Occupational therapy in adult palliative care. A rapid review

Abstract

Introduction: The Occupational Therapy Association of South Africa commissioned a task team to gather evidence that would inform the upcoming National Health Insurance 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 trials were searched for through the Stellenbosch University library. CINAHL (EBSCO), MEDLINE (EBSCO), the Cochrane Library (Wiley) and OTSeeker databases were used and hand searching of references in selected articles was done. Rayyan.ai 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 CASP quality appraisal showed a good rating. 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  and education, 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. Due to the unique and varied beliefs of South Africans to illness and end of life, evidence from high income countries needs to be supplemented with local knowledge to frame the role and intervention of occupational therapists in palliative care. Evidence to support and define the role of occupational therapists claims this needs to be a matter of priority.

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 at all levels of care need to be an available and accessible continuous professional development (CPD) activity.
• Occupational therapy clinicians working on the frontlines of palliative care need to be encouraged and supported to collect and present evidence for their practices in formats and at forums where it can be used to shape policies that affect palliative adult care locally and globally.