Evaluating a multidimensional strategy to improve the professional self-care of occupational therapists working with people with life limiting illness.

Abstract

Background: The term ‘’life limiting conditions’ refers to premature death following decline from chronic conditions, which is a common circumstance in which occupational therapists work with people at the end of life. The challenges for clinicians of working with these patients have long been recognised, and may have a significant impact on their professional self-care. This study aimed to evaluate a multidimensional workplace strategy to improve the professional self-care of occupational therapists working with people living with a life limiting condition.Methods: A pre and post mixed methods survey approach were utilised, with baseline data collection prior to the implementation of a multidimensional workplace strategy. The strategy included professional resilience education, targeted supervision prompts, changes to departmental culture and the promotion of self-care services across multiple organisational levels. Follow up data collection was undertaken after the strategy had been in place for two years. Quantitative data were analysed descriptively, while qualitative data were subjected to thematic analysis. Results: 103 occupational therapists responded (n=55 pre, n=48 post) across multiple service settings. Complex emotional responses and lived experiences were identified by participants working with patients with life limiting conditions, which were not influenced by the workplace strategy. Working with these patients was acknowledged to challenge the traditional focus of occupational therapy on rehabilitation and recovery. Participants were confident about their ability to access self-care support, and supervision emerged as a key medium. While the strategy increased the proportion of occupational therapists undertaking targeted training, around half identified ongoing unmet need around professional self-care with this patient group. Demographic factors (e.g. practice setting, years of experience) also had a significant impact on the experience and needs of participants. Conclusions: The multidimensional workplace strategy resulted in some improvements in professional self-care for occupational therapists, particularly around their use of supervision and awareness of available support resources. However, it did not impact upon their lived experience of working with people with life limiting conditions, and there remain significant gaps in our knowledge of support strategies for self-care of occupational therapist working with this patient group.

Development of an evidence-informed education package for occupational therapists for palliative and end of life care: promoting occupational justice

“…Despite these limitations, the educational package achieved its aim of integrating and utilising as many of the recommended resources as possible Face to face contact with clients at end-of-life can complement the flexible use of clinical scenarios, workshops and content targeted to specific topics as proposed in the package developed (Apostol et al, 2021;Breen et al, 2013).…”

“…The education package promotes occupational engagement across these domains and encourages the need for innovative clinical reasoning to identify when occupational performance is no longer an appropriate goal and may well increase emotional distress (Pickens et al, 2016). Apostol et al (2021) highlighted that moving from a purely rehabilitative focus to maintenance and compensation is challenging to most traditionally trained occupational therapists employed within a biomedical healthcare services model. Current practice in Australia has a relatively limited scope, with an emphasis on equipment prescription, carer training and discharge planning rather than occupational engagement (Keesing & Rosenwax, 2011).…”