Rapid review Occupational therapy in adult palliative care. A rapid review

Abstract

ABSTRACT

Introduction: The Occupational Therapy Association of South African commissioned a task team to gather evidence that would inform the upcoming National Health policies on the role and practice of occupational therapists. This rapid review aimed to identify level 1 and 2 peer reviewed published evidence that describes occupational therapists’ practice and intervention in adult palliative care.

Method: Systematic reviews and randomised control trails evidence was searched for through the XXX University library. CINAHL (EBSCO), MEDLINE (EBSCO), the Cochrane Library (Wiley) and OTSeeker data bases were used and hand searching of references in selected articles was done. Rayyan was used for the screening and selection of articles. The CASP appraisal tool was used for quality assessment of the selected articles. Data was captured in Excel and Word, and analysed and synthesised in Excel and Taguette.

Results: 15 articles were identified for data extraction in this rapid review. The quality appraisal showed a range of 65% - 90%. Occupational therapists working in palliative care were reported to address: Functionality, activity participation and quality of life, symptom management related to disease and the treatment thereof, environmental modification and adaption, assistive devices and equipment, education and caregiver support, lifestyle adaptation, return to work or higher education/training.

Conclusion: South Africa has a unique palliative burden of care due to diseases that shorten life expectancy.  First world evidence cannot be the only source of evidence used to frame the role and intervention of occupational therapists with adult’s palliative care due to South Africans varied and unique beliefs with regard to illness and end of life. Evidence to support and define the role of the occupational therapists claim this needs to be a matter of priority.

Keywords: life-limiting illness, terminal illness, end-of-life care, palliative intervention, ADL and iADL, cancer, quality of life, multi-disciplinary team, symptom management, assistive devices

Implications for practice:

• Contextually relevant palliative care intervention needs to be included in the undergraduate curriculum for occupational therapists and once they go to community service, they need to be supported in this.
• Development and upskilling of occupational therapy clinicians in contextually relevant palliative practice needs to be an available and accessibility continuous professional development (CPD) activity.
• Occupational therapy clinicians working in the frontlines of palliative care need to be encouraged and supported to collect and present evidence of their practices in formats and at forums where it can be used to shape policies that affect palliative adult care locally but also globally.