Work after breast cancer: Identification of cognitive difficulties using the Perceive,Recall,Plan,and Perform (PRPP) System of Task Analysis

Abstract

Introduction

Few ecologically valid assessment tools are available for occupational therapists to evaluate the cognitive demands and performance of women with breast cancer in the workplace. This study aims to identify difficulties in work-related cognitive strategy use experienced by women with breast cancer using the Perceive, Recall, Plan, and Perform (PRPP) System of Task Analysis.

Method

Deductive content analysis was used to code secondary data from 10 interview transcripts involving women who had breast cancer and experienced difficulties in everyday cognitive functioning after treatment. Thirty-four PRPP cognitive strategy items were used as pre-determined codes in a secondary analysis to identify and quantify specific cognitive difficulties described by the women.

Results

The 10 women experienced problems with work tasks that required the cognitive strategies related to the ‘programming’, ‘continuing’, and ‘attending’ processing categories of the PRPP system. In addition, the women demonstrated strengths in their capacity to evaluate their own thinking and performance.

Conclusion

This pilot study indicated the need for further research to determine how cognitive impairments which may occur after breast cancer treatment impact on occupational performance in a complex work environment. The PRPP System of Task Analysis was identified as a potentially useful measurement and interview tool for this purpose.

Keywords

Breast cancer cognition return to work

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References

Ahles

Root

Ryan

(2012) Cancer- and cancer treatment-associated cognitive change: An update on the state of the science. Journal of Clinical Oncology 30(30): 3675–3686.

Aubin

Lamoureux

Gelinas

(2014) Daily task performance and information processing among people with schizophrenia and healthy controls: A comparative study. British Journal of Occupational Therapy 77(9): 466–474.

Becker

Henneghan

Mikan

(2015) When do I get my brain back? Clinical Journal of Oncology Nursing 19(2): 180–184.

Bootes

Chapparo

(2010) Difficulties with multitasking on return to work after TBI: A critical case study. Work: A Journal of Prevention, Assessment & Rehabilitation 36(2): 207–216.

Bootes

Chapparo

(2013) Cognitive strategy application: Measuring the impact of acquired brain injury on return to work. Australian Occupational Therapy Journal 60(Suppl. 1): 107.

Boykoff

Moieni

Subramanian

(2009) Confronting chemobrain: An in-depth look at survivors’ reports of impact on work, social networks, and health care response. Journal of Cancer Survivorship 3(4): 223–232.

Calvio

Peugeot

Bruns

(2010) Measures of cognitive function and work in occupationally active breast cancer survivors. Journal of Occupational and Environmental Medicine 52(2): 219–227.

Castellon

Ganz

Bower

(2004) Neurocognitive performance in breast cancer survivors exposed to adjuvant chemotherapy and tamoxifen. Journal of Clinical and Experimental Neuropsychology 26(7): 955–969.

Chapparo C and Ranka J (2014) The perceive, recall, plan & perform system assessment course manual (Available from authors chris.chapparo@sydney.edu.au and jranka@bigpond.net.au).

10.

Chapparo

Lowe

Heard

(2013) ThePRPP@school (teacher questionnaire): Examination of discriminant validity. Australian Occupational Therapy Journal 60(Suppl. 1): 61.

11.

Duijts

SFA

van Egmond

Spelten

(2014) Physical and psychosocial problems in cancer survivors beyond return to work: A systematic review. Psycho-Oncology 23(5): 481–492.

12.

Ferguson

McDonald

Saykin

(2007) Brain structure and function differences in monozygotic twins: Possible effects of breast cancer chemotherapy. Journal of Clinical Oncology 25(25): 3866–3870.

13.

Guba

Lincoln

(2005) Paradigmatic controversies, contradictions, and emerging influences. In: Denzin

Lincoln

(eds) The SAGE of Qualitative Research, 3rd ed. Thousand Oaks, CA: SAGE, pp. 191–215.

14.

Inagaki

Yoshikawa

Matsuoka

(2007) Smaller regional volumes of brain gray and white matter demonstrated in breast cancer survivors exposed to adjuvant chemotherapy. Cancer 109(9): 146–156.

15.

Lindner

Phillips

McCabe

(2014) A meta-analysis of cognitive impairment following adult cancer chemotherapy. Neuropsychology 28(5): 726–740.

16.

Linn

Gronlund

(2000) Measurement and Assessment in Teaching, 8th ed. Upper Saddle River, NJ: Prentice Hall.

17.

Mackenzie

Knipe

(2006) Research dilemmas: Paradigms, methods and methodology. Issues in Educational Research 16(2): 193–205.

18.

Mizuno

Tanaka

Yamaguti

(2011) Mental fatigue caused by prolonged cognitive load associated with sympathetic hyperactivity. Behavioral and Brain Functions 7(17): 1–7.

19.

Moore

HCF

(2014) An overview of chemotherapy-related cognitive dysfunction, or ‘chemobrain’. Oncology 28(9): 797–804.

20.

Munir

Burrows

Yarker

(2010) Women’s perceptions of chemotherapy-induced cognitive side effects on work ability: A focus group study. Journal of Clinical Nursing 19(9–10): 1362–1370.

21.

Nelson

Suls

Padgett

(2014) Understanding ‘chemobrain’: A challenge and invitation for psychological scientists. Observer 27: 1.

22.

Neuendorf

(2002) The Content Analysis Guidebook, Thousand Oaks, CA: SAGE.

23.

Newman

(2013) An occupational therapy perspective in addressing breast-cancer-related cognitive dysfunction in the survivorship phase. Physical Disabilities Special Interest Section Quarterly 36(1): 1–3.

24.

Nott

Chapparo

(2012) Exploring the validity of the perceive, recall, plan and perform system of task analysis: Cognitive strategy use in adults with brain injury. The British Journal of Occupational Therapy 75(6): 256–263.

25.

Oberst

Bradley

Gardiner

(2010) Work task disability in employed breast and prostate cancer patients. Journal of Cancer Survivorship 4(4): 322–330.

26.

Ottati

Feuerstein

(2013) Brief self-report measure of work-related cognitive limitations in breast cancer survivors. Journal of Cancer Survivorship 7(2): 262–273.

27.

Player

Mackenzie

Willis

(2014) Women’s experiences of cognitive changes or ‘chemobrain’ following treatment for breast cancer: A role for occupational therapy? Australian Occupational Therapy Journal 61(4): 230–240.

28.

Ranka

Chapparo

(2010) Assessment of productivity performance in men with HIV associated neurocognitive disorder (HAND). Work: A Journal of Prevention, Assessment & Rehabilitation 36(2): 193–206.

29.

Reid-Arndt

Yee

Perry

(2009) Cognitive and psychological factors associated with early post-treatment functional outcomes in breast cancer survivors. Journal of Psychosocial Oncology 27(4): 415–434.

30.

Schreier

(2012) Qualitative Content Analysis in Practice, Thousand Oaks, CA: SAGE.

31.

Shaw

Strong

(2008) A client-centered framework for therapists in ergonomics. In: Jacobs

(ed.) Ergonomics for Therapists, 3rd ed. Mosby, MO: Elsevier, pp. 17–36.

32.

Silverman

DHS

Castellon

(2007) Altered frontocortical, cerebellar, and basal ganglia activity in adjuvant-treated breast cancer survivors 5–10 years after chemotherapy. Breast Cancer Research & Treatment 103(3): 303–311.

33.

Smidt

(2014) The Perceptions of Australian Oncologists Regarding Cognitive Changes in Cancer Survivors. Occupational Therapy, Sydney: University of Sydney.

34.

Tager FA, McKinley PS, Schnabel FR, et al. (2010) The cognitive effects of chemotherapy in post-menopausal breast cancer patients: A controlled longitudinal study. Breast Cancer Research & Treatment 123(1): 25–34. [Erratum appears in Breast Cancer Research & Treatment. 2011; 126: 271–272.].

35.

Vardy

Dhillon

(2011) Cognitive function in cancer survivors. In: Davis

(eds) Supportive Oncology, Philadelphia, PA: Elsevier, pp. 448–455.

36.

Vodermaier

(2009) Breast cancer treatment and cognitive function: The current state of evidence, underlying mechanisms and potential treatments. Women’s Health 5(5): 503–516.

37.

Von Ah

Tallman

(2015) Perceived cognitive function in breast cancer survivors: Evaluating relationships with objective cognitive performance and other symptoms using the functional assessment of cancer therapy–cognitive function instrument. Journal of Pain and Symptom Management 49(4): 697–706.

38.

Wefel

Lenzi

Theriault

(2004) The cognitive sequelae of standard-dose adjuvant chemotherapy in women with breast carcinoma: Results of a prospective, randomized, longitudinal trial. Cancer 100(11): 2292–2299.