Referral Facilitators & Barriers to OT Services Identified by Oncology Referral Sources: A Qualitative Study

PURPOSE: Evidence suggests that OT services are underutilized in cancer care. Therefore, exploring referral sources’ perspectives would provide a deeper understanding of the barriers, supports, and solutions to improve access to OT services. The purpose of this study was to explore perspectives of OT referral sources in cancer care.

DESIGN: A qualitative multiple-explanatory case study design was used. Researchers utilized purposive sampling methods, including professional contacts and recruitment by phone, email, flyer, social media, and word of mouth. Common referral sources to OT services, such as oncologists, nurses, and social workers, were included.

METHOD: Researchers conducted focus groups via video conference and used a semi-structured guide. Focus groups were transcribed verbatim and reviewed for accuracy, and data were analyzed using a grounded theory approach with recommended steps by Strauss & Corbin. Demographic data were collected using Qualtrics and were analyzed using IBM SPSS Version 28.

RESULTS: We recruited seventeen participants from four different professional groups. Four overarching themes emerged, ‘Support for OT referral, knowledge of client factors & side effects, barriers to OT referral, and participant context.’ Sub-themes consisted of (a) integration of OT in oncology; (b) knowledge of occupational performance; (c) knowledge of the scope of OT practice; (d) ideas to support referral; (e) insufficient awareness/knowledge of OT; (f) system barriers; (g) clinic barriers; (h) patient barriers; (i) profession; and (j) experience, interaction, and collaboration with OTs.

CONCLUSION: Referral sources expressed gaps in knowledge of OT’s role and scope of practice, various levels of barriers, and ideas to support referral. There are several implications for OT practice, including the possibility of therapists utilizing the suggestions offered to overcome barriers and maximize support for referrals in cancer care.

References

Pergolotti, M., Deal, A. M., Williams, G. R., Bryant, A. L., McCarthy, L., Nyrop, K. A., Covington, K. R., Reeve, B. B., Basch, E., & Muss, H. B. (2019). Older Adults with Cancer: A Randomized Controlled Trial of Occupational and Physical Therapy. Journal of the American Geriatrics Society, 67(5), 953–960. https://doi.org/10.1111/jgs.15930

Loubani, K., Polo, K. M., Baxter, M. F., & Rand, D. (in press) Phase I of an International Collaboration to Identify Referral Facilitators and Barriers to Occupational Therapy Services by Cancer Healthcare Professionals: A Qualitative Study. American Journal of Occupational Therapy, 78(1).

Corbin, J., & Strauss, A. (2014). Basics of qualitative research: techniques and procedures for developing grounded theory, 4th edn Sage Publications. Thousand Oaks.