Sagari Akira, Ikio Yuta, Imamura Nobuko, Deguchi Kayoko, Sakai Toko, Tabira Takayuki, Higashi Toshio
Shinshu University, Japan.
The Japanese Red Cross Society Nagasaki Genbaku Hospital, Japan.
Hong Kong J Occup Ther. 2018 Dec;31(2):97-105. doi: 10.1177/1569186118818680. Epub 2018 Dec 7.
BACKGROUND/OBJECTIVE: Chemotherapy for cancer negatively affects activities of daily living and quality of life. This study aimed to validate and compare the efficacy of two different interventions in patients with haematopoietic malignancies undergoing chemotherapy: (1) occupation-based interventions, designed using the Aid for Decision-making in Occupation Choice (ADOC) (an iPAD application) and (2) impairment-based interventions. ADOC helps promote decision-making during activities and participation in occupation-based goal setting. The impairment-based intervention group served as the comparison group and underwent impairment-based interventions focusing on dysfunction.
In this single-blinded pilot randomised controlled trial, 19 participants received an occupation-based intervention (n = 9) or an impairment-based intervention (n = 10). The treatment period comprised two sessions. Recruitment, compliance and outcome completion rates were calculated for the study. Effect sizes were examined for outcomes regarding physical performance, instrumental activities of daily living and quality of life as evaluated by a blinded assessor.
In this study, 24.8% (28/113) of the eligible patients with haematopoietic malignancies were enrolled, and 67.9% (19/28) of these were retained up to the post-assessment stage. Recruitment (25%) and compliance (68%) rates were satisfactory. The Functional Assessment of Cancer Therapy-General emotional well-being and total scores were significantly higher for the occupation-based intervention group than for the impairment-based intervention group (both p < 0.05; d = 0.54, d = 0.51, respectively). Other outcomes showed no significant differences.
Occupation-based interventions designed using the ADOC application were useful for patients with haematopoietic malignancies.
背景/目的：癌症化疗会对日常生活活动和生活质量产生负面影响。本研究旨在验证并比较两种不同干预措施对接受化疗的血液系统恶性肿瘤患者的疗效：（1）基于职业的干预措施，使用职业选择决策辅助工具（ADOC，一款iPad应用程序）进行设计；（2）基于损伤的干预措施。ADOC有助于在活动过程中促进决策制定以及参与基于职业的目标设定。基于损伤的干预组作为对照组，接受针对功能障碍的基于损伤的干预措施。
在这项单盲试验性随机对照试验中，19名参与者接受了基于职业的干预（n = 9）或基于损伤的干预（n = 10）。治疗期包括两个疗程。计算了该研究的招募率、依从率和结局完成率。由一名盲法评估者对身体功能、日常生活工具性活动和生活质量等结局的效应量进行了检查。
在本研究中，符合条件的血液系统恶性肿瘤患者中有24.8%（28/113）被纳入，其中67.9%（19/28）的患者保留至评估后阶段。招募率（25%）和依从率（68%）令人满意。基于职业的干预组的癌症治疗功能评估-总体情绪健康和总分显著高于基于损伤的干预组（均p < 0.05；效应量分别为d = 0.54，d = 0.51）。其他结局无显著差异。
使用ADOC应用程序设计的基于职业的干预措施对血液系统恶性肿瘤患者有用。
