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Support Care Cancer. 2017 Oct;25(10):3191-3197. doi: 10.1007/s00520-017-3728-2. Epub 2017 May 4.

Reported distress in patients living with advanced cancer: changes pre-post interdisciplinary palliative rehabilitation.

Feldstain A1,2,3, MacDonald N4,5, Bhargava R4,6,7,8, Chasen M4,6,7,8,9.

Author information

1
Department of Psychosocial and Rehabilitation Oncology, Tom Baker Cancer Centre, 2202-2nd Street SW, Calgary, AB, T2R 0S6, Canada. andrea.feldstain@albertahealthservices.ca.
2
School of Psychology, University of Ottawa, Ottawa, ON, Canada. andrea.feldstain@albertahealthservices.ca.
3
Elisabeth-Bruyère Research Institute, Bruyère Continuing Care, Ottawa, ON, Canada. andrea.feldstain@albertahealthservices.ca.
4
Elisabeth-Bruyère Research Institute, Bruyère Continuing Care, Ottawa, ON, Canada.
5
Palliative Care, William Osler Health System, c/o Dr. Martin Chasen, 2100 Bovaird Dr E, Brampton, ON, L6R 3J7, Canada.
6
William Osler Health System, Etobicoke, ON, Canada.
7
Ottawa Hospital Research Institute, Ottawa, ON, Canada.
8
Palliative Care, William Osler Health System, 2100 Bovaird Dr E, Brampton, ON, L6R 3J7, Canada.
9
Department of Medicine, University of Ottawa, Ottawa, ON, Canada.

Abstract

PURPOSE:

Patients are living extended life with advanced cancer making it chronic rather than imminently terminal. Literature on the experience of living with advanced cancer is emerging, indicating ongoing polysymptomatic burden, lack of information, burnout (patients and caregivers), and emotional concerns, all of which contribute to emotional distress. The interdisciplinary Ottawa Palliative Rehabilitation Program (PRP) offers a scarce clinical resource for this population. The current research aimed to explore changes in self-reported distress for patients who completed the PRP, from baseline to program completion.

METHODS:

A secondary analysis of self-report and clinical measures was performed for 180 patients who completed the PRP. Measures included the Distress Thermometer and the Problem checklists. Descriptive statistics described the sample, paired-sample t tests examined changes in Distress Thermometer scores from baseline to PRP completion, and McNemar's tests revealed whether the most commonly endorsed checklist items changed by PRP completion.

RESULTS:

Participants (n = 180) had advanced heterogeneous cancers (mean age = 62.18, 49.4% male). From baseline to completion, significant reported changes included decreases in endorsement of clinical distress (from 55.6 to 38.9%; p < 0.001) and decreases in 7/10 of the most commonly endorsed checklist problems (p values ranging from 0.016 to <0.001).

CONCLUSIONS:

A number of endorsed checklist problems significantly decreased, as did overall self-reported distress. Compared to the existing literature that does not show improvements, our finding begins to support that palliative rehabilitation may benefit patient levels of distress by improving function and quality of life. Psychotherapy, anesthesia, and additional intervention for cognitive difficulties may further benefit patients.

KEYWORDS:

Advanced cancer; Distress; Function; Interdisciplinary; Palliative rehabilitation; Quality of life

PMID:
28474241
DOI:
10.1007/s00520-017-3728-2
[Indexed for MEDLINE]

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