Abstract
Understanding the activities of daily living (ADL) of cancer patients at the end-of-life stage may help healthcare providers develop interventions for preserving physical function and enhance patient's dignity in an everyday care context. This study aims to develop and test a causal effect model of physical function in terminal cancer patients. A total of 238 participants were recruited from two hospitals in South Korea. The data were collected using a structured questionnaire including demographics, visual analogue scale for pain, Functional Assessment of Chronic Illness Therapy-Fatigue, and Katz index of independence in ADL. The collected data were analyzed using SPSS WIN 25.0 and AMOS 23.0 programs for structural equation modeling procedures. Most participants were aged 65years or older (65.5%), male (53.8%), and inpatients (74.4%). The most common primary cancer site was gastrointestinal tract (44.1%). Physical function of the participants was positively influenced by regular exercise and negatively influenced by hospitalization, fatigue, and pain, explaining 35.1% of the variance. In this study, regular exercise improved participants' ADL level directly and indirectly either by reducing fatigue or decreasing fatigue through controlling pain. Pain did not affect ADL directly but decreased ADL level indirectly through fatigue as a mediator. ADL was positively influenced by regular exercise and was negatively influenced by hospitalization, fatigue, and pain. Based on these results, in order to minimizing the problems of physical function in terminal cancer patients, interventions that reduce pain and fatigue and provide regular exercise are required.
Highlights
The five-year survival rate of cancer patients was about 45.1% in 2000 and reached 70.4% in 2017 due to consistent improvement in healthcare services for cancer patients [1]
Physical function of patients with terminal cancer was positively influenced by regular exercise and negatively influenced by hospitalization, fatigue, and pain, explaining 35.1% of the variance
Pain did not affect Activities of daily living (ADL) directly but decreased ADL level indirectly through fatigue as a mediator. Based on these results, in order to minimizing the problems of physical function in terminal cancer patients, interventions that reduce pain and fatigue and provide regular exercise are required
Summary
The five-year survival rate of cancer patients was about 45.1% in 2000 and reached 70.4% in 2017 due to consistent improvement in healthcare services for cancer patients [1]. Losing the ability to perform ADL is one of the major stresses for terminally-ill patients [8] and may increase terminal patient’s dependency on others and cause them to feel burdensome to their family, which may impose a sense of depression [9]. Such feelings of depression are the main cause of suicidal ideas in cancer patients [10]. Maintaining ADL abilities is essential for terminal cancer patients to preserve independence and autonomy, which leads to improved quality of life and dignity at the end-of-life stage
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