Importance: Despite the growing literature on the association of functional, physical, and quality-of-life (QOL) deficits with poor postoperative outcomes, there is a gap in the literature identifying women’s occupational performance needs after ovarian cancer surgery. Objective: To describe the experiences of women hospitalized after ovarian cancer surgery to identify potential areas for intervention. Goals were to (1) identify functional needs and limitations at time of discharge as measured by the typical acute care occupational therapy evaluation and semistructured interview and (2) understand the women’s perspectives of their needs for occupational therapy and a safe return to home. Design: Single-arm, cross-sectional descriptive study. Mixed-methods data collection and analysis. Setting: Academic cancer center. Participants: Women with ovarian cancer (N = 11) who had completed surgery. Intervention: Semistructured interviews and patient-reported outcome measures (PROMs) completed postsurgery. Outcomes and Measures: PROMs included the National Comprehensive Cancer Network (NCCN) Distress Thermometer and Problem List, the PROMIS® Global Physical Health (GPH) and Global Mental Health (GMH) scales, and the Possibilities for Activity Scale–Women (PActS–W). Results: The mean NCCN Distress score was 6.0 (standard deviation [SD] = 3.1, with the top three concerns being pain (80%), worry (80%), and fatigue (78%). Mean GPH and GMH T scores were 38.0 (SD = 8.8) and 48.2 (SD = 8.4), respectively. Women scored a mean of 39.2 (SD = 11.2, range = 26–58) on the PActS–W. Thematic analyses found that the women were uncertain about potential functional limitations and significantly distressed. Conclusion and Relevance: Women with ovarian cancer experienced high levels of uncertainty and distress after surgery. Integrating in-home or community-based occupational therapy into routine care could decrease functional distress and uncertainty and help women manage concerns related to pain, worry, and fatigue. What This Article Adds: This study suggests that occupational therapy evaluation and intervention are needed to decrease distress and improve QOL of women upon discharge after ovarian cancer surgery.
One in 4 older adults falls each year, and less than half of older adults discuss previous falls with their health care providers. 1 , 2 Falls (anytime a person comes to the fl oor inadvertently) remain the leading cause of fatal and nonfatal injuries in the United States. In 2014, 2.8 million nonfatal falls were treated in the emergency department of those 30% were hospitalized with severe injuries including traumatic brain injury and fractures. 3 Older adults, 75 years of age and older, are 4 to 5 times more likely to be removed from the community and institutionalized after a fall. 4 , 5 Furthermore, many who fall develop a fear of falling, even if the fall was not serious, and tend to reduce their engagement in daily tasks and time performing physical activity, limiting their overall fi tness and mobility that can increase their risk for future falls. [6][7][8] Standard predictors of fall risk include a limited functional ability in both activities of daily living (ADLs) and instrumental activities of daily living (IADL), decreased sensorimotor function, poor vision, reduced postural stability, and slower and less effective balance responses. 1 , 9 , 10 However, most of these predictors are not typically assessed in a general primary care clinic. 11 Moreover, the need for interventions that have been shown to be effective in decreasing fall risk, including physical and occupational therapy, may not be identifi ed in traditional primary care clinics until after an older adult sustains a Results and Discussion: Fifty-seven adults were recruited. Use of the Senior Sway mobile application was feasible. Ninetyone percent said that they liked the application and reported length of time of assessment was "just right." The average Senior Sway score was 64.0 (range: 47.8-84.0), which was signifi cantly associated with the 30-second sit-to-stand test. In addition, the motor reaction time score was associated with the Timed Up and Go. Conclusions: Senior Sway is a promising application to improve identifi cation of adults at risk for falls and need for rehabilitation but warrants further research.
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