Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations.
Cancer is a chronic disease that impacts function, and OT can help these individuals re-engage in meaningful occupations. This exploratory study evaluated occupational performance challenges identified by women impacted by cancer and their relationship to demographics. Results showed that challenges were identified in all areas of occupation and that age, race, and medications did not impact occupational challenges, highlighting a need for OT to intervene in this population across demographics.
Primary Author and Speaker: Hannah Goldberg-O’Neil
Additional Authors and Speakers: Colleen Maher, Rochelle Mendonca
PURPOSE: The incidence of cancer is continuously increasing in the population (WHO, 2015). Simultaneously, individuals with cancer are living longer due to advances in medicine, but with significant limitations in physical, social, and emotional functioning (Pergolotti, Cutchin, Weinberger, & Meyer, 2014). There are limited studies that evaluate the functioning of individuals impacted by cancer. The purpose of this study was to determine the most common occupational performance challenges identified by women impacted by cancer and the relationship between demographics and the identified occupational deficits.
DESIGN: This study used a retrospective exploratory design. The original population of women impacted by cancer were recruited for one-week activity based community camps over a span of 7 years (Maher & Mendonca, 2018). The women came from underserved communities in urban, suburban and rural areas. All women were diagnosed with cancer and were 21+ years. During the program, data was collected using the Canadian Occupational Performance Measure (COPM) to determine changes in a client's perception of occupational performance and satisfaction over time (Dedding, Cardol, Eyssen, & Beelen, 2004).
METHOD: This study retrospectively used anonymous data from the COPM to evaluate the most common occupational performance challenges identified by women. Anonymous demographic data including age, race, and medications were also obtained. Data was organized by areas of occupation and then further by specific sub-occupations to identify challenges. Percentages, graphs, and tables were used to describe the data. Additionally, regression analyses were conducted to determine if there were relationships between age, race, medication use and identified occupational challenges.
RESULTS: Data was obtained for a total of 111 women with ages ranging from 25 years to 84 years. Most women were aged 55 to 74 years. A majority of the participants were Black or African American (n = 68), followed by white (n = 27), Hispanic or Latino (5), American Indian (n = 5), and Asian (n = 3). Thirty-two of women identified that they were on hormonal therapy of which the most common were Aromatase and Tamoxifen. Based on the data, women identified challenges in all areas of occupation including activities of daily living (ADLs) (n = 147), instrumental activities of daily living (IADLs) (n = 214), rest and sleep (n = 6), education (n = 23), work (n = 19), play (n = 11), leisure (n = 42), and social participation (n = 46). Some of the most commonly identified sub-occupations included climbing up and down stairs (n = 29), driving (n = 15), budgeting (n = 16), taking medications (n = 9), opening containers (n = 14), preparing food (n = 9), dealing with problems (n = 16), managing responsibilities (n = 11), being punctual (n = 11), and traveling (n = 11) to name a few. Regression analyses showed that there were no relationships between age, race, medication use, and occupational challenges.
CONCLUSION: This study helped identify areas of occupational challenges experienced by women impacted by cancer living in the community. This highlights that although these women are living in the community, they still experience significant difficulties with occupational performance, which warrant further investigation and intervention by occupational therapists (OTs). This study also established that these challenges did not vary across the women by age or race, which highlight that OTs should be intervening across demographic groups in this population. This study has significant practice implications and provide evidence for intervention by occupational therapists, potentially starting in the acute phase and continuing in community based settings.
References
Dedding, C., Cardol, M., Eyssen, I. C., & Beelen, A. (2004). Validity of the Canadian Occupational Performance Measure: A client centered outcome measurement. Clinical Rehabiliation, 18(6), 660-667.
Maher, C. & Mendonca, R. (2018). Impact of an activity based program on health, quality of life and occupational performance of women with cancer. American Journal of Occupational Therapy, 72(2),7202205040. https://doi.org/10.5014/ajot.2018.023663.
Pergolotti, M., Cutchin, M. P., Weinberger, M., & Meyer, A. M. (2014). Occupational therapy use by older adults with cancer. American Journal of Occupational Therapy, 68(5), 597-607.
World Health Organization (WHO) (2015). Cancer. Retrieved from http://www.who.int/mediacentre/factsheets/fs297/en/
