Occupational therapy practice in oncology care: Results from a survey

Men's Lived Experiences of Breast Cancer and Changes in Occupation

Introduction

Male breast cancer is rare and frequently diagnosed at later stages of disease with low survival rates. There is a lack of knowledge of how breast cancer impacts men's occupations.

Objectives

This study is aimed at understanding the lived experiences of men with breast cancer and their changes in occupation. Methodology. Twenty-four men with breast cancer participated in semistructured phone interviews. Data was open-coded and analyzed for themes. Findings. The six major themes are as follows: (1) death as a reality, (2) unique personal insights, (3) social environment, (4) interactions with the healthcare system, (5) decreased engagement in occupations, and (6) finding meaning in new occupations.

Conclusion

The healthcare team can improve the patient experience by discussing and responding to the client's experience throughout the diagnosis, intervention, and survival continuum. The scope of occupational therapy is well suited to address the needs of men with breast cancer to maintain optimal levels of functioning.

Cancer-related fatigue in head and neck cancer survivors: Energy and functional impacts

BACKGROUND

Survivors with head and neck cancer (HNC) report cancer-related fatigue (CRF) as a devastating, prevalent health issue that limits activity engagement and adversely influences quality of life.

OBJECTIVE

To explore HNC survivors' written responses and descriptors regarding CRF, and offer potential healthcare strategies based on findings.

METHODOLOGY

In written format, similar to responses on intake forms in outpatient-clinics, 25 HNC survivors provided descriptions of their CRF experiences and their perspectives on its impact. An exploratory descriptive research design was utilized, drawing on social theory for content analysis and thematic development.

RESULTS

Two main themes regarding CRF arose from the data: (1) CRF as a barrier to daily function; and (2) uncontrollable and unpredictable energy fluctuations.

CONCLUSIONS

To enhance outcomes of CRF symptom management in HNC survivors, a healthcare approach that targets the functional implications of CRF, and utilizes energy cultivation strategies when communicating about the negative impacts of CRF (including limited function and fluctuating energy levels) may be beneficial for HNC survivors. Further research into the effects of CRF on function for HNC survivors is warranted.

Occupational therapy, cancer, and occupation-centred practice: impact of training in the model of human occupation

INTRODUCTION

This study examined the influence of training in an occupation-centred model on the practice of occupational therapists working in a cancer hospital. There is an increased need for occupation-based rehabilitation services for individuals with and surviving cancer. Incorporating an occupation-centred model into practice has unique challenges for occupational therapists working in oncology settings. Utilizing an occupation-centred model of practice may influence the therapeutic reasoning of occupational therapists.

METHODS

A generic qualitative inquiry (Patton, 2015) was used to examine therapeutic reasoning as related to post-professional training in a specific occupation-centred model, the Model of Human Occupation (MOHO). Initially, ten occupational therapists with various levels of experience, working across populations in a large cancer centre completed a training session about the MOHO. This was followed by participation in monthly focus groups with an emphasis on the use of MOHO in daily practice (Taylor, 2017). Focus group sessions were video recorded and transcribed. The transcripts were then analysed using open coding and theme generation (Patton, 2015).

RESULTS

Three major themes were extracted from the data during the thematic analysis: understanding and using MOHO language; challenges in incorporating a conceptual model of occupation-centred practice in an oncology setting; and therapeutic reasoning implications. Patterns in the themes indicated a progression from learning the model, to applying the model, to reflection on practice.

CONCLUSION

Post-professional training in an occupation-based model influenced the therapeutic reasoning and practice of occupational therapists in an oncology setting.

Reasons for and outcome of occupational therapy consultation and treatment in the context of multidisciplinary cancer rehabilitation; a historical cohort study

INTRODUCTION

The aim of this study was to investigate reasons why people consulted an occupational therapist following cancer treatment, and to examine the outcome of occupational therapy interventions, in the context of multidisciplinary rehabilitation.

METHODS

Data from 181 patients were collected retrospectively. The International Classification of Human Functioning and Health (ICF) was used to describe the reasons for occupational therapy consultation. Patients had completed the Canadian Occupational Performance Measurement (COPM) before and after the occupational therapy intervention. Change scores were calculated with a 95% confidence interval and a two-sided p-value obtained from a paired t-test.

RESULTS

The reasons for occupational therapy consultation were predominantly within the ICF domain "Activities and Participation". On average, patients improved 3.0 points (95% CI 2.8-3.2) on the performance scale of the COPM, and 3.4 points (95% CI 3.2-3.7) on the satisfaction scale (both: p = <.001).

CONCLUSION

The result of this study supports the added value of occupational therapy to cancer rehabilitation, and emphasise the positive effect of occupational therapy on everyday functioning. Controlled clinical studies are needed to strengthen the evidence.