A needs assessment for referral to occupational therapy. Nurses' judgment in acute cancer care

As a step toward developing criteria for referral to occupational therapy, the study set out to assess patients' needs of occupational therapy in an acute cancer care hospital. A 31-item Needs Assessment Questionnaire was produced. It was intended to reflect interventions/ measures of occupational therapy. Seventeen questions eliciting information on occupational therapy gave a factor with an alpha coefficient of 0.92. Four single questions on occupational therapy did not form a factor. Six questions about the disease had an alpha coefficient of 0.83, whereas four about rehabilitation prognoses formed a factor with an alpha coefficient of 0.57. The questionnaire was completed by 40 day-shift primary-care nurses acting as key informants. Their answers concerned a total of 88 of their patients. Twenty-six percent of the patients had been recommended for or referred to occupational therapy, whereas many whom the nurses judged to need this (47%) had not been referred (p = 0.01 chi-squared test, 10.59 McNemar test). Hence, no logical pattern of referral was found, and this seems to highlight both the absence of and the need for clear referral criteria.