Participation in cancer rehabilitation and unmet needs: a population-based cohort study

Abstract

PurposeTo investigate associations between cancer survivors’ sex, age, and diagnosis in relation to their (1) need for rehabilitation, (2) participation in rehabilitation activities, and (3) unmet needs for rehabilitation in a 14-month period following date of diagnosis.MethodsA population-based cohort study was performed on incident cancer patients diagnosed from 1 October 2007 to 30 September 2008. Fourteen months after diagnosis, participants completed a questionnaire developed to measure the aspects of rehabilitation. Logistic regression analyses were used to explore the association between sex, age, and diagnosis, and the outcome variables for rehabilitation.ResultsA total of 3,439 patients participated, yielding an overall response rate of 70%. One third of the cancer patients reported a need for physical rehabilitation and one third for psychological rehabilitation. Half of the patients participated in at least one activity. Unmet needs were most often reported in psychological, sexual, and financial areas. Women expressed more needs, participated more often in rehabilitation activities, and had, to a higher extent, their emotional needs fulfilled. Breast cancer patients participated more often in physical rehabilitation. Elderly who expressed rehabilitation needs more often had them unresolved.ConclusionsA substantial variation in rehabilitation needs, participation in activities, and unmet needs in relation to sex, age, and cancer type was observed. Cancer care ought to systematically address the wide range of needs in all groups through integration of systematic needs assessment and targeted supply of offers.

Occupational Therapy Use by Older Adults With Cancer

“…Only 32% of the sample used occupational therapy within the first 2 yr of their cancer diagnosis, a rate lower than the estimated £87% of adults who are in need of such services (Holm et al, 2012;Lehmann et al, 1978). The occupational therapy users were significantly older than nonusers, and women were the majority.…”

“…We identified several sociodemographic variations and lower usage than reported need in the patterns of occupational therapy use of older adults with cancer. Although cancer rehabilitation, defined to include occupational therapy and physical therapy, has been recommended, we noted large numbers of older adults not receiving services and considerable differences between those who did and did not use occupational therapy (Holm et al, 2012;Lehmann et al, 1978;Movsas et al, 2003;Ross, Petersen, Johnsen, Lundstrøm, & Groenvold, 2012;Stafford & Cyr, 1997). Because the burden of cancer and its treatments is greater for older adults, we stress that future researchers continue to understand the utilization of occupational therapy services and the appropriateness of the services for this population; it is especially critical for adults with lung cancer, who demonstrate the highest need and are least likely to use occupational therapy.…”

Fear of cancer recurrence and unmet needs among breast cancer survivors in the first five years. A cross-sectional study

“…In three cross-sectional Danish studies of patients with various cancer diagnoses (N ¼ 1490, N ¼ 3439 and N ¼ 4108), the prevalence of unmet needs ranged between approximately 10-50% [10][11][12]. The unmet needs reported were concerning lacking help managing physical and psychological symptoms and late effects, returning to normal everyday life and dealing with financial and work-related consequences.…”

Goal setting in cancer rehabilitation and relation to quality of life among women with gynaecological cancer

“…identification of individual needs followed by the definition of motivated goals is thus essential to cancer rehabilitation. several studies have evaluated the problems and needs of different cancer populations [5][6][7]. Focus on the patient's needs gives a systematic uncovering of the symptoms, increase the patient's attention to the presence of symptoms [8] and awareness of own upcoming needs [9].…”

“…research on rehabilitation, including different types of cancer, suggests that the patients' rehabilitation should be integrated in routine cancer care based on individual needs assessment and goal setting [14,21]. interventions aiming to support these women should therefore be planned and organised in a way to support this [7]. Knowledge of goals, women perceive as most important, and their association to quality of life is important to future planning of rehabilitation for patients with gynaecological cancer.…”