Department of Surgery, City of Hope, Duarte, CA, USA.
Department of Surgery, Johns Hopkins University, Baltimore, MD, USA.
Support Care Cancer. 2020 Aug;28(8):3867-3876. doi: 10.1007/s00520-019-05230-0. Epub 2019 Dec 16.
Older adults undergoing cancer surgery are at greater risk for poor postoperative outcomes. Caregivers also endure significant burden. Participation in perioperative physical activity may improve physical functioning and enhance overall well-being for both patients and caregivers. In this study, we assessed the feasibility of a personalized telehealth intervention to enhance physical activity for older (≥ 65 years) gastrointestinal (GI) and lung cancer surgery patients/caregivers.
Participants completed four telehealth sessions with physical therapy/occupational therapy (PT/OT) before surgery and up to 2 weeks post-discharge. Outcomes included preop geriatric assessment, functional measures, and validated measures for symptoms and psychological distress. Pre/post-intervention trends/trajectories for outcomes were explored.
Thirty-four patient/caregiver dyads (16, GI; 18, lung) were included. Accrual rate was 76% over 8 months; retention rate was 88% over 2 months. Median for postop of a 6-min walk test, timed up and go, and short physical performance battery test scores improved from baseline to postop. Participant satisfaction scores were high.
Our conceptually based, personalized, multimodal, telehealth perioperative physical activity intervention for older patient/caregiver dyads is feasible and acceptable. It offers an opportunity to improve postoperative outcomes by promoting functional recovery through telehealth, behavior change, and self-monitoring approaches.
ClinicalTrials.gov Identifier: NCT03267524.
接受癌症手术的老年人术后结局较差的风险更高。照顾者也承受着巨大的负担。参与围手术期身体活动可能会改善患者和照顾者的身体功能并增强整体幸福感。在这项研究中,我们评估了个性化远程医疗干预措施的可行性,以增强年龄在 65 岁及以上的胃肠道 (GI) 和肺癌手术患者/照顾者的身体活动能力。
参与者在手术前和出院后最多 2 周内与物理治疗/职业治疗师 (PT/OT) 一起完成了 4 次远程医疗会议。结果包括术前老年评估、功能测量以及症状和心理困扰的验证性测量。探索了干预前后结局的趋势/轨迹。
34 对患者/照顾者(16 对,GI;18 对,肺部)被纳入研究。8 个月内的入组率为 76%;2 个月内的保留率为 88%。从基线到术后,6 分钟步行测试、起立行走测试和简短体能测试的术后中位数有所改善。参与者的满意度评分很高。
我们基于概念的、个性化的、多模式的、远程医疗围手术期身体活动干预措施对于老年患者/照顾者对是可行且可接受的。它通过远程医疗、行为改变和自我监测方法促进功能恢复,为改善术后结局提供了机会。
ClinicalTrials.gov 标识符:NCT03267524。