Projects / Programmes
Pilot study on individualized integrated rehabilitation of breast cancer patients 2019-2022
| Code |
Science |
Field |
Subfield |
| 3.04.00 |
Medical sciences |
Oncology |
|
| Code |
Science |
Field |
| B710 |
Biomedical sciences |
Physical medicine, kinesitherapy, revalidation, rehabilitation |
| Code |
Science |
Field |
| 3.02 |
Medical and Health Sciences |
Clinical medicine |
Medicine, Oncology, Integrated Rehabilitation, Breast Cancer, Quality of Life
Researchers (29)
Organisations (2)
Abstract
A pilot study on individualized integrated rehabilitation of breast cancer patients 2019-2022 (hereinafter: the project) aims at assessing the feasibility and effectiveness of the proposed Cancer Control Program 2017-2021 (hereinafter referred to as: DPOR) for the proposed integrated rehabilitation of cancer patients. The project is based on the Action Plan of Integral Rehabilitation of Cancer Patients 2018-2021 (hereinafter: the Action Plan) and the related Analysis of the state of rehabilitation of cancer patients prepared by the DPOR in the multidisciplinary working group for integrated rehabilitation between 2018 and 2019.
Today, more than 100,000 people with cancer diagnoses live in Slovenia, of whom 16,482 were breast cancer patients in 2015. More than 13,500 Slovenians get cancer each year, of which about 1,300 are breast cancer, of which 400 die on average.
Numerous studies have shown the importance and positive impact of integrated rehabilitation of cancer patients. Similarly, associations and societies of cancer patients in Slovenia and abroad have long warned that early rehabilitation during and after oncological treatment is of outmost importance for the quality of life of patients. Tackling the diagnosis of cancer and difficult treatment brings many sequelae, both psychological and somatic, and social distress causing radically change of cancer patient’s lives. However, the quality of their lives may be affected by adverse side effects of oncological treatment during the treatment and for many years after it.
Therefore, the overall strategic goal of the DPOR is dedicated to the integrated rehabilitation and quality of life. The Republic of Slovenia has committed to ensure the integrated rehabilitation of cancer patients precisely within the framework of this objective, the DPOR, with strategic guidelines in the field of integrated rehabilitation for all patients in Slovenia formulated in the aforementioned Action Plan.
The defined vision in the Action Plan defines that "Through an integrated and timely rehabilitation of cancer patients, we guarantee a quality life". The Action Plan defines the following definition of integrated rehabilitation: "Integrated rehabilitation is an active process in which we enable cancer patients the best physical, mental and social functioning from the diagnosis onwards. Integrated rehabilitation must include medical, psychological, social and occupational rehabilitation."
Multidisciplinary Group for Integrated Rehabilitation DPOR in accordance with the Action Plan of 2018, prepared a new concept of rehabilitation of cancer patients following the implementation of rehabilitation based on the patient's needs assessment, therefore, the proposed concept of integrated rehabilitation for individualized and at the same time coordinated rehabilitation of patients. Patients will be monitored by the Integrated Rehabilitation Coordinator (hereinafter: coordinator) from the time of diagnosis of cancer. Monitoring patients from the diagnosis to the completion phase of treatment also allows patients to have the central reference point at the Institute of Oncology (OI) Ljubljana, to which it can turn in case of any questions and get needed advice. Namely, in the current system the pathway of patient is carried out through a number of health professionals and points where patient obtains partial information on treatment and rehabilitation. The coordinator is a graduate nurse who, in accordance with the recommendations for integrated rehabilitation of patients and the related triage questionnaires, identifies the problems of the patients. The coordinator records the answers of patients about what side effects of oncological treatment are being dealt with and, in agreement with oncologists refer to additional treatments according to the proposed network of providers to a particular clinical pathway.
On the basis of this new concept Multidisciplinary Group for Integrated Rehabilitation DPOR, prepared
Significance for science
Integrated rehabilitation of cancer patients in Slovenia is not currently in place, but it is absolutely essential for quality treatment of cancer patients. At the pilot level, the project will test the concept of individualized and coordinated guided integrated rehabilitation within the framework of the DPOR, which in today's Slovenian oncology represents an absolute novelty and an untested approach to treatment of cancer patients.
The coordinator of integrated rehabilitation is the main novelty of this new concept, which has not yet been tested in practice in such a multifaceted and multi-level implementation. This concept will enable and at the same time test the cooperation of primary healthcare with outpatient clinics at the tertiary level of health care. The coordinator also represents the novelty of monitoring patients from the time of diagnosis to the completion of the treatment, which will enable in study patients to have the central reference point at the Institute of Oncology, to which they will be able to address questions and get advice on time.
At the same time, the project will test the needs of Slovenian cancer patients in 14 different sets of integrated rehabilitation, which is the only such research in the field of rehabilitation of cancer patients in Slovenia. The data obtained in the project will enable the complete projection of the needs for a integrated rehabilitation of all cancer patients in Slovenia, which was not possible to be carried out so far.
The acquired knowledge about the types and frequency of acute, subacute and late complications of oncology treatment can significantly affect the possible modification of the treatment method of oncological patients in the future in order to reduce toxic effects and enable the same or better survival of cancer patients.
Significance for the country
One of the purposes of coordinated management of integrated rehabilitation is early identification of the consequences, both somatic and psychological, caused by the disease itself or by treatment of cancer and faster treatment within the established network of providers. The consequence of this is a better quality of life of cancer patients from the diagnosis of cancer, fewer complications during oncology treatment and therefore better "tolerance" and success of treatment.
It is expected that the importance of the project for the economy will be long-term, as on positive aspects of the impact of integrated rehabilitation on patients, this could shorten patients' sick leave initially for 300 patients in the intervention group of the project, and later, when this model will be introduced into the health system of the Republic of Slovenia, this shorter patients' sick leave could mean faster return to work for approximately 7,000 cancer patients who are being treated annually at the Institute of Oncology Ljubljana.
We expect that faster detection and elimination of side effects of cancer itself and treatment will have a beneficial impact in terms of lower morbidity and mortality of cancer patients, thereby improved quality of life and also a lower degree of disability. Namely, today, the diagnosis of neoplasm (cancer) is the fourth cause of disability retirement in Slovenia.
An important part of integrated rehabilitation is also the inclusion of specialists of occupational, traffic and sport medicine, who will, if necessary, have consultation with patients during the treatment itself. This will enable early retraining, additional training, workplace adjustment, if necessary according to the patient's health status. We believe that early return to work is very important for the patient as it enables patients' social inclusion and social security.
Most important scientific results
Annual report
2019,
2020
Most important socioeconomically and culturally relevant results
Annual report
2019,
2020
