Authors (including presenting author) :
Ho WS (1), Li YM (1), Leung CF (1), Lee HS (1), Hui N (1)
Affiliation :
(1) Occupational Therapy (OT) Department, United Christian Hospital (UCH)
Introduction :
Patients with cancer often experience a wide range of distressing symptoms, both physical and psychological. Cancer-related fatigue and cognitive impairment are two common symptoms experienced by patients with cancer. Occupational therapy, a patient-centered service, focuses on improving health, well-being, and functional capacity. Therefore, it has a crucial role in cancer rehabilitation. The Wellness Program was implemented in the Occupational Therapy department at United Christian Hospital, aiming to empower patients in symptoms management and facilitate their achievement of maximum functional performance, which ultimately improves their quality of life.
Objectives :
To study the effectiveness of the Wellness Program on alleviating cancer related fatigue and improving quality of life for patients with cancer.
Methodology :
Cases were recruited since June 2024 from three referral sources 1) Oncology Specialist Out-patient Clinic, 2) Chemotherapy Day Centre and 3) Cancer Patient Resource Centre. Cancer patients who expressed cancer related fatigue or had complaint of memory deficit were eligible to join the program. The Wellness Program consisted of 10 sessions which encompassed the following elements: 1) Cancer-related fatigue symptom management and education, 2) Stress management and psychoeducation, 3) Cognitive stimulation exercises and 4) Mind-body exercise: Health Qigong (Baduanjin). Pre and post outcome measurements included the General Fatigue Scale (GFS) which evaluated the level of cancer-related fatigue in patients; the Functional Assessment of Cancer Therapy - General (FACT-G) which measured patient’s quality of life; and the Montreal Cognitive Assessment 5-Minute Protocol Hong Kong Version (HK-MoCA 5-min), which assessed patient’s cognitive function. For data analysis, Wilcoxon signed rank test was utilized for all of the above outcome measures.
Result & Outcome :
From June to Dec 2024, a total of 11 cases completed full course of training. The average age of participants was 68 and 7 of them were female. The diagnosis of the participants was as follow: CA breast (n=3); CA prostate (n=2); CA pancreas (n=2); CA colon/ sigmoid (n=2); Gastrointestinal stromal cancer (n=1) and CA lung (n=1). 3 of the participants were receiving target therapy; 2 receiving chemotherapy; 1 receiving hormone therapy; with the remaining 5 participants not undergoing any active treatment. After completion of 10 sessions of wellness program, the average scores on the General Fatigue Scale decreased significantly by 10.8 points (p=0.02). Furthermore, there was a 5.8% increase of FACT-G total score from 68.5 to 72.5, indicating that patients experienced a better quality of life after attending the wellness program. Increases were noted in 3 out of 4 FACT-G subscale score, namely social / family well-being (from 18.9 to 19.9), emotional well-being (from 14.8 to 16.9) and functional well-being (from 15.6 to 17.3). For patient’s cognitive function, the HK-MoCA 5-min score increased from 24.7 to 25.0. Although the differences in pre and post FACT-G total score and HK-MoCA 5-min score were statistically insignificant (p=0.477 & p=0.588) owing to relative small sample size, this project being ongoing and it is hoped that further promising results will be yielded in the near future.
In conclusion, the Wellness Program effectively improved fatigue symptoms in cancer patients. An upward trend in patients' cognitive function and quality of life was also observed. Further investigations involving a larger population size and a control group are highly recommended.
