Feasibility study of a randomized controlled trial of a telephone-delivered problem-solving-occupational therapy intervention to reduce participation restrictions in rural breast cancer survivors undergoing chemotherapy.
OBJECTIVE
Breast cancer patients receiving adjuvant chemotherapy often experience functional effects of treatment that limit participation in life activities. The purpose of this study was to examine the feasibility of conducting a randomized controlled trial (RCT) of a novel intervention for these restrictions, determine acceptability of the intervention, and preliminarily assess its effects.


METHODS
A pilot RCT of a telephone-delivered Problem-solving and Occupational Therapy intervention (PST-OT) to improve participation restrictions in rural breast cancer patients undergoing chemotherapy. Thirty-one participants with Stages 1-3 breast cancer were randomized to 6 weekly sessions of PST-OT (n = 15) and usual care (n = 16). The primary study outcome was the feasibility of conducting the trial. Secondary outcomes were functional, quality of life and emotional status as assessed at baseline, 6 and 12 weeks.


RESULTS
Of 46 patients referred 31 were enrolled (67% recruitment rate), of which 6 participants withdrew (81% retention rate). Twenty-four participants completed all study-related assessments (77%). Ninety-two percent of PST-OT participants were highly satisfied with the intervention, and 92% reported PST-OT to be helpful/very helpful for overcoming participation restrictions. Ninety-seven percent of planned PST-OT treatment sessions were completed. Completion rates for PST-OT homework tasks were high. Measures of functioning, quality of life, and emotional state favored the PST-OT condition.


CONCLUSIONS
This pilot study suggests that an RCT of the PST-OT intervention is feasible to conduct with rural breast cancer patients undergoing adjuvant chemotherapy and that PST-OT may have positive effects on function, quality of life, and emotional state.
Hegel
Mark T
MT
Department of Psychiatry, Dartmouth Medical School, Hanover, NH 03756, USA. Mark.T.Hegel@Dartmouth.EDU
Lyons
Kathleen D
KD
Hull
Jay G
JG
Kaufman
Peter
P
Urquhart
Laura
L
Li
Zhongze
Z
Ahles
Tim A
TA
D000203:Activities of Daily Living / Q000523:psychology; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001007:Anxiety / Q000209:etiology / Q000523:psychology; D001943:Breast Neoplasms / Q000188:drug therapy / Q000523:psychology / Q000534:rehabilitation*; D003863:Depression / Q000209:etiology / Q000523:psychology; D005081:Exercise Therapy / Q000523:psychology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D009788:Occupational Therapy / Q000379:methods*; D010349:Patient Compliance; D011569:Psychiatric Status Rating Scales; D012424:Rural Population; D017741:Survivors / Q000523:psychology*; D013689:Telephone
D000970:Antineoplastic Agents
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