Exploratory Study of Breast Cancer Survivors’ Lived Experience Three to Four Years Post-treatment
Occupational Science and Occupational Therapy
Statement of purpose: Describe breast cancer survivors’ experiences participating in important activities three to four years after treatment.
Description of methods: Concurrent mixed method design using interpretative phenomenological analysis (IPA) to understand the experience of participating in the survivors’ important activities (Smith, Flowers, & Larkin, 2009) and descriptive statistics to illustrate the activity level resumed since surgery and important activities by category: instrumental, social, low-demand leisure (sedentary) and high-demand leisure (physical). Breast cancer survivors three to four years past treatment were recruited from a group who began a previous study (Fleischer & Howell, in press). Participants were mailed a modified version of the Activity Card Sort (ACSm). Within the ACSm, the participant assigned one of five categories: (a) never done, (b) do now as often as before breast cancer treatment, (c) do less or differently than before breast cancer treatment, (d) have not done since breast cancer treatment, or (e) new activity to each of the 80 activities listed, and recorded her five most important activities. After the ACSm and the consent form were received, each survivor participated in 45- to 60-minute semi-structured interview centering around the survivor’s experiences of participating in her important activities. IPA was used to analyze the data. To increase trustworthiness of the data, two researchers analyzed the data. When discrepancies occurred, data was reanalyzed until consensus was received. Additionally, descriptive statistics of the ACSm were used to further support the results.
Results: Three themes emerged from the interviews: a) exercise is important physically and emotionally, b) participating in important activities feels good, and c) plans have been made to continue engaging in important activities. Survivors returned to baseline or close to baseline activity levels for each category, as indicated by the ACSm except high-demand leisure in which half of the survivors were above baseline. Percentage of important activities by category was evenly distributed among the four categories.
Discussion/implications: This research adds to the understanding of the subjective relationship between occupation and well-being (Yerxa, 1990), and the intrinsic needs of engaging in occupations (Hammell, 2009), specifically among breast cancer survivors (Lyons, 2006). These survivors sought occupations, which were intrinsically important but also promoted physical and psychological well-being. Further investigation of these occupational science relationships are needed among a larger number of cancer survivors with other types of cancer at discrete points in their recovery, and from various cultures and age groups
Key words: Breast Neoplasms, Occupations, Quality of Life
Fleischer, A., & Howell, D. (in press). Comparing survivors’ experiences of participating in important activities during and after breast cancer treatment: Interpretative phenomenological analysis. British Journal of Occupational Therapy.
Hammell, K. W. (2009). Self-Care, Productivity, and Leisure, or Dimensions of Occupational Experience? Rethinking Occupational “Categories”. Canadian Journal of Occupational Therapy, 76(2), 107-114. doi:10.1177/000841740907600208
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
Smith, J. A., Flowers, P., & Larkin, M. (2009). Interpretative phenomenological analysis: Theory, method, and research. London: Sage.
Yerxa, E. J. (1990). An Introduction to Occupational Science, A Foundation for Occupational Therapy in the 21st Century. Occupational Therapy in Health Care, 6(4), 1-17. doi:10.1080/J003v06n04_04
Fleischer, Anne B. & Parsley, R. (October 19 2017). "Exploratory Study of Breast Cancer Survivors’ Lived Experience Three to Four Years Post-treatment." Society for the Study of Occupation, SSO:USA Annual Conference, Seattle, Washington
SSO:USA Annual Research Conference