Importance: Despite the growing literature on the association of functional, physical, and quality-of-life (QOL) deficits with poor postoperative outcomes, there is a gap in the literature identifying women’s occupational performance needs after ovarian cancer surgery. Objective: To describe the experiences of women hospitalized after ovarian cancer surgery to identify potential areas for intervention. Goals were to (1) identify functional needs and limitations at time of discharge as measured by the typical acute care occupational therapy evaluation and semistructured interview and (2) understand the women’s perspectives of their needs for occupational therapy and a safe return to home. Design: Single-arm, cross-sectional descriptive study. Mixed-methods data collection and analysis. Setting: Academic cancer center. Participants: Women with ovarian cancer (N = 11) who had completed surgery. Intervention: Semistructured interviews and patient-reported outcome measures (PROMs) completed postsurgery. Outcomes and Measures: PROMs included the National Comprehensive Cancer Network (NCCN) Distress Thermometer and Problem List, the PROMIS^® Global Physical Health (GPH) and Global Mental Health (GMH) scales, and the Possibilities for Activity Scale–Women (PActS–W). Results: The mean NCCN Distress score was 6.0 (standard deviation [SD] = 3.1, with the top three concerns being pain (80%), worry (80%), and fatigue (78%). Mean GPH and GMH T scores were 38.0 (SD = 8.8) and 48.2 (SD = 8.4), respectively. Women scored a mean of 39.2 (SD = 11.2, range = 26–58) on the PActS–W. Thematic analyses found that the women were uncertain about potential functional limitations and significantly distressed. Conclusion and Relevance: Women with ovarian cancer experienced high levels of uncertainty and distress after surgery. Integrating in-home or community-based occupational therapy into routine care could decrease functional distress and uncertainty and help women manage concerns related to pain, worry, and fatigue. What This Article Adds: This study suggests that occupational therapy evaluation and intervention are needed to decrease distress and improve QOL of women upon discharge after ovarian cancer surgery.

Life course health development (LCHD) is a framework that considers the transactional nature of risks and protective factors along the life trajectory and how this context influences health. Public policies, from health care to education to social services to labor laws, have many goals, including lessening and eliminating health disparities, yet inequities in health services and outcomes remain. Policy is a contextual factor that may be overlooked when examining influences on health and occupation. As such, the LCHD framework may assist occupational therapy practitioners in understanding the influences of policy—both successes and failures—on occupation. In this article, we introduce the principles of LCHD and use this framework to illustrate analysis of a policy example of paid family leave, demonstrating how gaps in or unintended consequences of policy may contribute to disparities in health and occupation for certain populations.

OBJECTIVE. This article describes the cost of occupational therapy by provider, insurance status, and geographic region and the number of visits allowed and out-of-pocket costs under proposed therapy caps. METHOD. This retrospective, population-based study used Medicare Provider Utilization and Payment Data for occupational therapists billing in 2012 and 2013 (Ns = 3,662 and 3,820, respectively). We examined variations in outpatient occupational therapy services with descriptive statistics and the impact of therapy caps on occupational therapy visits and patient out-of-pocket costs. RESULTS. Differences in cost between occupational and physical therapists were minimal. The most frequently billed service was therapeutic exercises. Wisconsin had the most inflated outpatient costs in both years. Under the proposed therapy cap, patients could receive an evaluation plus 12–14 visits. DISCUSSION . Wide variation exists in potential patient out-of-pocket costs for occupational therapy services on the basis of insurance coverage and state. Patients without insurance pay a premium.

Date Presented 4/8/2016 This study evaluated a new mobile application’s ability to predict fall risk in older adults. Senior SWAY was significantly associated with patient-reported previous falls and the Timed Up and Go. This application could potentially ease identification of older adults at risk of falling. Primary Author and Speaker: Mackenzi Pergolotti Additional Author and Speaker: Ashley Bryant Contributing Authors: A. Bennett, G. R. Williams

Date Presented 4/7/2016 The objective of this study was to describe utilization and cost of occupational therapy services. Variation exists within treatments and states. Medicare reimbursement caps place a limit on visits and can potentially provoke substantial financial risk to those with higher therapy needs. Primary Author and Speaker: Mackenzi Pergolotti Contributing Authors: Jessica Lavery, Bryce B. Reeve, Stacie B. Dusetzina

Date Presented 4/17/2015 Older adults are at risk of functional decline after a diagnosis of cancer, yet little is known about the association of those deficits and the subsequent use of cancer rehabilitation. This study provides the needed evidence to move toward the increased use of our services for this population.

Occupational therapy may significantly improve cancer survivors’ ability to participate in activities, thereby improving quality of life. Little is known, however, about the use of occupational therapy services by adults with cancer. The objective of this study was to understand what shapes patterns of occupational therapy use to help improve service delivery. We examined older (age >65 yr) adults diagnosed with breast, prostate, lung, or melanoma (skin) cancer between 2004 and 2007 (N = 27,131) using North Carolina Central Cancer Registry data linked to Medicare billing claims. Survivors who used occupational therapy within 1 yr before their cancer diagnosis were more likely to use occupational therapy after diagnosis but also experienced the highest levels of comorbidities. Survivors with Stage 4 cancers or lung cancer were less likely to use occupational therapy. These findings suggest possible disparities in utilization of occupational therapy by older adults with cancer.