Research Article
Issue Date: May/June 2020
Published Online: April 06, 2020
Updated: April 30, 2020
Women’s Experiences After Ovarian Cancer Surgery: Distress, Uncertainty, and the Need for Occupational Therapy
Author Affiliations
  • Mackenzi Pergolotti, PhD, OTR/L, is Director of Research, ReVital Cancer Rehabilitation, Mechanicsburg, PA. At the time of the study, she was Postdoctoral Fellow, Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill; mpergolotti@selectmedical.com
  • Antoine Bailliard, PhD, OTR/L, is Associate Professor, Department of Occupational Therapy, University of North Carolina at Chapel Hill.
  • Lauren McCarthy, MS, OTR/L, is Occupational Therapist, Duke University Health System, Durham, NC. At the time of the study, she was Research Assistant, Department of Occupational Therapy, University of North Carolina at Chapel Hill.
  • Erica Farley, MS, OTR/L, is Occupational Therapist, Teton Therapy, Cheyenne, WY. At the time of the study, she was Research Assistant, Department of Occupational Therapy, College of Health and Human Services, Colorado State University, Fort Collins.
  • Kelley R. Covington, MS, is Research and Education Manager, ReVital Cancer Rehabilitation, Mechanicsburg, PA. At the time of the study, she was Research Assistant, Department of Occupational Therapy, College of Health and Human Services, Colorado State University, Fort Collins.
  • Kemi M. Doll, MD, MSCR, is Assistant Professor, Department of Obstetrics and Gynecology, University of Washington, Seattle. At the time of the study, she was Postdoctoral Fellow, Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill.
Article Information
Evidence-Based Practice / Hand and Upper Extremity / Health and Wellness / Mental Health / Rehabilitation, Participation, and Disability / Research Articles
Research Article   |   April 06, 2020
Women’s Experiences After Ovarian Cancer Surgery: Distress, Uncertainty, and the Need for Occupational Therapy
American Journal of Occupational Therapy, April 2020, Vol. 74, 7403205140. https://doi.org/10.5014/ajot.2020.036897
American Journal of Occupational Therapy, April 2020, Vol. 74, 7403205140. https://doi.org/10.5014/ajot.2020.036897
Abstract

Importance: Despite the growing literature on the association of functional, physical, and quality-of-life (QOL) deficits with poor postoperative outcomes, there is a gap in the literature identifying women’s occupational performance needs after ovarian cancer surgery.

Objective: To describe the experiences of women hospitalized after ovarian cancer surgery to identify potential areas for intervention. Goals were to (1) identify functional needs and limitations at time of discharge as measured by the typical acute care occupational therapy evaluation and semistructured interview and (2) understand the women’s perspectives of their needs for occupational therapy and a safe return to home.

Design: Single-arm, cross-sectional descriptive study. Mixed-methods data collection and analysis.

Setting: Academic cancer center.

Participants: Women with ovarian cancer (N = 11) who had completed surgery.

Intervention: Semistructured interviews and patient-reported outcome measures (PROMs) completed postsurgery.

Outcomes and Measures: PROMs included the National Comprehensive Cancer Network (NCCN) Distress Thermometer and Problem List, the PROMIS® Global Physical Health (GPH) and Global Mental Health (GMH) scales, and the Possibilities for Activity Scale–Women (PActS–W).

Results: The mean NCCN Distress score was 6.0 (standard deviation [SD] = 3.1, with the top three concerns being pain (80%), worry (80%), and fatigue (78%). Mean GPH and GMH T scores were 38.0 (SD = 8.8) and 48.2 (SD = 8.4), respectively. Women scored a mean of 39.2 (SD = 11.2, range = 26–58) on the PActS–W. Thematic analyses found that the women were uncertain about potential functional limitations and significantly distressed.

Conclusion and Relevance: Women with ovarian cancer experienced high levels of uncertainty and distress after surgery. Integrating in-home or community-based occupational therapy into routine care could decrease functional distress and uncertainty and help women manage concerns related to pain, worry, and fatigue.

What This Article Adds: This study suggests that occupational therapy evaluation and intervention are needed to decrease distress and improve QOL of women upon discharge after ovarian cancer surgery.