Impact of a Cancer Survivorship Program on Well-Being and Community Involvement: Role of OT and Future Directions

PURPOSE: Although over 98% of Americans will face a diagnosis of cancer during their lives, there in a promising increase in cancer survivorship (NCI, 2018). The physical, psychosocial, and cognitive challenges facing survivors can reduce participation in daily occupations and diminish quality of life and well-being. Although occupational therapy practitioners provide interventions for individuals in medical settings, further research is needed to explore the role of occupational therapy on survivorship teams. This research studied the impact of a community-based cancer survivorship program, which included social workers (journaling, counseling, art), massage therapists, reiki providers, exercise practitioners (yoga, tai chi, strengthening), and occupational therapy students and faculty (cognitive re-training, knitting and crocheting).

DESIGN: This qualitative study followed a phenomenological approach, to more fully explore the lived experiences of cancer survivors in a community-based survivorship program. Convenience sampling identified nine interviewees (mean age 64, breast cancer most common, 2+ years since diagnosis, participation in program 2 months to 3 years).

METHOD: Semi-structured interviews were voice recorded and transcribed verbatim. Prior to coding, all six research team members engaged in the epoque process to identify and eliminate any potential bias. The first two rounds of descriptive and pattern coding were followed by member checking and peer debriefing to ensure trustworthiness of data. The final round of coding identified five themes.

RESULTS: Personal themes describing impact on the individuals included 1) journey of spiritual and emotional healing, 2) growing into a new sense of self, and 3) moving from survival to life. Participants related the ability to share difficult personal and emotional experiences, process these with others through the group activities, and engage in new and meaningful experiences. Many described their ability to shift from just surviving a diagnosis to embracing healing and personal empowerment. One participant stated, “I have more zest for life than I had before I even had the cancer.” Relational themes, which described the influence of the interprofessional team and other group members, included 1) building a community of caring and connection and 2) embracing the value of altruism. They described other cancer survivors and team members as family, expressing how the process of the journey of survivorship bonded them. Many participants became more involved in the community through increased occupational performance and volunteerism. They spoke powerfully of how participation in survivorship increased their occupational performance and well-being.

CONCLUSION: The lived experiences of cancer survivors clearly identified the importance of the interprofessional team, the connection with others, and the importance of occupational engagement. Personal benefits in the journey of dealing with a serious illness were identified, as well as improved relationships with others and communities. Additional research is ongoing to increase the sample size, add qualitative inquiry regarding the impact of each type of provider on the team (including occupational therapy), and add quantitative inquiry regarding the specific physical, cognitive, social and emotional outcomes of the programs.

IMPACT STATEMENT: This study clearly identifies the benefits of community-based cancer survivorship programs that include occupational therapy, a non-traditional setting for the provision of OT to people diagnosed with cancer. It lays a foundation for further exploration of the role and benefits of occupational therapy in long-term community-based cancer survivorship.

References

Baxter, M. F., Newman, R., Longpre, S. M., & Polo, K. M. (2017). Occupational therapy’s role in cancer survivorship as a chronic condition. American Journal of Occupational Therapy, 71(3), 7103090010. https://doi.org/10.5014/ajot.2017.713001

Pergolotti, M., Williams, G. R., Campbell, C., Munoz, L. A., & Muss, H. B. (2016). Occupational therapy for adults with cancer: Why it matters. The Oncologist, 21, 314-319. https://doi.org/10.1634/theoncologist.2015-0335

Hwang, E. J., Lokietz, N. C., Lozano, R. L., & Parke, M. A. (2015). Functional deficits and QoL among cancer survivors: Implications for occupational therapy in cancer survivorship care. American Journal of Occupational Therapy, 69(6), 6906290010. https://doi.org/10.5014/ajot.2015.015974

National Cancer Institute (2018). Cancer Statistics. https://www.cancer.gov/about-cancer/understanding/statistics