Exploratory study of breast cancer survivors\u27 lived experience : activity engagement during and after breast cancer treatment

The aim of this study is to describe breast cancer survivors\u27 experiences and the associated meanings participating in their important activities during and after breast cancer treatment and the relationship among the survivor, environment, occupation, and performance, using a concurrent mixed method design. Ten survivors between the ages of 45 and 64 with Stage I, II, or III breast cancer who had been treated consecutively with surgery, chemotherapy, and radiation therapy were recruited for the study. Each survivor completed the Activity Card Sort-modified scoring system (ACSm) during the first and last week of radiation therapy and 3 and 6 months post radiation therapy. Additionally, each survivor participated in a semi-structured interview at the end of radiation therapy and 6 months afterwards. Qualitative data was analyzed using interpretative phenomenological analysis (IPA) to understand the survivors\u27 experiences participating in their most important activities. The means and standard deviations of the proportion of activities resumed for the participants\u27 global and category activities were calculated at each time point. A desire to resume participation in meaningful activities emerged from the data and demonstrated the interrelationship between environment, person, and occupation. Themes from the last week of radiation were (a) individual outlook influences how activities are approached, (b) social support reduces the stress of life, (c) side effects influence how activities are completed, and (d) personal and treatment stresses and struggles influenced their perspectives on life. At 6 months post radiation therapy, the themes were (a) emotional effect on activities, (b) life after cancer has changed due to cancer diagnosis and treatment, and (c) side effects continue to influence daily activities. Using the seven stages of analyzing mixed method data developed by Onwuegbuzie and Teddlie (2003), the qualitative and quantitative data were integrated. The results illustrated that the participants resumed a greater proportion of instrumental activities, which were reported consistently as one of their five most important activities. Additionally, supportive extrinsic factors appeared to be more influential in resuming participation important activities than intrinsic factors. Findings from this study support using the Person-Environment-Occupational-Performance (PEOP) model to develop treatment plans for women undergoing or recovering from breast cancer treatment

Building Connections: An Interpretative Phenomenological Analysis of Qualitative Research Students’ Learning Experiences

This paper describes a phenomenological study in which the authors explored students’ experiences learning qualitative research in a variety of academic fields. Semi-structured in-depth interviews were conducted with six participants from various academic fields who had completed at least one post-secondary-school-level qualitative research course and who were not students of the researchers. Using Interpretative Phenomenological Analysis (IPA), the researchers identified five primary themes representing the lived experience and meaning found in the participants’ experience of learning qualitative research: (a) a variety of feelings are experienced, (b) a pivotal experience serves as a catalyst in the learning process, (c) the central role of story, (d) active learning, and (e) relating learning to prior knowledge. The findings both support and contribute new aspects to the knowledge of this experience. The results also point to “building connections” as the essence of the phenomenon of learning qualitative research

The Creation and Performance of Classification Schemes: Rating Systems in United States Broker-Dealers 1993-2000.

In the past few years, organizational researchers have found a renewed interest in categorization and its consequences. Most research focuses on the consequences of categorization for the categorized objects, arguing that a clear identity is important for users to understand (and thus value) an object. In my dissertation, I shift the perspective from the users and the categorized objects to focus on the creator of the classification scheme. I question the commonly held assumption that categories are created to reduce ambiguity and structure the world for users. In the first part of my dissertation, I suggest conditions under which a categorizer might create an ambiguous classification scheme rather than an unambiguous one. I argue that the ambiguity of the classification scheme depends on the categorizer’s relationship with the objects it rates, its relationship with many different types of users, and its status relative to other categorizers within the industry. By doing so, I move the focus away from the results of categorization to the antecedent of it. Users frequently question whether an object has been correctly placed in a classification scheme, but they must also question whether the scheme itself has been created strategically by the categorizer. In the second part of my dissertation, I examine the performance of the categorizer as a result of its classification scheme. While strategic behavior may help an organization achieve its objectives, in the long run, there may be negative consequences for a categorizer when the meaning of a classification scheme cannot be understood. I argue that overly ambiguous classification schemes lead to decreases in customer accounts. In addition, I measure the linguistic network position of individual schemes to illuminate how the usage of different schemes within an organizational field affects all firms in the industry. I use equity rating systems (for example, “buy, sell, hold”) in the United States during the years 1993-1999 as a setting in which to test my hypotheses.Ph.D.Business Administration and SociologyUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/64607/1/ahbowers_1.pd

Creating an Interprofessional Collaborative Research Opportunity for Physical and Occupational Therapy Students

Physical therapy (PT) and occupational therapy (OT) professional associations assert the importance that entry-level therapists learn and apply the knowledge and skills necessary for interprofessional collaborative practice; however, the majority of PT and OT programs do not have the other discipline at their university. A challenge exists for the creation of a transparent active learning opportunity promoting interprofessional student engagement when the two professions do not reside in the same university. This case study provides a model for how to feasibly create an interprofessional experience for students in universities that do not include a complementary or collaborative allied health professional program, using various technologies. While creating this collaborative project, we provided opportunities to meet the Interprofessional Education Collaborative’s (IPEC) competencies: a) value/ethics for interprofessional practice, b) roles and responsibilities, c) interprofessional communication, and d) teams and teamwork through participation in a breast cancer survivorship research study. Within this demonstration project, the faculty were able to make “micro level” changes to foster interprofessional collaboration among universities with other allied health profession programs, which may lead to improved health outcomes for our clients

Arm Function in Women Treated for Breast Cancer

Background/Purpose: Women with breast cancer (WBC) report decreased function following cancer treatment, yet objective measures of function typically return within the first year after surgery. Kinesiophobia, or fear of physical activity (PA), has been documented following other musculoskeletal pathologies. This study explored the relationships between fear of PA and self-reported arm function, QOL, perceived stress, and objective measures of range of motion (ROM), strength, and muscular endurance in WBC. Methods: Women (n=30) diagnosed with stage 0-3 breast cancer 6-60 months prior to enrollment participated; WBC were excluded with metastatic disease, shoulder pathology, or history of shoulder/neck surgery. Self-reported function was measured with the Penn Shoulder Score; FACT-B QOL, Perceived Stress Scale (PSS), Canadian Occupational Performance Measure (COPM), bilateral flexion, external and internal rotation ROM and strength, and muscular endurance measures were also collected. Relationships between fear of PA and all variables were explored using Pearson’s correlations. Significance was set ≤0.05 a priori. Results:Mean age and BMI were 57 (SD 13.65) and 28.86 (SD 5.17). Mean scores (SD) were: PENN 84.15 points (4.8), FACT-B 110.89 (16.13), FPAX-B 39.22 (11.73), COPM satisfaction 6.34 (1.71) and COPM performance (7.42 (1.19). Fear of PA was significantly correlated to PENN pain and satisfaction subscales (p Conclusion: Fear of PA was associated with self-reported function, QOL, and perceived stress in this population of WBC, while objective measures were not. These findings suggest that personal factors play a significant role in functional recovery. Clinical Relevance: Rehabilitation professionals must address personal factors to ensure complete and successful functional recovery among WBC.https://ecommons.udayton.edu/dpt_symposium/1004/thumbnail.jp

Aerosol emission of adolescents voices during speaking, singing and shouting

Since the outbreak of the COVID-19 pandemic, singing activities for children and young people have been strictly regulated with far-reaching consequences for music education in schools and ensemble and choir singing in some places. This is also due to the fact, that there has been no reliable data available on aerosol emissions from adolescents speaking, singing, and shouting. By utilizing a laser particle counter in cleanroom conditions we show, that adolescents emit fewer aerosol particles during singing than what has been known so far for adults. In our data, the emission rates ranged from 16 P/s to 267 P/s for speaking, 141 P/s to 1240 P/s for singing, and 683 P/s to 4332 P/s for shouting. The data advocate an adaptation of existing risk management strategies and rules of conduct for groups of singing adolescents, like gatherings in an educational context, e.g. singing lessons or choir rehearsals

Exploring Parents’ Experiences of Raising a Child with Sensorimotor Impairments and Expectations for Leisure Participation

Background: The objective of this descriptive study was to study parents’ experiences of raising a child with sensorimotor impairments and how leisure pursuits impact their expectations of their children. The development and participation in leisure activities is different for these children and could affect the parents’ hopes and dreams for their child’s future. Method: Six children between 5 and 8 years of age, with sensorimotor impairments, participated in a movement program that was held for eight sessions at an outpatient pediatric clinic to address praxis and sensory processing impairments. Six parent dyads were interviewed during the fifth, sixth, seventh, or eighth session of the program. Areas addressed in the semi-structured interviews included parenting challenges, school experiences, and sensorimotor impairments effect on the child’s leisure participation. Results: Five themes emerged following the interviews: (a) nobody prepares you for sensory problems, (b) positive and negative school support, (c) when they already feel left out or behind, (d) I know the team sports are 100% sensory, and (e) life challenges. Conclusion: The parents provided the practitioners with insight into their everyday lives, and this information is essential for making occupational therapy services more family-centered

Self-Reported Arm Function Is Associated with Stress and Fear of Physical Activity among Women Treated for Breast Cancer

Background: Self-reported upper extremity function and objective measures are not strongly associated with each other in women treated for breast cancer (BC). It is not known if the lack of relationship between self-reported upper extremity function and objective measurements may be influenced by perceived levels of stress and fear of physical activity. The purpose of this study was to investigate the relationships between self-reported upper extremity function and the following: perceived stress levels (PS), fear of physical activity (FPA), health-related quality of life (HRQOL), and objective measures of upper extremity function among women treated for BC. Methods: This cross-sectional observational study included 23 women diagnosed with breast cancer 12-60 months prior to data collection. Self-reported upper extremity function, PS, HRQOL and FPA were assessed using the Disabilities of the Arm, Shoulder and Hand (DASH), Perceived Stress Scale (PSS), Functional Assessment of Cancer Therapy-Breast Cancer (FACT-B), and Fear of Physical Activity and Exercise for Breast Cancer (FPAX-B), respectively. Objective shoulder measures included range of motion (ROM), strength, and muscular endurance. Results: The DASH was significantly correlated (p\u3c0.001) with the FACT-B, PSS, and FPAX-B (r=-0.863; r= -0.733; r= -0.709 respectively). No significant correlation was found between the DASH and objective measures except non-dominant shoulder endurance (p\u3c0.05, r=-0.432). Conclusions: There is a significant relationship between the self-reported arm function, PS, HRQOL and FPA among women treated for BC. Further research should be done to understand the role that PS and FPA have on the perceived level of upper extremity function that women treated for BC report

Perceived Stress Levels May Impact Upper Extremity Function Among Women Treated for Breast Cancer

Purpose/Hypothesis: Women treated for breast cancer report ongoing upper extremity disability with functional limitations; however, objective measures do not appear to explain the extent of perceived dysfunction. The purpose of this study was to investigate the relationship between perceived stress level, fear of physical activity, self-reported upper extremity function, and objective measures of upper extremity function including range of motion (ROM), strength, and muscular endurance, among women treated for breast cancer. Number of Subjects: 25 Materials/Methods: Women diagnosed with stage I-III breast cancer in the past 12-60 months were evaluated using the Disabilities of the Arm, Shoulder and Hand (DASH), Perceived Stress Scale (PSS), Fear of Physical Activity/Exercise Scale - Breast Cancer (FPAX-B), and the Functional Assessment of Cancer Therapy for Breast Cancer (FACT-B). Bilateral arm flexion, external rotation, and internal rotation ROM and strength were measured with a digital inclinometer and a hand held dynamometer fixed to a stationary device. Bilateral arm muscle endurance was measured using the Upper Limb Lift Test. Descriptive statistics were calculated for all variables and relationships between the PSS, FPAX-B, FACT-B and the DASH and objective measures were analyzed with Pearson’s r. Results: The mean age of participants was 52 (range 31-68), with a mean BMI of 28.07 (SD= 6.6). The mean ROM of shoulder flexion was ≥147°, ER ≥85°, and IR ≥70°. The PSS, FPAX-B, and FACT-B were significantly correlated (p=0.000) with the DASH (r= -.739; r= -.717 and r= .779 respectively). No significant correlation was found between any of the self-reported measures and the objective ROM, strength, or muscular endurance measures. Conclusions: The experience of stress and fear of physical activity appear to result in lower levels of self-reported upper extremity function despite adequate motion, strength, and muscular endurance. Perceived stress and other cognitive constructs may explain the apparent difference between objective and perceived measures of function currently observed in this population. Further exploration into the cognitive and psychological effect of a breast cancer diagnosis and the associated impact on self-perceived function is warranted. Clinical Relevance: Investigating the impact of stress and fear of physical activity on self-perceived upper extremity function in women treated for breast cancer may help clinicians identify and address barriers to recovery for this population