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Rehabilitation nursing in older oncology inpatients with physical activity intolerance: An exploratory feasibility
Tatiana Faria-Silva1, Paulo Reis-Pina2
1Francisco Gentil Portuguese Institute for Oncology of Lisbon, Rua Prof. Lima Basto, Lisbon, 1099-023, Portugal.
Introduction:
Physical activity intolerance (PAI) is common among oncology inpatients, leading to reduced autonomy, increased symptom burden, and diminished quality of life.
Objectives:
To evaluate the feasibility of delivering rehabilitation nursing interventions and to estimate changes in performance status, symptom burden, and well-being in hospitalized older adults with cancer and PAI.
Methods:
A quantitative, prospective, single-arm pre-post study was conducted in a General Oncology Surgery Department in collaboration with the In-Hospital Palliative Care Support Team. Participants were inpatients aged ≥65 years. Assessments included the Edmonton Symptom Assessment System (ESAS-r), Palliative Performance Scale (PPS), diagnostic confirmation of PAI, and physiological measurements. Rehabilitation nursing interventions-respiratory and motor re-education and activities of daily living training-were delivered. Changes between pre- and post-intervention scores were estimated using mean differences with 95% confidence intervals (CIs) and standardized within-participant effect sizes (Cohen's d_z).
Results:
Thirty inpatients (67% male; mean age 76.7 ± 7.3 years) participated. Performance status increased by a mean of +7.67 points (95% CI 3.00 to 12.34; d_z 0.61). Overall well-being improved (mean change -3.30 points; 95% CI -4.06 to -2.54; d_z -1.62). Fatigue decreased from 5.33 ± 2.51 to 2.87 ± 2.29 (mean change -2.47; 95% CI -3.68 to -1.25; d_z -0.76). Most symptoms showed changes toward improvement, whereas appetite loss and dyspnoea showed minimal change.
Conclusions:
Rehabilitation nursing interventions were feasible to deliver, and estimates suggested improvement in performance status and selected symptoms. Given the small sample size and single-arm design, findings should be interpreted cautiously and confirmed in controlled studies.