Catalyzing Research to Optimize Cancer Survivors' Participation in Work and Life Roles

Participation refers to a state of health in which a person is able to fully engage in roles and life situations. Adults living with and beyond cancer often report persistent participation restrictions that affect their productivity and quality of life. The American Occupational Therapy Foundation convened a group of scientists from seven different disciplines in a Planning Grant Collective (PGC) to stimulate research to identify scalable ways to preserve and optimize participation among cancer survivors. Participants identified challenges, prioritized solutions, and generated novel research questions that move beyond symptom and impairment mitigation as outcomes to identify interventions that improve participation in roles and life situations. This article summarizes the PGC discussion and recommendations regarding three challenges: (a) the dynamic and multi-faceted nature of participation, (b) a need to integrate the concept of participation within the culture of oncology, and (c) identification of priority areas in which new lines of research regarding participation would be most impactful.

Effect of art making on cancer-related symptoms of blood and marrow transplantation recipients

PURPOSE/OBJECTIVES

To examine whether a one-hour art-making session during blood and marrow transplantation (BMT) treatment significantly affects therapy-related symptoms, state anxiety, and stress.

DESIGN

A pre- and post-test crossover design.

SETTING

An urban outpatient cancer center in the midwestern United States.

SAMPLE

A convenience sample of 20 patients, aged 20-68 years (X = 38.5), receiving treatment at a BMT clinic.

METHODS

Participants completed a demographic questionnaire, the Therapy-Related Symptom Checklist, and the Spielberger State-Trait Anxiety Index, and provided salivary cortisol samples. After pretesting, individuals were assigned to either a wait list or intervention. Individuals in the wait-list group received the usual treatment before completing the post-test measures. Individuals in the intervention group participated in a one-hour art-making session, after which they completed post-test measures. Participants then crossed over to the other group.

MAIN RESEARCH VARIABLES

Art making, stress, state anxiety, and therapy-related symptoms.

FINDINGS

Therapy-related symptom concerns for the intervention group at post-test were significantly lower than at pretest; no change ocurred in the control group. The salivary cortisol levels were significantly lower at post-test in the intervention and control groups. No change occurred in the anxiety levels of participants in the intervention and control groups. The study hypothesis was partially supported.

CONCLUSIONS

Art making decreased therapy-related symptoms (e.g., feeling sluggish, difficulty concentrating). Use of more physiologic indices to measure stress and replication on a larger sample are suggested.

IMPLICATIONS FOR NURSING

Individuals receiving BMT may benefit from participation in art-making interventions. Art making is easy to implement in a clinic setting and allows for positive interactions between nurses and patients.

Changes in Activity Levels of Older Adult Cancer Survivors

Older adult cancer survivors often experience disability after cancer treatment, but little is known about how they adjust their daily activities during recovery and their opinions about those adjustments. Forty-three cancer survivors older than 60 years completed an oral interview using standardized and semi-structured assessments of activity level and mood. Overall, participants had a 12% reduction in their activity level at 3 months post-treatment. Greatest reductions were seen for high physically demanding leisure activities (34% reduction) and social activities (16% reduction), with lesser reductions in instrumental (7% reduction) and low physically demanding leisure activities (4% reduction). Twelve percent reported clinically significant depressive symptoms and none met criteria for anxiety disorders. Although cancer treatment is only one factor affecting activity routines, it creates challenges and older adults often reconsider priorities regarding how to spend limited energy. A customized balance of energizing and energy-depleting activities may be most conducive to recovery after cancer treatment.