Mapping the scope of occupational therapy practice in palliative care: A European Association for Palliative Care cross-sectional survey

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.

Evaluating a multidimensional strategy to improve the professional self-care of occupational therapists working with people with life limiting illness.

“…Stress and burnout in palliative care has been found to frequently be related to professional issues, but is not significantly more prevalent that rates found in other service settings (36). The source of frustration and stress for occupational therapists in this study was attributed to feelings of not providing best care for people with LLCs, which is also similar to the experiences of loss of control and uncertainty reported by other occupational therapists working with similar patient cohorts (5,9,31,37). The current lack of evidence around occupational therapy with people with LLCs is a barrier to effective and efficient work with this population (8,9,15,23,38,39), however this is beginning to be addressed.…”

“…Functional maintenance and symptom management are generally perceived as subordinate to recovery or cure, however these support aspects of quality of life which are a priority to people at the end of life (40). Theoretical approaches now beginning to emerge in occupational therapy (41,42) may assist the discipline to resolve this perceived dilemma, as will increased awareness of what it can contribute to this population of patients (9,32,33).…”

“…While the role of occupational therapy with people experiencing LLCs is less well defined that other patient populations, it broadly encompasses efforts to enable these patients to maintain the best possible functional performance, and to enable symptomatic relief and quality of life (7,8). Despite these important tasks, the majority of occupational therapists in a recent European study felt the profession was not being used to its full potential with people with LLCs (9). However, a recent qualitative study with patients and caregivers found they perceived occupational therapy interventions were beneficial, even when these activities increased their pain and/or fatigue in the short term (10).…”

“…The evidence base around education and training requirements for occupational therapists have been slowly increasing (8), and the free online suite of training in palliative care for health professionals available from the Australian Healthcare and Hospitals Association has been included in some preregistration courses (11). However, there remain consistent recommendations for the frequency and scope of education and training to be increased (9,(12)(13)(14)(15).…”

Promoting the use of outcome measures across disciplines through action research with practitioners in a palliative care setting

“…Some recommendations from the UK exist for occupational therapists working with people with motor neurone disease (COT 2015). In palliative care settings, specifically, it is suggested the reasons health care professionals do not use outcome measures are: a lack of staff training, time constraints, patient burden and difficulty choosing tools ( Participation is a key aim of palliative rehabilitation (Eva andMorgan, 2018, Brant et al, 2016). Therefore, It could be argued that AHPs require an additional outcome measure to address this.…”