Evaluation of a comprehensive rehabilitation program for post-treatment patients with cancer.

PURPOSE/OBJECTIVES: To evaluate the effects of a rehabilitation program on quality of life, fatigue, fear of movement (kinesiophobia), distress, anxiety, depression, and physical condition. DESIGN: Pretest/post-test. SETTING: An outpatient rehabilitation setting in the Oncology Centre at the University Hospital Brussels in Belgium. SAMPLE: 36 patients who had completed cancer treatment with a curative potential. METHODS: Participants completed a questionnaire and underwent a physical test at baseline and at the end of the program. The measurement instruments used included the European Organisation for Research and Treatment of Cancer Quality-of-Life Questionnaire-Core 30, Functional Assessment of Cancer Therapy-Fatigue, Hospital Anxiety and Depression Scale, RAND-36, Tampa Scale for Kinesiophobia, Distress Barometer, and Tecumseh Step Test. MAIN RESEARCH VARIABLES: Quality of life, fatigue, kinesiophobia, distress, anxiety, depression, and physical condition. FINDINGS: Significant improvement was observed in quality of life (p < 0.001), physical condition (p = 0.007), fatigue (p = 0.01), and depression (p = 0.012). In contrast, kinesiophobia (p = 0.229), distress (p = 0.344), and anxiety (p = 0.101) did not change significantly. CONCLUSIONS: A general and significant improvement in all aspects affecting quality of life and rehabilitation was observed, but less so for aspects that might be influenced by prognostic concerns. The relative contribution of the program versus spontaneous recovery and long-term impact need to be determined further in a prospective randomized study. IMPLICATIONS FOR NURSING: Multidisciplinary rehabilitation should become part of the total care plan for patients with cancer.

A community peer-volunteer telephone reminder call to increase breast cancer-screening attendance.

PURPOSE/OBJECTIVES: To assess the effect of a tailored telephone reminder call by community peer volunteers on mammography rates in women who do not attend a breast cancer-screening program. DESIGN: Individual-level randomized trial. SETTING: Four semirural communities in Belgium. SAMPLE: Women aged 50-69 years who had not had a mammogram. METHODS: Women in the usual care (control) arm received an invitation letter for screening mammography and an information leaflet; women in the intervention arm received usual care as well as a telephone reminder call. The call was tailored on four variables: individual mammography history, mailing of the invitation letter, mammography appointment date, and type of mammography facility in the area (e.g., mobile unit versus fixed site). Community peer volunteers made up to three attempts to call the women in the intervention arm. MAIN RESEARCH VARIABLES: Mammography rates verified by screening registration review and adverse events identified in contacts with peer volunteers, radiologists, and community workers of local authorities. FINDINGS: A total of 3,880 women were included in the study and individually randomized into control and intervention groups. Phone numbers were identified for 79% of the women in the intervention group, and 69% were contacted. Twenty-two percent had screening mammography, which was 4% higher than controls (relative risk = 1.22). No adverse effects were identified. An additional mammogram came at an average cost of 17 phone conversations and two hours of volunteer work. CONCLUSIONS: The tested telephone reminder call is suitable for Belgian women. IMPLICATIONS FOR NURSING: The telephone reminder call may be implemented in settings similar to the studied context.