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'Case in Context' - What therapeutic intervention should the client expect from an occupational therapist in an oncology service?

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Introduction

OTP 111 'Case in Context' What therapeutic intervention should the client expect from an occupational therapist in an oncology service? The therapeutic intervention a client should expect from an occupational therapist in an oncology service should be one that complies with government legislation, plans, standards and guidelines. The Governments plans for the National Health Service (NHS) are set out in several reports such as: - the Calman-Hine Cancer Report (1995), The New NHS - Modern and Dependable (1997) and The NHS Cancer Plan (2000), which provide information to service users regarding the quality of the services they should expect. Client's should also expect occupational therapists to adhere to the Code of Ethics and Professional Conduct for Occupational Therapists, which is 'a public statement of the values and principles used in promoting and maintaining high standards of professional behaviour in occupational therapy' (COT 2000). 'Cancer' is a general term used when referring to a malignant growth of tissue in any part of the body. Cells that become cancerous have an abnormal increase in their growth rate, which can result in the development of a tumour or growth. Malignant tumours can destroy the normal tissues surrounding them and if left untreated can spread via the lymphatic and circulatory systems, resulting in possible metastases forming away from the primary tumour. Many primary tumours have a predictable route of spread and since many of them have few early signs and symptoms, they may not be detected until they have formed metastases (Turner et al 1996). The range of services available to individuals with cancer has changed considerably over the last five years. Emphasis of care is now provided within a multidisciplinary teamwork approach, which incorporates the valuable skills of occupational therapy. Occupational therapists need to assess and consider the physical, functional, psychological and social needs of their clients and utilise their core skills together with the skills of the multidisciplinary team to maximise the independence and quality of life of the patient with cancer and their carers. ...read more.

Middle

It may be possible however, if Mary agrees, to provide home-care once she is discharged home and the occupational therapist will need to liase with the Social Worker regarding this issue. Mary may experience nausea, vomiting, reduced energy, initiative and motivation, which can all hinder intervention. The occupational therapist can provide treatments aimed at controlling these, which could include progressive muscular relaxation training and education concerning stress management and energy conservation techniques (Cooper 1997). Aims of treatment for Mary may include: - 1. Enabling the client to perform all activities of daily living (ADL) by providing equipment and home-care service support as necessary. 2) Assist the client in maintaining physical strength through organisation of rest and activity cycles (Reed 1991). 3) Maintain or increase range of motion through activities selected to promote the use of left arm and joints. 4) Provide orthotic devices, such as splints or other positioning support or prothesis as needed. 5) Teach concepts of energy conservation, stress management training and relaxation as required. 6) Explain side effects of chemotherapy and radiation treatments. 7) Provide information concerning post-surgery complications, exercise, pain and coping with disfigurement 8) Provide time and opportunity for client to discuss feelings and pass through the grieving process by assisting with exploring existential themes such as suffering, guilt, forgiveness, joy, freedom and loneliness if required. 9) Provide information on support agencies involved in cancer care 'Age Concern' and day centre facilities. As mentioned earlier, Mary has oedema in her left upper arm, which can create problems for the client when she is carrying out functional tasks (Cooper 1997). Exercise and activities of daily living practice that promote using the hand and arm to optimise functioning can be treatments applied by the occupational therapist to enable the client the ability to perform valued activities (Cooper 1997). Once the aims of treatment are completed the occupational therapist can evaluate outcomes with Mary by using COPM to reassess and establish improvement in her performance and satisfaction once intervention is completed. ...read more.

Conclusion

Also, providing information about the disease, the treatments and possible emotional reactions are further methods shown to improve patient's ability to adapt (Tiffany and Webb, 1989). In conclusion, the therapeutic intervention a client should expect from an occupational therapist in an oncology service should be one that complies with government legislation, plans, standards and guidelines and also one that adheres to the Code of Ethics and Professional Conduct for Occupational Therapists. Occupational therapists need to assess and consider the physical, functional, psychological and social needs of their clients and utilise their core skills to maximise the independence and quality of life of the patient with cancer and their carers. The treatment process and core skills of the occupational therapist should be based on a problem solving approach. All these issues have been discussed and applied concerning 'Mary' who is the client selected as the 'case in context' for this assignment. The main factor that that might hinder the best possible occupational therapy intervention, on critically evaluating the situation include lack of adequate, timely investment by the government to fund and provide more staff, equipment, research and resources. This may stretch services to the limits and ultimately affect the efficiency of teamwork and the health of staff due to overwork resulting in stress. Another factor includes the depth and range of the therapist's skills concerning her choice of activities for intervention, which if limited could hinder intervention and provision of a quality service. The main factors, which could aid intervention, include occupational therapists helping clients to adapt and work through the stages of grief by utilising the basic counselling skills of empathy, unconditional positive regard and congruence whilst utilising good listening and communication skills. Also, occupational therapists by following and complying efficiently with audit procedures and actively pursuing lifelong learning and continued professional development requirements could aid with providing a quality service and intervention. Finally, it will aid intervention when occupational therapists are aware of the potential causes of stress and how to prevent and manage it in order to foster effective communication and team working. ...read more.

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