Authors (including presenting author) :
Cheung KY, Tsui AYC
Introduction :
A clinical trial of Pre-Operation Physiotherapy Clinic for prostate cancer patients was established in May 2019 and worked collaboratively with the Department of Surgery, Prince of Wales Hospital to facilitate same day admission and better rehabilitation outcome. The Pre-Operation Physiotherapy Clinic provides a one-off 2-hour service at Physiotherapy Out-Patient Department for pre-operative chest physiotherapy, anti-thrombotic stockings, home-based pre-habilitation program and education. Home-based pre-habilitation program included pelvic floor strengthening exercise while education included mastering physiotherapy chest care technique.
Objectives :
To evaluate the effect of Pre-Operation Physiotherapy Clinic for prostate cancer patients in terms of hospital length of stay (LOS), symptomatic control and patients’ satisfaction
Methodology :
The LOS difference was evaluated by identifying the time difference between the day of admission and day of discharge. The mean LOS with Pre-Operation Physiotherapy Clinic was then compared to the mean LOS of year 2018 without Pre-Operation Physiotherapy Clinic. The International Prostate Symptoms Score (IPSS) Questionnaire was used on the day of Pre-Operation Physiotherapy Clinic service and the day of admission prior to operation to evaluate the effectiveness of pelvic floor muscle strengthening exercise to urinary symptoms control. The compared mean of IPSS was analyzed using paired t-test in SPSS. A subjective questionnaire was used to evaluate the timeliness, patient relevance, duration and overall satisfaction of the Pre-Operation Physiotherapy Clinic.
Result & Outcome :
A total of 59 patients received the Out-Patient Pre-Operation Physiotherapy Clinic, of which 23 patients were successfully recruited for the analysis of IPSS difference. Patients’ average LOS with the Pre-Operation Physiotherapy Clinic was 4.3 days while year 2018 without the Pre-Operation Physiotherapy Clinic was 5.2 days, showing a reduction of average LOS by 17%. A statistically significant difference was observed in the mean IPSS collected in the Pre-Operation Physiotherapy session (14.48 ± 6.95) and on the day of admission prior to operation (12.52 ± 6.71), p=0.004. Meanwhile, the questionnaire on patients’ satisfaction reflected that patients are highly satisfied with Pre-Operation Physiotherapy Clinic with an 90% overall satisfaction.
The clinical trial of Prostate Cancer Pre-Operation Physiotherapy clinic has shown to be a success in facilitating same day admission and decreasing LOS while home-based physiotherapy pre-habilitation program illustrated some benefits in controlling urinary symptoms among prostate cancer patients. This trial might indicate a potential service model of pre-operation physiotherapy for other types of patients in the future.
