The Road to Recovery: Experiences and Occupational Lives of Icelandic Women with Breast Cancer

ABSTRACT

The purpose of this qualitative study was to explore the experiences and occupational lives of Icelandic women with breast cancer. In all 18 women were interviewed using the Occupational Performance History Interview as a guide. The women employed different modes of interpreting and responding to the cancer event with occupational participation being the central vehicle to resist the illness. Adjustment to breast cancer survivorship was characterized by permanent changes in the women's lives with both positive and negative consequences. When working with women with breast cancer, occupational therapists should focus on their needs as occupational beings.     

Difficulties in using everyday technology after acquired brain injury: a qualitative analysis

Abstract

The aim of this study was to identify and describe the characteristics of the difficulties using everyday technology in persons with an aquired brain injury (ABI), and their experiences of how these difficulties influenced their life. Thirteen persons with an ABI were interviewed about their difficulties in using everyday technology and were observed in their use of technology. Data were analysed qualitatively with a constant comparative method. The results showed that the persons' experiences formed two categories: “A variety of combinations of difficulties in the use of everyday technology” and “Restrictions in life”. The difficulties identified were related not only to everyday technology itself but also to the interaction between the technology, the task, the person, and the environment. These difficulties influenced their experiences of restrictions in occupational performance, personal identification, and participation in society. The results emphasize that occupational therapists who design interventions for people with an ABI need to accommodate both the technology and other interacting aspects in order to overcome difficulties in using everyday technology.     

The Role of the Family Environment and Computer-Mediated Social Support on Breast Cancer Patients’ Coping Strategies

Despite the importance of family environment and computer-mediated social support (CMSS) for women with breast cancer, little is known about the interplay of these sources of care and assistance on patients’ coping strategies. To understand this relation, the authors examined the effect of family environment as a predictor of the use of CMSS groups as well as a moderator of the relation between group participation and forms of coping. Data were collected from 111 patients in CMSS groups in the Comprehensive Health Enhancement Support System “Living with Breast Cancer” intervention. Results indicate that family environment plays a crucial role in (a) predicting breast cancer patient's participation in CMSS groups and (b) moderating the effects of use of CMSS groups on breast cancer patients’ coping strategies such as problem-focused coping and emotion-focused coping.     

Climacteric women at work: What lurks behind poor occupational quality of life?

ABSTRACT

Physical and psychological changes during menopausal transition may affect various aspects of everyday functioning including women's work ability and work productivity. Presence of menopausal symptoms has been well-acknowledged to negatively affect quality of life (QOL). However, data on factors associated with occupational QOL among women at this period of life are lacking. The authors' purpose in this study was to evaluate factors affecting occupational QOL in a sample of employed mid-life women who are experiencing menopause. The authors performed a cross-sectional study among 335 employed women aged 40 to 65 years from Serbia. Socio-demographic questionnaire, Utian's Quality of Life Scale, and Beck's Depression Inventory were used in data collection. Women's average monthly household income and educational level were positively correlated, while having uterine prolapse was negatively associated with occupational QOL. Significant regression models assessing impact of gynecological illnesses and menopause-specific symptoms on occupational QOL (direct value and categories—below vs. above mean) showed that having insomnia, uterine prolapse, and genital inflammations may differentiate “good” from “poor” occupational QOL. Uterine prolapse, genital inflammation, and insomnia were associated with worse occupational QOL among working women in menopausal transition.     

基于扎根理论的执行突发公共卫生事件社区防控政策的影响因素研究

目的 探讨执行突发公共卫生事件社区防控政策的影响因素及其作用机制,并提出相应对策.方法 于2020年2-9月按照目的、理论和滚雪球抽样结合扎根理论研究方法对我国7个省(市)的122名社区管理人员、基层医疗机构医务人员、志愿者和社区居民进行半结构化访谈,经开放编码、主轴编码和选择性编码构建执行突发公共卫生事件社区防控政策...     

The influence of social support on the rehabilitation of women with spinal cord injury: experiences recounted by occupational therapists

Abstract

Objective: Women with a spinal cord injury (SCI) often require support from others to perform their everyday activities. The aim was to describe OTs' experiences of how social support from the network influences or could influence the rehabilitation of women with SCIs. Methods: Four occupational therapists, specialized in rehabilitation of persons with SCIs, narrated 11 separate stories relating to women with an SCI. Five themes were identified: “Assisting the women to identify new ways to perform activities”, “Giving support to the women by re-establishing relationships on their behalf”, “Enabling the women to find solutions to problems that have an impact on everyday activities”, “Enabling the women to learn what it is like to live with an SCI from first-hand accounts”, and “Assisting the women to set goals in anticipation of life outside the clinic”. Results and conclusions: The results indicate that professionals within rehabilitation need to be aware of and actively create and strengthen natural social networks during the complex and demanding rehabilitation process. Furthermore, they ought to use their capacity as professionals to ensure that support is provided and to reduce negative interactions within the injured person's network, given that social support, social integration, and negative interactions have the potential to influence health and well-being.     

Breast Cancer Screening among Employed American Women

Abstract

From the 1990 National Health Interview Survey Health Promotion and Disease Prevention supplement, the authors estimated the 1990 baseline prevalence of breast cancer screening among employed U.S. women aged 50–70 years. Proportions of women screened for breast cancer were calculated by occupational category and demographic characteristics, and were compared with the Healthy People 2000 objective that 60% of women aged 50 and older have had mammography and a clinical breast examination within the preceding two years. The objective was exceeded for white-collar workers (61.8%) and workers with some college (64.1%), but was not met by any blue-collar/service workers (40.8%); or any workers with only a high school diploma (54.7%) or less than a high school diploma (38.5%). Identification of occupational categories and demographic subgroups among working women will be helpful to those planning breast cancer screening program, in both the public and the private sectors.     

Comfort,Control, or Conformity: Women Who Choose Breast Reconstruction Following Mastectomy

Following breast amputation women commonly are presented with two choices: to wear a prosthesis or undergo reconstruction. Breast restoration is assumed to allow a full emotional and physical recovery from a breast cancer crisis. Surgical reconstruction is offered to women as the final step in regaining a sense of complete womanhood, enabling a sense of optimism that both body and self will “get back to normal.” This article examines 5 women's accounts of breast reconstruction and asks how breast reconstruction figures in the remaking of self following mastectomy. Issues pertaining to the reasoning behind seeking out the procedure, experiences of finding the right surgeon, and how women feel toward their reconstructed postsurgical body are examined. In conclusion it is argued that a number of contradictory expectations are held by women seeking reconstructions. While women suggest that reconstruction will restore lost femininity, sexuality, and normalcy in most cases it is not the procedure that enables this but the elimination of the hassles of prostheses. In contrast to the complete sense of self they expected to regain through reconstruction they articulate a restoration that is simply pragmatic. It is only once women have undertaken this last bastion of hope that they are forced to renegotiate their sense of themselves as women with or without breasts.     

Childhood and Contemporaneous Correlates of Adolescent Leisure Time Physical Inactivity: A Longitudinal Study

PurposeAlthough concurrent influences on adolescent physical activity are well documented, longitudinal studies offer additional insights about early life antecedents of participation. The aim of this study was to examine associations between childhood and contemporaneous factors and patterns of physical activity participation during adolescence.MethodsPhysical activity participation at ages 15 and 18 was assessed among members of the Dunedin Multidisciplinary Health and Development Study cohort using the interview-based Minnesota Leisure Time Physical Activity Questionnaire. Logistic regression was used to examine associations between childhood factors (socioeconomic status, family “active–recreation” orientation, home activities, motor ability, intelligence, and psychiatric disorder), contemporaneous factors (parental health, body mass index, predicted VO_{2 max}, general health, television viewing, smoking, and alcohol use) and “persistent inactivity,” “declining participation,” or “persistent activity” during adolescence.ResultsIn multivariate models, persistent inactivity during adolescence was associated with lower childhood family active–recreation orientation, and poorer cardiorespiratory fitness and general health during adolescence. Declining participation was more likely among those who reported fewer activities at home during childhood. Persistent activity was associated with better cardiorespiratory fitness and watching less television during adolescence.ConclusionsThis study found that childhood and contemporaneous factors were associated with persistent inactivity, persistent activity and declining participation during adolescence. The findings highlight several factors from the family and home environment of potential importance in early intervention programs to support adolescent participation in physical activity.     

Participating in diagnostic experience: Adults with neuropsychiatric disorders

Abstract

Knowledge regarding neuropsychiatric disabilities has increased in recent years, resulting in an increasing number of adults requesting neuropsychiatric evaluation. The aim of this qualitative study was to describe adult clients' experiences of participating actively in a supportive assessment process in which they received a diagnosis of either autism spectrum disorder (ASD) and/or attention-deficit hyperactivity disorder (ADHD) and then received follow-up counselling, guidance, and compensatory resources that were immediate and directly integrated into the diagnostic experience. The Occupational Performance History Interview – Second Version (OPHI-II) was selected because it is client-centred. It measures how a significant life event affects a person's occupational identity, occupational competence, and interaction with the environment. The OPHI-II was administered to capture 15 participants' experiences of being diagnosed with ASD and/or ADHD as the significant life event of focus. Three categories were formed by using qualitative content analysis: (i) strengthened occupational identity; (ii) compensatory support enhances occupational competence, and (iii) effects of the social environment on relationships. Findings indicated that the diagnostic experience had transformative effects on participants' occupational identities, occupational competence, and ability to self-advocate for increased understanding and resources within their environments. The implications of these findings and future research are discussed.     

Factors influencing nurses' perceptions of occupational safety

To determine nurses' perceptions of occupational safety and their work environment and examine the sociodemographic traits and job characteristics that influence their occupational safety, we studied a sample of 278 nurses. According to the nurses, the quality of their work environment is average, and occupational safety is insufficient. In the subdimensions of the work environment scale, it was determined that the nurses think “labor force and other resources” are insufficient. In the occupational safety subdimensions “occupational illnesses and complaints” and “administrative support and approaches,” they considered occupational safety to be insufficient. “Doctor-nurse-colleague relationships,” “exposure to violence,” and “work unit” (eg, internal medicine, surgical, intensive care) are the main factors that affect occupational safety. This study determined that hospital administrations should develop and immediately implement plans to ameliorate communication and clinical precautions and to reduce exposure to violence.     

Occupational Risk Factors for Breast Cancer among Nurses

Abstract

A case-referent study nested in a cohort was used to evaluate occupational variables in the incidence of breast cancer among nurses. There were 59 cases and 118 randomly chosen referents. The participation rate was 97%. Odds ratios (ORs) and 95% confidence intervals (Cls) were calculated and the weights of potential confounding factors estimated by unconditional logistic regression. The odds ratio for breast cancer in a sister was 2.83 (95% CI 1.03–7.81). Specialization in pediatric, psychiatric, general (surgical and medical), geriatric, and primary care nursing, and “other kinds of nursing,” gave an adjusted OR of 1.95 (95% CI 0.84–4.54). When working in different wards was accounted for, the highest adjusted ORs were found among nurses handling cytotoxic drugs, OR 1.65 (95% CI 0.53–5.17), and among pediatric nurses, OR 1.47 (95% CI 0.63–3.41); the lowest ORs were found among nurses in primary health care, OR 0.44 (95% CI 0.20–0.96). Analyses of the data stratified on age showed similar results. Occupational risks were not ascertained. Not only occupation but also career-related lifestyles should be taken into account in studies of health outcomes among working women.     

Everyday life in breast cancer survivors experiencing challenges: A qualitative study

Background: Early diagnosis and treatment of breast cancer results in an increasing number of survivors, some of whom face new challenges in their transition to daily life.

Aim: Based on these experiences, the aim of this study was to describe the everyday life in breast cancer survivors experiencing challenges.

Material and method: Eleven women recruited from a follow-up study of breast cancer patients participated in qualitative interviews about their everyday occupations seven years after ending treatment. The inductive analysis revealed ten categories that were organized into five subthemes under the two main themes ‘bodily and mental loneliness’ and ‘new center of gravity in everyday life’.

Results: Findings showed how relevant information and guidance; active support to the client and their relatives; and a balance between occupations at home and at work were important matters to handle their everyday life challenges.

Conclusion and significance: By assisting these women in finding new patterns of meaningful occupations that positively affect their everyday life, the study suggests some central elements to be included in future follow-up practice for breast cancer survivors. Approaching this goal, occupational therapists should contribute to more involvement assisting cancer survivors and their partners in finding new patterns of meaningful occupations that positively affect their everyday life.     

Client perceptions of the Tree Theme Method™: a structured intervention based on storytelling and creative activities

Abstract

The Tree Theme Method (TTM) is an intervention based on sessions involving creative activities and life storytelling/story-making, in which the client paints trees representing various periods of his/her life. The aim of this study was to investigate clients' experiences of participating in a TTM intervention and their perceptions of the therapeutic relationship. Thematic interviews were undertaken. Twenty clients attending general outpatient mental healthcare units were recruited after having participated in the intervention. A qualitative content analysis resulted in six categories: “From feeling a pressure to perform to becoming focused and expressive”, “Expressing oneself and one's life situation led to awakening of memories and feelings”, “New perspectives of self-image, everyday life and relations to others”, “Story-making led to shaping and reconstructing one's life story”, “Interaction was of importance when reconstructing one's life story” and, finally, “The attitude of the occupational therapist was of importance for the development of the therapeutic relationship”. There seemed to be a close association between the intervention and the therapeutic relationship in starting a process of opening up new perspectives on everyday life, but there is a need for further studies including therapists' experience of using the TTM and their perception of the client–therapist relationship.     

Choice and control for people ageing with intellectual disability in group homes

Background Many people ageing with intellectual disabilities (ID) age in place in group homes. Participation is a central concept in support and service to people with ID, but age is often a determining factor for participation among this group. Choice and control are dimensions of participation. Aim The aim of this article is to explore how choice and control in the everyday life of people ageing with ID is expressed and performed in the group home’s semi-private spaces. Material and methods Participant observations and interviews with residents and staff were conducted in four different group homes in Sweden that had older residents. Results Four categories were found that can be understood as aspects of choice and control in the group home’s semi-private spaces in the everyday life of people ageing with ID. These categories included aspects such as space and object, time and routines, privacy, and a person-centred approach. Conclusion and significance People ageing with ID are vulnerable when it comes to maintaining choice and control in various situations in the home’s semi-private spaces. It is argued that occupational therapists should include this occupational arena in their evaluations and interventions for people ageing with ID.     

Variation in female breast cancer risk by occupation

Data from a population-based case control study were used to estimate occupation-specific relative risks for female breast cancer, adjusted for established breast cancer risk factors. Breast cancer cases under age 75 were identified from tumor registries in four states. Controls were randomly selected from driver's license and Medicare beneficiary lists. Information on usual occupation and risk factors was obtained by telephone interview. Odds ratios from logistic regression adjusted for age, state, body mass index, benign breast disease, family history of breast cancer, menopausal status, age at menarche, parity, age at first birth, lactation history, education, and alcohol consumption were calculated for each of 26 occupational groups. Complete occupational information was obtained for 6,835 cases and 9,453 controls. Of 26 occupational groups, only “administrative support occupations” had a statistically significantly increased risk of breast cancer (OR = 1.15, 95% Cl 1.06–1.24). In these data, no specific occupational group had an unusual risk of breast cancer. Increased risks reported elsewhere for nurses and teachers were not corroborated. © 1996 Wiley-Liss, Inc.     

Social Support and Meaning of Life in Women with Breast Cancer

BackgroundSocial support is known as an affection-oriented coping mechanism when a person is involved with cancer. Therefore, this study was conducted to investigate the relationship between family social support and the meaning of life in women with breast cancer.MethodsIn this cross-sectional study, 84 women with a mean age of 60 (SD = 5.7) years with breast cancer who were admitted to a teaching hospital participated. Data were collected using social support and meaning of life questionnaires. After collecting the completed questionnaires and entering the data into the computer, the analysis was performed using SPSS software and using t-test, ANOVA, and Pearson correlation test at a significant level of 0.01.ResultsThe mean score of their social support was 39.35 ± 9.51, respectively and the meaning of life was 29.5 ± 7.49. ANOVA results indicated that the social support score and meaning of life had no significant relationship with any of the demographic variables. Also, the findings suggest that there is a statistically significant correlation between social support and the meaning of life (r = 0.773, P < 0.001).ConclusionIt is proposed to increase the level of social support from the family to help improve the meaning of life in cancer patients.