A033 rehabilitation needs and plans among patients with cancer, assessed at hospitals and when rehabilitation begins

1. Charlotte Handberg
PhD, MPH, RN
Needs assessment – four perspectives
Postdoctoral
study
Study 1
A cross-sectional
survey
Study 2
An ethnographic
fieldwork –
healthcare
professionals
Study 3
Register-based
study
Study 4
An ethnographic
fieldwork -
cancer survivors
The aim of the overall study is to establish a research basis for
systematic assessment of the rehabilitation needs of patients
with cancer at both hospital and municipalities

2. Charlotte Handberg
PhD, MPH, RN
Aim - Study 1
The aim of this study was to describe
specific stated rehabilitation needs and
plans among patients with cancer at
hospitals when diagnosed and when
municipal rehabilitation begins

3. Charlotte Handberg
PhD, MPH, RN
Background / Gaps
Patients with cancer are at risk of both adverse physical, psychological
and social symptoms Armes, Crowe et al. 2009, Thorsen, Gjerset et al. 2011
An increasing amount of evidence endorses cancer rehabilitation as
beneficial de Leeuw, Larsson 2013, Armes, Crowe et al. 2009, Hansen, Larsen et al. 2013
Not all patients receive an assessment of rehabilitation needs
Veloso, Sperling et al. 2013, Holm, Hansen et al. 2012
Systematic assessment of rehabilitation needs is prerequisite for
sufficient rehabilitation Veloso, Sperling et al. 2013, Holm, Hansen et al. 2012
Little is known on unmet rehabilitation needs and the related plans
Ganz 2009, von Heymann-Horan, Dalton et al. 2013

4. Charlotte Handberg
PhD, MPH, RN
Method and Materials
A cross-sectional survey:
Needs-assessment-forms for rehabilitation from 188
cancer patients
Two hospitals and two municipal cancer rehabilitation
programmes
The forms included:
1) stated needs: 58 fixed areas categorised in six
domains and
2) 2) an area to document the rehabilitation plan.
All data were categorised using the International
Classification of Functioning, Disability and Health (ICF)

5. Charlotte Handberg
PhD, MPH, RN
Baseline characteristics of the study population (n=188)
Hospitals [n=89] Municipalities [n=99]
n (%) n (%)
Sex
Women 39 (44) 68 (69)
Men 50 (56) 31 (31)
Age (years)
18 – 39 8 (9) 4 (4)
40 – 49 7 (8) 8 (8)
50 – 59 22 (25) 36 (36)
60 – 69 19 (21) 36 (36)
70+ 33 (37) 15 (15)
Cancer type
Leukaemia 24 (27) 0
Lymphoma 33 (37) 4 (4)
Myelomatosis 11 (12) 3 (3)
Breast 0 32 (32)
Colorectal 0 13 (13)
Lung 0 9 (9)
Head and neck 0 6 (6)
Ovarian 0 6 (6)
Prostate 0 6 (6)
Renal 0 4 (4)
Other 0 8 (8)
No type defined 21 (24) 8 (8)

6. Charlotte Handberg
PhD, MPH, RN
Stated rehabilitation needs and plans
Hospitals [n=89] Munici. [n=99] Total (n=188)
Mean number of stated needs [range] 7.5 [0; 22] 8.0 [1; 27] 8.0 [0; 27]
Total number of stated needs 666 836 1502
Patients completed rehabilitation plan 42 (47%) 53 (54%) 95 (51%)
Mean number of rehabilitation plans [range] 2.8 [1; 7] 3.3 [1; 12] 3.0 [1; 12]
Total number of rehabilitation plans 116 185 301

7. Charlotte Handberg
PhD, MPH, RN
Stated needs and rehabilitation plans
categorised in ICF components
Stated needs Rehabilitation plans
Hospitals
(666 needs)
Municipalities
(836 needs)
Hospitals
(116 plans)
Municipalities
(185 plans)
Body functions and
structures
521 (78%) 680 (81%) 68 (59%) 130 (70%)
Activity and
participation
85 (13%) 93 (11%) 25 (21%) 23 (12%)
Environmental
factors
39 (6%) 35 (4%) 8 (7%) 5 (3%)
Personal factors 0 0 0 0
Not definable 21 (3%) 28 (3%) 15 (13%)3 27 (16%)4
3of these 9 (8%) were physical activity
4of these 22 (12%) were physical activity

8. Charlotte Handberg
PhD, MPH, RN
Conclusion
1. The results underpin the urgent need for a systematic procedure on needs
assessment in clinical practice
2. Needs assessment is prerequisite for identifying needs, warranting a
rehabilitation plan and ensuring a referral to rehabilitation
3. The ICF framework proved useful in gaining insight into the distribution
and specifics of stated needs and plans
4. ICF further seemed potential as a framework to studies within cancer
rehabilitation and needs assessment
5. Gaining knowledge on needs assessment and the specifics of needs and
plans facilitates targeted rehabilitation interventions

9. Charlotte Handberg
PhD, MPH, RN
Thank you!
The study is funded by:
• Folkesundhed i Midten
• DEFACTUM
charlotte.handberg@stab.rm.dk
Future Research
1. Study needs assessment in both hospital and municipal settings
in order to develop validated needs-assessment-tools and to
develop and implement programmes to support those cancer
patients with rehabilitation needs
2. Learn more about which patients conduct a needs-assessment -
form (study 3)
3. Exploring patients and healthcare professionals’ experiences and
perspectives on the process of assessment of needs for cancer
rehabilitation (study 2 and 4)