Individualized Return-to-Work Intervention Within the Cancer Care Continuum.

Abstract

Importance: Advanced cancer treatments have led to more people wanting to return to work but are unable. Occupational therapists have the skills to address impaired person and environmental factors delaying return to work.

Objective: Describe a three-phase occupational therapy return-to-work intervention based on the Person-Environment-Occupation-Performance (PEOP) model.

Design: Case series.

Setting: Outpatient clinic.

Participants: Adults with brain cancer (N = 3) who completed or were undergoing cancer treatment and wanted to return to work.

Intervention: We evaluated a three-phase occupational therapy approach focusing on restoring self-care skills and advocacy (Phase 1), understanding job demands and developing prework skills (Phase 2), and providing return-to-work support (Phase 3).

Outcomes and measures: Employment status was based on patient self-report. Pre- and postintervention measurements were the 10-item Weekly Calendar Planning Activity; five times sit-to-stand test; Patient Health Questionnaire-9; Saint Louis University Mental Status Examination; Trail Making Test, Dynavision D2 Vision Training System assessment, Bell's Test, and peripheral vision screen.

Results: Each patient returned to work and demonstrated improvements in cognition, physical, mobility, and work-related skills. One transitioned from work to permanent disability after working 8 mo.

Conclusions and relevance: The three-phase occupational therapy approach, based on the PEOP model, considers cognitive and physical impairments and environmental and occupational demands to support persons with brain cancer return to work. The findings provide preliminary support for occupational therapy's involvement within the cancer care continuum to support return to work. Plain-Language Summary: Advances in cancer treatments have led to higher numbers of people with cancer who want to return to work but are unable, leading to financial stress and a reduced personal identity. This case series illustrates how three patients with brain cancer returned to work after participating in a tailored three-phase occupational therapy intervention. Each patient improved their cognitive, physical, mobility, and work skills after completing a three-phase occupational therapy program using rehabilitation and compensatory interventions. Phase 1 focused on restoring self-care skills and teaching about workplace policies. In Phase 2, the patients developed skills that reflected their unique job demands. The occupational therapist provided return-to-work support during Phase 3. These findings provide preliminary support for occupational therapy's early involvement within the cancer-care continuum to support returning to work.