Cancer rehabilitation at home: the potential of telehealthcare to support functional recovery of lung cancer survivors

Lung cancer is the most commonly diagnosed malignancy among adults worldwide. Curative lung resection is the preferred treatment for early-stage lung cancer, significantly improving 5-years survival rates in this population. Although being the preferred treatment, patients report persistent disability in daily functioning such as mobility, sleeping, breathing, and quality of life following lung resection. Cancer rehabilitation comprising exercise rehabilitation or physical activity programs have shown to improve treatment- and health-related outcomes in lung cancer survivors undergoing lung resection. Increasing physical activity may especially benefit lung cancer survivors to prevent or break through a vicious circle of deterioration of physical activity levels, functional capacity and symptom burden, which is often observed following diagnosis and treatment of lung cancer . Since its introduction, the accessibility and tailoring of rehabilitation programs for cancer survivors have been discussed. With the coming of internet and mobile technologies it is considered that rehabilitation for cancer survivors can be provided more tailored and timely using this technology, also called telehealthcare. Using the internet, smartphones and sensors, telehealthcare services are accessible on patients’ demand, wherever and whenever they need, providing continuous monitoring of health and behaviors, timely support, and easy access to specialized professionals. Despite the potential of telehealthcare to improve cancer rehabilitation, the use of tailored telehealthcare services in lung cancer survivors to provide personalized rehabilitation at home has been limited. The overall aim of this thesis was to gain knowledge on how to improve the quality and accessibility of home-based cancer rehabilitation that aims to support functional recovery following lung resection using telehealthcare. To do so, this thesis consecutively addressed the design, evaluation and adoption of a telehealthcare service for lung cancer survivors undergoing lung resection