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ES 03 - Current Topics for Nurses & Allied Health (ID 512)
- Event: WCLC 2017
- Type: Educational Session
- Track: Nursing/Palliative Care/Ethics
- Presentations: 1
- Moderators:Anne Fraser, S. Kim
- Coordinates: 10/16/2017, 15:45 - 17:30, Room 313 + 314
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ES 03.03 - Allied Health: The Missing Link in Comprehensive Cancer Care (ID 7594)
15:45 - 17:30 | Presenting Author(s): Kahren White
- Abstract
- Presentation
Abstract:
While lung cancer care internationally is spoken about in terms of being multidisciplinary, how far does this go in practice, to having comprehensive multidisciplinary involvement of all appropriate medical, nursing and allied health professionals as part of standard lung cancer care? There are an increasing number of allied health professionals internationally who specialise in oncology, with an increase in the evidence base for interventions. I propose that the involvement of allied health professionals as part of standard lung cancer care will lead to improved comprehensive multidisciplinary care, with improved quality of life and function for people living with a lung cancer diagnosis. The core allied health professions include occupational therapy, physiotherapy, exercise physiology, dietetics, speech pathology, social work and psychology. Some countries have other professions that fit into the allied health disciplines, such as physician’s assistant and respiratory therapist. This presentation will focus on the disciplines found primarily in Australia and the UK. Occupational Therapy focuses on enabling ongoing participation in chosen everyday activities. In curative treatment, the occupational therapist has a key role in pre-habilitation, assisting the individual to reach optimum function prior to treatment, and rehabilitation following treatment, to facilitate the persons return to previous chosen and meaningful roles. In metastatic disease, the occupational therapist focuses on enabling continued participation in chosen and meaningful roles. In the acute hospital setting the focus is often on what functional level the individual needs to be at to be able to safely manage the tasks of personal care, meal preparation and other personal and community activities of daily living at home following discharge. While these aspects of function are important, it is key to allow the person living with lung cancer to identify the roles and tasks that they find meaningful and important to participate in. A person may choose to have community assistance with personal care and meal preparation, as this ensures they have the energy to participate in activities that lead to improved engagement and quality of life. Physiotherapy is concerned with identifying and maximising quality of life and movement potential in the areas of promotion, prevention, treatment/intervention, habilitation and rehabilitation[1]. Physiotherapists have a key role in working with people living with lung cancer prior to and following their treatment for lung cancer. There is a growing body of evidence that suggests exercise following treatment for lung cancer is associated with improvements in physical and psychological outcomes[2]. Exercise physiologists are newer members of the lung cancer multidisciplinary team. In Australia, we are seeing as increasing use of exercise physiologists in the private hospital and pulmonary rehabilitation setting. Their role is of smaller scope than physiotherapists, focusing on prescribing and supervising exercise programs to improve exercise capacity, with the aim of improving function and quality of life. Dieticians are key members of the lung cancer team, however they are often not embedded within the multidisciplinary team. Given that cancer cachexia is a common symptom in lung cancer, affecting functional status, treatment tolerance and survival[3] we should be seeing an increase of dieticians within the lung cancer multidisciplinary team internationally. Speech pathologists provide expert assessment and treatment of swallowing and communication disorders. There is a growing body of evidence in the treatment for head and neck cancer, however there is currently no published speech pathology research in the lung cancer space. People living with lung cancer may require the specialist input of a speech pathologist due to dysphagia, as a result of treatment or disease, or speech difficulties caused by brain metastasis. Social Work and Psychology are key members of the lung cancer multidisciplinary team, as studies have demonstrated the prevalence of distress in lung cancer patients to be high[4,5]. All lung cancer patients should have their psychosocial needs regularly screened, with appropriate referrals for support made to ensure these needs are met. Psychologists and social workers need to be embedded within the lung cancer multidisciplinary team to ensure appropriate screening and intervention of patients. Lung cancer multidisciplinary teams need to utilise their allied health professionals to ensure comprehensive care is offered, and received, by patients who are living with a lung cancer diagnosis. There is a paucity of evidence and research into allied health interventions that may benefit people living with lung cancer. It is critical that allied health professionals build on the evidence and continue to research the efficacy of interventions used to optimise quality of life and function for people living with lung cancer. References: WORLD CONFEDERATION OF PHYSICAL THERAPY 2011. Policy statement: Description of physical therapy. World Federation of Physical Therapy. GRANGER CL 2016. Physiotherapy management of lung cancer. Journal of Physiotherapy, 62, 60-67. PERCIVAL C, HUSSAIN A, ZADORA-CHRZASTOWSKA S, WHITE G, MADDOCKS M & WILCOCK A 2013. Providing nutritional support to patients with thoracic cancer: Findings of a dedicated rehabilitation service. Respiratory Medicine, 107, 753-761. STEINBERG T, ROSEMAN M, KASYMJANOVA G, DOBSON S, LAJEUNESSE L, DAJCZMAN E, KREISMAN H, MACDONALD N, AGULNIK J, COHEN V, ROSBERGER Z, CHASEN M & SMALL D 2009. Prevalence of emotional distress in newly diagnosed lung cancer patients. Support Care Cancer, 17, 1493-1497. ZABORA J, BRINTZENHOFESZOC K, CURBOW B, HOOKER C & PIANTADOSI S 2001. The prevalence of psychological distress by cancer site. Psycho-Oncology, 10, 19-28.
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