Title

Developing Occupational Science Informed Quality of Life Interventions to Address Head and Neck Cancer Survivors and Caregiver Concerns

Start Time

15-10-2009 2:00 PM

End Time

15-10-2009 3:30 PM

Abstract

Annually in the United States, more than 40,000 new cases of head and neck cancer are diagnosed. Treatment typically involves surgery, radiation and chemotherapy, resulting in a general decline in the mortality rates if individuals with these types of cancer. The medical community's recognition of quality of life concerns in patient outcomes has provided an expanded role for occupational therapy. In order to assist individuals to live a fulfilling life during and after their medical treatment, occupational therapy interventions are therefore shifting to a more holistic approach that is informed by occupational and social sciences. Two Masters in Occupational Therapy Students identified related interests for their Master’s Projects and were mentored in exploring the occupational science foundation to build such interventions for head and neck cancer survivors and their caregivers. The cancer center supported this quality improvement project as Stage II in the process of building a model out-patient occupational therapy service in an academic medical center. One student reviewed the literature related to cancer patients needs during and post treatment. The second student’s literature review focused on the evidence regarding caregiver needs while assisting an individual during and post cancer treatment. The literature from the two reviews informed the development of questions for individualized interviews of outpatients and their caregivers at the cancer center. Patients and their caregivers were interviewed during a scheduled out-patient appointment. Analysis of the qualitative data was accomplished by coding themes, comparing with the evidence base provided by the literature review, and patient/caregiver review. Results of this triangulation included identification of the following common treatment sequelae: severe side effects such as facial deformity, speech and swallowing difficulties, and chronic pain in the oral cavity, neck, face, or shoulder. In addition, cognitive impairment, psychiatric problems, physical impairment, chemosensory changes, pain and fatigue were the most common side effects that impacted occupational performance and quality of life. Common caregiver needs while assisting an individual during and post cancer treatment included challenges with time management, fatigue, body mechanics, and finding time for personally meaningful occupations. These results are being used to build the model occupational therapy intervention to bridge gaps in medical care, and improve and sustain meaningful occupational performance in support of quality of life for patients and their caregivers.

References

American Cancer Society. (2008). Cancer facts and figures 2008. Retrieved November 7, 2008, from http://www.cancer.org.

Baghi, M., Wagenblast, J., Hambek, M., et al. (2007). Demands on caring relatives of head and neck cancer patients. Laryngoscope, 117, 712-716. DOI: 10.1097/MLG.0b013e318031d0b4

Hudson, P., Arranda, S. & McMurray, N. (2002). Intervention development for enhanced lay palliative caregiver support-the use of focus groups. European Journal of Cancer Care, 11, 262-270. DOI: 10.1046/j.1365-2354.2002.00314.x

Kealey, P. & McIntyre I. (2005). An evaluation of the domiciliary occupational therapy service in palliative cancer care in a community trust: a patient and carers’ perspective. European Journal of Cancer Care, 14, 232–243. DOI: 10.1111/j.1365-2354.2005.00559.x

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Oct 15th, 2:00 PM Oct 15th, 3:30 PM

Developing Occupational Science Informed Quality of Life Interventions to Address Head and Neck Cancer Survivors and Caregiver Concerns

Annually in the United States, more than 40,000 new cases of head and neck cancer are diagnosed. Treatment typically involves surgery, radiation and chemotherapy, resulting in a general decline in the mortality rates if individuals with these types of cancer. The medical community's recognition of quality of life concerns in patient outcomes has provided an expanded role for occupational therapy. In order to assist individuals to live a fulfilling life during and after their medical treatment, occupational therapy interventions are therefore shifting to a more holistic approach that is informed by occupational and social sciences. Two Masters in Occupational Therapy Students identified related interests for their Master’s Projects and were mentored in exploring the occupational science foundation to build such interventions for head and neck cancer survivors and their caregivers. The cancer center supported this quality improvement project as Stage II in the process of building a model out-patient occupational therapy service in an academic medical center. One student reviewed the literature related to cancer patients needs during and post treatment. The second student’s literature review focused on the evidence regarding caregiver needs while assisting an individual during and post cancer treatment. The literature from the two reviews informed the development of questions for individualized interviews of outpatients and their caregivers at the cancer center. Patients and their caregivers were interviewed during a scheduled out-patient appointment. Analysis of the qualitative data was accomplished by coding themes, comparing with the evidence base provided by the literature review, and patient/caregiver review. Results of this triangulation included identification of the following common treatment sequelae: severe side effects such as facial deformity, speech and swallowing difficulties, and chronic pain in the oral cavity, neck, face, or shoulder. In addition, cognitive impairment, psychiatric problems, physical impairment, chemosensory changes, pain and fatigue were the most common side effects that impacted occupational performance and quality of life. Common caregiver needs while assisting an individual during and post cancer treatment included challenges with time management, fatigue, body mechanics, and finding time for personally meaningful occupations. These results are being used to build the model occupational therapy intervention to bridge gaps in medical care, and improve and sustain meaningful occupational performance in support of quality of life for patients and their caregivers.