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2. Cancer Rehabilitation NeedsPage 2 of 33 3. 2008/10/21~10/30 2008/11/01~06 Cancer Rehabilitation Needs Page 3 of 33 4. 54 11 2012/7/11Cancer Rehabilitation NeedsPage 4 of 33 5. 2012/7/11Cancer Rehabilitation Needs Page 5 of 33 6. (Oxford English Dictionary, OED) (1) (2) (3) (4) (Weber English Dictionary, 1983)Cancer Rehabilitation Needs Page 6 of 33 7. Want Needs Demand (Oxford English Dictionary, OED) (Weber English Dictionary, 1983) wantsneeds x demands Cancer Rehabilitation NeedsPage 7 of 33 8. (personal) (subjective) (variable) (constantly changing) (Cowley et al., 2000)Cancer Rehabilitation Needs Page 8 of 33 9. Pre-diagnosisTreatmentRecurrenceBereavementDiagnosis/Referral SurvivorshipPalliative Figure 1 Patients spectrum of experience during cancer journeyCancer Rehabilitation Needs Page 9 of 33 10. (withdraw) (distress)Cancer Rehabilitation Needs Page 10 of 33 11. ; 50% (physical problems) 50% (psychological problems)29% Lehmann JF, DeLisa JA, Warren CG, et al., Cancer rehabilitation: assessment of need, development, and evaluation of a model of care. Arch Phys Med Rehabil. 1978; 59(9): 410-9.Cancer Rehabilitation Needs Page 11 of 33 12. (psychosocial support services)(comprehensive rehabilitation team)Lehmann JF, DeLisa JA, Warren CG, et al., Cancer rehabilitation: assessment of need, development, and evaluation of amodel of care. Arch Phys Med Rehabil. 1978; 59(9): 410-9.Cancer Rehabilitation NeedsPage 12 of 33 13. Ganz 500()3 80%(ambulation) (41% with colorectal cancer, 69% with lung cancer,and 40% with prostate cancer) (psychosocial problems) Ganz PA, Schag CA, Lee JJ, Sim MS. The CARES: a generic measure of health-related quality of life for patients with cancer.Cancer Rehabilitation NeedsRes. 1992; 1(1), 19-29. Qual LifePage 13 of 33 14. 1970(National CancerAct) ... 1972(NCI) (National Cancer Rehabilitation Planning Conference) (psychosocial support) (optimization of physical functioning) (vocational counseling) (optimization of social functioning)Cancer Rehabilitation Needs Page 14 of 33 15. (Cromes, 1978) (DeLisa, 2001)Cancer Rehabilitation NeedsPage 15 of 33 16. : - - - - - - - - - - - - - - (DeLisa, 2001)Cancer Rehabilitation NeedsPage 16 of 33 17. (multidisciplinary approach) (physiatrist); (Physiatrist ) (DeLisa, 2001)Cancer Rehabilitation NeedsPage 17 of 33 18. : (1)(Preventive rehabilitation) (2)(Restorative rehabilitation) (Diez, 1981)Cancer Rehabilitation NeedsPage 18 of 33 19. :(3)(Supportive rehabilitation) Diez, 1981Cancer Rehabilitation NeedsPage 19 of 33 20. : (4) (Palliative rehabilitation) Diez, 1981Cancer Rehabilitation Needs Page 20 of 33 21. Table 1. Updated model: opportunities for rehabilitation interventions throughout the disease continuum I. / ROM, ADL, strengthening,II. ROM/III. / (Gerber, 2005)Cancer Rehabilitation NeedsPage 21 of 33 22. Table 1. Updated model: opportunities for rehabilitation interventions throughout the disease continuum (cont.) IV. / ( )ROM, ADL, strengthening, V. (Gerber, 2005)Cancer Rehabilitation Needs Page 22 of 33 23. Speech/language pathologistsVocational counselors NursesOccupational/physical therapists Physiatrists Client/FamilyNutritionist PharmacistPsychologistsSocial workers Figure 1 committee membership teamCancer Rehabilitation NeedsPage 23 of 33 24. Shared planning and decision making Team approach Power is shared based on knowledge and expertise and role and title Effective group dynamics including excellent communication skills, respect and trustCancer Rehabilitation Needs Page 24 of 33 25. Cancer Rehabilitation NeedsPage 25 of 33 26. (ADL) Cancer Rehabilitation NeedsPage 26 of 33 27. Broadwell DC. Rehabilitation needs of the patient with cancer. Cancer. 1987;60(3 Suppl):563-8.Cancer Rehabilitation NeedsPage 27 of 33 28. (limits referrals for rehabilitation) Cancer Rehabilitation Needs Page 28 of 33 29. (rehabilitation medical staff) (long-term survivorship) Cancer Rehabilitation NeedsPage 29 of 33 30. (rehabilitation units )(rehabilitation services) Cancer Rehabilitation Needs Page 30 of 33 31. (maximize function) (QOL)Cancer Rehabilitation Needs Page 31 of 33 32. References 1. Broadwell DC. Rehabilitation needs of the patient with cancer. Cancer. 1987;60(3 Suppl):563-8. 2. Cromes GF. Implementation of interdisciplinary cancer rehabilitation. Rehabil Counsel Bull 1978;21:2307. 2. DeLisa, J. A. A history of cancer rehabilitation. Cancer 2001; 92: 970-974. 3. Dietz JH. Rehabilitation Oncology. New York, NY:. John Wiley & Sons;1981. 4. Ganz PA, Schag CA, Lee JJ, Sim MS. The CARES: a generic measure of health-related quality of life for patients with cancer.Qual Life Res. 1992; 1(1), 19-29. 5. Gerber LH. Cancer rehabilitation into the future. Cancer 2001;92:9759. 6. Gerber LH, Vargo MH, Smith RG, Rehabilitation of the cancer patient. In: Devita V, Hellman S, Risenberg S, editors. Cancer: principles and practice of oncology. 7th edition. Philadelphia: Lippincott Williams and Wilkins; 2005. p.3089- 3110. 7. Lehmann JF, DeLisa JA, Warren CG, et al., Cancer rehabilitation: assessment of need, development, and evaluation of a model of care. Arch Phys Med Rehabil. 1978; 59(9): 410-9. 8. Movsas SB, Chang VT, Tunkel RS, et al. Rehabilitation needs of an inpatient medical oncology unit. Arch Phys Med Rehabil. Nov 2003; 84(11):1642-6. 9. Trotti A. Toxicity in head and neck cancer: a review of trends and issues. International Journal of Radiation Oncology, Biology, Physics, 2000; 47(1), 1-12. 10. van Harten WH, van Noort O, Warmerdam R, et al. Assessment of rehabilitation needs in cancer patients. Int J Rehabil Res. 1998; 21(3):247-57. 10. van Weert E, Hoekstra-Weebers JE, Grol BM, et al. Physical functioning and quality of life after cancer rehabilitation. Int J Rehabil Res. 2004;27(1):27-35. 14.Zackrisson B, Mercke C, Strander H, Wennerberg J, Cavallin-Stahl E. A systematic overview of radiation therapy effects in head and neck cancer. Acta Oncol. 2003;42(5-6):443-61.Cancer Rehabilitation NeedsPage 32 of 33 33. Thank YouCancer Rehabilitation Needs Page 33 of 33