Title

Health-related quality of life of older adults with cancer: Race, illness and participation in occupation.

1

Location

Armory Room

Start Time

30-9-2016 3:00 PM

End Time

30-9-2016 4:30 PM

Session Type

Research Paper

Abstract

Research Paper

Statement of purpose: In occupational science, quality of life has been considered an “achievable…. realistic outcome” for older adults (Carlson, Clark & Young, 1998, p. 108). The connection between the quality of health and occupation continues to be highlighted within occupational science research, with calls to examine the relationship in more detail (Wilcock, 2007). Yet, studies examining the impact of basic, daily occupations on the quality of life for older adults with cancer, remain limited. This paper will present a large interdisciplinary and collaborative study which aimed to (1) describe physical and mental health-related quality of life (HRQOL) of a large sample of older adults (age > 65) with cancer and (2) examine the association of self-reported ability to participate in daily occupations on HRQOL.

Methods: This study utilized the Health Registry/Cancer Survivorship Cohort for secondary data analyses. This cohort is a hospital-based registry consisting of data on adults with cancer at various points along the cancer survivorship continuum. Adults enrolled in the Registry are characterized by demographic, clinical and interview data. Specifically, patient-reported measures include comorbidity, as well as, performance (Patient-Generated Subjective Global Assessment) and HRQOL assessments (FACT-G and PROMIS global measures for physical and mental health). For this study, only adults over the age of 65 were included and multivariable regression analyses were used to determine associations with HRQOL in this population.

Results: Sample consisted of 807 older adults with cancer, mean age 72 years, 60% female, and 12% Black. Mean scores for HRQOL: FACT-G (85, range: 25-108), PROMIS-Physical (48, range: 16-67), and PROMIS-Mental (51, range: 21-67). In multivariable models, race, number of co-morbid conditions, self-reported activity-limiting anxiety/depression, and daily occupations were significantly associated with HRQOL. Older adults with cancer who are Black, have high comorbidity burden, anxiety and depression, and those with low ability to participate in daily occupations have poor HRQOL. In our sample, self-reported ability to participate in daily occupations was independently associated with all measures of HRQOL (p <.0001).

Implications related to occupational science: These findings add to our understanding, and the research behind the importance of daily occupation in HRQOL, especially for older adults with cancer. Lastly, this study found a strong association of race on HRQOL for older adults with cancer and highlights the need to better understand the relationships between occupation, race, illness and HRQOL for Black Americans with cancer.

Discussion questions to further occupational science concepts and ideas:

  1. How does this study relate to the understandings of social determinants of health?
  2. Using a transactional lens, how does this study relate to the situations/relationships within the cancer system and cancer care continuum?
  3. How does this study relate to health care policy? Can occupational scientists use this data to demonstrate the power of everyday occupation?

Key words: cancer, older adults, race, health related quality of life.

References

Carlson, M., Clark, F., & Young, B. (1998). Practical contributions of occupational science to the art of successful ageing: How to sculpt a meaningful life in older adulthood. Journal of Occupational Science, 5(3), 107-118.

Wilcock, A. A. (2007). Occupation and health: Are they one and the same? Journal of Occupational Science, 14(1), 3-8.

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Sep 30th, 3:00 PM Sep 30th, 4:30 PM

Health-related quality of life of older adults with cancer: Race, illness and participation in occupation.

Armory Room

Research Paper

Statement of purpose: In occupational science, quality of life has been considered an “achievable…. realistic outcome” for older adults (Carlson, Clark & Young, 1998, p. 108). The connection between the quality of health and occupation continues to be highlighted within occupational science research, with calls to examine the relationship in more detail (Wilcock, 2007). Yet, studies examining the impact of basic, daily occupations on the quality of life for older adults with cancer, remain limited. This paper will present a large interdisciplinary and collaborative study which aimed to (1) describe physical and mental health-related quality of life (HRQOL) of a large sample of older adults (age > 65) with cancer and (2) examine the association of self-reported ability to participate in daily occupations on HRQOL.

Methods: This study utilized the Health Registry/Cancer Survivorship Cohort for secondary data analyses. This cohort is a hospital-based registry consisting of data on adults with cancer at various points along the cancer survivorship continuum. Adults enrolled in the Registry are characterized by demographic, clinical and interview data. Specifically, patient-reported measures include comorbidity, as well as, performance (Patient-Generated Subjective Global Assessment) and HRQOL assessments (FACT-G and PROMIS global measures for physical and mental health). For this study, only adults over the age of 65 were included and multivariable regression analyses were used to determine associations with HRQOL in this population.

Results: Sample consisted of 807 older adults with cancer, mean age 72 years, 60% female, and 12% Black. Mean scores for HRQOL: FACT-G (85, range: 25-108), PROMIS-Physical (48, range: 16-67), and PROMIS-Mental (51, range: 21-67). In multivariable models, race, number of co-morbid conditions, self-reported activity-limiting anxiety/depression, and daily occupations were significantly associated with HRQOL. Older adults with cancer who are Black, have high comorbidity burden, anxiety and depression, and those with low ability to participate in daily occupations have poor HRQOL. In our sample, self-reported ability to participate in daily occupations was independently associated with all measures of HRQOL (p <.0001).

Implications related to occupational science: These findings add to our understanding, and the research behind the importance of daily occupation in HRQOL, especially for older adults with cancer. Lastly, this study found a strong association of race on HRQOL for older adults with cancer and highlights the need to better understand the relationships between occupation, race, illness and HRQOL for Black Americans with cancer.

Discussion questions to further occupational science concepts and ideas:

  1. How does this study relate to the understandings of social determinants of health?
  2. Using a transactional lens, how does this study relate to the situations/relationships within the cancer system and cancer care continuum?
  3. How does this study relate to health care policy? Can occupational scientists use this data to demonstrate the power of everyday occupation?

Key words: cancer, older adults, race, health related quality of life.