How Receptive Are Patients With Late Stage Cancer to Rehabilitation Services and What Are the Sources of Their Resistance?
Andrea L Cheville, Lori Rhudy, Jeffrey R Basford and 2 others
PMID 27592401WHAT IT FOUND
Most patients with late-stage lung cancer refused rehabilitation even when distressed by their limitations.
The main barrier was believing they did not need help. Clinicians should expect resistance and discuss why therapy matters before referring, rather than assuming distress drives uptake.
Key findings
01Only 31.8% of participants expressed interest in receiving rehabilitation services at any point during the two-year follow-up.
02Higher distress about functional limitations and lower mobility scores were associated with increased interest in rehabilitation.
03The most common reason for refusing rehabilitation was the belief that services were unnecessary, even among those with significant mobility limitations.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The sample was homogeneous, consisting mostly of Caucasian patients with advanced lung cancer. Participants were recruited from a comprehensive cancer center, which may not reflect the experience of patients treated in community settings. The study used a single question to assess interest, which may not capture the complexity of real-life conversations with clinicians. The study did not measure actual referral rates or whether interested patients successfully accessed services.
Declared interests
No conflicts of interest or funding sources are explicitly stated in the provided text.
The easy way to misread this
Do not interpret the association between high distress and interest as evidence that distress alone drives referral acceptance. Most distressed patients still refused rehabilitation because they believed it was unnecessary. Referrals require addressing this specific belief, not just identifying functional limitations.