Participation in Daily Activities Among Women 5 Years After Breast Cancer

Abstract

Importance: Understanding the long-term participation restrictions after breast cancer (BC) is crucial for developing occupation-based interventions. Objective: To (1) compare women’s participation during the BC subacute phase (2 yr postdiagnosis) with the chronic (5 yr postdiagnosis) phase, (2) explore factors associated with participation in the chronic phase, and (3) describe strategies women use to overcome participation restrictions. Design: Descriptive longitudinal study. Setting: A community health service in Israel. Participants: A convenience sample of 30 women (M age = 53.9 yr, SD = 8.3) diagnosed with BC (Stages 1–3). Outcomes and Measures: Demographic and BC–related symptom questionnaires; an adapted version of the Activity Card Sort, used to assess retained activity levels (RALs) compared with prediagnosis activity levels in sociocultural, physical, and instrumental domains; the Canadian Occupational Performance Measure; and one open-ended qualitative question, “How were you able to retain your participation in daily activities despite the long-term effects of BC?” Results: Significantly higher total RALs were found in most domains for women in the chronic (M = 0.93 RAL, SD = 0.27) compared with the subacute (M = 0.71, SD = 0.22) phase, t(29) = 4.72, p < .001. Almost half the women achieved clinically significant change in their meaningful activities. Lower levels of participation were significantly correlated with higher symptom severity. The qualitative findings indicated that coping strategies, such as positive thinking and changing priorities, helped in managing women’s participation. Conclusions and Relevance: Participation restrictions and residual BC-related symptoms 5 yr postdiagnosis demonstrated the need for a comprehensive evaluation and early occupational therapy intervention to prevent long-term restrictions. What This Article Adds: This study highlights the value of a comprehensive assessment of daily participation (i.e., participation in various activity domains and in specific individual meaningful activities) of women with BC. The combination of quantitative and qualitative analysis provided a subjective perspective and deeper understanding of the associations among long-term symptoms, participation restrictions, and coping strategies.

An exploration into the occupational identity of women following breast cancer and treatment: A qualitative study

“…Rachel's weakness and confidence affected her ability to dress and Elizabeth's ability to walk. These findings were expected since evidence reports that occupations requiring the most physical, emotional and cognitive skills are usually most impacted by cancer treatment side effects (Fangel et al, 2013;Loubani et al, 2022). While these cancer treatment effects are well documented in the literature, our study also presented the role of the environment, including social groups of support and technology, to facilitate occupational participation of cancer survivors and, therefore, a way to support their occupational identity (Nizzero et al, 2017).…”

“…Since the aim of the study was to explore the lived experience of participants, we did not focus in depth on details of variables such as breast cancer characteristics, cancer treatment and demographics of participants; instead, we wanted to know their experience regarding occupational identity, congruent with the studies of Palmadottir (2009) and McGrath (2013). Moreover, recent evidence did not identify correlations between those characteristics and participation in meaningful occupation in women after breast cancer in their chronic phase; 5 years after treatment (Loubani et al, 2022).…”

Usability of a mobile phone application to enhance activities of daily living in occupational therapy services for breast cancer survivors

“…Occupational therapists approach the rehabilitation of breast cancer patients from a holistic perspective, considering not only physical symptoms but also cognitive, emotional, and social aspects that influence the recovery process (Désiron et al, 2015; Loubani et al, 2022; Lozano-Lozano et al, 2023). This approach takes into account roles, interests, habits, routines, performance contexts, competencies, physical and emotional abilities, as well as personal backgrounds («Occupational Therapy Practice Framework», 2020).…”

“…Several studies have shown that cancer survivors often experience unmet occupational needs in areas such as personal care, instrumental activities, social participation, work, and education (Algeo et al, 2021; Brick et al, 2022; Loubani et al, 2022; Stevens et al, 2020). Thus, OT interventions for breast cancer survivors should primarily focus on enhancing occupational performance and improving HRQoL (Lai et al, 2021; Loubani et al, 2022). The main objective of this study was to examine the impact of breast cancer on occupational performance in order to develop an App aimed at improving functionality and occupational performance.…”

“…However, cognitive impairment and emotional distress are prevalent in 10–50% of patients (Player et al, 2014), and this aspect is often neglected in most interventions. This highlights a gap in addressing the emotional well-being of these individuals (Loubani et al, 2022), who also experience anxiety due to changes in social support and the fear of cancer recurrence or death (Lattanzi et al, 2010).…”