Telerehabilitation for Managing Daily Participation among Breast Cancer Survivors during COVID-19: A Feasibility Study

Khawla Loubani,Rachel Kizony,Naomi Schreuer

doi:10.3390/jcm11041022

Abstract

We aimed to examine the feasibility and impact of a short-term occupation-based telerehabilitation intervention (Managing Participation with Breast Cancer (MaP-BC)) on daily participation, health-related quality-of-life, and breast-cancer-related symptoms and understand women’s perspectives regarding strategies to manage daily participation and symptoms during COVID-19 pandemic. A mixed-methods study (single-arm pre–post with a qualitative component) included 14 women after their primary medical treatment for breast cancer. Women received six weeks of occupation-based intervention using a video-communication. Sessions focused on identifying functional goals and training strategies to manage daily participation. The primary outcome was perceived performance and satisfaction with meaningful activities by the Canadian Occupational Performance Measure (COPM). Secondary outcomes were participation in the Activity Card Sort (ACS), upper-extremity functioning of Disability Arm Shoulder Hand, self-reported symptom severity, executive-functioning, health-related quality of life, and a question regarding strategies used to manage daily participation. Women significantly improved their daily participation in meaningful activities in the COPM, most ACS activity domains, self-reported executive functioning, and health-related-quality-of-life. Qualitative findings revealed three main themes: (1) daily life under the threats of breast cancer and COVID-19, (2) women’s own strategies to overcome challenges, and (3) contribution of the MaP-BC. Providing telerehabilitation during the COVID-19 pandemic is feasible and successful in improving women’s daily participation after breast cancer.

Highlights

Women with breast cancer cope with decreased daily participation and quality of life (QOL) due to residual symptoms related to the cancer and its medical treatments [1]
This study examined the impact of a short-term occupation-based individual and group telerehabilitation intervention, the Managing Participation with Breast Cancer (MaP-BC), on participation and breast-cancerrelated symptoms, as well as the participants’ perceived ability to manage their daily lives under the multiple threats resulting from breast cancer, as well as COVID-19
Significant improvements in the women’s daily participation were reflected in the quantitative outcome measures and confirmed by the qualitative findings. These were accompanied by significant increases in Health-related quality of life (HRQOL), self-reported executive functioning, and the ability to generate metacognitive and self-management strategies to cope with the challenges of breast cancer and COVID-19

Summary

Introduction

Women with breast cancer cope with decreased daily participation and quality of life (QOL) due to residual symptoms related to the cancer and its medical treatments [1]. These short- and long-term symptoms include physical (e.g., fatigue, pain, nausea, and limited range of motion in the affected upper limb) [2,3]; cognitive, such as difficulties in executive functioning (e.g., planning and problem solving); attention [4]; and processing speed [5,6]. In the past decade, rehabilitation programs aimed at regaining the daily participation of breast cancer survivors have emerged. Occupation-based interventions were initiated, and initial results point to their feasibility in improving functional outcomes [9,10,11,12,13]

Objectives

Discussion

Conclusion