in our unit (95% CI 4-9.1 days P < .0001). Higher CFS was associated with poor survival (P < .05). CONCLUSION Outpatient OT services can avoid and shorten hospital admissions through advance care planning, management of functional disruption, onward referral to other allied health professionals and palliative care. A comprehensive multidisciplinary outpatient service may benefit patients further and should be the focus of future research.
Collapse
|
16
|
Zok A, Matecka M, Zapala J, Izycki D, Baum E. The Effect of Vinyasa Yoga Practice on the Well-Being of Breast-Cancer Patients during COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3770. [PMID: 36834464 PMCID: PMC9967391 DOI: 10.3390/ijerph20043770] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 02/11/2023] [Accepted: 02/15/2023] [Indexed: 05/31/2023]
Abstract
BACKGROUND Vinyasa yoga practice improves body fitness and potentially positively affects practitioners' well-being and health. Due to the diverse intensity of practice and positions customized to the practitioner's needs, it can also support cancer patients. Undertaking physical activity that has a potentially positive effect on well-being and health was particularly important during the self-isolation that followed the COVID-19 pandemic. The purpose of this study was to evaluate the impact of three-month mild and moderate intensity vinyasa yoga practice on breast-cancer patients' stress perception, self-confidence, and sleep quality during COVID-19 induced self-isolation. METHODS Female breast-cancer patients participated in twelve-weeks of online vinyasa practice during the COVID-19 induced self-isolation period. Meetings were held once a week, where 60-min vinyasa yoga sequences were followed by 15 min of relaxation. Patients completed pre- and post-intervention surveys to evaluate changes in the following outcomes: stress perception, self-confidence, and sleep quality. Forty-one female patients enrolled in the Vinyasa course completed the pre-intervention survey, while 13 attended all the meetings and completed the post-intervention survey. RESULTS The effect of the twelve-week yoga and relaxation practice significantly reduced sleep problems and stress of oncological patients. The participants also declared an improvement in their general well-being and self-acceptance. CONCLUSION Dynamic forms of yoga combined with mindfulness techniques can be applied to patients treated for oncological diseases. It contributes to improving their well-being. However, in-depth studies are needed to analyze the complexity of this effect.
Collapse
Affiliation(s)
- Agnieszka Zok
- Department of Social Sciences and Humanities, Poznan University of Medical Sciences, 60-812 Poznan, Poland
- Division of Philosophy of Medicine and Bioethics, Poznan University of Medical Sciences, 60-812 Poznan, Poland
| | - Monika Matecka
- Department of Occupational Therapy, Poznan University of Medical Sciences, 60-812 Poznan, Poland
| | - Joanna Zapala
- Department of Postgraduate Studies, SWPS University, 03-815 Warszawa, Poland
| | - Dariusz Izycki
- Department of Cancer Immunology, Poznan University of Medical Sciences, 60-812 Poznan, Poland
| | - Ewa Baum
- Department of Social Sciences and Humanities, Poznan University of Medical Sciences, 60-812 Poznan, Poland
- Division of Philosophy of Medicine and Bioethics, Poznan University of Medical Sciences, 60-812 Poznan, Poland
| |
Collapse
|
17
|
Yilmaz S, Janelsins MC, Flannery M, Culakova E, Wells M, Lin PJ, Loh KP, Epstein R, Kamen C, Kleckner AS, Norton SA, Plumb S, Alberti S, Doyle K, Porto M, Weber M, Dukelow N, Magnuson A, Kehoe LA, Nightingale G, Jensen-Battaglia M, Mustian KM, Mohile SG. Protocol paper: Multi-site, cluster-randomized clinical trial for optimizing functional outcomes of older cancer survivors after chemotherapy. J Geriatr Oncol 2022; 13:892-903. [PMID: 35292232 PMCID: PMC9283231 DOI: 10.1016/j.jgo.2022.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 02/01/2022] [Accepted: 03/04/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Cancer survivors over the age of 65 have unique needs due to the higher prevalence of functional and cognitive impairment, comorbidities, geriatric syndromes, and greater need for social support after chemotherapy. In this study, we will evaluate whether a Geriatric Evaluation and Management-Survivorship (GEMS) intervention improves functional outcomes important to older cancer survivors following chemotherapy. METHODS A cluster-randomized trial will be conducted in approximately 30 community oncology practices affiliated with the University of Rochester Cancer Center (URCC) National Cancer Institute Community Oncology Research Program (NCORP) Research Base. Participating sites will be randomized to the GEMS intervention, which includes Advanced Practice Practitioner (APP)-directed geriatric evaluation and management (GEM), and Survivorship Health Education (SHE) that is combined with Exercise for Cancer Patients (EXCAP©®), or usual care. Cancer survivors will be recruited from community oncology practices (of participating oncology physicians and APPs) after the enrolled clinicians have consented and completed a baseline survey. We will enroll 780 cancer survivors aged 65 years and older who have completed curative-intent chemotherapy for a solid tumor malignancy within four weeks of study enrollment. Cancer survivors will be asked to choose one caregiver to also participate for a total up to 780 caregivers. The primary aim is to compare the effectiveness of GEMS for improving patient-reported physical function at six months. The secondary aim is to compare effectiveness of GEMS for improving patient-reported cognitive function at six months. Tertiary aims include comparing the effectiveness of GEMS for improving: 1) Patient-reported physical function at twelve months; 2) objectively assessed physical function at six and twelve months; and 3) patient-reported cognitive function at twelve months and objectively assessed cognitive function at six and twelve months. Exploratory health care aims include: 1) Survivor satisfaction with care, 2) APP communication with primary care physicians (PCPs), 3) completion of referral appointments, and 4) hospitalizations at six and twelve months. Exploratory caregiver aims include: 1) Caregiver distress; 2) caregiver quality of life; 3) caregiver burden; and 4) satisfaction with patient care at six and twelve months. DISCUSSION If successful, GEMS would be an option for a standardized APP-led survivorship care intervention. TRIAL REGISTRATION ClinicalTrials.govNCT05006482, registered on August 9, 2021.
Collapse
Affiliation(s)
- S Yilmaz
- Division of Supportive Care in Cancer, Department of Surgery, University of Rochester Medical Center School of Medicine and Dentistry, Rochester, NY, USA; Geriatric Oncology Research, James P Wilmot Cancer Institute, University of Rochester Medical Center School of Medicine and Dentistry, Rochester, NY, USA.
| | - M C Janelsins
- Division of Supportive Care in Cancer, Department of Surgery, University of Rochester Medical Center School of Medicine and Dentistry, Rochester, NY, USA
| | - M Flannery
- School of Nursing, University of Rochester Medical Center School of Medicine and Dentistry, Rochester, NY, USA
| | - E Culakova
- Division of Supportive Care in Cancer, Department of Surgery, University of Rochester Medical Center School of Medicine and Dentistry, Rochester, NY, USA
| | - M Wells
- Geriatric Oncology Research, James P Wilmot Cancer Institute, University of Rochester Medical Center School of Medicine and Dentistry, Rochester, NY, USA
| | - P-J Lin
- Division of Supportive Care in Cancer, Department of Surgery, University of Rochester Medical Center School of Medicine and Dentistry, Rochester, NY, USA
| | - K P Loh
- Division of Hematology/Oncology, Department of Medicine, James P Wilmot Cancer Institute, University of Rochester Medical Center School of Medicine and Dentistry, Rochester, NY, USA
| | - R Epstein
- Department of Family Medicine Research, University of Rochester Medical Center School of Medicine and Dentistry, Rochester, NY, USA
| | - C Kamen
- Division of Supportive Care in Cancer, Department of Surgery, University of Rochester Medical Center School of Medicine and Dentistry, Rochester, NY, USA
| | - A S Kleckner
- Department of Pain and Translational Symptom Science, University of Maryland School of Nursing, Baltimore, MD, USA
| | - S A Norton
- School of Nursing, University of Rochester Medical Center School of Medicine and Dentistry, Rochester, NY, USA
| | - S Plumb
- Geriatric Oncology Research, James P Wilmot Cancer Institute, University of Rochester Medical Center School of Medicine and Dentistry, Rochester, NY, USA
| | - S Alberti
- Division of Supportive Care in Cancer, Department of Surgery, University of Rochester Medical Center School of Medicine and Dentistry, Rochester, NY, USA
| | - K Doyle
- Division of Supportive Care in Cancer, Department of Surgery, University of Rochester Medical Center School of Medicine and Dentistry, Rochester, NY, USA
| | - M Porto
- Division of Supportive Care in Cancer, Department of Surgery, University of Rochester Medical Center School of Medicine and Dentistry, Rochester, NY, USA
| | - M Weber
- Department of Neurology, University of Rochester Medical Center School of Medicine and Dentistry, Rochester, NY, USA
| | - N Dukelow
- Department of Medicine, Physical Medicine and Rehabilitation, University of Rochester Medical Center School of Medicine and Dentistry, Rochester, NY, USA
| | - A Magnuson
- Division of Hematology/Oncology, Department of Medicine, James P Wilmot Cancer Institute, University of Rochester Medical Center School of Medicine and Dentistry, Rochester, NY, USA
| | - L A Kehoe
- Division of Supportive Care in Cancer, Department of Surgery, University of Rochester Medical Center School of Medicine and Dentistry, Rochester, NY, USA
| | - G Nightingale
- Department of Pharmacy Practice, Jefferson College of Pharmacy, Thomas Jefferson University, Philadelphia, PA, USA
| | - M Jensen-Battaglia
- Geriatric Oncology Research, James P Wilmot Cancer Institute, University of Rochester Medical Center School of Medicine and Dentistry, Rochester, NY, USA
| | - K M Mustian
- Division of Supportive Care in Cancer, Department of Surgery, University of Rochester Medical Center School of Medicine and Dentistry, Rochester, NY, USA
| | - S G Mohile
- Geriatric Oncology Research, James P Wilmot Cancer Institute, University of Rochester Medical Center School of Medicine and Dentistry, Rochester, NY, USA; Division of Hematology/Oncology, Department of Medicine, James P Wilmot Cancer Institute, University of Rochester Medical Center School of Medicine and Dentistry, Rochester, NY, USA
| |
Collapse
|
18
|
Stehle L, Hoosain M, van Niekerk L. A systematic review of work-related interventions for breast cancer survivors: Potential contribution of occupational therapists. Work 2022; 72:59-73. [DOI: 10.3233/wor-210053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: A high number of breast cancer survivors need to resume work. Therefore, interventions aimed at effective work-related transitions are important. OBJECTIVE: A systematic review to determine what occupational therapy interventions are effective in work-related transitions of breast cancer survivors. METHODS: Multiple databases were searched for studies on work-related interventions within the scope of occupational therapy. Studies were included if 70% or more study participants were working age (> 18 years) breast cancer survivors, and work-related transition outcome measures were used. RESULTS: The search yielded 2 872 articles, of which 12 met the inclusion criteria. When classified according to the International Classification of Function Framework, quantitative sources focussed on Body Structures and Functions component and Multicomponents (consists of the Body Structures and Functions Component and the Activities Component) showed positive effects on improving the work-related transitions of BC survivors, however, the effects were statistically insignificant and the strength of evidence was moderate. Participants in a qualitative source reported that after they underwent a physical exercise programme their work performance improved. A Multicomponents intervention study showed statistically significant improvements on self-reported work-related outcomes of BC survivors. Low evidence was found for implementing a vocational rehabilitation case management programme targeting the Activities component, which showed positive effects in reducing the sick leave days of BC survivors, but the effects were statistically insignificant. No evidence was found for programmes focussed on restoring the Participation component. CONCLUSION: The evidence included in this systematic review were insufficient to recommend occupational therapy interventions that are effective (showing statistically significant improvements) for work-related transitions of BC cancer survivors.
Collapse
Affiliation(s)
- Luna Stehle
- Division of Occupational Therapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Munira Hoosain
- Division of Occupational Therapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Lana van Niekerk
- Division of Occupational Therapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| |
Collapse
|
19
|
Mackenzie L, Marshall K. Effective non-pharmacological interventions for cancer related cognitive impairment in adults (excluding central nervous system or head and neck cancer): systematic review and meta-analysis. Eur J Phys Rehabil Med 2022; 58:258-270. [PMID: 34498828 PMCID: PMC9980504 DOI: 10.23736/s1973-9087.21.06898-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Cancer-related cognitive impairment (CRCI) is prevalent in cancer survivors, and impairments affect daily living tasks and overall wellbeing. This review aimed to identify and evaluate published randomized controlled trials (RCTs) of interventions to manage CRCI in adult populations, to analyze their effectiveness and to investigate the quality of the studies. EVIDENCE ACQUISITION Seven databases were searched (Medline, Scopus, CINAHL, AMED, PsychINFO, OTseeker, and the Cochrane Database of Systematic Reviews), including years 2005-2020, for randomized controlled trials (RCTs) investigating interventions to address cognition for adults with cancer. The final search was conducted in February 2021. The quality of studies was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for RCTs. Meta-analysis used comprehensive meta-analysis software. The study protocol was registered with PROSPERO (registration N. CRD42017076868). EVIDENCE SYNTHESIS A total of 45 studies involving 4727 participants examined interventions for CRCI and met selection criteria. Categories of interventions included cognitive training-based intervention (N.=15), cognitive behavior therapy (CBT) (N.=4), physical activity (N.=16) and other supportive therapies (N.=10). Meta-analysis indicated beneficial overall effects for all categories of interventions: cognitive training (standardized mean difference [SMD]=0.41, 95% CI: 0.28-0.53, I2=88.87%); CBT (SMD=0.30, 95% CI: 0.14-0.46, I2=44.86%); physical activity (SMD=0.27, 95% CI: 0.20-0.35, I2=37.67%); and supportive therapies (SMD=0.27, 95% CI: 0.16-0.39, I2=64.94%). Studies used self-report cognitive outcome measures and neurocognitive testing, or a mixture. CONCLUSIONS Findings suggest that effective intervention for CRCI exist, and cognitive training is consistently supported as an effective intervention; however, a high level of heterogeneity was found. CRCI research is currently dominated by breast cancer survivors, and quality research is also needed to address the broader population of cancer survivors who experience CRCI.
Collapse
Affiliation(s)
- Lynette Mackenzie
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia -
| | - Kelsey Marshall
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| |
Collapse
|
20
|
High-Intensity Interval Training for Reducing Cancer-Related Fatigue in Survivors of Cancer. REHABILITATION ONCOLOGY 2022. [DOI: 10.1097/01.reo.0000000000000288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
21
|
Martin E, Hocking C, Sandham M. The occupational impact of bowel cancer: Survivors' voices and advancing the role of occupational therapy assessment and intervention. Aust Occup Ther J 2021; 69:117-128. [PMID: 34658023 DOI: 10.1111/1440-1630.12773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 09/10/2021] [Accepted: 09/21/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The aim of this study was to investigate the occupational impact (i.e., how engagement in occupation is affected) of having had bowel cancer and the role of occupational therapy with bowel cancer survivors and their significant others. METHODS Two rounds of semi-structured interviews were carried out with individuals who had completed treatment for bowel cancer, with interviews designed to gain insight into their occupational experiences post treatment. Thematic analysis was utilised to construct themes and patterns founded on the perceptions of participants. Analysis involved concurrent data collection and analysis, constant comparative analysis, and iterative analysis. FINDINGS Eighteen participants were interviewed, with occupational impact evident across multiple aspects of everyday life. Four themes were identified: Changes in eating habits, changes in toileting habits, changes in relationships, and rethinking occupational choices. CONCLUSION Findings of the occupational impact of having had bowel cancer reveal a possible role for occupational therapists with people affected by bowel cancer. Occupation focused assessments and self-management programmes are identified as a possible means of meeting the needs of this population, making use of the experiences of peers to provide a credible, relatable voice.
Collapse
Affiliation(s)
- Elizabeth Martin
- Otago Polytechnic, Auckland University of Technology, Auckland, New Zealand
| | - Clare Hocking
- School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Margaret Sandham
- School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| |
Collapse
|
22
|
Taylor S, Keesing S, Wallis A, Russell B, Smith A, Grant R. Occupational therapy intervention for cancer patients following hospital discharge: How and when should we intervene? A systematic review. Aust Occup Ther J 2021; 68:546-562. [PMID: 34533212 DOI: 10.1111/1440-1630.12750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 05/24/2021] [Accepted: 06/05/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Advances in cancer treatment over the last decade have led to increased survival rates. As a result, survivors are living longer with and beyond cancer, often with greater levels of morbidity. Occupational therapists, with their focus on remedial and compensatory strategies to improve function and participation, are well suited to assess and intervene with this population. Despite this, little research exists to demonstrate the efficacy of interventions and value of the occupational therapy role. This systematic review aimed to review how and when occupational therapists provide services for adult patients with cancer and identify where they add the most value. METHODS A systematic search was conducted of six electronic databases. Eligible studies reported on occupational therapy interventions targeting management of cancer symptoms, rehabilitation or environmental modifications for adult cancer patients discharged from acute hospital services. Data extraction and quality assessment were undertaken by two reviewers. Narrative synthesis summarised the attributes and treatment outcomes of each intervention. RESULTS Nine articles were included from a total of 309 articles retrieved. Eight different interventions were reported for people with cancer (n = 531). Small sample sizes and methodological quality precluded any formal analysis; however, intervention components that showed positive results were person-centred, individualised and included regular monitoring and flexibility in care, with input from multidisciplinary health professionals. Therapists also need to reflect upon the optimal duration of interventions and selection of outcome measures that specifically match intervention components. CONCLUSION Despite inconclusive support of any particular type of intervention, this systematic review identified several successful intervention components for occupational therapists working with people with or beyond cancer. Overall, findings suggest that monitored tailored programmes compensating for fluctuations in a patient's condition have efficacy to improve patient outcomes and should be considered when delivering intervention with patients post hospital discharge.
Collapse
Affiliation(s)
- Susan Taylor
- School of Allied Health, Curtin University, Perth, Western Australia, Australia.,Occupational Therapy Department, Perth Children's Hospital, Child and Adolescent Health Service, Perth, Western Australia, Australia.,Occupational Therapy Department, Sir Charles Gairdner Hospital, North Metropolitan Health Service, Perth, Western Australia, Australia
| | - Sharon Keesing
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Amy Wallis
- School of Occupational Therapy, Edith Cowan University, Perth, Western Australia, Australia
| | - Brooke Russell
- Occupational Therapy Department, Sir Charles Gairdner Hospital, North Metropolitan Health Service, Perth, Western Australia, Australia
| | - Andrew Smith
- Leukaemia Foundation, Melbourne, Victoria, Australia
| | - Rebecca Grant
- Occupational Therapy Department, Sir Charles Gairdner Hospital, North Metropolitan Health Service, Perth, Western Australia, Australia
| |
Collapse
|
23
|
Morikawa S, Amanat Y. Occupational Therapy's Role with Oncology in the Acute Care Setting: A Descriptive Case Study. Occup Ther Health Care 2021; 36:152-167. [PMID: 34396894 DOI: 10.1080/07380577.2021.1961181] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
As individuals with cancer actively undergo medical treatment, they often experience profound impairments and side-effects that impact their physical and psychosocial functioning and well-being. As occupational therapy practitioners working in acute care, challenges when working with those with oncological diseases may include high acuity, impact on multiple body systems, and fluctuating symptom presentation and levels of function. Thus, it is critical for occupational therapy practitioners to be skilled in identifying and addressing the distinct needs of cancer survivors in the acute care setting. This manuscript presents a descriptive case study to highlight occupational therapy's role in cancer rehabilitation in the acute care setting.
Collapse
Affiliation(s)
- Stacey Morikawa
- USC Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
| | - Yasaman Amanat
- USC Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
| |
Collapse
|
24
|
Dolgoy N, Driga A, Brose JM. The Essential Role of Occupational Therapy to Address Functional Needs of Individuals Living with Advanced Chronic Cancers. Semin Oncol Nurs 2021; 37:151172. [PMID: 34275707 DOI: 10.1016/j.soncn.2021.151172] [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: 11/18/2022]
Abstract
OBJECTIVE Medical progress in cancer care has led to increased life expectancy outcomes across all stages of cancer, including in advanced cancers. People now living with advanced chronic cancers have unique, ongoing functional and quality-of-life needs. This article explores the functional considerations of individuals living with advanced chronic cancers in terms of managing chronic palliative care needs, assessing and intervening for functional issues, and consistently using occupational therapy in shared service provision together with medical and nursing teams. The unique and changing functional needs of these individuals may be effectively addressed through consideration of chronic palliative approaches to care; earlier access to occupational therapy services to facilitate continued engagement in everyday activities; and shared service provision with nursing to address both medical wellness and functional status. DATA SOURCES These include key databases (Pubmed, CINAHL), international guidelines, and professional guidance documents. CONCLUSION Individuals living with advanced chronic cancer have ongoing and fluctuating functional needs that should be addressed in palliative care service provision. The inclusion of occupational therapy as part of inter- and multidisciplinary teams can facilitate maximization of function for individuals living with advanced chronic cancer. IMPLICATIONS FOR NURSING PRACTICE Timely early referrals to occupational therapy can address functional issues as they arise, and can prepare individuals for future functional considerations.
Collapse
Affiliation(s)
- Naomi Dolgoy
- University of Alberta and Canadian Lymphedema Framework, Edmonton, Alb, Canada.
| | - Amy Driga
- Alberta Health Services, Edmonton, Alb, Canada
| | - Julie M Brose
- Research Centre for Palliative Care, Death & Dying, Flinders University, Adelaide, SA, Australia
| |
Collapse
|
25
|
Loubani K, Kizony R, Milman U, Schreuer N. Hybrid Tele and In-Clinic Occupation Based Intervention to Improve Women's Daily Participation after Breast Cancer: A Pilot Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5966. [PMID: 34199448 PMCID: PMC8199623 DOI: 10.3390/ijerph18115966] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 05/30/2021] [Accepted: 05/31/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Women after breast cancer (BC) cope with decreased daily participation and quality of life (QOL) due to physical, cognitive, and emotional symptoms. This study examined a hybrid occupation-based intervention, Managing Participation with Breast Cancer (MaP-BC), to improve daily participation in their meaningful activities. METHODS Thirty-five women after BC phase were randomly allocated to the MaP-BC intervention (n = 18) or control (n = 17) group (standard care only). Assessments were administered at baseline (T1), 6-week (T2), and 12-week (T3) post-T1. MAIN OUTCOME perceived performance and performance-satisfaction with meaningful activities according to the Canadian Occupational Performance Measure. SECONDARY OUTCOMES retained activity levels (Activity Card Sort), QOL (Functional Assessment of Cancer Therapy-Breast), cognitive abilities (Montreal Cognitive Assessment and Behavior Rating Inventory of Executive Function), and upper-extremity functioning (Disability of Arm, Shoulder, Hand). Results showed significant interaction (group x time) effects for the primary outcome in performance, F(2,66) = 29.54, p = 0.001, ɳP2 = 0.472, and satisfaction, F(2,66) = 37.15, p = 0.000, ɳP2 = 0.530. The intervention group improved more in performance, t = 5.51, p = 0.0001, d = 1.298, and satisfaction, t = -5.32, p = 0.0001, d = 1.254, than the control group between T1 and T2. Secondary outcomes demonstrated within-group improvements. CONCLUSION MaP-BC, a comprehensive occupation-based hybrid intervention tailored to women's functional daily needs after BC, improved participation in meaningful activities within a short period.
Collapse
Affiliation(s)
- Khawla Loubani
- Department of Occupational Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Mount Carmel, Haifa 31905, Israel; (R.K.); (N.S.)
- Clalit Health Services, Haifa and Western Galilee, Tel Aviv 62098, Israel;
| | - Rachel Kizony
- Department of Occupational Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Mount Carmel, Haifa 31905, Israel; (R.K.); (N.S.)
- Sheba Medical Center, Department of Occupational Therapy, Tel Hashomer, Ramat Gan 52621, Israel
| | - Uzi Milman
- Clalit Health Services, Haifa and Western Galilee, Tel Aviv 62098, Israel;
| | - Naomi Schreuer
- Department of Occupational Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Mount Carmel, Haifa 31905, Israel; (R.K.); (N.S.)
| |
Collapse
|
26
|
CIUBEAN AD, CIORTEA VM, UNGUR RA, BORDA IM, POPA T, IRSAY L. Role of occupational therapy in rehabilitation of cancer patients. BALNEO AND PRM RESEARCH JOURNAL 2021. [DOI: 10.12680/balneo.2021.434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background. Most adult cancer survivors report a significant decrease of their quality of life and limitations in performing activities of daily living. Occupational therapy is a form of rehabilitation treatment that uses certain techniques and tools aimed at improving functional capacity, improve social participation and overall quality of life. Objective. The overall purpose of this narrative review is to provide a better understanding of the role that occupational therapy can play in the rehabilitation of cancer patients with a focus on the most important cancer-related aspects amenable and manageable by occupational therapy interventions and to increase awareness regarding this form of rehabilitation.
Discussion. Given the fact that there is constant grow in the number of cancer survivors with complex needs, rehabilitation and occupational therapy strategies can increase functionality and health-related quality of life of patients with cancer at any point of the disease, but it remains underused, due to certain barriers.
Conclusions. Occupational therapy, as part of cancer rehabilitation therapy, can lead to improvements in both short and long-term outcomes, while being cost-effective as goals are always set in collaboration with the patients and are aimed to identify and improve the activities most important and relevant for them.
Keywords: occupational therapy, cancer, rehabilitation, activities of daily living, quality of life,
Collapse
Affiliation(s)
- Alina Deniza CIUBEAN
- 1. Department of Rehabilitation, University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj-Napoca, Romania
| | - Viorela Mihaela CIORTEA
- 1. Department of Rehabilitation, University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj-Napoca, Romania 2. Department of Rehabilitation, Clinical Rehabilitation Hospital, Cluj-Napoca, Romania
| | - Rodica Ana UNGUR
- 1. Department of Rehabilitation, University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj-Napoca, Romania 2. Department of Rehabilitation, Clinical Rehabilitation Hospital, Cluj-Napoca, Romania
| | | | - Theodor POPA
- 2. Department of Rehabilitation, Clinical Rehabilitation Hospital, Cluj-Napoca, Romania
| | - Laszlo IRSAY
- 1. Department of Rehabilitation, University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj-Napoca, Romania 2. Department of Rehabilitation, Clinical Rehabilitation Hospital, Cluj-Napoca, Romania
| |
Collapse
|
27
|
Wheatley T, Desrosiers M, Specchierla D, Lynn EK, Jackson S. Increased Mobility and Fall Reduction: An Interdisciplinary Approach on a Hematology-Oncology and Stem Cell Transplantation Unit. Clin J Oncol Nurs 2021; 25:329-332. [PMID: 34019032 DOI: 10.1188/21.cjon.329-332] [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
Patients in the hematology-oncology and stem cell transplantation (SCT) setting are at high risk for functional decline and falls related to prolonged hospitalizations and inactivity during inpatient treatment. After underperforming on the Press Ganey National Database of Nursing Quality Indicators benchmark for falls in 2018, staff on a hematology-oncology and SCT unit implemented a practical and evidence-based fall prevention program. Fall rates from 2018 to 2019 ranged from 3.4 to 4.8 falls per 1,000 patient days. After the introduction of the unit-based gym program, early mobility increased and falls decreased to 2.57 per 1,000 patient days.
Collapse
|
28
|
Williamson HJ, Armin JS, Stakely E, Nasimi B, Joseph DH, Meyers J, Baldwin JA. Community-Engaged Research to Address Health Disparities of Indigenous Women With Disabilities. ANNALS OF INTERNATIONAL OCCUPATIONAL THERAPY 2021; 4:e158-e165. [PMID: 34676309 PMCID: PMC8528383 DOI: 10.3928/24761222-20201202-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION To address health disparities among underserved populations, occupational therapists can participate in community-engaged research and practice to improve access to preventive health services. METHODS This study used grounded theory and participant observation approaches to identify lessons learned from a community-engaged research project to improve cancer screening rates for Indigenous women with an intellectual and/or developmental disability (IDD). Audio recordings of meetings with a community advisory board (AB) were analyzed with an inductive coding approach, and results were member checked with AB members. The AB members (N = 8) were involved in statewide Indigenous health, cancer, and disability activities. Six of the eight AB members identified as Indigenous. RESULTS Key themes highlighted within the Indigenous research framework included reflection, relationship building, project planning, and project execution. Results of this phase of the research project highlight the importance of codesigning research projects with Indigenous communities. CONCLUSION The findings have limited transferability to other research contexts. However, this study highlights the need for future research on best practices for occupational therapists to participate in community-engaged research projects to address health disparities in underserved populations, such as Indigenous women with IDD.
Collapse
|
29
|
Nightingale G, Battisti NML, Loh KP, Puts M, Kenis C, Goldberg A, Haase KR, Krok-Schoen J, Liposits G, Sattar S, Stolz-Baskett P, Pergolotti M. Perspectives on functional status in older adults with cancer: An interprofessional report from the International Society of Geriatric Oncology (SIOG) nursing and allied health interest group and young SIOG. J Geriatr Oncol 2021; 12:658-665. [PMID: 33172805 PMCID: PMC8102651 DOI: 10.1016/j.jgo.2020.10.018] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 08/17/2020] [Accepted: 10/27/2020] [Indexed: 12/18/2022]
Abstract
Most adults with cancer are over 65 years of age, and this cohort is expected to grow exponentially. Older adults have an increased burden of comorbidities and risk of experiencing adverse events on anticancer treatments, including functional decline. Functional impairment is a predictor of increased risk of chemotherapy toxicity and shorter survival in this population. Healthcare professionals caring for older adults with cancer should be familiar with the concept of functional status and its implications because of the significant interplay between function, cancer, anticancer treatments, and patient-reported outcomes. In this narrative review, we provide an overview of functional status among older patients with cancer including predictors, screening, and assessment tools. We also discuss the impact of functional impairment on patient outcomes, and describe the role of individual members of an interprofessional team in addressing functional impairment in this population, including the use of a collaborative approach aiming to preserve function.
Collapse
Affiliation(s)
- Ginah Nightingale
- Department of Pharmacy Practice, Jefferson College of Pharmacy, Thomas Jefferson University, Philadelphia, PA, USA.
| | - Nicolò Matteo Luca Battisti
- Breast Unit, Department of Medicine, The Royal Marsden NHS Foundation Trust, Sutton, Surrey SM1 2JP, United Kingdom; Breast Cancer Research Division, The Institute of Cancer Research, London SM2 5NG, United Kingdom
| | - Kah Poh Loh
- James P Wilmot Cancer Institute, Division of Hematology/Oncology, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Martine Puts
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON M5T 1P8, Canada
| | - Cindy Kenis
- Department of General Medical Oncology and Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Annette Goldberg
- Department of Nutrition, Dana Farber Cancer Institute, Boston, MA, USA
| | - Kristen R Haase
- School of Nursing, University of British Columbia, Wesbrook Mall, Vancouver, British Columbia, Canada
| | - Jessica Krok-Schoen
- School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Gábor Liposits
- Department of Oncology, Regional Hospital West Jutland, Herning, Denmark
| | - Schroder Sattar
- College of Nursing, University of Saskatchewan, Saskatoon, Canada
| | - Petra Stolz-Baskett
- Oncology Service, Nelson Hospital Nelson Marlborough Health, Nelson 7048, New Zealand
| | - Mackenzi Pergolotti
- ReVital Cancer Rehabilitation, Select Medical; Colorado State University, Fort Collins, CO, USA
| |
Collapse
|
30
|
Leisure and Productivity in Older Adults with Cancer: A Systematic Review. Occup Ther Int 2021; 2021:8886193. [PMID: 33880113 PMCID: PMC8041549 DOI: 10.1155/2021/8886193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 03/13/2021] [Accepted: 03/20/2021] [Indexed: 01/11/2023] Open
Abstract
Introduction Self-care, leisure, and productivity are important occupational domains for older adults' quality of life, which might be affected by cancer and its treatment. A great number of publications about older adults focus on function or self-care, so we aimed to analyse how cancer and its treatments affect leisure and productivity. Secondary objectives were to identify whether particular clinical and/or sociodemographic factors were associated with occupational disruptions and to assess the impact of rehabilitation approaches on leisure and productivity in this population. Methods A systematic review of the 2009-2019 literature performed on Medline, Embase, and the Cochrane Central Register of Controlled Trials. Results 1471 publications were retrieved: 48 full texts were assessed; seven of these (four cross-sectional studies, two cohort studies, and a case report) were reviewed, including data on 16668 people (12649 healthy controls, 3918 cancer survivors, and 101 ill patients). Older adults with comorbidities and a low level of activity before cancer diagnosis may be more at risk of occupational disruptions. However, studies focused more on physical activity than leisure and productivity. Two studies mentioned occupational therapy. Discussion. As cancer can become a chronic disease, it appears important to also offer occupation-centred assessments and follow-up. Conclusion An occupation-centred approach could be developed; its effectiveness must be assessed.
Collapse
|
31
|
Navarrete-Reyes AP, Animas-Mijangos K, Gómez-Camacho J, Juárez-Carrillo Y, Torres-Pérez AC, Cataneo-Piña DJ, Negrete-Najar JP, Soto-Perez-de-Celis E. Geriatric principles for patients with cancer. GERIATRICS, GERONTOLOGY AND AGING 2021. [DOI: 10.5327/z2447-212320212100009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Cancer is primarily a disease of older persons. Given the heterogeneity of aging, physiological age, rather than chronological age, better expresses the cumulative effect of environmental, medical, and psychosocial stressors, which modifies life expectancy. Comprehensive geriatric assessment, a tool that helps ascertain the physiological age of older individuals, is the gold standard for assessing older adults with cancer. Several international organizations recommend using the geriatric assessment domains to identify unrecognized health problems that can interfere with treatment and predict adverse health-related outcomes, aiding complex treatment decision making. More recently, it has been shown that geriatric assessment-guided interventions improve quality of life and mitigate treatment toxicity without compromising survival. In this review, we discuss the role of comprehensive geriatric assessment in cancer care for older adults and provide the reader with useful information to assess potential treatment risks and benefits, anticipate complications, and plan interventions to better care for older people with cancer.
Collapse
|
32
|
Schubert M. Besonderheiten der onkologischen Rehabilitation älterer Patienten. FORUM 2020; 35:460-464. [DOI: 10.1007/s12312-020-00847-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
|
33
|
Dolgoy ND, O'Krafka P, McNeely ML. Cancer-related fatigue in head and neck cancer survivors: Energy and functional impacts. Cancer Treat Res Commun 2020; 25:100244. [PMID: 33254042 DOI: 10.1016/j.ctarc.2020.100244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 11/01/2020] [Accepted: 11/20/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Survivors with head and neck cancer (HNC) report cancer-related fatigue (CRF) as a devastating, prevalent health issue that limits activity engagement and adversely influences quality of life. OBJECTIVE To explore HNC survivors' written responses and descriptors regarding CRF, and offer potential healthcare strategies based on findings. METHODOLOGY In written format, similar to responses on intake forms in outpatient-clinics, 25 HNC survivors provided descriptions of their CRF experiences and their perspectives on its impact. An exploratory descriptive research design was utilized, drawing on social theory for content analysis and thematic development. RESULTS Two main themes regarding CRF arose from the data: (1) CRF as a barrier to daily function; and (2) uncontrollable and unpredictable energy fluctuations. CONCLUSIONS To enhance outcomes of CRF symptom management in HNC survivors, a healthcare approach that targets the functional implications of CRF, and utilizes energy cultivation strategies when communicating about the negative impacts of CRF (including limited function and fluctuating energy levels) may be beneficial for HNC survivors. Further research into the effects of CRF on function for HNC survivors is warranted.
Collapse
Affiliation(s)
- Naomi D Dolgoy
- University of Alberta, 250 Corbett Hall, Edmonton, AB, T6G 2G4, Canada.
| | - Patricia O'Krafka
- Alberta Health Services, Alberta Children's Hospital 2888 Shaganappi Trail, Calgary, AB, T3B 6A9, Canada
| | - Margaret L McNeely
- University of Alberta and Cross Cancer Institute, 250 Corbett Hall University of Alberta, Edmonton, AB, T6G 2G4, Canada
| |
Collapse
|
34
|
Mackenzie L. Defining the role of occupational therapy with people living with and beyond cancer: Perspectives of British and Irish occupational therapists. Br J Occup Ther 2020. [DOI: 10.1177/0308022620963746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction More people are surviving cancer treatment and face challenges in everyday life. Occupational therapists may often interact with people living with and beyond cancer. This study aimed to identify the perspectives of United Kingdom and Irish occupational therapists about their views on the role of occupational therapy with people living with and beyond cancer. Method A cross-sectional online survey was distributed via the United Kingdom and Irish occupational therapy professional associations, social media invitations and snowball sampling. Data were analysed using descriptive statistics. Results A total of 141 occupational therapists (56.6% from Ireland and 43.4% from the United Kingdom) responded; however, some did not answer every question. The largest group were those who worked in publicly funded community service settings: National Health Service, Health Service Executive in Ireland and social care ( n = 49, 33.8%), or publicly funded hospitals ( n = 45, 31.0%), and 40% ( n = 54) frequently worked with people living with and beyond cancer. Participants rated the most common interventions used, therapeutic gaps, barriers to best practice in survivorship care and opinions about further education needed. Conclusion Participants agreed that the occupational therapy role with people living with and beyond cancer was under-developed. The study identified gaps in best practice that need to be addressed to accommodate the predicted growth in numbers of people living with and beyond cancer.
Collapse
Affiliation(s)
- Lynette Mackenzie
- Discipline of Occupational Therapy, The University of Sydney, Australia
| |
Collapse
|
35
|
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.
Collapse
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
| |
Collapse
|
36
|
Pergolotti M, Bailliard A, McCarthy L, Farley E, Covington KR, Doll KM. Women's Experiences After Ovarian Cancer Surgery: Distress, Uncertainty, and the Need for Occupational Therapy. Am J Occup Ther 2020; 74:7403205140p1-7403205140p9. [PMID: 32365320 PMCID: PMC7198238 DOI: 10.5014/ajot.2020.036897] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
IMPORTANCE Despite the growing literature on the association of functional, physical, and quality-of-life (QOL) deficits with poor postoperative outcomes, there is a gap in the literature identifying women's occupational performance needs after ovarian cancer surgery. OBJECTIVE To describe the experiences of women hospitalized after ovarian cancer surgery to identify potential areas for intervention. Goals were to (1) identify functional needs and limitations at time of discharge as measured by the typical acute care occupational therapy evaluation and semistructured interview and (2) understand the women's perspectives of their needs for occupational therapy and a safe return to home. DESIGN Single-arm, cross-sectional descriptive study. Mixed-methods data collection and analysis. SETTING Academic cancer center. PARTICIPANTS Women with ovarian cancer (N = 11) who had completed surgery. INTERVENTION Semistructured interviews and patient-reported outcome measures (PROMs) completed postsurgery. OUTCOMES AND MEASURES PROMs included the National Comprehensive Cancer Network (NCCN) Distress Thermometer and Problem List, the PROMIS® Global Physical Health (GPH) and Global Mental Health (GMH) scales, and the Possibilities for Activity Scale-Women (PActS-W). RESULTS The mean NCCN Distress score was 6.0 (standard deviation [SD] = 3.1, with the top three concerns being pain (80%), worry (80%), and fatigue (78%). Mean GPH and GMH T scores were 38.0 (SD = 8.8) and 48.2 (SD = 8.4), respectively. Women scored a mean of 39.2 (SD = 11.2, range = 26-58) on the PActS-W. Thematic analyses found that the women were uncertain about potential functional limitations and significantly distressed. CONCLUSION AND RELEVANCE Women with ovarian cancer experienced high levels of uncertainty and distress after surgery. Integrating in-home or community-based occupational therapy into routine care could decrease functional distress and uncertainty and help women manage concerns related to pain, worry, and fatigue. WHAT THIS ARTICLE ADDS This study suggests that occupational therapy evaluation and intervention are needed to decrease distress and improve QOL of women upon discharge after ovarian cancer surgery.
Collapse
Affiliation(s)
- Mackenzi Pergolotti
- Mackenzi Pergolotti, PhD, OTR/L, is Director of Research, ReVital Cancer Rehabilitation, Mechanicsburg, PA. At the time of the study, she was Postdoctoral Fellow, Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill;
| | - Antoine Bailliard
- Antoine Bailliard, PhD, OTR/L, is Associate Professor, Department of Occupational Therapy, University of North Carolina at Chapel Hill
| | - Lauren McCarthy
- Lauren McCarthy, MS, OTR/L, is Occupational Therapist, Duke University Health System, Durham, NC. At the time of the study, she was Research Assistant, Department of Occupational Therapy, University of North Carolina at Chapel Hill
| | - Erica Farley
- Erica Farley, MS, OTR/L, is Occupational Therapist, Teton Therapy, Cheyenne, WY. At the time of the study, she was Research Assistant, Department of Occupational Therapy, College of Health and Human Services, Colorado State University, Fort Collins
| | - Kelley R Covington
- Kelley R. Covington, MS, is Research and Education Manager, ReVital Cancer Rehabilitation, Mechanicsburg, PA. At the time of the study, she was Research Assistant, Department of Occupational Therapy, College of Health and Human Services, Colorado State University, Fort Collins
| | - Kemi M Doll
- Kemi M. Doll, MD, MSCR, is Assistant Professor, Department of Obstetrics and Gynecology, University of Washington, Seattle. At the time of the study, she was Postdoctoral Fellow, Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
| |
Collapse
|
37
|
Hong I, Hreha K, Swartz MC, Pappadis MR, Yoo K, Ko M. Differences in physical function across cancer recovery phases: Findings from the 2015 National Health Interview Survey. Br J Occup Ther 2020; 84:135-143. [PMID: 33879954 DOI: 10.1177/0308022620944071] [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: 11/16/2022]
Abstract
Introduction Recent cancer survivors (<2 years post-diagnosis) report poorer general health and physical weakness compared to long-term cancer survivors (≥2 years post-diagnosis), but differences in functional limitations are unknown. It is unclear which daily tasks are more difficult for recent versus long-term survivors. We aimed to examine differences in functional performances across cancer recovery phases as potential targets for functional impairment screening. Method The cohort consisted of adults with a cancer history in the 2015 National Health Interview Survey (n=2372). Multivariate logistic regression models were used to estimate the odds of having difficulty in health-related outcomes across the cancer recovery phases (recent versus long-term). Results Most subjects were long-term survivors (84.9%). Recent survivors were more likely to have difficulty in work, mobility-related daily tasks and social participation compared to long-term survivors. No differences were found in basic activities of daily living, cognition and emotional functioning between the groups. Conclusion While recent cancer survivors were independent in basic daily tasks, they had difficulties in performing daily tasks that required a high level of physical function. Clinicians, especially occupational therapists, should prioritize evaluating physical functioning to guide intervention planning for recent cancer survivors.
Collapse
Affiliation(s)
- Ickpyo Hong
- Department of Occupational Therapy, Yonsei University, Wonju, Gangwon-do, Republic of Korea
| | - Kimberly Hreha
- Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, TX, USA
| | - Maria Chang Swartz
- Department of Pediatrics-Research, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Monique R Pappadis
- Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, TX, USA
| | - Kyungtae Yoo
- Department of Physical Therapy, Namseoul University, Cheonan, Chungcheongnam-do, Republic of Korea
| | - Mansoo Ko
- Department of Physical Therapy, University of Texas Medical Branch, Galveston, TX, USA
| |
Collapse
|
38
|
Yang J, Choi M, Choi J, Kang M, Jo A, Chung SH, Sim SH, Kim YJ, Yang EJ, Yu SY. Supervised Physical Rehabilitation in the Treatment of Patients with Advanced Cancer: a Systematic Review and Meta-analysis. J Korean Med Sci 2020; 35:e242. [PMID: 32715671 PMCID: PMC7384905 DOI: 10.3346/jkms.2020.35.e242] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 06/01/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND As the survival rate of cancer patients increases, the clinical importance of rehabilitation provided by healthcare professionals also increases. However, the evidence supporting the relevance of rehabilitation programs is insufficient. This study aimed to review the literature on effectiveness in physical function, quality of life (QOL) or fatigue of supervised physical rehabilitation in patients with advanced cancer. METHODS A systematic review and meta-analysis was conducted following the Cochrane guidelines. We narratively described the results when meta-analysis was not applicable or appropriate. Literature databases including Ovid-MEDLINE, Ovid-EMBASE, and the Cochrane Library, as well as several Korean domestic databases, were searched up to June 2017 for studies that investigated the effectiveness of supervised physical rehabilitation programs on physical function, QOL or fatigue in patients with advanced cancer. The quality of the selected studies was evaluated independently by paired reviewers. RESULTS Eleven studies with 922 participants were finally selected among 2,459 articles. The meta-analysis revealed that after physical exercise, the physical activity level and strength of patients with advanced cancer increased significantly. The QOL showed a statistically significant improvement after physical rehabilitation according to the European Organization for Research and Treatment of Cancer version C30. Though some of measurements about cardiovascular endurance or strength in several studies were not able to be synthesized, each study reported that they were significantly improved after receiving rehabilitation. CONCLUSION Supervised physical rehabilitation for patients with advanced cancer is effective in improving physical activity, strength, and QOL. However, more trials are needed to prove the effectiveness of supervised exercise and to strengthen the evidence.
Collapse
Affiliation(s)
- Jangmi Yang
- National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
| | - Miyoung Choi
- National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
| | - JinA Choi
- National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
| | - Minjoo Kang
- National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
| | - AeJung Jo
- National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
| | - Seung Hyun Chung
- Department of Physical Medicine and Rehabilitation, National Cancer Center, Goyang, Korea
| | - Sung Hoon Sim
- Department of Physical Medicine and Rehabilitation, National Cancer Center, Goyang, Korea
| | - Yu Jung Kim
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Eun Joo Yang
- National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
| | - Su Yeon Yu
- National Evidence-based Healthcare Collaborating Agency, Seoul, Korea.
| |
Collapse
|
39
|
Mahumud RA, Alam K, Dunn J, Gow J. The changing relationship between health burden and work disability of Australian cancer survivors, 2003-2017: evidence from a longitudinal survey. BMC Public Health 2020; 20:548. [PMID: 32321481 PMCID: PMC7178584 DOI: 10.1186/s12889-020-08710-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 04/15/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The purpose of this study was to examine the relationship between the cancer health burden and themagnitude of work disability on cancer survivors in Australia from 2003 to 2017. METHODS A longitudinal prospective study design was undertaken among cancer patients using data from the Household, Income and Labour Dynamics in Australia survey. The longitudinal effect was captured using a fixed effect multinomial logistic regression model, which predicted changes in the relationship between cancer burden and work disability level controlling for socio-demographic, lifestyle and life conditions predictors. RESULTS The prevalence of long-term disability among cancer survivors was 50%, with 18% of patients experiencing extreme work disability. The magnitude of disability levels increased significantly with the level of health burden. Cancer survivors who faced a severe health burden were at 5.32 times significantly higher risk of having work disability compared with patients who had no health burden. Other potential predictors, such as older patients (relative risk ratio, RRR = 1.82; 95% CI: 1.57, 5.87), those engaged in lower levels of physical activities (RRR = 1.91; 95% CI: 1.07, 3.40), those who drink alcohol (RRR = 1.29; 95% CI: 1.15, 1.49), and poor socioeconomic status (RRR = 1.28; 95% CI: 1.16, 2.23) were all significantly associated with extreme work disability. CONCLUSION A substantial proportion of cancer survivors experienced work disability which was more pronounced with the magnitude of the cancer health burden. The different dimensions of disability might be prevented by introducing cancer survivor-specific evidence-based interventions, and incorporating comprehensive social support. Recommendations to improve public health policy aimed at reducing population-level unhealthy lifestyle behaviours include: using these findings to better outline the management of a sequelae course of treatment for cancer survivors; and identifying those who should undergo more intensive physical rehabilitation aimed at reducing their work disability level.
Collapse
Affiliation(s)
- Rashidul Alam Mahumud
- Health Economics and Policy Research, Centre for Health Research, Faculty of Business, Education, Law and Arts, University of Southern Queensland, Toowoomba, Queensla, nd-4350, Australia. .,School of Commerce, University of Southern Queensland, Toowoomba, QLD-4350, Australia. .,School of Social Sciences, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia. .,Health Economics Research, Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, 1212, Bangladesh. .,Department of Rajshahi, Health and Epidemiology Research, Rajshahi, 6205, Bangladesh.
| | - Khorshed Alam
- Health Economics and Policy Research, Centre for Health Research, Faculty of Business, Education, Law and Arts, University of Southern Queensland, Toowoomba, Queensla, nd-4350, Australia.,School of Commerce, University of Southern Queensland, Toowoomba, QLD-4350, Australia
| | - Jeff Dunn
- Health Economics and Policy Research, Centre for Health Research, Faculty of Business, Education, Law and Arts, University of Southern Queensland, Toowoomba, Queensla, nd-4350, Australia.,Cancer Research Centre, Cancer Council Queensland, Fortitude Valley, Queensland, QLD, 4006, Australia.,Prostate Cancer Foundation of Australia, St Leonards, NSW, 2065, Australia
| | - Jeff Gow
- Health Economics and Policy Research, Centre for Health Research, Faculty of Business, Education, Law and Arts, University of Southern Queensland, Toowoomba, Queensla, nd-4350, Australia.,School of Commerce, University of Southern Queensland, Toowoomba, QLD-4350, Australia.,School of Accounting, Economics and Finance, University of KwaZulu-Natal, Durban, 4000, South Africa
| |
Collapse
|
40
|
Lindahl-Jacobsen LE, la Cour K, Gregersen Oestergaard L, Sampedro Pilegaard M, Peoples H, Brandt Å. The development of the 'Cancer Home-Life Intervention': An occupational therapy-based intervention programme for people with advanced cancer living at home. Scand J Occup Ther 2020; 28:542-552. [PMID: 32255714 DOI: 10.1080/11038128.2020.1735514] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Occupational therapy-based interventions may help people with advanced cancer to live actively despite their illness. However, there is limited evidence concerning what kinds of content intervention should encompass, and how this should be done. OBJECTIVE To describe the development and content of an occupational therapy-based intervention programme for people with advanced cancer living at home. MATERIAL AND METHODS In the development of the intervention, an evidence synthesis was performed based on a systematic literature search, data from a cross-sectional study, and experiences from an expert panel. RESULTS The programme contains six components: 1) An initial interview to select which of the other five components to address, based on the participants' individual needs. The interview addressed problems and needs of participants in relation to prioritized activities, in order to tailor the following components: 2) prioritisation of resources, energy and everyday activities; 3) adaptation of activities; 4) adaptation of posture and seating; 5) provision of assistive technology; and, 6) modification of the physical home environment. CONCLUSION An occupational therapy-based intervention programme for people with advanced cancer living at home has been developed. The study generates knowledge and insights relevant to improving the treatment of this patient group.
Collapse
Affiliation(s)
- Line Elisabeth Lindahl-Jacobsen
- Centre for Nutrition and Rehabilitation, University College Absalon, Naestved, Denmark.,The Research Initiative of Activity Studies and Occupational Therapy, Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense C, Denmark
| | - Karen la Cour
- The Research Initiative of Activity Studies and Occupational Therapy, Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense C, Denmark.,REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark
| | - Lisa Gregersen Oestergaard
- The Research Initiative of Activity Studies and Occupational Therapy, Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense C, Denmark.,Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus N, Denmark.,Centre of Research in Rehabilitation (CORIR), Aarhus University Hospital and Aarhus University, Aarhus, Denmark.,Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Marc Sampedro Pilegaard
- The Research Initiative of Activity Studies and Occupational Therapy, Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense C, Denmark.,REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark
| | - Hanne Peoples
- The Research Initiative of Activity Studies and Occupational Therapy, Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense C, Denmark.,Faculty of Health Sciences, Health Sciences Research Center, University College Lillebaelt, Odense M, Denmark
| | - Åse Brandt
- The Research Initiative of Activity Studies and Occupational Therapy, Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense C, Denmark.,The National Board of Social Services, Odense C, Denmark
| |
Collapse
|
41
|
Integrating Nurses and Allied Health Professionals in the care of older adults with cancer: A report from the International Society of Geriatric Oncology Nursing and Allied Health Interest Group. J Geriatr Oncol 2020; 11:187-190. [DOI: 10.1016/j.jgo.2019.06.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 05/30/2019] [Accepted: 06/19/2019] [Indexed: 12/24/2022]
|
42
|
Rijpkema C, Duijts SFA, Stuiver MM. Reasons for and outcome of occupational therapy consultation and treatment in the context of multidisciplinary cancer rehabilitation; a historical cohort study. Aust Occup Ther J 2020; 67:260-268. [PMID: 32056221 DOI: 10.1111/1440-1630.12649] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 01/09/2020] [Accepted: 01/15/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The aim of this study was to investigate reasons why people consulted an occupational therapist following cancer treatment, and to examine the outcome of occupational therapy interventions, in the context of multidisciplinary rehabilitation. METHODS Data from 181 patients were collected retrospectively. The International Classification of Human Functioning and Health (ICF) was used to describe the reasons for occupational therapy consultation. Patients had completed the Canadian Occupational Performance Measurement (COPM) before and after the occupational therapy intervention. Change scores were calculated with a 95% confidence interval and a two-sided p-value obtained from a paired t-test. RESULTS The reasons for occupational therapy consultation were predominantly within the ICF domain "Activities and Participation". On average, patients improved 3.0 points (95% CI 2.8-3.2) on the performance scale of the COPM, and 3.4 points (95% CI 3.2-3.7) on the satisfaction scale (both: p = <.001). CONCLUSION The result of this study supports the added value of occupational therapy to cancer rehabilitation, and emphasise the positive effect of occupational therapy on everyday functioning. Controlled clinical studies are needed to strengthen the evidence.
Collapse
Affiliation(s)
- Corine Rijpkema
- Centre for Quality of Life, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Saskia F A Duijts
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands.,Department of Public and Occupational Health, Amsterdam Public Health research institute, UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Martijn M Stuiver
- Centre for Quality of Life, Netherlands Cancer Institute, Amsterdam, the Netherlands.,Center of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
| |
Collapse
|
43
|
Loh SY, Sapihis M, Danaee M, Chua YP. The role of occupational-participation, meaningful-activity and quality-of-life of colorectal cancer survivors: findings from path-modelling. Disabil Rehabil 2020; 43:2729-2738. [DOI: 10.1080/09638288.2020.1715492] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Siew Yim Loh
- Department of Rehabilitation Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Musaropah Sapihis
- Allied Health Sciences College, Sungai Buluh, Ministry of Health, Kuala Lumpur, Malaysia
| | - Mahmoud Danaee
- Department of Social Preventive Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Yan Piaw Chua
- Institute of Educational Leadership, Faculty of Education, University of Malaya, Kuala Lumpur, Malaysia
| |
Collapse
|
44
|
Wallis A, Meredith P, Stanley M. Cancer care and occupational therapy: A scoping review. Aust Occup Ther J 2020; 67:172-194. [PMID: 31957031 DOI: 10.1111/1440-1630.12633] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2019] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Cancer can disrupt participation in everyday activities, suggesting a place for occupational therapy; however, there is a need to articulate the nature, scope and available evidence supporting the occupational therapy role within cancer care. In this scoping review, we identify the breadth of practice and evidence for occupational therapy in cancer care, across all stages of the disease trajectory (diagnosis to palliation/survivorship) throughout the lifespan. METHODS Five electronic databases were searched in June 2018, for English language articles. Key words were: cancer care, OR oncolog*, OR oncologic care, OR neoplasms, OR cancer survivors, OR terminal cancer, OR cancer rehabilitation, AND occupational therap*. No date restrictions were imposed. Included were: all styles of literature including grey literature, all types of cancers and all age brackets. There were no restrictions on place of origin of papers. Following the Arksey and O'Malley (2006; International Journal of Social Research Methodology, 8: 19-32) framework for scoping reviews, the first author screened titles and abstracts, and all three authors reviewed sets of the included articles. Conflicts were discussed until consensus was reached. RESULTS After evaluating 305 titles and abstracts and 111 full-text articles, 89 papers were retained. Articles included research studies (n = 43), reviews (n = 15), grey literature (n = 16), practice analyses (n = 14) and an editorial (n = 1). The occupational therapy roles described were diverse, but largely descriptive in nature, with little evidence of outcomes from treatment. Furthermore, the majority of papers addressed adult populations, with few considering children, adolescents or young adults. Most papers focused on specific stages of the disease, and none addressed the disease along its full trajectory. CONCLUSION Despite identifying a diverse range of occupational therapy roles in cancer care throughout the disease trajectory and across the lifespan, the need for professional discourse and research within our profession was highlighted. This was particularly evident for adolescents and young adults with cancer.
Collapse
Affiliation(s)
- Amy Wallis
- School of Medical and Health Sciences, Edith Cowan University.,School of Health, Medical and Applied Sciences, Central Queensland University
| | - Pamela Meredith
- School of Health, Medical and Applied Sciences, Central Queensland University
| | - Mandy Stanley
- School of Medical and Health Sciences, Edith Cowan University
| |
Collapse
|
45
|
Raj VS, Pugh TM, Yaguda SI, Mitchell CH, Mullan SS, Garces NS. The Who, What, Why, When, Where, and How of Team-Based Interdisciplinary Cancer Rehabilitation. Semin Oncol Nurs 2020; 36:150974. [PMID: 31955923 DOI: 10.1016/j.soncn.2019.150974] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To review the key components necessary for successful application of rehabilitation principles to oncology survivors. DATA SOURCES Validated databases, including PubMed, MEDLINE, and Scopus. CONCLUSION Rehabilitation is an essential component of cancer care that addresses functional needs for oncology survivors and is best accomplished via an interdisciplinary team. Interdisciplinary care, provided by nursing, physiatry, rehabilitation therapy, and exercise physiology, are critical components for comprehensive intervention. Challenges exist in implementing services, but opportunity also exists within the post-acute care sector. IMPLICATIONS FOR NURSING PRACTICE Nurses play an important role in the screening, assessment, and treatment of cancer-related functional impairments.
Collapse
Affiliation(s)
- Vishwa S Raj
- Department of Physical Medicine & Rehabilitation, Carolinas Rehabilitation, Charlotte, NC; Department of Supportive Care, Levine Cancer Institute, Charlotte, NC.
| | - Terrence M Pugh
- Department of Physical Medicine & Rehabilitation, Carolinas Rehabilitation, Charlotte, NC; Department of Supportive Care, Levine Cancer Institute, Charlotte, NC
| | - Susan I Yaguda
- Department of Supportive Care, Levine Cancer Institute, Charlotte, NC
| | - Charles H Mitchell
- Department of Physical Medicine & Rehabilitation, Carolinas Rehabilitation, Charlotte, NC; Department of Supportive Care, Levine Cancer Institute, Charlotte, NC
| | - Sarah S Mullan
- Department of Supportive Care, Levine Cancer Institute, Charlotte, NC
| | - Natalie S Garces
- Department of Supportive Care, Levine Cancer Institute, Charlotte, NC
| |
Collapse
|
46
|
Martin E, Hocking C, Sandham M. The impact of surviving bowel cancer on occupation: A scoping review. Br J Occup Ther 2020. [DOI: 10.1177/0308022619891837] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Introduction The number of people surviving bowel cancer is increasing globally, with many of those affected living with long-term psychological and physical sequelae that potentially disrupt occupations. Method A scoping review – guided by Arksey and O’Malley’s methodological framework – was conducted to provide an overview of what is known about the impact of having had bowel cancer on occupations, and to reveal the potential role of occupational therapy. A systematic search of four databases and a grey literature repository generated 244 results. Applying inclusion and exclusion criteria, 33 items addressing bowel cancer and occupations were selected and thematically analysed. Results Researchers have identified six domains of occupation that are impacted by bowel cancer (social activity, physical activity, sexual activity, employment and role functioning, physical functioning, and self-care) but survivors report a distinct lack of health professional support after completion of medical treatment and being left to devise self-management strategies to accommodate the long-term effects of their cancer. Conclusion The sequelae of bowel cancer can have a significant impact on occupational participation. There is scope for increasing and improving occupational therapy input to assist people with cancer-related loss of function to re-engage in valued occupations and improve wellbeing.
Collapse
Affiliation(s)
- Elizabeth Martin
- School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Clare Hocking
- School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Margaret Sandham
- School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| |
Collapse
|
47
|
Abdur Rahman M, Rashid MM, Le Kernec J, Philippe B, Barnes SJ, Fioranelli F, Yang S, Romain O, Abbasi QH, Loukas G, Imran M. A Secure Occupational Therapy Framework for Monitoring Cancer Patients' Quality of Life. SENSORS (BASEL, SWITZERLAND) 2019; 19:E5258. [PMID: 31795384 PMCID: PMC6928807 DOI: 10.3390/s19235258] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 11/07/2019] [Accepted: 11/22/2019] [Indexed: 02/02/2023]
Abstract
Once diagnosed with cancer, a patient goes through a series of diagnosis and tests, which are referred to as "after cancer treatment". Due to the nature of the treatment and side effects, maintaining quality of life (QoL) in the home environment is a challenging task. Sometimes, a cancer patient's situation changes abruptly as the functionality of certain organs deteriorates, which affects their QoL. One way of knowing the physiological functional status of a cancer patient is to design an occupational therapy. In this paper, we propose a blockchain and off-chain-based framework, which will allow multiple medical and ambient intelligent Internet of Things sensors to capture the QoL information from one's home environment and securely share it with their community of interest. Using our proposed framework, both transactional records and multimedia big data can be shared with an oncologist or palliative care unit for real-time decision support. We have also developed blockchain-based data analytics, which will allow a clinician to visualize the immutable history of the patient's data available from an in-home secure monitoring system for a better understanding of a patient's current or historical states. Finally, we will present our current implementation status, which provides significant encouragement for further development.
Collapse
Affiliation(s)
- Md. Abdur Rahman
- Department of Cyber Security and Forensic Computing, College of Computer and Cyber Sciences (C3S), University of Prince Mugrin, Madinah 41499, Saudi Arabia
| | - Md. Mamunur Rashid
- Consumer and Organisational Digital Analytics (CODA) Research Centre, King’s Business School, King’s College, London WC2B 4BG, UK; (M.M.R.); (S.J.B.)
| | - Julien Le Kernec
- James Watt School of Engineering, University of Glasgow, Glasgow G12 8QQ, UK; (J.L.K.); (F.F.); (S.Y.); (Q.H.A.); (M.I.)
- Laboratoire ETIS, Université Paris Seine, Université Cergy-Pontoise, ENSEA, CNRS, UMR8051, 95000 Paris, France;
- School of Information and Communication, University of Electronic, Science, and Technology of China, Chengdu 610000, China
| | - Bruno Philippe
- Pneumology Department, René Dubos Hospital, 95300 Pontoise, France;
| | - Stuart J. Barnes
- Consumer and Organisational Digital Analytics (CODA) Research Centre, King’s Business School, King’s College, London WC2B 4BG, UK; (M.M.R.); (S.J.B.)
| | - Francesco Fioranelli
- James Watt School of Engineering, University of Glasgow, Glasgow G12 8QQ, UK; (J.L.K.); (F.F.); (S.Y.); (Q.H.A.); (M.I.)
| | - Shufan Yang
- James Watt School of Engineering, University of Glasgow, Glasgow G12 8QQ, UK; (J.L.K.); (F.F.); (S.Y.); (Q.H.A.); (M.I.)
| | - Olivier Romain
- Laboratoire ETIS, Université Paris Seine, Université Cergy-Pontoise, ENSEA, CNRS, UMR8051, 95000 Paris, France;
| | - Qammer H. Abbasi
- James Watt School of Engineering, University of Glasgow, Glasgow G12 8QQ, UK; (J.L.K.); (F.F.); (S.Y.); (Q.H.A.); (M.I.)
| | - George Loukas
- Computing and Mathematical Sciences, University of Greenwich, London SE1 09LS, UK;
| | - Muhammad Imran
- James Watt School of Engineering, University of Glasgow, Glasgow G12 8QQ, UK; (J.L.K.); (F.F.); (S.Y.); (Q.H.A.); (M.I.)
| |
Collapse
|
48
|
Andersen BL, Valentine TR, Lo SB, Carbone DP, Presley CJ, Shields PG. Newly diagnosed patients with advanced non-small cell lung cancer: A clinical description of those with moderate to severe depressive symptoms. Lung Cancer 2019; 145:195-204. [PMID: 31806360 DOI: 10.1016/j.lungcan.2019.11.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 11/19/2019] [Accepted: 11/20/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The aims of this observational study were to 1) accrue newly diagnosed patients with advanced-stage non-small cell lung cancer (NSCLC) awaiting the start of first-line treatment and identify those with moderate to severe depressive symptoms and, 2) provide a clinical description of the multiple, co-occurring psychological and behavioral difficulties and physical symptoms that potentially exacerbate and maintain depressive symptoms. MATERIALS AND METHODS Patients with stage IV NSCLC (N = 186) were enrolled in an observational study (ClinicalTrials.gov Identifier: NCT03199651) and completed the American Society of Clinical Oncology-recommended screening measure for depression (Patient Health Questionnaire-9 [PHQ-9]). Individuals with none/mild (n = 119; 64 %), moderate (n = 52; 28 %), and severe (n = 15; 8 %) depressive symptoms were identified. Patients also completed measures of hopelessness, generalized anxiety disorder (GAD) symptoms, stress, illness perceptions, functional status, and symptoms. RESULTS Patients with severe depressive symptoms reported concomitant feelings of hopelessness (elevating risk for suicidal behavior), anxiety symptoms suggestive of GAD, and traumatic, cancer-specific stress. They perceived lung cancer as consequential for their lives and not controllable with treatment. Pain and multiple severe symptoms were present along with substantial functional impairment. Patients with moderate depressive symptoms had generally lower levels of disturbance, though still substantial. The most salient differences were low GAD symptom severity and fewer functional impairments for those with moderate symptoms. CONCLUSIONS Depressive symptoms of moderate to severe levels co-occur in a matrix of clinical levels of anxiety symptoms, traumatic stress, impaired functional status, and pain and other physical symptoms. All of the latter factors have been shown, individually and collectively, to contribute to the maintenance or exacerbation of depressive symptoms. As life-extending targeted and immunotherapy use expands, prompt identification of patients with moderate to severe depressive symptoms, referral for evaluation, and psychological/behavioral treatment are key to maximizing treatment outcomes and quality of life for individuals with advanced NSCLC.
Collapse
Affiliation(s)
- B L Andersen
- Department of Psychology, The Ohio State University, United States.
| | - T R Valentine
- Department of Psychology, The Ohio State University, United States
| | - S B Lo
- Department of Psychology, The Ohio State University, United States
| | - D P Carbone
- Department of Internal Medicine, Division of Medical Oncology, The Ohio State University Comprehensive Cancer Center and The James Cancer Hospital/Solove Research Institute, United States
| | - C J Presley
- Department of Internal Medicine, Division of Medical Oncology, The Ohio State University Comprehensive Cancer Center and The James Cancer Hospital/Solove Research Institute, United States
| | - P G Shields
- Department of Internal Medicine, Division of Medical Oncology, The Ohio State University Comprehensive Cancer Center and The James Cancer Hospital/Solove Research Institute, United States
| |
Collapse
|
49
|
Banks I, Weller D, Ungan M, Selby P, Aapro M, Beishon M, Bolt M, Bonanno F, Champeix C, Dégi C, Eneqvist LJ, Kazmierska J, Kolacinska A, Malas S, Moine S, Pavlic DR, Price R, Walter F, Wyld L. ECCO Essential Requirements for Quality Cancer Care: Primary care. Crit Rev Oncol Hematol 2019; 142:187-199. [PMID: 31445441 DOI: 10.1016/j.critrevonc.2019.07.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 07/03/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND ECCO Essential Requirements for Quality Cancer Care (ERQCC) are checklists and explanations of organisation and actions that are necessary to give high-quality care to cancer patients. They are written by European experts representing all disciplines involved in cancer care. This paper concerns the integration of primary care into care for all cancers in Europe. Primary care integration.
Collapse
Affiliation(s)
- Ian Banks
- European Cancer Organisation Patient Advisory Committee (ECCO PAC); European Men's Health Forum
| | - David Weller
- World Organization of Family Doctors (WONCA Europe); Centre for Population Health Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Mehmet Ungan
- World Organization of Family Doctors (WONCA Europe); Department of Family Medicine, Ankara University School of Medicine, Ankara, Turkey
| | - Peter Selby
- European Cancer Concord (ECC); Leeds Institute of Cancer and Pathology, Leeds, United Kingdom
| | - Matti Aapro
- European Cancer Organisation (ECCO); Genolier Cancer Centre, Clinique de Genolier, Genolier, Switzerland
| | - Marc Beishon
- Cancer World, European School of Oncology (ESO), Milan, Italy.
| | - Marije Bolt
- Council of Occupational Therapists for European Countries (COTEC)
| | - Fiona Bonanno
- European Society of Oncology Pharmacy (ESOP); Sir Anthony Mamo Oncology Centre, Malta
| | | | - Csaba Dégi
- International Psycho-Oncology Society (IPOS); Faculty of Sociology and Social Work, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Lisa Jelf Eneqvist
- European Oncology Nursing Society (EONS); Regional Cancercenter Stockholm-Gotland, Sweden
| | - Joanna Kazmierska
- European Society of Radiotherapy and Oncology (ESTRO); Radiotherapy Department II, Greater Poland Cancer Center, Poznan, Poland
| | - Agnieszka Kolacinska
- European Society of Surgical Oncology (ESSO); Department of Head and Neck Cancer Surgery and Surgical Oncology, Medical University of Lodz, Lodz, Poland
| | - Simon Malas
- Association of European Cancer Leagues (ECL); Oncology Clinic, Limassol General Hospital, Limassol, Cyprus
| | - Sébastien Moine
- European Association of Palliative Care (EAPC); Education and Health Practices Laboratory, University of Paris, France
| | | | | | - Fiona Walter
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, United Kingdom
| | - Lynda Wyld
- European Society of Breast Cancer Specialists (EUSOMA); Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
| |
Collapse
|
50
|
Sun V, Raz DJ, Kim JY, Melstrom L, Hite S, Varatkar G, Fong Y. Barriers and facilitators of adherence to a perioperative physical activity intervention for older adults with cancer and their family caregivers. J Geriatr Oncol 2019; 11:256-262. [PMID: 31208829 DOI: 10.1016/j.jgo.2019.06.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 05/31/2019] [Accepted: 06/05/2019] [Indexed: 12/11/2022]
Abstract
PURPOSE Perioperative physical activity behavior change in older adults with cancer is complex. Identifying the barriers and facilitators to physical activity before and after surgery can help predict adherence and optimize outcomes. We aimed to determine the barriers and facilitators of adherence to a perioperative physical activity intervention in older adults with lung and gastrointestinal (GI) cancers and their family caregivers (FCGs). METHODS A qualitative analysis of physical therapy/occupational therapy (PT/OT) baseline geriatric/functional assessment and intervention sessions notes were undertaken (N = 34 dyads). Written text documents (N = 6 independent PT/OT notes per dyad) were transcribed into a spreadsheet for coding and thematic analysis. Content analysis qualitative approach was used to identify themes and guide data interpretation. RESULTS Ten themes for barriers and five themes for facilitators emerged, reflecting barriers to and facilitators of perioperative physical activity adherence. Primary barriers to adherence included comorbid health conditions, physical symptoms, functional limitations, anxiety, other roles and responsibilities, unexpected life events, lack of time and motivation, not accustomed to physical activity, and environment/weather. Facilitators that enabled intervention adherence included physical activity as part of routine, coping strategies, setting goals for motivation, social/family support, and experiencing benefits from walking. CONCLUSIONS Barriers and facilitators to a perioperative physical activity is multidimensional, and focused on social-ecological determinants of health behaviors, including intrapersonal, interpersonal, and environmental factors. Perioperative physical activity interventions for older adults with cancer and their FCGs should integrate strategies to promote self-efficacy, support realistic activity goals, enhance motivation, and optimize social support.
Collapse
Affiliation(s)
- Virginia Sun
- Department of Population Sciences, United States of America.
| | - Dan J Raz
- Department of Surgery, United States of America
| | - Jae Y Kim
- Department of Surgery, United States of America
| | | | - Sherry Hite
- Department of Rehabilitation, City of Hope, Duarte, CA, United States of America
| | - Gouri Varatkar
- Department of Rehabilitation, City of Hope, Duarte, CA, United States of America
| | - Yuman Fong
- Department of Surgery, United States of America
| |
Collapse
|