Community based OT and breast cancer

Intro
Today’s Elevate Tuesday is inspired by a reader’s suggestion to look at literature for OT and women’s health (Thank-you! We love our members’ input).

Women face unique health challenges, roles, and transitions that should be considered in the framework of occupational therapy.

To date, OT and women’s health is an emerging area of practice, and a cursory review of the literature reveals a clear lack of research (we had to really dig to find a OT-specific study here).

Side note: Two opinion papers we came across that may be worth your glance include...

  • George, M. (2011). Proposed Role for Occupational Therapy to Serve New Mothers.

  • Slootjes, H., McKinstry, C., & Kenny, A. (2016). Maternal role transition: Why new mothers need occupational therapists.


Today's Paper
Petruseviciene, D., Surmaitiene, D., Baltaduoniene, D., & Lendraitiene, E. (2018). Effect of Community-Based Occupational Therapy on Health-Related Quality of Life and Engagement in Meaningful Activities of Women with Breast Cancer. Occupational therapy international, 2018.

The Problem
Breast cancer is the most common form of cancer for women.

For survivors, initial treatment is often only a first step in the full healing process.

Following treatment, a variety of issues can negatively affect Quality Of Life (QOL). These can include  ongoing struggle with symptoms; emotional impacts of stress and life changes; and occupational issues that include return to work, difficulty parenting, and challenges with relationships and sex.

Although treatment (i.e surgical, hormone targeted therapies, etc..) continues to advance, many international communities lack meaningful support for women as they resume or re-integrate into life in the community.

Occupational therapists may be well positioned to deliver community-based interventions to improve QOL for women recovering from breast cancer.

Study Details
Researchers from Lithuania conducted a first-of-its-kind study on the effects of a community-based OT program for women recovering from breast cancer.

The study was a small RCT of 22 women aged 18-80 years old (11 received the intervention).

The intervention group got a six week OT program and the control group did not receive intervention (normal activities only).

The study used self-report measures to collect data that addressed QOL (EORTC QLQ-C30 questionnaire) and engagement in meaningful activity (Engagement in Meaningful Activities Survey).

Here’s what the group-based intervention consisted of:

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Results
For the women who received the OT treatment (as above):

  • Clinically significant improvement were found in self-reported QOL (effect sizes below). This included improvements in global quality of life, physical, cognitive, emotional, fatigue, and insomnia.

  • There was a reduced report of negative symptoms (and side effects) in the OT group.

  • Statistically significant improvements in activity engagement were found


Meaningful activity engagement was also found to relate to improved emotional function and reduced insomnia (and constipation - of all things).


Key Takeaways
Despite clear limitations due to a very small sample size and the measurement tools being solely self-report questionnaires, this important preliminary research fundamentally supports OT practice for women post treatment of breast cancer.

Specifically, increased engagement in meaningful activities helps to improve QOL and function in women recovering from breast cancer.

There’s a need to better support women post cancer treatment in the community, and OTs are well placed to support women in this part of their recovery.

OT Specific education and resources to help you save time, be evidence based, and deliver great patient care.

PS
If you work in community health with survivors of breast cancers (and/or other cancers) let us know of your work or story!