Women’s Experiences After Ovarian Cancer Surgery: Distress, Uncertainty, and the Need for Occupational Therapy

Abstract

Abstract Importance: Despite the growing literature on the association of functional, physical, and quality-of-life (QOL) deficits with poor postoperative outcomes, there is a gap in the literature identifying women’s occupational performance needs after ovarian cancer surgery. Objective: To describe the experiences of women hospitalized after ovarian cancer surgery to identify potential areas for intervention. Goals were to (1) identify functional needs and limitations at time of discharge as measured by the typical acute care occupational therapy evaluation and semistructured interview and (2) understand the women’s perspectives of their needs for occupational therapy and a safe return to home. Design: Single-arm, cross-sectional descriptive study. Mixed-methods data collection and analysis. Setting: Academic cancer center. Participants: Women with ovarian cancer (N = 11) who had completed surgery. Intervention: Semistructured interviews and patient-reported outcome measures (PROMs) completed postsurgery. Outcomes and Measures: PROMs included the National Comprehensive Cancer Network (NCCN) Distress Thermometer and Problem List, the PROMIS® Global Physical Health (GPH) and Global Mental Health (GMH) scales, and the Possibilities for Activity Scale–Women (PActS–W). Results: The mean NCCN Distress score was 6.0 (standard deviation [SD] = 3.1, with the top three concerns being pain (80%), worry (80%), and fatigue (78%). Mean GPH and GMH T scores were 38.0 (SD = 8.8) and 48.2 (SD = 8.4), respectively. Women scored a mean of 39.2 (SD = 11.2, range = 26–58) on the PActS–W. Thematic analyses found that the women were uncertain about potential functional limitations and significantly distressed. Conclusion and Relevance: Women with ovarian cancer experienced high levels of uncertainty and distress after surgery. Integrating in-home or community-based occupational therapy into routine care could decrease functional distress and uncertainty and help women manage concerns related to pain, worry, and fatigue. What This Article Adds: This study suggests that occupational therapy evaluation and intervention are needed to decrease distress and improve QOL of women upon discharge after ovarian cancer surgery.