Occupational Therapy in Oncology - Essay Example

Occupational therapy in oncology Occupational therapy is defined as the art and science of helping people do their important and meaningful daily activities through participation in valued occupations to improve their health and well-being (Rothstein, 2001). In addition to that, occupational therapists can help patients maximize their quality of life through the improvements in certain difficulties while maintaining a specialist knowledge of disease related problems (Vockins, 2004). This has been used in different groups of patients who have suffered and are still suffering from cancer, stroke, mental retardation, physical disability and other related matters. Occupational therapists give services providing assistance to people in different occupational activities including self-maintenance (including ability to clean self, dress and use the toilet), leisure (hobbies and other recreations), productivity (household chores, paid or voluntary work) and rest (Chapparo & Ranka, 1997). These tasks are commonly called activities of daily living (ADL) (Taylor & Currow, 2003). Mailoo, Williams and Bridges (2004) have stated that the original principles of occupational therapy were propped up by researches on psychoneuroimmunology. Their study points that psychoneuroimmunology can add evidences for the application of occupational therapy in oncology. A person can benefit from occupational therapy intervention regardless of the stage of his illness and his or her life expectancy (Vockins, 2004). Occupational therapy can be initiated from primary diagnosis until the illness is already terminated (Penfold, 1996). A cancer treatment team's organization varies depending on the type of cancer (Hacker, 1998). Tattersall (1999) described the team as composed of the surgeon, medical oncologist together with other clinicians and other practitioners such as the occupational therapist. Diaz and Levy (2005) discussed how occupational therapy has been playing a major role in the rehabilitation process of cancer patients. Therapy interventions used in the care and treatment of cancer patients include assistive technology, education on the utilization of techniques on energy conservation, and adaptation of activity for continual function of daily routines (Soderback et al., 2000). One concrete example is the use of custom made devices to assist in the proper functioning of the patient and to protect certain body parts (Penfold, 1996). This enables the individual to continue normal functioning in different activities. Specific devices were also named as tailored scrotal support, paediatric chest guard, and four-quarter amputation prosthesis (Diaz & Levy, 2005). These devices were designed for cancer patients who have difficulty in those specific parts of their body which decreased in mobility and function due to different cancer treatments and the cancer itself. As the name suggests it, the tailored scrotal support is suited for male patients with lymphoedematous genitals and lower extremities. The paediatric chest guard is for children who have had surgery in the pectoral region. This device is also for protection during different activities. The four-quarter amputation prosthesis is for cancer patients whose parts of the upper extremities have been amputated. This device changes the physical appearance of the patient (Diaz & Levy, 2005). A study has shown that a large proportion of time spent by occupational therapists is focused on activities which are indirect and are not patient-related (Cooper and Littlechild, 2004). However, these activities were reflective of the nature of the particular patient group. Vockins' study also proved the large amount of time used on supervision, reports and connections verifies the importance of occupational therapists' written and verbal communication within the multidisciplinary team and with community personnel. Cooper and Littlechild (2004) also describe the senior status of occupational therapists dedicated to oncology and palliative care. Occupational therapists can be of service even to out-patients. Normally, prior to patients' discharge from the hospital, therapists educate the latter regarding self-regulated activities (Bauer, 2005). Often, they provide home services to those who still need help with other postoperative complications. Occupational therapists could also provide home services especially to the elderly who cannot afford to go to the hospital because of their condition. In these cases, occupational therapists can conduct screening on home safety to remove accident risks on the home of the elderly (Keister, 2004). Occupational therapy studies have found that older cancer patients in the on-going stage of their treatment are more likely to need occupational therapy input (Soderback, Pettersson, Von Essen & Stein, 2000). Taylor and Currow (2003) also found that older patients reported higher levels of unmet needs in occupational therapy. However, other studies stressed that in general, patients with advanced cancer and those not reacting to treatments have higher needs of occupational therapy intervention (Newell et al., 1999). One study by Ghazinouri (2005) illustrated the importance of occupational therapy to breast cancer patients with shoulder impairments. These patients acquired the shoulder impairment after surgery for breast cancer. The study showed that physical and occupational therapy interventions have helped in the improvement of the shoulder function in 67% of the patients. The interventions also decreased shoulder symptoms. Although most patients felt an increase in pain at the start of the therapy, the pain also subsided as the sessions progressed. Occupational therapy recognizes the variability in the phases undergone by breast cancer patients. Since they are undergoing medication and different changes in their body and this could mean the patient's withdrawal from the therapy. Taking note of body changes and side effects is important and should not be neglected during the course of the therapy. The study also affirmed that many of the patients who received occupational therapy continued it after their medication. In addition to this, occupational therapy has provided breast cancer patients with services which include: management of pain in metastatic patients, intervention with radiation-induced brachial plexopathy, addressing body image, stress management programmes and the value of engagement in meaningful activities (Vockins, 2004). Specific interventions on breast cancer patients were described by Vockins (2004) beginning with interviews aiming to know their domestic situation, physical arrangement of the home, social support, character summary, current performance in activities of daily living (ADLs) and personal goals. Also, occupational therapists provide for the patients' practice in different activities in the hospital which include wheelchair, equipment and home assessment and provision, and relaxation and fatigue management. They also conduct and arrange case conferences, family meetings, referrals, support groups. These interventions are initiated on specific phases of the person's treatment from pre-surgery through post-surgery, discharge, and adjuvant therapy. For some patients, interventions are instigated when he has lymphoedema and metastatic disease. This overview of the interventions used shows that occupational therapists address both functional and psychological issues using a patient-centred approach, enabling the patients to regain control and independence over occupations and activities meaningful to their lives (Vockens, 2004). This also increases the self-determination and hope of the patients by merely taking over themselves in progression. Normally, cancer patients work both with physical and occupational therapists. Often, both therapies are done at the same time (Bauer, 2005). Many occupational therapists suppose that occupational therapy skills are not sufficiently used thus leading to unmet needs of patients (Taylor & Currow, 2003). Since they commonly work hand in hand with physical therapists, they are masked and their services are perceived to be under-utilized in services catering cancer patients (Soderback & Paulsson, 1997). Occupational therapists also give services to patients in hospices together with physicians, nurses, social workers and physical therapists. Hospices are institutions catering the needs of patients with less than six months of life expectancy. Hospices are specialized in the sense that they provide the necessary sensitivity, care and support for people in the terminal stages of their illnesses ("Hospice Care"). This implies that occupational therapists should also be equipped not only with knowledge of their craft but also of emotional skills. These therapists can be found on different places like hospitals, nurseries and the community. They are exposed to different miserable situations, the hospices to be specific. They are able to witness different depressing scenarios of patients who cry in pain and lose hope in the process. Across different situations and individuals concerned, they have proven to be emphatic and yet, stand firm to ease the patient's pain and help him see hope with every step he takes. In hiring occupational therapists the health institution should note that the applicant should have a minimum of two to four years of work-related skill, knowledge, or experience. According to 2005 statistics, median wages of occupational therapist is $27.34 hourly, $ 56,860 annually ("2005 wage data"). In 2004 there was an estimated 92,000 occupational therapists in the United States. It was projected to grow by 21-35% between 2004 and 2014 which implies a need of 43,000 additional employees (Bureau of Labor Statistics). Occupational therapists have been in service to people affected by continuous changes to their environments (Boshoff, Alant & May, 2005). To ensure the efficiency of the services to these people, Shackleton and Gage (1995) suggest taking note of changes and performing the suitable analysis and planning. Vestal (1995) described the service delivery models used by occupational therapists are continually evolving thus therapists need to formulate for newer principles to adapt to the changing models (Dunn, 2000). This requires innovation and creativity on the therapist's part. They should be rooted to evidences and basic health knowledge. Based on Fitzpatrick (1998) description of his organization's respective staffing level of occupational therapists, the following should be considered: Occupational Therapist Team Manager-1 full-time equivalent (FTE), Senior OT-1FTE-jobshare, Adult OT's (4FTE), Children's OT (1FTE), OT Aides (5FTE), Technicians (2 FTE), Administrative Assistants (3 FTE). Necessary placements and alterations could also be conducted to provide for the delivery of home services. Occupational therapists live in a very dynamic environment and serve people who experience intense variations in and out of their body. They proved to be of service to patient's struggling with their illnesses. Having them in an institution will be an advantage to the advancement of health care practice and services. References Bauer, K. (2005). Rehabilitation after Total Sacrectomy. Rehabilitation Oncology. FindArticles.com. Retrieved July 12, 2007, from: http://findarticles.com/p/articles/mi_qa3946/is_200501/ai_n15348089 Boshoff, K., Alant, E., & May, E. (2005). Occupational therapy managers' perceptions of challenges faced in early intervention service delivery in South Australia. Australian Occupational Therapy Journal, 52(3), 232-242. Bureau of Labor Statistics. (n.d.) "2005 wage data". Retrieved July 12, 2007, from: http://www.bls.gov/oes/. Bureau of Labor Statistics. (n.d.) "2004-2014 employment projections" Retrieved July 12, 2007, from: http://www.bls.gov/emp/. Cooper, J. & Littlechild, B. (2004). A study of occupational therapy intervention on oncology and palliative care. International Journal of Therapy & Rehabilitation, 11 (7), 329-333. Diaz, M. & Levy, C. (2005). Custom Made Occupational Therapy Adaptive Devices Designed for Patients with Cancer. Rehabilitation Oncology. FindArticles.com. Retrieved July 11, 2007, from: http://findarticles.com/p/articles/mi_qa3946/is_200501/ai_n15348087. Dunn, W. (2000). Best practice occupational therapy in community service with children and families. New Jersey: Slack Inc. Fitzpatrick, C. (1998). Development of Occupational Therapy services. Retrieved July 12, 2007, from: http://www.bathnes.gov.uk/Committee_Papers/SocialServices/ss981119/13develo.htm. Ghazinouri, R. (2005). Shoulder Impairments in Patients with Breast Cancer: a Retrospective Review. Rehabilitation Oncology. FindArticles.com. Retrieved July 12, 2007, from: http://findarticles.com/p/articles/mi_qa3946/is_200501/ai_n15348079 Hacker, N.E. (1998). Organization of gynecological cancer care: A time for change. International Journal of Gynecological Cancer, 8,1-5. "Hospice Care". (2005). Rehabilitation Oncology. FindArticles.com. Retrieved July 12, 2007, from: http://findarticles.com/p/articles/mi_qa3946/is_200501/ai_n15348092 Keister, D. (2004). Allowing the elderly to age in place. Health Progress, FindArticles.com. Retrieved July 12, 2007, from: http://findarticles.com/p/articles/mi_qa3859/is_200411/ai_n9460137 Mailoo, V., Williams, C. & Bridges, H. (2004). Psychoneuroimmunology: a theoretical basis for occupational therapy in oncology International Journal of Therapy & Rehabilitation, 11(1), 7-12. Newell, S., Sanson-Fisher, R. W., Girgis, A. & Ackland, S. (1999). The physical and psycho-social experiences of patients attending an outpatient medical oncology department: A cross-sectional study. European Journal of Cancer Care, 8, 73-82. Penfold, S. (1996). The role of the occupational therapist in oncology. Cancer Treatment Reviews, 22, 75-81. Rothstein J. M. (2001). Guide to Physical Therapist Practice, 2nd ed. Alexandria, VA: American Physical Therapy Association. Shackleton, T. L. & Gage, M. (1995). Strategic planning: Positioning occupational therapy to be proactive in the new health care paradigm. Canadian Journal of Occupational Therapy, 62, 188-1995. Soderback, I. & Paulsson, E. H. (1997). A needs assessment for referral to occupational therapy; nurses' judgement in acute cancer care. Cancer Nursing, 20, 267-73. Soderback I, Pettersson I, von Essen L, Stein F. (2000). Cancer patients' and their physicians' perceptions of the formers' need for occupational therapy. Scandinavian Journal of Occupational Therapy, 7, 77-86. Tattersall, M. (1999). Oncology. British Medical Journal. FindArticles.com. Retrieved July 11, 2007, from: http://findarticles.com/p/articles/mi_m0999/is_7181_318/ai_54031861. Taylor, K., & Currow, D. (2003). A prospective study of patient identified unmet activity of daily living needs among cancer patients at a comprehensive cancer care centre. Australian Occupational Therapy Journal, 50(2), 79-85. Retrieved July 12, 2007, from Academic Search Premier database. Vestal, K. W. (1995). Nursing management: Concepts and issues. Philadelphia: J.B. Lippincott. Vockins, H. (2004). Original article Occupational therapy intervention with patients with breast cancer: a survey. European Journal of Cancer Care, 13(1), 45-52. Retrieved July 12, 2007, from Academic Search Premier database. Read More