The use and timing of rehabilitation and palliative care to cancer patients, and the influence of social vulnerability - a population-based study.

OBJECTIVES: To identify and investigate different cohorts of cancer patients' use of physical rehabilitation and specialised palliative care (SPC) services, focusing on patients with incurable cancer and the impact of social vulnerability. METHODS: The sample originated from patients diagnosed during 2013-2018 and alive 1 January 2015. Use of physical rehabilitation and/or SPC units were identified from contacts registered in population-based administrative databases. Competing-risks regression models were applied to investigate disparities with regard to social vulnerability, disease duration, gender and age. RESULTS: A total of 101 268 patients with cancer were included and 60 125 survived longer than 3 years after their diagnosis. Among the 41 143 patients, who died from cancer, 66%, survived less than 1 year, 23% survived from 1 to 2 years and 11% survived from 2 to 3 years. Contacts regarding physical rehabilitation services appeared in the entire cancer trajectory, whereas contacts regarding SPC showed a steep increase as time drew closer to death. The largest disparity was related to disease duration. Socially vulnerable patients had less contact with SPC, while a larger proportion of the socially vulnerable cancer survivors used rehabilitation, compared with the non-vulnerable patients. CONCLUSIONS: This study provides a previously unseen detailed overview of the use of physical rehabilitation and/or SPC among patients with incurable cancer. The services appeared to overlap at a group level in the cancer trajectory, emphasising the importance of awareness with regard to coordination and combination of the services. Disparities between socially vulnerable or non-vulnerable patients were identified.

International consensus on occupational therapy interventions for people with palliative care needs: A European Association for Palliative Care Group Concept Mapping study.

BACKGROUND: While evidence shows that occupational therapists can play a key role in the care of people with palliative care needs, more knowledge about effective occupational therapy interventions for this group is needed. AIM: To identify, organise and prioritise intervention components considered to be effective within occupational therapy for people with palliative care needs from the perspective of occupational therapy clinicians, managers and researchers. DESIGN: Group Concept Mapping utilising a mixed methods participatory approach. Using a focus prompt, participants brainstormed, sorted, labelled and rated generated statements about effective occupational therapy intervention components. Multidimensional scaling analysis and cluster analysis were conducted. SETTING/PARTICIPANTS: Snowball recruitment was used to recruit participants. Participants included occupational therapists worldwide who were able to read and write in English and were working as clinicians, managers and/or researchers with occupational therapy interventions for people with palliative care needs. RESULTS: Seventy-two occupational therapists from 15 countries participated in the study representing Asia (n = 3, 20%), Europe (n = 8, 53%), Oceania (n = 2, 13%) and North America (n = 2, 13%). A total of 117 statements were identified and organised into five clusters: (1) being client-centred, (2) promoting occupational engagement to optimise quality of life, (3) involving the social and relational environment, (4) enabling occupations and (5) facilitating occupational adaptation. CONCLUSIONS: Five clusters of core occupational therapy intervention components were considered to be effective when supporting people with palliative care needs. Research should use this knowledge to inform future occupational therapy interventions for this group of people.

The 'Young Adult Taking Action' programme for young adult cancer survivors: A study protocol for a feasibility study.

BACKGROUND: Young adult cancer survivors (YACS) aged 18-39 report age-specific multifactorial challenges with self-care, leisure, work and education requiring multicomponent rehabilitation intervention. Therefore, the 'Young Adult Taking Action' (YATAC) programme was developed. AIMS/OBJECTIVES: To present a protocol for a feasibility study evaluating the acceptability of the YATAC programme and exploring implementation, mechanisms of impact and outcomes. MATERIAL AND METHODS: A mixed-method feasibility study with a convergent research design will be conducted. The programme is an age-specific, multicomponent, goal-oriented, and peer-based rehabilitation programme delivered by an interdisciplinary staff consisting of nine components: 1) Goal setting, 2) Everyday life, 3) Physical activity, 4) Psychological issues, 5) Work and study, 6) Sexuality and relationship, 7) Rights and finance, 8) Peer-to-peer support and 9) Individual consultation. Quantitative and qualitative data about acceptability, implementation, mechanisms of impact and outcomes will be collected. RESULTS: The results will provide essential knowledge about the programme's acceptability, implementation, mechanisms of impact and outcomes. CONCLUSION AND SIGNIFICANCE: The study will inform adjustment of the programme and will provide knowledge of whether and how to deliver age-specific rehabilitation to YACS.

Social vulnerability among cancer patients and changes in vulnerability during their trajectories - A longitudinal population-based study.

BACKGROUND: Identification of socially vulnerable cancer patients in the health care system is difficult. Only little is known concerning changes in the patients' social circumstances during the trajectory. Such knowledge is valuable regarding the identification of socially vulnerable patients in the health care system. The objective of this study was to use administrative data to identify population-based characteristics of socially vulnerable cancer patients and investigate how social vulnerability changed during the cancer trajectory. METHODOLOGY: A registry-based social vulnerability index (rSVI) was applied to each cancer patient prior to their diagnosis, and used to assess changes in social vulnerability after the diagnosis. RESULTS: A total of 32,497 cancer patients were included. Short-term survivors (n = 13,994) died from cancer from one to three years after the diagnosis, and long-term survivors (n = 18,555) survived at least three years after the diagnosis. 2452 (18 %) short-term survivors and 2563 (14 %) long-term survivors were categorized as socially vulnerable at diagnosis, of these 22 % and 33 % changed category to not socially vulnerable during the first two years after the diagnosis, respectively. For patients changing status of social vulnerability, several social and health-related indicators changed, which is in line with the complexity of the multifactorial social vulnerability. Less than 6 % of the patients categorized as not vulnerable at diagnosis, changed to become vulnerable during the following two years. CONCLUSION: During the cancer trajectory, social vulnerability may change in both directions. Surprisingly, more patients, who were categorized as socially vulnerable when their cancer was diagnosed, changed status to not socially vulnerable during follow-up. Future research should attempt to increase knowledge on identifying cancer patients, who experience deterioration after the diagnosis.

Clinical utility of the Danish version of the Self-Assessment of Modes Questionnaire (D-SAMQ).

BACKGROUND: The the Self-Assessment of Modes Questionnaire (SAMQ) has been translated into Danish and culturally adapted (D-SAMQ), and aspects of validity and reliability have also been evaluated. However, no knowledge about the clinical utility of the D-SAMQ exists. AIMS/OBJECTIVES: The aims were to investigate the clinical utility of the D-SAMQ among Danish occupational therapists (OTs) and occupational therapy students (OTSs), and to determine differences in perceived clinical utility between the two groups. MATERIAL AND METHODS: Data was collected using an online survey consisting of 17 questions related to four dimensions of clinical utility; appropriateness, accessibility, practicability, and acceptability. RESULTS: A total of 25 OTs and 41 OTSs participated. The clinical utility was perceived to be high across all questions related to the four dimensions. No statistically significant differences were found between OTs and OTSs in any of the four dimensions. CONCLUSIONS AND SIGNIFICANCE: The D-SAMQ is ready for use in occupational therapy practice, education, and research. D-SAMQ can be used to gain insight into own therapeutic style. This insight serves as a basis for facilitating therapeutic relationships with the clients during the process of enabling engagement in occupation.

Rehabilitation interventions for young adult cancer survivors: A scoping review.

OBJECTIVE: To map existing research concerning rehabilitation interventions for young adult cancer survivors (YACS) that address at least one factor from the biopsychosocial health model. DESIGN: Scoping review. DATA SOURCES: Searches were performed in EMBASE, MEDLINE, PsycINFO, CINAHL and Cochrane in January 2022 and updated in March 2023, and grey literature between February and April 2022. METHODS: The review followed Joanna Briggs Institute's methodology for scoping reviews. Quantitative, qualitative and mixed methods studies evaluating interventions for YACS of any cancer who had completed primary treatment and were between 18 and 39 years old at diagnosis were included. Two authors independently screened studies for eligibility, and standardised forms were used for data extraction. Descriptive statistics, narrative summaries and thematic analysis were used to analyse the data. RESULTS: The search revealed 5706 records, of which 70 were full-text screened. The 20 included studies represented a heterogeneous group of 444 young adults with different cancer types, mean age above 25, and an overrepresentation of females. Most studies were feasibility and pilot studies. The 20 studies consisted of 14 unique interventions focusing primarily on one dimension of the biopsychosocial health model like biological or psychological factors. In the 14 interventions, the most frequent intervention element was peer-to-peer support (n = 12). The interventions were often delivered online (n = 9), lasting 3-12 months (n = 8). A wide variety of theories, providers and outcome measures were used. CONCLUSION: The results show that current research on multicomponent, biopsychosocial and age-specific rehabilitation for YACS remains at an early stage.

Reliability and validity of the Danish version of the Self-Assessment of Modes Questionnaire.

BACKGROUND: The Self-Assessment of Modes Questionnaire (SAMQ) is developed to help therapists identify their preferred use of modes when interacting with clients in clinical practice. A Danish translation of the SAMQ has been developed (D-SAMQ). To provide a robust instrument for occupational therapy practice and research, evaluation of the psychometric properties of the D-SAMQ is needed. OBJECTIVES: The study aims to evaluate test-retest reliability, measurement error and content validity in terms of cultural relevance of the D-SAMQ. MATERIAL AND METHODS: Danish occupational therapists were recruited to represent diverse clinical settings and to work with various age groups. The D-SAMQ consists of 20 clinical cases. A repeated measures design was employed with evaluation of content validity at the second timepoint. The Content Validity Index and Kappa statistics were employed. RESULTS: In most cases (n = 12, 60%) agreement (test-retest reliability and measurement error) was moderate or strong. Also, there was a moderate (n = 6 cases, 30%), strong (n = 4 cases, 20%) or almost perfect agreement (n = 10 cases, 50%) on the cultural relevance of the cases. CONCLUSIONS: Acceptable test-retest reliability, measurement error and content validity were found. The SAMQ may support occupational therapists to adapt their therapeutic style to meet the needs of the clients.

Danish translation, adaptation and initial validation of the clinical assessment of modes questionnaires.

BACKGROUND: The Clinical Assessment of Modes questionnaires (CAMQs) determine clients' preferential modes for therapy (CAM-C1), clients' perception of modes used by the occupational therapist (OTs) during therapy (CAM-C2), or modes the OTs believed to have used (CAM-T). Access to valid CAMQs for Danish OTs and clients required a rigorous translation and cultural adaptation process. OBJECTIVES: To translate and culturally adapt the CAMQs into Danish, examining face validity in a Danish context. MATERIAL AND METHODS: A 10-step guideline for the process of translating and culturally adapting questionnaires was followed. Steps 1-6 included translation into Danish, steps 7-8 involved cognitive debriefing interviews and validation based on the Content Validity Index (CVI) analyzed using Kappa statistics. Steps 9-10 finalized the process. RESULTS: CAMQs were translated into Danish. Based on cognitive debriefing interviews and CVIs involving 15 clients and 7 OTs, modifications regarding titles, layouts, instructions, wording and response categories were performed in all Danish CAMQs. The Item CVI and the modified kappa revealed that most participants had a high level of agreement on the cultural relevance. CONCLUSIONS AND SIGNIFICANCE: Translated versions of the CAMQs have been culturally adapted into Danish. The current Danish versions seem culturally relevant and useable in Danish occupational therapy.

Users' perspective on rehabilitation interventions for young adult cancer survivors: A group concept mapping study.

OBJECTIVE: We aim to identify and prioritise rehabilitation interventions to strengthen participation in everyday life for young adult cancer survivors (YACS) between 18 and 39 years, involving the perspectives of YACS and relevant stakeholders. METHODS: A group concept mapping study was conducted in Denmark from 2019 to 2020. Online, participants generated and sorted ideas followed by rating their importance. Multidimensional scaling followed by hierarchical cluster analyses were applied to generate a cluster rating map of the prioritised interventions, which participants validated at a face-to-face meeting. Finally, a concluding conceptual model of prioritised rehabilitation intervention for YACS was developed. RESULTS: The study involved 25 YACS, three family members and 31 professionals working with YACS. The conceptual model included 149 ideas classified into eight intervention components created by the participants: (1) Treatment and possibilities within the social and healthcare system, (2) Rights and Finance, (3) Education and Work, (4) Psychological problems, (5) Body and Everyday Life, (6) Peer-to-peer, (7) Sexuality and Relationships and (8) Family and Friends. All components were rated equally important, whereby 17 ideas across the eight components were rated very important. CONCLUSION: This study indicates that rehabilitation of YACS should be composed of eight equally important intervention components requiring an interdisciplinary approach.

Cancer rehabilitation and palliative care for socially vulnerable patients in Denmark: an exploration of practices and conceptualisations.

Background: Despite a tax-funded, needs-based organisation of the Danish health system, social inequality in cancer rehabilitation and palliative care (PC) has been noted repeatedly. Little is known about how best to improve access and participation in cancer rehabilitation and PC for socio-economically disadvantaged and socially vulnerable patients. Aim: To gather, synthesise and describe practice-orientated development studies presented in Danish-language publications and examine the underpinning conceptualisations of social inequality and vulnerability; explore related views of stakeholders working in the field. Methods: The study comprised a narrative review of Danish-language literature on practice-orientated development studies which address social inequality and vulnerability in cancer rehabilitation and PC and an online stakeholder consultation workshop with Danish professionals and academics working in the field. Results: Two themes characterise the included publications (n = 8): types of interventions; conceptualisations of social inequality and vulnerability; three themes were identified in the workshop data: focus and type of interventions; organisation of cancer care; and vulnerability of the healthcare system. The publications and the workshop participants (n = 12) favoured approaches which provide additional individualised resources throughout the cancer trajectory for this patient group. The terms social inequality and social vulnerability are largely used interchangeably, and associated with low income and no or little education yet qualified with multiple descriptors, which reflect the diverse socio-economic situations professionals encounter in cancer patients and their psychosocial needs. Conclusion: Addressing social inequality and vulnerability in cancer rehabilitation and PC in Denmark entails practical and conceptual challenges. Of importance is individualised support and the integration of rehabilitation and PC into standardised care pathways. To conceive of social vulnerability as a layered, dynamic, relational and contextual concept reflects current practice in identifying the diversity of cancer patients who may benefit from additional support in accessing and participating in rehabilitation and PC.

Differences in functioning between young adults with cancer and older age groups: A cross-sectional study.

OBJECTIVE: This study aimed to explore whether young adults with cancer have different functioning compared to older age groups with cancer. METHODS: This study is a cross-sectional study including 654 adults (≥18 years) with cancer. Exposure was age groups categorised as (1) young adults (n = 121) = 18-39 years; (2) middle-aged adults (n = 406) = 40-64 years; and (3) older people (n = 127) = ≥65 years. Outcomes were physical, role, social and cognitive functioning. Analyses consisted of linear regression models. RESULTS: Middle-aged adults had a statistically significant worse physical functioning compared to young adults (-3.90: [95% CI: -6.84; -0.95]). The older age group also had a statistically significant worse physical functioning compared to young adults (-7.63: [95% CI: -11.29; -3.96]). Young adults had statistically significant lower role functioning (-7.11: [95% CI: -1.13; -13.08]) and cognitive functioning (-13.82: [95% CI: -7.35; -20.29]) compared to the older age group. There was no statistically significant difference in social functioning between the age groups. CONCLUSION: Young adults with cancer seem to have other functioning problems compared with higher age groups. These findings support current research regarding the need to develop age-specific and appropriate rehabilitation services for young adults with cancer.

A resource-oriented intervention addressing balance in everyday activities and quality of life in people with advanced cancer: protocol for a feasibility study.

BACKGROUND: People with advanced cancer need to balance their resources and energy in order to experience enjoyment and quality of life in the time they have left. A resource-oriented intervention is developed targeting these aspects. The present protocol presents a feasibility study of this resource-oriented intervention in people with advanced cancer. METHODS: A feasibility study with a repeated-measurement design without a control group will be conducted at the research clinic of REHPA, the Danish Knowledge Center for Rehabilitation and Palliative Care. Data will be gathered at baseline, during and after a 5-day residential stay, after 6 weeks, during a 2-day follow-up stay and after 12 weeks. In total, 20-25 home-living adults (≥ 18 years) with advanced cancer reporting needs in everyday life will be recruited. The intervention consists of workshops and engagement in physical and creative everyday activities provided by a multidisciplinary team. Outcome measures are quality of life, physical function and fatigue, which will be assessed using the European Organisation for Research and Treatment of Cancer Quality-of-Life Questionnaire Core-30. Balance in everyday activities will be assessed using the Occupational Balance Questionnaire. Feasibility data will also be collected regarding (1) fidelity, (2) adherence, (3) dose and (4) reach and mechanisms of impact. For exploration of mechanism of impact, participant observations and focus group interviews will be used. DISCUSSION: This study presents a new approach in rehabilitation and palliative care aimed at supporting people with advanced cancer; instead of identification of problems, the present resource-oriented palliative rehabilitation intervention will target people's resources, enhancing balance in everyday activities and underpinning enjoyment and quality of life. The results from the feasibility study can inform ways in which to support the everyday life of people with advanced cancer and thus have potential to improve their quality of life. The long-term perspectives are to evaluate the intervention in terms of effect, process and cost-effectiveness. This will provide evidence to adjust the content of rehabilitation and palliative care for this group of people. TRIAL REGISTRATION: NCT04772690 Name of the registry: Balance, Activity and Quality of Life (BAL) Date of registry: February 26, 2021.

Identification of socially vulnerable cancer patients - development of a register-based index (rSVI).

BACKGROUND: Social vulnerability is a complex construct which is beyond relying on single measures. If socially vulnerable patients should be identified, we need a composite measure capturing the patient's overall circumstances. This study presents the development of a social vulnerability index (rSVI) for cancer patients based on administrative data from population-based registers. METHODS: All patients, who died from cancer within 5 years after the cancer diagnosis during 2013-2018 (n = 44,187), were identified and divided in four subcohorts according to survival; index cohort surviving 3-5 years (n = 3044 surviving 3-5 years), cohort 1 (n = 27,170 surviving < 1 year), cohort 2 (n = 9450 surviving 1-2 years), and cohort 3 (n = 4523 surviving 2-3 years). Variables from ten registries on health and social issues were linked to each individual patient. Variables of interest were weighted to construct the rSVI using the index-cohort. rSVI was subsequently tested on the three other cohorts for validation. RESULTS: The rSVI included weighted values for marital status, ethnicity, education, income, unemployment, psychiatric comorbidity, and somatic comorbidity. The validity of the rSVI was supported by the expected trend in proportions of vulnerable patients when applied on the other cohorts. Single social measures appeared insufficient in identification of vulnerable patients when compared with the rSVI. CONCLUSION: The rSVI provides a tool for identification of socially vulnerable cancer patients using administrative data. The index requires further validation in other patient groups and is tested against other measures of vulnerability. Future perspectives are to use the rSVI as predictor of advanced cancer patients' use of healthcare services.

Assistive devices among people living at home with advanced cancer: Use, non-use and who have unmet needs for assistive devices?

OBJECTIVE: To investigate which assistive devices people with advanced cancer have and whether they are in use. In addition, to explore the characteristics of people with advanced cancer who have unmet needs for assistive devices. METHODS: This descriptive cross-sectional study used data from a randomised controlled trial evaluating efficacy of an occupational therapy-based intervention. Participants were 237 people with advanced cancer. Data were collected by means of instruments about demography, functioning and assistive devices. RESULTS: The most frequent assistive devices possessed by the participants were as follows: (1) small aids for dressing (47%), (2) Pillow for positioning (40%) and (3) electrically operated adjustable bed (39%). The prevalence of assistive devices was 92% (95% confidence interval [CI]: 88%-95%) with 14.2% non-use, largest for trolley tables (50%). In all, 27.4% of the participants were found to have unmet needs for assistive devices. These participants had similar characteristics to the other participants except from lower activity of daily living (ADL) ability (p values = <0.001). CONCLUSION: The assistive devices possessed by the participants were primarily for positioning and resting, and most were in use. More than a fourth of the participants had unmet needs for assistive devices and were characterised by lower ADL ability.

Process evaluation of the Cancer Home-Life Intervention: What can we learn from it for future intervention studies?

BACKGROUND: The Cancer Home-Life Intervention showed no significant effects, and examination of the processes affecting or inhibiting outcomes is relevant. AIM: To evaluate the Cancer Home-Life Intervention for its processes of implementation, mechanisms of impact and contextual factors. DESIGN: Process evaluation conducted alongside the randomised controlled trial, using quantitative and qualitative methods (ClinicalTrials.gov NCT02356627). The Cancer Home-Life Intervention is a tailored, occupational therapy-based programme. SETTING/PARTICIPANTS: This study took place in participants' homes and at hospital. A total of 113 home-dwelling adults (⩾18 years) with advanced cancer who had received the Cancer Home-Life Intervention were included, together with five intervention-therapists. RESULTS: All 113 participants (100%) received a first home visit; 32 participants (26%) received a second visit; and 4 participants (3%) received a third visit. Median number of delivered intervention components were 3 (interquartile range: 2; 4). Identified barriers for effect included unclear decision process for intervention dosage; participants' low expectations; participants' lack of energy; and insufficient time to adopt new strategies. The trial design constituted a barrier as the intervention could only be provided within a specific short period of time and not when relevant. Intervention components working to solve practical everyday problems, enhance enjoyment and increase a sense of safety were perceived as useful. CONCLUSION: Future interventions can benefit from inclusion criteria closely related to the intervention focus and clear procedures for when to continue, follow-up and terminate intervention. Decisions about dose and timing may benefit from learning theory by taking into account the time and practice needed to acquire new skills.

Lessons learned about occupation-focused and occupation-based interventions: A synthesis using group concept mapping methodology.

Introduction: Occupational therapy (OT) is based on the core assumption that humans are active beings through engagement in occupations. Within OT, occupation is typically used as primary means and/or ends i.e. occupation-focused and/or occupation-based interventions are employed. Studies evaluating such interventions are limited.Objectives: To synthesize experiences about occupation-focused and/or occupation-based interventions. Hence, to identify, organize and prioritize experiences with employing occupation as a core element in OT intervention studies.Methods: Participants were OT PhD students and researchers involved in studies concerning occupation-focused and/or occupation-based interventions. Group Concept Mapping was applied.Results: Based on 133 ideas, a conceptual model emerged encompassing two overall dimensions concerning 'developing interventions' and 'planning intervention studies', respectively. Moreover, ten themes related to one or both dimensions were defined and 94 ideas across clusters had high importance ratings.Conclusion: Synthesis of participants' experiences indicates that 'doing' as agent of change is a core element of OT interventions. Moreover, a multi-level perspective is needed to reach sustainable changes in doing. Group- and peer-support can work as amplifier for change, and flexibility is important during intervention. Such complex interventions need special design and mixed methods in the development, and evaluation of outcome needs to address occupation.

Evaluation of an intervention programme addressing ability to perform activities of daily living among persons with chronic conditions: study protocol for a feasibility trial (ABLE).

INTRODUCTION: The number of persons living with a chronic condition is increasing worldwide. Conditions are considered chronic when lasting 1 year or more and requiring ongoing medical attention and/or limiting activities of daily living (ADL). Besides medical treatment, physical exercise to improve body functions is recommended and prescribed. However, improvements in body functions do not necessarily improve ability to perform ADL. Thus, it is necessary to develop interventions aiming directly at enhancing ADL ability. As a part of the research programme 'A Better Everyday Life', the first version of the ABLE intervention programme was developed. METHODS AND ANALYSIS: This feasibility study examine the perceived value and acceptability of the ABLE programme by evaluating the fidelity, reach, dose and potential outcomes using a pretest and post-test design involving 30 persons living with chronic conditions. Qualitative interviews among occupational therapists delivering and participants receiving the ABLE programme will be conducted to explore aspects affecting the intervention. ETHICS AND DISSEMINATION: The results will form the base for refinement of the ABLE programme and planning of a large-scale randomised controlled trial investigating the effect of the programme on self-reported and observed ADL ability. Dissemination will include peer-reviewed publications and presentations at national and international conferences. PROTOCOL VERSION: 7 November 2017: v ersion 1.0. 19 February 2018: v ersion 2.0. TRIAL REGISTRATION NUMBER: NCT03335709; Pre-results.

The 'Cancer Home-Life Intervention': A randomised controlled trial evaluating the efficacy of an occupational therapy-based intervention in people with advanced cancer.

BACKGROUND: People with advanced cancer face difficulties with their everyday activities at home that may reduce their health-related quality of life. To address these difficulties, we developed the 'Cancer Home-Life Intervention'. AIM: To evaluate the efficacy of the 'Cancer Home Life-Intervention' compared with usual care with regard to patients' performance of, and participation in, everyday activities, and their health-related quality of life. DESIGN AND INTERVENTION: A randomised controlled trial ( ClinicalTrials.gov NCT02356627). The 'Cancer Home-Life Intervention' is a brief, tailored, occupational therapy-based and adaptive programme for people with advanced cancer targeting the performance of their prioritised everyday activities. SETTING/PARTICIPANTS: Home-living adults diagnosed with advanced cancer experiencing functional limitations were recruited from two Danish hospitals. They were assessed at baseline, and at 6 and 12 weeks of follow-up. The primary outcome was activities of daily living motor ability. Secondary outcomes were activities of daily living process ability, difficulty performing prioritised everyday activities, participation restrictions and health-related quality of life. RESULTS: A total of 242 participants were randomised either to the intervention group ( n = 121) or the control group ( n = 121). No effect was found on the primary outcome (between-group mean change: -0.04 logits (95% confidence interval: -0.23 to 0.15); p = 0.69). Nor was any effect on the secondary outcomes observed. CONCLUSION: In most cases, the 'Cancer Home-Life Intervention' was delivered through only one home visit and one follow-up telephone contact, which not was effective in maintaining or improving participants' everyday activities and health-related quality of life. Future research should pay even more attention to intervention development and feasibility testing.