MacDonald Anne Marie, Chafranskaia Aleksandra, Lopez Christian J, Maganti Manjula, Bernstein Lori J, Chang Eugene, Langelier David Michael, Obadia Maya, Edwards Beth, Oh Paul, Bender Jacqueline L, Alibhai Shabbir Mh, Jones Jennifer M
Cancer Rehabilitation and Survivorship Program, Princess Margaret Cancer Centre, Toronto, ON M5G 2C1, Canada.
IMS Program, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada.
J Clin Med. 2020 Sep 25;9(10):3092. doi: 10.3390/jcm9103092.
Although facility-based cancer rehabilitation and exercise programs exist, patients are often unable to attend due to distance, cost, and other competing obligations. There is a need for scalable remote interventions that can reach and serve a larger population.
We conducted a mixed methods pilot study to assess the feasibility, acceptability and impact of CaRE@Home: an 8-week online multidimensional cancer rehabilitation and exercise program. Feasibility and acceptability data were captured by attendance and adherence metrics and through qualitative interviews. Preliminary estimates of the effects of CaRE@Home on patient-reported and physically measured outcomes were calculated.
A total of = 35 participated in the study. Recruitment (64%), retention (83%), and adherence (80%) rates, along with qualitative findings, support the feasibility of the CaRE@Home intervention. Acceptability was also high, and participants provided useful feedback for program improvements. Disability (WHODAS 2.0) scores significantly decreased from baseline (T1) to immediately post-intervention (T2) and three months post-intervention (T3) ( = 0.03 and = 0.008). Physical activity (GSLTPAQ) levels significantly increased for both Total LSI ( = 0.007 and = 0.0002) and moderate to strenuous LSI ( = 0.003 and = 0.002) from baseline to T2 and T3. Work productivity (iPCQ) increased from T1 to T3 ( = 0.026). There was a significant increase in six minute walk distance from baseline to T2 and T3 ( < 0.001 and = 0.010) and in grip strength from baseline to T2 and T3 ( = 0.003 and < 0.001).
Results indicate that the CaRE@Home program is a feasible and acceptable cancer rehabilitation program that may help cancer survivors regain functional ability and decrease disability. In order to confirm these findings, a controlled trial is required.
尽管存在基于机构的癌症康复和运动项目，但患者常常因距离、费用及其他事务而无法参加。需要可扩展的远程干预措施，以覆盖和服务更多人群。
我们开展了一项混合方法的试点研究，以评估“居家关爱康复计划（CaRE@Home）”的可行性、可接受性及影响。该计划是一项为期8周的在线多维癌症康复和运动项目。通过出勤和依从性指标以及定性访谈收集可行性和可接受性数据。计算了“居家关爱康复计划”对患者报告结局和身体测量结局影响的初步估计值。
共有35人参与了该研究。招募率（64%）、留存率（83%）和依从率（80%），以及定性研究结果，均支持“居家关爱康复计划”干预措施的可行性。可接受性也很高，参与者为项目改进提供了有用的反馈。残疾（世界卫生组织残疾评定量表2.0版，WHODAS 2.0）得分从基线期（T1）到干预后即刻（T2）以及干预后三个月（T3）显著降低（P = 0.03和P = 0.008）。从基线期到T2和T3，总体生活方式干预得分（GSLTPAQ）中的总生活方式干预得分（Total LSI）（P = 0.007和P = 0.0002）以及中度至剧烈生活方式干预得分（moderate to strenuous LSI）（P = 0.003和P = 0.002）的身体活动水平均显著增加。工作生产力（iPCQ）从T1到T3有所提高（P = 0.026）。从基线期到T2和T3，6分钟步行距离显著增加（P < 0.001和P = 0.010），握力从基线期到T2和T3也显著增加（P = 0.003和P < 0.001）。
结果表明，“居家关爱康复计划”是一项可行且可接受的癌症康复项目，可能有助于癌症幸存者恢复功能能力并减少残疾。为了证实这些发现，需要进行一项对照试验。
