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A new model of early, integrated palliative care: palliative rehabilitation for newly diagnosed patients with non-resectable cancer

  • Lise Nottelmann
  • Lars Henrik Jensen
  • Tove Bahn Vejlgaard
  • Mogens Groenvold
Original Article

Abstract

Purpose

The aim of this paper is to describe a model of palliative rehabilitation for newly diagnosed advanced cancer patients and present data on how it was utilised during a randomised controlled trial (RCT).

Methods

We designed a highly flexible, multidisciplinary model of palliative rehabilitation consisting of a “basic offer” and tailored elements. The model was evaluated in the setting on an RCT investigating the effect of systematic referral to a palliative rehabilitation clinic concurrently with standard oncology treatment or standard treatment alone. The basic offer of palliative rehabilitation was two consultations and a 12-week possibility of contacting a palliative rehabilitation team, if needed. In addition, patients and family caregivers could be offered participation in a 12-week patient/caregiver school combined with individually tailored physical exercise in groups, individual consultations, or both. Contacts with the palliative rehabilitation team and participant evaluation were registered prospectively.

Results

Between December 2014 and December 2017, 132 adults with newly diagnosed advanced cancer were seen in the palliative rehabilitation outpatient clinic. Twenty percent of the participants received the basic offer only (n = 26), 45% additionally participated in the group program (n = 59), and 35% received supplementary individual consultations without participating in the group program (n = 47). The intervention was primarily led by nurses, and the main themes of the individual consultations were coping, pain, and nutrition. When asked if they would recommend the intervention to others in the same situation, 93% of the respondents agreed, 7% partly agreed, and no one disagreed.

Conclusion

The new model of palliative rehabilitation presented here had a flexibility to meet the needs of the participants and led to a very high degree of patient satisfaction. It could serve as an inspiration to other cancer centres wanting to integrate palliative care into standard oncology services.

Keywords

Palliative care Rehabilitation Quality of life Neoplasms Models of care Patient satisfaction 

Notes

Acknowledgments

The authors first and foremost wish to thank the patients and family caregivers participating in the study and the Patient and Relatives Council of Vejle Hospital for important input and inspiring discussions. We thank the Danish Cancer Society for conducting by invitation-only workshops during the trial period with valuable exchange of knowledge with other researchers working with patient and caregiver involvement. We thank the employees in the palliative rehabilitation team, especially facilitating nurses Birgitte Skov Zellweger and Grethe Misser Hansen for their important contribution to the study. We thank Karin Larsen for linguistic editing of the manuscript.

Funding information

This study is financially supported by the Danish Cancer Society, the Research Council of Lillebaelt Hospital, the Andreas and Grethe Gullev Hansen Foundation and the Hede Nielsen Family Foundation.

Compliance with ethical standards

All procedures performed in this study were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments. Informed consent was obtained from all individual participants included in the study.

The study protocol, including all written material intended for study participants, was approved by The Regional Committees on Health Research Ethics for Southern Denmark on April 2, 2014 (Project ID S-20140038).

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Institute of Regional Health Research, Department of Oncology, Palliative Team, Vejle HospitalUniversity of Southern DenmarkVejleDenmark
  2. 2.Danish Colorectal Cancer Center South, Vejle Hospital, Institute of Regional Health ResearchUniversity of Southern DenmarkOdenseDenmark
  3. 3.The Research Unit, Department of Palliative Medicine, Bispebjerg HospitalCopenhagen University HospitalCopenhagenDenmark
  4. 4.Department of Public HealthUniversity of CopenhagenCopenhagenDenmark

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