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Introduction: Caregivers of patients undergoing hematopoietic stem cell transplantation need encouragement to maintain their own wellbeing. This feasibility study explored a six-session wellness intervention for caregivers entitled Ready to CARE (Connect, Actively Relax, and Exercise). Method: This study used a single-arm pre–post design to explore the feasibility and acceptability of the intervention and study procedures. The individual, participant-directed intervention was initiated at hospitalization for stem cell reinfusion. Caregivers completed telephone surveys on four occasions and engaged in one semi-structured interview to share their perceptions of the intervention. Results: Twenty participants enrolled and completed the baseline survey, with 50%, 90%, and 80% completing the subsequent three surveys, respectively. Seventy-four percent completed all six sessions of the intervention. Caregivers most often used the sessions to set goals related to physical activity (36%), stress management (14%), sleep (13%), and caregiving tasks (11%). Caregivers reported appreciation of the intervention's focus on supporting caregivers, taking action with goal-setting, and allowing caregivers to determine the focus of the goals. Scheduling the sessions was the most problematic aspect of the intervention. Conclusion: While caregivers were open to a wellness intervention, a high degree of flexibility and tailoring is needed to engage and support busy caregivers. Clinical Trial Registration: NCT03210727 [ABSTRACT FROM AUTHOR]

Occupational therapy practitioners provide interventions to promote activity engagement to multiple clinical populations. They help clients develop restorative, adaptive, and compensatory skills to improve their performance in daily activities. The issue addressed in this article is that current clinical frameworks lack translation of learned skills to consistent everyday performance. There is a gap between what clients can do and what clients actually do in everyday life. Behavioral activation provides an explicit, structured, and practical approach that can translate capacity into long-term engagement. This article presents behavioral activation as a transdiagnostic approach that targets populations experiencing chronic illness to bridge the gap between what the client can do in therapy and what the client could do in everyday life. What This Article Adds: People with chronic illness have difficulty translating the skills learned in traditional practice settings to everyday life. Behavioral activation offers occupational therapy practitioners a practical structure to promote the translation of learned skills. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this research was to assess the feasibility, acceptability and potential effectiveness of a program to support the occupational performance of urban breast cancer survivors living with cancer-related cognitive impairment. Method: Participants (n = 15) reporting cognitive changes following breast cancer treatment were enrolled in an occupation-focused self-management program. Occupational performance challenges, activity level, subjective cognitive function and quality of life were measured at the beginning, end and 3 months after completion of the program. Results: Participants reported high satisfaction with the program and high confidence in their problem-solving and goal-setting skills. The 11 participants who completed the post-program assessment showed significant increases in self-perceived performance and satisfaction in daily living, participation, physical and functional wellbeing and perceived cognitive impairment. Conclusion: The program was feasible for a vulnerable, socio-economically diverse patient population, acceptable to participants and may have positive effects on occupational performance. [ABSTRACT FROM AUTHOR]

OBJECTIVE. The objective of this study was to assess the feasibility of conducting a future full-scale trial to test the efficacy of an in-home occupational therapy intervention designed to reduce disability in older adult cancer survivors. METHOD. Participants reporting activity limitations during or after cancer treatment were enrolled in a Phase 1 pilot randomized controlled trial comparing the 6-wk intervention (n = 30) to usual care (n = 29). Descriptive data on retention rates were collected to assess feasibility of intervention and study procedures. Potential efficacy was explored through participants' self-reported disability, quality of life, activity level, and behavioral activation at 0, 8, and 16 wk after enrollment. RESULTS. Retention rates were high regarding completion of the intervention (90%) and outcome assessments (90% of usual-care participants and 80% of intervention participants). Outcomes consistently favored the intervention group, although group differences were small. CONCLUSION. The procedures were feasible to implement and acceptable to participants. [ABSTRACT FROM AUTHOR]

OBJECTIVE. In this pilot study of a home-based occupational therapy intervention intended to reduce disability and improve quality of life, our objective was to identify rates of goal attainment and patterns of goal adjustment of participants. METHOD. Thirty older adults with cancer were randomized to the intervention arm, and 24 participants identified goals and completed the six-session intervention. An exploratory content analysis of qualitative and quantitative session data was performed. RESULTS. Participants set 63 6-wk goals and attained 62% of them. Most of the goals addressed walking (28%), sedentary leisure (24%), exercising (16%), or instrumental activities of daily living (14%). When 6-wk goals were not attained (n = 24), there were 10 instances of goal disengagement and 14 instances of goal reengagement. CONCLUSION. Although most participants were able to meet their goals, many also changed their goals and priorities after reflection and attempts to resume or initiate meaningful activities. [ABSTRACT FROM AUTHOR]

Objective: Randomized controlled trials (RCTs) of early palliative care interventions in advanced cancer have positively impacted patient survival, yet the mechanisms remain unknown. This secondary analysis of 2 RCTs assessed whether an early palliative care intervention moderates the relationship between depressive symptoms and survival. Method: The relationships among mood, survival, and early palliative care intervention were studied among 529 advanced cancer patients who participated in 2 RCTs. The first (N = 322) compared intervention versus usual care. The second (N = 207) compared early versus delayed intervention (12 weeks after enrollment). The interventions included an in-person consultation, weekly nurse coach-facilitated phone sessions, and monthly follow-up. Mood was measured using the Center for Epidemiologic Studies-Depression (CES-D) scale. Cox proportional hazard analyses were used to examine the effects of baseline CES-D scores, the intervention, and their interaction on mortality risk while controlling for demographic variables, cancer site, and illness severity. Results: The combined sample was 56% male (M = 64.7 years). Higher baseline CES-D scores were significantly associated with greater mortality risk (hazard ratio [HR] = 1.042, 95% confidence interval [CI] [1.017, 1.067], p = .001). However, participants with higher CES-D scores who received the intervention had a lower mortality risk (HR = .963, CI [0.933, 0.993], p = .018) even when controlling for demographics, cancer site, and illness-related variables. Conclusion: This study is the first to demonstrate that patients with advanced cancer who also have depressive symptoms benefit the most from early palliative care. Future research should be devoted to exploring the mechanisms responsible for these relationships. [ABSTRACT FROM AUTHOR]

Objective To solicit expert opinions and develop consensus around the research that is needed to improve cancer rehabilitation for older adults. Design Delphi methods provided a structured process to elicit and prioritize research questions from national experts. Setting National, Web-based survey. Participants Members (N=32) of the American Congress of Rehabilitation Medicine completed at least 1 of 3 investigator-developed surveys. Interventions Not applicable. Main Outcome Measures In the first survey, participants identified up to 5 research questions that needed to be answered to improve cancer rehabilitation for older adults. In 2 subsequent surveys, participants viewed the compilation of questions, rated the importance of each question, and identified the 5 most important questions. This generated priority scores for each question. Consensus scores were created to describe the degree of agreement around the priority of each question. Results Highest priority research concerns the epidemiology and measurement of function and disability in older adult cancer survivors; the effects of cancer rehabilitation interventions on falls, disability, participation, survival, costs, quality of care, and health care utilization; and testing models of care that facilitate referrals from oncology to rehabilitation providers as part of coordinated, multicomponent care. Conclusions A multipronged approach is needed to fill these gaps, including targeted funding opportunities developed with an advisory panel of cancer rehabilitation experts, development of a research network to facilitate novel collaborations and grant proposals, and coordinated efforts of clinical groups to advocate for funding, practice change, and policy change. [ABSTRACT FROM AUTHOR]

OBJECTIVE. We assessed the psychometrics of a self-administered survey modification of the Activity Card Sort (modified; ACSm) when used to track activity resumption after stem cell transplantation (SCT). METHOD. Thirty-six participants completed the ACSm for a descriptive pilot study of recovery after SCT. Reliability was assessed by determining the longitudinal consistency of participants' designation of an activity as never done versus done previously and by calculating internal consistency. Construct validity was assessed by correlating the ACSm scores with measures of quality of life, performance status, and perceived cognitive impairment. RESULTS. Participants gave consistent designations for 72% of items. Internal consistency of the total score was a > 0.86 at all assessments. The ACSm scores were correlated with quality of life (r 5 0.51, p 5 .0019), functional well-being (r 5 0.59, p 5 .0002), and performance status (r 5 0.42, p 5 0.011) and not associated with cognitive impairment (r 5 .22, p 5 .19). CONCLUSION. The ACSm demonstrated provisional evidence of reliability, internal consistency, and construct validity. [ABSTRACT FROM AUTHOR]