ASSESSMENT OF REHABILITATION NEEDS IN CANCER-PATIENTS

In Germany and the United States cancer patients are admitted to rehab ilitation programmes after anti-cancer treatment. Such programmes do n ot er,ist in the Netherlands. This leads to the question of whether in the Dutch health care situation certain problems (impairments-disabil ities-handicaps) exist in (ex)cancer patients that can be dealt with b y a rehabilitation programme. Using theories on the development of hea lth care needs of chronic patients and the WHO approach of Impairment, Disability and Handicap, a framework for a questionnaire was develope d. This questionnaire used quality of life items, functional health it ems and items mainly from specific cancer-orientated instruments. One hundred and forty seven patients participated in the study. After the results of this phase were clear, a focus group approach combined with in-depth interviews was used to present patients with possible rehabi litation programmes. Questions were formulated verifying the nature of prior results, inquiring about specific elements and desired outcomes and about practical aspects concerning post-cancer rehabilitation. Th e population consisted mostly of breast cancer (69.4%) and bowel cance r patients (23.8%). Quality of life scored averagely moderate, not ind icating large problems. About 26% of all respondents wanted to receive professional help; this was largely determined by perceived quality o f life and level of social support. The desire for professional help c oncentrated significantly on role performance, cognition, control, fam ily relations, psychologic and somatic aspects. The focus group discus sion and interviews revealed that patients would prefer a rehabilitati on programme focusing on reducing fatigue, reinforcing loadability, co ping with social aspects, dietary aspects and finding new life targets . Quality of life seemed to be relatively high and only 26% of post-ca ncer patients indicated the need of rehabilitation. Related to a signi ficantly lower quality of life score, improved physical loadability an d psychosocial functioning (coping) should be the main outcomes of suc h a programme. Specific elements such as dietary advice and finding ne w life targets should, from the patients' perspective, be included.