Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations.
The purpose of this research was to examine the efficacy of a 4-week OT-based cancer survivorship program named Life Unpaused (LU). The participants had the option to attend the program onsite or virtually on a Telehealth platform. LU addressed participation in roles and daily activities through education and training and by providing resources to participants.The outcome results showed increases in occupational performance, satisfaction, and quality-of-life scores.
Primary Author and Speaker: Adrienne Marilla
BACKGROUND: Given the advances in technology and treatment, cancer survivorship rates are on the rise (Miller et al., 2019). However, these life-saving treatments come with a physical, cognitive, and psychosocial cost that impacts the survivor's participation in daily occupations and leads to a significant decrease in quality of life (QOL) (Baxter et al., 2017). Even though OT has the skill set to address the transition back to cherished roles via symptom management, health promotion, and adaptive equipment and strategy training, it is often left out of cancer survivorship care.
PURPOSE: The purpose of this research was to address this gap by exploring the efficacy of Life Unpaused, a four-week, occupational therapy based cancer survivorship program. The participants had an option of attending the program onsite or virtually via Telehealth.
DESIGN: A mixed-method research design included 12 adult participants who had either completed active cancer treatment or had metastatic cancer. The recruitment was done by distribution of program flyers, social media posts, emails and by posting the information on the website of the community- based cancer organization. All the participants were active members of the organization at the time of the study.
INTERVENTIONS: OT Intervention focus on Week 1 was on ADL/IADL, week 2 was on health management, week 3 was on work, productivity, and leisure and week 4 was focussed on sleep participation and preparation
DATA COLLECTION: Baseline and post program assessments included Canadian Occupational Performance Measure (COPM) and Quality of Life-Cancer Survivor Version (QOL-CSV) assessments to measure the perceptions of occupational performance/satisfaction and QOL, respectively. Post- program feedback was collected by asking open-ended survey questions via face- to face personal interviews.Content analysis was applied to open-ended questions from surveys and participants' experiences to find common themes.
RESULTS: Quantitative: A paired sample t-test found a statistically significant difference between pre and post assessments scores. COPM performance results (t = 4.93, p < 0.05, effect size = 1.42) and satisfaction scores (t = 7.12, p < 0.05, effect size = 2.06) both indicated statistical significance with exceptionally large effect sizes. QOL-CSV results for the psychological well-being (t = 5.57, p < 0.05, effect size = 1.61) and social concern domains (t = 5.57, p < 0.05, effect size = 1.61) indicated statistical significance with a larger effect size as well. Qualitative: Phenomenological methodology was used to analyze the interviews, including line coding. Most frequent themes emerged from the interviews were 1) strategies learnt attending LU program had real-life applicability; (2) learning about adaptive equipment and energy conservation techniques optimized daily planning; (3) group participation validated experience of symptoms; and (4) Telehealth platform was convenient to attend without leaving home, traveling or worrying about childcare. It was easy to access.
CONCLUSION: The finding supports that LU program is promising approach to improve occupational performance and QOL of cancer survivors. Telehealth can be a viable method for filling the accessibility gap due to its flexibility and time/energy-saving benefits. Despite the small sample size and lack of generalizability, the results are promising for future OT survivorship care.
IMPACT STATEMENT: OT can contribute to survivorship care through community-based programs. Telehealth OT is a new approach which enables continued participation despite distance, to maintain safety and to prevent complications for those who have underlying conditions and are at high risk in current pandemic situations
References
Baxter, M. F., Newman, R., Longpré, S. M., & Polo, K. M. (2017). Occupational therapy’s role in cancer survivorship as a chronic condition. American Journal of Occupational Therapy, 71(3), 7103090010. https://doi.org/10.5014/ajot.2017.713001
Miller, K. D., Nogueira, L., Mariotto, A. B., Rowland, J. H., Yabroff, K. R., Alfano, C. M., Jemal, A., Kramer, J. L. and Siegel, R. L. (2019), Cancer treatment and survivorship statistics, 2019. CA: A Cancer Journal for Clinicians, 69(5). 363-385. https://doi.org/10.3322/caac.21565
Law, M., Baptiste, S., Carswell, A., McColl, M. A., Polatajko, H., & Pollock, N. (2014). Canadian Occupational Performance Measure (5th ed.) [Measurement Instrument]. http://www.thecopm.ca/
Ferrell, B. R., Hassey-Dow, K., & Grant, M. (2012). Quality of Life Patient/Cancer Survivor Version [Measurement instrument]. Measurement Instrument Database for the Social Science. http://www.midss.org/sites/default/files/qol-cs.pdf
