Title

NO EFFECTS ON OCCUPATIONAL OUTCOMES OF AN ADAPTIVE INTERVENTION FOR PEOPLE WITH ADVANCED CANCER: RESULTS FROM A RANDOMIZED CONTROLLED TRIAL

1

Location

Studio 3

Start Time

21-10-2017 2:30 PM

End Time

21-10-2017 3:30 PM

Session Type

Research Paper

Abstract

Research has shown that a substantial proportion of people with advanced cancer have unmet occupational needs (Johnsen et al. 2013), and a literature review found no available evidence of effective interventions to meet these needs. Therefore an intervention program, “The Cancer Home-Life Intervention”, was developed on basis of: data from a cross-sectional study, which mapped occupational performance of people with advanced cancer; literature on effective interventions for groups of people with similar occupational needs; experiences from an underpowered randomized controlled trial (RCT) (Lindahl-Jacobsen 2014). The aim of the present study was to examine occupational outcomes of the newly developed intervention program.

The study was a part of a RCT, “The Cancer Home-Life Project” (Brandt et al. 2016). The intervention applied an adaptive strategy consisting of an interview about important occupational problems, followed by selection of one to five possible adaptive strategy components, such as prioritization of important occupations, adaptation of occupations, and provision of assistive technology. In addition, the intervention group received usual care, which was the only intervention the control group received. In all 242 adult home-dwelling patients with advanced cancer and functional limitations who were able to take part in an interview and fulfill a questionnaire were enrolled consecutively from two Danish University Hospitals. After baseline data were collected the participants were randomized to either intervention or control group. At 12 weeks follow-up the intervention group consisted of 97 participants and the control group of 94. Reasons for drop-out were mainly death or illness and were similar for both groups. All data were collected in the participants’ homes, and for the present study they comprised demographic data and occupational outcomes data: observed quality of occupational performance assessed by means of the Assessment of Motor and Process Skills (AMPS); structured interview about ease/difficulty of prioritized occupations using the Individually Prioritized Problems Analysis (IPPA); and participation limitations by means of The Impact on Participation and Autonomy questionnaire (IPA-DK).

The results showed that the changes in occupational outcomes did not differ between the two groups at follow-up; thus it can be concluded that the intervention did not seem to have any effect on occupational outcomes. However, more analyses are required, e.g. of effects for subgroups and of participants’ subjective experiences of the intervention.

References

Johnsen, A. T., Petersen, M. A., Pedersen, L., Houmann, L. J., & Groenvold, M. (2013). Do advanced cancer patients in Denmark receive the help they need? A nationally representative survey of the need related to 12 frequent symptoms/problems. Psychooncology, 22(8), 1724-30.

Lindahl-Jacobsen, L. (2014). Occupational therapy for cancer patients - a randomised, controlled study [dissertation]. Odense, Denmark: University of Southern Denmark.

Brandt, Å, Pilegaard M. S., Oestergaard, L. G., Lindahl-Jacobsen, L., Sørensen, J, Johnsen, A. T., & la Cour, K. (2016). Effectiveness of the "Cancer Home-Life Intervention" on everyday activities and quality of life in people with advanced cancer living at home: a randomised controlled trial and an economic evaluation. BMC Palliat Care, 15:1-11.

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Oct 21st, 2:30 PM Oct 21st, 3:30 PM

NO EFFECTS ON OCCUPATIONAL OUTCOMES OF AN ADAPTIVE INTERVENTION FOR PEOPLE WITH ADVANCED CANCER: RESULTS FROM A RANDOMIZED CONTROLLED TRIAL

Studio 3

Research has shown that a substantial proportion of people with advanced cancer have unmet occupational needs (Johnsen et al. 2013), and a literature review found no available evidence of effective interventions to meet these needs. Therefore an intervention program, “The Cancer Home-Life Intervention”, was developed on basis of: data from a cross-sectional study, which mapped occupational performance of people with advanced cancer; literature on effective interventions for groups of people with similar occupational needs; experiences from an underpowered randomized controlled trial (RCT) (Lindahl-Jacobsen 2014). The aim of the present study was to examine occupational outcomes of the newly developed intervention program.

The study was a part of a RCT, “The Cancer Home-Life Project” (Brandt et al. 2016). The intervention applied an adaptive strategy consisting of an interview about important occupational problems, followed by selection of one to five possible adaptive strategy components, such as prioritization of important occupations, adaptation of occupations, and provision of assistive technology. In addition, the intervention group received usual care, which was the only intervention the control group received. In all 242 adult home-dwelling patients with advanced cancer and functional limitations who were able to take part in an interview and fulfill a questionnaire were enrolled consecutively from two Danish University Hospitals. After baseline data were collected the participants were randomized to either intervention or control group. At 12 weeks follow-up the intervention group consisted of 97 participants and the control group of 94. Reasons for drop-out were mainly death or illness and were similar for both groups. All data were collected in the participants’ homes, and for the present study they comprised demographic data and occupational outcomes data: observed quality of occupational performance assessed by means of the Assessment of Motor and Process Skills (AMPS); structured interview about ease/difficulty of prioritized occupations using the Individually Prioritized Problems Analysis (IPPA); and participation limitations by means of The Impact on Participation and Autonomy questionnaire (IPA-DK).

The results showed that the changes in occupational outcomes did not differ between the two groups at follow-up; thus it can be concluded that the intervention did not seem to have any effect on occupational outcomes. However, more analyses are required, e.g. of effects for subgroups and of participants’ subjective experiences of the intervention.