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Corvin J, Hoskinson Z, Mozolic-Staunton B, Hattingh L, Plumbridge-Jones R. The effects of virtual reality interventions on occupational participation and distress from symptoms in palliative care patients: A pilot study. Palliat Support Care 2024:1-8. [PMID: 38605653 DOI: 10.1017/s1478951524000245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
BACKGROUND Virtual reality (VR) offers the prospect of a safe and effective adjunct therapeutic modality to promote mental health and reduce distress from symptoms in palliative care patients. Common physiological and psychological symptoms experienced at the end of life may impact the person's participation in day-to-day activities that bring them meaning. The purpose of this study was to examine the effect of VR interventions on occupational participation and distress from symptoms. OBJECTIVES To describe the stimulus, results, and learnings from a single-site pilot study of virtual reality therapy in a specialist palliative care setting. METHODS Participants engaged in a VR session lasting from 9 to 30 minutes related to coping with pain, inner peace and mindfulness, adventure, and bucket list. METHODS MEASURES The pilot prospective quantitative observational cohort study was conducted from November 2021 through March 2022 using a pre-post VR intervention research design. Quantitative data was collected using patient-rated assessments and a wireless pulse oximeter. Occupational performance, satisfaction, and distress symptoms were measured using the Canadian Occupational Performance Measure and the Palliative Care Outcomes Collaboration Symptom Assessment Scale (PCOC SAS). The intervention and study design adhered to international guidelines. RESULTS Ten participants engaged in the VR interventions. Data showed significantly improved occupational performance and satisfaction scores (p < .001), decreases in PCOC SAS distress from pain (p = .01), fatigue (p < .001), and heart rate (p = .018). No adverse side effects were observed. SIGNIFICANCE OF RESULTS Outcomes included an analysis of virtual reality's effectiveness to alleviate symptom burden and increase occupational participation for palliative care patients. Of specific interest to the research team was the application of virtual reality in a community-based and inpatient palliative care context to supplement allied health services and its feasibility of integration into standard palliative care. CONCLUSION VR therapy showed positive improvements in the participants' occupational performance, satisfaction, and distress from pain and fatigue.
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Affiliation(s)
- Julian Corvin
- Faculty of Health Science and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Zara Hoskinson
- Supportive and Specialist Community Palliative Care Service, Gold Coast Health, Robina, Queensland, Australia
| | - Beth Mozolic-Staunton
- Faculty of Health Science and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Laetitia Hattingh
- Department of Allied Health Research, Allied Health & Rehabilitation Services, Gold Coast Health, Southport, Queensland, Australia
| | - Russell Plumbridge-Jones
- Supportive and Specialist Community Palliative Care Service, Gold Coast Health, Robina, Queensland, Australia
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Volberg C, Fleck P, Vradelis P, Morin A, Gschnell M, Pape AE. How to Enable Participation until the End of Life? A Survey of German Occupational Therapists Working in Palliative Care. J Clin Med 2023; 12:5257. [PMID: 37629299 PMCID: PMC10455849 DOI: 10.3390/jcm12165257] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 08/06/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND In palliative care, the needs of people with life-limiting illnesses must be addressed with the support of a multidisciplinary team. Occupational therapy is a profession that focuses on activity and participation. In Germany, there are no surveys to date that demonstrate the work of occupational therapists in palliative care and which problems can occur in this field. AIM The aim of this study is to describe the work and problems of occupational therapists in German palliative care. DESIGN The survey consists of 17 questions and could be conducted anonymously. Descriptive statistics and a thematic analysis of the free text responses were used to analyze data. SETTING/PARTICIPANTS Respondents were German occupational therapists who are members of the "German Association of Occupational Therapy". RESULTS A total of 281 valid responses were evaluated, of which 120 respondents work in the context of palliative care. Most of them provide needs-based therapies (74%), train relatives (69%), or help patients with positioning (69%) or relaxation therapy (66%). Four themes were developed in the free text responses that describe problems in the utilization of occupational therapy in palliative care. CONCLUSIONS The evaluation shows that occupational therapy in palliative care offers a variety of possible applications and approaches. The findings urgently need to be implemented in daily practice to improve the status of occupational therapists. This requires appropriate billing modalities and clear guidelines. There is still a significant need for research and training in this area.
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Affiliation(s)
- Christian Volberg
- Department of Anesthesiology & Intensive Care Medicine, Faculty of Medicine, Philipps University of Marburg, 35032 Marburg, Germany
- Research Group Medical Ethics, Faculty of Medicine, Philipps University of Marburg, 35032 Marburg, Germany
| | - Pauline Fleck
- Department of Anesthesiology & Intensive Care Medicine, Faculty of Medicine, Philipps University of Marburg, 35032 Marburg, Germany
| | - Paula Vradelis
- Department of Anesthesiology & Intensive Care Medicine, Faculty of Medicine, Philipps University of Marburg, 35032 Marburg, Germany
| | - Astrid Morin
- Department of Anesthesiology & Intensive Care Medicine, Faculty of Medicine, Philipps University of Marburg, 35032 Marburg, Germany
| | - Martin Gschnell
- Department of Dermatology and Allergology, Faculty of Medicine, Philipps University of Marburg, 35032 Marburg, Germany
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Morgan DD, Taylor RR, Ivy M, George S, Farrow C, Lee V. Contemporary occupational priorities at the end of life mapped against Model of Human Occupation constructs: A scoping review. Aust Occup Ther J 2022; 69:341-373. [PMID: 35199343 DOI: 10.1111/1440-1630.12792] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 11/21/2021] [Accepted: 01/12/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION People with end-of-life care needs are seen in an increasingly diverse range of health and community settings. Opportunity for continued occupational participation is highly valued by people at the end of life. This scoping review sought to identify the priorities and preferences for participation at the end of life and to map findings using the model of human occupation. METHODS A search strategy informed by the research question was developed in collaboration with a research librarian. Data sources used were Ovid Medline(R), CINAHL, Ovid Emcare, Scopus, Web of Science and PsychInfo. Studies that focused on clinician perspectives, clinical care, grief and loss, did not clearly identify end-stage diseases, <18 years and written in languages other than English were excluded. FINDINGS Forty-four studies were included with a total of 1,070 study participants. Inductively developed themes were mapped against the model of human occupation constructs of volition (personal causation, values, interests), habituation (habits of occupational performance and routine), performance capacity and the lived body within the physical, social and occupational environment. The majority of findings sat within the construct of volition, particularly around sense of personal capacity, self-efficacy and values. At the end of life, people prioritise ongoing engagement in valued occupations even if participation is effortful. As disease progresses, opportunity to exert influence and control over this participation and engagement increases in importance. Personal causation plays an important role in the experience of occupational participation at this time. CONCLUSION This review provides important insights into the occupational priorities of people at the end of life and the importance of supporting agency and volition at this time. The model of human occupation and its client-centred focus offer a framework for a more robust examination of ways to enhance volitional capacity and enable occupational participation for people at the end of life.
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Affiliation(s)
- Deidre D Morgan
- Research Centre for Palliative Care, Death and Dying (RePaDD), College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Renée R Taylor
- Director, Model of Human Occupation Clearinghouse, Department of Occupational Therapy, University of Illinois, Chicago, Illinois, USA
| | - Mack Ivy
- Rehabilitation Services, MD Anderson Cancer Center, Manvel, Texas, USA
| | - Stacey George
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Caroline Farrow
- SA Health, Northern Adelaide Palliative Care Service, Adelaide, South Australia, Australia
| | - Vincci Lee
- Eastern Health, Box Hill Hospital, Box Hill, Victoria, Australia
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Talbot-Coulombe C, Guay M. Occupational therapy training on palliative and end-of-life care: Scoping review. Br J Occup Ther 2020. [DOI: 10.1177/0308022620926935] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction While occupational therapists promote quality of life enabling occupation, many receive little to no training on palliative and end-of-life care. This study synthesizes relevant literature to find out what is known about training for them on this matter. Methods A scoping review using Arksey and O’Malley’s five-stage framework exploring literature on palliative and end-of-life care training in occupational therapy (French or English; undergraduate or graduate). The first author screened the titles, abstracts, and keywords and selected literature to be read by the teams to extract and include relevant knowledge. Corroborated thematic analysis synthesized the findings. Result Out of the 384 publications initially identified, 25 were included in the review. To be trained in palliative and end-of-life care, occupational therapists have to (a) be exposed to knowledge on specific (b) topics required for competent practice using (c) educational strategies supporting learning about palliative and end-of-life care. Conclusion Whereas introductory-level knowledge of palliative and end-of-life care should be offered to all students, advanced training should allow occupational therapists to master the philosophy of this type of care, deepen the understanding of topics such as being confronted with death, and empower them to advocate for their unique contribution.
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Affiliation(s)
- Claudia Talbot-Coulombe
- Health Sciences Research Programs, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada
- Research Centre on Aging, Centre intégré universitaire de santé et de services sociaux de l’Estrie-Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Québec, Canada
| | - Manon Guay
- Research Centre on Aging, Centre intégré universitaire de santé et de services sociaux de l’Estrie-Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Québec, Canada
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada
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Batista MPP, Rebelo JE, de Carvalho RT, de Almeida MHM, Lancman S. Widow's perception of their marital relationship and its influence on their restoration-oriented everyday occupations in the first six months after the death of the spouse: A thematic analysis. Aust Occup Ther J 2019; 66:700-710. [PMID: 31657033 DOI: 10.1111/1440-1630.12609] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The death of a spouse greatly affects the survivor's emotions and may change one's everyday occupations, especially during recent bereavement. Considering the centrality of everyday occupations to occupational therapy practice, this research aimed to understand women's restoration-oriented everyday occupations within the first six months after the death of their spouse. METHODS This was a qualitative thematic analysis that applied a realistic method and a theoretical approach at the semantic level. Semi-structured interviews were conducted to understand the everyday occupations of widows after their husbands' deaths, emphasising those that were restoration-oriented, according to the dual process model of coping with bereavement framework. The analysis was conducted according to the phases expected to be conducted during a thematic analysis. RESULTS Fourteen widows with long-term marital relationships participated in this research. Their perceptions concerning their relationships with their spouses were an important aspect that influenced their everyday occupations. Women who qualitatively described their marital relationships in terms of attributes grouped by the researcher as lost and lonely also mentioned difficulty managing previously habitual occupations and changes in the meanings assigned to some of those occupations. These women mobilised unique strategies to address suffering and occupational changes during bereavement. Women who qualitatively described their relationships with attributes grouped by the researcher as free at last felt freedom after their husbands' deaths, which, according to the widows, brought happiness and feelings of peace and enabled them to engage in freely chosen occupations and to broaden their social networks. CONCLUSION Everyday occupations and their meanings can considerably change during widowhood. This study contributes to comprehending the uniqueness of responses to loss.
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Affiliation(s)
- Marina Picazzio Perez Batista
- Department of Physical Therapy, Speech Therapy and Occupational Therapy, Medical School, Universidade de São Paulo, São Paulo, Brazil
| | | | | | - Maria Helena Morgani de Almeida
- Department of Physical Therapy, Speech Therapy and Occupational Therapy, Medical School, Universidade de São Paulo, São Paulo, Brazil
| | - Selma Lancman
- Department of Physical Therapy, Speech Therapy and Occupational Therapy, Medical School, Universidade de São Paulo, São Paulo, Brazil
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Banks I, Weller D, Ungan M, Selby P, Aapro M, Beishon M, Bolt M, Bonanno F, Champeix C, Dégi C, Eneqvist LJ, Kazmierska J, Kolacinska A, Malas S, Moine S, Pavlic DR, Price R, Walter F, Wyld L. ECCO Essential Requirements for Quality Cancer Care: Primary care. Crit Rev Oncol Hematol 2019; 142:187-199. [PMID: 31445441 DOI: 10.1016/j.critrevonc.2019.07.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 07/03/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND ECCO Essential Requirements for Quality Cancer Care (ERQCC) are checklists and explanations of organisation and actions that are necessary to give high-quality care to cancer patients. They are written by European experts representing all disciplines involved in cancer care. This paper concerns the integration of primary care into care for all cancers in Europe. Primary care integration.
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Affiliation(s)
- Ian Banks
- European Cancer Organisation Patient Advisory Committee (ECCO PAC); European Men's Health Forum
| | - David Weller
- World Organization of Family Doctors (WONCA Europe); Centre for Population Health Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Mehmet Ungan
- World Organization of Family Doctors (WONCA Europe); Department of Family Medicine, Ankara University School of Medicine, Ankara, Turkey
| | - Peter Selby
- European Cancer Concord (ECC); Leeds Institute of Cancer and Pathology, Leeds, United Kingdom
| | - Matti Aapro
- European Cancer Organisation (ECCO); Genolier Cancer Centre, Clinique de Genolier, Genolier, Switzerland
| | - Marc Beishon
- Cancer World, European School of Oncology (ESO), Milan, Italy.
| | - Marije Bolt
- Council of Occupational Therapists for European Countries (COTEC)
| | - Fiona Bonanno
- European Society of Oncology Pharmacy (ESOP); Sir Anthony Mamo Oncology Centre, Malta
| | | | - Csaba Dégi
- International Psycho-Oncology Society (IPOS); Faculty of Sociology and Social Work, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Lisa Jelf Eneqvist
- European Oncology Nursing Society (EONS); Regional Cancercenter Stockholm-Gotland, Sweden
| | - Joanna Kazmierska
- European Society of Radiotherapy and Oncology (ESTRO); Radiotherapy Department II, Greater Poland Cancer Center, Poznan, Poland
| | - Agnieszka Kolacinska
- European Society of Surgical Oncology (ESSO); Department of Head and Neck Cancer Surgery and Surgical Oncology, Medical University of Lodz, Lodz, Poland
| | - Simon Malas
- Association of European Cancer Leagues (ECL); Oncology Clinic, Limassol General Hospital, Limassol, Cyprus
| | - Sébastien Moine
- European Association of Palliative Care (EAPC); Education and Health Practices Laboratory, University of Paris, France
| | | | | | - Fiona Walter
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, United Kingdom
| | - Lynda Wyld
- European Society of Breast Cancer Specialists (EUSOMA); Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
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Eva G, Morgan D. Mapping the scope of occupational therapy practice in palliative care: A European Association for Palliative Care cross-sectional survey. Palliat Med 2018; 32:960-968. [PMID: 29756556 PMCID: PMC5946674 DOI: 10.1177/0269216318758928] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
BACKGROUND Occupational therapists play an integral role in the care of people with life-limiting illnesses. However, little is known about the scope of occupational therapy service provision in palliative care across Europe and factors influencing service delivery. AIM This study aimed to map the scope of occupational therapy palliative care interventions across Europe and to explore occupational therapists' perceptions of opportunities and challenges when delivering and developing palliative care services. DESIGN A 49-item online cross-sectional survey comprised of fixed and free text responses was securely hosted via the European Association for Palliative Care website. Survey design, content and recruitment processes were reviewed and formally approved by the European Association for Palliative Care Board of Directors. Descriptive statistics and thematic analysis were used to analyse data. Setting/respondents: Respondents were European occupational therapists whose caseload included palliative care recipients (full-time or part-time). RESULTS In total, 237 valid responses were analysed. Findings demonstrated a consistency in occupational therapy practice in palliative care between European countries. Clinician time was prioritised towards indirect patient care, with limited involvement in service development, leadership and research. A need for undergraduate and postgraduate education was identified. Organisational expectations and understanding of the scope of the occupational therapy role constrain the delivery of services to support patients and carers. CONCLUSION Further development of occupational therapy in palliative care, particularly capacity building in leadership and research activities, is warranted. There is a need for continuing education and awareness raising of the role of occupational therapy in palliative care.
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Affiliation(s)
- Gail Eva
- Department of Clinical Sciences, Brunel University London, London, UK
| | - Deidre Morgan
- Palliative and Supportive Services, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
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von Post H, Wagman P. What is important to patients in palliative care? A scoping review of the patient’s perspective. Scand J Occup Ther 2017; 26:1-8. [DOI: 10.1080/11038128.2017.1378715] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Helen von Post
- Advanced Palliative Home Care, Region Skåne, Helsingborg, Sweden
| | - Petra Wagman
- School of Health and Welfare, Jönköping University, Sweden
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Buckland N, Mackenzie L. Exploring the role of occupational therapy in caring for cancer survivors in Australia: A cross sectional study. Aust Occup Ther J 2017; 64:358-368. [DOI: 10.1111/1440-1630.12386] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2017] [Indexed: 11/28/2022]
Affiliation(s)
| | - Lynette Mackenzie
- Discipline of Occupational Therapy; University of Sydney; Lidcombe New South Wales Australia
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