Date Presented 4/19/2018
A scoping review of 70 articles explored the contribution of occupational therapists in palliative care. The analysis resulted in five themes and three major findings focusing on promoting valued occupations, intervening from diagnosis to death, and forming a model to guide practice and research.
Primary Author and Speaker: Hsin-Hsiu Yeh
Additional Authors and Speakers: Mary Ann McColl, Lin-Jye Huang
PURPOSE: This study explored the unique contribution of occupational therapists in palliative care to propose a model to guide intervention in the future.
BACKGROUND: Although only about 8% of occupational therapists in Canada work in palliative care, the ability to deal with clients facing death is arguably a skill that all occupational therapists should possess. Currently in palliative care, the importance of occupation is not emphasized, and the occupational therapist’s role is often misunderstood not only by clients and families but also by other health professionals, and even by occupational therapists themselves (Foley, 2007; Keesing & Rosenwax, 2011; Rahman, 2000). Therefore, it is important to identify the unique role of occupational therapists and provide a model to guide practice, education, and research.
METHOD: This poster presents the results of a scoping review to identify the roles of occupational therapists in palliative care. Articles were published in 2000 to 2016 and searched with the key words of occupational therap*, palliative*, terminal*, hospice, end of life, and dying in PubMed, CINAHL, Google, EMBASE, and PsycNET. Two researchers read and eliminated articles on the basis of specific inclusion and exclusion criteria.
RESULTS: Seventy articles fit the criteria and were included in the analysis. Five themes emerged regarding the parameters of effective occupational therapy in palliative care. The first theme is the importance of valued occupations even at the end of life. The second theme explores how occupations change over the trajectory of a terminal illness. The third theme deals with the balance between affirming life and preparing for death. The fourth theme shows that valued occupations might be doing, being, becoming, or belonging occupations. The fifth theme emphasizes a safe and supportive environment as an essential dimension for effective palliative care. These five themes were combined to form a model to guide occupational therapy in palliative care.
CONCLUSION: This model offers structure and direction for occupational therapists in palliative care. There were three important findings from this scoping review. First, the literature is unanimous that the most valuable and unique contribution that occupational therapy can make to palliative care is to focus on valued occupations. A second major finding of this review is the importance of time, from diagnosis to the end of life, and its implications for the range, intensity, and conditions of occupation. The third major finding is the model proposed to guide practice, education, and research on occupational therapy in palliative care.
References
Foley, G. (2007). What are the care needs for people with motor neurone disease and how can occupational therapists respond to meet these needs? British Journal of Occupational Therapy, 70, 32–34. https://doi.org/10.1177/030802260707000108
Keesing, S., & Rosenwax, L. (2011). Is occupation missing from occupational therapy in palliative care? Australian Occupational therapy Journal, 58, 329–336. https://doi.org/10.1111/j.1440-1630.2011.00958.x
Rahman, H. (2000). Journey of providing care in hospice: Perspective of occupational therapists. Qualitative Health Research, 10, 806–818. https://doi.org/10.1177/104973200129118831
