Date of Paper/Work

5-2022

Type of Paper/Work

Doctoral Project

Degree Name

Doctor of Occupational Therapy

Department

Occupational Science/Occupational Therapy

First Advisor

Teresa Wickboldt

Department/School

Doctor of Occupational Therapy

Abstract

Head and neck cancer survivors experience significant changes to their health, well-being, and ability to participate in daily life activities as a result of cancer treatment. Oftentimes, these patients are left to their own devices without concrete instructions or strategies to mitigate, much less prevent, the sequelae they experience. Likewise, interdisciplinary teams lack an evidence-based framework in which to provide comprehensive supportive care for patients with head and neck cancer. Despite acknowledgement within the occupational therapy profession of the chronic nature of survivorship (Baxter et al., 2017) and the national public health initiatives to prevent and reduce the impact of secondary chronic disease burden (American Occupational Therapy foundation, n.d.; National Center for Chronic Disease Prevention and Health Promotion (U.S.) et al., 2004), there remains a critical gap in preventative services in head and neck cancer populations regarding known side effects of cancer treatment (Berkowitz et al., 2018; Fang & Heckman, 2016; Rogers et al., 2011). Therefore, a review and critical appraisal of the existing evidence surrounding prehabilitation as a model of care and the role of occupational therapy with head and neck cancer survivors was indicated. The evidence review and critical appraisal, which took place in the fall of 2021, provided the underpinning for three knowledge translation projects.

The aims of this doctoral project are to increase awareness of head and neck cancer survivors’ needs and to share knowledge concerning evidence-based interventions and approaches to meet these needs. To accomplish these aims, I selected three different methods to translate knowledge. In the first project I sought to educate generalist practitioners and students in the context of a collaborative synchronous webinar series with the Minnesota Occupational Therapy Association about implications for practice. The second project involved a live webinar embedded within a semi-annual meeting of the Michigan Occupational Therapy Association Oncology Special Interest Section. Attendees in this project were assumed to have had at least minimal training or experience in oncology practice and included a range of practitioners and students. Attendees also participated in discussion pertaining to implementation. The third project was a scoping review article submitted to the interdisciplinary journal Archives of Physical Medicine and Rehabilitation. This article serves as a method to reach a wide audience in terms of discipline as well as geographic location.

Together, these three projects provided a variety of opportunities to increase knowledge about prehabilitation and occupational therapy approaches in the supportive care of head and neck cancer survivors. In light of the vast scope of this project, future refinements of the recommended model are expected. Additional information and input from other disciplines would serve the usability of the model well. Future planned projects include a poster presentation at the American Congress of Rehabilitative Medicine Annual Conference in the fall of 2022, in addition to a critical issues article in the American Journal of Occupational Therapy to provide a call to action for occupational therapy practitioners to take their place on the interdisciplinary team.

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