Judy Ranka

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

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.

Assessment of productivity performance in men with HIV Associated Neurocognitive Disorder (HAND).

OBJECTIVES The purpose of this paper is to review what is known about return to productivity roles for people who have HIV/AIDS and HIV Associated Neurocognitive Disorder (HAND), to highlight gaps in knowledge and practice for assisting people with HAND to engage in productivity roles, to describe an occupational therapy assessment system that overcomes some of the limitations of current research and practice, and to demonstrate the clinical utility of this instrument for use with clients who have HAND. PARTICIPANTS The participant in this study is a man with HIV Associated Dementia (HAD), one sub-type of HAND. METHODS The real-world impact of HAD on productivity role participation was assessed using the Perceive, Recall, Plan and Perform (PRPP) System of Task Analysis, an ecological assessment method. Productivity tasks assessed were those associated with this mans desire to become a volunteer grocery shopper. The assessment took place under naturalistic conditions in a grocery store. RESULTS The participant demonstrated 28.6% mastery of the grocery shopping task. Performance was impacted on primarily by errors of accuracy and timing. Reasons for these errors centered on the participants difficulties in applying cognitive strategies to perceive, recall, plan and perform the task. CONCLUSIONS The PRPP System of Task Analysis shows promise in being able to identify errors in task mastery and the underlying cognitive strategy application errors that impact on mastery in people with HAND.

The Clinical Utility of the Comparative Analysis of Performance — Motor (CAP-M) for Children with Cerebral Palsy

Background and aim: The focus of upper limb assessment for people with neurological damage has expanded beyond impairment factors. Assessments that evaluate the impact of impairment factors within tasks are needed to ensure that interventions address task performance. The Comparative Analysis of Performance — Motor (CAP-M) identifies upper limb impairments during performance of a client-chosen occupational task and uses this information to guide goal formulation. This study investigated the clinical utility of the CAP-M with children with cerebral palsy. Method: Ten occupational therapists each administered the CAP-M with one child with cerebral palsy. The participants were involved in a focus group or focused discussion. Constant comparative analysis was used to guide data collection and identify key themes. Findings and conclusion: The participants reported that the tool was a useful addition to the current upper limb assessments available for children with spastic cerebral palsy and some voluntary movement. Useful features of the tool were its focus on meaningful tasks, its effectiveness as an observational and educational tool and its usefulness in directing intervention selection. The findings support the development of upper limb assessment tools that span a range of ages and diagnoses and link impairment level factors with task performance.