A Conceptual-Practice Model for Occupational Therapy to Facilitate Return to Work in Breast Cancer Patients

Purpose Improved therapies and early detection have significantly increased the number of breast cancers survivors, leading to increasing needs regarding return to work (RTW). Occupational therapy (OT) interventions provide successful RTW assistance for other conditions, but are not validated in breast cancer. This paper aims to identify a theoretical framework for OT intervention by questioning how OT models can be used in OT interventions in RTW of breast cancer patients; criteria to be used to select these models and adaptations that would be necessary to match the OT model(s) to breast cancer patients’ needs? Methods Using research specific criteria derived from OT literature (conceptual OT-model, multidisciplinary, referring to the International Classification of functioning (ICF), RTW in breast cancer) a search in 9 electronic databases was conducted to select articles that describe conceptual OT models. A content analysis of those models complying to at least two of the selection criteria was realised. Checking for breast cancer specific issues, results were matched with literature of care-models regarding RTW in breast cancer. Results From the nine models initially identified, three [Canadian Model of Occupational Performance, Model of Human Occupation (MOHO), Person–Environment–Occupation–Performance model] were selected based on the selection criteria. The MOHO had the highest compliance rate with the criteria. To enhance usability in breast cancer, some adaptations are needed. Conclusion No OT model to facilitate RTW in breast cancer could be identified, indicating a need to fill this gap. Individual and societal needs of breast cancer patients can be answered by using a MOHO-based OT model, extended with indications for better treatment, work-outcomes and longitudinal process factors.

[1]  M. Feuerstein.  Cancer Survivorship and Work , 2005, Journal of Occupational Rehabilitation.

[2]  J. C. Clark,et al.  Reintegration and Maintenance of Employees with Breast Cancer in the Workplace , 1989, AAOHN journal : official journal of the American Association of Occupational Health Nurses.

[3]  Rhysa T Leyshon,et al.  Using the ICF as a conceptual framework to guide ergonomic intervention in occupational rehabilitation. , 2008, Work.

[4]  G. Kielhofner.  Conceptual foundations of occupational therapy practice , 2009 .

[5]  M. Feuerstein.  Work and Cancer Survivors , 2009 .

[6]  P. Capodaglio,et al.  Work capacity of the upper limbs after mastectomy. , 1997, Giornale italiano di medicina del lavoro ed ergonomia.

[7]  C. Haslam,et al.  Cancer survivorship and work: Symptoms, supervisor response, co-worker disclosure and work adjustment , 2007, Journal of Occupational Rehabilitation.

[8]  P. Loisel,et al.  From Evidence to Community Practice in Work Rehabilitation: The Quebec Experience , 2003, The Clinical journal of pain.

[9]  Paul Hough,et al.  Guidelines prescribed by general practitioners to patients with acute low back pain regarding ‘return to work’ , 2006 .

[10]  M. Neyt,et al.  The Long-Term Evolution of Quality of Life for Disease-Free Breast Cancer Survivors , 2006, Journal of psychosocial oncology.

[11]  C. Haslam,et al.  Returning to work following cancer: a qualitative exploratory study into the experience of returning to work following cancer. , 2007, European journal of cancer care.

[12]  A. Cieza,et al.  Exploration of the link between conceptual occupational therapy models and the International Classification of Functioning, Disability and Health , 2005 .

[13]  S. Paquette.  Return to work with chronic low back pain: using an evidence-based approach along with the occupational therapy framework. , 2008, Work.

[14]  L. Rieth,et al.  Integrated Disability Management , 1995, AAOHN journal : official journal of the American Association of Occupational Health Nurses.

[15]  H. L. Hopkins,et al.  Willard and Spackman's Occupational Therapy , 1993 .

[16]  D. Uebelhart,et al.  Use of the ICF model as a clinical problem-solving tool in physical therapy and rehabilitation medicine. , 2002, Physical therapy.

[17]  C. Bradley,et al.  Correlates of return to work for breast cancer survivors. , 2006, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[18]  C. Henriksson,et al.  Concepts in occupational therapy in relation to the ICF. , 2003, Occupational therapy international.

[19]  R. Gatchel,et al.  Treatment- and Cost-Effectiveness of Early Intervention for Acute Low-Back Pain Patients: A One-Year Prospective Study , 2003, Journal of Occupational Rehabilitation.

[20]  Y. Jang,et al.  A work‐oriented occupational therapy programme for individuals with physical disabilities , 1997 .

[21]  Gwyn McClelland.  Survivors , 1891, The Hospital.

[22]  G. Kielhofner,et al.  Vocational intervention based on the Model of Human Occupation: a review of evidence , 2010 .

[23]  C. Dewa,et al.  Disability management, return to work and treatment. , 2004, HealthcarePapers.

[24]  A. Schene,et al.  Adjuvant occupational therapy for work-related major depression works: randomized trial including economic evaluation , 2006, Psychological Medicine.

[25]  A. Cieza,et al.  Exploration of the link between conceptual occupational models and the International Classification of Functioning, Disability and Health: Answers to the comments from Norway , 2006 .

[26]  U. Bültmann,et al.  Trends in return to work of breast cancer survivors , 2010, Breast Cancer Research and Treatment.

[27]  J. Steiner,et al.  A qualitative study of work and work return in cancer survivors , 2005, Psycho-oncology.

[28]  M. Sprangers,et al.  Factors reported to influence the return to work of cancer survivors: a literature review , 2002, Psycho-oncology.

[29]  Ilse de Bourdeaudhuij,et al.  The contribution of general and cancer‐related variables in explaining physical activity in a breast cancer population 3 weeks to 6 months post‐treatment , 2013, Psycho-oncology.

[30]  M. Cole,et al.  Applied Theories in Occupational Therapy: A Practical Approach , 2007 .

[31]  M. Frings-Dresen,et al.  Return to work of breast cancer survivors: a systematic review of intervention studies , 2009, BMC Cancer.

[32]  Alison Hammond,et al.  Rehabilitation in musculoskeletal diseases. , 2008, Best practice & research. Clinical rheumatology.

[33]  F. Munir,et al.  Helping Cancer Survivors Return to Work: What Providers Tell Us About the Challenges in Assisting Cancer Patients with Work Questions , 2012, Journal of Occupational Rehabilitation.

[34]  J. Groothoff,et al.  Return to Work After Early-stage Breast Cancer: A Cohort Study into the Effects of Treatment and Cancer-related Symptoms , 2008, Journal of Occupational Rehabilitation.

[35]  K. Luker,et al.  Return to paid work after cancer: A British experience , 2007, Journal of cancer survivorship : research and practice.

[36]  M. Chen-Sea,et al.  Factors Related to Return to Work and Job Modification After a Hand Burn , 2009, Journal of Burn Care & Research.

[37]  L. Thorell,et al.  Return to work: the predictive value of the Worker Role Interview (WRI) over two years. , 2010, Work.

[38]  B. J. Carter.  Surviving breast cancer: a problematic work re-entry. , 1994, Cancer practice.

[39]  C. Earle,et al.  Models of care for post-treatment follow-up of adult cancer survivors: a systematic review and quality appraisal of the evidence , 2012, Journal of Cancer Survivorship.

[40]  M. Frings-Dresen,et al.  Interventions to enhance return-to-work for cancer patients. , 2011, The Cochrane database of systematic reviews.

[41]  M. Mendez.  World Federation of Occupational Therapists , 1982 .

[42]  Ilse de Bourdeaudhuij,et al.  Care needs after primary breast cancer treatment. Survivors' associated sociodemographic and medical characteristics , 2013, Psycho-oncology.

[43]  M. Arbyn,et al.  High burden of breast cancer in Belgium: recent trends in incidence (1999-2006) and historical trends in mortality (1954-2006) , 2011, Archives of public health = Archives belges de sante publique.

[44]  Patricia A. Ganz,et al.  From cancer patient to cancer survivor : lost in transition , 2006 .

[45]  M. Chan.  Description of a return-to-work occupational therapy programme for stroke rehabilitation in Singapore. , 2008, Occupational therapy international.

[46]  M. Olsson,et al.  Factors influencing return to work: a narrative study of women treated for breast cancer. , 2010, European journal of cancer care.

[47]  B. Braveman.  Development of a Community-Based Return to Work Program for People with AIDS , 2001, Occupational therapy in health care.

[49]  Kathlyn L. Reed,et al.  Concepts of occupational therapy , 1980 .

[50]  A. Burdorf,et al.  Treatment of Impingement Syndrome: A Systematic Review of the Effects on Functional Limitations and Return to Work , 2006, Journal of Occupational Rehabilitation.

[51]  Raymond Baril,et al.  Workplace-Based Return-to-Work Interventions: Optimizing the Role of Stakeholders in Implementation and Research , 2005, Journal of Occupational Rehabilitation.

[52]  Renee M. Williams,et al.  Perspectives on workplace disability management: a review of the literature. , 2002, Work.

[53]  M. Christiaens,et al.  Survived but feeling vulnerable and insecure: a qualitative study of the mental preparation for RTW after breast cancer treatment , 2012, BMC Public Health.

[54]  E. Cohn,et al.  Willard & Spackman's Occupational Therapy , 2010 .

[55]  S. Corr,et al.  Returning to Work after a Stroke: An Important but Neglected Area , 2003 .

[56]  C. Kalina.  Strategies in Disability Management: Corporate Disability Management Programs Implemented at the Work Site , 1999, Annals of the New York Academy of Sciences.

[57]  J. Vasey,et al.  Employment pathways in a large cohort of adult cancer survivors , 2005, Cancer.

[58]  T. D. de Reijke,et al.  Cancer, fatigue and the return of patients to work-a prospective cohort study. , 2003, European journal of cancer.

[59]  M. Christiaens,et al.  Experiences and concerns about ‘returning to work’ for women breast cancer survivors: a literature review , 2010, Psycho-oncology.

[60]  D. Knol,et al.  Randomised controlled trial of integrated care to reduce disability from chronic low back pain in working and private life , 2010, BMJ : British Medical Journal.

[61]  Xinhua Yu,et al.  Work in cancer survivors: a model for practice and research , 2010, Journal of cancer survivorship : research and practice.

[62]  Deborah H. Charbonneau,et al.  Doody's Core Titles in the Health Sciences (DCT) , 2005 .

[63]  T. D. de Reijke,et al.  Work ability and return-to-work in cancer patients , 2008, British Journal of Cancer.

[64]  B. Dierckx de Casterlé,et al.  Supporting Return-to-Work in the Face of Legislation: Stakeholders’ Experiences with Return-to-Work After Breast Cancer in Belgium , 2012, Journal of Occupational Rehabilitation.

[65]  J. Perlmutter,et al.  From Cancer Patient to Cancer Survivor: Lost in Translation , 2006 .

[66]  M. Ikiugu,et al.  A Framework for Combining Theoretical Conceptual Practice Models in Occupational Therapy Practice , 2009, Canadian journal of occupational therapy. Revue canadienne d'ergotherapie.

[67]  A. Mehnert.  Employment and work-related issues in cancer survivors. , 2011, Critical reviews in oncology/hematology.

[68]  A. D. de Rijk,et al.  Occupational therapy and return to work: a systematic literature review , 2011, BMC public health.

[69]  M. Christiaens,et al.  Breast cancer treatment and work disability: patient perspectives. , 2011, Breast.