title: In-home occupational therapy for a patient with stage IV lung cancer: changes in quality of life and analysis of causes.
abstract: BACKGROUND
  We tracked and analyzed the changes in the quality of life (QOL) of a stage 4 lung cancer patient receiving occupational therapy at home.
  
  
  METHODS
  In a longitudinal study consisting of 4 evaluations over 9 months, a 66-year-old female with lung cancer was assessed using the Philadelphia Geriatric Center (PGC) Morale Scale and the 100-Point Satisfaction Scale. The QOL scores over time and factors influencing changes in these scores were analyzed.
  
  
  RESULTS
  A histogram of QOL scores demonstrated a rapid increase followed by a mild decrease and then stable level. Interviews revealed the patient's response to knowing her life expectancy, meeting a qualified occupational therapist, increasing her leisure activity, changing her family relationships and facing the prospect of death. We also confirmed that occupational therapy, such as writing letters or keeping a diary, reminded her of her late parents, hometown and childhood and helped her accept death.
  
  
  CONCLUSIONS
  For a terminal lung cancer patient, meeting an occupational therapist to discuss fear or self-loathing improved QOL. Further, an active lifestyle played an important role in helping the patient accept death and lead a peaceful and stable life.
authors: Research Institute of Rehabilitation Sciences, Osaka Prefectural University, Habikino 3-7-30, Habikino-shi, Osaka Japan.
authors: Miyuki
authors: M
authors: Imanishi
authors: Department of Psychiatry, Kyoto University Hospital, Shogoin-kawaracho 54, Sakyo-ku, Kyoto Japan.
authors: Hisao
authors: H
authors: Tomohisa
authors: Department of Community Health, Osaka Prefectural University, Habikino 3-7-30, Habikino-shi, Osaka Japan.
authors: Kazuo
authors: K
authors: Higaki
keywords: End of life; Occupational therapy; Quality of life