Feasibility study of a randomized controlled trial of a telephone‐delivered problem‐solving–occupational therapy intervention to reduce participation restrictions in rural breast cancer survivors undergoing chemotherapy

Abstract

Objective-Breast cancer patients receiving adjuvant chemotherapy often experience functional effects of treatment that limit participation in life activities. The purpose of this study was to examine the feasibility of conducting a randomized controlled trial (RCT) of a novel intervention for these restrictions, determine acceptability of the intervention, and preliminarily assess its effects.Methods-A pilot RCT of a telephone-delivered Problem Solving and Occupational Therapy intervention (PST-OT) to improve participation restrictions in rural breast cancer patients undergoing chemotherapy. Thirty-one participants with Stages 1-3 breast cancer were randomized to 6 weekly sessions of PST-OT (n=15) and Usual Care (n=16). The primary study outcome was the feasibility of conducting the trial. Secondary outcomes were functional, quality of life and emotional status as assessed at baseline, 6 weeks and 12 weeks.Results-Of 46 patients referred 31 were enrolled (67% recruitment rate), of which 6 participants withdrew (81% retention rate). Twenty-four participants completed all study-related assessments (77%). Ninety-two percent of PST-OT participants were highly satisfied with the intervention, and 92% reported PST-OT to be helpful/very helpful for overcoming participation restrictions. Ninety-seven percent of planned PST-OT treatment sessions were completed. Completion rates for PST-OT homework tasks were high. Measures of functioning, quality of life and emotional state favored the PST-OT condition.Conclusion-This pilot study suggests that an RCT of the PST-OT intervention is feasible to conduct with rural breast cancer patients undergoing adjuvant chemotherapy and that PST-OT may have positive effects on function, quality of life, and emotional state.

Terapia ocupacional en oncología: experiencias en prácticas académicas y revisión de literatura

“…Entre las debilidades del trabajo se menciona que no se consideraron los tipos de estudios empleados, que mostraran nivel de validez de las experiencias rastreadas; algunos artículos mencionan que las propuestas o resultados aún no son contundentes o deben revisarse en su validez (37,38), lo que estaba fuera de las intenciones de este trabajo, pero que debe capitalizarse como una oportunidad para abrir discusiones y generar análisis en tales ámbitos. También, que pudieron haberse excluido trabajos que aplicaban para este análisis, si los términos clave o títulos no coincidían con los criterios de búsqueda establecidos …”

“…Según el material consultado, en el área biosocial el terapeuta participa mediante evaluación, cuidado y tra-tamiento para «(…) restaurar, mantener o evitar pérdidas motoras, sensoriales y/o cognitivas que puedan resultar de la enfermedad o los tratamientos necesarios» del paciente oncológico (2,8,9,11,12,15,16,19,23,24,26,27,(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44). Aborda usuarios con restricciones para realizar actividades significativas y aporta en el abordaje integral desde equipos interdisciplinarios e incorporando acciones de humanización (8,9,11,12,20,36,45).…”

“…Asesoría telefónica y en contextos rurales para pacientes: brindando soporte sobre funcionalidad, calidad de vida y condiciones emocionales (37,38). Atención indirecta-trabajo con cuidadores: orientación a familia, fortalecimiento de redes, apoyo y orientación en rol de facilitadores del tratamiento ante sentimientos de incertidumbre y desconocimiento de procesos, Disposición de estrategias para mejorar la vida cotidiana de cuidadores, pues se afecta la dinámica familiar, participación en actividades de ocio, autocuidado y productivas (2,25,29,50).…”

Breast cancer: rehabilitation

“…Sessions over the telephone can be useful to strengthen these orientations when the patient has difficulty in being physically present 43,44 (B).…”

Integral strategy to supportive care in breast cancer survivors through occupational therapy and a m-health system: design of a randomized clinical trial

“…However, to our knowledge, the only published randomized controlled trial evaluating occupational therapy in BCS is an intervention aimed at reducing the limitations of rural patients in their daily activities [31]. The authors found that a telephone-based problem-solving occupational therapy intervention program was feasible and had positive effects on the patients’ function, QoL and emotional state.…”