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Winters CA, Marshall HK, Victorson DE, Adler RF, Magasi S. Does the Canadian Occupational Performance Measure (COPM) Capture the Complex Experiences of Cancer Survivors? A Mixed Methods Approach. Occup Ther Health Care 2024; 38:347-363. [PMID: 37302410 PMCID: PMC10711147 DOI: 10.1080/07380577.2023.2215875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 05/14/2023] [Indexed: 06/13/2023]
Abstract
Occupational therapy practitioners are uniquely positioned to address the needs of cancer survivors. This study aimed to understand the complex needs of survivors using The Canadian Occupational Performance Measure and in-depth interviewing. A convergent, mixed methods approach was utilized with a purposive sample of 30 cancer survivors. The results indicate that while the COPM can be a practical tool to address basic occupational performance problems, the in-depth interviews exposed these challenges are intricately connected to identity, relationships, and roles. Implications for occupational therapy practitioners include a critical approach to evaluation and interventions to capture the complex needs of survivors.
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Affiliation(s)
- Cassandra A Winters
- Department of Disability Studies, University of Illinois Chicago, Chicago, Illinois, USA
| | - Hilary K Marshall
- Department of Occupational Therapy, University of Illinois Chicago, Chicago, Illinois, USA
| | - David E Victorson
- Northwestern University Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Rachel F Adler
- Department of Computer Science, Northeastern Illinois University, Chicago, Illinois, USA
| | - Susan Magasi
- Department of Disability Studies, University of Illinois Chicago, Chicago, Illinois, USA
- Department of Occupational Therapy, University of Illinois Chicago, Chicago, Illinois, USA
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Fleischer A, Humphrey C. Women's Experiences after Hormone Positive Breast Cancer: Beginning of Radiation to 3-4 Years Post-Radiation. Occup Ther Health Care 2024; 38:364-384. [PMID: 36112023 DOI: 10.1080/07380577.2022.2121991] [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] [Received: 01/06/2022] [Revised: 08/23/2022] [Accepted: 09/03/2022] [Indexed: 06/15/2023]
Abstract
This study found that a breast cancer survivor cohort who were 3-4 years post-treatment returned to near baseline activity levels, and their important activity categories were nearly evenly distributed among instrumental activities of daily living, high-demand leisure, and social participation. When describing their experiences, three themes emerged: exercise is important physically and emotionally, participating in important activities feels good, and plans have been made to continue engaging in important activities. Further research is needed to compare activity resumption among those receiving or not receiving occupational therapy-at different timepoints-to understand when occupational therapy can make the greatest impact.
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Affiliation(s)
- Anne Fleischer
- Occupational Therapy Program, Department of Rehabilitation, Exercise and Nutrition Sciences, University of Cincinnati
| | - Casey Humphrey
- Department of Occupational Science and Occupational Therapy, Eastern Kentucky University
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Hagelskjær V, Wæhrens EE, von Bülow C, Nielsen KT. Qualitative realist evaluation of an occupational therapy intervention programme (ABLE), addressing ability to perform activities of daily living among persons with chronic conditions. BMC Health Serv Res 2024; 24:9. [PMID: 38172780 PMCID: PMC10765686 DOI: 10.1186/s12913-023-10498-4] [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] [Received: 02/08/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Chronic conditions are associated with problems related to performance of activities of daily living (ADL) stressing a need to develop and evaluate intervention programmes addressing such problems. Hence, the ABLE programme was developed, and its feasibility evaluated. Implementing intervention programmes in community-based rehabilitation settings requires understanding of how the programme works in various contexts. Applying a realist evaluation approach, the aim of this study was to identify and evaluate interactions between contexts, mechanisms, and outcomes in the ABLE 2.0, to confirm, refine, or reject aspects of the initial programme theory. METHODS Realist evaluation using qualitative data collected in the ABLE 2.0 randomised controlled trial (n = 78). Based on the ABLE 2.0 initial programme theory, qualitative realist interviews were conducted among receivers (n = 8) and deliverers (n = 3) of the ABLE 2.0 in a Danish municipality. Transcripts were coded, and context-mechanism-outcome configurations were extracted and grouped into contiguous themes. Results were then held up against the initial programme theory. RESULTS Four contiguous themes were identified including a total of n = 28 context-mechanism-outcome configurations: building a foundation for the entire intervention; establishing the focus for further intervention; identifying and implementing relevant compensatory solutions; and re-evaluating ADL ability to finalise intervention. Overall, the ABLE 2.0 initial programme theory was confirmed. The evaluation added information on core facilitating mechanisms including active involvement of the client in the problem-solving process, a collaborative working relationship, mutual confidence, and a consultative occupation-based process using compensatory solutions. Several contextual factors were required to activate the desired mechanisms in terms of supportive management, referral procedures encouraging the problem-solving process, delivery in the client's home, skilled occupational therapists, and clients feeling ready for making changes. CONCLUSIONS The ABLE 2.0 represents a coherent problem-solving occupational therapy process, applicable across sex, age, and diagnoses with the potential to enhance ADL ability among persons with chronic conditions, when delivered as part of community-based rehabilitation services. Knowledge about the interactions between contextual factors, mechanisms, and outcomes in the ABLE 2.0 is central in case of future implementation of the programme in community-based rehabilitation settings. TRIAL REGISTRATION The trial was prospectively registered on www. CLINICALTRIALS gov (registration date: 05/03/2020; identifier: NCT04295837 ) prior to data collection that occurred between August 2020 and October 2021.
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Affiliation(s)
- Vita Hagelskjær
- Occupation Centered occupational therapy, The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark.
- Occupational Science, User Perspectives and Community-based Interventions, Department of Public Health, University of Southern Denmark, Odense, Denmark.
- Department of Occupational Therapy, VIA University College, Holstebro, Denmark.
| | - Eva Ejlersen Wæhrens
- Occupation Centered occupational therapy, The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
- Occupational Science, User Perspectives and Community-based Interventions, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Cecilie von Bülow
- Occupation Centered occupational therapy, The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Kristina Tomra Nielsen
- Occupation Centered occupational therapy, The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Occupational Therapy, University College of Northern Denmark, Aalborg, Denmark
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Boland L, Bennett KE, Cuffe S, Grant C, Kennedy MJ, Connolly D. Feasibility Randomised Control Trial of OptiMal: A Self-Management Intervention for Cancer Survivors. Curr Oncol 2023; 30:10195-10210. [PMID: 38132376 PMCID: PMC10742444 DOI: 10.3390/curroncol30120742] [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] [Received: 10/23/2023] [Revised: 11/22/2023] [Accepted: 11/25/2023] [Indexed: 12/23/2023] Open
Abstract
PURPOSE Cancer survivors can experience symptoms such as fatigue, pain and distress that persist for many months following treatment. These enduring symptoms often impact on participation in self-care activities, returning to school and/or work, and leisure and social activities. Self-management support is increasingly recognised as a core aspect of cancer survivorship care to reduce the impact of persistent symptoms. The purpose of this study was to examine the feasibility and potential effectiveness of a group-based self-management intervention, OptiMal, to improve the physical and psychological health of cancer survivors. OptiMal is a six-week intervention comprising weekly sessions on fatigue, stress and physical activity, diet and effective communication strategies. METHODS A feasibility randomised control trial was undertaken. Individuals up to two years after cancer treatment were randomised to OptiMal or usual care. Feasibility was examined through recruitment and retention metrics. Potential effectiveness was tested through patient-reported outcomes collected at baseline and three months post-intervention. Descriptive and inferential statistics were used to analyse study data. RESULTS Recruitment for this study was 32.5% (80/246 eligible individuals) with 77.5% retention at three-month follow-up (82.5% for intervention group and 72.5% for control group). Of those who attended the intervention, 19 (73%) attended all OptiMal sessions, indicating high adherence to the intervention. The majority of participants had breast cancer and were between 12 and 24 months post-treatment. The intervention group (n = 29) had statistically significant greater improvements in anxiety (p = 0.04) and health-related quality of life (health index score: p = 0.023, visual analogue score: p = 0.035) at three months post-intervention than the control group. CONCLUSIONS Recruitment and retention in this study was similar to other cancer trials and the high adherence rate indicates that OptiMal is an acceptable self-management intervention for cancer survivors and warrants further investigation. OptiMal is intended to address symptoms reported across different cancer types. However, a limitation of this study was that the majority of participants had breast cancer, and therefore, generalisability of findings cannot be assumed for other cancer types. Future studies of OptiMal therefore need to use different strategies to recruit survivors of other cancer types.
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Affiliation(s)
- Lauren Boland
- Discipline of Occupational Therapy, Trinity College Dublin, D08 W9RT Dublin, Ireland;
| | - Kathleen E. Bennett
- Data Science Centre, School of Population Health, RCSI University of Medicine and Health Sciences, D02 YN77 Dublin, Ireland;
| | - Sinead Cuffe
- Medical Oncologist, St James’s Hospital, James’ St, D08 W9RT Dublin, Ireland; (S.C.); (C.G.); (M.J.K.)
| | - Cliona Grant
- Medical Oncologist, St James’s Hospital, James’ St, D08 W9RT Dublin, Ireland; (S.C.); (C.G.); (M.J.K.)
| | - M. John Kennedy
- Medical Oncologist, St James’s Hospital, James’ St, D08 W9RT Dublin, Ireland; (S.C.); (C.G.); (M.J.K.)
- Trinity St James’s Cancer Institute, D08 W9RT Dublin, Ireland
| | - Deirdre Connolly
- Discipline of Occupational Therapy, Trinity College Dublin, D08 W9RT Dublin, Ireland;
- Trinity St James’s Cancer Institute, D08 W9RT Dublin, Ireland
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von Bülow C, Wæhrens EE, Andersen U, Amris K, la Cour K. How a group-based occupational therapy program works in woman with fibromyalgia: A process evaluation of the ADAPT program. Scand J Occup Ther 2023; 30:1523-1540. [PMID: 37557901 DOI: 10.1080/11038128.2023.2242380] [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] [Received: 11/10/2022] [Revised: 06/30/2023] [Accepted: 07/25/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND The ADAPT Program have improved activities of daily living (ADL) in women with fibromyalgia. To understand the functioning of the program, it is relevant to evaluate how program theory components are linked to outcomes (mechanisms) and how the randomised controlled trial (RCT) context, influenced delivery and outcomes. OBJECTIVE To evaluate ADAPT in terms of dose, mechanisms of change and contextual factors. MATERIAL/METHODS Dose was recorded on the n = 21 participants receiving ADAPT in the IMPROvE trial (NCT01352052). A subsample of n = 16 attended one of three 2-hour focusgroups, evaluating mechanisms of change and contextual factors. Interview questions explored participants' interaction with four program components, i.e. how the 'client-centred approach', 'group-based peer-exchange format', 'teaching-learning strategies' and 'long-term program format' triggered mechanisms facilitating/hindering outcomes. Moreover, how randomisation procedures influenced delivery and outcomes. RESULTS Attending a long-term educational peer-exchange program, in which participants experienced met by a health professional that legitimised difficulties, facilitated participants knowledge, insights and motivation for changing habits. With time and support, participants experienced increased acceptance of their situation and began to implement more effective ways to perform ADL tasks. CONCLUSIONS/SIGNIFICANCE Results support previous findings of improved ADL ability post-ADAPT and provide initial evidence to support the ADAPT Program theory.
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Affiliation(s)
- Cecilie von Bülow
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
- Occupational Science, User Perspectives and Community-based Interventions, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Eva Ejlersen Wæhrens
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
- Occupational Science, User Perspectives and Community-based Interventions, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Ulla Andersen
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
- Occupational Science, User Perspectives and Community-based Interventions, Department of Public Health, University of Southern Denmark, Odense, Denmark
- The Department of Occupational Therapy, Copenhagen University College, Copenhagen, Denmark
| | - Kirstine Amris
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Karen la Cour
- Occupational Science, User Perspectives and Community-based Interventions, Department of Public Health, University of Southern Denmark, Odense, Denmark
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Men's Lived Experiences of Breast Cancer and Changes in Occupation. Occup Ther Int 2023; 2023:9641922. [PMID: 36815121 PMCID: PMC9940971 DOI: 10.1155/2023/9641922] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 01/28/2023] [Accepted: 01/30/2023] [Indexed: 02/15/2023] Open
Abstract
Introduction Male breast cancer is rare and frequently diagnosed at later stages of disease with low survival rates. There is a lack of knowledge of how breast cancer impacts men's occupations. Objectives This study is aimed at understanding the lived experiences of men with breast cancer and their changes in occupation. Methodology. Twenty-four men with breast cancer participated in semistructured phone interviews. Data was open-coded and analyzed for themes. Findings. The six major themes are as follows: (1) death as a reality, (2) unique personal insights, (3) social environment, (4) interactions with the healthcare system, (5) decreased engagement in occupations, and (6) finding meaning in new occupations. Conclusion The healthcare team can improve the patient experience by discussing and responding to the client's experience throughout the diagnosis, intervention, and survival continuum. The scope of occupational therapy is well suited to address the needs of men with breast cancer to maintain optimal levels of functioning.
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Efverman A. Physical, Leisure, and Daily Living Activities in Patients Before, During, and After Radiotherapy for Cancer: Which Patients Need Support in Activities? Cancer Nurs 2023; Publish Ahead of Print:00002820-990000000-00086. [PMID: 36728442 DOI: 10.1097/ncc.0000000000001187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Avoiding inactivity and staying active during cancer therapy have great health effects. OBJECTIVE The aims of this study were to describe level of daily, leisure, and physical activities before, during, and after radiotherapy and to investigate whether patients who had not restored activity level after radiotherapy differed from patients who had restored activity level regarding different characteristics. METHODS In this descriptive longitudinal study, 196 patients undergoing pelvic-abdominal radiotherapy reported their activity level at baseline, weekly during radiotherapy, and at 1 month after radiotherapy. RESULTS Patients decreased activity level during radiotherapy (P < .001 for all activities): physical activity (34% of patients decreased level), walking (26%), leisure activities (44%), social activities (15%), housework (34%), shopping (28%), and activities in general (28%). Almost half (47%) had not restored activity level after radiotherapy. Patients with colorectal cancer, older than 65 years, who had less education than university, and high capacity in overall daily activities at baseline were more likely than other patients not to restore activity level after radiotherapy. The patients not restoring their activity level after radiotherapy were more likely than others to experience anxious mood (P = .016), depressed mood (P = .003), and poor quality of life (P = .003) after radiotherapy. CONCLUSION Patients' activity level decreased during radiotherapy, and almost half of patients did not restore activity level after radiotherapy. IMPLICATIONS FOR PRACTICE Given that restored activity level after radiotherapy was less common in certain subgroups and that patients who restored activity level experienced better quality of life and less frequent anxious and depressed mood, cancer nursing professionals should consider supporting these subgroups of patients in performing activities.
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Affiliation(s)
- Anna Efverman
- Author Affiliation: Faculty of Health and Occupational Studies, Department of Caring Sciences, University of Gävle, Sweden
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Blichfeldt M, Gregersen Oestergaard L, Sampedro Pilegaard M, la Cour K, Lindahl-Jacobsen L. Occupational performance and prioritized problematic everyday occupations among people with advanced cancer living alone versus living with someone. Scand J Occup Ther 2022:1-11. [DOI: 10.1080/11038128.2022.2141314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Melanie Blichfeldt
- European Master of Science in Occupational Therapy, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
| | - Lisa Gregersen Oestergaard
- The Research Unit for User Perspectives and Community-based Interventions, Occupational Science, Department of Public Health, University of Southern Denmark, Odense, Denmark
- DEFACTUM, Central Denmark Region, Aarhus, Denmark
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - Marc Sampedro Pilegaard
- The Research Unit for User Perspectives and Community-based Interventions, Occupational Science, Department of Public Health, University of Southern Denmark, Odense, Denmark
- REHPA, the Danish Knowledge Centre for Rehabilitation and Palliative Care, Nyborg, Denmark
| | - Karen la Cour
- Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Line Lindahl-Jacobsen
- Department of Nutrition, Rehabilitation and Midwifery, University College Absalon, Naestved, Denmark
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Validade do Índice de Katz para avaliar a dependência em pacientes em tratamento oncológico. ACTA PAUL ENFERM 2022. [DOI: 10.37689/acta-ape/2022ao015266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Faaij M, Schoormans D, Pearce A. Work, daily activities and leisure after cancer. Eur J Cancer Care (Engl) 2022; 31:e13596. [PMID: 35451156 PMCID: PMC9542011 DOI: 10.1111/ecc.13596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 03/29/2022] [Accepted: 04/05/2022] [Indexed: 11/27/2022]
Abstract
Objective Determine if cancer survivors have lower participation in paid work, more limitations in daily activities or more limitations in leisure compared with those without cancer, stratified by age (working age ≤65 years; retirement age >65 years). Secondary objectives are identifying sociodemographic or clinical factors associated with work, daily activities or leisure and analysis of the relationship between work, daily activities and leisure. Methods Secondary analyses, using logistic regression, were performed on three cohorts (lymphoma, prostate and thyroid cancer) from the Dutch Patient Reported Outcomes Following Initial treatment and Long‐term Evaluation of Survivorship (PROFILES) registry and a nationally representative non‐cancer sample. Results Working‐age cancer survivors (n = 926) were significantly (p < 0.001) less likely to participate in paid work and more likely to report limitations in daily activities and leisure compared to the non‐cancer cohort (n = 1279). Among retirement aged cancer survivors (n = 1046), paid work was significantly more likely (p < 0.001), as were limitations in leisure (p < 0.05), compared with the non‐cancer controls (n = 334). Conclusions Cancer impacts daily activities and leisure, as well as paid work. These roles are important for cancer survivors' quality of life, suggesting support to return to these activities may be an important component of survivorship care.
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Affiliation(s)
- Marjon Faaij
- University Utrecht, Utrecht, The Netherlands.,Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Dounya Schoormans
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Alison Pearce
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, New South Wales, Australia.,Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
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Telerehabilitation for Managing Daily Participation among Breast Cancer Survivors during COVID-19: A Feasibility Study. J Clin Med 2022; 11:jcm11041022. [PMID: 35207294 PMCID: PMC8878496 DOI: 10.3390/jcm11041022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 01/31/2022] [Accepted: 02/14/2022] [Indexed: 02/05/2023] Open
Abstract
We aimed to examine the feasibility and impact of a short-term occupation-based telerehabilitation intervention (Managing Participation with Breast Cancer (MaP-BC)) on daily participation, health-related quality-of-life, and breast-cancer-related symptoms and understand women's perspectives regarding strategies to manage daily participation and symptoms during COVID-19 pandemic. A mixed-methods study (single-arm pre-post with a qualitative component) included 14 women after their primary medical treatment for breast cancer. Women received six weeks of occupation-based intervention using a video-communication. Sessions focused on identifying functional goals and training strategies to manage daily participation. The primary outcome was perceived performance and satisfaction with meaningful activities by the Canadian Occupational Performance Measure (COPM). Secondary outcomes were participation in the Activity Card Sort (ACS), upper-extremity functioning of Disability Arm Shoulder Hand, self-reported symptom severity, executive-functioning, health-related quality of life, and a question regarding strategies used to manage daily participation. Women significantly improved their daily participation in meaningful activities in the COPM, most ACS activity domains, self-reported executive functioning, and health-related-quality-of-life. Qualitative findings revealed three main themes: (1) daily life under the threats of breast cancer and COVID-19, (2) women's own strategies to overcome challenges, and (3) contribution of the MaP-BC. Providing telerehabilitation during the COVID-19 pandemic is feasible and successful in improving women's daily participation after breast cancer.
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Hagelskjær V, Nielsen KT, von Bulow C, Oestergaard LG, Graff M, Wæhrens EE. Evaluating a complex intervention addressing ability to perform activities of daily living among persons with chronic conditions: study protocol for a randomised controlled trial (ABLE). BMJ Open 2021; 11:e051722. [PMID: 34836902 PMCID: PMC8628341 DOI: 10.1136/bmjopen-2021-051722] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION The need to develop and evaluate interventions, addressing problems performing activities of daily living (ADL) among persons with chronic conditions, is evident. Guided by the British Medical Research Council's guidance on how to develop and evaluate complex interventions, the occupational therapy programme (A Better everyday LifE (ABLE)) was developed and feasibility tested. The aim of this protocol is to report the planned design and methods for evaluating effectiveness, process and cost-effectiveness of the programme. METHODS AND ANALYSIS The evaluation is designed as a randomised controlled trial with blinded assessors and investigators. Eighty participants with chronic conditions and ADL problems are randomly allocated to ABLE or usual occupational therapy. Data for effectiveness and cost-effectiveness evaluations are collected at baseline (week 0), post intervention (week 10) and follow-up (week 26). Coprimary outcomes are self-reported ADL ability (ADL-Interview (ADL-I) performance) and observed ADL motor ability (Assessment of Motor and Process Skills (AMPS)). Secondary outcomes are perceived satisfaction with ADL ability (ADL-I satisfaction); and observed ADL process ability (AMPS). Explorative outcomes are occupational balance (Occupational Balance Questionnaire); perceived change (Client-Weighted Problems Questionnaire) and general health (first question of the MOS 36-item Short Form Survey Instrument). The process evaluation is based on quantitative data from registration forms and qualitative interview data, collected during and after the intervention period. A realist evaluation approach is applied. A programme theory expresses how context (C) and mechanisms (M) in the programme may lead to certain outcomes (O), in so-called CMO configurations. Outcomes in the cost-effectiveness evaluation are quality-adjusted life years (EuroQool 5-dimension) and changes in ADL ability (AMPS, ADL-I). Costs are estimated from microcosting and national registers. ETHICS AND DISSEMINATION Danish Data Protection Service Agency approval: Journal-nr.: P-2020-203. The Ethical Committee confirmed no approval needed: Journal-nr.: 19 045 758. Dissemination for study participants, in peer-reviewed journals and conferences. TRIAL REGISTRATION NUMBER NCT04295837.
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Affiliation(s)
- Vita Hagelskjær
- Copenhagen University, Bispebjerg and Frederiksberg Hospital, The Parker Institute, Copenhagen, Denmark
- Department of Public Health, University of Southern Denmark, Odense, Syddanmark, Denmark
- Department of Occupational Therapy, VIA University College, Holstebro, Denmark
| | - Kristina Tomra Nielsen
- Copenhagen University, Bispebjerg and Frederiksberg Hospital, The Parker Institute, Copenhagen, Denmark
- Department of Occupational Therapy, University College of Northern Denmark (UCN), Aalborg, Denmark
| | - Cecilie von Bulow
- Copenhagen University, Bispebjerg and Frederiksberg Hospital, The Parker Institute, Copenhagen, Denmark
- Department of Public Health, University of Southern Denmark, Odense, Syddanmark, Denmark
| | - Lisa Gregersen Oestergaard
- Department of Public Health, University of Southern Denmark, Odense, Syddanmark, Denmark
- DEFACTUM, Department of Public Health and Rehabilitation, Central Denmark Region, Aarhus, Denmark
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - Maud Graff
- Department of Rehabilitation & Scientific Institute for Quality of Care Research, Radboud University Medical Center, Nijmegen, Netherlands
| | - Eva Ejlersen Wæhrens
- Copenhagen University, Bispebjerg and Frederiksberg Hospital, The Parker Institute, Copenhagen, Denmark
- Department of Public Health, University of Southern Denmark, Odense, Syddanmark, Denmark
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Measuring self-reported ability to perform activities of daily living: a Rasch analysis. Health Qual Life Outcomes 2021; 19:243. [PMID: 34663347 PMCID: PMC8522042 DOI: 10.1186/s12955-021-01880-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 10/11/2021] [Indexed: 11/15/2022] Open
Abstract
Background Since the number of persons diagnosed with multi-morbidity is increasing, there is a need for generic instruments to be able to assess, measure and compare ADL ability across diagnoses. Accordingly, the ADL-Interview (ADL-I) was developed to be used in rehabilitation research and clinical practice. The aim of this study was to investigate if the ADL-I can be used to provide valid and reliable ADL ability measures across gender and diagnostic groups. Methods ADL-I data were extracted from an existing research database on persons with chronic conditions including medical, rheumatological, oncological, neurological, geriatric and psychiatric diagnoses. Data were analysed based on Rasch Measurement methods to examine: the psychometric properties of the rating scale; ADL item and person fit to the Rasch model; if the difficulty of the ADL tasks differs across gender and diagnostic groups, and if the ADL-I provides precise and reliable measures of ADL ability. Results Data on n = 2098 persons were included in the final analysis. Initial evaluation of the 0–3 rating scale revealed threshold disordering between categories 1 and 2. After removal of 16 underfitting items, the variance explained by the Rasch dimension increased from 54.3 to 58.0%, thresholds were ordered, but the proportion of persons with misfitting ADL-I measures increased slightly from 8.7 to 9.1%. The person separation index improved slightly from 2.75 to 2.99 (reliability = 0.90). Differential test function analysis, however, supported that the 16 underfitting items did not represent a threat to the measurement system. Similarly, ADL items displaying differential item functioning across gender and diagnoses did not represent a threat to the measurement system. The ADL items and participants were well distributed along the scale, with item and person measures well targeted to each other, indicating a small ceiling effect and no floor effect. Conclusions The study results overall suggest that the ADL-I is producing valid and reliable measures across gender and diagnostic groups among persons within a broad range of ADL ability, providing evidence to support generic use of the ADL-I. Trial registration N/A.
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Polo KM, Moore ES, Sommers SH. Exploring the Impact of the Occupational Therapy Health and Wellness Program (OT-HAWP) on Performance and the Health-Related Quality of Life of Cancer Survivors. Occup Ther Health Care 2021; 36:168-183. [PMID: 34459712 DOI: 10.1080/07380577.2021.1943595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Creating innovative community-based programs for those living with and beyond cancer has the potential to improve outcomes; however, little has been done to explore these programs with participants that have various cancer diagnoses. We evaluated the impact of a 4-week community Occupational Therapy Health and Wellness Program (OT-HAWP) on self-perceived satisfaction and performance of daily activities, health-related quality of life, sleep quality, and fatigue among adults living with and beyond various cancer diagnoses. An uncontrolled, prospective, one-group pretest-posttest design was used. Participants completed patient reported measures of occupational performance and satisfaction (Canadian Occupational Performance Measure [COPM]), global health related quality of life (Patient-Reported Outcomes Measurement Information System-Global Health [PROMIS® Global Health]), sleep quality (Pittsburgh Sleep Quality Index [PSQI]), and the effect of fatigue on activities (Multidimensional Assessment of Fatigue [MAF]) before and after the program completion. Data was fully collected on 34 participants with various cancer diagnoses. For all outcomes, there was a statistically significant improvement after participating in the OT-HAWP program. Effect sizes range from small (0.46) to large (1.28). The OT-HAWP has the potential to improve self-reported occupational performance and satisfaction, global health-related quality of life, sleep quality, and fatigue in adults living with and beyond cancer in the community. Efficacy studies exploring community-based interventions are warranted to support legislation for improved access to care.
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Affiliation(s)
- Katie M Polo
- School of Occupational Therapy, University of Indianapolis, Indianapolis, IN, USA
| | - Elizabeth S Moore
- Department of Interprofessional Health & Aging Studies, University of Indianapolis, Indianapolis, IN, USA
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Hagelskjær V, Nielsen KT, von Bülow C, Graff M, Wæhrens EE. Occupational therapy addressing the ability to perform activities of daily living among persons living with chronic conditions: a randomised controlled pilot study of ABLE 2.0. Pilot Feasibility Stud 2021; 7:122. [PMID: 34116727 PMCID: PMC8192272 DOI: 10.1186/s40814-021-00861-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 05/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The ABLE intervention was developed to enhance the ability to perform activities of daily living (ADL) tasks among persons living with chronic conditions. ABLE is a generic, home-based, individualised, 8-week occupational therapy intervention program, developed to be delivered in Danish municipalities. In a previous study, the feasibility of ABLE was evaluated in terms of content and delivery. In this pilot study, the remaining feasibility aspects of a randomised controlled trial including (i) trial procedures (recruitment and retention), (ii) randomisation, (iii) adherence to program, (iv) feasibility of additional outcome measurements, and (iv) access to information on usual occupational therapy were evaluated. METHODS The study was conducted in a Danish municipality, using a two-armed parallel randomised controlled design, planning a recruitment strategy including 20 persons living with one/more chronic conditions and experiencing problems performing ADL. The following progression criteria were used to determine if a future full-scale randomised controlled trial was feasible: (i) recruitment (50% met the eligibility criteria) and retention (80%), (ii) randomisation (80% accepted randomisation, procedure was executed as planned), (iii) adherence to program (100% followed the treatment protocol), (iv) outcome measurements (80% of the participants delivered relevantly and fully answered questionnaires), and (v) usual occupational therapy (extraction of needed information was successful). RESULTS Due to the COVID-19 pandemic, the study was truncated resulting in limited but sufficient data to answer most of the study questions. (i) Eighteen of 37 eligible persons (48.6%) were recruited; of those treated (n = 6), all remained (100%); (ii) 18 accepted randomisation (100%), and procedure was effective; (iii) ABLE was delivered with adherence (100%); (iv) 92.3-100% of the participants gave relevant and complete answers in two of three questionnaires; and (v) needed information on usual occupational therapy was extractable in seven of nine aspects. CONCLUSIONS Proceeding to full-scale trial is recommendable; however, a few adjustments on outcome measurements, inclusion criteria and extraction of information on usual occupational therapy are needed. TRIAL REGISTRATION The study was registered at ClinicalTrials.gov (Identifier: NCT04295837 ) on December 5th, 2019. Retrospectively registered.
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Affiliation(s)
- Vita Hagelskjær
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark. .,Occupational Science & Occupational Therapy, User Perspectives and Community-based Interventions, Department of Public Health, University of Southern Denmark, Odense, Denmark. .,Department of Occupational Therapy, VIA University College, Holstebro, Denmark.
| | - Kristina Tomra Nielsen
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark.,Department of Occupational Therapy, University College of Northern Denmark, Aalborg, Denmark
| | - Cecilie von Bülow
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark.,Occupational Science & Occupational Therapy, User Perspectives and Community-based Interventions, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Maud Graff
- Department of Rehabilitation & Scientific Institute for Quality of Care Research, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Eva Ejlersen Wæhrens
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark.,Occupational Science & Occupational Therapy, User Perspectives and Community-based Interventions, Department of Public Health, University of Southern Denmark, Odense, Denmark
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Nielsen KT, Klokker L, Wæhrens EE. Self-reported quality of activities of daily living task performance in four diagnostic groups with chronic conditions. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2021. [DOI: 10.12968/ijtr.2020.0025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/aims To design intervention programmes addressing activities of daily living task performance problems in individuals with chronic conditions, more knowledge about the types of challenges these individuals experience is needed. The aim of this study was to examine the types of activities of daily living tasks, as well as the types of problems related to the quality of task performance, that individuals with chronic conditions report and determine similarities and differences in four diagnostic sub-groups. Methods Data on self-reported quality of activities of daily living task performance were collected among 593 individuals with rheumatological disease, incurable cancer, chronic obstructive pulmonary disease and schizophrenia, using the ADL-Interview. Activities of daily living tasks most frequently reported as problematic were identified within each sub-group. Sub-group profiles were generated to identify similarities and differences in quality of performance. Results Participants reported problems performing similar types of activities of daily living tasks across diagnostic sub-groups, especially within instrumental activities of daily living. Moreover, participants mainly reported a decreased quality of performance in terms of using extra time and/or increased physical effort while performing personal activities of daily living. Conclusions As individuals across four chronic conditions reported somewhat similar problems related to activities of daily living task performance, generic activities of daily living interventions addressing these problems seem appropriate, especially interventions addressing problems related to use of extra time and increased effort.
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Affiliation(s)
- Kristina Tomra Nielsen
- Department of Occupational Therapy, University College of Northern Denmark, Aalborg, Denmark
- The ADL Unit, The Parker Institute, Copenhagen University Hospital, Frederiksberg and Bispebjerg, Copenhagen, Denmark
| | - Louise Klokker
- The Musculoskeletal Statistics Unit, The Parker Institute, Copenhagen University Hospital, Frederiksberg and Bispebjerg, Copenhagen, Denmark
| | - Eva Ejlersen Wæhrens
- The ADL Unit, The Parker Institute, Copenhagen University Hospital, Frederiksberg and Bispebjerg, Copenhagen, Denmark
- Occupational Science and Occupational Therapy, User Perspectives and Community-based Research, Department of Public Health, University of Southern Denmark, Odense, Denmark
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17
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Stormoen DR, Baeksted C, Taarnhøj GA, Johansen C, Pappot H. Patient reported outcomes interfering with daily activities in prostate cancer patients receiving antineoplastic treatment. Acta Oncol 2021; 60:419-425. [PMID: 33641578 DOI: 10.1080/0284186x.2021.1881818] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Patient-reported outcome (PRO) can give information to caregivers and doctors about adverse effects and give real-world data on symptom burden for patients during treatment. We here report PROs from patients with metastatic castration resistant prostate cancer (mCRPC) receiving oncological treatment. Our findings are compared with adverse events from published findings in relevant registration studies and we discuss possible applications by looking at the level of interference with usual or daily activities. MATERIAL AND METHODS An electronic PRO-Common Terminology Criteria for Adverse Events (ePRO-CTCAE) questionnaire, with 41 items corresponding to 22 symptoms/adverse events associated with the treatment regimens commonly used for mCRPC, were collected from 54 patients with mCRPC receiving medical oncological treatment. Eleven symptoms attributing interference with usual or daily living were selected and stratified by antineoplastic treatment administered. The responses were pooled and compared with data from relevant registration studies for docetaxel, cabazitaxel, radium-223 and abiraterone. RESULTS 168 questionnaires were completed, and among responses from patients receiving docetaxel, 89% of responses shows that fatigue interfered with their usual or daily activities to some degree and 22% to a high or very high degree. In the registration study for docetaxel fatigue is reported with 53% for all grades and 5% for grade 3 or above. For cabazitaxel, radium-223 and abiraterone the percentage of responses with interference of daily activities from fatigue range from 58% to 82%. Between four and six of the eleven chosen PRO-CTCAE symptoms are not reported in the registration studies as common side effects. CONCLUSION PRO may help inform caregivers about symptoms not previously reported, interfering with usual or daily activities but also point to the use of this information to inform new patients. This may help clinicians and patients decide a treatment plan with an acceptable benefit-to-harm ratio.
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Affiliation(s)
- Dag Rune Stormoen
- Department of Oncology, Rigshospitalet, University Hospital Copenhagen, Copenhagen, Denmark
| | | | - Gry Assam Taarnhøj
- Department of Oncology, Rigshospitalet, University Hospital Copenhagen, Copenhagen, Denmark
| | - Christoffer Johansen
- Department of Oncology, Rigshospitalet, University Hospital Copenhagen, Copenhagen, Denmark
- The Danish Cancer Society, Copenhagen, Denmark
| | - Helle Pappot
- Department of Oncology, Rigshospitalet, University Hospital Copenhagen, Copenhagen, Denmark
- The Danish Cancer Society, Copenhagen, Denmark
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Nielsen KT, Guidetti S, von Bülow C, Klokker L, Wæhrens EE. Feasibility of ABLE 1.0-a program aiming at enhancing the ability to perform activities of daily living in persons with chronic conditions. Pilot Feasibility Stud 2021; 7:52. [PMID: 33602338 PMCID: PMC7891027 DOI: 10.1186/s40814-021-00790-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 02/04/2021] [Indexed: 12/31/2022] Open
Abstract
Background The “A Better everyday LifE” (ABLE) intervention was developed to accommodate the need of a program addressing ability to perform activities of daily living (ADL) in persons with chronic conditions living at home. During intervention development, it is necessary to evaluate relevant aspects of the feasibility of a program. Thus, the aim was to evaluate the feasibility of content and delivery of ABLE version 1.0. Methods A one group pre- and post-test design was applied. Thirty persons with chronic conditions, two occupational therapists (OTs), and five occupational therapy students (OTSs) participated. ABLE 1.0 is an 8-week program consisting of ADL evaluation (session 1); goal setting and reasons for ADL problems (session 2); intervention (sessions 3–7); and re-evaluation (final session), conducted in the clients’ home-setting and local area. Sessions 1–4 and the final session was mandatory. To evaluate the feasibility of content and delivery, the OTs, after each session, reported on applied intervention component(s), time-use, needed equipment, adjustments, meaningfulness, confidence, progress toward goal attainment, and side effects using registration forms. The clients reported on progress toward goal attainment, meaningfulness, and satisfaction. Clinically relevant improvements in ADL ability were identified using the ADL-Interview (ADL-I) and the Assessment of Motor and Process Skills (AMPS). Goal attainment was evaluated using the Goal Attainment Scaling (GAS). Results Twenty clients (67%) completed ABLE 1.0 and received four sessions (median = 4, range 4–7) each lasting between 30 and 94 min. Most frequently applied component was “Changing habits related to task performance”. Generally, OTs reported having the needed equipment. Deviations from the manual were made by omission of GAS and AMPS and less than mandatory number of sessions per client. The OTs reported confidence in delivering the program and the clients perceived the program as meaningful and satisfying, and experienced progress toward goal attainment. Goal attainment was found in 52% of the goals. Sixteen (80%) clients obtained clinically relevant improvements in self-reported or observed ADL ability. Conclusions The content and delivery of ABLE 1.0 was feasible. However, the study revealed a need to adjust the recruitment procedure and make minor changes in the intervention manual. A pilot randomized controlled trial (RCT) study is recommended. Trial registration The study was registered at ClinicalTrials.gov with registration no. NCT03335709 on November 8, 2017. Supplementary Information The online version contains supplementary material available at 10.1186/s40814-021-00790-7.
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Affiliation(s)
- Kristina Tomra Nielsen
- Department of Occupational Therapy, University College of Northern Denmark (UCN), Selma Lagerløfs vej 2, DK-9220, Aalborg Ø, Denmark. .,The ADL Unit, the Parker Institute, Copenhagen University Hospital Bispebjerg - Frederiksberg, Nordre Fasanvej 57, Road 8, entrance 19, DK-2000, Frederiksberg, Denmark. .,The Research Initiative for Activity Studies and Occupational Therapy, Research Unit for General Practice, Department of Public Health, University of Southern Denmark (SDU), J.B. Winsløwsvej 9, DK-5000, Odense, Denmark.
| | - Susanne Guidetti
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Alfred Nobels Allé 23, SE-141 83, Huddinge, Sweden
| | - Cecilie von Bülow
- The ADL Unit, the Parker Institute, Copenhagen University Hospital Bispebjerg - Frederiksberg, Nordre Fasanvej 57, Road 8, entrance 19, DK-2000, Frederiksberg, Denmark.,The Research Initiative for Activity Studies and Occupational Therapy, Research Unit for General Practice, Department of Public Health, University of Southern Denmark (SDU), J.B. Winsløwsvej 9, DK-5000, Odense, Denmark
| | - Louise Klokker
- The Musculoskeletal Statistics Unit, the Parker Institute, Copenhagen University Hospital Bispebjerg - Frederiksberg, Nordre Fasanvej 57, Road 8, entrance 19, DK-2000, Frederiksberg, Denmark
| | - Eva Ejlersen Wæhrens
- The ADL Unit, the Parker Institute, Copenhagen University Hospital Bispebjerg - Frederiksberg, Nordre Fasanvej 57, Road 8, entrance 19, DK-2000, Frederiksberg, Denmark.,The Research Initiative for Activity Studies and Occupational Therapy, Research Unit for General Practice, Department of Public Health, University of Southern Denmark (SDU), J.B. Winsløwsvej 9, DK-5000, Odense, Denmark
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la Cour K, Gregersen Oestergaard L, Brandt Å, Offersen SMH, Lindahl-Jacobsen L, Cutchin M, Pilegaard MS. Process evaluation of the Cancer Home-Life Intervention: What can we learn from it for future intervention studies? Palliat Med 2020; 34:1425-1435. [PMID: 32611224 DOI: 10.1177/0269216320939227] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND The Cancer Home-Life Intervention showed no significant effects, and examination of the processes affecting or inhibiting outcomes is relevant. AIM To evaluate the Cancer Home-Life Intervention for its processes of implementation, mechanisms of impact and contextual factors. DESIGN Process evaluation conducted alongside the randomised controlled trial, using quantitative and qualitative methods (ClinicalTrials.gov NCT02356627). The Cancer Home-Life Intervention is a tailored, occupational therapy-based programme. SETTING/PARTICIPANTS This study took place in participants' homes and at hospital. A total of 113 home-dwelling adults (⩾18 years) with advanced cancer who had received the Cancer Home-Life Intervention were included, together with five intervention-therapists. RESULTS All 113 participants (100%) received a first home visit; 32 participants (26%) received a second visit; and 4 participants (3%) received a third visit. Median number of delivered intervention components were 3 (interquartile range: 2; 4). Identified barriers for effect included unclear decision process for intervention dosage; participants' low expectations; participants' lack of energy; and insufficient time to adopt new strategies. The trial design constituted a barrier as the intervention could only be provided within a specific short period of time and not when relevant. Intervention components working to solve practical everyday problems, enhance enjoyment and increase a sense of safety were perceived as useful. CONCLUSION Future interventions can benefit from inclusion criteria closely related to the intervention focus and clear procedures for when to continue, follow-up and terminate intervention. Decisions about dose and timing may benefit from learning theory by taking into account the time and practice needed to acquire new skills.
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Affiliation(s)
- Karen la Cour
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital and University of Southern Denmark, Nyborg, Denmark
| | - Lisa Gregersen Oestergaard
- DEFACTUM, Central Denmark Region, Aarhus, Denmark.,Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark.,Department of Public Health, Aarhus University, Aarhus, Denmark.,The Research Initiative of Activity Studies and Occupational Therapy, Research Unit of General Practice, University of Southern Denmark, Odense, Denmark
| | - Åse Brandt
- The Research Initiative of Activity Studies and Occupational Therapy, Research Unit of General Practice, University of Southern Denmark, Odense, Denmark
| | - Sara Marie Hebsgaard Offersen
- Research Unit for General Practice, Research Centre for Cancer Diagnosis in Primary Care, Aarhus University, Aarhus, Denmark
| | - Line Lindahl-Jacobsen
- The Research Initiative of Activity Studies and Occupational Therapy, Research Unit of General Practice, University of Southern Denmark, Odense, Denmark.,University College Absalon, Center for Nutrition and Rehabilitation, Sorø, Denmark
| | - Malcolm Cutchin
- Department of Health Care Sciences, Wayne State University, Detroit, MI, USA
| | - Marc Sampedro Pilegaard
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital and University of Southern Denmark, Nyborg, Denmark.,The Research Initiative of Activity Studies and Occupational Therapy, Research Unit of General Practice, University of Southern Denmark, Odense, Denmark
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20
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Udovicich A, Edbrooke L, Brown T, Marston C. Achieving patient-centred goals in oncology: A retrospective analysis of a domestic activities of daily living group. Br J Occup Ther 2020. [DOI: 10.1177/0308022620918757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Introduction This retrospective study aimed to investigate the effectiveness of a domestic activities of daily living group on the occupational performance and satisfaction of adult inpatients with cancer. Method A retrospective analysis was completed with an initial cohort of patients who participated in the group during their acute inpatient oncology admission. As part of their routine care, patients completed the Canadian Occupational Performance Measure before and after their participation in the group. The occupational performance and satisfaction scores of 31 adults (mean age 71.61 years, 19 females) were reported descriptively and within-group changes analysed using one-sample t-test analyses and bootstrapping. Results Most (71%) of the 31 patients were discharged home following their inpatient stay. Canadian Occupational Performance Measure mean (SD) change scores were 3.44 (3.90) for performance and 2.04 (2.16) for satisfaction following participation in one domestic activities of daily living intervention group session. Statistically significant improvements in patients’ Canadian Occupational Performance Measure performance and satisfaction scores were demonstrated in the one-sample t-test ( p < .002) and bootstrapping sampling ( p < .002). Conclusion Acute oncology inpatients who attended a domestic activities of daily living intervention group reported a positive change in Canadian Occupational Performance Measure occupational performance and satisfaction. This study highlights the potential benefit of a group-based domestic activities of daily living intervention in an acute oncology setting.
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Affiliation(s)
- Anthea Udovicich
- Occupational Therapy Department, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Lara Edbrooke
- Allied Health Department, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Physiotherapy Department, The University of Melbourne, Parkville, Victoria, Australia
| | - Ted Brown
- Department of Occupational Therapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, Victoria, Australia
| | - Celia Marston
- Occupational Therapy Department, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Occupational Therapy Department, Royal Melbourne Hospital, Australia
- Department of Occupational Therapy, Monash University, Victoria, Australia
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Megari K. Instrumental activities of daily living and neuropsychological functioning among patients with different types of cancer. Eur J Neurol 2020; 28:66-70. [PMID: 32918849 DOI: 10.1111/ene.14522] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 09/02/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES The ability to perform instrumental activities of daily living (IADL) is important for maintaining independent living, and optimal health-related quality of life and well-being. Neuropsychological measures are predictors of IADL ratings. The aims of the present study were to measure ability to perform IADL in patients with cancer and to explore the relationship between IADL and neuropsychological functioning. METHODS We evaluated IADL in 182 patients with four different types of cancer (thyroid, colorectal, breast and prostate cancer) and examined the relationship between IADL and neuropsychological functioning 6 months after chemotherapy treatment. RESULTS Our results showed that patients with breast cancer had significantly greater difficulty in performing IADL compared to patients with other types of cancer. There were no differences in IADL performance among the other three study groups. In addition, we found that neuropsychological score was a predictor of IADL; the greater the patients' disability, the lower their performance on neuropsychological measures. This is in accordance with the literature that suggests neuropsychological measures to be predictors of IADL ratings. CONCLUSIONS The present findings are important because, although many researchers have studied the relationship between IADL and neuropsychological functioning in cancer, few studies have investigated IADL in different types of cancer. Optimal neuropsychological functioning is connected with better ability with regard to IADL.
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Affiliation(s)
- K Megari
- Global Engagement Representative, International Neuropsychological Society, Laboratory of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Udovicich A, Foley KR, Bull D, Salehi N. Occupational Therapy Group Interventions in Oncology: A Scoping Review. Am J Occup Ther 2020; 74:7404205010p1-7404205010p13. [DOI: 10.5014/ajot.2020.036855] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
Importance: Patients with cancer frequently experience difficulties with everyday activities. This scoping review explores occupational therapy group interventions in oncology, an area relevant to occupational therapy practitioners, but one that has limited evidence.
Objective: This scoping review examines the association between occupational therapy–based oncology groups and improved functional activity of daily living outcomes for adults with cancer. It poses the following research question: Are occupational therapy groups associated with improved functional outcomes for adults with cancer?
Data Sources: Searches of MEDLINE, CINAHL, AMED, OTseeker, Health Source: Nursing/Academic Edition, and OTDBase were completed for peer-reviewed articles published from 1997 to 2018.
Study Selection and Data Collection: Inclusion criteria were articles published in English and occupational therapy–based groups for adults with cancer.
Findings: Eight articles matched the inclusion criteria. The articles reviewed were 2 randomized controlled trials, 1 case study, 1 descriptive exploratory research study, 1 mixed-methods study, 2 pretest–posttest studies, and 1 longitudinal prospective comparative study.
Conclusions and Relevance: Occupational therapy groups led to a significant increase in occupational performance and satisfaction, an improvement in functioning, and a decrease in fatigue. Engagement in important roles and occupations and sharing the experience with others were also highly valued. This review provides support for the implementation of group-based occupational therapy interventions in oncology. Further research is required in this area, particularly in the inpatient setting with men included in the sample.
What This Article Adds: This scoping review demonstrates the benefits of group-based occupational therapy interventions for adult patients with cancer.
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Affiliation(s)
- Anthea Udovicich
- Anthea Udovicich, MAHL, GradCertPallCare, BOT, is Senior Grade Three Occupational Therapist, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia, and Master of Healthcare Leadership Graduate, School of Health and Human Sciences, Southern Cross University, Gold Coast, Queensland, Australia;
| | - Kitty-Rose Foley
- Kitty-Rose Foley, PhD, BSC(OT), is Lecturer, Occupational Therapy Department, School of Health and Human Sciences, Southern Cross University, Gold Coast, Queensland, Australia
| | - Danielle Bull
- Danielle Bull, PhD Candidate, MAEPRS, MAOT, BHumanMovSt, is Lecturer, Occupational Therapy Department, School of Health and Human Sciences, Southern Cross University, Gold Coast, Queensland, Australia
| | - Nasim Salehi
- Nasim Salehi, PhD, is Course Coordinator, Master of Healthcare Leadership, School of Health and Human Sciences, Southern Cross University, Gold Coast, Queensland, Australia
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Wæhrens EE, Brandt Å, Peoples H, Cour K. Everyday activities when living at home with advanced cancer: A cross‐sectional study. Eur J Cancer Care (Engl) 2020; 29:e13258. [DOI: 10.1111/ecc.13258] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 01/13/2020] [Accepted: 04/16/2020] [Indexed: 01/22/2023]
Affiliation(s)
- Eva Ejlersen Wæhrens
- The Research Initiative for Activity Studies and Occupational Therapy, Research Unit of General Practice Institute of Public Health University of Southern Denmark Odense Denmark
- Department of Rheumatology The ADL Unit The Parker Institute Copenhagen University Hospitals Bispebjerg – Frederiksberg Frederiksberg Denmark
| | - Åse Brandt
- The Research Initiative for Activity Studies and Occupational Therapy, Research Unit of General Practice Institute of Public Health University of Southern Denmark Odense Denmark
- The National Board of Social Services Center for Disability and Mental Vulnerability Odense Denmark
| | - Hanne Peoples
- The Research Initiative for Activity Studies and Occupational Therapy, Research Unit of General Practice Institute of Public Health University of Southern Denmark Odense Denmark
| | - Karen Cour
- The Research Initiative for Activity Studies and Occupational Therapy, Research Unit of General Practice Institute of Public Health University of Southern Denmark Odense Denmark
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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.
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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
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Newman R, Lyons KD, Coster WJ, Wong J, Festa K, Ko NY. Feasibility, acceptability and potential effectiveness of an occupation-focused cognitive self-management program for breast cancer survivors. Br J Occup Ther 2019. [DOI: 10.1177/0308022619861893] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Robin Newman
- Department of Occupational Therapy, Sargent College of Health and Rehabilitation Sciences, Boston University, MA, USA
| | - Kathleen Doyle Lyons
- Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
- Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Wendy J Coster
- Department of Occupational Therapy, Sargent College of Health and Rehabilitation Sciences, Boston University, MA, USA
| | - Jasin Wong
- Department of Occupational Therapy, Sargent College of Health and Rehabilitation Sciences, Boston University, MA, USA
| | - Kate Festa
- Department of Medicine, Section of Hematology Oncology, Boston University Medical School, MA, USA
| | - Naomi Y Ko
- Department of Medicine, Section of Hematology Oncology, Boston University Medical School, MA, USA
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Enemark Larsen A, Jessen Winge C, Christensen JR. Clinical utility of the Danish version of the Canadian Occupational Performance Measure. Scand J Occup Ther 2019; 28:239-250. [PMID: 31269403 DOI: 10.1080/11038128.2019.1634150] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND The Canadian Occupational Performance Measure (COPM) is intended to help clients identify and evaluate their occupational performance issues. As it enhances client-centred practice (CCP), more frequent use of the COPM might fulfill the political agenda of patient involvement in Denmark. However, in a study translating the COPM into Danish, challenges were found highlighting the need to study its clinical utility. AIM To examine the clinical utility of the Danish version of the COPM (COPM-DK) and help determine whether to recommend a more routinely use. METHODS Data gathered during qualitative interviews with 16 occupational therapists (OTs) from various settings were subjected to a qualitative content analysis. RESULTS The COPM-DK appeared to have clinical utility, especially regarding the meaning and relevance of the information obtained, and seemed to facilitate an occupational lens and CCP. The OTs' difficulties and concerns when using the COPM and their personal and environmental commitment to the COPM seemed associated with how they performed the COPM. Thus, training was recommended to facilitate a valid and reliable use. CONCLUSION Given the benefits and the perceived utility of the COPM-DK, a more routinely use, to place OTs and CCP in the center of Danish healthcare system, is recommended.Key MessagesThe utility of the Danish version of the Canadian Occupational Performance Measure is supported, according to Danish occupational therapists in various rehabilitation settings and hospitals.Using the Canadian Occupational Performance Measure seems to enhance a client-centred practice with collaborative goals and helps to establish partnership, being of value to the interdisciplinary team, too.The utility and acceptability of the Canadian Occupational Performance Measure seemed to be linked to the occupational therapists' experience and understanding of the Canadian Occupational Performance Measure's content and form, thus an introduction course is recommended to avoid a use that affects the assessment's validity and reliability.
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Affiliation(s)
- Anette Enemark Larsen
- Department of Occupational Therapy, Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy, University College Copenhagen, Copenhagen, Denmark.,The Research Initiative for Activity Studies and Occupational Therapy, General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Christina Jessen Winge
- Department of Occupational Therapy, Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy, University College Copenhagen, Copenhagen, Denmark
| | - Jeanette Reffstrup Christensen
- The Research Initiative for Activity Studies and Occupational Therapy, General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark.,The Research Unit Physical Activity and Health in Working life, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Werdani YDW. Effect of Cancer Related Fatigue tTo the Level of Independence of Cancer Patients and Caregiver Stress Level. FOLIA MEDICA INDONESIANA 2018. [DOI: 10.20473/fmi.v54i2.8859] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Chemotherapy/radiation in cancer patients causes cancer-related fatigue (CRF). It affects the level of independence of patients’ activity of daily living (ADL). Thus, the responsibility of caregivers will be higher and it impacts on caregiver stress level. The aim of this study was to prove the effects of CRF on independence level of cancer patients and caregivers’ stress level. This study used analytical associative design. The population was cancer patients and caregivers in Yayasan Kanker Indonesia in East Java. The number of samples were 30 cancer patients and 30 caregivers, taken by total sampling method. The assessment was based on instrument brief fatigue questionnaire, activity of daily living based on Katz, and caregiver stress on self assessment questionnaire. The effects of CRF on the level of independence were indicated by p=0.000, and the levels of independence of the caregiver stress level were indicated by p=0.000. As a conclusion, the failure of muscle function due to CRF can affect the independence of patient’s ADL fulfilling, so caregiver should take much time to treat patient and it affects on the increased stress level of caregiver.
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Guidetti S, Nielsen KT, von Bülow C, Pilegaard MS, Klokker L, Wæhrens EE. Evaluation of an intervention programme addressing ability to perform activities of daily living among persons with chronic conditions: study protocol for a feasibility trial (ABLE). BMJ Open 2018; 8:e020812. [PMID: 29780029 PMCID: PMC5961614 DOI: 10.1136/bmjopen-2017-020812] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
INTRODUCTION The number of persons living with a chronic condition is increasing worldwide. Conditions are considered chronic when lasting 1 year or more and requiring ongoing medical attention and/or limiting activities of daily living (ADL). Besides medical treatment, physical exercise to improve body functions is recommended and prescribed. However, improvements in body functions do not necessarily improve ability to perform ADL. Thus, it is necessary to develop interventions aiming directly at enhancing ADL ability. As a part of the research programme 'A Better Everyday Life', the first version of the ABLE intervention programme was developed. METHODS AND ANALYSIS This feasibility study examine the perceived value and acceptability of the ABLE programme by evaluating the fidelity, reach, dose and potential outcomes using a pretest and post-test design involving 30 persons living with chronic conditions. Qualitative interviews among occupational therapists delivering and participants receiving the ABLE programme will be conducted to explore aspects affecting the intervention. ETHICS AND DISSEMINATION The results will form the base for refinement of the ABLE programme and planning of a large-scale randomised controlled trial investigating the effect of the programme on self-reported and observed ADL ability. Dissemination will include peer-reviewed publications and presentations at national and international conferences. PROTOCOL VERSION 7 November 2017: v ersion 1.0. 19 February 2018: v ersion 2.0. TRIAL REGISTRATION NUMBER NCT03335709; Pre-results.
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Affiliation(s)
- Susanne Guidetti
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institute, Stockholm, Sweden
| | - Kristina Tomra Nielsen
- Department of Occupational Therapy, University College of Northern Denmark (UCN), Aalborg, Denmark
- The Parker Institute, Copenhagen University Hospital, Copenhagen, Denmark
- The Research Initiative for Occupational Science and Occupational Therapy, Research Unit for General Practice, Department of Public Health, University of Southern Denmark (SDU), Odense, Denmark
| | - Cecilie von Bülow
- The Parker Institute, Copenhagen University Hospital, Copenhagen, Denmark
- The Research Initiative for Occupational Science and Occupational Therapy, Research Unit for General Practice, Department of Public Health, University of Southern Denmark (SDU), Odense, Denmark
| | - Marc Sampedro Pilegaard
- The Research Initiative for Occupational Science and Occupational Therapy, Research Unit for General Practice, Department of Public Health, University of Southern Denmark (SDU), Odense, Denmark
| | - Louise Klokker
- The Parker Institute, Copenhagen University Hospital, Copenhagen, Denmark
| | - Eva Ejlersen Wæhrens
- The Parker Institute, Copenhagen University Hospital, Copenhagen, Denmark
- The Research Initiative for Occupational Science and Occupational Therapy, Research Unit for General Practice, Department of Public Health, University of Southern Denmark (SDU), Odense, Denmark
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Sampedro Pilegaard M, Oestergaard LG, la Cour K, Thit Johnsen A, Brandt Å. Subgroup effects of occupational therapy-based intervention for people with advanced cancer. Scand J Occup Ther 2018; 27:517-523. [PMID: 29571271 DOI: 10.1080/11038128.2018.1455897] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Background: Many people with advanced cancer have decreased ability to perform activities of daily living (ADL). We recently performed a randomized, controlled trial (RCT) assessing the efficacy of an occupational therapy-based program, the 'Cancer Home-Life Intervention' in people with advanced cancer (N = 242) and found no overall effects on ADL ability. However, heterogeneity of treatment effect may disguise subgroup differences.Objective: To investigate whether subgroups of people with advanced cancer gain positive effects from the 'Cancer Home-Life Intervention' on ADL ability.Material and method: An exploratory subgroup analysis including 191 participants from a RCT. The outcome was ADL motor ability measured by the Assessment of Motor and Process Skills (AMPS). Subgroups were defined by age, gender, years of education, type of primary tumor, functional level, and activity problems.Results: The 'Cancer Home-Life Intervention' had no statistically significant effect in the six subgroups. Modifying effects of age (0.30 [95% CI: -0.05 to 0.64]) and gender (0.23 [95% CI: -0.11 to 0.57]) were not found.Conclusion: There were no subgroup effects of the 'Cancer Home-Life Intervention'on ADL motor ability. Some indications suggest greater effects for those aged below 69 years; however, this result should be interpreted with caution.
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Affiliation(s)
- Marc Sampedro Pilegaard
- The Research Initiative of Activity Studies and Occupational Therapy, Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense C, Denmark.,Odense Patient Data Explorative Network, Odense University Hospital, University of Southern Denmark, Odense C, Denmark
| | - Lisa Gregersen Oestergaard
- Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus C, Denmark.,Institute of Public Health, Aarhus University, Aarhus C, Denmark
| | - Karen la Cour
- The Research Initiative of Activity Studies and Occupational Therapy, Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense C, Denmark.,Odense Patient Data Explorative Network, Odense University Hospital, University of Southern Denmark, Odense C, Denmark
| | - Anna Thit Johnsen
- Department of Psychology, University of Southern Denmark, Odense M, Denmark.,Department of Palliative Medicine, Bispebjerg Hospital, Copenhagen NV, Denmark
| | - Åse Brandt
- Odense Patient Data Explorative Network, Odense University Hospital, University of Southern Denmark, Odense C, Denmark.,Centre for Disability and Mental Vulnerability, The National Board of Social Services, Odense C, Denmark
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Neo J, Fettes L, Gao W, Higginson IJ, Maddocks M. Disability in activities of daily living among adults with cancer: A systematic review and meta-analysis. Cancer Treat Rev 2017; 61:94-106. [DOI: 10.1016/j.ctrv.2017.10.006] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 10/16/2017] [Accepted: 10/20/2017] [Indexed: 01/01/2023]
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Whittaker AL, Zhu Y, Howarth GS, Loung CS, Bastian SEP, Wirthensohn MG. Effects of commercially produced almond by-products on chemotherapy-induced mucositis in rats. World J Gastrointest Pathophysiol 2017; 8:176-187. [PMID: 29184703 PMCID: PMC5696615 DOI: 10.4291/wjgp.v8.i4.176] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 05/20/2017] [Accepted: 07/03/2017] [Indexed: 02/07/2023] Open
Abstract
AIM To determine if almond extracts reduce the severity of chemotherapy-induced mucositis as determined through biochemical, histological and behavioural markers.
METHODS Intestinal mucositis is a debilitating condition characterized by inflammation and ulceration of the gastrointestinal mucosa experienced by cancer patients undergoing chemotherapy. Certain bioactive plant products have shown promise in accelerating mucosal repair and alleviating clinical symptoms. This study evaluated almond extracts for their potential to reduce the severity of chemotherapy-induced mucositis in Dark Agouti rats. Female Dark Agouti rats were gavaged (days 3-11) with either PBS, almond hull or almond blanched water extract at two doses, and were injected intraperitoneally with 5-fluorouracil (5-FU-150 mg/kg) or saline on day 9 to induce mucositis. Burrowing behavior, histological parameters and myeloperoxidase activity were assessed.
RESULTS Bodyweight was significantly reduced in rats that received 5-FU compared to saline-treated controls (P < 0.05). Rats administered 5-FU significantly increased jejunal and ileal MPO levels (1048%; P < 0.001 and 409%; P < 0.001), compared to healthy controls. Almond hull extract caused a pro-inflammatory response in rats with mucositis as evidenced by increased myeloperoxidase activity in the jejunum when compared to 5-FU alone (rise 50%, 1088 ± 96 U/g vs 723 ± 135 U/g, P = 0.02). Other extract-related effects on inflammatory activity were minimal. 5-FU significantly increased histological severity score compared to healthy controls confirming the presence of mucositis (median of 9.75 vs 0; P < 0.001). The extracts had no ameliorating effect on histological severity score in the jejunum or ileum. Burrowing behavior was significantly reduced in all chemotherapy-treated groups (P = 0.001). The extracts failed to normalize burrowing activity to baseline levels.
CONCLUSION Almond extracts at these dosages offer little beneficial effect on mucositis severity. Burrowing provides a novel measure of affective state in studies of chemotherapy-induced mucositis.
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Affiliation(s)
- Alexandra L Whittaker
- School of Animal and Veterinary Sciences, the University of Adelaide, Roseworthy Campus, Roseworthy, SA 5371, Australia
| | - Ying Zhu
- School of Agriculture, Food and Wine, the University of Adelaide, Glen Osmond, SA 5064, Australia
| | - Gordon S Howarth
- School of Animal and Veterinary Sciences, the University of Adelaide, Roseworthy Campus, Roseworthy, SA 5371, Australia
- Department of Gastroenterology, Women’s and Children’s Hospital, North Adelaide, SA 5006, Australia
| | - Chi S Loung
- School of Animal and Veterinary Sciences, the University of Adelaide, Roseworthy Campus, Roseworthy, SA 5371, Australia
| | - Susan E P Bastian
- School of Agriculture, Food and Wine, the University of Adelaide, Glen Osmond, SA 5064, Australia
| | - Michelle G Wirthensohn
- School of Agriculture, Food and Wine, the University of Adelaide, Glen Osmond, SA 5064, Australia
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Larsen AE, Morville AL, Hansen T. Translating the Canadian Occupational Performance Measure to Danish, addressing face and content validity. Scand J Occup Ther 2017; 26:33-45. [DOI: 10.1080/11038128.2017.1388441] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Anette Enemark Larsen
- Dept. of Occupational Therapy, Institute of Physiotherapy and Occupational Therapy, Metropolitan University College, Copenhagen, Denmark
| | - Anne-Le Morville
- Dept. of Occupational Therapy, Institute of Physiotherapy and Occupational Therapy, Metropolitan University College, Copenhagen, Denmark
| | - Tina Hansen
- Dept. of Occupational Therapy, Institute of Physiotherapy and Occupational Therapy, Metropolitan University College, Copenhagen, Denmark
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Schiavi M, Costi S, Pellegrini M, Formisano D, Borghi S, Fugazzaro S. Occupational therapy for complex inpatients with stroke: identification of occupational needs in post-acute rehabilitation setting. Disabil Rehabil 2017; 40:1026-1032. [DOI: 10.1080/09638288.2017.1283449] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Margherita Schiavi
- Physical Medicine and Rehabilitation Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Stefania Costi
- Physical Medicine and Rehabilitation Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
- Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Martina Pellegrini
- Physical Medicine and Rehabilitation Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Debora Formisano
- Research and Statistics Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Sergio Borghi
- Physical Medicine and Rehabilitation Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Stefania Fugazzaro
- Physical Medicine and Rehabilitation Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
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34
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Enemark Larsen A, Rasmussen B. Perceptions of the Canadian occupational performance measure in enhancing the client-centered approach in the rehabilitation process. ACTA ACUST UNITED AC 2016; 14:3-10. [DOI: 10.11124/jbisrir-2016-003190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Haj Mohammad N, De Rooij S, Hulshof M, Ruurda J, Wijnhoven B, Erdkamp F, Sosef M, Gisbertz S, van Berge Henegouwen M, Sprangers M, van Laarhoven H. Activities of daily living and quality of life during treatment with neoadjuvant chemoradiotherapy and after surgery in patients with esophageal cancer. J Surg Oncol 2016; 114:684-690. [DOI: 10.1002/jso.24378] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 07/06/2016] [Indexed: 12/22/2022]
Affiliation(s)
- Nadia Haj Mohammad
- Department of Medical Oncology; Academic Medical Center; Amsterdam The Netherlands
- Department of Medical Oncology; University Medical Center Utrecht; Utrecht The Netherlands
| | - Sophia De Rooij
- Department of Internal Medicine; Section of Geriatric Medicine; Academic Medical Center Groningen; Groningen The Netherlands
- Department of Internal Medicine; Section of Geriatric Medicine; Academic Medical Center; Amsterdam The Netherlands
| | - Maarten Hulshof
- Department of Radiation Oncology; Academic Medical Center; Amsterdam The Netherlands
| | - Jelle Ruurda
- Department of Surgery; University Medical Center Utrecht; Utrecht The Netherlands
| | - Bas Wijnhoven
- Department of Surgery; Erasmus MC; University Medical Center Rotterdam; Rotterdam The Netherlands
| | - Frans Erdkamp
- Department of Internal Medicine; Zuyderland Medisch Centrum; Heerlen/Sittard/Geleen The Netherlands
| | - Meindert Sosef
- Department of Surgery; Zuyderland Medisch Centrum; Heerlen/Sittard/Geleen The Netherlands
| | - Suzanne Gisbertz
- Department of Surgery; Academic Medical Center; Amsterdam The Netherlands
| | | | - Mirjam Sprangers
- Department of Medical Psychology; Academic Medical Center; Amsterdam The Netherlands
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Marinho FS, Moram CBM, Rodrigues PC, Franzoi ACOB, Salles GF, Cardoso CRL. Profile of disabilities and their associated factors in patients with type 2 diabetes evaluated by the Canadian occupational performance measure: the Rio De Janeiro type 2 diabetes cohort study. Disabil Rehabil 2016; 38:2095-101. [PMID: 26729414 DOI: 10.3109/09638288.2015.1111440] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
PURPOSE To investigate the profile of disability in patients with type 2 diabetes and to evaluate its associated variables. METHOD The Canadian Occupational Performance Measure (COPM) assessed disabilities in 475 type 2 diabetic individuals. The activities were categorised by the International Classification of Functioning, Disability and Health. The Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) was used to evaluate pain, emotional and physical functioning domains of life-quality. Multivariable logistic regression assessed the independent correlates of better/worse performance. RESULTS Median COPM score was 4.5 (interquartile range 3-6). Problems in mobility (53.6%), self-care (21.1%) and daily-life (13.0%) were most frequently self-reported. Presence of restriction/pain in the upper limbs (odds ratio [OR]: 1.66; 95% CI: 1.11-2.47; p=0.013) and of peripheral neuropathy (OR: 1.64; 95% CI: 1.06-2.53; p=0.026) were associated with greater chance of worse performance. Higher values of SF-36 in pain and emotional domains (each 10 point increase; OR: 0.92 95% CI: 0.85-0.98; p=0.011; OR: 0.96; 95% CI: 0.92-1.00; p=0.063, respectively) and physical activity (OR: 0.63; 95% CI: 0.41-0.98; p=0.042) were associated with better performance. CONCLUSIONS Type 2 diabetic patients frequently reported disabilities in mobility, self-care and daily-life domains; and its associated factors were the presence of depression, upper limb pain and diabetic peripheral neuropathy. Implications for Rehabilitation The Canadian Occupational Performance Measure (COPM) instrument can be applied to patients with diabetes, as it identifies several disabilities, mostly in mobility, self-care and domestic life areas. Rehabilitation directed to upper limb pain/limitation and to lower limb peripheral neuropathy shall be implemented and may improve diabetic patients' performance and quality of life. A patient-centered rehabilitation strategy, guided by the COPM, may enable greater independence and autonomy, but this should be confirmed in future intervention studies.
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Affiliation(s)
- Fernanda S Marinho
- a Department of Occupational Therapy , Universidade Federal Do Janeiro , Rio De Janeiro , Brazil
| | - Camila B M Moram
- a Department of Occupational Therapy , Universidade Federal Do Janeiro , Rio De Janeiro , Brazil
| | - Priscila C Rodrigues
- a Department of Occupational Therapy , Universidade Federal Do Janeiro , Rio De Janeiro , Brazil
| | - Ana C O B Franzoi
- b Department of Internal Medicine , School of Medicine, Universidade Federal Do Janeiro , Rio De Janeiro , Brazil
| | - Gil F Salles
- b Department of Internal Medicine , School of Medicine, Universidade Federal Do Janeiro , Rio De Janeiro , Brazil
| | - Claudia R L Cardoso
- b Department of Internal Medicine , School of Medicine, Universidade Federal Do Janeiro , Rio De Janeiro , Brazil
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Jepsen LØ, Høybye MT, Hansen DG, Marcher CW, Friis LS. Outpatient management of intensively treated acute leukemia patients--the patients' perspective. Support Care Cancer 2015; 24:2111-2118. [PMID: 26553032 DOI: 10.1007/s00520-015-3012-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 11/01/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE In recent years, patients with acute leukemia (AL) have, to a greater extent, been managed in an outpatient setting where they live at home but appear every other day for follow-up visits at hospital. This qualitative article elucidates how patients with AL experience the different conditions of the inpatient and outpatient settings and how they reflect on these transitions in order to create meaning in and keep up everyday life. METHODS Qualitative semi-structured individual interviews twice with each AL patient focusing on the outpatient setting, impact on everyday life, responsibility and the home were performed. Twenty-two patients were interviewed the first time, and 15 of these were interviewed the second time. The data were analyzed in an everyday life relational perspective. RESULTS Outpatient management facilitates time to be administrated by the patients and thereby the possibility of maintaining everyday life, which was essential to the patients. The privacy ensured by the home was important to patients, and they accepted the necessary responsibility that came with it. However, time spent together with fellow patients and their relatives was an important and highly valued part of their social life. CONCLUSIONS Approached from the patient perspective, outpatient management provided a motivation for patients as it ensured their presence at home and provided the possibility of taking part in everyday life of the family, despite severe illness and intensive treatment. This may suggest a potential for extending the outpatient management further and also for patient involvement in own care.
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Affiliation(s)
- Lene Østergaard Jepsen
- Department of Hematology, Odense University Hospital, Sdr. Boulevard 29, DK-5000, Odense, Denmark. .,Clinical Institute, University of Southern Denmark, Odense, Denmark.
| | - Mette Terp Høybye
- Interdisciplinary Research Unit, Elective Surgery Center, Silkeborg Regional Hospital, Falkevej 3, 8600, Silkeborg, Denmark
| | - Dorte Gilså Hansen
- The National Research Center of Cancer Rehabilitation, Research Unit of General Practice, University of Southern Denmark, Copenhagen, Denmark
| | - Claus Werenberg Marcher
- Department of Hematology, Odense University Hospital, Sdr. Boulevard 29, DK-5000, Odense, Denmark
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