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Julie K Silver - One of the best experts on this subject based on the ideXlab platform.
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Integrating Impairment-Driven Cancer Rehabilitation into the Care Continuum
Cancer Rehabilitation, 2020Co-Authors: Julie K SilverAbstract:Cancer is one of the most common, disabling, and costly diagnoses that affects people living in the USA and worldwide. However, even though there is an increase in the overall 5-year survival rate, survival is not necessarily disease free, and often people live with Cancer as a chronic condition. Historically, Cancer Rehabilitation was not well integrated into oncology care. More recently, research has demonstrated that Cancer survivors may have multiple impairments that are not treated. Indeed, while the field of Cancer Rehabilitation has been present for decades, it has grown a lot recently, and there is an urgent need to diagnose and treat the many impairments that Cancer or its treatments may cause.
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training and practice patterns in Cancer Rehabilitation a survey of physiatrists specializing in oncology care
Pm&r, 2020Co-Authors: Raman Sharma, Sarah Wittry, Susan Maltser, Diana Molinaresmejia, Ashish Khanna, Lisa Marie Ruppert, Ryan Murphy, Anne Felicia Ambrose, Julie K SilverAbstract:BACKGROUND: Cancer Rehabilitation is an integral part of the continuum of care for survivors. Due to the increasing number of survivors, physiatrists commonly see Cancer patients in their general practices. Essential to guiding the field is to understand the current training and practice patterns of Cancer Rehabilitation physicians. OBJECTIVES: To assess current trends in training and practice for Cancer Rehabilitation physicians, including the level of burnout among providers in this field. DESIGN: Cross-sectional descriptive survey study. SETTING: Online survey. PARTICIPANTS: American physicians who are affiliated with the Cancer Rehabilitation Physician Consortium (CRPC) of the American Academy of Physical Medicine and Rehabilitation (AAPM&R). The CRPC is a group of Cancer Rehabilitation providers (both fellowship-trained and not fellowship-trained) with the mission of furthering Cancer Rehabilitation medicine through education, research, and networking. METHODS: All CRPC physicians were invited to complete a voluntary and anonymous 43-question online survey. The survey was conceived by a group of eight experts interested in providing additional information to the current literature regarding the training and practice in the Cancer Rehabilitation field. MAIN OUTCOME MEASUREMENTS: Training, practice, opioid prescribing, and professional support. RESULTS: Thirty-seven of 50 physicians participated (response rate = 74%). Respondents were from various states, the three most common being New York (16%, n = 6), Texas (16%, n = 6), and Massachusetts (11%, n = 4). About 57% (n = 21) of the respondents were employed in an academic medical center and 73% (n = 27) reported their primary departmental affiliation was Physical Medicine and Rehabilitation (PM&R). Approximately 78% (n = 29) credited mentorship early in training for their interest in the field. More than half (54%, n = 20) either strongly agreed or agreed that Cancer Rehabilitation fellowship training is necessary for graduating physiatrists who plan to treat oncology patients/survivors. National PM&R meetings were the primary source of continuing education for 86% (n = 31). Sixty-five percent (n = 24), strongly agreed or agreed that Cancer Rehabilitation physiatrists should know how to prescribe opioids, and 35% (n = 13) reported prescribing them when appropriate. About 54% (n = 20) rated their level of burnout as low or very low, and more than half (51%, n = 19) believed their burnout level was lower than physiatrists treating other Rehabilitation populations. CONCLUSIONS: Cancer Rehabilitation is a growing subspecialty in PM&R, and most physiatrists in general practice will treat many survivors-often for neurologic or musculoskeletal impairments related to Cancer or its treatment. Cancer Rehabilitation physicians perceive that they have relatively low levels of burnout, and early mentorship and fellowship training is beneficial. Professional conferences and mentorship are a primary source for continuing education. LEVEL OF EVIDENCE: IV.
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Cancer Rehabilitation as an essential component of quality care and survivorship from an international perspective
Disability and Rehabilitation, 2020Co-Authors: Sean R Smith, Julie K Silver, Jasmine Y Zheng, Andrew J Haig, Andrea ChevilleAbstract:Background: There has recently been an emphasis on improving Cancer care globally, including access to lifesaving treatment and earlier identification of disease. This will lead to more survivors stricken by impairments related to the early and late effects of Cancer treatment. An unintended consequence of the noble plan to improve oncology care worldwide is demand on health care systems that may be unable to accommodate increased patient care needs for myriad reasons. As a result, those with disabilities may suffer.Methods: Literature search and input from experts in the field were used to evaluate the growing need for Cancer Rehabilitation and survivorship care to reduce morbidity associated with Cancer treatment.Results: Many governmental and non-governmental organizations have started initiatives to improve Cancer care across the continuum, and reduce the symptom burden of those living with Cancer. While the start is promising, many barriers must be overcome to ensure high-quality care that would reduce cost and improve patient access, including a lack of trained Rehabilitation specialists, poor coordination of efforts, and funding restrictions. Furthermore, global efforts to improve Rehabilitation care often do not emphasize Cancer Rehabilitation, potentially leaving a gap and increasing physical and economic costs of disability. Finally, low-resource countries face unique challenges in improving Cancer Rehabilitation care.Conclusion: Cancer Rehabilitation and survivorship care are needed to improve health care quality, as there is an expected influx of Cancer patients with new global efforts to improve oncology care. To accomplish this, Rehabilitation initiatives must emphasize Cancer Rehabilitation as a component of any program, and oncology endeavors should include a plan for the Rehabilitation of Cancer survivors to reduce morbidity and health care cost.Implications for RehabilitationCancer Rehabilitation has the potential to reduce morbidity and health care costs associated with Cancer and disability worldwideAdvocacy from international organizations regarding Cancer Rehabilitation is increasing, but has been disjointed and incompleteLow-resource countries in particular face several barriers to providing Cancer Rehabilitation and survivorship care.
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The State of Cancer Rehabilitation in the United States.
Journal of cancer rehabilitation, 2018Co-Authors: Julie K Silver, Nicole L. Stout, Mandi Pratt-chapman, Pamela J. Haylock, Raman SharmaAbstract:The field of Cancer Rehabilitation and pRehabilitation has grown significantly over the past decade. Advancements in early detection and treatment have resulted in a growing number of Cancer survivors in the United States (US), expected to reach 26 million by 2040.1 Health care professional graduate education is trying to catch up with anticipated clinical demand by increasing the number of Cancer Rehabilitation fellowship training programs and introducing Rehabilitation/pRehabilitation concepts earlier in training. Numerous national organizations have issued guidelines for Cancer Rehabilitation research and posttreatment Cancer health care. As treatment modalities evolve, so too must research on side-effects and multisystem management over the continuum of care. Current research strategies address different Cancer types with a broad focus on timing of interventions, cost effectiveness, efficacy of Rehabilitation, and improving screening and assessment tools. A collaborative, interdisciplinary research model is paramount to deepen impact and broaden reach. Policy supports could advance Cancer survivorship and rehabilitative care. Funding to advance evidence-based practices for distress screening, psychosocial support, survivorship care planning, and Rehabilitation services remains critical. Current social policies and health care access protections must be expanded to best serve the growing number of Cancer survivors in the US. Equitable health care access, health care experience and health care outcomes remain a critical area for research and policy supports. The cost of Cancer treatment requires significant reform to ensure access to all. Rehabilitation services are elements of standards of care for many neurological, cardiovascular and orthopedic diagnoses, but currently are not standard for actual or potential dysfunctions among Cancer survivors. Both the disease process and the variety of therapeutic modalities increase risks of dysfunction, impairments, poor survival, and diminished quality of life. Rehabilitation focuses on optimizing quality of life and maximizing function throughout the continuum of Cancer care. Health care professionals are urged to integrate high quality interdisciplinary care to promote collaboration and dissemination of knowledge which will yield better care for Cancer survivors. PRehabilitation has the potential to play key roles in reducing or eliminating many Cancer-related impairments and disabilities.
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Follow the trail: Using insights from the growth of palliative care to propose a roadmap for Cancer Rehabilitation
CA: a cancer journal for clinicians, 2018Co-Authors: Kathleen Doyle Lyons, Mackenzi Pergolotti, Julie K Silver, David S. Zucker, Vishwa S. Raj, Lynne S. Padgett, Timothy F. Marshall, Joseph A. Greer, Alix G. SleightAbstract:Despite research explicating the benefits of Cancer Rehabilitation interventions to optimize physical, social, emotional, and vocational functioning, many reports document low rates of referral to and uptake of Rehabilitation in oncology. Cancer Rehabilitation clinicians, researchers, and policy makers could learn from the multidisciplinary specialty of palliative care, which has benefited from a growth strategy and has garnered national recognition as an important and necessary aspect of oncology care. The purpose of this article is to explore the actions that have increased the uptake and integration of palliative care to yield insights and multimodal strategies for the development and growth of Cancer Rehabilitation. After examining the history of palliative care and its growth, the authors highlight 5 key strategies that may benefit the field of Cancer Rehabilitation: 1) stimulating the science in specific gap areas; 2) creating clinical practice guidelines; 3) building clinical capacity; 4) ascertaining and responding to public opinion; and 5) advocating for public policy change. Coordinated and simultaneous advances on these 5 strategies may catalyze the growth, utilization, and effectiveness of patient screening, timely referrals, and delivery of appropriate Cancer Rehabilitation care that reduces disability and improves quality of life for Cancer survivors who need these services.
Michael D. Stubblefield - One of the best experts on this subject based on the ideXlab platform.
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Evaluation of outpatient Cancer Rehabilitation for upper extremity functioning for individuals with breast Cancer.
Journal of Clinical Oncology, 2020Co-Authors: Mackenzi Pergolotti, Michael D. Stubblefield, Kelley R Covington, Tiffany D KendigAbstract:287Background: Specialized Cancer Rehabilitation is recommended for individuals with breast Cancer from diagnosis throughout survivorship to mitigate the negative acute, late and lasting effects of...
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Toward a National Initiative in Cancer Rehabilitation: Recommendations From a Subject Matter Expert Group
Archives of physical medicine and rehabilitation, 2016Co-Authors: Nicole L. Stout, Andrea Cheville, Julie K Silver, Lynn H Gerber, Vishwa S. Raj, Julia H. Rowland, Kirsten K. Ness, Mary Vining Radomski, Ralph Nitkin, Michael D. StubblefieldAbstract:The health care delivery system in the United States is challenged to meet the needs of a growing population of Cancer survivors. A pressing need is to optimize overall function and reduce disability in these individuals. Functional impairments and disability affect most patients during and after disease treatment. Rehabilitation health care providers can diagnose and treat patients' physical, psychological, and cognitive impairments in an effort to maintain or restore function, reduce symptom burden, maximize independence and improve quality of life in this medically complex population. However, few care delivery models integrate comprehensive Cancer Rehabilitation services into the oncology care continuum. The Rehabilitation Medicine Department of the Clinical Center at the National Institutes of Health with support from the National Cancer Institute and the National Center for Medical Rehabilitation Research convened a subject matter expert group to review current literature and practice patterns, identify opportunities and gaps regarding Cancer Rehabilitation and its support of oncology care, and make recommendations for future efforts that promote quality Cancer Rehabilitation care. The recommendations suggest stronger efforts toward integrating Cancer Rehabilitation care models into oncology care from the point of diagnosis, incorporating evidence-based Rehabilitation clinical assessment tools, and including Rehabilitation professionals in shared decision-making in order to provide comprehensive Cancer care and maximize the functional capabilities of Cancer survivors. These recommendations aim to enable future collaborations among a variety of stakeholders to improve the delivery of high-quality Cancer care.
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Cancer Rehabilitation principles and practice: E-book
2015Co-Authors: Michael D. Stubblefield, Michael W. O’dell.Abstract:Cancer Rehabilitation principles and practice: E-book , Cancer Rehabilitation principles and practice: E-book , کتابخانه دیجیتال جندی شاپور اهواز
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Current perspectives and emerging issues on Cancer Rehabilitation.
Cancer, 2013Co-Authors: Michael D. Stubblefield, Gill Hubbard, Andrea Cheville, Uwe Koch, Kathryn H Schmitz, Susanne Oksbjerg DaltonAbstract:Cancer Rehabilitation is a rapidly emerging and evolving medical field in both Europe and the United States, in large part because of increases in the number of Cancer survivors. Although few argue with the need to restore function and quality of life to patients affected by Cancer and its treatments, differences exist between European countries with regard to the funding, accessibility, and even the definition of Cancer Rehabilitation services. In the United States, there is tremendous variability in the provision of Rehabilitation services resulting from a variety of factors, including a lack of highly trained Cancer Rehabilitation physicians and therapists as well as a lack of comprehensive Cancer Rehabilitation programs, even at the majority of top Cancer centers. Although studies evaluating the effectiveness of Rehabilitation programs in the Cancer setting, particularly exercise, have influenced clinical decision-making in both Europe and the United States for some time, this emerging evidence base also is now starting to influence guideline and policy making. Coordinated research efforts are essential to establish a robust framework to support future investigation and establish shared initiatives. Determining the best way forward for Cancer survivors will require investment in large-scale prospective cohort studies that sufficiently describe their Rehabilitation needs through the continuum of the survivorship experience.
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Current perspectives and emerging issues on Cancer Rehabilitation.
Cancer, 2013Co-Authors: Michael D. Stubblefield, Gill Hubbard, Andrea Cheville, Uwe Koch, Kathryn H Schmitz, Susanne Oksbjerg DaltonAbstract:Cancer Rehabilitation is a rapidly emerging and evolving medical field in both Europe and the United States, in large part because of increases in the number of Cancer survivors. Although few argue with the need to restore function and quality of life to patients affected by Cancer and its treatments, differences exist between European countries with regard to the funding, accessibility, and even the definition of Cancer Rehabilitation services. In the United States, there is tremendous variability in the provision of Rehabilitation services resulting from a variety of factors, including a lack of highly trained Cancer Rehabilitation physicians and therapists as well as a lack of comprehensive Cancer Rehabilitation programs, even at the majority of top Cancer centers. Although studies evaluating the effectiveness of Rehabilitation programs in the Cancer setting, particularly exercise, have influenced clinical decision-making in both Europe and the United States for some time, this emerging evidence base also is now starting to influence guideline and policy making. Coordinated research efforts are essential to establish a robust framework to support future investigation and establish shared initiatives. Determining the best way forward for Cancer survivors will require investment in large-scale prospective cohort studies that sufficiently describe their Rehabilitation needs through the continuum of the survivorship experience. Cancer 2013;119(11 suppl):2170-8. © 2013 American Cancer Society.
Deborah Julie Franklin - One of the best experts on this subject based on the ideXlab platform.
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Cardiopulmonary Rehabilitation and Cancer Rehabilitation. 3. Cancer Rehabilitation.
Archives of Physical Medicine and Rehabilitation, 2006Co-Authors: Michael D. Stubblefield, Christian M. Custodio, Deborah Julie FranklinAbstract:Abstract Stubblefield MD, Custodio CM, Franklin DJ. Cardiopulmonary Rehabilitation and Cancer Rehabilitation. 3. Cancer Rehabilitation. This self-directed learning module highlights the treatment and Rehabilitation of patients with Cancer. It is part of the study guide on cardiac, pulmonary, and Cancer Rehabilitation in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and Rehabilitation. This article reviews medical and Rehabilitation issues in patients with various types of Cancer. Cases were selected to allow discussion of problems seen in both younger and older patient populations. Identification of common sequelae of Cancer and Cancer treatments, associated Rehabilitation challenges, and appropriate interventions are included. Overall Article Objective To summarize the medical and Rehabilitation issues in patients with various types of Cancer.
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Cardiopulmonary Rehabilitation and Cancer Rehabilitation. 3. Cancer Rehabilitation.
Archives of physical medicine and rehabilitation, 2006Co-Authors: Michael D. Stubblefield, Christian M. Custodio, Deborah Julie FranklinAbstract:This self-directed learning module highlights the treatment and Rehabilitation of patients with Cancer. It is part of the study guide on cardiac, pulmonary, and Cancer Rehabilitation in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and Rehabilitation. This article reviews medical and Rehabilitation issues in patients with various types of Cancer. Cases were selected to allow discussion of problems seen in both younger and older patient populations. Identification of common sequelae of Cancer and Cancer treatments, associated Rehabilitation challenges, and appropriate interventions are included. To summarize the medical and Rehabilitation issues in patients with various types of Cancer.
Eduardo Bruera - One of the best experts on this subject based on the ideXlab platform.
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Cancer Rehabilitation Providers and Oncology Patient Expectations for Functional Outcomes after Inpatient Rehabilitation
PM & R : the journal of injury function and rehabilitation, 2020Co-Authors: Ekta Gupta, Swati Bansal, Minjeong Park, Rajesh R Yadav, An Ngo-huang, Eduardo BrueraAbstract:Cancer Rehabilitation is a valued resource for patients and oncologists. Cancer Rehabilitation providers are seeing increasing numbers of referrals for inpatient Rehabilitation as the number of Cancer survivors grows. However, Cancer Rehabilitation providers, oncologists, therapists, patients, and caregivers may not always clearly communicate the goals of care, which can lead to different expectations for inpatient Rehabilitation. To determine the difference in expectations of function after an acute inpatient Rehabilitation stay between Cancer patients and Cancer Rehabilitation providers and how they align with achieved goals after treatment. Prospective survey study. Quaternary academic medical center inpatient Rehabilitation unit. Out of 194 eligible patients, 132 were enrolled and completed admission surveys, and 110 completed the discharge survey. Twelve Cancer Rehabilitation providers completed the surveys. Not applicable. Barthel Index. Patients estimated their expected functional status as a median (interquartile range) score of 19 points (18, 20) using the Barthel Index, compared to Cancer Rehabilitation providers, who estimated a median score of 17 points (15, 19) (P < .001). Actual functional status upon discharge was a median score of 16 points (13, 18) using the Barthel Index, which was three points lower than expected by patients (P < .001). Oncology patients and Cancer Rehabilitation providers significantly overestimate functional goals for acute inpatient Rehabilitation. This overestimation was clinically significant for oncology patients and statistically but not clinically significant for Cancer Rehabilitation providers. Increased communication may allow for a more realistic expectation of functional status upon discharge. © 2020 American Academy of Physical Medicine and Rehabilitation.
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A Survey Regarding the Knowledge, Attitudes, and Beliefs of Graduates of Cancer Rehabilitation Fellowship Program.
Journal of cancer education : the official journal of the American Association for Cancer Education, 2018Co-Authors: Rajesh R Yadav, Christian M. Custodio, An Ngo-huang, Eduardo BrueraAbstract:Currently there are limited options for physiatrists to further subspecialize in Cancer Rehabilitation. Since 2007, few Cancer Rehabilitation fellowship programs have been started. There is currently absolutely no information about such training programs and their graduates. This study is the first to survey a small number of graduates from two Cancer Rehabilitation fellowship programs. The purpose of this study was to report characteristics, attitudes, and beliefs of Cancer Rehabilitation fellowship graduates. Graduates of Cancer Rehabilitation fellowship programs from 2008 through 2015 responded to a 26-question survey. Information collected included exposure to Cancer Rehabilitation prior to fellowship training, usefulness of fellowship training program, information about current practice, and suggested areas of improvement. The setting of the study is online survey. Participants were graduates of two Cancer Rehabilitation fellowship programs from 2008 through 2015. Participants were contacted via email about completion of an online survey and information was collected anonymously. Primary outcome measure was satisfaction of respondents with their fellowship training program in meeting the Rehabilitation needs of their Cancer patients. Sixteen responses, with a response rate of 89%, were recorded. Sixty-three percent of the respondents had exposure to Cancer Rehabilitation prior to post-graduate year 3 (PGY-3). Majority of graduates had practice involving at least 50% of care to Cancer patients. Fifty percent indicated that their position was specifically created after their job interview. Career development was one of the major areas of suggested improvement in training. Graduates of Cancer Rehabilitation fellowship programs strongly value their training. Majority of the graduates were able to continue their career into jobs that were primarily Cancer Rehabilitation related. Further work needs to be done to define this subspecialty further and incorporate building practice as part of this training.
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Characteristics of Cancer Rehabilitation Fellowship Training Programs in the USA.
Journal of cancer education : the official journal of the American Association for Cancer Education, 2018Co-Authors: Rajesh R Yadav, Christian M. Custodio, An Ngo-huang, Eric Wisotzky, Raj Mitra, Eduardo BrueraAbstract:Cancer Rehabilitation is emerging as a specialized field within Physical Medicine and Rehabilitation. The purpose of this systemic review is to summarize the various Cancer Rehabilitation fellowship programs in the USA and the scope of training in this discipline. Currently, four institutions offer such a training program. All of the fellowship directors were contacted about characteristics of their programs. The oldest program has been in existence since 2007. All of these programs are 1 year in duration and have between one and two fellowship positions annually. There have been total of 29 graduates as of July 2017. With regard to Cancer Rehabilitation care delivery model, all four centers reported inpatient consult teams and outpatient Rehabilitation. Outpatient experience included electrodiagnosis, botulin toxin, and ultrasound-guided injections. Three of the four programs also reported the presence of an acute inpatient Cancer Rehabilitation service. A number of clinical rotations are available at each of the four programs with considerable variation. Comprehensive educational efforts are present in all programs with varying expectations for research.
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Patient-Reported Usefulness of Acute Cancer Rehabilitation
PM & R : the journal of injury function and rehabilitation, 2017Co-Authors: Ekta Gupta, Rhodora C. Fontillas, Swati Bansal, Janet L. Williams, Minjeong Park, Diane Liu, Rajesh R Yadav, Eduardo BrueraAbstract:Abstract Background Cancer survivors often have unmet needs, and Cancer Rehabilitation is becoming an integral part of the continuum of care. Understanding the needs and satisfaction of patients undergoing Cancer Rehabilitation is important for the development of effective programs. Objective To determine the overall perception of acute inpatient Cancer Rehabilitation usefulness. Design Prospective study. Setting Acute inpatient Cancer Rehabilitation unit at a National Cancer Institute (NCI) Comprehensive Cancer Center. Participants Patients admitted to the acute inpatient Cancer Rehabilitation unit from September 2014 to July 2015 were approached, and 200 patients enrolled with completed surveys. Methods Patients meeting study criteria were asked to complete a survey about their perception of the Rehabilitation received; their attitudes and beliefs on their condition, treatment, functional independence; and their attitudes and beliefs on obtaining health information and psychosocial issues. Main Outcome Measures Functional Independence Measure (FIM) scores, FIM efficiency, and results from an anonymous survey with a 22-item Likert-type scale at the end of patients' Rehabilitation stay were analyzed. Results Of 327 patients admitted, 239 patients (73%) were approached, and 200 patients (84%) were enrolled with completed surveys. Patients agreed or strongly agreed that Rehabilitation helped with improving physical function (n = 193, 97%), regaining physical independence (n = 181, 91%), and preparing to deal with self-care tasks (n = 183, 94%). Patients agreed that Rehabilitation improved hope (n = 187, 94%), mood (n = 176, 84%), anxiety (n = 180, 90%), and spirituality (n = 182, 94%). FIM score improvements (from admission to discharge) and FIM efficiency (change in FIM score / length of stay) were significant in all functional domains. Overall, respondents believed that their Rehabilitation stay was extremely good (n = 128, 64%) or very good (n = 60, 30%). Conclusions Patients perceived their Rehabilitation stay as beneficial in multiple respects. Significant improvements in FIM measurements were also found. Level of Evidence IV
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Symptom burden and functional gains in a Cancer Rehabilitation unit
International journal of therapy and rehabilitation, 2015Co-Authors: Jay Lee, Kenny Bao Tran, Christian Siangco, Dennis W. Smith, Eduardo BrueraAbstract:Aim: To determine whether symptom burden at the time of admission to inpatient Rehabilitation is predictive of functional improvement in Cancer Rehabilitation inpatients. Methods: Retrospective review of medical records at a tertiary referral-based Cancer centre of all patients admitted to an inpatient Rehabilitation unit between 1 March 2013 and 20 May 2013. The medical records for 71 unique Cancer Rehabilitation inpatients were analysed. Outcome measures included the Edmonton Symptom Assessment System and Functional Independence Measure. Results: Statistical analysis of total admission Edmonton Symptom Assessment System scores and total change in Functional Independence Measure scores found no significant relationships. The symptom burden of patients was mild. Patients demonstrated statistically significant improvements in symptoms and function during inpatient Rehabilitation. The mean change in total Edmonton Symptom Assessment System and total Functional Independence Measure scores was a decrease of 7...
Christian M. Custodio - One of the best experts on this subject based on the ideXlab platform.
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A Survey Regarding the Knowledge, Attitudes, and Beliefs of Graduates of Cancer Rehabilitation Fellowship Program.
Journal of cancer education : the official journal of the American Association for Cancer Education, 2018Co-Authors: Rajesh R Yadav, Christian M. Custodio, An Ngo-huang, Eduardo BrueraAbstract:Currently there are limited options for physiatrists to further subspecialize in Cancer Rehabilitation. Since 2007, few Cancer Rehabilitation fellowship programs have been started. There is currently absolutely no information about such training programs and their graduates. This study is the first to survey a small number of graduates from two Cancer Rehabilitation fellowship programs. The purpose of this study was to report characteristics, attitudes, and beliefs of Cancer Rehabilitation fellowship graduates. Graduates of Cancer Rehabilitation fellowship programs from 2008 through 2015 responded to a 26-question survey. Information collected included exposure to Cancer Rehabilitation prior to fellowship training, usefulness of fellowship training program, information about current practice, and suggested areas of improvement. The setting of the study is online survey. Participants were graduates of two Cancer Rehabilitation fellowship programs from 2008 through 2015. Participants were contacted via email about completion of an online survey and information was collected anonymously. Primary outcome measure was satisfaction of respondents with their fellowship training program in meeting the Rehabilitation needs of their Cancer patients. Sixteen responses, with a response rate of 89%, were recorded. Sixty-three percent of the respondents had exposure to Cancer Rehabilitation prior to post-graduate year 3 (PGY-3). Majority of graduates had practice involving at least 50% of care to Cancer patients. Fifty percent indicated that their position was specifically created after their job interview. Career development was one of the major areas of suggested improvement in training. Graduates of Cancer Rehabilitation fellowship programs strongly value their training. Majority of the graduates were able to continue their career into jobs that were primarily Cancer Rehabilitation related. Further work needs to be done to define this subspecialty further and incorporate building practice as part of this training.
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Characteristics of Cancer Rehabilitation Fellowship Training Programs in the USA.
Journal of cancer education : the official journal of the American Association for Cancer Education, 2018Co-Authors: Rajesh R Yadav, Christian M. Custodio, An Ngo-huang, Eric Wisotzky, Raj Mitra, Eduardo BrueraAbstract:Cancer Rehabilitation is emerging as a specialized field within Physical Medicine and Rehabilitation. The purpose of this systemic review is to summarize the various Cancer Rehabilitation fellowship programs in the USA and the scope of training in this discipline. Currently, four institutions offer such a training program. All of the fellowship directors were contacted about characteristics of their programs. The oldest program has been in existence since 2007. All of these programs are 1 year in duration and have between one and two fellowship positions annually. There have been total of 29 graduates as of July 2017. With regard to Cancer Rehabilitation care delivery model, all four centers reported inpatient consult teams and outpatient Rehabilitation. Outpatient experience included electrodiagnosis, botulin toxin, and ultrasound-guided injections. Three of the four programs also reported the presence of an acute inpatient Cancer Rehabilitation service. A number of clinical rotations are available at each of the four programs with considerable variation. Comprehensive educational efforts are present in all programs with varying expectations for research.
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Cardiopulmonary Rehabilitation and Cancer Rehabilitation. 3. Cancer Rehabilitation.
Archives of Physical Medicine and Rehabilitation, 2006Co-Authors: Michael D. Stubblefield, Christian M. Custodio, Deborah Julie FranklinAbstract:Abstract Stubblefield MD, Custodio CM, Franklin DJ. Cardiopulmonary Rehabilitation and Cancer Rehabilitation. 3. Cancer Rehabilitation. This self-directed learning module highlights the treatment and Rehabilitation of patients with Cancer. It is part of the study guide on cardiac, pulmonary, and Cancer Rehabilitation in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and Rehabilitation. This article reviews medical and Rehabilitation issues in patients with various types of Cancer. Cases were selected to allow discussion of problems seen in both younger and older patient populations. Identification of common sequelae of Cancer and Cancer treatments, associated Rehabilitation challenges, and appropriate interventions are included. Overall Article Objective To summarize the medical and Rehabilitation issues in patients with various types of Cancer.
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Cardiopulmonary Rehabilitation and Cancer Rehabilitation. 3. Cancer Rehabilitation.
Archives of physical medicine and rehabilitation, 2006Co-Authors: Michael D. Stubblefield, Christian M. Custodio, Deborah Julie FranklinAbstract:This self-directed learning module highlights the treatment and Rehabilitation of patients with Cancer. It is part of the study guide on cardiac, pulmonary, and Cancer Rehabilitation in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and Rehabilitation. This article reviews medical and Rehabilitation issues in patients with various types of Cancer. Cases were selected to allow discussion of problems seen in both younger and older patient populations. Identification of common sequelae of Cancer and Cancer treatments, associated Rehabilitation challenges, and appropriate interventions are included. To summarize the medical and Rehabilitation issues in patients with various types of Cancer.
