Abstract
Dear Editor:
The incidence of cancer among the elderly in Japan has been increasing 1 along with the number of patients with cancer requiring care at home. We believe that individualized home-visit rehabilitation is an important approach toward preventing the decline in activities of daily living (ADL). However, one study showed that rehabilitation rates among patients with cancer presenting with functional impairment have been mediocre. 2 This suggests that the implementation rate of home-visit rehabilitation is likely to be even lower. To improve the implementation rate of home-visit rehabilitation for patients with cancer, it is necessary to understand the status of implementation and the details of requests.
Therefore, this survey sought to investigate the status of implementation of home-visit rehabilitation, content of requests among home-visit rehabilitation users whose main disease was cancer, and understand the actual situation.
This survey was conducted with the approval of the International University of Health and Welfare Ethics Review (Approval No.: 20-Io-142). In addition, this survey was conducted according to the principles of the Declaration of Helsinki.
Subjects were users who requested home nursing and rehabilitation at the Itabashi Rehabilitation Home-Visit Nursing Station from September 1, 2005 to December 31, 2021. The inclusion criteria were users diagnosed with cancer as their primary disease and received home-visit rehabilitation interventions by rehabilitation professionals.
This study was designed to be a single-facility retrospective study. The survey included age, gender, main disease, and gait independence at the start of the home-visit rehabilitation and details regarding home-visit rehabilitation requests.
The home-visit rehabilitation was conducted once or twice a week for 40–60 minutes and included basic movement practice, gait practice, ADL practice, and environmental adjustments tailored to each individual user.
This study included 1007 home nursing and rehabilitation users, of whom 28 users had cancer as their main disease.
Details regarding home-visit rehabilitation users whose primary disease was cancer are summarized in Table 1. The level of gait independence at the start of the home-visit rehabilitation was greatest for those with indoor gait independence, followed by those who were bedridden and those who needed assistance for gait indoors. The most common reason for requesting home-visit rehabilitation was terminal care, followed by gait and improvement of ADL.
Details Regarding Home-Visit Rehabilitation Users Whose Primary Disease Was Cancer
Values are presented as mean ± standard deviation or number.
ADL, activities of daily living.
The results of this single-facility study showed that 2.8% of the users had cancer as their primary disease and were undergoing home-visit rehabilitation. Previous studies have stated that insufficient evidence 3 due to rehabilitation professionals' lack of experience and lack of research is a factor inhibiting the spread of rehabilitation in patients with terminal cancer. In particular, no evidence has been presented for home-visit rehabilitation, with clients voicing their apprehension regarding the effectiveness of home-visit rehabilitation. 4 The fact that many of those included in this survey were bedridden or needed support for gait indoors suggests that home-visit rehabilitation should be requested before a certain level of physical function decline and that walking practice, ADL practice, and environmental adjustments should be provided. To increase the number of requests for home-visit rehabilitation, objective effectiveness needs to be demonstrated in the future.
Footnotes
Authors' Contributions
E.K. conceived and designed the analysis, data collection, contributed data/analysis tools, performed the analysis, and wrote the article. T.O. conceived and designed the analysis, data collection, and contributed data/analysis tools. T.H. contributed data/analysis tools. All authors have approved the article and agree with submission to Journal of Palliative Medicine.
Acknowledgments
The authors thank the staff at the Itabashi Rehabilitation Home Visit Nursing Station for their help with data collection.