Effect of Community-Based Occupational Therapy on Health-Related Quality of Life and Engagement in Meaningful Activities of Women with Breast Cancer

Daiva Petruseviciene,Egle Lendraitiene,Deive Surmaitiene,Daiva Baltaduoniene

doi:10.1155/2018/6798697

Abstract

We aimed to evaluate the short-term effects of community-based occupational therapy on health-related quality of life and engagement in meaningful activities among women with breast cancer. An open label randomized controlled trial study design was applied. The participants were members of various societies of women with cancer. In total, 22 women have participated in the study. Participants of the experimental group (n = 11) participated in a 6-week community-based occupational therapy program and the usual activities of various societies, whereas the control group (n = 11) women participated in the usual activities of the societies only. 1 of the participants withdrew during the course; therefore 21 completed the study successfully. Participants of both groups were assessed for health-related quality of life and the participants of the experimental group were assessed for engagement in meaningful activities. The evaluation was carried out during the nonacute period of the disease—at the beginning of the study and after 6 weeks. Women of the experimental group demonstrated statistically significantly better scores in the global quality of life, role functions, physical, emotional, cognitive, and social functions, fatigue, insomnia, financial impact, systemic therapy side effects, and breast symptoms scales compared to the control group participants (p < 0.05) after the 6 weeks, as measured by the EORTC QLQ-C30 questionnaire and its breast cancer module QLQ-BR23. Furthermore, women of the experimental group demonstrated significant greater engagement in meaningful activities when applying community-based occupational therapy (p < 0.05), as measured by using the Engagement in Meaningful Activities Survey (EMAS). The evaluation of the associations between the women's engagement in meaningful activities and changes in health-related quality of life showed that greater engagement in meaningful activities was associated with better emotional functions and a lower level of insomnia (p < 0.05). Based on the results of our study, we recommend applying occupational therapy in the field of community healthcare in order to maintain or improve breast cancer patients' health-related quality of life and suggest involving women into meaningful activities during community-based occupational therapy after clarifying which activities are important to them.

Highlights

On the global scale, cancer causes one-seventh of all deaths
Even though survival rates in Lithuania are among the lowest, the overall situation is improving: breast cancer is detected at increasingly earlier stages, and women’s survival is improving [7]
We hope that the results of our study will be useful for occupational therapists working with breast cancer patients’ communities. All these reasons have affected the following aim of the study: to evaluate the short-term effects of community-based occupational therapy on health-related quality of life and engagement in meaningful activities among women with breast cancer. This randomized controlled trial was conducted with the permission of the Bioethics Center of the Lithuanian University of Health Sciences (number BEC-SR(M)-186), the permission of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Group to use the quality of life questionnaire EORTC QLQ-C30 and its module EORTC QLQ-BR23 in the study, and the permission of the Associate Professor A

Summary

Introduction

Cancer causes one-seventh of all deaths. According to the most recent estimates, there have been over 14 million new cases of cancer and over 8 million deaths from cancer registered worldwide, and it is expected that, due to the increasing numbers and aging of the population, these numbers will increase to, 21.7 million and 13 million by the year 2030 [1].Breast cancer, defined by the National Cancer Institute as cancer forming in breast tissues, is the most common malignant tumor among women and in as many as 19 out of 21 regions it is the leading cause of death among women in both the developed and the developing countries [2,3,4].Occupational Therapy InternationalOver 1.5 million new cases of invasive breast cancer are registered globally every year, and this is the single most common form of cancer among women that is prevalent in absolutely all regions of the world [2, 5]. According to the most recent estimates, there have been over 14 million new cases of cancer and over 8 million deaths from cancer registered worldwide, and it is expected that, due to the increasing numbers and aging of the population, these numbers will increase to, 21.7 million and 13 million by the year 2030 [1]. Breast cancer, defined by the National Cancer Institute as cancer forming in breast tissues, is the most common malignant tumor among women and in as many as 19 out of 21 regions it is the leading cause of death among women in both the developed and the developing countries [2,3,4]. Over 1.5 million new cases of invasive breast cancer are registered globally every year, and this is the single most common form of cancer among women that is prevalent in absolutely all regions of the world [2, 5]. Even though survival rates in Lithuania are among the lowest, the overall situation is improving: breast cancer is detected at increasingly earlier stages, and women’s survival is improving [7]

Methods

Results

Conclusion