Occupational Therapy and Cancer: Perspectives of Patients and Health Care Providers

Abstract

Background: This mixed method study investigated how cancer impacts the everyday life of cancer survivors from both the perspective of the cancer survivor and physicians. This study also explored factors which may be interfering with the physician’s ability to address the everyday needs of cancer survivors and refer their patients to occupational therapy. Methods: This study used a sequential explanatory mixed methods design. RedCap electronic surveys were utilized to collect data from both cancer survivors (n=35) and physicians (n=13). To gather a deeper understanding, semi-structured focus groups (n=2) and interviews (n=3) were conducted to gather qualitative information from both cancer survivors (n=10) and physicians (n=2). Quantitative data were analyzed via descriptive statistics. Qualitative data were recorded, transcribed verbatim, and analyzed thematically. Results across data were compared to identify patterns. Rigor was enhanced by multiple coders, expert review, and triangulation. Results: Survey results from cancer survivors revealed that participants had difficulty performing activities of daily living (30%); independent living skills (36%); leisure pursuits (53%); health management (35%); and work. Fifty percent of survivors were able work part-time during their treatment but 30% did not return to work after oncological treatments. Thirty-six percent indicated their physician did not inquire if they were having difficulties with their daily occupations and 85% were never referred to occupational therapy (OT). Survey results from the physicians revealed they believed their patients had difficulty with activities of daily living (46%); instrumental activities of daily (54%); and work (92%), yet only 31% specified that they always inquire about how cancer treatments are impacting their patient’s daily routines. Four themes emerged from the survivors: (1) Challenges related to occupational participation; (2) Support enhances resilience and occupational balance; (3) Psychosocial issues influence the survivors' well being and occupational balance; and (4) Healthcare communication concerns. Four themes emerged from the physicians: (1) Concerns regarding effects of cancer treatments; (2) Need to inquire about daily function to guide medical treatments; (3) Importance of communication and rapport; and (4) Providers have limited education on how OT can benefit patients’ participation. Conclusion: These findings reinforce the limited evidence on these topics and provide a deeper understanding of how occupational performance is affected from the perspectives of both cancer survivors and physicians.