Department of Psychosocial and Rehabilitation Oncology, Tom Baker Cancer Centre, 2202-2nd Street SW, Calgary, AB, T2R 0S6, Canada.
School of Psychology, University of Ottawa, Ottawa, ON, Canada.
Support Care Cancer. 2017 Oct;25(10):3191-3197. doi: 10.1007/s00520-017-3728-2. Epub 2017 May 4.
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.
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.
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).
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.
患有晚期癌症的患者寿命延长，使癌症成为慢性病而非即将致命的疾病。关于晚期癌症患者生存体验的文献不断涌现，表明他们仍承受着多种症状的负担、缺乏信息、倦怠（患者和护理人员）以及情绪问题，所有这些都导致了情绪困扰。渥太华姑息康复计划（PRP）是为这一人群提供的稀缺临床资源。本研究旨在探讨完成 PRP 的患者的自我报告的困扰程度从基线到计划完成时的变化。
对完成 PRP 的 180 名患者的自我报告和临床测量数据进行了二次分析。测量包括痛苦温度计和问题检查表。描述性统计数据描述了样本，配对样本 t 检验检查了痛苦温度计评分从基线到 PRP 完成的变化，McNemar 检验揭示了 PRP 完成后最常被认可的检查表项目是否发生了变化。
参与者（n=180）患有晚期异质性癌症（平均年龄 62.18 岁，49.4%为男性）。从基线到完成，报告的显著变化包括临床困扰的认可程度降低（从 55.6 降至 38.9%；p<0.001）和 10 个最常被认可的检查表问题中的 7 个问题的严重程度降低（p 值范围从 0.016 到<0.001）。
许多被认可的检查表问题显著减少，自我报告的总体困扰程度也降低了。与没有显示改善的现有文献相比，我们的发现开始支持姑息康复可以通过改善功能和生活质量来使患者的困扰程度受益。心理治疗、麻醉和认知困难的额外干预可能使患者进一步受益。
