riwc_para_a033 rehabilitation needs and plans among patients with cancer, assessed at hospitals and...

Charlotte HandbergPhD, MPH, RN

Needs assessment – four perspectives

Postdoctoralstudy

Study 1A cross-sectional

survey

Study 2An ethnographic

fieldwork – healthcare

professionals

Study 3Register-based

study

Study 4An ethnographic

fieldwork -cancer survivors

The aim of the overall study is to establish a research basis for systematic assessment of the rehabilitation needs of patients

with cancer at both hospital and municipalities


Aim - Study 1

The aim of this study was to describe specific stated rehabilitation needs and plans among patients with cancer at hospitals when diagnosed and when municipal rehabilitation begins


Background / GapsPatients with cancer are at risk of both adverse physical, psychological and social symptoms Armes, Crowe et al. 2009, Thorsen, Gjerset et al. 2011

An increasing amount of evidence endorses cancer rehabilitation as beneficial de Leeuw, Larsson 2013, Armes, Crowe et al. 2009, Hansen, Larsen et al. 2013

Not all patients receive an assessment of rehabilitation needs Veloso, Sperling et al. 2013, Holm, Hansen et al. 2012

Systematic assessment of rehabilitation needs is prerequisite forsufficient rehabilitation Veloso, Sperling et al. 2013, Holm, Hansen et al. 2012

Little is known on unmet rehabilitation needs and the related plans Ganz 2009, von Heymann-Horan, Dalton et al. 2013


Method and MaterialsA cross-sectional survey:Needs-assessment-forms for rehabilitation from 188 cancer patients

Two hospitals and two municipal cancer rehabilitation programmes

The forms included: 1) stated needs: 58 fixed areas categorised in six

domains and 2) 2) an area to document the rehabilitation plan.

All data were categorised using the International Classification of Functioning, Disability and Health (ICF)


Baseline characteristics of the study population (n=188)

Hospitals [n=89] Municipalities [n=99]

n (%) n (%)Sex Women 39 (44) 68 (69) Men 50 (56) 31 (31)Age (years) 18 – 39 8 (9) 4 (4) 40 – 49 7 (8) 8 (8) 50 – 59 22 (25) 36 (36) 60 – 69 19 (21) 36 (36) 70+ 33 (37) 15 (15)Cancer type Leukaemia 24 (27) 0 Lymphoma 33 (37) 4 (4) Myelomatosis 11 (12) 3 (3) Breast 0 32 (32) Colorectal 0 13 (13) Lung 0 9 (9) Head and neck 0 6 (6) Ovarian 0 6 (6) Prostate 0 6 (6) Renal 0 4 (4) Other 0 8 (8) No type defined 21 (24) 8 (8)


Stated rehabilitation needs and plans

Hospitals [n=89] Munici. [n=99] Total (n=188)

Mean number of stated needs [range] 7.5 [0; 22] 8.0 [1; 27] 8.0 [0; 27]

Total number of stated needs 666 836 1502

Patients completed rehabilitation plan 42 (47%) 53 (54%) 95 (51%)

Mean number of rehabilitation plans [range] 2.8 [1; 7] 3.3 [1; 12] 3.0 [1; 12]

Total number of rehabilitation plans 116 185 301


Stated needs and rehabilitation plans categorised in ICF components

Stated needs Rehabilitation plans

Hospitals (666 needs)

Municipalities (836 needs)

Hospitals (116 plans)

Municipalities(185 plans)

Body functions and structures 521 (78%) 680 (81%) 68 (59%) 130 (70%)

Activity and participation 85 (13%) 93 (11%) 25 (21%) 23 (12%)

Environmental factors 39 (6%) 35 (4%) 8 (7%) 5 (3%)

Personal factors 0 0 0 0

Not definable 21 (3%) 28 (3%) 15 (13%)3 27 (16%)4

3of these 9 (8%) were physical activity4of these 22 (12%) were physical activity


Conclusion1. The results underpin the urgent need for a systematic procedure on needs

assessment in clinical practice

2. Needs assessment is prerequisite for identifying needs, warranting a rehabilitation plan and ensuring a referral to rehabilitation

3. The ICF framework proved useful in gaining insight into the distribution and specifics of stated needs and plans

4. ICF further seemed potential as a framework to studies within cancer rehabilitation and needs assessment

5. Gaining knowledge on needs assessment and the specifics of needs and plans facilitates targeted rehabilitation interventions


Thank you!

The study is funded by: • Folkesundhed i Midten

• [email protected]

Future Research1. Study needs assessment in both hospital and municipal settings

in order to develop validated needs-assessment-tools and to develop and implement programmes to support those cancer patients with rehabilitation needs

2. Learn more about which patients conduct a needs-assessment -form (study 3)

3. Exploring patients and healthcare professionals’ experiences and perspectives on the process of assessment of needs for cancer rehabilitation (study 2 and 4)

riwc_para_a033 rehabilitation needs and plans among patients with cancer, assessed at hospitals and...

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