Washington University in St. Louis School of Medicine, 660 S. Euclid Ave., Campus Box 8505-45-01, St. Louis, MO, 63110, USA.
Massachusetts General Hospital Institute of Health Professions, Boston, MA, USA.
Support Care Cancer. 2023 Mar 14;31(4):213. doi: 10.1007/s00520-023-07672-z.
To determine how participation in daily life is impacted during the first six months following a new cancer diagnosis and to identify risk factors for participation restrictions. Patient-reported outcomes (PROs) were used to suggest referrals to rehabilitation services.
Participants (n = 123) were adults (> 18 years) with the newly diagnosed primary brain, breast, colorectal, or lung cancer. PROs were collected at baseline (within 30 days of diagnosis/treatment initiation), two and five months post baseline. Daily life participation was assessed through the community participation indicators (CPI) (score range: 0-1) and patient-reported outcome measurement information system (PROMIS) ability to participate, (score range: 20-80; mean: 50, SD: 10). PROMIS-43 profile was also completed. Linear mixed-effect models with random intercept evaluated change in participation over time.
The baseline total sample mean CPI score was 0.56; patients reported mildly impaired participation based on PROMIS scores (baseline: 46.19, 2-month follow-up: 44.81, 5 months: 44.84). However, no statistically significant changes in participation were observed over the study period. Risk factors for lower participation included receiving chemotherapy, lower physical function, higher anxiety and fatigue, and reduction in employment, p < 0.05. PROs indicated that roughly half of the participants may benefit from physical or occupational therapy or mental health support, but only 20-36% were referred by their medical team.
People newly diagnosed with cancer experience impaired participation, but they are infrequently referred to supportive services such as rehabilitation. The use of PROs to assess participation, physical function, and mental health can promote access to supportive care services by identifying patients who may benefit from rehabilitation beyond those identified through routine clinical care.
确定在新诊断出癌症后的头六个月内日常生活参与度受到了怎样的影响，并确定日常生活参与受限的风险因素。患者报告的结果（PROs）被用于建议转诊至康复服务。
参与者（n=123）为患有新诊断的原发性脑癌、乳腺癌、结直肠癌或肺癌的成年人（>18 岁）。在基线（诊断/治疗开始后 30 天内）、两个月和五个月后收集 PROs。通过社区参与指标（CPI）（评分范围：0-1）和患者报告的结果测量信息系统（PROMIS）参与能力（评分范围：20-80；平均值：50，标准差：10）来评估日常生活参与度。还完成了 PROMIS-43 概况。带有随机截距的线性混合效应模型评估了随时间推移的参与变化。
基线时总样本的平均 CPI 评分为 0.56；根据 PROMIS 评分，患者报告的参与度轻度受损（基线：46.19，2 个月随访：44.81，5 个月：44.84）。然而，在研究期间未观察到参与度的统计学显著变化。较低参与度的风险因素包括接受化疗、较低的身体功能、较高的焦虑和疲劳以及就业减少，p<0.05。PROs 表明，大约一半的参与者可能受益于物理或职业治疗或心理健康支持，但只有 20-36%的人是由他们的医疗团队转诊的。
新诊断出癌症的人会经历参与度受损，但他们很少被转介到支持性服务，如康复。使用 PROs 评估参与度、身体功能和心理健康，可以通过识别那些可能受益于康复治疗的患者，从而促进获得支持性护理服务，这些患者可能是通过常规临床护理所无法识别的。
