An exploratory study of the measurement of changes in daily activities in patients undergoing cancer chemotheraphy

The cancer patient today is faced with adaptation to a chronic disease that may be characterized by psychological, physical, and social alterations in daily living. A study was conducted to determine the nature of changes in self-care, household, employment, and leisure activities experienced by a cancer patient undergoing treatment. A convenience sample of 19 subjects receiving chemotherapy for one year or less was obtained from two outpatient oncology clinics. Subjects were selected on the first day of chemotherapy cycle and asked to complete a Likert scale questionnaire developed by the researcher. The questionnaire assessed four areas: past and current activities with regards to self-care, employment, and leisure activities; patients’ perceptions of the nature of their disease; support from family and friends; and physical symptoms. Subjects were interviewed again at the beginning of two subsequent chemotherapy cycles. The data were analyzed for changes in activity levels from normal levels (prior to illness) to the current levels with each of the three subsequent interviews. The level of significance was established at .05. T-tests between normal overall activities and activities occurring at the initial, second, and third interviews showed a significant decrease in activities from normal. Changes in single activities were not widespread. Significant decreases were shown in yard work, holding a full-time job, participation in community activities, and planning leisure activities and vacations with families. Self-care tasks showed no changes and the majority of household activities remained stable in their level of performance. Age and the stage of the cancer were not found to be significant factors in the activity changes that occurred. Breast Cancer patients showed a significantly slower rate of activity change. They were more active at the time of the initial and second interviews but showed no significant differences from the other diagnostic categories by the third interview. Subjects were generally positive about their cancer diagnosis and treatment outcomes with 72 to 79% feeling their cancer was controllable. The majority, 63 to 68% felt the changes in their lives were slight. Family and friends were important sources of support to 100% and 74% of the subjects, respectively. The most common and severe side effects were fatigue and nausea, followed by sleeping difficulties and bowel problems. Pain was the least common side effect with 88 to 100% reporting no pain at all. The overall effects of cancer treatment were generally less than expected. Subjects appeared to have maintained many of their normal activities with some decrease in activities outside the home. They were generally optimistic and found family and friends to be supportive. Knowledge of the changes which occurred might decrease the apprehension of newly diagnosed patients and lessen some of the uncertainty of the diagnosis. This allows health professionals to provide anticipatory guidance, support, and positive intervention to patients and families.