# Exploring the Integration of Occupational Therapy in Pediatric Oncology Care in Spain: A Descriptive Study

## TL;DR

This study explores how occupational therapy is used in pediatric cancer care in Spain, finding limited integration and identifying barriers like lack of resources and training.

## Contribution

The study provides the first descriptive analysis of occupational therapy integration in Spanish pediatric oncology units and identifies actionable barriers to its implementation.

## Key findings

- Only 16 out of 42 hospital centers in Spain reported having occupational therapy services for pediatric oncology.
- Key barriers to occupational therapy integration include lack of resources, insufficient training, and limited institutional recognition.
- Professionals who use occupational therapy report positive outcomes in patients' functional autonomy and emotional well-being.

## Abstract

Background/Objectives: Childhood cancer leads to significant physical, cognitive, and psychosocial consequences that adversely affect the development and quality of life. Occupational Therapy (OT) has the potential to mitigate these effects. However, its integration into pediatric oncology care in Spain remains limited and underexplored. This study aims to examine the availability, characteristics, and perceived impact of OT services within pediatric oncology units across Spain and to identify key barriers to their implementation. Methods: A descriptive, cross-sectional study using a mixed-methods approach was conducted. An online questionnaire was distributed to healthcare professionals working in pediatric oncology units nationwide. Quantitative data were analyzed using descriptive statistics, Fisher’s exact test, and odds ratios with 95% confidence intervals to explore associations. Effect sizes were calculated using Cramér’s V where applicable. Qualitative responses underwent inductive thematic analysis. Results: A total of 42 hospital centers from 12 autonomous communities participated. Only 16 reported having OT services in pediatric oncology, with notable regional disparities. A significant proportion of respondents were unaware of the integration of OT in their institutions. Identified barriers included lack of resources, insufficient specialized training, and limited institutional recognition of OT. Nonetheless, professionals familiar with OT interventions reported positive outcomes, particularly in improving patients’ functional autonomy, emotional well-being, and social participation. Conclusions: OT remains insufficiently integrated into pediatric oncology care in Spain. To optimize the quality of care, it is essential to address educational, structural, and institutional challenges and promote OT as a key component of multidisciplinary teams.