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Pergolotti M, Wood KC, Kendig T, Love K, Mayo S. Cancer rehabilitation services for older women with breast cancer: Impact on health-related quality of life outcomes. J Am Geriatr Soc 2024; 72:2402-2411. [PMID: 38884258 DOI: 10.1111/jgs.19021] [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: 01/22/2024] [Revised: 04/12/2024] [Accepted: 04/27/2024] [Indexed: 06/18/2024]
Abstract
BACKGROUND Older breast cancer survivors (BCS, age ≥ 65) are vulnerable to experiencing persistent symptoms and associated declines in health-related quality of life (HRQOL). In research trials, cancer rehabilitation interventions (physical or occupational therapy, PT/OT) have been shown to enhance HRQOL, but the impact of community-based PT/OT services for older BCS is unknown. We performed a retrospective, observational study to better understand the impact of PT/OT services on the HRQOL of older BCS. METHODS Outcomes and covariates were extracted from the outpatient rehabilitation medical record. HRQOL outcomes included: PROMIS® global physical health (GPH), global mental health (GMH), physical function (PF), and ability to participate in social roles and activities (SRA). Linear mixed-effect models were used to examine change in HRQOL outcomes and explore the influence of patient age and service type (PT/OT). ICD-10 codes were examined and compared between service types to describe the impairments treated. RESULTS PT/OT cases (N = 694) were 71.79 ± 5.44 years old and participated in a median of 11 visits (IQR: 7.0-17.25) over 9.71 weeks (IQR: 6.29-15.29). Most (84.4%) attended PT (n = 579; 84%) versus OT (n = 115; 16%). Overall, significant improvement was observed in each HRQOL outcome (GPH: +3.00, p < 0.001; GMH: +1.80, p < 0.001; PF: +1.97, p < 0.001; SRA: +2.34, p < 0.001). Service type influenced only GPH (p = 0.041); mean improvement was +3.24 (SE: 0.290, p < 0.001) for PT cases and + 1.78 for OT cases (SE: 0.651, p = 0.007). PT cases commonly received treatment for weakness/atrophy, pain, walking, and posture; OT cases commonly received treatment for lymphedema and scarring/fibrosis. No age effects were observed. CONCLUSIONS In this large study of older BCS who participated in community-based PT/OT services across the United States, we observed significant improvements in HRQOL outcomes that are important to older BCS and their providers. Although more research is needed, these findings suggest that improved access to PT/OT could help address unmet HRQOL needs among this population.
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Affiliation(s)
- Mackenzi Pergolotti
- ReVital Cancer Rehabilitation, Select Medical, Mechanicsburg, Pennsylvania, USA
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kelley C Wood
- ReVital Cancer Rehabilitation, Select Medical, Mechanicsburg, Pennsylvania, USA
| | - Tiffany Kendig
- ReVital Cancer Rehabilitation, Select Medical, Mechanicsburg, Pennsylvania, USA
| | - Kim Love
- K. R. Love Quantitative Consulting and Collaboration, Athens, Georgia, USA
| | - Stacye Mayo
- ReVital Cancer Rehabilitation, Select Medical, Mechanicsburg, Pennsylvania, USA
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Pergolotti M, Wood KC, Kendig TD, Mayo S. Impact of Real-World Outpatient Cancer Rehabilitation Services on Health-Related Quality of Life of Cancer Survivors across 12 Diagnosis Types in the United States. Cancers (Basel) 2024; 16:1927. [PMID: 38792004 PMCID: PMC11119581 DOI: 10.3390/cancers16101927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 05/06/2024] [Accepted: 05/11/2024] [Indexed: 05/26/2024] Open
Abstract
Compared to adults without cancer, cancer survivors report poorer health-related quality of life (HRQOL), which is associated with negative treatment outcomes and increased healthcare use. Cancer-specialized physical and occupational therapy (PT/OT) could optimize HRQOL; however, the impact among survivors with non-breast malignancies is unknown. This retrospective (2020-2022), observational, study of medical record data of 12 cancer types, examined pre/post-HRQOL among cancer survivors who completed PT/OT. PROMIS® HRQOL measures: Global Health (physical [GPH] and mental [GMH]), Physical Function (PF), and Ability to Participate in Social Roles and Activities (SRA) were evaluated using linear mixed effect models by cancer type, then compared to the minimal important change (MIC, 2 points). Survivors were 65.44 ± 12.84 years old (range: 19-91), male (54%), with a median of 12 visits. Improvements in GPH were significant (p < 0.05) for all cancer types and all achieved MIC. Improvements in GMH were significant for 11/12 cancer types and 8/12 achieved MIC. Improvements in PF were significant for all cancer types and all achieved the MIC. Improvements in SRA were significant for all cancer types and all groups achieved the MIC. We observed statistically and clinically significant improvements in HRQOL domains for each of the 12 cancer types evaluated.
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Affiliation(s)
- Mackenzi Pergolotti
- ReVital Cancer Rehabilitation, Select Medical, Mechanicsburg, PA 17055, USA; (K.C.W.); (T.D.K.); (S.M.)
- Department of Occupational Therapy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Kelley C. Wood
- ReVital Cancer Rehabilitation, Select Medical, Mechanicsburg, PA 17055, USA; (K.C.W.); (T.D.K.); (S.M.)
| | - Tiffany D. Kendig
- ReVital Cancer Rehabilitation, Select Medical, Mechanicsburg, PA 17055, USA; (K.C.W.); (T.D.K.); (S.M.)
| | - Stacye Mayo
- ReVital Cancer Rehabilitation, Select Medical, Mechanicsburg, PA 17055, USA; (K.C.W.); (T.D.K.); (S.M.)
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Stimler L, Campbell C, Cover L, Pergolotti M. Current Trends in Occupational Therapy for Adolescent and Young Adult Cancer Survivors: A Scoping Review. Occup Ther Health Care 2023; 37:664-687. [PMID: 35697347 PMCID: PMC10964189 DOI: 10.1080/07380577.2022.2086335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 06/01/2022] [Indexed: 10/18/2022]
Abstract
Adolescent and young adult cancer survivors experience barriers to occupational participation following cancer treatment. This article aims to identify the scope of occupational therapy evidence for adolescent and young adult cancer survivors. A scoping review of articles cited in CINAHL Complete, MEDLINE (EBSCO), Academic Search Complete, APA PsycINFO, and PubMed was performed. The initial search yielded 391 articles, with eight publications included in the final review. Results revealed a significant lack of age-specific occupational therapy-based resources for adolescent and young adult cancer survivors. Evidence supports the use of self-management, physical activity, therapeutic exercise, activities of daily living training and adaptation, and app-based coaching to improve client outcomes. Further research is required to determine the effectiveness of occupational therapy services, as well as to establish evidence-based guidelines for practice.
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Affiliation(s)
- Laura Stimler
- Auerbach School of Occupational Therapy, Spalding University, Louisville, KY, USA
| | - Claudine Campbell
- Lead Occupational Therapist, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Leah Cover
- Instruction and Learning Services Librarian, Spalding University Library, Louisville, KY, USA
| | - Mackenzi Pergolotti
- Research and Clinical Development, ReVital Cancer Rehabilitation, Select Medical, Adjunct Assistant Professor, Occupational Therapy, Colorado State University, USA
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Kennedy MA, Potiaumpai M, Maitin-Shepard M, Wilson CM, Campbell A, Schwartz AL, Gorzelitz J, Caru M, Grimmett C, Schmitz KH. Looking back: a review of policy implications for exercise oncology. J Natl Cancer Inst Monogr 2023; 2023:140-148. [PMID: 37139975 PMCID: PMC10501465 DOI: 10.1093/jncimonographs/lgad002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 12/16/2022] [Accepted: 01/13/2023] [Indexed: 05/05/2023] Open
Abstract
The evidence to support the benefits of exercise for people living with and beyond cancer is robust. Still, exercise oncology interventions in the United States are only eligible for coverage by third-party payers within the restrictions of cancer rehabilitation settings. Without expanded coverage, access will remain highly inequitable, tending toward the most well-resourced. This article describes the pathway to third-party coverage for 3 programs that address a chronic disease and utilize exercise professionals: the Diabetes Prevention Program, Supervised Exercise Training for Peripheral Artery Disease, and Cancer Rehabilitation. Lessons learned will be applied toward expanding third-party coverage for exercise oncology programming.
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Affiliation(s)
- Mary A Kennedy
- Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Melanie Potiaumpai
- Milton S. Hershey College of Medicine, Public Health Sciences, Pennsylvania State University, Hershey, PA, USA
| | | | - Christopher M Wilson
- Physical Therapy Program, School of Health Sciences, Oakland University, Rochester, MI, USA
| | - Anna Campbell
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, United Kingdom
| | - Anna L Schwartz
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
| | - Jessica Gorzelitz
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA, USA
| | - Maxime Caru
- Milton S. Hershey College of Medicine, Public Health Sciences, Pennsylvania State University, Hershey, PA, USA
| | - Chloe Grimmett
- School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Kathryn H Schmitz
- Division of Hematology and Oncology, University of Pittsburgh, Pittsburgh, PA, USA
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Longpré SM, Rader NC, Dougherty KJ, Motai Y, Leinhauser KC. Factors That Influence Occupational Engagement of Young Adults Who Are Cancer Survivors: A Pilot Study. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2023; 43:218-227. [PMID: 36245400 DOI: 10.1177/15394492221128779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Cancer and its treatment can impact occupational engagement. However, occupational therapy-specific research studying young adult cancer survivors remains limited. The objective of this study to identify the type of occupations that young adult cancer survivors choose to engage in and to understand their decision-making process when choosing these occupations. A mixed-methods explanatory sequential design was used. Eleven participants, nine females and two males, between the ages of 18 and 35, were included. Several occupations were identified for engagement such as activities of daily living, leisure, work, sleep and rest, and health management. The predominant factor that influenced why occupations were chosen was that individuals purposefully selected occupations that allowed them to choose a path toward a more meaningful life. Information gained from this pilot study can be used to inform occupational therapy practitioners regarding services and interventions that promote occupational engagement for young adult cancer survivors.
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Affiliation(s)
| | - Nadeya C Rader
- Blanchfield Army Community Hospital, Fort Campbell, KY, USA
| | | | - Yael Motai
- Wellness Beyond Rehab, LLC, Oldsmar, FL, USA
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Brick R, Natori A, Moreno PI, Molinares D, Koru-Sengul T, Penedo FJ. Predictors of cancer rehabilitation medicine referral and utilization based on the Moving Through Cancer physical activity screening assessment. Support Care Cancer 2023; 31:216. [PMID: 36928440 PMCID: PMC10281047 DOI: 10.1007/s00520-023-07679-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 03/07/2023] [Indexed: 03/18/2023]
Abstract
PURPOSE Cancer survivors experience high rates of physical inactivity that often go unaddressed. The My Wellness Check program (MWC) is an EHR-integrated screening and referral system that includes surveillance of physical activity and triage to cancer rehabilitation medicine services. This study examined assessment of physical activity and subsequent referrals to cancer rehabilitation medicine. METHODS A secondary analysis was performed for survivors who completed the MWC between April 2021 and January 2022. Univariable and multivariable logistic regression modeled determinants of qualification for a physical activity referral and provider completion of referral to cancer rehabilitation medicine. Referral was based on responses to the Moving Through Cancer questionnaire. Adjusted odds ratios (aOR) and corresponding 95% confidence intervals (95% CI) were calculated. RESULTS There were 1,174 survivors who completed the assessment, of which 46% (n = 540) reported physical inactivity. After controlling for group differences, individuals with moderate-severe physical dysfunction (aOR: 1.750; 95% CI: 1.137, 2.693) had higher odds, and self-reporting Hispanic or Latino ethnicity (aOR: 0.720; CI: 0.556, 0.932) had lower odds of physical inactivity. Only 31% (n = 168) received a completed physician referral to cancer rehabilitation medicine following identification of physical inactivity. No patient-level factors were associated with receiving a physician referral. Following referral, 8% (n = 13) utilized cancer rehabilitation medicine services. CONCLUSIONS Patient-level and clinical factors may predict qualification for physical activity referrals; however, they don't appear to predict referral completion to cancer rehabilitation medicine. Future research should focus on potential provider- and organization-level factors that interact and influence access to cancer rehabilitation medicine services.
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Affiliation(s)
- Rachelle Brick
- Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, Rockville, MD, USA.
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA.
| | - Akina Natori
- Division of Medical Oncology, Department of Medicine, Miller School of Medicine, FL, Miami, USA
| | - Patricia I Moreno
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Diana Molinares
- Department of Physical Medicine and Rehabilitation, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Tulay Koru-Sengul
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA
- Sylvster Comprehensive Cancer Center, Miami, FL, USA
| | - Frank J Penedo
- Division of Medical Oncology, Department of Medicine, Miller School of Medicine, FL, Miami, USA
- Department of Psychology, University of Miami, Miami, FL, USA
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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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Kaya C, Chan F, Iwanaga K, Wu JR, Bezyak J. A Psychometric Validation of the Impact on Participation and Autonomy Questionnaire in a Sample of Turkish Cancer Survivors. REHABILITATION COUNSELING BULLETIN 2023. [DOI: 10.1177/00343552221146160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Community participation and autonomy are two of the vital treatments and rehabilitation outcomes for people with chronic health conditions and disabilities, including people with cancer. The purpose of this study is to investigate psychometric properties of the Impact on Participation and Autonomy Scale (IPA) in a sample of Turkish cancer survivors. An exploratory factor analysis was used to analyze data collected from 186 cancer survivors who completed the IPA, Health Care Climate Questionnaire, Satisfaction with Life Scale, and the Role Functioning subscale of the EORTC Core Quality of Life Questionnaire. In contrast to the original five-factor solution, the results provided a better fit for a three-factor correlated model ( Activities of Daily Living [ADL]/ Instrumental ADL, social relations, and employment and education). The IPA factors were significantly associated with supportive healthcare climate, role functioning, and life satisfaction in the theoretically expected directions, providing support for the nomological construct validity of the Turkish version of the IPA. Overall, the Turkish version of the IPA is a psychometrically sound measure of participation and autonomy that can be used to assess cancer survivors’ levels of community participation for treatment planning and selection of evidence-based healthcare and psychosocial interventions for cancer survivors.
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Affiliation(s)
- Cahit Kaya
- University of Texas Rio Grande Valley, Edinburg, TX, USA
- Harran University, Sanliurfa, Turkey
| | - Fong Chan
- University of Wisconsin-Madison, USA
| | | | - Jia Rung Wu
- Northern Illinois University, DeKalb, IL, USA
| | - Jill Bezyak
- University of Northern Colorado, Greeley, USA
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Ahmad T, Ornos EDB, Ahmad S, Al-Wassia RK, Mushtaque I, Shah SM, Al-Omari B, Baig M, Tang K. Global Research Mapping of Psycho-Oncology Between 1980 and 2021: A Bibliometric Analysis. Front Psychol 2022; 13:947669. [PMID: 35910981 PMCID: PMC9326365 DOI: 10.3389/fpsyg.2022.947669] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 06/07/2022] [Indexed: 01/15/2023] Open
Abstract
Background and Aim Psycho-oncology is a cross-disciplinary and collaborative sub-specialty of oncology that focuses on the psychological, behavioral, ethical, and social aspects of cancer in clinical settings. The aim of this bibliometric study was to analyze and characterize the research productivity and trends in psycho-oncology between 1980 and 2021. Methodology In May 2022, the Scopus® database was searched for psycho-oncology-related publications using predetermined search keywords with specific restrictions. Lotka’s law was applied to check the authors’ productivity, while Bradford’s law was used to assess the core journals in this field. The data was analyzed for different bibliometric indicators in the Biblioshiny package, an RStudio tool for bibliometric analysis. Results The initial search resulted in a total of 2,906 publications. Of which, 1,832 publications were included in the final analysis, published between 1980 and 2021. The analyzed publications were written by 7,363 authors from 74 countries and published in 490 journals. There has been a significant increase in psycho-oncology-related publications after 2010. The most productive year was 2021 (n = 365). The annual scientific growth rate was found to be 13.9%. The most relevant leading author in terms of publications was Luigi Grassi from the University of Ferrara, Italy (n = 42). Lotka’s law found that the number of authors declined as the number of papers written increased. The core journals were Psycho-Oncology, Supportive Care in Cancer, and Journal of Psychosocial Oncology. The most frequently used author’s keywords other than searching keywords were cancer, oncology, quality of life, depression, and anxiety. Recent psycho-oncology-related topics included mental health, COVID-19 infection in humans, people, pandemic, and tumor. The University of Sydney was the top-ranked institution. The leading country in terms of publications, citations, corresponding author country, and international collaboration was the United States of America (United States). The United States had the strongest collaboration with Australia and Canada. Conclusion The research hotspots include mental health conditions and interventions in cancer patients. We identified international collaboration and research expenditure to be strongly associated with psycho-oncology research productivity. Researchers’ collaboration, which is visible among developed countries, should be extended to low-income countries in order to expand psycho-oncology-related research and understanding.
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Affiliation(s)
- Tauseef Ahmad
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
- *Correspondence: Tauseef Ahmad, ; ; orcid.org/0000-0001-8793-273X
| | - Eric David B. Ornos
- College of Medicine, University of the Philippines Manila, Manila, Philippines
| | - Shabir Ahmad
- Department of Agriculture, Bacha Khan University Charsadda, Charsadda, Pakistan
| | - Rolina Kamal Al-Wassia
- Department of Radiology, Radiation Oncology Unit, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Iqra Mushtaque
- Department of Psychology, Bahauddin Zakariya University, Multan, Pakistan
| | - S. Mudasser Shah
- Department of Psychosomatics and Psychiatry, School of Medicine, Zhongda Hospital, Southeast University, Nanjing, China
| | - Basem Al-Omari
- Department of Epidemiology and Population Health, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
- KU Research and Data Intelligence Support Center (RDISC), Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
- Basem Al-Omari,
| | - Mukhtiar Baig
- Department of Clinical Biochemistry, Faculty of Medicine, Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Kun Tang
- Vanke School of Public Health, Tsinghua University, Beijing, China
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10
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Brooks FA, Keeney T, Ritchie C, Tolchin DW. Rehabilitation for Symptom Management for Patients with Cancer at the End of Life: Current Evidence and Barriers to Care. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2021. [DOI: 10.1007/s40141-021-00325-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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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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12
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Morikawa S, Amanat Y. Occupational Therapy's Role with Oncology in the Acute Care Setting: A Descriptive Case Study. Occup Ther Health Care 2021; 36:152-167. [PMID: 34396894 DOI: 10.1080/07380577.2021.1961181] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
As individuals with cancer actively undergo medical treatment, they often experience profound impairments and side-effects that impact their physical and psychosocial functioning and well-being. As occupational therapy practitioners working in acute care, challenges when working with those with oncological diseases may include high acuity, impact on multiple body systems, and fluctuating symptom presentation and levels of function. Thus, it is critical for occupational therapy practitioners to be skilled in identifying and addressing the distinct needs of cancer survivors in the acute care setting. This manuscript presents a descriptive case study to highlight occupational therapy's role in cancer rehabilitation in the acute care setting.
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Affiliation(s)
- Stacey Morikawa
- USC Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
| | - Yasaman Amanat
- USC Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, California, USA
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13
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Schroder J, Mackenzie L. Outcomes Related to Activity Performance and Participation of Non-Pharmacological Cancer-Related Fatigue Interventions. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2021; 42:50-64. [PMID: 34315289 DOI: 10.1177/15394492211029214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Increased cancer survivorship means more people are living with cancer-related fatigue (CRF), which is associated with activity performance limitations, restricted participation in meaningful life roles, and reduced quality of life. To identify whether non-pharmacological interventions that are effective in minimizing CRF also have an impact on everyday activity performance and participation outcomes for adult cancer survivors. This is a systematic review with narrative synthesis. Eight databases were searched (Medline, CINAHL, PsychINFO, EMBASE, Scopus, OT Seeker, CENTRAL, Cochrane SR database), from 2000 to 2020 for randomized controlled trials of effective non-pharmacological CRF interventions in adult cancer survivors with fatigue. A total of 5,762 studies were identified of which 29 studies were reviewed. In 28 studies, quality of life was investigated as a primary or secondary outcome, where concepts of participation or activity performance were used. Review findings indicate there is insufficient evidence to determine whether activity performance and participation is affected by CRF interventions.
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Mack A, Arrigo M, Fink T, Garrity K, Cox D, Kwasnowski L, Wong J. Fatigue and functional outcomes in cancer rehabilitation. Support Care Cancer 2021; 29:8069-8076. [PMID: 34231039 DOI: 10.1007/s00520-021-06405-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 06/26/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Cancer-related fatigue (CRF) is one of the most common symptoms experienced by oncology patients, though its impact on functional outcomes during inpatient rehabilitation is relatively unknown. The purpose of this study is to determine whether CRF severity on admission is related to functional gains following standard rehabilitation care in an inpatient oncology rehabilitation population. METHODS A retrospective cohort study was conducted within an inpatient oncology unit at a long-term acute care hospital. Seventy-six patients admitted to the hospital between April and December 2015 with an oncology diagnosis, planned discharge, and completed standardized assessments of CRF and functional ability were included in this study. Patients received standard interdisciplinary rehabilitation services including physical and occupational therapy. CRF was assessed on admission using the Brief Fatigue Inventory, and functional abilities were assessed on admission and discharge using the basic mobility and daily activity domains of the Activity Measure for Post-Acute Care inpatient short forms (AM-PAC). RESULTS Ninety-seven percent of patients reported CRF, and 57% reported severe CRF upon admission. Patients demonstrated on average a 30% and 14% reduction in functional impairment in basic mobility and daily activity respectively during their admission. There was no significant correlation found between CRF on admission and change in functional impairment. CONCLUSION This study contributes to existing literature in that it found patients who received inpatient rehabilitation services demonstrate significant improvement in their functional status despite reporting CRF upon admission to a long-term acute care hospital oncology unit.
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Affiliation(s)
- Amanda Mack
- Spaulding Hospital for Continuing Medical Care Cambridge, 1575 Cambridge St, Cambridge, MA, 02138, USA. .,MGH Institute of Health Professions, 36 1st Avenue, Charlestown, MA, 02129, USA.
| | - Monica Arrigo
- Spaulding Hospital for Continuing Medical Care Cambridge, 1575 Cambridge St, Cambridge, MA, 02138, USA.,MGH Institute of Health Professions, 36 1st Avenue, Charlestown, MA, 02129, USA
| | - Twyla Fink
- Spaulding Hospital for Continuing Medical Care Cambridge, 1575 Cambridge St, Cambridge, MA, 02138, USA.,Salem State University, 352 Lafayette St, Salem, MA, 01970, USA
| | - Karla Garrity
- Spaulding Hospital for Continuing Medical Care Cambridge, 1575 Cambridge St, Cambridge, MA, 02138, USA
| | - David Cox
- MGH Institute of Health Professions, 36 1st Avenue, Charlestown, MA, 02129, USA
| | - Lauren Kwasnowski
- Spaulding Hospital for Continuing Medical Care Cambridge, 1575 Cambridge St, Cambridge, MA, 02138, USA.,MGH Institute of Health Professions, 36 1st Avenue, Charlestown, MA, 02129, USA
| | - John Wong
- MGH Institute of Health Professions, 36 1st Avenue, Charlestown, MA, 02129, USA
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Williamson HJ, Armin JS, Stakely E, Nasimi B, Joseph DH, Meyers J, Baldwin JA. Community-Engaged Research to Address Health Disparities of Indigenous Women With Disabilities. ANNALS OF INTERNATIONAL OCCUPATIONAL THERAPY 2021; 4:e158-e165. [PMID: 34676309 PMCID: PMC8528383 DOI: 10.3928/24761222-20201202-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION To address health disparities among underserved populations, occupational therapists can participate in community-engaged research and practice to improve access to preventive health services. METHODS This study used grounded theory and participant observation approaches to identify lessons learned from a community-engaged research project to improve cancer screening rates for Indigenous women with an intellectual and/or developmental disability (IDD). Audio recordings of meetings with a community advisory board (AB) were analyzed with an inductive coding approach, and results were member checked with AB members. The AB members (N = 8) were involved in statewide Indigenous health, cancer, and disability activities. Six of the eight AB members identified as Indigenous. RESULTS Key themes highlighted within the Indigenous research framework included reflection, relationship building, project planning, and project execution. Results of this phase of the research project highlight the importance of codesigning research projects with Indigenous communities. CONCLUSION The findings have limited transferability to other research contexts. However, this study highlights the need for future research on best practices for occupational therapists to participate in community-engaged research projects to address health disparities in underserved populations, such as Indigenous women with IDD.
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Stout NL, Santa Mina D, Lyons KD, Robb K, Silver JK. A systematic review of rehabilitation and exercise recommendations in oncology guidelines. CA Cancer J Clin 2021; 71:149-175. [PMID: 33107982 PMCID: PMC7988887 DOI: 10.3322/caac.21639] [Citation(s) in RCA: 98] [Impact Index Per Article: 32.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 08/06/2020] [Accepted: 08/06/2020] [Indexed: 12/18/2022] Open
Abstract
Guidelines promote high quality cancer care. Rehabilitation recommendations in oncology guidelines have not been characterized and may provide insight to improve integration of rehabilitation into oncology care. This report was developed as a part of the World Health Organization (WHO) Rehabilitation 2030 initiative to identify rehabilitation-specific recommendations in guidelines for oncology care. A systematic review of guidelines was conducted. Only guidelines published in English, for adults with cancer, providing recommendations for rehabilitation referral and assessment or interventions between 2009 and 2019 were included. 13840 articles were identified. After duplicates and applied filters, 4897 articles were screened. 69 guidelines were identified with rehabilitation-specific recommendations. Thirty-seven of the 69 guidelines endorsed referral to rehabilitation services but provided no specific recommendations regarding assessment or interventions. Thirty-two of the 69 guidelines met the full inclusion criteria and were assessed using the AGREE II tool. Twenty-one of these guidelines achieved an AGREE II quality score of ≥ 45 and were fully extracted. Guidelines exclusive to pharmacologic interventions and complementary and alternative interventions were excluded. Findings identify guidelines that recommend rehabilitation services across many cancer types and for various consequences of cancer treatment signifying that rehabilitation is a recognized component of oncology care. However, these findings are at odds with clinical reports of low rehabilitation utilization rates suggesting that guideline recommendations may be overlooked. Considering that functional morbidity negatively affects a majority of cancer survivors, improving guideline concordant rehabilitative care could have substantial impact on function and quality of life among cancer survivors.
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Affiliation(s)
- Nicole L Stout
- Department of Hematology/Oncology Cancer Prevention and Control, West Virginia University Cancer Institute, Morgantown, West Virginia
- Rehabilitation Medicine Department, National Institutes of Health, Bethesda, Maryland
| | - Daniel Santa Mina
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Kathleen D Lyons
- Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
- Norris Cotton Cancer Center, Geisel School of Medicine, Hanover, New Hampshire
| | - Karen Robb
- North East London Cancer Alliance, London, United Kingdom
- Transforming Cancer Services Team for London, Healthy London Partnership, London, United Kingdom
| | - Julie K Silver
- Department of Physical Medicine & Rehabilitation, Harvard Medical School, Boston, Massachusetts
- Massachusetts General Hospital, Boston, Massachusetts
- Brigham and Women's Hospital, Boston, Massachusetts
- Spaulding Rehabilitation Hospital, Boston, Massachusetts
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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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18
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Hwang NK, Jung YJ, Park JS. Information and Communications Technology-Based Telehealth Approach for Occupational Therapy Interventions for Cancer Survivors: A Systematic Review. Healthcare (Basel) 2020; 8:healthcare8040355. [PMID: 32977651 PMCID: PMC7712965 DOI: 10.3390/healthcare8040355] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/21/2020] [Accepted: 09/21/2020] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Occupational therapy (OT) practice has a unique perspective that addresses the complex needs of cancer survivors. Despite the expanded research and application of OT services using telehealth (TH) to promote clients’ health and well-being, studies on OT services using TH for cancer survivors are rare. This study aimed to review the TH approaches in the scope of OT and the outcome of factors affecting occupational engagement in adult cancer survivors. (2) Materials and Methods: This systematic review performed a literature search of five databases (Medline Complete, PubMed, CINAHL, PsycINFO, Web of Science) using a combination of keywords and cross-referencing. Studies were included if they described a TH intervention within the scope of OT practice to improve occupational engagement. (3) Results: Fifteen studies (12 randomized controlled trials, three quasiexperimental studies) were reviewed. Physical activity had a positive effect on physical and cognitive function. Symptom self-management showed positive effects on the relief of symptom burden. Psychosocial interventions, which included cognitive behavioral therapy, problem-solving, cognitive behavioral therapy for insomnia, mind–body training, reduced sleep disturbance, and improved physical activity. Lifestyle behavior change interventions improved participation in moderate-intensity physical activity and diet quality. In addition, these interventions reduced cancer-related symptoms such as pain, depression, fatigue, distress, and improved quality of life. There were no direct outcomes of occupational engagement, excluding sleep, that could be confirmed through this review. (4) Conclusion: This review explored and confirmed the usefulness of TH approaches in the scope of OT practice in adult cancer survivors. It also supports the notion that OT-specific research using TH interventions for cancer survivors will be needed in the future.
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Affiliation(s)
- Na-Kyoung Hwang
- Department of Occupational Therapy, Seoul North Municipal Hospital, Seoul 02062, Korea;
| | - Young-Jin Jung
- Department of Radiological Science at Health Sciences Division DongSeo University, Busan 47011, Korea
- Correspondence: (Y.-J.J.); (J.-S.P.)
| | - Ji-Su Park
- Advanced Human Resource Development Project Group for Health Care in Aging Friendly Industry, Dongseo University, Busan 47011, Korea
- Correspondence: (Y.-J.J.); (J.-S.P.)
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Curtin S, Galvin R, Robinson K. The relationship between cancer survivors’ well-being and participation in work, activities of daily living and social engagement: Findings from the European Social Survey (2014). Scand J Occup Ther 2019; 28:531-541. [DOI: 10.1080/11038128.2019.1695932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Sara Curtin
- School of Allied Health, University of Limerick, Limerick, Ireland
| | - Rose Galvin
- School of Allied Health, University of Limerick, Limerick, Ireland
- Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Katie Robinson
- School of Allied Health, University of Limerick, Limerick, Ireland
- Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
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Pigott A, Nixon J, Brennan K, Trevethan M, Mahoney L. Developing a sustainable cancer educational resource for occupational therapists. Br J Occup Ther 2019. [DOI: 10.1177/0308022619848954] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Amanda Pigott
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
- Occupational Therapy Department, Princess Alexandra Hospital, Brisbane, Australia
- Centre for Functioning and Health Research (CFAHR), Metro South Hospital and Health Service, Brisbane, Australia
| | - Jodie Nixon
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
- Occupational Therapy Department, Princess Alexandra Hospital, Brisbane, Australia
| | - Kate Brennan
- Occupational Therapy Department, Princess Alexandra Hospital, Brisbane, Australia
| | - Megan Trevethan
- Occupational Therapy Department, Princess Alexandra Hospital, Brisbane, Australia
| | - Lauren Mahoney
- Occupational Therapy Department, Princess Alexandra Hospital, Brisbane, Australia
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Newman RM, Alfano CM, Radomski MV, Pergolotti M, Wolf TJ, Sleight AG, Bryant AL, Voelbel GT, de Moor JS, Nitkin R, Daniels E, Braveman B, Walker RK, Williams GR, Winters-Stone KM, Cheville AL, Campbell SE, Lawlor MC, King AA, Ness KK, Srivastava P, Lyons KD. Catalyzing Research to Optimize Cancer Survivors' Participation in Work and Life Roles. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2019; 39:189-196. [PMID: 31046601 DOI: 10.1177/1539449219844749] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
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.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Ralph Nitkin
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA
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Csontos JK, Fitzsimmons D, Jones M, Wilkinson WM, Horton J, Love-Gould L, Tee A, Watts T. Realist evaluation of cancer rehabilitation services in South Wales (REEACaRS): a mixed methods study protocol. BMJ Open 2019; 9:e025953. [PMID: 31015271 PMCID: PMC6500344 DOI: 10.1136/bmjopen-2018-025953] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 03/14/2019] [Accepted: 03/18/2019] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Long-term and late effects of cancer treatments can cause functional limitations and reduce quality of life. Cancer rehabilitation services, which can comprise physical exercise, psychological support and educational interventions depending on the individual's needs, have been found to have a positive effect on health-related quality of life worldwide. However, accessibility or the lack of awareness on available help can act as barriers and influence the uptake of services, resulting in people having unmet rehabilitation needs. In Wales, UK, 41% of people, who have had health and social care needs resulting from cancer and its treatments, reported that they did not receive care when needed. The reason for this lack of support has not yet been fully investigated. The aim of this study is to investigate the conditions in which cancer rehabilitation services work and their underpinning mechanisms in South Wales, UK, specifically addressing barriers, facilitators and costs. METHODS AND ANALYSIS Realist evaluation, which explains for whom a service works in what circumstances and how through context-mechanism-outcome pattern conjunctions, will be used in three phases to investigate the conditions in which cancer rehabilitation services work and their underpinning mechanisms. Phase 1 will be secondary analysis of a cancer rehabilitation database from a local Health Board to give context to who are accessing rehabilitation. Phase 2 will be thematic analysis of face-to-face, semistructured rehabilitation participant (n=20) and healthcare professional (n=20) interviews to explore the mechanisms of how cancer rehabilitation works. Phase 3 will be two case studies and cost-consequences analysis of cancer rehabilitation services. ETHICS AND DISSEMINATION This study received favourable ethical opinion from London South-East Research Ethics Committee (17/LO/2123) in December 2017. This project is part of the author's PhD thesis and it is expected that the findings will be disseminated in academic journals and at local and international conferences.
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Affiliation(s)
| | | | | | | | - Joanne Horton
- Abertawe Bro Morgannwg University Health Board, Port Talbot, UK
| | | | - Anna Tee
- Macmillan Cancer Support, Bridgend, UK
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Sagari A, Ikio Y, Imamura N, Deguchi K, Sakai T, Tabira T, Higashi T. Effect of occupation-based interventions in patients with haematopoietic malignancies undergoing chemotherapy: A pilot randomised controlled trial. Hong Kong J Occup Ther 2018; 31:97-105. [PMID: 30643497 PMCID: PMC6322108 DOI: 10.1177/1569186118818680] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Accepted: 11/20/2018] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND/OBJECTIVE Chemotherapy for cancer negatively affects activities of daily living and quality of life. This study aimed to validate and compare the efficacy of two different interventions in patients with haematopoietic malignancies undergoing chemotherapy: (1) occupation-based interventions, designed using the Aid for Decision-making in Occupation Choice (ADOC) (an iPAD application) and (2) impairment-based interventions. ADOC helps promote decision-making during activities and participation in occupation-based goal setting. The impairment-based intervention group served as the comparison group and underwent impairment-based interventions focusing on dysfunction. METHODS In this single-blinded pilot randomised controlled trial, 19 participants received an occupation-based intervention (n = 9) or an impairment-based intervention (n = 10). The treatment period comprised two sessions. Recruitment, compliance and outcome completion rates were calculated for the study. Effect sizes were examined for outcomes regarding physical performance, instrumental activities of daily living and quality of life as evaluated by a blinded assessor. RESULTS In this study, 24.8% (28/113) of the eligible patients with haematopoietic malignancies were enrolled, and 67.9% (19/28) of these were retained up to the post-assessment stage. Recruitment (25%) and compliance (68%) rates were satisfactory. The Functional Assessment of Cancer Therapy-General emotional well-being and total scores were significantly higher for the occupation-based intervention group than for the impairment-based intervention group (both p < 0.05; d = 0.54, d = 0.51, respectively). Other outcomes showed no significant differences. CONCLUSION Occupation-based interventions designed using the ADOC application were useful for patients with haematopoietic malignancies.
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Affiliation(s)
| | - Yuta Ikio
- The Japanese Red Cross Society Nagasaki Genbaku Hospital, Japan
| | | | - Kayoko Deguchi
- The Japanese Red Cross Society Nagasaki Genbaku Hospital, Japan
| | - Toko Sakai
- The Japanese Red Cross Society Nagasaki Genbaku Hospital, Japan
| | | | - Toshio Higashi
- Nagasaki University Graduate School of Biomedical Sciences, Japan
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Stein Duker LI, Sleight AG. Occupational therapy practice in oncology care: Results from a survey. Nurs Health Sci 2018; 21:164-170. [PMID: 30345585 DOI: 10.1111/nhs.12576] [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] [Received: 05/07/2018] [Revised: 08/10/2018] [Accepted: 08/31/2018] [Indexed: 01/01/2023]
Abstract
The everyday landscape of occupational therapy (OT) in oncology is underexplored, hindering targeted improvements. The purpose of the present study was to identify the OT interventions commonly provided and reimbursed in oncology. A survey utilizing snowball sampling was disseminated online to OT working in oncology care; 167 surveys were received from 21 states in the United States. Results found that over 90% of therapists reported focusing on physical impairment, weakness, fatigue, and activities of daily living. Interventions for emotional/social support, self-advocacy, quality of life, lifestyle management, and cognitive impairment were not directly billed. More than 90% of therapists reported that, in the absence of barriers, they would address quality of life, emotional difficulties, lifestyle management, and home safety. Overall, the findings suggested that OT in the United States primarily provide physical interventions for oncology patients. However, they also provide psychosocial services and client/caregiver education, but often do not bill directly for this care. Reimbursement structures should be modified to allow for the direct billing of mental/psychosocial and educational interventions in OT for cancer care.
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Affiliation(s)
- Leah I Stein Duker
- Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, California, USA
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Kramer B, Wenzel A, Boerger M, Lippert B, Feist K, Petrasch R, Riemann R, Hoermann K, Aderhold C. Long-Term Quality of Life and Nutritional Status of Patients with Head and Neck Cancer. Nutr Cancer 2018; 71:424-437. [PMID: 30273055 DOI: 10.1080/01635581.2018.1506492] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Disease and therapy of head and neck cancer impair quality of life (QOL). QOL varies profoundly during therapy and follow-up. AIM We sought to monitor QOL and nutritional status of patients before, during and after therapy (AT). PATIENTS AND METHODS This study evaluates QOL by using the EORTC-questionnaires QLQ-C30 and H&N35, body weight and plasma albumin up to two years AT. RESULTS Chemoradiotherapy is the period of the most profound QOL-impairment. Postoperative QOL almost reaches preoperative levels just before adjuvant therapy and does not differ significantly from pretherapeutic QOL. Long-term QOL is not significantly deteriorated. Patients have an average weight loss of 17%. Nutritional supplements are used continuously. Xerostomia and sticky saliva are chronic symptoms that persist AT. CONCLUSIONS QOL is an important parameter for the evaluation of therapy success. Head and neck cancer and its therapy cause permanent xerostomia, sticky saliva and need of nutritional supplements. Adequate patient information, psychooncological counseling, analgesia and nutritional support may alleviate QOL impairment.
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Affiliation(s)
- Benedikt Kramer
- a Department of Otorhinolaryngology Head and Neck Surgery , University Hospital Mannheim , Mannheim , Germany
| | - Angela Wenzel
- a Department of Otorhinolaryngology Head and Neck Surgery , University Hospital Mannheim , Mannheim , Germany
| | - Maja Boerger
- a Department of Otorhinolaryngology Head and Neck Surgery , University Hospital Mannheim , Mannheim , Germany
| | - Burkard Lippert
- b Department of Otorhinolaryngology Head and Neck Surgery , SLK-Hospital Heilbronn , Heilbronn , Germany
| | - Klaus Feist
- b Department of Otorhinolaryngology Head and Neck Surgery , SLK-Hospital Heilbronn , Heilbronn , Germany
| | - Renate Petrasch
- b Department of Otorhinolaryngology Head and Neck Surgery , SLK-Hospital Heilbronn , Heilbronn , Germany
| | - Randolf Riemann
- c Department of Otorhinolaryngology Head and Neck Surgery , Elbe-Hospital Stade , Stade , Germany
| | - Karl Hoermann
- a Department of Otorhinolaryngology Head and Neck Surgery , University Hospital Mannheim , Mannheim , Germany
| | - Christoph Aderhold
- a Department of Otorhinolaryngology Head and Neck Surgery , University Hospital Mannheim , Mannheim , Germany
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Pilegaard MS, la Cour K, Gregersen Oestergaard L, Johnsen AT, Lindahl-Jacobsen L, Højris I, Brandt Å. The 'Cancer Home-Life Intervention': A randomised controlled trial evaluating the efficacy of an occupational therapy-based intervention in people with advanced cancer. Palliat Med 2018; 32:744-756. [PMID: 29299957 PMCID: PMC5881790 DOI: 10.1177/0269216317747199] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND People with advanced cancer face difficulties with their everyday activities at home that may reduce their health-related quality of life. To address these difficulties, we developed the 'Cancer Home-Life Intervention'. AIM To evaluate the efficacy of the 'Cancer Home Life-Intervention' compared with usual care with regard to patients' performance of, and participation in, everyday activities, and their health-related quality of life. DESIGN AND INTERVENTION A randomised controlled trial ( ClinicalTrials.gov NCT02356627). The 'Cancer Home-Life Intervention' is a brief, tailored, occupational therapy-based and adaptive programme for people with advanced cancer targeting the performance of their prioritised everyday activities. SETTING/PARTICIPANTS Home-living adults diagnosed with advanced cancer experiencing functional limitations were recruited from two Danish hospitals. They were assessed at baseline, and at 6 and 12 weeks of follow-up. The primary outcome was activities of daily living motor ability. Secondary outcomes were activities of daily living process ability, difficulty performing prioritised everyday activities, participation restrictions and health-related quality of life. RESULTS A total of 242 participants were randomised either to the intervention group ( n = 121) or the control group ( n = 121). No effect was found on the primary outcome (between-group mean change: -0.04 logits (95% confidence interval: -0.23 to 0.15); p = 0.69). Nor was any effect on the secondary outcomes observed. CONCLUSION In most cases, the 'Cancer Home-Life Intervention' was delivered through only one home visit and one follow-up telephone contact, which not was effective in maintaining or improving participants' everyday activities and health-related quality of life. Future research should pay even more attention to intervention development and feasibility testing.
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Affiliation(s)
- Marc Sampedro Pilegaard
- 1 The Research Initiative of Activity Studies and Occupational Therapy, Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark.,2 OPEN - Odense Patient Data Explorative Network, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Karen la Cour
- 1 The Research Initiative of Activity Studies and Occupational Therapy, Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark.,2 OPEN - Odense Patient Data Explorative Network, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Lisa Gregersen Oestergaard
- 3 Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Aarhus, Denmark.,4 Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Anna Thit Johnsen
- 5 Department of Psychology, University of Southern Denmark, Odense, Denmark.,6 Department of Palliative Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| | | | - Inger Højris
- 8 Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Åse Brandt
- 1 The Research Initiative of Activity Studies and Occupational Therapy, Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark.,2 OPEN - Odense Patient Data Explorative Network, Odense University Hospital, University of Southern Denmark, Odense, Denmark.,9 Centre for Disability and Mental Vulnerability, The National Board of Social Services, Odense, Denmark
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Rijpkema C, Van Hartingsveldt M, Stuiver MM. Occupational therapy in cancer rehabilitation: going beyond physical function in enabling activity and participation. ACTA ACUST UNITED AC 2018. [DOI: 10.1080/23809000.2018.1438844] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Corine Rijpkema
- Center for Quality of Life, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Margo Van Hartingsveldt
- Faculty of Health, ACHIEVE Centre of Expertise, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Martijn M. Stuiver
- Center for Quality of Life, Netherlands Cancer Institute, Amsterdam, The Netherlands
- Faculty of Health, ACHIEVE Centre of Expertise, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
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Abstract
Cancer is a devastating disease causing significant psychological problems among patients and their families. In the past few decades, there have been growing implementation and dissemination of screening methods for the psychological consequences of cancer, including distress, depression, anxiety, post-traumatic stress, and demoralisation. Also, guidelines for the management of psychological distress have been developed and endorsed by a number of scientific cancer associations. This review examines some of the most significant related issues, also focusing on recent advances in psychosocial and psychopharmacological interventions as a part of a mandatory, integrated, and comprehensive approach to cancer care.
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Affiliation(s)
- Luigi Grassi
- University Hospital Psychiatric Unit, Integrated Department of Mental Health and Addictive Behavior, S. Anna University Hospital and Health Trust, Ferrara, Italy
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - David Spiegel
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
| | - Michelle Riba
- University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
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Farley E, McCarthy L, Pergolotti M. Rehabilitation Strategies in Older Adult Oncology Patients: a Focus on Occupational and Physical Therapy. CURRENT GERIATRICS REPORTS 2017. [DOI: 10.1007/s13670-017-0228-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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