Title

Use of secondary analysis of large databases to explore impact of occupation on quality of life for cancer patients

Start Time

22-10-2011 9:05 AM

End Time

22-10-2011 9:35 AM

Session Type

Event

Abstract

Researchers across many disciplines use large national databases to further understand health outcomes such as quality of life. Outcomes research is relevant to a number of stakeholders including patients, families, payers and researchers. However, the possibility to use such datasets to study occupation and participation has largely been overlooked. This type of research can influence policy makers’ decisions regarding the role of certain fields (e.g., occupational science and therapy) in promoting quality of life (Lipscomb et al., 2004). To more adequately investigate if and how occupation is related to health and quality of life, and to widen our disciplinary scope and be heard in other circles besides our own, collaboration on national and international research teams using large databases is important. This paper discusses these broader issues and uses a specific example to illustrate possibilities for occupational science through analysis of large secondary datasets.

Research looking at those with cancer provides an interesting opportunity to examine occupation through secondary data analysis. For numerous reasons, cancer patients tend to have lower levels of participation in occupations (Hurria, 2009; Extermann & Hurria, 2007), and those may be related to mortality and morbidity in older patients who undergo cancer treatment (Extermann & Hurria, 2007). One approach to more definitively examine those relationships is with the Cancer Care Outcomes Research and Surveillance Consortium (CanCORS), a national database designed to improve the quality of cancer care in the US. CanCORS includes a longitudinal survey and medical chart data on over 10,000 people newly diagnosed with lung and colorectal cancer. After a life-threatening illness and subsequent disruption within the typical daily routine, a decrease in participation may challenge how people perceive themselves within society (Vrkljan, & Miller-Polgar, 01). The concept of participation, itself, is situated deep in context and can determine wellbeing and overall quality of life (Law, 2002). With this focus, using a large sample allows for use of structural equation modeling to examine the mediating and/or moderating effects of occupation with more power. In conclusion, the use of large-scale, secondary datasets such as CanCORS could be one-way occupational scientists may examine the relationships among health-related outcomes, participation and occupation to further our scope and impact.

Objectives for Discussion Period:

  1. To engage in scholarly discussion regarding the use of large databases and secondary analysis to increase the knowledge and exposure of occupational science.
  2. Discussion concerning the use of secondary analysis to examine impact of participation in occupation on HRQOL.
  3. Dialog about the ways that occupational scientists may utilize large databases to examine concepts such as participation and quality of life.

References

Ayanian, J.Z., Chrischilles, E.A., Fletcher, R.H., Fouad, M.N., Harrington, D.P., Kahn, K Kahn, K. L. . . . West, D. W. (2004). Understanding cancer treatment and outcomes: The cancer care outcomes research and surveillance consortium. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology, 22(15), 2992- 2996. http://dx.doi.org/10.1200/JCO.2004.06.020

Baum, M. C. (2003). Participation: Its relationship to occupation and health. OTJR, 23(2), 46.

Extermann,M. M. & Hurria, A. (2007). Comprehensive geriatric assessment for older patients with cancer. Journal of Clinical Oncology, 25(14), 1824-1831. http://dx.doi.org/10.1200/JCO.2007.10.6559

Hurria, A. (2009). Geriatric assessment in oncology practice. Journal of the American Geriatrics Society, 57 Suppl 2, S246-9. http://dx.doi.org/10.1111/j.1532-5415.2009.02503.x

Lipscomb,J. J., Gotay, C. C., & Snyder, C. F. (2007). Patient-reported outcomes in cancer: A review of recent research and policy initiatives. CA: A Cancer Journal for Clinicians, 57(5), 278-300. http://dx.doi.org/10.3322/CA.57.5.278

Vrkljan, B., & Miller-Polgar, J. (2001). Meaning of occupational engagement in life-threatening illness: a qualitative pilot project. Canadian Journal of Occupational Therapy, 68(4), 237-246

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Oct 22nd, 9:05 AM Oct 22nd, 9:35 AM

Use of secondary analysis of large databases to explore impact of occupation on quality of life for cancer patients

Researchers across many disciplines use large national databases to further understand health outcomes such as quality of life. Outcomes research is relevant to a number of stakeholders including patients, families, payers and researchers. However, the possibility to use such datasets to study occupation and participation has largely been overlooked. This type of research can influence policy makers’ decisions regarding the role of certain fields (e.g., occupational science and therapy) in promoting quality of life (Lipscomb et al., 2004). To more adequately investigate if and how occupation is related to health and quality of life, and to widen our disciplinary scope and be heard in other circles besides our own, collaboration on national and international research teams using large databases is important. This paper discusses these broader issues and uses a specific example to illustrate possibilities for occupational science through analysis of large secondary datasets.

Research looking at those with cancer provides an interesting opportunity to examine occupation through secondary data analysis. For numerous reasons, cancer patients tend to have lower levels of participation in occupations (Hurria, 2009; Extermann & Hurria, 2007), and those may be related to mortality and morbidity in older patients who undergo cancer treatment (Extermann & Hurria, 2007). One approach to more definitively examine those relationships is with the Cancer Care Outcomes Research and Surveillance Consortium (CanCORS), a national database designed to improve the quality of cancer care in the US. CanCORS includes a longitudinal survey and medical chart data on over 10,000 people newly diagnosed with lung and colorectal cancer. After a life-threatening illness and subsequent disruption within the typical daily routine, a decrease in participation may challenge how people perceive themselves within society (Vrkljan, & Miller-Polgar, 01). The concept of participation, itself, is situated deep in context and can determine wellbeing and overall quality of life (Law, 2002). With this focus, using a large sample allows for use of structural equation modeling to examine the mediating and/or moderating effects of occupation with more power. In conclusion, the use of large-scale, secondary datasets such as CanCORS could be one-way occupational scientists may examine the relationships among health-related outcomes, participation and occupation to further our scope and impact.

Objectives for Discussion Period:

  1. To engage in scholarly discussion regarding the use of large databases and secondary analysis to increase the knowledge and exposure of occupational science.
  2. Discussion concerning the use of secondary analysis to examine impact of participation in occupation on HRQOL.
  3. Dialog about the ways that occupational scientists may utilize large databases to examine concepts such as participation and quality of life.