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Background. Lymphedema affects a significant number of women with breast cancer. Self-Management Programs (SMP) are important in the long-term management of chronic conditions such as lymphedema. Motivation is crucial in the daily performance of the SMP. The study explored the effect of the Remotivation Process on the motivation of women with breast cancer-related lymphedema to incorporate an SMP into their daily routine. Methodology. The study was a within-subjects quasi-experimental design that used the Volitional Questionnaire, frequency count of the SMP, and circumferential measurement as outcome measures. Eleven participants (n = 11) with breast cancer-related lymphedema completed the study that used the Remotivation Process as the intervention for 4 weeks with a follow-up session during the 8th week. Results. The participants progressed to a higher state of motivation on the Volitional Questionnaire at the end of the study. There was an increase in the performance of the exercise component of the SMP in 7 days, and a significant decrease in the circumferential measurement of the affected arm. There was also a positive correlation between VQ and circumferential measurements. Conclusion. The study suggests the usefulness of the Remotivation Process in an occupational therapy intervention to promote self-management. It can possibly facilitate motivation, improvement in the manifestation of lymphedema, and the daily performance of the self-management program for lymphedema.

Background Older adults undergoing cancer surgery are at greater risk for poor postoperative outcomes. Caregivers also endure significant burden. Participation in perioperative physical activity may improve physical functioning and enhance overall well-being for both patients and caregivers. In this study, we assessed the feasibility of a personalized telehealth intervention to enhance physical activity for older (≥ 65 years) gastrointestinal (GI) and lung cancer surgery patients/caregivers. Methods Participants completed four telehealth sessions with physical therapy/occupational therapy (PT/OT) before surgery and up to 2 weeks post-discharge. Outcomes included preop geriatric assessment, functional measures, and validated measures for symptoms and psychological distress. Pre/post-intervention trends/trajectories for outcomes were explored. Results Thirty-four patient/caregiver dyads (16, GI; 18, lung) were included. Accrual rate was 76% over 8 months; retention rate was 88% over 2 months. Median for postop of a 6-min walk test, timed up and go, and short physical performance battery test scores improved from baseline to postop. Participant satisfaction scores were high. Conclusion Our conceptually based, personalized, multimodal, telehealth perioperative physical activity intervention for older patient/caregiver dyads is feasible and acceptable. It offers an opportunity to improve postoperative outcomes by promoting functional recovery through telehealth, behavior change, and self-monitoring approaches. Trial registration ClinicalTrials.gov Identifier: NCT03267524

Date Presented 4/16/2015 This 12-mo prospective quality improvement study explored the efficacy of early occupational therapy and cognitive intervention for hematology patients with chemotherapy-related cognitive impairments undergoing an autologous stem cell transplant.