Stacey Morikawa OTD, OTR/L

Objective. These Practice Guidelines aim to assist occupational therapy practitioners, educators, and researchers in applying evidence and expert opinion to occupational therapy practice across the cancer continuum of care, including identifying gaps in care. Key focus areas include psychosocial function, fatigue, cognition, pain, sleep, and physical activity. These guidelines can serve as a reference for policymakers, health care professionals, health care managers, regulators, third-party payers, and managed care organizations to manage, reimburse, and set policy.

Method. We examined, synthesized, and integrated the results of systematic reviews, supporting literature, and expert opinion to develop and provide clinical recommendations for practice in the care of adults living with and beyond cancer.

Results. Sixteen systematic reviews with moderate to strong strength of evidence published between 2019 and 2022 served as the foundation for these Practice Guidelines.

Conclusions and Recommendations. To support symptom management for adults living with and beyond cancer, occupational therapy practitioners can consider using psychosocial interventions for anxiety, depression, posttraumatic growth, and overall psychological distress. Practitioners can consider using physical activity interventions for cancer-related fatigue, cognitive performance, and sleep. Practitioners could also consider using interventions for cognition, pain management, and self-management for the improvement of cancer-related symptoms.

Keywords. adult, cancer, occupational therapists, practice guidelines, fatigue, systematic reviews

The articles “Systematic Review of Occupational Therapy and Adult Cancer Rehabilitation,” part 1 and part 2, examine the evidence of the effectiveness of occupational therapy interventions on adults with cancer. The systematic review highlights the importance of interventions including physical activity, symptom management, multidisciplinary rehabilitation programs, and interventions targeting psychosocial concerns, sexuality, and return to work. Strong evidence indicates that physical exercise is safe and beneficial for most cancer survivors, most notably to address cancer-related fatigue. Strong evidence supports the benefit of multidisciplinary rehabilitation for cancer survivors as well as the benefit of psychosocial intervention in reducing anxiety and depression. Moderate evidence supports the effectiveness of interventions on sexuality and return to work; however, further research in this area is needed. This systematic review provides support for occupational therapy intervention in addressing the activity and participation needs of adult cancer survivors.

Keywords. adult cancer rehabilitation, occupational therapy, oncology rehabilitation, activity, participation, exercise, psychosocial, physical activity