Evaluation by electronic patient-reported outcomes of cancer survivors’ needs and the efficacy of inpatient cancer rehabilitation in different tumor entities

• Published in: Supportive care in cancer 2021-10, Vol.29 (10), p.5853-5864
• Main Authors: Licht, Thomas, Nickels, Alain, Rumpold, Gerhard, Holzner, Bernhard, Riedl, David
• Format: Article
• Language: English
• Subjects: Analysis; Anxiety; Anxiety - epidemiology; Bladder cancer; Brain cancer; Brain Neoplasms; Breast cancer; Cancer; Cancer Survivors; Care and treatment; Depression - epidemiology; Depression, Mental; Electronic health records; Electronics; Esophageal cancer; Fatigue; Humans; Inpatient care; Inpatients; Insomnia; Liver; Liver cancer; Lung cancer; Medicine; Medicine & Public Health; Mental depression; Multidisciplinary teams; Multiple myeloma; Nursing; Nursing Research; Oncology; Original; Original Article; Pain; Pain Medicine; Patient outcomes; Patient Reported Outcome Measures; Patients; Physical fitness; Quality of Life; Rehabilitation; Rehabilitation Medicine; Stress (Psychology); Surveys and Questionnaires; Survivor; Thyroid cancer
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-021-06123-x

Objective We investigated cancer survivors’ health-related quality of life (HRQOL), specific deficiencies related to underlying disease or treatment, and benefits of rehabilitation in a large variety of cancer entities. Patients and methods Electronic patient-reported outcomes were performed as clinical routine procedures. Cancer survivors underwent a 3-week multidisciplinary inpatient rehabilitation. Twenty-one different cancer entities were analyzed separately before (T0) and by the end (T1) of rehabilitation. HRQOL, symptoms, and functions were assessed with EORTC-QLQ-C30 questionnaire, psychological distress with Hospital Anxiety and Depression Scale (HADS). Results Four thousand four hundred one of 5912 rehabilitants were evaluable, having completed both questionnaires at T0 and T1. All function mean scores and HRQOL were lower than in Austrian normal population, while levels of anxiety, depression, and all symptom scores were higher. HRQOL was particularly low in lung, liver, and bladder cancer patients. Maximum anxiety levels were observed in patients with breast and thyroid cancer patients, the highest levels of depression in liver and brain cancer patients. Fatigue was severe in patients with lung, liver, esophageal, bladder cancer, and myeloma patients. Mean scores were also high for pain and insomnia. In the group of all rehabilitants, a highly significant improvement of global HRQOL, anxiety, depression, and all function and symptom scores was observed at T1 ( p < 0.001). We noted significant improvement of HRQOL, anxiety, depression, fatigue, emotional, social, role, and physical functions in each cancer entity with medium to large effect sizes. Other recorded symptoms were reduced in the majority of cancers. Conclusion Rehabilitation effectively improves psychological distress and HRQOL as a part of treatment for various cancers.