The purpose of this research was to describe participation restrictions in younger and older adult cancer survivors post treatment.
Method
Younger adult cancer survivors (n = 20) and older adult cancer survivors (n = 21) completed questionnaires and a semi-structured interview of satisfaction with daily life activities and self-reported health outcomes in a single visit. Reports were based on recall during treatment and current perspectives post treatment.
Results
Despite general health short forms revealing health within normal limits, semi-structured interview approaches revealed dissatisfaction with occupational performance in both younger and older adult cancer survivors. Older adults reported persistent dissatisfaction with instrumental activities from diagnosis through post treatment compared to younger adult cancer survivors. Older adults received fewer referrals for cancer rehabilitation services (19%) compared to younger adult cancer survivors (50%).
Conclusion
Dissatisfaction with daily life activities persists several years post cancer diagnosis in older and younger adult cancer survivors, despite self-reported health within normal limits. Impairment-based short forms may lack sensitivity to detect activity limitations and participation restrictions conveyed through in-depth assessment. Adoption of more comprehensive screening methods may be needed for timely referral to cancer-based occupational therapy services.
AlfanoCMPergolottiM (2018) Next-generation cancer rehabilitation: A giant step forward for patient care. Rehabilitation Nursing43(4): 186–194.
2.
AlfanoCMLeachCRSmithTG, et al. (2019) Equitably improving outcomes for cancer survivors and supporting caregivers: A blueprint for care delivery, research, education, and policy. CA: A Cancer Journal for Clinicians69(1): 35–49.
3.
American Cancer Society (2018) Cancer Facts & Figures 2018. Atlanta: American Cancer Society.
4.
American Occupational Therapy Association (2014) Occupational therapy practice framework: Domain and process. American Journal of Occupational Therapy68(Suppl. 1): S1–S48.
5.
BaumCEdwardsDF (2001) Activity Card Sort. St. Louis: Washington University School of Medicine.
6.
BaxterMFNewmanRLongpreSM, et al. (2017) Occupational therapy’s role in cancer survivorship as a chronic condition. American Journal of Occupational Therapy71(3): 7103090010P1–7103090010P7.
7.
Bellizzi KM and Blank TO (2007) Cancer-related identity and positive affect in survivors of prostate cancer. Journal of Cancer Survivorship: Research and Practice 1(1): 44–48.
8.
BellizziKMRowlandJ (2007) Role of comorbidity, symptoms and age in the health of older survivors following treatment for cancer. Aging Health3(5): 625–635.
9.
BlankTOBellizziKM (2008) A gerontologic perspective on cancer and aging. Cancer112(Suppl. 11): 2569–2576.
10.
BluethmannSMMariottoABRowlandJH (2016) Anticipating the “silver tsunami”: Prevalence trajectories and comorbidity burden among older cancer survivors in the United States. Cancer Epidemiology, Biomarkers & Prevention25(7): 1029–1036.
11.
BrickRSLyonsKDRodakowskiJ, et al. (in press) The issue is … A need to activate lasting engagement.American Journal of Occupational Therapy74(5).
12.
FillenbaumGGSmyerMA (1981) The development, validity, and reliability of the OARS multidimensional functional assessment questionnaire. Journal of Gerontology36(4): 428–434.
13.
FleischerAHowellD (2017) The experience of breast cancer survivors’ participation in important activities during and after treatments. British Journal of Occupational Therapy80(8): 470–478.
14.
FriedLPHerdmanSJKuhnKE, et al. (1991) Preclinical disability: Hypotheses about the bottom of the iceberg. Journal of Aging and Health3(2): 285–300.
15.
HunterEGGibsonRWArbesmanM, et al. (2017) Systematic review of occupational therapy and adult cancer rehabilitation: Part 2. Impact of multidisciplinary rehabilitation and psychosocial, sexuality, and return-to-work interventions. American Journal of Occupational Therapy71(2): 7102100040p1–7102100040p8.
16.
LyonsKDBruceMLHullJG, et al. (2019) Health through activity: Initial evaluation of an in-home intervention for older adults with cancer. American Journal of Occupational Therapy73(5): 7305205070p1–7305205070p11.
17.
LyonsKDEricksonKSHegelMT (2012) Problem-solving strategies of women undergoing chemotherapy for breast cancer. Canadian Journal of Occupational Therapy79(1): 33–40.
18.
LyonsKDLambert La BalanSHegelMT, et al. (2013) Changes in activity levels of older adult cancer survivors. OTJR: Occupation Participation and Health33(1): 31–39.
19.
LyonsKDLiZTostesonTD, et al. (2010) Consistency and construct validity of the Activity Card Sort (modified) in measuring activity resumption after stem cell transplantation. American Journal of Occupational Therapy64(4): 562–569.
20.
LyonsKDRadomskiMVAlfanoCM, et al. (2017) Delphi study to determine rehabilitation research priorities for older adults with cancer. Archives of Physical Medicine and Rehabilitation98(5): 904–914.
NewmanRLyonsKDCosterWJ, et al. (2019a) Feasibility, acceptability, and potential effectiveness of an occupation-focused cognitive self-management program for breast cancer survivors. British Journal of Occupational Therapy82(10): 604–611.
24.
NewmanRMAlfanoCMRadomskiMV, et al. (2019b) Catalyzing research to optimize cancer survivors’ participation in work and life roles. OTJR: Occupation, Participation and Health39(4): 189–196.
25.
PergolottiMDealAMLaveryJR, et al. (2015) The prevalence of potentially modifiable functional deficits and the subsequent use of occupational and physical therapy by older adults with cancer. Journal of Geriatric Oncology6(3): 194–201.
26.
ReeveBBHaysRDBjornerJB, et al. (2007) Psychometric evaluation and calibration of health-related quality of life item banks: Plans for the Patient-Reported Outcomes Measurement Information System (PROMIS). Medical Care45(5 Suppl 1): S22–S31.
27.
SilverJKBaimaJMayerRS (2013) Impairment-driven cancer rehabilitation: An essential component of quality care and survivorship. CA: A Cancer Journal for Clinicians63(5): 295–317.
28.
Van DykKCrespiCMPetersenL, et al. (2019) Identifying cancer-related cognitive impairment using the FACT-Cog Perceived Cognitive Impairment. JNCI Cancer Spectrum4(1): PKZ099.
29.
WagnerLISchinkJBassM, et al. (2015) Bringing PROMIS to practice: Brief and precise symptom screening in ambulatory cancer care. Cancer121(6): 927–934.
30.
WagnerLISweetJButtZ, et al. (2009) Measuring patient self-reported cognitive function: Development of the functional assessment of cancer therapy–cognitive function instrument. The Journal of Supportive Oncology7(6): W32–W39.
31.
World Health Organization (2001) International Classification of Functioning, Disability and Health (ICF). Geneva: World Health Organization.
32.
YooGJLevineEGAvivC, et al. (2010) Older women, breast cancer, and social support. Support Care Cancer18(12): 1521–1530.
