Abstract
The results of a four-week quasi-experimental pretest-posttest research study examining the effectiveness of an OT-HAWP on health-related quality of life, fatigue, sleep quality, and self-perceived satisfaction or performance of daily activities of cancer survivors in the community setting will be presented. Understanding these results allows OTs to consider practicing this effective intervention and to discern their role within an emerging practice area in cancer survivorship.
Primary Author and Speaker: Katie Polo
Additional Authors and Speakers: Sharaya Sommers
The number of cancer survivors today is growing exponentially and many have unmet needs due to the late side effects of treatment. Hunter, Gibson, Arbesman, & D’Amico (2017) called for studies looking at return to participation as it relates to managing these late side effects. The purpose of this study was to explore the impact that a 4 wk. OT Health and Wellness Program (OT-HAWP) has on self-perceived performance and satisfaction of daily activities, fatigue, sleep quality, and health-related quality of life among adult cancer survivors. Researchers used a quasi-experimental, uncontrolled, prospective, one-group pretest-posttest design to explore the effects of the OT-HAWP. Eligible participants with a past or present diagnosis of cancer, at least 18 yrs., and English speaking were recruited from a cancer support community. Survivors that indicated concerns of great severity on a distress screening tool in OT service areas qualified to participate. A collection of demographic information, satisfaction and performance scores of daily activities with the Canadian Occupational Performance Measure (COPM), health related QOL with the Patient-Reported Outcomes Measurement Information System (PROMIS), sleep quality with the Pittsburgh Sleep Quality Index (PSQI), and fatigue levels with the Multidimensional Assessment of Fatigue Scale (MAF) were collected. Paired t-tests and Wilcoxon signed-ranks tests were used to determine significant differences in scores from pre to post-intervention with a significance level set at <.05. Thirty-five survivors agreed to participate and completed the full OT-HAWP. Using Kolmogorov-Smirnov test of normality, the mean difference between scores before and after the OT-HAWP was normally distributed for the performance scores of the COPM and the PROMIS; while satisfaction scores for the COPM and the PSQI were not. There was a statistically significant difference between pretest and posttest scores on COPM, PROMIS, and PSQI (See results below). Results of the MAF as well as basic demographic information are forthcoming and will be presented at conference.
Pre Post
Mdn (IQR) Mdn (IQR) p
COPM-Satisfaction 2.90 (1.70) 6.48 (2.98) < .001
PSQI 11.00 (7.00) 7.00 (2.98) < .001
M (SD) M (SD) p
COPM-Performance 4.62 (1.33) 6.27 (1.65) < .001
PROMIS Physical Health 38.51 (8.41) 41.63 (7.35) .004
PROMIS Mental Health 44.08 (7.65) 46.31 (7.93) .011
The preliminary results of this pilot study are promising with statistically significant change scores in satisfaction and performance of daily activities, sleep quality, and health related QOL. It is hypothesized that fatigue scores will also follow this trend. This study explored the efficacy of the OT-HAWP intervention in the community, a non-traditional service setting. Most survivors receive follow-up care in the community, creating a call for OTs to practice within this setting (Polo & Smith, 2017) despite a lack of reimbursement for these services and call for legislation to improve access to care (Baxter et al., 2017). Community intervention studies focusing on occupational performance such as this one, continue to be warranted in order for to show our value in non-traditional cancer settings for future service reimbursement.
Hunter, E. G., Gibson, R. W., Arbesman, M., & D’Amico, M. (2017). Centennial Topics—Systematic review of occupational therapy and adult cancer rehabilitation: Part1. Impact of physical activity and symptom management interventions. American Journal of Occupational Therapy, 71, 7102100030. https://doi.org/10.5014/ajot.2017.023564
Polo, K. M., & Smith, C. (2017). Taking our seat at the table: Community cancer survivorship. American Journal of Occupational Therapy, 71(2), 7102100010p1-7102100010p5. https://doi.org/10.5014/ajot.2017.020693
Baxter, M. F., Newman, R., Longpré, S.M. & Polo, K. (2017). Occupational therapy’s role in cancer survivorship as a chronic condition. The American Journal of Occupational Therapy: Official Publication of the American Occupational Therapy Association,71(3), 1-7. https://doi.org/10.5014/ajot.2017.713001