Title

Exploratory study of breast cancer survivors’ lived experience: Activity engagement during and after breast cancer treatment

Location

New River Room A

Start Time

2-10-2015 9:00 AM

End Time

2-10-2015 11:00 AM

Session Type

Research Paper

Abstract

Breast cancer is the most widespread cancer among females in the United States. In 2015, an estimated 234,190 women will be diagnosed with breast cancer with an average of 91% of women surviving breast cancer for 5 years (Siegel, Miller, & Jemal, 2015). Due to the growing number of women surviving breast cancer, understanding breast cancer survivors’ occupational viewpoint is relevant since engagement in occupations has been found to improve the quality of life of breast cancer survivors (Palmadottir, 2010), and survivors frequently gauge their quality of life from an occupational outlook and express goals in occupation-based terms (Lyons, 2006).

The purpose of the study was to describe breast cancer survivors’ experience and associated meaning when participating in their important activities during and after breast cancer treatment to gain a clearer understanding of the “essence of occupation” (Gray, 1997). A multiple-stage critical case purposeful sampling was used to recruit ten breast cancer survivors during chemotherapy or after the initial visit with the radiation oncologist. Participants heard about the study through an oncology provider, a flyer posted within the radiation oncology clinic, or electronically on the Wake Forest Baptist Health research website, which included a confidential phone number and e-mail address to call to receive additional information about the study. The investigator contacted each inquiring participant by telephone or e-mail and provided information about the study. Participants in this study had the following characteristics: (a) diagnosed with Stage I, II, or III breast cancer, (b) consecutively received surgery, chemotherapy, and radiation therapy, (c) were between 40 and 65 years of age, and (d) did not receive additional treatment for their breast cancer, excluding adjuvant therapy.

Each survivor took part in a semi-structured interview at the end of radiation therapy and 6-month's afterwards. Interpretative Phenomenological Analysis (IPA) was used to analyze the in-depth interviews. This approach allowed the investigator to write a concise statement reflecting the psychological essence of the participant. Themes that emerged from the transcript reflected the participant's original thoughts and words but also the investigator's analysis (Smith, Flowers, & Larkin, 2009).

At the end of radiation therapy two themes emerged which seemed to positively influence occupational performance: “individual outlook influences how activities are approach” and “social support reduces the stress of life;” and two other themes seemed to discourage occupational performance: “side effects impact how activities are completed” and “personal and treatment stresses and struggles influence perspectives on life.” At 6-months post-radiation, different themes emerged. Themes that encouraged occupational performance were “positive emotions affect daily life” and “life after cancer has changed due to cancer and diagnosis and treatment;” and discouraging themes were “side effects continue to influence daily activities” and “negative emotions affect daily activities.” This study provides support for exploring occupational factors influencing performance to gain a greater understanding of the “occupational essence” of specific groups of people. In the future, comparisons of “occupational essence” among various groups of people can be compared to provide a richer understanding of occupation and its role in recovery.

Key words: Breast Neoplasms, Occupations, Quality of Life

References

Gray, J. M. (1997). Application of the phenomenological method to the concept of occupation. Journal of Occupational Science, 4(1), 5-17. doi: 10.1080/14427591.1997.9686416

Lyons, K. D. (2006). Occupation as a vehicle to surmount the psychosocial challenges of cancer. Occupational Therapy in Health Care, 20(2), 1-16. doi: 10.1300/J003v20n02_01

Palmadottir, G. (2010). The role of occupational participation and environment among Icelandic women with breast cancer: A qualitative study. Scandinavian Journal of Occupational Therapy, 17(4), 299-307. doi: 10.3109/11038120903302874

Siegel, R., Miller, K., & Jemal, A. (2015). Cancer statistics, 2015. CA: A Cancer Journal for Clinicians, 65(1), 5-29. doi: 10.3322/caac.21254

Smith, J. A., Flowers, P., & Larkin, M. (2009). Interpretative phenomenological analysis: Theory, method, and research. London: Sage.

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Oct 2nd, 9:00 AM Oct 2nd, 11:00 AM

Exploratory study of breast cancer survivors’ lived experience: Activity engagement during and after breast cancer treatment

New River Room A

Breast cancer is the most widespread cancer among females in the United States. In 2015, an estimated 234,190 women will be diagnosed with breast cancer with an average of 91% of women surviving breast cancer for 5 years (Siegel, Miller, & Jemal, 2015). Due to the growing number of women surviving breast cancer, understanding breast cancer survivors’ occupational viewpoint is relevant since engagement in occupations has been found to improve the quality of life of breast cancer survivors (Palmadottir, 2010), and survivors frequently gauge their quality of life from an occupational outlook and express goals in occupation-based terms (Lyons, 2006).

The purpose of the study was to describe breast cancer survivors’ experience and associated meaning when participating in their important activities during and after breast cancer treatment to gain a clearer understanding of the “essence of occupation” (Gray, 1997). A multiple-stage critical case purposeful sampling was used to recruit ten breast cancer survivors during chemotherapy or after the initial visit with the radiation oncologist. Participants heard about the study through an oncology provider, a flyer posted within the radiation oncology clinic, or electronically on the Wake Forest Baptist Health research website, which included a confidential phone number and e-mail address to call to receive additional information about the study. The investigator contacted each inquiring participant by telephone or e-mail and provided information about the study. Participants in this study had the following characteristics: (a) diagnosed with Stage I, II, or III breast cancer, (b) consecutively received surgery, chemotherapy, and radiation therapy, (c) were between 40 and 65 years of age, and (d) did not receive additional treatment for their breast cancer, excluding adjuvant therapy.

Each survivor took part in a semi-structured interview at the end of radiation therapy and 6-month's afterwards. Interpretative Phenomenological Analysis (IPA) was used to analyze the in-depth interviews. This approach allowed the investigator to write a concise statement reflecting the psychological essence of the participant. Themes that emerged from the transcript reflected the participant's original thoughts and words but also the investigator's analysis (Smith, Flowers, & Larkin, 2009).

At the end of radiation therapy two themes emerged which seemed to positively influence occupational performance: “individual outlook influences how activities are approach” and “social support reduces the stress of life;” and two other themes seemed to discourage occupational performance: “side effects impact how activities are completed” and “personal and treatment stresses and struggles influence perspectives on life.” At 6-months post-radiation, different themes emerged. Themes that encouraged occupational performance were “positive emotions affect daily life” and “life after cancer has changed due to cancer and diagnosis and treatment;” and discouraging themes were “side effects continue to influence daily activities” and “negative emotions affect daily activities.” This study provides support for exploring occupational factors influencing performance to gain a greater understanding of the “occupational essence” of specific groups of people. In the future, comparisons of “occupational essence” among various groups of people can be compared to provide a richer understanding of occupation and its role in recovery.

Key words: Breast Neoplasms, Occupations, Quality of Life