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Hoey EM, Pino M. Procedural Detailing: A Patient's Practice for Normalizing Routine Behaviors. HEALTH COMMUNICATION 2024; 39:1285-1297. [PMID: 37198912 DOI: 10.1080/10410236.2023.2211364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
In palliative care in the UK, occupational and/or physiotherapists consult with patients to assess how they are managing their activities for daily living in light of their life-limiting condition(s), and to identify any activities that might benefit from therapeutic intervention. In this paper we use conversation analysis to describe a patient's practice in these consultations, which we call "procedural detailing," whereby they produce a step-by-step description of how they do some everyday activity, such that it is depicted as adequate, stable, and unproblematic. Based on a collection of 15 cases identified in video recordings of consultations in a large English hospice, we demonstrate how patients use this practice to normalize their routine conduct and thereby reject or rule out an actual or anticipated therapeutic recommendation. Our analysis suggests that such descriptions let patients participate in shared decision-making by revealing their preference for routines that preserve their level of independence and dignity.
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Affiliation(s)
- Elliott M Hoey
- Department of Language, Literature and Communication, Vrije Universiteit Amsterdam
| | - Marco Pino
- School of Social Sciences and Humanities, Loughborough University
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End-of-Life Care and the Role of Occupational Therapy. Am J Occup Ther 2023; 77:7713410210. [PMID: 38154142 DOI: 10.5014/ajot.2023.77s3002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2023] Open
Abstract
This AOTA Position Statement describes the role of occupational therapy practitioners in providing services to clients who are living with terminal conditions and who are at the end of life, as well as their role in providing services and support to caregivers.
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Chow JK, Pickens ND, Fletcher T, Thompson M, Bowyer P. "You've Got to Do Something": Developing Occupational Therapists' Role in End-of-Life Care. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2023; 43:109-118. [PMID: 35481376 DOI: 10.1177/15394492221088239] [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] [Indexed: 12/29/2022]
Abstract
Occupational therapists support the occupational participation of people who are dying yet remain underutilized in end-of-life care. The purpose of this article was to explore how occupational therapists develop their role in end-of-life care to provide strategies to address underutilization. Using a grounded-theory method, semi-structured interviews were conducted with 21 occupational therapists. Three themes emerged which demonstrate participants' role development process. Participants' experiences with dying (Close Experience of Loss) often instilled the importance of end-of-life care. Led by these convictions (Willing to Do It), participants developed skills for end-of-life care. Reflecting on their experiences and treatment outcomes (Making a Difference), participants self-validated their role. The Model of Occupational Therapists' Role Development in End-of-Life Care captured this process. Personal experiences and critical self-reflection may provide an adaptive means to drive role development and appropriately increase end-of-life care occupational therapy utilization.
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Talbot-Coulombe C, Bravo G, Carrier A. Occupational Therapy Practice in Palliative and End-of-Life Care in Québec. Can J Occup Ther 2022; 89:201-211. [PMID: 35243918 PMCID: PMC9136369 DOI: 10.1177/00084174221084466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background. There is an emerging evidence base about the scope of occupational therapy in palliative and end-of-life care, but little is known about this practice in Québec or barriers impeding it. Purpose. To describe Québec occupational therapists’ practice in palliative and end-of-life care and barriers they encounter. Method. Using the Québec regulatory board members list, we invited occupational therapists working in palliative and end-of-life care to answer an online survey comprising 24 closed- and 5 open-ended questions. We analyzed data using descriptive statistics and content analysis. Findings. The 67 survey participants mainly optimized comfort and safety in meaningful occupations such as mobility, transfers, and hygiene. Barriers to their practice included organizational obstacles and unfamiliarity with their role. Implications. Findings highlight the need to improve education and awareness among occupational therapists and other healthcare professionals about the scope of what occupational therapists can do in palliative and end-of-life care.
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Affiliation(s)
- Claudia Talbot-Coulombe
- Claudia Talbot-Coulombe, Health Sciences Research Programs, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada. Research Centre on Aging, Centre intégré universitaire de santé et de services sociaux de l’Estrie-Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec, Canada.
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Kessner K, Hitch D. Development of an evidence-informed education package for occupational therapists for palliative and end of life care: promoting occupational justice. CADERNOS BRASILEIROS DE TERAPIA OCUPACIONAL 2022. [DOI: 10.1590/2526-8910.ctore23883117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Introduction Death is inevitable, yet hospitals and health services continue to focus on life-sustaining practices despite clients presenting with clear decline related to life-limiting illness. Social and occupational injustice is common for clients receiving palliative or end-of-life care, as they experience increased occupational disengagement and disempowerment. A gap was identified in the Occupational Therapy department of a metropolitan Australian hospital regarding clinician skills, knowledge and confidence in working with these clients. Objective To describe the development of an evidence informed education package designed to support occupational therapists to provide the best possible quality of care and promote occupational justice for clients receiving palliative or end-of-life care. Method Consultation with key stakeholders and a review of existing resources including a skills audit, was conducted to identify current practice. A review of professional and grey literature was completed, and benchmarking with similar organisations provided a wider perspective on current Australian practice. Review of widely available educational resources were evaluated. Results Baseline data collection confirmed that promoting occupational and social justice for people requiring palliative or end-of-life care was under-recognised across the health service. Benchmarking identified significant variation in educational practices across similar Australian health services. The structure and content of a face-to-face clinical education session was formulated using evidence from the literature review and relevant available resources. There are plans to transfer this education package to an e-learning platform with evaluation built into the package to allow content to remain up to date. Conclusion Occupational Therapy clinicians are well placed to promote occupational and social justice for people requiring palliative or end-of-life care but require additional occupationally focused education to optimise their practice in this area.
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Wallis A, Meredith P, Stanley M. Occupational therapy in oncology palliative care for adolescents and young adults: Perspectives of Australian occupational therapists. Aust Occup Ther J 2021; 69:165-176. [PMID: 34961958 DOI: 10.1111/1440-1630.12780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 10/19/2021] [Accepted: 12/05/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Palliative Care Australia suggests current needs (emotional wellbeing, understanding of cancers impact on relationships, everyday activities, and life milestones) for adolescent and young adults in palliative care are unmet due to a lack of age-specific palliative care facilities in Australia. This includes the provision of occupational therapy that can impact these unmet needs. Although the occupational therapy role in palliative care has been documented, little is known about existing occupational therapy services or occupational needs for young people with palliative care needs. The aims of this study were to obtain occupational therapists insights of working with this population in Australia regarding (1) gaps in palliative care services for this population; (2) facilitators and challenges to providing occupational therapy for this group; and (3) perceived occupational needs of young people living with a life-limiting cancer diagnosis. METHODS Using snowball sampling, an online survey was distributed to occupational therapists with experience working in palliative cancer care with adolescents and young adults. Available for 6 weeks, the survey included demographic, work history, and service delivery questions. Forced-choice questions were summarised descriptively, and content analysis was used to analyse free-text data. RESULTS Eleven completed surveys were returned. Overall, therapists perceived current palliative care services for this population within Australia to be lacking. Two gaps emerged: age-appropriate facilities and gaps in provision of psycho-social and occupational therapy services. Funding, lack of knowledge of the occupational therapy role, and professional confidence were highlighted as challenges to practice. Main occupational needs related to maintenance of as "normal" a life as possible: maintaining occupational role engagement, continuing connection with others, and being heard regarding their occupational needs. CONCLUSION Findings suggest a need for service changes, including custom-designed facilities, improved funding, training and mentoring, to support age-appropriate and occupation-focussed care for the young person in cancer-specific palliative care.
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Affiliation(s)
- Amy Wallis
- Edith Cowan University, Western Australia, Australia.,Central Queensland University, Queensland, Australia
| | | | - Mandy Stanley
- Edith Cowan University, Western Australia, Australia
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Figueiredo CDS, Ferreira EF, Assis MG. Death and Dying in Long-Term Care Facilities: The Perception of Occupational Therapists. OMEGA-JOURNAL OF DEATH AND DYING 2021; 87:177-193. [PMID: 34024180 DOI: 10.1177/00302228211019206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
End-of-life care in long-term care facilities for older adults requires numerous skills. However, many professionals, including occupational therapists, feel unprepared to deal with death and dyingand have difficulties to attend to the real needs of the older adults and their families.This is a qualitative study anchored in phenomenologywhich had the objective to understand the perception of occupational therapists regarding death and dying inlong-term care facilities. Data were collected through focus groups and analyzed by thematic content analysis. A total of 12 occupational therapists participated in this study, and two themeswere generated: "The Experience of Death and Dying" and "The Occupational Therapist's approach in Facing Death and Dying". These results may contribute to improvingthe care provided to older adults in the process of death and dying.
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Affiliation(s)
- Carolina de S Figueiredo
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Efigênia F Ferreira
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Marcella G Assis
- Dentistry School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Apostol C, Cranwell K, Hitch D. Evaluating a multidimensional strategy to improve the professional self-care of occupational therapists working with people with life limiting illness. BMC Palliat Care 2021; 20:2. [PMID: 33397343 PMCID: PMC7781397 DOI: 10.1186/s12904-020-00695-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 12/11/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The term 'life limiting conditions' refers to premature death following decline from chronic conditions, which is a common circumstance in which occupational therapists work with people at the end of life. The challenges for clinicians of working with these patients have long been recognised, and may have a significant impact on their professional self-care. This study aimed to evaluate a multidimensional workplace strategy to improve the professional self-care of occupational therapists working with people living with a life limiting condition. METHODS A pre and post mixed methods survey approach were utilised, with baseline data collection prior to the implementation of a multidimensional workplace strategy. The strategy included professional resilience education, targeted supervision prompts, changes to departmental culture and the promotion of self-care services across multiple organisational levels. Follow up data collection was undertaken after the strategy had been in place for 2 years. Quantitative data were analysed descriptively, while qualitative data were subjected to thematic analysis. RESULTS One hundred three occupational therapists responded (n = 55 pre, n = 48 post) across multiple service settings. Complex emotional responses and lived experiences were identified by participants working with patients with life limiting conditions, which were not influenced by the workplace strategy. Working with these patients was acknowledged to challenge the traditional focus of occupational therapy on rehabilitation and recovery. Participants were confident about their ability to access self-care support, and supervision emerged as a key medium. While the strategy increased the proportion of occupational therapists undertaking targeted training, around half identified ongoing unmet need around professional self-care with this patient group. Demographic factors (e.g. practice setting, years of experience) also had a significant impact on the experience and needs of participants. CONCLUSIONS The multidimensional workplace strategy resulted in some improvements in professional self-care for occupational therapists, particularly around their use of supervision and awareness of available support resources. However, it did not impact upon their lived experience of working with people with life limiting conditions, and there remain significant gaps in our knowledge of support strategies for self-care of occupational therapist working with this patient group.
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Affiliation(s)
| | | | - Danielle Hitch
- Occupational Therapy, Western Health, Sunshine, Australia
- Occupational Therapy, Deakin University, Geelong, Australia
- Allied Health, Western Health, Sunshine Hospital, 176 Furlong Road, St, Albans, Victoria 3021 Australia
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Maersk JL, Cutchin MP, Cour KL. Managing daily life among people with advanced cancer living at home: Responding to uncertainties related to shifting abilities, home care, and treatment. Br J Occup Ther 2020. [DOI: 10.1177/0308022620954120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction People with advanced cancer are increasingly expected to live at home and manage the consequences of illness and treatment. The purpose of this study was to explore how people with advanced cancer manage the influence of home care and treatment on occupations and habits. Method Constructivist grounded theory guided the collection and analysis of data from 22 people with advanced cancer. Data were collected using in-depth interviews and participant diaries. Findings Uncertainty about abilities to engage in occupation and home care and treatment delivery disrupted participants’ daily life. Participants employed various strategies to manage uncertainties and to preserve a sense of agency and control. Conclusions This study provides insights into how people with advanced cancer manage and respond to the impact of illness, home care, and treatment in their daily life. The findings may aid occupational therapists to develop and deliver interventions that allow their patients to maintain a sense of agency in their daily life.
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Affiliation(s)
- Jesper Larsen Maersk
- Department of Occupational Therapy, University College Absalon, Naestved, Denmark
- Department of Public Health, Research Unit of General Practice, Research Initiative for Activity Studies and Occupational Therapy, University of Southern Denmark, Odense C, Denmark
- The Social and Health Academy, Nykoebing Falster, Denmark
| | - Malcolm P Cutchin
- Department of Health Care Sciences, Wayne State University, Detroit, MI, USA
- Institute of Gerontology, Wayne State University, Detroit, MI, USA
| | - Karen la Cour
- REHPA, The Danish Knowledge Center for Rehabilitation and Palliative Care, Department of Clinical Research, Odense University Hospital & University of Southern Denmark
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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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Chow JK, Pickens ND. Measuring the Efficacy of Occupational Therapy in End-of-Life Care: A Scoping Review. Am J Occup Ther 2020; 74:7401205020p1-7401205020p14. [PMID: 32078513 PMCID: PMC7018467 DOI: 10.5014/ajot.2020.033340] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Underutilization of hospice occupational therapy may be attributable to a lack of evidence on efficacy. OBJECTIVE To conduct a scoping review of occupational therapy outcome studies to ascertain how efficacy is captured in the literature. DATA SOURCES PubMed, CINAHL, MEDLINE, Scopus, Directory of Open Access Journals, Web of Science, OT Search, and Google Scholar. STUDY SELECTION AND DATA COLLECTION Search terms: hospice, palliative care, occupational therapy, rehabilitation, outcome measure, and assessment. Inclusion criteria: research studies in English, centered on adult hospice care, published between January 1997 and September 2017, and investigated occupational therapy efficacy with an outcome measure. Exclusion criteria: systematic reviews, participants not at terminal disease end stages, or intervention program reviews lacking differentiated occupational therapy outcomes. FINDINGS Seven articles met the inclusion criteria. Findings include frequent use of noncontrolled, quasi-experimental, prospective research designs; a focus on occupational performance; and no generally accepted hospice occupational therapy outcome measure. CONCLUSION AND RELEVANCE Outcome measures of participation in end-of-life occupations and environmental influences on occupational engagement are needed to effectively support occupational therapy practice and research with people who are terminally ill. WHAT THIS ARTICLE ADDS Occupational therapy in end-of-life care is growing in complexity yet remains low in utilization. This review adds insights into current practice and future research foci for the profession.
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Affiliation(s)
- Janice Kishi Chow
- Janice Kishi Chow, DOT, MA, OTR/L, is Occupational Therapist, Physical Medicine and Rehabilitation Services, Palo Alto Veterans Affairs Health Care System, Palo Alto, CA, and Doctoral Candidate, School of Occupational Therapy, Texas Woman's University, Dallas;
| | - Noralyn Davel Pickens
- Noralyn Davel Pickens, PhD, OT, is Professor, School of Occupational Therapy, Texas Woman's University, Dallas
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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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Abstract
This article presents a scoping review of 74 papers from the peer reviewed literature dealing with occupational therapy in palliative care. Five themes emerged regarding the parameters of occupational therapy in palliative care. The themes include: the importance of valued occupations even at the end of life, an exploration of how occupations change over the trajectory of a terminal illness, the balance between affirming life and preparing for death, valued occupations might be doing, being, becoming, or belonging occupations and the emphasis of a safe and supportive environment as an essential dimension for effective palliative care. These five themes are combined to form a model to guide occupational therapy in palliative care. The model offers structure and direction for occupational therapists in order to offer an opportunity for clients in palliative care to flourish toward the end of their lives.
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Affiliation(s)
| | - Mary Ann McColl
- b School of Rehabilitation Therapy , Queen's University , Kingston , Ontario , Canada
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Knecht-Sabres LJ, Weppner A, Powers C, Siesel B. Do Health-Care Professionals Really Understand the Role of Occupational Therapy in Hospice Care? Am J Hosp Palliat Care 2018; 36:379-386. [PMID: 30463419 DOI: 10.1177/1049909118812858] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND: The distinct value of occupational therapy (OT) in end-of-life care is to facilitate quality of life for clients and their caregivers through engagement in occupations during the clients' remaining days. The purpose of this study was to explore health-care professionals' perceptions and knowledge regarding the role of OT in hospice care and to better understand why OT may be underutilized in this setting. PARTICIPANTS: A total of 104 professionals working in hospice care from 31 different states participated in this study. METHODS: Electronic surveys were distributed to hospice agencies throughout the United States. DATA ANALYSIS: Descriptive statistics was used to analyze quantitative data, and content analysis was used to identify patterns with qualitative data. Rigor was enhanced through peer-review, multiple coders, and triangulation. RESULTS: The results of this study revealed that OT's role in hospice care is misunderstood, and OT services are underutilized. Five themes were identified regarding the underutilization of OT services: (1) lack of reimbursement, (2) timing of referral, (3) knowledge of the role of OT, (4) refusal of services by family members, and (5) lack of OT presence in this setting. CONCLUSION: This study revealed that health-care professionals do believe that OTs are vital members of the hospice care team. However, many recipients of hospice care are not receiving OT. More consistent referrals to OT may better ensure that the terminally ill are able to attain end-of-life goals and live their lives to the fullest, regardless of life expectancy.
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Affiliation(s)
| | - Ashley Weppner
- 1 Occupational Therapy Program, Midwestern University, Downers Grove, IL, USA
| | - Cassandra Powers
- 1 Occupational Therapy Program, Midwestern University, Downers Grove, IL, USA
| | - Brooke Siesel
- 1 Occupational Therapy Program, Midwestern University, Downers Grove, IL, USA
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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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Maersk JL, Johannessen H, la Cour K. Occupation as marker of self: Occupation in relation to self among people with advanced cancer. Scand J Occup Ther 2017; 26:9-18. [DOI: 10.1080/11038128.2017.1378366] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Jesper Larsen Maersk
- Department of Public Health, University of Southern Denmark, Odense, Denmark
- Department of Occupational Therapy, University College Absalon, Naestved, Denmark
- Sosu Nykoebing, Nykøbing Falster, Denmark
| | - Helle Johannessen
- Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Karen la Cour
- Department of Public Health, University of Southern Denmark, Odense, Denmark
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Marston C, Agar M, Brown T. Patients’ and caregivers’ perceptions of occupational therapy and adapting to discharge home from an inpatient palliative care setting. Br J Occup Ther 2015. [DOI: 10.1177/0308022615586417] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction There is limited research into the role of occupational therapy in discharge planning in palliative care. This study aimed to explore patients’ and caregivers’ perceptions of occupational therapy in the context of discharge home from an inpatient palliative care setting. Method Semi-structured interviews were conducted with patients and caregivers following discharge home from inpatient palliative care. Participants were selected using purposive sampling and data was thematically analysed. Results Five caregivers and three patients were interviewed. Three main themes emerged: (1) shared roles in discharge planning; (2) perceived benefits of occupational therapy; and (3) adapting to discharge home. Patients and caregivers viewed occupational therapy as the practical help needed to achieve discharge. They had difficulty differentiating between professional roles and perceived the discharge process as a shared responsibility between themselves and the clinicians. Adapting to discharge home involved coping with the uncertain and unexpected, where limited understanding of professional roles meant participants did not know who to seek assistance from. Conclusion Occupational therapy was viewed as the practical help needed for discharge home from a palliative care setting. Clinicians need to take primary responsibility for understanding each other’s roles and providing information on who can assist after discharge.
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Affiliation(s)
- Celia Marston
- Lecturer, Monash University, Melbourne, Victoria, Australia and Senior Occupational Therapist, Department of Palliative and Supportive Care, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Meera Agar
- Director of Palliative Care, Department of Palliative Care, Braeside Hospital, HammondCare, Sydney, New South Wales, Australia
- Conjoint Associate Professor, South West Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia
- Senior Lecturer, Discipline of Palliative and Supportive Services, Flinders University, Adelaide, South Australia, Australia
| | - Ted Brown
- Associate Professor, Department of Occupational Therapy, Monash University, Melbourne, Victoria, Australia
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