Patients’ and caregivers’ perceptions of occupational therapy and adapting to discharge home from an inpatient palliative care setting

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.

Feasibility study of a wellness intervention for caregivers of patients undergoing hematopoietic stem cell transplantation: The Ready to CARE Intervention

“…For example, in a study of a problem-solving intervention for caregivers of HSCT, the caregivers who declined to engage in the intervention had more distress and less caregiving confidence than those who chose to participate (Bevans et al., 2014). Other studies have echoed our participants’ suggestion that intervening after discharge may be helpful (Bevans et al., 2010; Metoyer, 2013), but it could be hard to schedule sessions at the time when physical caregiving tasks peak and require high amounts of time and energy from caregivers, leaving less for other tasks and activities. These issues make it difficult to ascertain the best time to intervene and the best way to reach the caregivers in the most need of support.…”

Equipo multiprofesional y trabajo interdisciplinario en cuidados paliativos: reflexiones sobre factores contextuales y profesionales que afectan la práctica de Terapia Ocupacional

“…Sobre el panorama brasileño: dinámica de trabajo de terapeutas ocupacionales en los equipos de cuidados paliativos En esta reflexión, por tanto, no nos interesamos en rescatar las experiencias científicas que se centran en el abordaje práctico de la Terapia Ocupacional en los cuidados paliativos, considerando que existen diversas revisiones (Pyle, 2018;Nascimento, 2019) y producciones que explicitan experiencias de intervención (Mckenna y Mellson, 2013;Marston et al, 2015;Baltazar et al, 2016;Eva y Morgan, 2018;Lucchi et al, 2020) y modelos de actuación (American Occupational Therapy Association -AOTA, 2011 ;Pickens et al, 2016;Essential y McColl, 2019. En su lugar, pretendemos enfocarnos en evidencias que ayuden a entender la construcción en torno al trabajo interdisciplinario y los significados de las dinámicas colaborativas para las y los terapeutas ocupacionales en los equipos de cuidados paliativos, desde una realidad cultural más cercana.…”

“…En la última década, la Terapia Ocupacional se ha involurado con este tipo de pacientes dando mayor fundamento a las orientaciones y directrices profesionales que validan el quehacer profesional en cuidados paliativos. Este campo de ejercicio se basa en la participación ocupacional y social, y en la comprensión de las consecuencias del declive generado por una enfermedad que amenaza la vida (Mckenna y Mellson, 2013); por tanto, la intervención incide en la calidad de vida, la autonomía, la sensación de control sobre la pérdida de roles y el enriquecimiento ocupacional y espiritual de la cotidianidad, al evitar la evolución de una muerte social antes de la muerte biológica (Marston et al, 2015).…”

Experience and acceptability of a carer‐focussed intervention in acute oncology settings: A qualitative study of people with advanced cancer and their carers

“…International policy recommends support for cancer carers throughout the discharge planning process (Carers UK, 2021; Victorian Government, 2018, 2020). However, carers describe being largely unsupported, navigating distress and uncertainty (Guo et al, 2022; Isenberg et al, 2021; Marston et al, 2015; Miller & Porter, 2021; Plank et al, 2012; Wang et al, 2018). Carers report inadequate access to information and support related to the illness, treatment, discharge planning, and practical aspects of caring (Wang et al, 2018).…”