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T.M. Tönis



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    O26 - Support and Palliation II (ID 140)

    • Event: WCLC 2013
    • Type: Oral Abstract Session
    • Track: Nurses
    • Presentations: 1
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      O26.07 - Towards Cancer Rehabilitation at Home<br /> Design of a Telerehabilitation Service for Lung Cancer Patients (ID 2697)

      16:15 - 17:45  |  Author(s): T.M. Tönis

      • Abstract
      • Presentation
      • Slides

      Background
      Although lung resection still provides the best long-term outcome for lung cancer, it is also associated with a considerable decay in physical and psychosocial health status[1,2]. If not controlled, these symptoms can hamper postsurgical recovery, and lead to unscheduled healthcare use[3]. This study aimed to determine the clinical relevance of and functional requirements for a telerehabilitation (TR) service to support recovery following lung resection.

      Methods
      A sociotechnical scenario-based design approach was used, characterized by early and systematically involvement of patients and healthcare providers during an iterative design process (figure 1). First, end users’ requirements for the TR service were explored by means of semi-structured interviews. Subsequently a small focus group with healthcare providers from the Netherlands Cancer Institute – Antoni van Leeuwenhoek hospital (NKI-AVL) in Amsterdam was organised to establish requirements for the TR service in more detail. The findings from the interviews and focus group were summarized in a scenario and validated by healthcare professionals from the NKI-AVL. Figure 1

      Results
      Survivors and professionals expected a TR service to be beneficial for improving quality of current care, and identified three modules that should be included in the TR service: ambulant monitoring of recovery and symptoms, home exercise programs and patient-provider contact. The functional requirements for these three modules and general requirements as reported by the patients and professionals are presented in table 1. The results also indicated that successful implementation of the service will be promoted by structurally embedding the service in existing healthcare processes, and record clearly the specific roles and responsibilities of all involved healthcare professionals. Figure 1

      Conclusion
      End-users showed positive intention to use a TR service for home-based symptom monitoring and rehabilitation. At this moment, a prototype of the TR service is designed, which will be evaluated this summer in patients and healthcare providers to improve end-users’ acceptance.

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    P2.24 - Poster Session 2 - Supportive Care (ID 157)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Supportive Care
    • Presentations: 1
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      P2.24-055 - ReaLCaRe: Recovery after lung resection. Study design and preliminary results. (ID 3308)

      09:30 - 16:30  |  Author(s): T.M. Tönis

      • Abstract

      Background
      Although lung resection still provides the best long-term outcome for lung cancer, it is also associated with a considerable decay of physical and psychosocial health status. Physical activity (PA) is considered beneficial for post-surgery recovery, and patients often are encouraged to increase PA in daily life. Surprisingly, only few studies objectively assessed daily PA in lung cancer patients, and none of these studies examined possible associations between daily PA and recovery of health status following lung resection. Therefore, our study aims to explore the relationship between daily PA and recovery of physical and psychosocial health status in lung cancer patients treated with lung resection.

      Methods
      Lung cancer patients undergoing curative lung resection at the Nederlands Canker Institute-Antoni van Leeuwenhoek Hospital in Amsterdam are enrolled in the study before surgery (T0). Follow-up measurements are scheduled at 1 (T1), 3 (T2) and 6 months (T3) post-surgery. PA levels are measured for three days on all occasions using a triaxial accelerometer and expressed as amount of activity in counts per minute. Secondary outcome measures include VO~2~max, pulmonary function, six-minute-walking-distance, times standing on the 30-seconds-chair-stand test, quality of life, mental distress, fatigue, and pain. The aim is to include 60 patients by October 2015.

      Results
      So far, fourteen lung cancer patients (6 male; mean age 65.4±10.4 yrs) are included in the study. Ten patients underwent lobectomy, four segment resection, while no patients underwent pneumectomy. Four patients dropped out due to comorbidity (n=1), disinterest (n=1), and inability to perform the measurements (n=2). First analyses show that both physical and psychosocial health are worse one month post-surgery, but improve during the following five months (table 1). Activity patterns from pre-surgery to 6 months post-surgery of the included patients are being analysed at the moment. Figure 1

      Conclusion
      As was expected from earlier research, physical and psychosocial outcome measures worsened following lung resection, but returned to baseline levels at 6 months post-surgery, except of VO2max. At this moment, we cannot calculate associations between daily PA and secondary outcome measures yet. However, patients are actively recruited and enrolled, and at the time of the conference we will be able to draw more firm conclusions about possible associations between daily PA and recovery of health status following lung resection.