Date of Award

Spring 4-25-2020

Document Type


Degree Name

Doctor of Occupational Therapy (OTD)


Occupational Therapy

First Advisor

Susan MacDermott, OTD, OTR/L

Second Advisor

Becki Cohill, OTD, OTR/L

Third Advisor

Erin Schwier, EdD, OTD, OTR/L

Medical Subject Headings

Occupational Therapy, Cancer, Parents, Activities of Daily Living, Adaptation, Psychological, Home Care Services


Background: According to the American Cancer Society (2019), there were more than 1.7 million new cases of cancer in 2019 alone. Individuals are being diagnosed at a young age with 22.4% of cases occurring in individuals 22-55 years old and whom are childrearing age (Shah et al., 2017). There are an estimated 2.85 million children under the age of 18 who are living with a parent who has cancer (Shah et al., 2017). Newly diagnosed individuals face changes in daily life, the threat of possible death, and fear of dying (Compas et al., 1994). Changes in shared family roles can impact the entire family across many domains (Heiney et al., 1997; Helseth & Ulfsæt, 2005). Newly diagnosed individuals develop secondary psychosocial symptoms that impact the parenting roles and face challenges maintaining routines in the home (Kim et al., 2006; Smith et al., 2005). The purpose of this project is to further explore the impact of a cancer diagnosis and subsequent treatment on the individual and their family. This project also aims to investigate the role of occupational therapy in integrative therapy services.

Methods: This project took place at the Knight Cancer Institute which is part of a large hospital: Oregon Health and Science University (OHSU) in Portland, Oregon. Needs assessment consisted of three parts: a survey to intended population, in-depth interviews with two participants using a modified version of the Occupational Circumstance Assessment and Rating Form (OCAIRS), and in-depth interviews with current instructors of the integrative therapy program.

Results: Of the 10 survey respondents, eight were pre-treatment or in treatment. Of those participants, 87.5 reported their daily routine impacted by pain or fatigue. OCAIRS interviews revealed three common themes: Roles in the family became blended, independently sought additional care, and mindfulness as a strong coping tool. In-depth interviews with instructors developed common themes: Impact of cancer diagnosis and treatment, need to provide education on integrative therapies, programs typically accessed after treatment, and the value of in-home services.

Discussion: Results from the survey suggest psychosocial symptoms develop at diagnosis and continue through treatment. There is a need to provide services in the home environment for parents to address psychosocial symptoms during their cancer treatment and additional resources to support their roles and responsibilities as parents of minor (dependent) children. Occupational therapists have an important role in integrative medicine within the home environment. To address psychosocial symptoms secondary to cancer, an occupation-based home program will be offered to the newly diagnosed parents at the Knight Cancer Institute. “Healing at Home” is a program guided by the occupational therapist in the natural setting of the family.


Capstone project submitted to the University of St. Augustine for Health Sciences in partial fulfillment of the requirements for the degree of Doctor of Occupational Therapy.