Systematic Review of Occupational Therapy and Adult Cancer Rehabilitation: Part 2. Impact of Multidisciplinary Rehabilitation and Psychosocial,Sexuality,and Return-to-Work Interventions

Abstract

This article is the second part of a systematic review of evidence for the effectiveness of cancer rehabilitation interventions within the scope of occupational therapy that address the activity and participation needs of adult cancer survivors. This article focuses on the use of multidisciplinary rehabilitation and interventions that address psychosocial outcomes, sexuality, and return to work. Strong evidence indicates that multidisciplinary rehabilitation benefits cancer survivors and that psychosocial strategies can reduce anxiety and depression. Moderate evidence indicates that interventions can support survivors in returning to the level of sexuality desired and help with return to work. Part 1 of the review also appears in this issue.

Advances in treatment have improved survival rates in patients with cancer, including those who emerge from cancer treatment needing rehabilitation. Consequently, patients are living longer with the physical impairments that result from their disease and its treatment in addition to comorbidities they acquire as they age (American Cancer Society, 2015; Ries et al., 2002). As of January 2014, the United States had nearly 14.5 million cancer survivors (American Cancer Society, 2015). The number of survivors is projected to grow to 18 million by 2022 (Howlader et al., 2009). Cancer can now be categorized as a chronic condition for many people, resulting in a stronger focus on return to function, participation, and quality of life (Howlader et al., 2009).

The potential for cancer to result in disability can increase the cost and burden for cancer survivors, highlighting the importance of long-term health outcomes (Cohen, 2010; Extermann, 2007). Research has shown that functional measures are strong predictors of survival for older adults living in the community (Keeler, Guralnik, Tian, Wallace, & Reuben, 2010). Functional decline increases significantly among people with cancer age ≥65 yr, and older cancer survivors experience more functional decline than older adults without cancer (Lunney, Lynn, Foley, Lipson, & Guralnik, 2003; Sweeney et al., 2006). Cancer and its treatment can cause interruptions to daily routines, self-care, work, and leisure and social activities (Longpre & Newman, 2011).

Objective of the Systematic Review

The objective of this review was to systematically search for and assess the evidence supporting interventions within the scope of occupational therapy to improve occupational engagement. The focused question guiding selection of research studies for review was “What is the effectiveness of cancer rehabilitation interventions within the scope of occupational therapy practice to address the activity and participation needs of adult cancer survivors in activities of daily living (ADLs), instrumental activities of daily living, work, leisure, social participation, and rest and sleep?”

This systematic review was supported by the American Occupational Therapy Association (AOTA) as part of the Evidence-Based Practice (EBP) Project (Lieberman & Scheer, 2002). Because of the breadth of the systematic review, the results were divided into two parts. This article presents Part 2 of the systematic review, which is focused on the benefits of multidisciplinary rehabilitation and interventions that address psychosocial outcomes, sexuality, and return to work.

Method

Process

Search terms for the reviews were developed by the methodology consultant to the AOTA EBP Project and AOTA staff, along with the review authors and the advisory group. The search terms were related to population (adult cancer survivors), types of intervention, outcomes, sequelae, and types of study design to be included in the systematic review. Databases and sites searched included Medline, PsycINFO, CINAHL, and OTseeker. In addition, consolidated information sources, such as the Cochrane Database of Systematic Reviews, were included in the search.

Eligibility Criteria

Included in the review were peer-reviewed scientific articles on adults with cancer published in English between 1995 and 2014 and within the scope of practice of occupational therapy. The review excluded data from presentations, conference proceedings, non–peer-reviewed research literature, dissertations, and theses. The review also excluded studies focusing on caregivers, family members, or friends rather than cancer survivors; studies of childhood cancer; and interventions that required an academic degree other than occupational therapy (e.g., music therapy). AOTA uses standards of evidence modeled on those developed in evidence-based medicine (Sackett, Rosenberg, Gray, Haynes, & Richardson, 1996):

Level I: Systematic reviews, meta-analyses, randomized controlled trials (RCTs)

Level II: Two-group, nonrandomized studies (e.g., cohort, case control)

Level III: One-group, nonrandomized studies (e.g., pretest and posttest)

Level IV: Descriptive studies that include analysis of outcomes (e.g., single-subject design, case series)

Level V: Case reports and expert opinion that include narrative literature reviews and consensus statements.

Studies included in the review provide Level I, II, and III evidence. Level IV evidence was included only when higher level evidence on a given topic was not found; no Level V evidence was included in this part of the review.

Data Extraction

A team of three reviewers (Hunter, Gibson, and D’Amico) worked together to evaluate all articles at all stages of the review. The synthesis entailed a detailed reading of the studies and the completion of the evidence table describing each study specifically. Figure 1 in Part 1 of the review depicts the flow of abstracts and articles through the process (Hunter, Gibson, Arbesman, & D’Amico, 2017; see https://doi.org/10.5014/ajot.2017.023564). The evidence table for Part 2 is provided in Supplemental Table 1 (available online at http://otjournal.net; navigate to this article, and click on “Supplemental”). The articles were grouped into themes and analyzed and reported by theme.

Analysis

Analysis of study design, outcomes, and risk of bias determined which studies were assessed as strong or moderate evidence. Strong evidence typically includes two or more well-designed RCTs. Moderate evidence includes one RCT, two or more studies providing lower level evidence, or inconsistent findings from well-designed projects. Only selected articles from the systematic review are mentioned in this article.

Results

The review team identified a total of 138 articles for inclusion in the final qualitative synthesis; 52 articles are described in this article (Part 2). Forty-five articles provide Level I evidence, 3 provide Level II evidence, 3 provide Level III evidence, and 1 provides Level IV evidence. Articles were organized into four broad intervention areas: multidisciplinary rehabilitation (18 articles), psychosocial outcomes (29 articles), sexuality (2 articles), and return to work (3 articles).

Risk of Bias

Risk of bias was assessed using the Cochrane risk-of-bias guidelines described by Higgins, Altman, and Sterne (2011; see Supplemental Table 2, online). The method for assessing the risk of bias of systematic reviews was based on the Assessment of Multiple Systematic Reviews system developed by Shea et al. (2007; see Supplemental Table 3, online).

Outcome Measures

Although many studies discussed ADLs, function, return to work, participation, and sleep as a goal, few if any measured these constructs. Instead, the measurement tools used addressed quality of life (e.g., SF–12, SF–36) and symptom control, which many authors indicated would allow return to previous activities. Other studies discussed these constructs generically in their findings as wellness, health, and quality of life. Most studies discussed the interventions provided, even occupation-based interventions, in terms of addressing mental or emotional health, physical activity, symptom management, and well-being. Only a few studies discussed occupation-based outcomes or outcome measures.

Interventions in Multidisciplinary Rehabilitation Programs

Multidisciplinary rehabilitation programs use a team approach that includes occupational therapy, physical therapy, and other allied health professions. Eighteen articles related to the use of multidisciplinary rehabilitation programs met the criteria and were included in the review; 2 were Level I systematic reviews, 12 were Level I RCTs, 2 were Level II studies, 1 was a Level III study, and 1 article provided Level IV evidence.

Strong Evidence.

Strong evidence indicates that rehabilitation programs benefit survivors with many types of cancer. Multidisciplinary rehabilitation programs resulted in improved function and participation regardless of type of cancer, stage of cancer, or age of survivor (Level I: Cinar et al., 2008; Khan, Amatya, Pallant, Rajapaksa, & Brand, 2012; Lapid et al., 2007; Scott et al., 2013; Level II: Gordon, Battistutta, Scuffham, Tweeddale, & Newman, 2005; Level III: Hanssens et al., 2011).

Moderate Evidence.

Moderate evidence indicates that rehabilitation can be beneficial both before and after treatment (Level I: Benzo et al., 2011). Cognitive rehabilitation improved attention and overall quality of life (Level I: Cherrier et al., 2013). Aquatic therapy and exercise were beneficial for breast cancer survivors (Level I: Cuesta-Vargas, Buchan, & Arroyo-Morales, 2014). Rehabilitation in advanced, progressive, recurrent cancer was found to be cost-effective and to increase quality of life (Level I: Jones, Fitzgerald, et al., 2013).

Psychosocial Interventions

Twenty-nine articles related to psychosocial interventions met the criteria for the review: 6 Level I systematic reviews, 21 Level I RCTs, 1 Level II, and 1 Level III studies. Such interventions included life review, stress management, expressive or disclosure groups, problem-solving therapy, mindfulness-based therapy, and cognitive–behavioral therapy.

Strong Evidence.

Strong evidence indicates that psychosocial strategies, including cognitive–behavioral and educational interventions (e.g., problem solving, knowledge of illness and side effects), reduce anxiety >3 mo posttreatment and depression 1–3 mo posttreatment (Level I: Chien, Liu, Chien, & Liu, 2014).

Moderate Evidence.

Moderate evidence supports a variety of psychosocial interventions. A systematic review found that psychosocial interventions increased quality of life for people with advanced-stage cancer (Level I: Uitterhoeve et al., 2004). Short-term life review increased spiritual well-being for people with terminal cancer (Level I: Ando, Morita, Akechi, & Okamoto, 2010), and stress management groups increased psychosocial adjustment among breast cancer survivors (Level I: Antoni et al., 2006).

Problem-solving therapy using home-based care training by phone helped women with breast cancer reduce stress (Level I: Allen et al., 2002), and cognitive–behavioral therapy decreased symptom limitations for people undergoing chemotherapy and those with advanced-stage cancer (Level I: Doorenbos et al., 2005; Sherwood et al., 2005). Self-management training was beneficial in both group and individual interventions for improving quality of life (Level I: Korstjens et al., 2008). Expressive writing about one’s breast cancer experience significantly improved quality of life outcomes for early-stage breast cancer survivors (Level I: Craft, Davis, & Paulson, 2013).

Interventions for Sexuality

Two articles related to sexuality and sexual function met the criteria for the review, 1 Level I systematic review and 1 Level I RCT.

Moderate Evidence.

Moderate evidence supports exercise as beneficial for prostate cancer patients reporting an interest in sex (Cormie et al., 2013). The systematic review pointed to three types of intervention used for return to sexual function: exercise, medical, and psychoeducational.

Limited Evidence.

Limited evidence supports the effectiveness of couple-based and psychoeducational interventions (Taylor, Harley, Ziegler, Brown, & Velikova, 2011).

Interventions for Return to Work

Three articles related to intervention for return to work met the criteria for the review: 1 Level I systematic review, 1 Level I RCT, and 1 Level III study. Moderate evidence indicates that high-intensity exercise (strength, interval, and home based) helped patients minimize the decrease in work ability after cancer and treatment (Thijs et al., 2012) and that multidisciplinary interventions that include physical and psychological aspects in addition to vocational support provided return-to-work benefits (de Boer et al., 2011). Finally, a Level III study provided limited evidence related to an occupational therapy intervention to help cancer patients return to work (Désiron, 2010).

Discussion

This systematic review examined the evidence for the effectiveness of interventions within the scope of occupational therapy practice to improve the activity and participation needs of adult cancer survivors in all areas of occupation. Part 2 is focused on the effects of multidisciplinary rehabilitation and interventions for psychosocial outcomes, sexuality, and return to work.

Strong evidence indicates that multidisciplinary rehabilitation programs are helpful for cancer survivors regardless of cancer type or stage of cancer. Such programs may be beneficial before treatment of some types of cancer and are beneficial during and after treatment. Moderate to strong evidence indicates that addressing the psychosocial components of cancer survivorship is beneficial for survivors regardless of age or type or stage of cancer and can improve anxiety, depression, and quality of life.

Limited research has been conducted on interventions related to sexuality. This area of rehabilitation is relevant for occupational therapists, and more high-quality studies should be conducted in this area in the future. Moderate evidence supports interventions to address sexuality in cancer patients and survivors. The strongest evidence related to sexuality supports physical exercise for survivors, an important area to address for numerous types of cancer. Return to prediagnosis sexual ability and activity is a goal for many cancer survivors.

Moderate evidence supports rehabilitation interventions addressing return to work for cancer patients and survivors. Return to work is an important part of recovery and rehabilitation for many adults with cancer, but limited research has addressed this component of return to participation. Return to the valued and needed role of worker is important for occupational therapy practitioners to facilitate.

Implications for Occupational Therapy Practice

Cancer rehabilitation interventions benefit patients and survivors with a wide variety of cancers. The evidence demonstrates that this impact takes place at all stages of cancer and at all points on the cancer survivorship continuum. Consequently, occupational therapy practitioners should be involved in all stages of cancer rehabilitation.

The types of services occupational therapy practitioners might provide are broad. Interventions such as problem solving and stress reduction address survivorship issues such as depression, anxiety, and cancer-related fatigue. Return to work is an up-and-coming area in cancer survivorship interventions; current evidence regarding effective strategies for return to work is limited. Research describing the negative effects of not returning to work highlights how important it is to address this area of participation. Finally, occupational therapy providers can work with multidisciplinary teams to address the variety of issues related to psychosocial issues associated with cancer, return to work, and sexuality among cancer survivors.

Implications for Research

In general, more rigorous, well-designed research is needed to understand which people need what type of intervention at what point in their cancer care and survivorship. Specifically, increased research is needed addressing occupational therapy interests such as participation and occupation-based outcomes and interventions. All of the research projects evaluated in this review were within the purview of occupational therapy; however, very few addressed return to participation or included occupation-based interventions.

Rehabilitation services can potentially be incorporated before, during, and after medical treatment. However, little research evidence is available to support clinical decisions such as when to assess survivors, at what point in the cancer continuum services would be optimal, and which survivors are in greatest need of rehabilitation. Sexuality and return to work are two specific areas that are open to opportunities for new research.

Finally, very few of the studies reviewed used specific assessments of function other than health-related quality of life. The majority of studies did not include assessments or outcome measures specifically addressing return to meaningful activity and participation. Future research needs to specifically include participation and return to meaningful activities rather than simply global quality of life.

Limitations

Limitations of the systematic review include the design and methodology of the individual studies, such as small sample sizes, short intervention periods, limited use of standardized assessments, and short follow-up periods. Many of the studies included multiple interventions, so pinpointing the effects of each individual intervention was not always possible. Finally, although comprehensive literature search strategies were used, it is possible that eligible studies were missed and that publication selection bias may have resulted.

Conclusion

Occupational therapy practitioners working with cancer survivors of all types, stages, and points on the survivorship trajectory (diagnosis through long-term survivorship) have some evidence to support practice. The interventions presented in this review are part of an emerging body of research; more research is needed to support occupation-based interventions for this growing population. Occupational therapy practitioners are well suited to investigate occupational performance, occupation-based strategies, quality of life, and participation status to support client-centered interventions before, during, and after treatment of clients with cancer diagnoses.

Supplemental Material

Supplementary material for Systematic Review of Occupational Therapy and Adult Cancer Rehabilitation: Part 2. Impact of Multidisciplinary Rehabilitation and Psychosocial, Sexuality, and Return-to-Work Interventions

Supplementary material, sj-pdf-1-aot-10.5014_ajot.2017.023572.pdf for Systematic Review of Occupational Therapy and Adult Cancer Rehabilitation: Part 2. Impact of Multidisciplinary Rehabilitation and Psychosocial, Sexuality, and Return-to-Work Interventions by Elizabeth G. Hunter, Robert W. Gibson, Marian Arbesman and Mariana D’Amico in The American Journal of Occupational Therapy

Footnotes

Acknowledgments

We thank Deborah Lieberman, Program Director, AOTA Evidence-Based Practice Project, for her guidance and support during the process of this review. Marian Arbesman is methodology consultant, AOTA Evidence-Based Practice Project; no other potential conflicts of interest are reported.

*

Indicates studies that were systematically reviewed for this article.

Note. Each issue of the 2017 volume of the American Journal of Occupational Therapy features a special Centennial Topics section containing several articles related to a specific theme; for this issue, the theme is occupational therapy's role in cancer treatment and recovery. The goal is to help occupational therapy professionals take stock of how far the profession has come and spark interest in the many exciting paths for the future. For more information, see the editorial in the January/February issue, .

References

* Ahlberg

Engstrom

Nikolaidis

Gunnarsson

Johansson

Sharp

, & Laurell

(2011). Early self-care rehabilitation of head and neck cancer patients. Acta Oto-Laryngologica, 131, 552–561. https://doi.org/10.3109/00016489.2010.532157

* Allen

S. M.

Shah

A. C.

Nezu

A. M.

Nezu

C. M.

Ciambrone

Hogan

, & Mor

(2002). A problem-solving approach to stress reduction among younger women with breast carcinoma: A randomized controlled trial. Cancer, 94, 3089–3100. https://doi.org/10.1002/cncr.10586

American Cancer Society. (2015). American Cancer Society: Cancer facts and figures. Atlanta: Author.

* Ando

Morita

Akechi

, & Okamoto

; Japanese Task Force for Spiritual Care. (2010). Efficacy of short-term life-review interviews on the spiritual well-being of terminally ill cancer patients. Journal of Pain and Symptom Management, 39, 993–1002. https://doi.org/10.1016/j.jpainsymman.2009.11.320

* Antoni

M. H.

Lechner

S. C.

Kazi

Wimberly

S. R.

Sifre

Urcuyo

K. R.

, . . . Carver

C. S.

(2006). How stress management improves quality of life after treatment for breast cancer. Journal of Consulting and Clinical Psychology, 74, 1143–1152. https://doi.org/10.1037/0022-006X.74.6.1143

* Benzo

Wigle

Novotny

Wetzstein

Nichols

Shen

R. K.

, . . . Deschamps

(2011). Preoperative pulmonary rehabilitation before lung cancer resection: Results from two randomized studies. Lung Cancer, 74, 441–445. https://doi.org/10.1016/j.lungcan.2011.05.011

* Buss

de Walden-Gałuszko

Modlińska

Osowicka

Lichodziejewska-Niemierko

, & Janiszewska

(2010). Kinesitherapy alleviates fatigue in terminal hospice cancer patients—An experimental, controlled study. Supportive Care in Cancer, 18, 743–749. https://doi.org/10.1007/s00520-009-0709-0

* Carmack

C. L.

Basen-Engquist

Yuan

Greisinger

Rodriguez-Bigas

Wolff

R. A.

, . . . Pennebaker

J. W.

(2011). Feasibility of an expressive-disclosure group intervention for post-treatment colorectal cancer patients: Results of the Healthy Expressions study. Cancer, 117, 4993–5002. https://doi.org/10.1002/cncr.26110

* Cherrier

M. M.

Anderson

David

Higano

C. S.

Gray

Church

, & Willis

S. L.

(2013). A randomized trial of cognitive rehabilitation in cancer survivors. Life Sciences, 93, 617–622. https://doi.org/10.1016/j.lfs.2013.08.011

10.

* Chien

C. H.

Liu

K. L.

Chien

H. T.

, & Liu

H. E.

(2014). The effects of psychosocial strategies on anxiety and depression of patients diagnosed with prostate cancer: A systematic review. International Journal of Nursing Studies, 51, 28–38. https://doi.org/10.1016/j.ijnurstu.2012.12.019

11.

* Cimprich

Janz

N. K.

Northouse

Wren

P. A.

Given

, & Given

C. W.

(2005). Taking CHARGE: A self-management program for women following breast cancer treatment. Psycho-Oncology, 14, 704–717. https://doi.org/10.1002/pon.891

12.

* Cinar

Seckin

Keskin

Bodur

Bozkurt

, & Cengiz

(2008). The effectiveness of early rehabilitation in patients with modified radical mastectomy. Cancer Nursing, 31, 160–165. https://doi.org/10.1097/01.NCC.0000305696.12873.0e

13.

Cohen

H. J.

(2010). Functional assessment and the cancer survivor: Something old, something new. Journal of the National Cancer Institute, 102, 1450–1451. https://doi.org/10.1093/jnci/djq365

14.

* Cormie

Newton

R. U.

Taaffe

D. R.

Spry

Joseph

Akhlil Hamid

, & Galvão

D. A.

(2013). Exercise maintains sexual activity in men undergoing androgen suppression for prostate cancer: A randomized controlled trial. Prostate Cancer and Prostatic Diseases, 16, 170–175. https://doi.org/10.1038/pcan.2012.52

15.

* Craft

M. A.

Davis

G. C.

, & Paulson

R. M.

(2013). Expressive writing in early breast cancer survivors. Journal of Advanced Nursing, 69, 305–315. https://doi.org/10.1111/j.1365-2648.2012.06008.x

16.

* Cuesta-Vargas

A. I.

Buchan

, & Arroyo-Morales

(2014). A multimodal physiotherapy programme plus deep water running for improving cancer-related fatigue and quality of life in breast cancer survivors. European Journal of Cancer Care, 23, 15–21. https://doi.org/10.1111/ecc.12114

17.

* Dale

H. L.

Adair

P. M.

, & Humphris

G. M.

(2010). Systematic review of post-treatment psychosocial and behaviour change interventions for men with cancer. Psycho-Oncology, 19, 227–237. https://doi.org/10.1002/pon.1598

18.

* de Boer

Taskila

Tamminga

S. J.

Frings-Dresen

M. H.

Feuerstein

, & Verbeek

J. H.

(2011). Interventions to enhance return-to-work for cancer patients. Cochrane Database of Systematic Reviews , 2011 , CD007569. https://doi.org/10.1002/14651858.CD007569.pub2

19.

* Désiron

(2010). Occupational therapy and return to work for breast cancer survivors. WFOT Bulletin, 61, 45–51. https://doi.org/10.1179/otb.2010.61.1.013

20.

* Doorenbos

Given

, & Verbitsky

(2006). Physical functioning: Effect of behavioral intervention for symptoms among individuals with cancer. Nursing Research, 55, 161–171. https://doi.org/10.1097/00006199-200605000-00002

21.

* Doorenbos

Given

Verbitsky

Cimprich

, & McCorkle

(2005). Reducing symptom limitations: A cognitive behavioral intervention randomized trial. Psycho-Oncology, 14, 574–584. https://doi.org/10.1002/pon.874

22.

Extermann

(2007). Interaction between comorbidity and cancer. Cancer Control, 14, 13–22.

23.

* Faller

Schuler

Richard

Heckl

Weis

, & Küffner

(2013). Effects of psycho-oncologic interventions on emotional distress and quality of life in adult patients with cancer: Systematic review and meta-analysis. Journal of Clinical Oncology, 31, 782–793. https://doi.org/10.1200/JCO.2011.40.8922

24.

* Gordon

L. G.

Battistutta

Scuffham

Tweeddale

, & Newman

(2005). The impact of rehabilitation support services on health-related quality of life for women with breast cancer. Breast Cancer Research and Treatment, 93, 217–226. https://doi.org/10.1007/s10549-005-5151-5

25.

* Guo

Tang

H. Y.

Tan

S. K.

Feng

K. H.

Huang

Y. C.

, . . . Jiang

(2013). The benefits of psychosocial interventions for cancer patients undergoing radiotherapy. Health and Quality of Life Outcomes, 11, 121. https://doi.org/10.1186/1477-7525-11-121

26.

* Hanssens

Luyten

Watthy

Fontaine

Decoster

Baillon

, . . . De Grève

(2011). Evaluation of a comprehensive rehabilitation program for post-treatment patients with cancer. Oncology Nursing Forum, 38, E418–E424. https://doi.org/10.1188/11.ONF.E418-E424

27.

* Hayama

, & Inoue

(2012). The effects of deep breathing on “tension-anxiety” and fatigue in cancer patients undergoing adjuvant chemotherapy. Complementary Therapies in Clinical Practice, 18, 94–98. https://doi.org/10.1016/j.ctcp.2011.10.001

28.

* Hegel

M. T.

Lyons

K. D.

Hull

J. G.

Kaufman

Urquhart

, & Ahles

T. A.

(2011). Feasibility study of a randomized controlled trial of a telephone-delivered problem-solving occupational therapy intervention to reduce participation restrictions in rural breast cancer survivors undergoing chemotherapy. Psycho-Oncology, 20, 1092–1101. https://doi.org/10.1002/pon.1830

29.

* Henderson

V. P.

Clemow

Massion

A. O.

Hurley

T. G.

Druker

, & Hébert

J. R.

(2012). The effects of mindfulness-based stress reduction on psychosocial outcomes and quality of life in early-stage breast cancer patients: A randomized trial. Breast Cancer Research and Treatment, 131, 99–109. https://doi.org/10.1007/s10549-011-1738-1

30.

Higgins

J. P. T.

Altman

D. G.

, & Sterne

J. A. C.

(2011). Assessing risk of bias in included studies. In Higgins

J. P. T.

& Green

(Eds.), Cochrane handbook for systematic reviews of interventions (Version 5.1.0). London: Cochrane Collection. Retrieved from http://handbook.cochrane.org

31.

* Hopko

D. R.

Armento

M. E.

Robertson

S. M.

Ryba

M. M.

Carvalho

J. P.

Colman

L. K.

, . . . Lejuez

C. W.

(2011). Brief behavioral activation and problem-solving therapy for depressed breast cancer patients: Randomized trial. Journal of Consulting and Clinical Psychology, 79, 834–849. https://doi.org/10.1037/a0025450

32.

Howlader

Noone

A. M.

Krapcho

Neyman

Aminou

Waldron

, . . . Cronin

K. A.

(Eds.). (2009). SEER cancer statistics review, 1975–2009 (vintage 2009 populations). Bethesda, MD: National Cancer Institute. Retrieved from http://seer.cancer.gov/csr/1975_2009_pops09/

33.

Hunter

E. G.

Gibson

R. W.

Arbesman

, & D’Amico

(2017). Systematic review of occupational therapy and adult cancer rehabilitation: Part 1. Impact of physical activity and symptom management interventions. American Journal of Occupational Therapy, 71, 7102100030. https://doi.org/10.5014/ajot.2017.023564

34.

* Jones

J. M.

Cheng

Jackman

Walton

Haines

Rodin

, & Catton

(2013). Getting back on track: Evaluation of a brief group psychoeducation intervention for women completing primary treatment for breast cancer. Psycho-Oncology, 22, 117–124. https://doi.org/10.1002/pon.2060

35.

* Jones

Fitzgerald

Leurent

Round

Eades

Davis

, . . . Tookman

(2013). Rehabilitation in advanced, progressive, recurrent cancer: A randomized controlled trial. Journal of Pain and Symptom Management, 46, 315–325.e3. https://doi.org/10.1016/j.jpainsymman.2012.08.017

36.

* Kangas

Milross

Taylor

, & Bryant

R. A.

(2013). A pilot randomized controlled trial of a brief early intervention for reducing posttraumatic stress disorder, anxiety and depressive symptoms in newly diagnosed head and neck cancer patients. Psycho-Oncology, 22, 1665–1673. https://doi.org/10.1002/pon.3208

37.

Keeler

Guralnik

J. M.

Tian

Wallace

R. B.

, & Reuben

D. B.

(2010). The impact of functional status on life expectancy in older persons. Journals of Gerontology, Series A: Biological Sciences and Medical Sciences, 65, 727–733. https://doi.org/10.1093/gerona/glq029

38.

* Khan

Amatya

Pallant

J. F.

Rajapaksa

, & Brand

(2012). Multidisciplinary rehabilitation in women following breast cancer treatment: A randomized controlled trial. Journal of Rehabilitation Medicine, 44, 788–794. https://doi.org/10.2340/16501977-1020

39.

* Korstjens

May

van Weert

Mester

Tan

Ros

, . . . van den Borne

(2008). Quality of life after self-management cancer rehabilitation: A randomized controlled trial comparing physical and cognitive-behavioral training versus physical training. Psychosomatic Medicine, 70, 422–429. https://doi.org/10.1097/PSY.0b013e31816e038f

40.

* Korstjens

Mesters

van der Peet

Gijsen

, & van den Borne

(2006). Quality of life of cancer survivors after physical and psychosocial rehabilitation. European Journal of Cancer Prevention, 15, 541–547. https://doi.org/10.1097/01.cej.0000220625.77857.95

41.

* Lapid

M. I.

Rummans

T. A.

Brown

P. D.

Frost

M. H.

Johnson

M. E.

Huschka

M. M.

, . . . Clark

M. M.

(2007). Improving the quality of life of geriatric cancer patients with a structured multidisciplinary intervention: A randomized controlled trial. Palliative and Supportive Care, 5, 107–114. https://doi.org/10.1017/S1478951507070174

42.

* Lemoignan

Chasen

, & Bhargava

(2010). A retrospective study of the role of an occupational therapist in the cancer nutrition rehabilitation program. Supportive Care in Cancer, 18, 1589–1596. https://doi.org/10.1007/s00520-009-0782-4

43.

Lieberman

, & Scheer

(2002). AOTA’s Evidence-Based Literature Review Project: An overview. American Journal of Occupational Therapy, 56, 344–349. https://doi.org/10.5014/ajot.56.3.344

44.

* Lloyd-Williams

Cobb

O’Connor

Dunn

, & Shiels

(2013). A pilot randomised controlled trial to reduce suffering and emotional distress in patients with advanced cancer. Journal of Affective Disorders, 148, 141–145. https://doi.org/10.1016/j.jad.2012.11.013

45.

Longpre

, & Newman

(2011). The role of occupational therapy in oncology. Bethesda, MD: American Occupational Therapy Association. Retrieved from https://www.aota.org/-/media/Corporate/Files/AboutOT/Professionals/WhatIsOT/RDP/Facts/Oncology%20fact%20sheet.pdf

46.

* Luckett

Britton

Clover

, & Rankin

N. M.

(2011). Evidence for interventions to improve psychological outcomes in people with head and neck cancer: A systematic review of the literature. Supportive Care in Cancer, 19, 871–881. https://doi.org/10.1007/s00520-011-1119-7

47.

Lunney

J. R.

Lynn

Foley

D. J.

Lipson

, & Guralnik

J. M.

(2003). Patterns of functional decline at the end of life. JAMA, 289, 2387–2392. https://doi.org/10.1001/jama.289.18.2387

48.

* Manos

Sebastián

Mateos

, & Bueno

M. J.

(2009). Results of a multi-componential psychosocial intervention programme for women with early-stage breast cancer in Spain: Quality of life and mental adjustment. European Journal of Cancer Care, 18, 295–305. https://doi.org/10.1111/j.1365-2354.2008.00978.x

49.

* Pitceathly

Maguire

Fletcher

Parle

Tomenson

, & Creed

(2009). Can a brief psychological intervention prevent anxiety or depressive disorders in cancer patients? A randomised controlled trial. Annals of Oncology, 20, 928–934. https://doi.org/10.1093/annonc/mdn708

50.

* Pool

M. K.

Nadrian

, & Pasha

(2012). Effects of a self-care education program on quality of life after surgery in patients with esophageal cancer. Gastroenterology Nursing, 35, 332–340. https://doi.org/10.1097/SGA.0b013e3182605f86

51.

Ries

L. A. G.

Eisner

M. P.

Kosary

C. L.

Hankey

B. F.

Miller

B. A.

Clegg

, . . . Edwards

B. K.

(Eds.). (2002). SEER cancer statistics review, 1975–2002. Bethesda, MD: National Cancer Institute. Retrieved from http://seer.cancer.gov/csr/1975_2002/

52.

* Ruff

R. L.

Adamson

V. W.

Ruff

S. S.

, & Wang

(2007). Directed rehabilitation reduces pain and depression while increasing independence and satisfaction with life for patients with paraplegia due to epidural metastatic spinal cord compression. Journal of Rehabilitation Research and Development, 44, 1–10. https://doi.org/10.1682/JRRD.2005.10.0168

53.

Sackett

D. L.

Rosenberg

W. M.

Gray

J. A.

Haynes

R. B.

, & Richardson

W. S.

(1996). Evidence based medicine: What it is and what it isn’t. BMJ, 312, 71–72. https://doi.org/10.1136/bmj.312.7023.71

54.

* Schofield

, & Payne

(2003). A pilot study into the use of a multisensory environment (Snoezelen) within a palliative day-care setting. International Journal of Palliative Nursing, 9, 124–130. https://doi.org/10.12968/ijpn.2003.9.3.11485

55.

* Schofield

Ugalde

Gough

Reece

Krishnasamy

Carey

, . . . Aranda

(2013). A tailored, supportive care intervention using systematic assessment designed for people with inoperable lung cancer: A randomised controlled trial. Psycho-Oncology, 22, 2445–2453. https://doi.org/10.1002/pon.3306

56.

* Scott

D. A.

Mills

Black

Cantwell

Campbell

Cardwell

C. R.

, . . . Donnelly

(2013). Multidimensional rehabilitation programmes for adult cancer survivors. Cochrane Database of Systematic Reviews, 2013, CD007730. https://doi.org/10.1002/14651858.CD007730.pub2

57.

* Semple

Parahoo

Norman

McCaughan

Humphris

, & Mills

(2013). Psychosocial interventions for patients with head and neck cancer. Cochrane Database of Systematic Reviews , 2013, CD009441. https://doi.org/10.1002/14651858.CD009441.pub2

58.

Shea

B. J.

Grimshaw

J. M.

Wells

G. A.

Boers

Andersson

Hamel

, . . . Bouter

L. M.

(2007). Development of AMSTAR: A measurement tool to assess the methodological quality of systematic reviews. BMC Medical Research Methodology, 7, 10. https://doi.org/10.1186/1471-2288-7-10

59.

* Sherwood

Given

B. A.

Given

C. W.

Champion

V. L.

Doorenbos

A. Z.

Azzouz

, . . . Monahan

P. O.

(2005). A cognitive behavioral intervention for symptom management in patients with advanced cancer. Oncology Nursing Forum, 32, 1190–1198. https://doi.org/10.1188/05.ONF.1190-1198

60.

* Smeenk

F. W.

van Haastregt

J. C.

de Witte

L. P.

, & Crebolder

H. F.

(1998). Effectiveness of home care programmes for patients with incurable cancer on their quality of life and time spent in hospital: Systematic review. BMJ, 316, 1939–1944. https://doi.org/10.1136/bmj.316.7149.1939

61.

* Stigt

J. A.

Uil

S. M.

van Riesen

S. J.

Simons

F. J.

Denekamp

Shahin

G. M.

, & Groen

H. J.

(2013). A randomized controlled trial of postthoracotomy pulmonary rehabilitation in patients with resectable lung cancer. Journal of Thoracic Oncology, 8, 214–221. https://doi.org/10.1097/JTO.0b013e318279d52a

62.

Sweeney

Schmitz

K. H.

Lazovich

Virnig

B. A.

Wallace

R. B.

, & Folsom

A. R.

(2006). Functional limitations in elderly female cancer survivors. Journal of the National Cancer Institute, 98, 521–529. https://doi.org/10.1093/jnci/djj130

63.

* Taylor

Harley

Ziegler

Brown

, & Velikova

(2011). Interventions for sexual problems following treatment for breast cancer: A systematic review. Breast Cancer Research and Treatment, 130, 711–724. https://doi.org/10.1007/s10549-011-1722-9

64.

* Thijs

K. M.

de Boer

A. G. E. M.

Vreugdenhil

van de Wouw

A. J.

Houterman

, & Schep

(2012). Rehabilitation using high-intensity physical training and long-term return-to-work in cancer survivors. Journal of Occupational Rehabilitation, 22, 220–229. https://doi.org/10.1007/s10926-011-9341-1

65.

* Uitterhoeve

R. J.

Vernooy

Litjens

Potting

Bensing

De Mulder

, & van Achterberg

(2004). Psychosocial interventions for patients with advanced cancer—A systematic review of the literature. British Journal of Cancer, 91, 1050–1062. https://doi.org/10.1038/sj.bjc.6602103

66.

* Yang

E. J.

Lim

J. Y.

Rah

U. W.

, & Kim

Y. B.

(2012). Effect of a pelvic floor muscle training program on gynecologic cancer survivors with pelvic floor dysfunction: A randomized controlled trial. Gynecologic Oncology, 125, 705–711. https://doi.org/10.1016/j.ygyno.2012.03.045

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