Colorectal cancer (CRC) and its side effects of treatment tend to affect the survivors’ quality of life (QoL), level of emotional distress, and activities of daily living (ADL). Healthy lifestyle is believed to promote better QoL, sense of well-being, and ADL function for cancer survivors. The purpose of the study was to examine the effect of healthy lifestyle education in improving the QoL, degree of emotional distress, and ADL for CRC survivors, and was also to explore the association between the improvements in the QoL, emotional distress, ADL, and the healthy lifestyle factors of the education.
The participants during hospitalization were designed as a two-group controlled trial, and a single-blind randomized controlled trial was conducted. Before discharge, the participants were randomly assigned to one of two groups, namely an Occupational therapy (OT) intervention and non-intervention group. The process of random assignment adopts blocked randomization. Those participants in the OT intervention group were given a consultation based on a CRC education handbook by an occupational therapist before discharge (about 30 minutes) and after each follow-up visit to the clinic (about 15-20 minutes); the non-intervention group participants were given a CRC education handbook (the same handbook) only before discharge. A total of three assessments, namely baseline assessment, 1 month and 3 months follow-up assessments were applied, thereby comprising a tracking duration of 3 months. Four questionnaires including basic information, the World Health Organization QoL-BREF (WHOOQOL-BREF), and the Brief Symptom Rating Scale (BSRS-5) and the Barthal index (BI) were measured.
A total of 68 participants (61.79 ± 11.04 years old; 32 males) enrolled in the study. 34 participants enrolled as an experimental group and 34 participants as a control group.The findings revealed that lower family income status was the most important predictive factor reducing QoL scores in all WHOQOL-BREF domains. The OT intervention related to three items in the WHOQOL-BREF (p < .05 ~ .01), including item 1 (How would you rate your quality of life?), item 10 (Do you have enough energy for everyday life?) and item 26 (How often do you have negative feelings such as blue mood, despair, anxiety, depression?). This means that comparing with the non-intervention group, participants who received OT intervention could have better QoL, energy for everyday life, and less negative feelings exhibited.
Our findings showed that occupational therapist working with CRC survivors could help these survivors to have better QoL. It may be beneficial for CRC survivors to receive occupational therapist’s consultations based on healthy lifestyle for discharge preparation and in the last few months after discharge.