Occupational therapy needs of patients with thoracic cancer at the time of diagnosis: findings of a dedicated rehabilitation service

Our plain-English summary of Occupational therapy needs of patients with thoracic cancer at the time of diagnosis: findings of a dedicated rehabilitation service, by R. Bentley, A. Hussain, M. Maddocks, et al (Supportive Care in Cancer, 2013).

The study

• Authors: R. Bentley, A. Hussain, M. Maddocks, A. Wilcock
• Journal: Supportive Care in Cancer
• Published: 2013;21(6):1519-24
• Cited by: 15 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Purpose: Guidelines recommend screening patients with cancer to identify their rehabilitation needs. To help quantify this area of need and associated workload from an occupational therapy perspective in patients with thoracic cancer, we report the experiences of a dedicated rehabilitation service.

Methods: Consecutive patients were screened soon after diagnosis using items associated with occupational performance in the Sheffield Profile for Assessment and Referral for Care questionnaire. Those reporting predetermined levels of distress underwent a full occupational therapy evaluation; this generated a problem list from which individualised goals and interventions were instigated.

Results: Of 540 patients screened, 273 (51 %) reported levels of distress which warranted a full occupational therapy assessment. Of these, 260 (95%) reported a total of 681 problems (median of 4 [2-5] per patient). Mostly these lay within the domain of self care (553, 78%) in the categories of transfers, functional mobility and bathing/showering. A total of 646 goals (median of 2 [1-3] per patient) were formulated, resulting in 652 individual interventions, most frequently the provision of equipment (79%) or advice (32%) and referral to another professional/agency (23%). Patients considered that most goals were achieved (98%) and that the provision of equipment was useful (97%).

Conclusions: About half of patients with thoracic cancer screened have occupational therapy needs around the time of diagnosis. Problems are mostly in the area of self-care, with equipment provision the most frequent intervention provided. Future work should examine the efficacy of occupational therapy interventions further.

In plain English

This article reported a service evaluation, which the authors described as not formal research, of a rehabilitation service for people with thoracic cancer at Nottingham University Hospitals NHS Trust in the UK, from October 2009 to September 2011. It did not study asbestos exposure. Of the 273 patients assessed, 11 had mesothelioma and the rest had lung cancer, and results were not reported separately for mesothelioma. Soon after diagnosis, patients completed the SPARC questionnaire. Those reporting high distress about independence, daily activities, household tasks or tiredness were offered an occupational therapy assessment. Of 540 patients seen by the service, 273 were assessed. Of these, 260 reported 681 problems, a median of 4 per patient, mostly (78%) in self-care such as transfers, moving about and bathing. The most common interventions were equipment (79% of patients), advice (32%) and referral to other professionals or agencies (23%). Patients considered 638 of 646 goals achieved and 653 of 672 pieces of equipment useful. The authors concluded that about half of patients screened had occupational therapy needs around diagnosis, and said their screening approach needs formal validation.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Service evaluation of a clinical rehabilitation service, analysed with descriptive statistics; the authors describe it as a service evaluation rather than formal research
• Who was studied: Patients newly diagnosed with thoracic cancer at Nottingham University Hospitals NHS Trust, UK, over 2 years (1 October 2009 to 30 September 2011). 540 patients returned the SPARC questionnaire and were seen by the rehabilitation service, and 273 were assessed by the occupational therapist. Of these 273, 168 were male and 105 female, with a mean age of 71. By cancer type, 222 had non-small cell lung cancer, 40 had small cell lung cancer and 11 had mesothelioma.
• Exposure: No asbestos or other exposure was studied. The article concerns occupational therapy needs and interventions in patients with thoracic cancer, including mesothelioma.
• Main results:
  • 273 of the 540 patients screened (51%) reported distress levels that triggered a full occupational therapy assessment
  • Of the 273 patients assessed, 260 (95%) reported a total of 681 problems, a median of 4 (interquartile range 2 to 5) per patient
  • Most problems (78%) were in the self-care domain. The text gives the count as 553, but the table total for self-care is 533.
  • About half of the 260 patients reported problems with transfers (155 patients, 59%), functional mobility (128, 49%) and bathing/showering (124, 47%)
  • 652 interventions were given to the 260 patients. Equipment went to 79% of patients, advice to 32%, and referral to another professional or agency to 23%.
  • Patients considered that 638 (98%) of 646 goals had been achieved
  • Of 672 pieces of equipment provided, patients considered 653 (97%) useful
  • Over 2 years, the full-time occupational therapist provided 1978 episodes of care (296 new and 1,682 follow-up)
• The authors' conclusion: The authors concluded that about half of patients with thoracic cancer screened have occupational therapy needs around the time of diagnosis. These needs were mostly in self-care, and equipment was the most frequent intervention. They called for further research to validate the approach and to examine the efficacy of the interventions.
• Limitations the authors state:
  • As a service evaluation, the occupational therapy assessment and the evaluation of outcomes were necessarily brief for practical reasons
  • Fewer than 10% of patients reported psychological or cognitive problems to the occupational therapist, despite higher distress on related questionnaire items; the authors suggest the brief assessment may partly explain this
  • The use of selected questionnaire scores to screen for occupational therapy needs has not been formally validated
  • About 4% of patients did not return the questionnaire, about one third of them because of cognitive problems, so an alternative approach is needed for such patients

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

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