A study looking at rehabilitation for women with gynaecological cancer

Cancer type:

Cervical cancer

Ovarian cancer

Vaginal cancer

Vulval cancer

Womb (uterine or endometrial) cancer

Status:

Results

Phase:

Other

This study looked at 2 planned rehabilitation sessions for women with gynaecological cancers.

This study was open for women to join between 2011 and 2014. These results were published in 2017.

More about this trial

A gynaecological cancer is:

vaginal cancer
vulval cancer
womb cancer (uterine or endometrial)
ovarian cancer

Following treatment for a gynaecological cancer, some women may have long term physical, social or emotional difficulties. These difficulties can affect their health and quality of life possibly reducing their ability to return to the life they had before. The rehabilitation Open a glossary item services offered at a hospital or in their community can help them to cope with these difficulties.

Doctors refer people to the rehabilitation services when a problem arises. Researchers thought that planned rehabilitation sessions might be better. To find this out they used a tool to identify any possible difficulties women may have and to develop a plan of action to address these problems.

The tool the researchers used to guide the conversation with the women was a holistic needs assessment. This looked at the needs of the whole person including the physical, social and emotional aspects of their life.

The aim of this study was to find out if having 2 planned rehabilitation sessions using the holistic needs assessment helped women with gynaecological cancers return to as normal life as possible.

Summary of results

The team found that a planned session with an allied health professional is acceptable and useful for some women with a gynaecological cancer.

About this study
150 women took part in this randomised study. Everyone was put into 1 of 2 groups. Neither they nor their doctor chose which group they were in.

75 women had the usual care plus 2 rehabilitation sessions
75 women had the usual care

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Usual care was a referral to a specialist when a need was identified. The woman herself, a member of the family or a member of her healthcare team could identify the need.

The rehabilitation sessions were with a healthcare profession. They would be experienced in rehabilitation and know how to change behaviour.

Before the first session the women filled in a holistic needs assessment.

The sessions were either in person or over the telephone.

Everyone filled in questionnaires when they were put into their group and then at:

3 months
6 months

These were quality of life questionnaires. The questions asked were about:

side effects from treatment
general health
daily activities
use of health services and social services

After completing the study 10 women from the rehabilitation session group were interviewed. The interviewer asked them about:

the rehabilitation sessions
what impact the sessions had on them
what parts or features of the sessions was important to them

Results
The questionnaires at the beginning of the study showed there was no difference between the 2 groups.

The team then looked at the difference in the scores of the questionnaires at:

3 months
6 months

The number of women whose score improved by more than 10 points at 3 months and 6 months was:

22 women (30%) in the usual care group
23 women (31%) in the rehabilitation sessions group

The only factor that could predict what the score would be at 6 months was the score at the beginning.

At 6 months there was a trend for women in the rehabilitation sessions group to have improved in their:

feelings and emotions
work and social lives
symptoms such as tiredness, breathlessness and difficulty sleeping

Overall the women in the usual care group used the health services and social services more than the women in the rehabilitation sessions group. But this wasn’t a statically significant Open a glossary item difference.

Results of the interviews
Between October 2012 and November 2013 the study interviewed 10 women from the rehabilitation sessions group.

All the women were happy for the hospital to provide the rehabilitation sessions. When asked their preference of how:

2 women (20%) said over the telephone
1 woman (10%) said by email

Isolation, helplessness and uncertainty were the main feelings women had after treatment.

The opportunity to explore issues was important for 8 women (80%). And to have these issues confirmed by someone who isn’t a part of the medical team.

6 women (60%) stated it was important to be able to talk about and explore things outside the family. This related to feelings of being a burden to the family.

Others benefited from the support and reassurance to access other services such as relaxation, complementary therapies and mental health services. They felt more able to access these services understanding that they could be a benefit to them. And without the feeling that they should leave these services for women who were in a worse situation.

The value of the rehabilitation sessions was clearer towards the end for some. Because they were able to look back and reflect on the difference this type of support made.

Many said that having gaps in their knowledge and not having tailored information made it more difficult to manage things themselves.

Other positive comments included:

signposting and helping with access to other support services
continuity and availability of the contact
support with focusing, target or goal setting

Follow up was highlighted as an important feature for 9 of the women (90%).

Conclusion
The study team concluded the rehabilitation sessions were useful for women after treatment for a gynaecological cancer. And these sessions should be made routinely available.

Where this information comes from
We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item ) and published in a medical journal. The figures we quote above were provided by the trial team who did the research. We have not analysed the data ourselves.