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Objective: This study aimed to clarify the details of inpatient cancer rehabilitation interventions provided by designated cancer hospitals in Japan. Methods: This questionnaire-based survey asked specialists regarding the outline of their facilities’ inpatient cancer rehabilitation, Dietz classification, disease, and intervention details. Results: Restorative interventions were the most common, and the most common cancer was lung cancer followed by colorectal cancer; hematologic malignancy; gastric cancer; and liver, gallbladder, and pancreatic cancer. Intervention proportions for colorectal and gastric cancer were significantly higher in general hospitals than in university hospitals and cancer centers; in contrast, those for hematological malignancy were significantly higher in university hospitals than in general hospitals. For bone and soft tissue sarcomas, intervention proportions in cancer centers were significantly higher than those in university and general hospitals; and for oral, pharyngeal, and laryngeal cancers, they were significantly higher in university hospitals and cancer centers than in general hospitals. The most common intervention was walking training, followed by resistance training, basic motor training, activities of daily living training, and respiratory rehabilitation. Respiratory rehabilitation was performed significantly more frequently in university and general hospitals than in cancer centers.Conclusion: The diseases had differed according to the characteristics of the facilities, and the interventions were considered accordingly. In future, it will be necessary to verify the effectiveness of inpatient cancer rehabilitation according to facility characteristics and to disseminate information on inpatient cancer rehabilitation.
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Rehabilitation therapy is important for patients with cancer, especially for those with terminal stage cancer who have physical malfunction and psychological distress. By setting goals according to patients' wishes, rehabilitation therapy may positively affect physical activity. In this study, we reported the implementation of rehabilitation training outside the hospital as a rehabilitation treatment. A 64-year-old man was diagnosed as having multiple brain metastases from lung cancer. The patient was admitted to the palliative care ward without active treatment according to his wish and was referred to the rehabilitation department. The patient had mild right hemiplegia at the time of initial examination and therefore required assistance for walking and eating. On the 51st day of the intervention, he requested to visit the ramen restaurant of his friend, which recently opened. Going out independently to the restaurant served as his practical training for improving his quality of life (QOL). This outing further expanded his activities of daily living, which made him motivated to treat his cancer. On the 71st day of intervention, he was discharged from the hospital and underwent outpatient examination. Therefore, the role of treatment in palliative care is to achieve the highest possible QOL. In this case, providing options according to the patients' wishes, such as outing, is believed to be effective in cancer treatment
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OBJECTIVE@#To investigate the application status of Chinese medicine (CM) in cancer rehabilitation, so as to provide references for improving the level of CM cancer rehabilitation.@*METHODS@#A survey questionnaire regarding "application status of CM rehabilitation in cancer patients" for oncologists (doctor version) and cancer patients (patient version) were developed, respectively. From September 2014 to November 2016, a total of 1,000 doctors from oncology department in 48 hospitals and 2,000 cancer patients from CM oncology department from 8 hospitals in China were recruited in this survey. The psychological, nutrition and exercise rehabilitation guidance for cancer patients provided by doctors, their mastery conditions regarding cancer staging treatment and CM syndrome differentiation, and recommendation from doctors on CM rehabilitation were investigated. Cancer patients' awareness on the importance of psychological, nutrition and exercise rehabilitation, as well as their knowledge and needs for rehabilitation were also analyzed. The impact of gender, age, professional title, hospitals grades of physicians on their knowledge of cancer staging treatment and CM syndrome differentiation, and the relationship between gender, age, education level and economic conditions and patient's knowledge along with the needs of CM rehabilitation were further analyzed.@*RESULTS@#Totally 1,000 questionnaires were issued to doctors and 963 questionnaires returned, among which 948 were valid representing a response rate of 94.80%. A total of 2,000 questionnaires were issued to patients and 1,705 valid data finally returned with a response rate of 85.25%. The survey showed that cancer patients generally paid much attention to psychological, nutritional and sports rehabilitation, and had a strong demand for CM rehabilitation. Knowledge of CM rehabilitation was not well provided by oncologists, and the rehabilitation guidance as well as CM rehabilitation measures were obviously insufficient in cancer patients. Educational and economic levels were positively correlated with cognition level of CM rehabilitation knowledge among cancer patients (Kendall-tau_b correlation coefficients=0.130, 0.057, respectively; P<0.05). Gender and education level were positively correlated with the patients' willingness for taking CM measures (Kendall-tau_b correlation coefficient=0.057, 0.105, respectively; P<0.05). Age was negatively correlated with intention of applying CM measures (kendall-taub correlation coefficient=-0.105, P<0.05).@*CONCLUSIONS@#Health education and professional training for both cancer patients and oncologists should be strengthened and CM rehabilitation knowledge among cancer patients and oncologists should be improved, so as to give full play to CM in cancer rehabilitation.
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Purpose: Approximately 30% of the patients who received intervention from a palliative care team for problematic symptoms (e.g., pain, nausea, depression) also underwent rehabilitation at our acute hospital. We investigated their changes in activities of daily living (ADLs) and outcomes (i.e., death, changing hospitals, or being discharged to their homes). Method: We retrospectively analyzed the patients’ medical records data to examine patient training content, Barthel Index (B.I.) scores, and outcomes. Results: For one year, 86 patients received rehabilitation and 42 (48%) underwent anticancer therapy. B.I. scores increased for 35% of the patients, were stable for 20%, and decreased for 45%; 95% of the patients with decreased B.I. scores could not be discharged home. Conclusion: Advanced cancer patients are likely to experience a decline in ADLs and require longer rehabilitation periods to improve. A team approach is important for preventing disuse syndromes within a palliative care setting.
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Cancer survivors are faced with physical, emotional, mental, social relationship, vocational, economic and other challenges with the diagnosis and treatment of cancer.Those challenges would last for their whole cancer survivorship.In this case cancer has become a chronic disease.It is one of the most promising models that cancer rehabilitation organizations involving in community management and self-management of cancer patients.The comprehensive social, psychological and behavior intervention of Shanghai Cancer Rehabilitation Club has achieved positive results.It should be considered to summa-rize, evaluate and promote the intervention mode further.
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Background & Purpose : For cancer patients and survivors, some rehabilitation seems to be required in order for them to function properly and to maintain their ADL and QOL. To improve outcomes, the subject of cancer rehabilitation in our hospital, one of Japan's regional centers for cancer treatment, was examined. Methods:Our section met 246 patients who were admitted to our hospital for cancer treatment from April, 2008 to March, 2010. We assessed their age, cancer origin, disability, the term between admission, operation and consultation, the period of hospitalization and rehabilitation, and the outcome. Results:Most patients had some deficits due to their cancer, which included neurological defects, bone and joint troubles, especially bone metastasis, or dysphasia. “Disuse syndrome” was found in 101 patients who had been lying in bed without these deficits. Owing to their treatment, 139 patients were discharged home with some functional inconvenience. Their length of stay in our hospital was suggested to be shortened by early consultation with our section (<i>R</i>=0.84). Despite their efforts, 90 patients died. They enrolled in some program for an average of 56.4±6.3 days, and continued their rehabilitation for 7.6±1.2 days on average before their deaths. Conclusion:Patients who are suffering from cancer need rehabilitation in all stages of their disease, which are preventive, restorative, supportive and palliative. Both in a hospital setting and in community-based medicine, a better rehabilitation system is required for most cancer patients, not only the survivors, especially those falling into “disuse syndrome” unnecessarily, but also terminally ill patients.
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OBJECTIVE: To determine the type and prevalence of rehabilitation problems common among cancer patients and to survey the patients' recognition of and need for rehabilitation services. METHOD: The current study was conducted using a questionnaire developed by our rehabilitation team. Five hundred seven cancer patients participated in the survey. RESULTS: The percentage of patients with more than one problem from each physical, psychological, and socioeconomic categories were 87.1%, 48.2%, and 50.9% respectively. Cancer patients with needs of rehabilitation services related to physical, psychological, and socioeconomic problems comprised 77.1%, 84.6%, and 84.8%. However patients who had information about rehabilitation services related to physical, psychological, and socioeconomic problems were 22.7%, 44.7%, and 24.5%. The percentage of patients with actual rehabilitation problems needing rehabilitation services related to physical, psychological, and socioeconomic problems were 65.1%, 52.1%, and 63.6%, but only 18.2% of patients with physical problems and 5.3% of patients with psychological and socioeconomic problems received such services. The prevalence of rehabilitation problems and rehabilitation needs was very high not only in the group still receiving cancer treatment but also in the group which had completed cancer treatment. CONCLUSION: The results of this study suggest that cancer patients have various kinds of physical, psychological, socioeconomic problems differing between cancer types and cancer treatment states with high levels of rehabilitation needs. We contend that the results of this study camay not only be able to aidin the development of appropriate cancer rehabilitation programs but also be used as a basis for policy studies.
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Humans , Prevalence , Surveys and QuestionnairesABSTRACT
OBJECTIVE: Exercise may contribute to alteration in cancer in many ways. The major cell in cellular immunity to defense against cancer cell is natural killer [NK] cell. So this study is aimed to investigate the effects of exercise on NK cell cytotoxic activity (NKCA) in breast cancer patients who underwent mastectomy. METHOD: Thirty-one breast cancer patients who had undergone curative surgery were randomly assigned to an exercise group (n=16) and a non-exercise group (n=15). Exercise therapy was consisted of aerobic activity such as bicycle ergometer for 30 minutes, twice a day, five times each week for 2 weeks. The venous blood samplings were obtained on postoperative days 1, 7 and 14. NKCA was assayed by cytotoxic response against K562 cells. The venous blood samplings were obtained on postoperative days 1, 7 and 14. NKCA was assayed by cytotoxic response against K562 cells. RESULT: The baseline study did not show any statistical difference between exercise group and non-exercise group. Mean NKCA of day 7 decreased in both groups compared with that at postoperative day 1 (p<0.05). At day 14, the difference of the mean NKCA between two groups was not significant, but the mean NKCA of the exercise group without metastasis demonstrated a significant increase compared with that of the non-exercise group without metastasis (p<0.05). CONCLUSION: This study suggested that early moderate exercise had a beneficial effect on the function of NK cells in early stage of breast cancer patients after curative surgery. A further study will be needed to evaluate long-term effect of exercise on NK cell.