Abstract
Date Presented 4/9/2016
The study among 164 persons with advanced cancer showed that the everyday activity problems they prioritized mainly concerned fulfilment of social roles, maintaining everyday life, and enjoying leisure activities. Types of activity problems could not be predicted for subgroups.
Primary Author and Speaker: Åse Brandt
Contributing Authors: Hanne Peoples, Eva Ejlertsen Wæhrens, Karen la Cour
BACKGROUND: The number of people with advanced cancer is growing, and research has shown that many have problems with everyday activities. Even so, only little evidence of effective interventions targeting everyday activity problems is available. Therefore “The Cancer Home Life Project” was launched, aiming at designing and testing an activity intervention package. To do so it is important to gain knowledge about which types of activities people with advanced cancer have problems with and prioritize to have solved. Moreover, it would be useful to be able to predict types of activity problems among subgroups.
PURPOSE: To investigate which everyday activity problems people with advanced cancer have and prioritize and to identify predictors for different types of activity problems
METHOD: In the cross-sectional part of “The Cancer Home Life Project,” 164 adult outpatients diagnosed with cancer, evaluated to be incurable, and having a functional level of 1–3 on the World Health Organization performance scale were enrolled consecutively from two Danish hospitals. Demographic and health data (EORTC QLQ-C30 was used) were collected by means of a questionnaire in addition to an interview conducted by trained occupational therapists about prioritized activity problems using “The Individually Prioritised Problems Analysis.” The identified prioritized activity problems were grouped according to the International Classification of Functioning, Disability and Health. Associations between prioritized activity problems and possible predictors (age, gender, living situation, cancer diagnosis, and symptoms) were examined using regression analyses of variables identified as statistically significant in bivariate analyses. A p ≤ .05 was considered statistically significant.
RESULTS: The median age of the 164 study participants was 68 yr, 52% were men, 32% lived alone, 55% suffered from fatigue, 48% had mobility limitations, and no cancer diagnosis was predominant. The most frequently prioritized activity problems concerned move about (47%); transportation (32%); prepare meals and do housework (22%); maintain dwelling and vehicle (17%); take care of plants (32%); maintain social relationships (22%); employment (14%); sports and training (23%); hobbies (24%); and socializing and holidays (29%). Out of 150 tested associations, 23 were statistically significant in the bivariate analyses and 10 in the regression analyses with no trends in prediction of subgroups’ prioritized activity problems.
DISCUSSION: The prioritized activity problems mostly concerned fulfilment of social roles, maintaining everyday life, and enjoying leisure activities. This study thus shows that the needs of people with advanced cancer are broad, directed toward societal participation, and many occupational therapy interventions are more narrow and aim at supporting activities of daily living. The fact that it was not possible to predict prioritized activity problems for subgroups shows that these are individual. Subsequently, interventions should be based on a dialogue with the client, and interventions should aim at supporting a broad scope of everyday activities including societal participation.
IMPACT STATEMENT: The study results can inform occupational practitioners when planning interventions for clients with advanced cancer. The results have been used for designing “The Cancer Home Life Intervention,” which presently is being tested in a randomized controlled trial.
