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影响晚期癌症住院康复患者日常生活活动能力的因素:一项回顾性观察研究的结果

Factors affecting the performance of activities of daily living in patients with advanced cancer undergoing inpatient rehabilitation: results from a retrospective observational study.

作者信息

Shimoda Kaori, Imai Hisao, Tsuji Tetsuya, Tsuchiya Kenji, Tajima Hiroshi, Kanemaki Hatsumi, Tozato Fusae

机构信息

Department of Rehabilitation Sciences, Gunma University Graduate School of Health Sciences: 3-39-22 Showa-machi, Maebashi-shi, Gunma 371-8514, Japan.

Division of Respiratory Medicine, Gunma Prefectural Cancer Center, Japan.

出版信息

J Phys Ther Sci. 2019 Oct;31(10):795-801. doi: 10.1589/jpts.31.795. Epub 2019 Oct 19.

Abstract

[Purpose] Many clinicians believe that rehabilitation for patients with advanced cancer is futile. We determined factors affecting the performance of activities of daily living in patients with advanced cancer based on age, gender, marital status, living arrangement, rehabilitation intensity, type of cancer, impairment, metastasis, and active cancer treatment. [Participants and Methods] We assessed the Barthel Index to evaluate the performance of activities of daily living. Of the 120 adult patients with cancer who underwent inpatient rehabilitation, we analyzed the Barthel Index scores, consisting of 10 items, and reviewed the clinical characteristics from the medical records of 48 patients who completed supportive or palliative rehabilitation according to Dietz and showed an increased or maintained total Barthel Index score at final evaluation. [Results] The median total Barthel Index score increased from 45 (5-95) to 72.5 (5-100); the rehabilitation intensity was 320 (40-1,240) minutes. The analytical results showed that the increase of total Barthel Index score was positively associated with rehabilitation intensity (β=0.350) and negatively associated with the initial grooming score (β=-0.277). [Conclusion] Adequate rehabilitation positively affects performance of activities of daily living, especially in patients with advanced cancer who lost their grooming ability at the onset of rehabilitation. Importantly, rehabilitation may be beneficial for patients with advanced cancer.

摘要

[目的] 许多临床医生认为,晚期癌症患者的康复治疗是徒劳的。我们基于年龄、性别、婚姻状况、居住安排、康复强度、癌症类型、功能障碍、转移情况以及积极的癌症治疗,确定了影响晚期癌症患者日常生活活动能力的因素。[参与者与方法] 我们评估了巴氏指数以评价日常生活活动能力。在120名接受住院康复治疗的成年癌症患者中,我们分析了由10项内容组成的巴氏指数评分,并根据迪茨标准回顾了48名完成支持性或姑息性康复治疗且在最终评估时巴氏指数总分增加或维持不变的患者的病历临床特征。[结果] 巴氏指数总分中位数从45(5 - 95)增至72.5(5 - 100);康复强度为320(40 - 1240)分钟。分析结果显示,巴氏指数总分的增加与康复强度呈正相关(β = 0.350),与初始修饰评分呈负相关(β = -0.277)。[结论] 充分的康复治疗对日常生活活动能力有积极影响,尤其是对康复开始时丧失修饰能力的晚期癌症患者。重要的是,康复治疗可能对晚期癌症患者有益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3f8/6801346/ed6cd185114f/jpts-31-795-g001.jpg

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