Occupational therapy is an integral part of our modern healthcare system. Its aim is to complement care and assist patients in reaching their fullest potential in various health parameters.
To understand the rich depths of the goals of occupational therapy, we need only to turn to the definition provided by Occupational Therapy Europe. In part, it states:
“Occupational therapy is a profession concerned with improving well-being for persons of all ages through enabling occupations to promote health and participation in society. Occupational therapists do this by supporting persons’ engagement in occupations and activities that they want, need, and choose to do in everyday life.”
To achieve this, occupational therapists explore the ways in which patients can engage in activities that fit in their physical and social contexts. For example, a person who is recovering from a stroke may not be fully mobile; nevertheless, that person may still be able to participate in social activities via walking aids or online video calls. An occupational therapist works in sync with the patient in order to understand their needs and take steps to address them.
Occupational therapy has long been overlooked by the medical community because it is easy to imagine occupational therapists coming in only once a patient has been medically discharged. Nevertheless, this form of therapy will play a bigger role in the holistic healing of an individual as we move away from institutional care to community care.
The shift away from hospital-based care is in part driven by the increasing pressures placed on healthcare institutions. In the immediate aftermath of the COVID-19 pandemic, many hospitals experienced an influx of cases that were left on the back burner during the worst of the pandemic. Now and in the future, we simply cannot keep up with the traditional model of increasing institutional care at the expense of community care.
Occupational therapists are experts at working with family members and caregivers to ensure that patients receive the best care possible. This has been an approach that physicians are realizing works best—a combination of pharmaceutical treatment and the support and encouragement of the people around the patient.
Different Stages of Needs
Patients are also beginning to realize the importance of occupational therapy in complementing institutional care. As published in the International Journal of Environmental Research and Public Health, Gayà-Barroso and colleagues conducted a study to understand the occupational therapy needs of patients with hereditary transthyretin amyloidosis (hATTR).
There are 4 stages of hATTR. In the first phase, patients may experience mild autonomic dysfunction, as well as sensory impairment in the legs. In the second phase, the disease progresses to include autonomic dysfunction and sensory impairment in the upper extremities. This dysfunction is more severe in the third phase, and in the fourth phase, patients may experience complete paralysis.
Patients with this condition may have trouble with basic tasks such as self-care. Depending on the severity of their condition, some patients struggle to find the motivation to engage with the wider world. This is where occupational therapy comes in.
“An individual’s occupational performance is essential for a balanced daily life; by developing specific interventions for these patients, occupational therapy can play an important role in reducing activity limitations, improving personal autonomy, and empowering patients to overcome disease-related barriers,” Gayà-Barroso and colleagues wrote.
Read more about hATTR etiology
The authors of this study hence set out to conduct semi-structured interviews to understand the occupational therapy needs of individuals with hATTR. Selected participants were interviewed by an experienced occupational therapist. All participants were diagnosed with hATTR and were aged 18 or more years (n=44).
The results revealed that 86.36% of patients were independent in performing activities of daily living; however, they were in the early stages of the disease (stages 1 and 2). Gayà-Barroso and colleagues believed that this rate would be fluid and expected it to change as the disease progressed. The interviews revealed that many patients understand this and are worried about progressively losing their occupational skills.
In terms of the impact of this condition on their daily lives, patients expressed that this was difficult to measure objectively. Rather, they reported that the 3 main areas of concern were general well-being, social function, and emotional well-being. All patients interviewed blamed their difficulties in daily living on their diagnosis, with the most common symptoms being pain and loss of sensation in the lower extremities, fine motor skill deterioration, and fatigue.
Read more about hATTR treatment
This study clearly demonstrates that mere medical intervention is insufficient in addressing the bulk of the concerns of patients, even for those in the early stages of the disease. However, a silver lining is that patients are generally aware that occupational therapy can delay dependency and help them achieve their goals, especially as the disease progresses.
“Our findings reveal that [hATTR] is debilitating not only physically but also psychologically and occupationally,” the authors of the study concluded. “The data obtained through the semi-structured interviews performed may provide essential information for future specific [occupational therapy] programs.”
Bolt M, Ikking T, Baaijen R, Saenger S. Occupational therapy and primary care. Prim Health Care Res Dev. 2019;20:e27. doi:10.1017/S1463423618000452
Gayà-Barroso A, González-Moreno J, Rodríguez A, et al. Establishing occupational therapy needs: a semi-structured interview with hereditary transthyretin amyloidosis patients. Int J Environ Res Public Health. 2022;19(18):11721. doi:10.3390/ijerph191811721