Supporting Occupational Engagement for Individuals Living with Cancer: Implications for Occupational Therapy Practice

Kristin Domville, PhD, MOTR/L and Brianna Batista OTD

Cancer survivorship continues to increase in the United States, creating a growing need for rehabilitation services that address the functional and psychosocial challenges experienced during and after treatment. Individuals living with cancer often experience disruptions in daily occupations due to symptoms such as fatigue, pain, emotional distress, and changes in physical functioning (Fleischer et al., 2023; Fu et al., 2022). Occupational therapy practitioners are uniquely positioned to support participation in meaningful activities and improve quality of life for this population.

Despite the documented benefits of occupational therapy in oncology rehabilitation, services remain underutilized and are not consistently integrated into cancer care across healthcare settings (Ciubean et al., 2021). This article describes a doctoral capstone project that explored occupational engagement and satisfaction among individuals living with cancer and highlights implications for occupational therapy practice. 

Occupational Engagement and Cancer

Cancer and its treatments can significantly disrupt participation in everyday life. Fatigue, pain, cognitive changes, and emotional stress often affect an individual’s ability to engage in work, self-care, leisure, and social activities (Fleischer et al., 2023; Fu et al., 2022). These disruptions may lead to decreased life satisfaction and increased risk of depression or social isolation.

Occupational engagement, the involvement in meaningful daily activities, plays an essential role in well-being. Research suggests that participation in valued occupations supports emotional health, identity, and quality of life for individuals living with chronic illness, including cancer (Buwana et al., 2023). When individuals are unable to engage in these activities, they may experience a loss of independence or a sense of purpose.

Occupational therapy practitioners address these challenges by helping individuals adapt tasks, modify environments, and develop strategies that support continued participation in meaningful occupations. Evidence suggests that occupational therapy interventions can improve performance in activities of daily living (ADLs), increase confidence in task completion, and enhance overall quality of life for individuals undergoing cancer treatment (Boyer et al., 2021).

Capstone Project Overview

Throght the completion of a literature review it was identifyed that, little is known about individuals living with cancer perceptions on everyday experiences that relate to occupational engagement and satisfaction (Wallis et al., 2020; Buwana et al., 2023). The purpose of this doctoral capstone project was to explore how individuals living with cancer experience occupational engagement and satisfaction in their daily lives. Understanding these experiences can help occupational therapy practitioners better address the needs of this population and develop interventions that support meaningful participation.

The project utilized a descriptive approach to examine occupational engagement among adults living with cancer. Participants completed an online survey examining occupational satisfaction and participation in everyday activities. The project sought to identify patterns in occupational engagement, barriers to participation, and areas where occupational therapy interventions may provide meaningful support.

Participants

Surveys for this capstone research project were distributed both in person at the experiential site and digitally through various social media platforms. Inclusion criteria required participants to be 18 years or older and currently living with a cancer diagnosis. A total of 25 individuals met the inclusion criteria and were eligible to participate. However, only 10 participants completed the self-developed online survey in full. Table 1 summarizes the demographics of the participants.

Table 1

Participant Demographics

Results

Qualitative data from the open-ended responses were transcribed into Excel and analyzed through thematic coding using Saldana’s (2021) method. The analysis involved open and focused coding to identify recurring concepts across participant responses. Through this process, three core themes emerged:

1. Theme 1- Finding Meaning and Purpose – Participants emphasized the desire to maintain a sense of identity and fulfillment through roles such as working, caregiving, or creative activities, even amidst cancer-related disruptions.
2. Theme 2- Overcoming Physical Limitations – Individuals described modifying routines and activities to accommodate fatigue, pain, or limited mobility, reflecting a strong intention to remain engaged and independent.
3. Theme 3- Psychosocial Resilience – Participants shared coping strategies to manage emotional distress, including maintaining social support, adapting expectations, and focusing on mental well-being despite their diagnosis.

Conclusion

Individuals living with cancer often experience disruptions in occupational engagement due to treatment-related physical, cognitive, and emotional challenges. However, meaningful activities remain essential for maintaining identity, emotional health, and overall quality of life.

This capstone project highlights the importance of understanding the lived experiences of individuals with cancer and incorporating their perspectives into rehabilitation interventions. Occupational therapy practitioners are uniquely positioned to support engagement in meaningful occupations by addressing barriers and facilitating adaptive strategies.

As cancer survivorship continues to increase, integrating occupational therapy into oncology care has the potential to significantly enhance patient-centered care and improve quality of life for individuals navigating the cancer journey.

References

Boyer, B. A., McVey, K., Gossard, L., Quigg, A. M., & Buckingham-Howes, S. (2021). OT and confidence to perform ADLs among adults treated for cancer. American Journal of Occupational Therapy, 75(Suppl. 2). https://doi.org/10.5014/ajot.2021.75s2-rp257

Buwana, C., Dwijayanti, F., Nurhidayah, N., Ito, Y., & Bontje, P. (2023). The meaning of occupation for adults with advanced cancer: A scoping review. American Journal of Occupational Therapy, 77(5). https://doi.org/10.5014/ajot.2023.050072

Ciubean, A. D., Ciortea, V. M., Ungur, R. A., Borda, I. M., Popa, T., & Irsay, L. (2021). Role of occupational therapy in rehabilitation of cancer patients. Balneo and PRM Research Journal, 12(2), 145–150.

Fleischer, A., Campbell, C., & Polo, K. M. (2023). Cancer-related fatigue (2018–2022). American Journal of Occupational Therapy, 77(Suppl. 1).

Fu, M. R., McTernan, M. L., Qiu, J. M., et al. (2022). Co-occurring fatigue and lymphatic pain incrementally aggravate their negative effects on activities of daily living, emotional distress, and overall health of breast cancer patients. Integrative Cancer Therapies, 21.

Wallis, A., Meredith, P., & Stanley, M. (2020). Cancer care and occupational therapy: A scoping review. Australian occupational therapy journal, 67(2), 172–194. https://doi.org/10.1111/1440-1630.12633