Aims
Childhood cancer survivors are at risk of ongoing difficulties with activities of daily living many years after cancer treatment concludes. Occupational therapists support patients/clients to engage in meaningful activities but there is limited research exploring the role of occupational therapy with childhood cancer survivors. This study aimed to investigate the extents to which survivors of childhood cancer experience ongoing difficulties with activities of daily living, and explore how many had been supported by an occupational therapist.
Methods
This study analysed data collected from a nurse-led health and lifestyle assessment with childhood cancer survivors, a secondary analysis of the ‘Engage’ study. Eligible survivors were diagnosed <18 years, ≥5 years post-diagnosis, in remission, and >2 years from last specialist appointment. Two authors independently reviewed ‘Engage’ assessment tools and extracted relevant variables, categorising them according to the International Classification of Functioning, Disability and Health (ICF). Data were analysed using descriptive statistics in R version 4.5.1.
Results
In total, 127 participants completed the nurse-assessment (mean age at diagnosis 7.04 years, mean time since diagnosis, 14 years). We found that 72.4% (89/123) reported ongoing problems in the ICF domain ‘Body Function and Structures’, and 36.5% (34/93) had ongoing difficulties engaging in everyday ‘Activities’. We found that 41% (50/122) scored ≥5 for fatigue on the Emotion Thermometer. Only 8.1% (9/111) had seen an occupational therapist within the previous 12 months.
Conclusions
Many years after treatment completion, survivors continue to experience fatigue and broader physical and cognitive difficulties, impacting their capacity to do the things they want and need to do. However, few receive occupational therapy support. There is an urgent need to better understand the long-term impacts of cancer on survivor’s engagement in activities of daily living and ways in which professions such as occupational therapy, can support survivors to live fulfilling, active lives.