Authors (including presenting author) :
Lam WY (1)
Affiliation :
Tik NY (1), Sit LK (1), Po TF (1), Hui N (1)
Introduction :
A cancer diagnosis has always been dreadful in Chinese countries. Treatment side effects, such as fatigue, cognitive impairment and weakness tortured patients both physically and psychologically (Stein et. al, 2008). Traditional Occupational Therapy (OT) rehabilitation programme has been implemented addressing cases’ symptoms in their survivorship with promising results (Silver & Gilchrist, 2011).
Prehabilitation has been a common approach adopted in arthroplasty and colorectal surgery in enhancing clinical outcomes. Prehabilitation before/in-between neoadjuvant chemotherapy or targeted agent cycles has also demonstrated its paramount importance in Oncology with journals (Stout et.al, 2021) illustrating improvement in functional outcome, quality of life (QOL) and cost-effectiveness in healthcare. To align with the commissioning project of KEC oncology centre, an OT-specific oncology Prehabilitation/Rehabilitation and Wellness programme was implemented in benefiting the cases throughout their cancer journey.
Objectives :
To investigate the effect of Blended-Mode Oncology Prehabilitation/Rehabilitation on cognitive performance, fatigue level, emotional distress and QOL of these patients.
Methodology :
This study adopted a pre-post study design. Potential cases with cancer diagnoses were referred from SOPD and Health Resources Centre during May to November 2024. Cases with subjective cognitive, physical or emotional complaints in self-rated questionnaires were recruited. Participants would receive 1-hour training for at least 10 sessions. Blended-mode (face-to-face and tele mode) of cognitive training, functional rehabilitation, health Qigong and symptoms management were provided. Standardised assessment, Hong Kong Version of Montreal Cognitive Assessment (HK-MoCA), Functional Assessment of Cancer Therapy-General (FACT-G), General Fatigue Scale (GFS) and Depression Anxiety and Stress Scale 21 (DASS-21) were conducted.
Result & Outcome :
7 participants with a mean age of 70 and diagnoses including gastrointestinal, breast, skin, lung and urinary bladder cancers, attended an average of 28 sessions. Post-training improvement in cognitive performance, fatigue level, emotional distress and QOL was noted.
Fatigue level in GFS was reduced by 15.5% for participants attending health Qigong training (n=5) and functional rehabilitation (n=5). Emotional distress, including “Anxiety”, “Depression” and “Stress” in DASS-21, were reduced by 40.6%, 56.1% and 51.0% respectively. QOL as reflected by total FACT-G score was increased by 22.2%, with significant rises of 40.8% in physical well-being, 21.6% in functional well-being, 8.0% in social well-being and 7.4% in emotional well-being. For those attending blended-mode of cognitive training (n=4), their HK-MoCA scores were increased by 5.2%.
The result showed comprehensive OT prehabilitation/rehabilitation programme yielded significant improvement in fatigue level, emotional distress, QOL and cognitive function of cancer patients. Yet, a further up-scale study with larger sample sizes would be warranted to improve the overall validity and its clinical significance in oncology rehabilitation service.
