The effect of cancer rehabilitation on QoL

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The effect of cancer rehabilitation on QoL

• E. van Weert, J.E.H.M. Hoekstra-Weebers R.
  Otter R. Sanderman J.H. Arendzen K. Postema
  C.P. van der Schans
• Comprehensive Cancer Centre North Netherlands
• University Medical Center Groningen

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Rehabilitation, Qol and cancer

• Oncology number of patients with cancer?
• Treatment physical psychosocial side effects ?
  Quality of life ?
• 30 of cancer survivors need support/
  rehabilitation
• Rehabilitation current and aimed functioning
• ? QoL Multidimensional construct
• ? Multidimensional rehabilitation program

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Purposes of the study

• To examine the effect of a multi- dimensional
  rehabilitation program on Qol in cancer patients

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Inclusion criteria

• Age gt 18 years
• Referred by medical specialists or general
  practitioners
• Last cancer-related treatment gt 3 months ago
• Life expectancy ? 1 year
• An indication for rehabilitation

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Indication for rehabilitation

• Minimally 3 positive findings on the following
  questions, as judged by a physician
• - Physical complaints
• - Reduced physical capacity
• - Psychological problems
• - Increased levels of fatigue
• - Sleep disturbances
• - Problems with coping

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Exclusion criteria

• A very low activity level
• Inability to travel independently to the
  rehabilitation center
• Severe cognitive disturbances
• Severe emotional instability and serious
  psycho-pathology

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Multidimensional program

• 15 weeks, groups of 8-12 patients
• 4 components
• Individual exercise
• Sports
• Psycho-education
• Information
• Intensive phase of 6 weeks, twice a week
• Phase out of 9 weeks

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Outcome measures

• Health Related Quality of Life
• RAND-36
• Rotterdam Symptom Check List (RSCL)

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Measurement times

• Before the program (T0)
• After completion of the program (T1)

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Patients characteristics, N81
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Patients characteristics
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RAND-36 (global HRQoL)
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RSCL (disease specific HRQoL)
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Effect Sizes Rand-36
LC
MC
SC
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Effect Sizes RSCL
LC
MC
SC
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Conclusions

• The multidimensional rehabilitation program has
  clinically relevant effects on Quality of life,
  including
• physical functioning
• psychological functioning
• social functioning

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Methodological considerations

• Design No control group - Pre-post
• Effects of different components?
• Onco-Rev (2003-2007)
• Effect of a multidimensional program on QoL,
  compared to a physical program and to a (waiting
  list) control group

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Thank you!!

• Physical functioning
• Journal of Rehabilitation Research, 2004, 27,
  27-35
• Qol
• Journal of Psychosomatic Research, 2005, 58,
  485-496
• Fatigue
• The Oncologist, 2006, 11, 184-196