Browsing by Subject "Survivor"

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    Impact of a Personal Health Record Intervention Upon Surveillance Among Colorectal Cancer Survivors: Feasibility Study
    (JMIR, 2022-08-11) Vachon, Eric; Robb, Bruce W.; Haggstrom, David A.; School of Nursing
    Background: There are currently an estimated 1.5 million individuals living in the United States with colorectal cancer (CRC), and although the 5-year survival rate has increased, survivors are at risk for recurrence, particularly within the first 2-3 years after treatment. National guidelines recommend continued surveillance after resection to identify recurrence early on. Adherence among survivors ranges from 23% to 94%. Novel interventions are needed to increase CRC survivors' knowledge and confidence in managing their cancer and thus to increase adherence to follow-up surveillance. Objective: The objective of this study is to develop and test the feasibility and efficacy of a stand-alone, web-based personal health record (PHR) to increase surveillance adherence among CRC survivors, with patient beliefs about surveillance as secondary outcomes. Methods: A pre- and postintervention feasibility trial was conducted testing the efficacy of the colorectal cancer survivor (CRCS)-PHR, which had been previously developed using an iterative, user-centered design approach. Results: The average age of the sample was 58 (SD 9.9) years, with 57% (16/28) male and the majority married (20/28, 71%) and employed full-time (15/28, 54%). We observed a significant increase in adherence to colonoscopy (before: 11/21, 52% vs after: 18/21, 86%; P=.005) and CEA (14/21, 67% vs 20/21, 95%; P=.01), as well as a slight increase in CT scans (14/21, 67% vs 18/21, 86%; P=.10). The only significant impact on secondary outcome (patient beliefs) was benefits of CEA test (P=.04), as most of the beliefs were high at baseline. Conclusions: This feasibility study lays the groundwork for continued development of the CRCS-PHR to increase CRC surveillance. Patient-centered technologies, such as the CRCS-PHR, represent an important potential approach to improving the receipt of guideline-concordant care and follow-up surveillance, and not just for CRC survivors. Researchers should continue to develop patient-centered health technologies with clinician implementation in mind to increase patient self-efficacy and surveillance adherence.
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    Implementation of Occupational Therapy as Standard of Care for Pediatric Cancer Recovery: A Rapid Systematic Review
    (2024-04-24) Waltz, Audrey; Reckard, Addison; Lee, Kyla; Lee, Molly; John, Emma; Warne, Caiti; Chase, Anthony; Lee, Chang Dae; Department of Occupational Therapy, School of Health and Human Sciences
    Objective Pediatric oncology patients can experience different symptoms and difficulties impacting their daily lives. Currently, the standard of care for these patients varies based on location, setting, referrals, diagnosis, treatment plan, and interventions. The objective of this study was to evaluate the current standard of care for pediatric oncology patients and the impact and effectiveness occupational therapy (OT) can have on this population. Study Design This rapid systematic review (RSR) was conducted utilizing a program called Covidence. There were 2,927 articles from PubMed in the initial screen. Following this first screening of articles, 249 articles passed the title and abstract screening process. A full text review was completed from these and resulted in 33 articles for extraction. In total, 33 articles passed the screening process to be reviewed (Covidence, 2024). Results The goal of this study was to investigate whether the standard of care for pediatric cancer patients included OT or should include OT. Currently, skilled therapy is not consistently integrated into the pediatric oncology standard of care, likely due to insufficient awareness of its benefits and the inherent rigidity of cancer treatment plans. Treatment centers that did include skilled therapy services, such as OT, contributed to improvements in health related quality of life (HRQoL), motor skills, and the experience of the family unit. Additional findings include a reduction in pain, fatigue, and anxiety experienced by pediatric cancer patients. Examples of incorporated OT skilled therapy services included play-based therapy, aquatic therapy, hippotherapy, gross motor rehabilitation, and education and training programs for the patient and caregivers. Despite these findings, there is not an established standardized protocol implemented in hospitals and other centers that are aiming to address the occupational performance deficits experienced by pediatric cancer patients. Conclusion Skilled OT services should be implemented into a standard of care protocol for pediatric oncology patients as it has been found to help decrease levels of fatigue, anxiety, and pain as well as increase HRQoL and motor skills. Further research should be conducted to address two areas of focus. First, to determine the essential components of a skilled therapy protocol. Second, to create an established protocol for the rehabilitation of pediatric oncology patients.