Browsing by Author "Daun, Julia Teresa"

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    The Feasibility of Patient-Reported Outcomes, Physical Function, and Mobilization in the Care Pathway for Head and Neck Cancer Surgical Patients: A Mixed-Methods Study
    (2020-07-24) Daun, Julia Teresa; Culos-Reed, Susan Nicole; Dort, Joseph C.; Capozzi, Lauren C.; Watson, Linda C.
    Head and neck cancer (HNC) surgical patients experience difficult treatment, high symptom burden, and complex and lengthy recoveries. Initial research has found physical activity (PA) and exercise to be feasible and beneficial post-surgery through to survivorship, yet no studies have addressed the role of PA or exercise in the earlier stages of clinical care. Exercise prehabilitation is a promising tool for this population. Considering the unique nature of the HNC surgical trajectory, it is necessary to first establish whether the number and types of assessments are feasible with this population in advance of piloting an exercise prehabilitation program. The purpose of this work was to therefore explore the feasibility of measuring patient-reported outcomes (PROs), physical function, and in-hospital mobilization as part of the care pathway in HNC surgical patients. A mixed-methods study gathered quantitative and qualitative information from patients and healthcare providers (HCPs) on the feasibility of conducting assessments throughout the clinical timeline for HNC surgical patients. Participants were HNC patients scheduled for oncologic resection with free-flap reconstruction, and HCPs were those involved in immediate HNC patient care. Quantitative data was collected from patients, and included PROs and measures of physical function and in-hospital mobilization. Feasibility included tracking recruitment numbers and completion of measures. Qualitative data captured perspectives around the acceptability of assessment completion and perceptions of a future exercise prehabilitation program. HCPs also provided information on clinical logistics of exercise prehabilitation. The quantitative study revealed that most assessments were feasible, except for pre-operative measures of physical function. The qualitative study demonstrated that both patients and HCPs found the assessments to be acceptable and necessary, and additionally value the potential for an exercise prehabilitation program in the HNC surgical timeline. Based on findings from this study, new workflows were implemented to support recruitment and assessment of outcomes across the HNC surgical timeline, facilitating implementation of a future exercise prehabilitation intervention.