Occupational therapy and physiotherapy interventions in palliative care: a cross-sectional study of patient-reported needs

Nina Høgdal; Inge Eidemak; Per Sjøgren; Henrik Larsen; Jonas Sørensen; Jan Christensen

doi:10.1136/bmjspcare-2020-002337

Occupational therapy and physiotherapy interventions in palliative care: a cross-sectional study of patient-reported needs

BMJ Support Palliat Care. 2020 Aug 11:bmjspcare-2020-002337. doi: 10.1136/bmjspcare-2020-002337. Online ahead of print.

Authors

Nina Høgdal¹, Inge Eidemak², Per Sjøgren², Henrik Larsen², Jonas Sørensen², Jan Christensen^{3

4}

Affiliations

¹ Section of Occupational Therapy and Physiotherapy, Rigshospitalet HovedOrtoCentret, Copenhagen, Denmark nina.hoegdal@regionh.dk.
² Section of Palliative Medicine, Rigshospitalet Department of Oncology, Copenhagen, Denmark.
³ Section of Occupational Therapy and Physiotherapy, Rigshospitalet HovedOrtoCentret, Copenhagen, Denmark.
⁴ REHPA - The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital and University of Southern Denmark, Nyborg, Denmark.

PMID: 32788277
DOI: 10.1136/bmjspcare-2020-002337

Abstract

Introduction: An interdisciplinary team approach to patients in specialised palliative care is recommended; however, the composition of the professionals tends to vary, and the roles of physiotherapists and occupational therapists may be underestimated. We aimed to investigate patient-reported unmet needs, which potentially could benefit from physiotherapy and occupational therapy interventions in a specialised palliative care team.

Methods: Adult patients with chronic advanced diseases referred to the Specialised Palliative Care Team at Copenhagen University Hospital, Rigshospitalet were enrolled in the study. The Three-Levels-of-Needs Questionnaire was used as primary outcome to assess symptom/problem intensity, symptom/problem burden and felt needs for 12 commonly reported symptoms/problems for patients referred to a specialised palliative care team. Furthermore, participants' level of distress, fatigue and physical activity, symptoms of anxiety and depression, and barriers towards the rehabilitation programme were registered with other measures.

Results: In total, 43 of 67 (64%) patients participated. The majority of participants reported severe symptoms/problems concerning fatigue (81%), impaired physical activities (77%), carrying out work and daily activities (77%), pain (72%), and worries (58%). Furthermore, need for help was expressed concerning physical activities (79%), work and daily activities (77%), fatigue (70%), pain (65%), concentration (58%) and worries (51%). On average the patients characterised 6 (out of 12) symptoms/problems as severe.

Conclusion: Patients referred to a specialised palliative care team reported extensive unmet needs concerning physical activities, work and daily activities, fatigue, pain, concentration and worries. Unmet needs that potentially could be alleviated by physiotherapists or occupational therapists implemented in the interdisciplinary team.

Keywords: assessment of health care needs; palliative care; physical examination; quality of life; rehabilitation.