Oncology Rehabilitation Overview

Course Information

• Course Code and Name: HEY413E REHABILITATION NURSING
• Course Week: 14
• Course Day and Time: Tuesday (12:00 to 13:50)
• Course Credit/ACTS: 2
• Examination Type: Mcqs
• Instructor's Name & Surname: Dr. Hina Zahoor
• E-mail & Phone: [email protected]
• Instructor's Room: 305
• Office Hours: 9.00 to 5.00
• GBS Link: https://gbs.gelisim.edu.tr/ders-detay-5-160-6267-1
• ALMS Link: https://lms.gelisim.edu.tr/almsp/u/Home/Index
• AVESIS Link: https://persis.gelisim.edu.tr/Default.aspx

Weekly Learning Outcomes

• Understand the importance of oncology rehabilitation in the cancer care continuum.
• Identify the different settings where oncology rehabilitation occurs.
• Recognize the key phases of the rehabilitation process for cancer patients.
• Understand the roles of various cancer rehabilitation professionals involved in the rehabilitation process.
• Gain knowledge of how oncology rehabilitation contributes to improving the quality of life for cancer survivors.

Attendance and Responsibility

• Attendance is mandatory for all scheduled lectures.
• Be responsible. Come to class on time.
• Be disciplined. Avoid talking to friends in the class.
• Mobiles are not allowed in the class.

About the Last Lesson

• Principles of Neurological Rehabilitation
• Cognitive Rehabilitation Strategies: Nurturing Brain Function
• Targeted Exercise Programs for Neurological Recovery
• Assistive Technologies in Neurorehabilitation: Enhancing Independence
• Conditions That Can Be Treated With Neuro Rehab
• Case study

About the Today Lesson

• Oncological Rehabilitation Nursing 1&2

Daily Flow

• 12.00-12.50 / 1st Hour: Indication Phases
• 13.00-13.50/ 2nd Hour: Settings For Oncology Rehabilitation, Rehabilitation process, Types Of Cancer Rehabilitation Professionals

Oncology Rehabilitation Nursing 1&2

• Oncology rehabilitation is an area that has the potential to reduce cancer-related morbidity and healthcare costs.
• Often used interchangeably with cancer rehabilitation, oncology rehabilitation focuses on managing and improving the impairments and functional limitations experienced by individuals with cancer due to the disease itself or the side effects of the treatment they receive.
• The Rehabilitation 2030 call to action, aimed to advance global access to rehabilitation for non-communicable diseases.

Indications

• Pain
• Fatigue
• Chemotherapy-Induced Peripheral Neuropathy (CIPN)
• Spasticity
• Cognitive deficits
• Psychosocial problems
• Sexual dysfunction
• Urinary dysfunction
• Speech impairment
• Swallowing impairment
• Chemotherapy Side Effects and Syndromes
• Symptoms of Lymphoedema
• Radiation Side Effects and Syndromes
• Paraneoplastic Syndrome
• Cardiovascular Disease
• Amputations
• Functional Limitations

Four Phases of Oncology Rehabilitation

• Preventative rehabilitation phase/prehabilitation: Encompasses the time between the onset of cancer diagnosis and beginning of oncological treatment. Aims to decrease the impact of expected disability from oncological care.
• Restorative rehabilitation: Restoring the cured or controlled patients with residual impairments to their previous level of function.
• Supportive rehabilitation: Maximizes functionality as individuals experience declines due to progressive or stable cancer.
• Palliative phase: Emphasizes care aiming at comfort and function in the terminal stage of cancer.

Settings For Oncology Rehabilitation

• Post-acute care: Inpatient rehabilitation facilities, skilled nursing facilities, home health care agencies, and long-term care hospitals.
• Outpatient therapy: Patient visits at a therapy center for focused rehabilitation intervention.

Advantages of Cancer Rehabilitation

• Improved Physical Function
• Pain Management
• Enhanced Quality of Life
• Increased Energy and Stamina
• Emotional and Psychological Support
• Improved Body Image and Self-esteem
• Enhanced Survivorship
• Supportive Community

How Do You Rehabilitate Cancer Patients?

• Assessment: Evaluate the patient's physical, functional, and emotional status.
• Development of a rehabilitation plan: Tailored plan addressing patient's specific needs and goals.
• Implementation of the rehabilitation plan: Work with patient to improve mobility, strength, flexibility, daily living skills, communication, swallowing, and psychological issues.
• Monitoring and adjustment of the rehabilitation plan: Monitor progress, make adjustments to plan, or add new interventions as needed.
• Discharge planning and follow-up care: Develop discharge plan, and provide follow-up to ensure continued progress and goal achievement.

Assessment Tools

• Health-related quality of life and/or quality of life: European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, the 36-Item Short Form Survey, and the Functional Assessment of Cancer Therapy.
• Activities of daily living and instrumental activities of daily living
• Fatigue
• Functional mobility
• Exercise behavior
• Cognition function: Neuropsychological tests, patient-reported outcome measures.
• Communication
• Sexual function
• Return to work

Types of Cancer Rehabilitation Professionals

• Physicians: Coordinate rehabilitation process, monitor progress, and manage any medical issues.
• Physical Therapists: Improve mobility, balance, strength, flexibility, and physical function.
• Occupational Therapists: Help with daily living activities, such as bathing, dressing, and grooming.
• Speech Therapists: Work with patients having speech, communication, and swallowing difficulties.
• Psychologists: Support patients with emotional and psychological issues.
• Social Workers: Support patients and their families, including practical, and emotional elements.
• Nurse: Provide comprehensive care aligned with the cancer care continuum, emphasizing prevention, early detection, outcomes (e.g., increased screening rates) and clinical roles.

Cardiac Rehabilitation Nursing

• Cardiac rehabilitation is a complex intervention offering health education, advice on cardiovascular risk reduction, physical activity, and stress management.
• Three core components are exercise counseling and training, education for heart-healthy living, and counseling to reduce stress.
• Core components include patient assessment, exercise training, physical activity counseling, tobacco cessation, nutritional counseling, weight management, aggressive coronary risk-factor management, and psychosocial counseling.
• Cardiac rehabilitation programs generally span three months with weekly sessions (typically 36 sessions over 12 weeks).
• Dietary recommendations for cardiac patients often emphasize a reduced intake of saturated fats, cholesterol, and increased intake of polyunsaturated/monounsaturated fats, fiber, and appropriate portioning of calories.
• Weight management is assessed based on waist circumference and BMI.
• Blood pressure management is crucial, for example a reduction in systolic blood pressure by 10 mmHg can lead to a 20%-40% reduction in cardiovascular mortality.
• Diabetes management is also an important aspect, about 26% of patients referred to cardiac rehabilitation have diabetes, and interventions focus on maintaining glycosylated hemoglobin (HbA1c) below 7%.
• Psychosocial and professional issues are addressed to support patients returning to normal lives and work.

Pulmonary Rehabilitation Nursing

• Pulmonary rehabilitation (PR) is a multidisciplinary approach improving physical and emotional well-being in patients with chronic respiratory diseases.
• PR strategies utilize supervised exercise, education, support, and behavioral interventions to function in daily life and enhance quality of life.
• Indications for PR include COPD, ILD, cystic fibrosis, pulmonary hypertension, severe asthma, post-lung transplant, post-surgerical recovery (e.g., pneumonectomy), and pulmonary fibrosis.
• Benefits of PR include improved exercise capacity, reduced breathlessness, improved survival, reduced hospitalizations, reduced anxiety, improved health-related quality of life, and improved psychological wellbeing.
• PR programs include exercise training, inspiratory muscle training, psychosocial counseling, nutritional evaluation, and education on the proper use of prescribed medications.
• Nurses play a critical role in assessing patients (thorough health history, monitoring vital signs, physical function, psychological assessment, and coping strategies), and implementing key interventions, such as breathing techniques, exercise programs, patient education, psychosocial support, and nutritional support.
• Barriers to PR include physical limitations, psychological factors, socioeconomic factors, and cultural factors.
• Programs are tailored for various special populations, such as older adults, patients with obesity hypoventilation syndrome, etc.
• The six-week structure of the program involves supervised exercise, education, and home training sessions, with individualized plans developed based on assessment.
• Goals of PR include improve exercise capacity, enhance quality of life, decrease symptoms, prevent hospital readmissions, and enhance self-management programs.
• Programs cover activities like relaxation, disease education, dietary advice, energy conservation, and medication advice.

Neurological Rehabilitation Nursing-1

• Neurological rehabilitation refers to the process of engaging in therapy to improve function and well-being for patients with neurological conditions.
• The goal of programs is to restore health, independence, and functionality using the best rehabilitation strategies.
• Phases include Long-Term Acute Care Hospital (LTACH), Acute Rehab,Subacute Rehabilitation in Skilled Nursing Facilities, and Long-Term Care Facility or Nursing Home and Home Services.
• Common approaches include Bobath, Carr & Shepherd (functional movements that are repeatedly practiced), gait re-education (identifying and correcting variations during walking), transfer rehabilitation, and mobility. contracture management (to relieve tension in muscles), and equipment assessment for assistive devices.

Neurological Rehabilitation Nursing-2

• Targeted Exercise Programs, tailored workouts recognize the diverse nature of neurological conditions ensuring exercises meet individual need. Adaptive equipment integration further promotes optimal recovery.
• Neurological rehabilitation uses assistive technologies, including Augmented Reality Tools enhance engagement in the rehabilitation process and deliver more realistic approaches, and Smart Wearables for seamless data collection and personalized care plans.
• Robot-assisted therapy provides precise, targeted support during renewal.
• Conditions that benefit from neurological rehabilitation include traumatic brain injuries, spinal cord problems, Parkinson's disease, and other neurological issues.

Take-Home Topics

• Indication
• Phases
• Settings for Oncology Rehabilitation
• Rehabilitation process
• Types of Cancer Rehabilitation Professionals

Explore the essential concepts of oncology rehabilitation through this quiz. It covers benefits, phases, and critical focuses in cancer care rehabilitation. Assess your knowledge on the roles of rehabilitation professionals and cognitive strategies in managing cancer-related impairments.