The Care for the Dying: A critical historical analysis of occupational therapy in hospice.

Russell, Marion; Lampe, Angela

doi:10.15453/2168-6408.1216

Cited by 10 publications

(6 citation statements)

References 19 publications

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“…The source of frustration and stress for occupational therapists in this study was attributed to feelings of not providing best care for people with LLCs, which is also similar to the experiences of loss of control and uncertainty reported by other occupational therapists working with similar patient cohorts (5,9,31,37). The current lack of evidence around occupational therapy with people with LLCs is a barrier to effective and efficient work with this population (8,9,15,23,38,39), however this is beginning to be addressed.…”

Section: Discussionsupporting

confidence: 57%

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

Apostol

Cranwell

Hitch

2020

Preprint

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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.

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Section: Discussionsupporting

confidence: 57%

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

Apostol

Cranwell

Hitch

2020

Preprint

View full text Add to dashboard Cite

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“…The current lack of evidence around occupational therapy with people with LLCs is a barrier to effective and efficient work with this population [ 8 , 10 , 15 , 23 , 47 , 48 ], however this is beginning to be addressed. The health service has been conducting research and focus groups with senior leaders and staff to develop a broader wellbeing strategy, which will provide a framework and guidance for future initiatives around professional self-care undertaken by occupational therapy.…”

Section: Discussionmentioning

confidence: 99%

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

2021

View full text Add to dashboard Cite

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 2 years. Quantitative data were analysed descriptively, while qualitative data were subjected to thematic analysis. Results One hundred three 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.

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“…For example, realizing that pharmaceutical pain management is only one part of quality of life, hospice staff may consider how they can enable individuals’ engagement in occupations they find meaningful to facilitate quality of life. Given the time constraints already facing hospice staff, occupational therapists may be valuable additions to the team given their expertise in enabling meaningful and contextually attune engagement (Essential Yeh & McColl, 2019; Russell & Bahle-Lampe, 2016).…”

Section: Implications For Practice and Educationmentioning

confidence: 99%

Understanding Experiences in Hospice: Exploring Temporal, Occupational, and Relational Dimensions Using Pictor Technique

et al. 2020

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Temporality, occupation, and relationships are identified as discrete factors that impact quality of life for individuals at the end of life and those around them. However, scholars, practitioners, and educators require insights regarding whether and how interactions between these factors shape this quality of life. This study is framed by an understanding that meaning is negotiated between people through social interaction and occupational engagement in temporal contexts. We conducted in-depth interviews with 9 patients and 10 family members, incorporating the Pictor visual elicitation technique. Analysis was conducted through an iterative process involving open and selective coding. Findings are described as three main processes: (a) experiences of temporal rupture, (b) diminished significance of clock time, and (c) shifts in occupational priorities. Participants’ perspectives may help carers understand how to foster positive temporal experiences and quality of life for patients and those who love them.

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The Care for the Dying: A critical historical analysis of occupational therapy in hospice.

Cited by 10 publications

References 19 publications

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

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

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

Understanding Experiences in Hospice: Exploring Temporal, Occupational, and Relational Dimensions Using Pictor Technique

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