Supporting the Unmet Needs of Mothers in Breast Cancer Survivorship: Integrating Occupational Therapy into an Urban Outpatient Cancer Center Rehabilitation Program

Abstract

Breast cancer survivorship is a chronic condition that disrupts a mother’s physical and psychosocial abilities to participate in meaningful activities; yet, rehabilitation to address her needs is rarely considered. This study examined how the integration of occupational therapy (OT) into a cancer center rehabilitation program might address the broad impact of a mother’s breast-cancer diagnosis, and its treatments, on the role of parenting, activity participation and QOL. Methods: Needs analysis; informal interviews; formal surveys; rehabilitation and oncology provider education; protocol and program development for target population; development of screening tools to address unmet needs; and resource development to facilitate referral to OT providers. Results: Mean pre- and post-education scores were calculated for each group and scores compared with an unpaired t-test. Responses indicated rehabilitation practitioners were significantly more confident after education on the physical and psychosocial disease impacts, and how outpatient OT services might address related limitations (>2.0 mean score improvement vs baseline and p<0.001 for all). Oncology navigation pre- and post- education session responses indicated a significantly increased level of confidence in the benefits of OT (p < 0.05) for the population, and a slightly increased likelihood of referral for OT services (p = 0.08). Clinical implications: Oncology and rehabilitation providers must be willing and able to consider the wide-ranging impacts of breast cancer on a mother, including the influence on her ability to cope and participate in meaningful activities. Comprehensive oncology rehabilitation programming that includes OT is necessary to meet a mother’s needs, promote participation, and improve QOL. Providers must increase referrals to rehabilitation, including OT, to provide maximal benefit to breast cancer survivors with children in the home.