Occupational therapists' role in sleep management in palliative care: A cross-sectional survey.
Madeleine Webster, Linda Barclay, Dhwani Parikh and 1 others
88% of Australian palliative care OTs say sleep is in their scope, but only 3 of 51 rate their sleep assessment knowledge as good or excellent.
Barriers are time, workload, and missing guidelines. This profiles current practice; it does not test any intervention.
Key findings
145 of 51 occupational therapists (88.2%) said sleep is part of their role in palliative care, and 40 of 51 (78%) reported asking about sleep in their initial assessment. However, only 3 of 51 (5.88%) rated their knowledge of sleep assessments as good or excellent, and 12 of 51 (23.53%) rated their knowledge of sleep interventions as good or excellent.
2The interventions OTs reported using for sleep in palliative care were equipment prescription (pressure-relieving mattresses, electric beds, bed wedges), symptom management (stress, discomfort, pain, urination), education and sleep hygiene advice, environmental modifications, and liaison with nursing, medical, and allied health staff.
3The three barriers OTs identified were service constraints (caseload demands, limited time, limited resources and staffing), their own limited knowledge and confidence in sleep assessment and intervention, and poor understanding of the OT role by the multidisciplinary team, which led to missed or late referrals.
Still to come
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The survey instrument was not validated; the authors acknowledge potential for measurement error. Participants self-selected via convenience and snowball sampling, so those with a strong interest in sleep were more likely to respond. The paper does not describe the patient populations the OTs worked with (ages, diagnoses), so it is unclear whether findings apply to paediatric, adult, or mixed palliative care settings. Responses were concentrated in New South Wales and Victoria, so the profile may not represent all Australian states. 9 of 60 surveys were excluded for incomplete responses, and one participant missed a single item. Cross-sectional design: captures a single time point and cannot show whether knowledge or practice changes over time.
Declared interests
The authors declared no conflicts of interest and no financial support for the research, authorship, or publication.
The easy way to misread this
Do not read the 88% who say sleep is in their scope as evidence that sleep is being adequately addressed in palliative care. The same survey shows only 3 of 51 have good knowledge of sleep assessments, assessment is often informal and subjective, and the main barriers are time, workload, and missing guidelines. This is a description of what OTs currently do and what they say they need, not a test of whether current care is sufficient.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →