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Open Access Study protocol

Cancer survivor rehabilitation and recovery: Protocol for the Veterans Cancer Rehabilitation Study (Vet-CaRes)

Aanand D Naik12, Lindsey A Martin12*, Michele Karel34, Jennifer Schuster Wachen35, Elizabeth Mulligan34, Jeffrey S Gosian3, Levi Ian Herman12 and Jennifer Moye34

Author Affiliations

1 Houston VA Health Services Research and Development Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, TX, USA

2 Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA

3 VA Boston Healthcare System, Boston, MA, 02130, USA

4 Harvard Medical School, Boston, MA, 02115, USA

5 Boston University School of Medicine, Boston, MA, 02118, USA

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BMC Health Services Research 2013, 13:93  doi:10.1186/1472-6963-13-93

Published: 11 March 2013

Abstract

Background

Cancer survivors are a rapidly growing and aging population in the U.S., but there are many challenges associated with the survivorship experience such as functional disabilities and psychosocial distress. When viewed next to the general population, Veterans are especially at risk for these challenges as they are older and have a high incidence of co-morbid conditions. While the Institute of Medicine (IOM) has called for further cancer survivorship research to address these challenges, we still know little about this experience from the perspective of aging Veterans.

Methods/design

We conducted a longitudinal, mixed-methods study over the course of three and a half years at the Boston and Houston VA Medical Centers. We recruited 170 Veterans diagnosed with head and neck, colorectal and esophageal/gastric cancers that were identified from the VA tumor registry. Veterans completed three in-depth interviews, conducted at 6, 12 and 18 months after pathology confirmation, measuring the physical, social and psychological factors related to cancer survivorship. The longitudinal design allowed us to assess any changes in cancer related disability and distress over time.

Discussion

Weekly teleconference study team meetings were a key aspect to the research process. Issues related to recruitment, data management and analysis, and the dissemination of research results was discussed. Interviewers presented detailed case reports of completed interviews that allowed us to refine our interview protocols. We also discussed issues relevant to the Veteran population of which we were previously unaware and some of the challenges of the research process itself. This novel study produced a robust data set that documents the functional and psychosocial cancer survivorship experiences of aging Veterans. The longitudinal design will help us more fully understand the recovery patterns for this specific population, and identify the unique needs and gaps in health services.

Keywords:
Cancer care; Cancer survivorship; Veterans; Aging; Psychosocial; Functional assessment; Quality of life