How Receptive Are Patients With Late Stage Cancer to Rehabilitation Services and What Are the Sources of Their Resistance?
OBJECTIVE
To describe the proportion and characteristics of patients with late stage cancer that are and are not receptive to receiving rehabilitation services, and the rationale for their level of interest.


METHODS
Prospective mixed-methods study.


METHODS
Comprehensive cancer center in a quaternary medical center.


METHODS
Adults with stage IIIC or IV non-small cell or extensive stage small cell lung cancer (N=311).


METHODS
Not applicable.


METHODS
Telephone-acquired responses to the administration of (1) the Activity Measure for Post Acute Care Computer Adaptive Test (AM-PAC-CAT); (2) numerical rating scales for pain, dyspnea, fatigue, general emotional distress, and distress associated with functional limitations; (3) a query regarding receptivity to receipt of rehabilitation services, and (4) a query about rationale for nonreceptivity.


RESULTS
Overall, 99 (31.8%) of the study's 311 participants expressed interest in receiving rehabilitation services: 38 at the time of enrollment and an additional 61 during at least 1 subsequent contact. Participants expressing interest were more likely to have a child as primary caregiver (18.18% vs 9.91%, P=.04) and a musculoskeletal comorbidity (42.4% vs 31.6%, P=.05). Function-related distress was highly associated with receptivity, as were lower AM-PAC-CAT scores. Reasons provided for lack of interest in receiving services included a perception of their limited benefit, being too busy, and prioritization below more pressing tasks/concerns.


CONCLUSIONS
One-third of patients with late stage lung cancer are likely to be interested in receiving rehabilitation services despite high levels of disability and related distress. These findings suggest that patient misperception of the role of rehabilitation services may be a barrier to improved function and quality of life. Efforts to educate patients on the benefits of rehabilitation and to more formally integrate rehabilitation as part of comprehensive care may curb these missed opportunities.
Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN. Electronic address: Cheville.andrea@mayo.edu.
Andrea L
AL
Cheville
Department of Nursing, Mayo Clinic, Rochester, MN; School of Nursing, University of Minnesota, Minneapolis, MN.
Lori
L
Rhudy
Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN.
Jeffrey R
JR
Basford
Department of Health Sciences Research, Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN.
Joan M
JM
Griffin
Department of Physical Therapy, Movement and Rehabilitation Sciences, Northeastern University, Boston, MA.
Ann Marie
AM
Flores
D000368:Aged; D002173:Cancer Care Facilities; D017028:Caregivers; D015897:Comorbidity; D005260:Female; D006304:Health Status; D006801:Humans; D008175:Lung Neoplasms / Q000523:psychology* / Q000534:rehabilitation*; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D011788:Quality of Life; D013315:Stress, Psychological / Q000523:psychology; D019467:Subacute Care / Q000523:psychology*; D013997:Time Factors
Attitude; Neoplasms; Patient preference; Physical medicine and rehabilitation; Physical therapy modalities; Qualitative research; Rehabilitation