The patient specific functional scale in outpatient cancer rehabilitation.

Abstract

94 Background: Cancer rehabilitation is an underutilized service within the oncology care spectrum. Approximately 65% of survivors have functional impairments, while only 6% receive services. The effectiveness of cancer rehabilitation must be demonstrated to increase access to care, however there are no nationally recognized outcome tools for use with the oncology population across therapy disciplines. The Patient Specific Functional Scale (PSFS) is validated for use in many traditional rehabilitation populations, and has been referenced in one study with breast cancer patients. The purpose of this quality improvement project was to investigate the utility of the PSFS with cancer patients seen in an outpatient therapy setting. Methods: The PSFS was selected for its comprehensiveness and the ability to use across rehabilitation therapy disciplines. The PSFS measures patient perception of functional improvement during rehabilitation. Patients select up to three limiting activities and rate them on an 11-point scale. An average score is computed. Occupational, physical, and speech therapists were trained on administration, scoring, and reporting of the PSFS. The initial score was obtained at evaluation and the final score was collected during the last treatment session. PSFS scores were collected over a one-year period. Results: 307 new patients were evaluated in the outpatient clinic and 65 of those patients completed the PSFS at both the initial and final visits. Most patients had breast, prostate, and brain cancers. Barriers to completion of PSFS included patients not being appropriate for treatment, therapist compliance with the tool, and patients not returning for their final therapy appointment. Of the 65 patients, 86% reported the minimal clinically important change of 2-points or greater. The average increase in PSFS score was 3.7 points. Conclusions: The PSFS was successfully utilized in the outpatient rehabilitation setting with oncology patients. Therapists perceived the tool as quick, patient-centered, and easy to use. Patients showed functional improvement using the PSFS. Further research is necessary to understand the psychometric properties of the PSFS with the oncology population.