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: Dr. Hina Zahoor
• Instructor's Email: [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
• AYESIS 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.

Notes

• Attendance is mandatory for all scheduled lectures.
• Be responsible; come to class on time.
• Be disciplined; avoid talking to friends in class.
• Mobiles are not allowed in 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: First Hour, Indication, Phases
• 13:00-13:50: Second Hour, Settings For Oncology Rehabilitation, Rehabilitation process, Types Of Cancer Rehabilitation Professionals

Oncological 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, launched by the World Health Organization in 2017, 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 (also called prehabilitation) encompasses the time between the onset of a cancer diagnosis and the start of treatment. It involves interventions and therapies that aim to reduce the impact of expected disability from cancer treatment.
• Restorative rehabilitation focuses on restoring function in patients who are cured or have controlled cancer.
• Supportive rehabilitation aims to maximize functionality for individuals with progressive or stable cancer.
• Palliative phase focuses on comfort and function during the terminal stage of cancer.

Settings For Oncology Rehabilitation

• Post-acute care includes inpatient rehab facilities, skilled nursing facilities, home health care agencies and long-term care hospitals.
• Outpatient therapy involves patient visits at a therapy center for focused rehab 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
• Development of a rehabilitation plan
• Implementation of the rehabilitation plan
• Monitoring and adjustment of the rehabilitation plan
• Discharge planning and follow-up care

Assessment Tools

• Health-related quality of life and/or quality of life
• Functional Assessment of Cancer Therapy
• Activities of daily living and instrumental activities of daily living
• Fatigue
• Functional mobility
• Exercise behavior
• Cognition function
• Communication
• Sexual function
• Return to work

Types Of Cancer Rehabilitation Professionals

• Physicians
• Physical Therapists
• Occupational Therapists
• Speech Therapists
• Psychologists
• Social Workers
• Nurses

Cardiac Rehabilitation Nursing

• Cardiac rehabilitation is a complex intervention offered to patients diagnosed with heart disease, which includes components of health education, advice on cardiovascular risk reduction, physical activity and stress management.
• Cardiac rehab has three equally important parts: exercise counseling and training, education for heart-healthy living, and counseling to reduce stress.
• Core components of cardiac rehab include patient assessment, exercise training, physical activity counseling, tobacco cessation, nutritional counseling, weight management, and aggressive coronary risk-factor management and psychosocial counseling.
• Cardiac rehab programs generally span three months, with sessions two or three times a week (usually 36 sessions over a 12-week time-period).
• Dieticians organize practical workshops to teach patients healthy eating habits and general dietary recommendations for cardiac patients include a reduced intake of saturated fats and cholesterol, and increased intake of polyunsaturated and monounsaturated fats, and increased fiber intake.
• Weight management according to WHO if waist circumference is 88 cm or more in women and 102 cm or more in men, there is central obesity; the risk is accepted as >80 cm for women and >94 cm for men. If the body mass index is >25 kg / m2, individualized short and long-term targets are determined by considering other risk factors.
• High blood pressure management is significant in cardiac rehabilitation.
• Diabetes management in cardiac rehab is important as 26% of patients referred to cardiac rehabilitation have diabetes.

Pulmonary Rehabilitation Nursing

• Pulmonary rehabilitation (PR) is a multidisciplinary approach designed to improve the physical and emotional well-being of patients with chronic respiratory diseases.
• PR uses supervised exercise, education, support, and behavioral intervention to improve how people with chronic lung disease function in daily life and to enhance their quality of life.
• Indications for PR include COPD, ILD, cystic fibrosis, pulmonary hypertension, severe asthma, post-lung transplant, post-surgical recovery (e.g., pneumonectomy), and pulmonary fibrosis.
• Benefits of PR include improved exercise capacity, reduced breathlessness, improved survival, reduced hospitalizations, reduced anxiety and depression, improved health-related quality of life, and improved psychological wellbeing.
• PR programs may also improve quality of life by reducing shortness of breath, increasing exercise tolerance, promoting a sense of well-being, and decreasing the number of hospitalizations.
• Goals of PR include improving exercise capacity, enhancing quality of life, decreasing symptoms (e.g., dyspnea), preventing hospital readmissions, and enhancing emotional well-being and self-management.
• Components of a PR program include exercise training, inspiratory muscle training, psychosocial counseling, nutritional evaluation and counseling, and education, including on proper use of prescribed drugs.
• Nursing assessment in PR involves a thorough health history and clinical assessment, monitoring vital signs (oxygen saturation, heart rate, and blood pressure), assessing physical function (mobility, muscle strength, and endurance), and psychological assessment (anxiety, depression, and coping strategies).
• Key nursing interventions include breathing techniques (diaphragmatic breathing, pursed-lip breathing to reduce dyspnea), exercise programs (supervised low-impact aerobic exercises like walking or cycling), patient education (medication adherence, oxygen therapy management, energy conservation techniques, and avoidance of environmental triggers), psychosocial support, and nutritional support.
• Barriers to PR include physical limitations, psychological factors, socioeconomic factors, and cultural factors.
• Implementing PR in nursing practice requires modifying programs for older adults (COPD, ILD, pulmonary fibrosis) by lowering the intensity and focusing on functional independence, addressing comorbidities (e.g., osteoporosis, cardiovascular disease), and managing polypharmacy and medication side effects.
• PR for patients with obesity hypoventilation syndrome should include a focus on weight management and sleep hygiene, addressing breathing difficulties and using CPAP/BiPAP in respiratory support.

Neurological Rehabilitation Nursing-1

• Neurological rehabilitation refers to the process of engaging in therapy to improve function and well-being.
• The goal of neurorehabilitation is to restore health, independence, and functionality.
• Phases of neurorehabilitation include: Long-Term Acute Care Hospital (LTACH), Acute Rehab, Subacute Rehabilitation in Skilled Nursing Facilities, and Home with services.

Neurological Rehabilitation Nursing-2

• Targeted exercise programs enhance the practicality of rehab for patients by emphasizing activities that mirror daily life.
• Tailored workouts for neurological rehab create plans tailored to individual needs and address specific neurological challenges.
• Adaptive equipment integration is crucial to facilitate better recovery and promote optimal outcome.
• Assistive technologies in neurorehabilitation, such as augmented reality tools and smart wearables, enhance training and improve patient participation.
• Robotic-assisted therapy and similar approaches offer precise and targeted support in the patient's recovery process and promote better outcome.
• Conditions that can particularly benefit from neurorehab include traumatic brain injuries (TBI), spinal cord problems, Parkinson's Disease, and other neurological issues.
• Aims of neurorehabilitation are focused on preventing complications. Complications resulting from neurological conditions could negatively affect the condition and potentially lead to a life-threatening situation. Secondary complications can also worsen recovery and curb rehabilitation. Therefore, early identification and intervention is critical in neurorehabilitation.

Additional Information

• Recommended Daily Studies: Include details from McPherson, Gibson, & Leplege (2015) and Hoeman (2008).
• References: Include details about citations.
• About the Next Week: Indicate the final exam.
• Important Note: Presentations are private; using the texts and images contained in the presentations on social media or otherwise without permission is against the regulations.

Test your knowledge on the goals and processes of supportive rehabilitation in oncology. This quiz covers various aspects such as pain management, patient comfort, and the challenges faced by cancer patients. Enhance your understanding of the essential components of rehabilitation programs in cancer care.