Mayer Robert Samuel, Engle Jessica
Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Ann Rehabil Med. 2022 Apr;46(2):60-70. doi: 10.5535/arm.22036. Epub 2022 Apr 30.
The survival rate of cancer is increasing as treatment improves. As patients with cancer now live longer, impairments may arise that impact quality of life (QOL) and function. Therefore, a focus on QOL is often as important as survival. An interdisciplinary team can achieve goal-oriented and patient-centered rehabilitation, which can optimize function and QOL, and minimize impairments, restrictions, and activity limitations. In most cases, cancer patients must be active participants in therapy and exhibit carryover. Patients with cancer often have impairments that include fatigue, pain, brain fog, impaired cognition, paresis, mood disorders, difficulty with activities of daily living (ADL), bowel/bladder/sexual dysfunction, and bone and soft tissue involvement. Adaptive equipment, exercise, and ADL training can mitigate restrictions on activity. The trajectory and phase of the disease along the continuum of cancer care may influence the goals of rehabilitation in that time window. QOL is often influenced by participation in vocational, recreational, and home-based activities. A holistic perspective should include an analysis of distress, socioeconomic barriers, and transportation limitations when addressing issues.
随着治疗水平的提高，癌症患者的生存率正在上升。由于现在癌症患者的寿命延长，可能会出现影响生活质量（QOL）和功能的损伤。因此，关注生活质量通常与生存同样重要。一个跨学科团队可以实现以目标为导向和以患者为中心的康复，这可以优化功能和生活质量，并将损伤、限制和活动受限降至最低。在大多数情况下，癌症患者必须积极参与治疗并表现出延续性。癌症患者通常存在包括疲劳、疼痛、脑雾、认知障碍、轻瘫、情绪障碍、日常生活活动（ADL）困难、肠道/膀胱/性功能障碍以及骨骼和软组织受累等损伤。适应性设备、运动和ADL训练可以减轻对活动的限制。在癌症治疗连续过程中疾病的轨迹和阶段可能会影响该时间窗口内的康复目标。生活质量通常受到参与职业、娱乐和家庭活动的影响。在解决问题时，整体观点应包括对痛苦、社会经济障碍和交通限制的分析。
