Characterization of functioning in breast cancer survivors: an interpretive descriptive analysis study based on the International Classification of Functioning, Disability, and Health (ICF) and the Item-Perspective Classification Framework

Abstract

Purpose

Breast cancer survivors may experience a variety of disabilities that could potentially compromise their independent functioning. This study aimed to examine their perspectives and experts on their functioning and interpret concepts with the International Classification of Functioning, Disability, and Health (ICF) and the Item-Perspective Classification Framework (IPF).

Methods

Interpretive descriptive methods were used with in-depth interviewing with 16 breast cancer survivors and 22 experts using a semi-structured interview guide. The interviews were recorded, transcribed, and qualitatively analyzed using thematic analysis. The extracted data were linked to the ICF Core Set for Breast cancer and were interpreted by the IPF.

Results

Four main themes emerged to define the functioning of breast cancer survivors: body functioning, physical functioning, social functioning, and mental functioning. Three other factors were also categorized as modifiers of functioning personal, emotional, and environmental. The 592 extracted meaningful concepts were linked to 38 (47%) categories from the ICF: 16 Body Functions, 14 Activities and Participation, and 8 Environmental Factors. The IPF classified all the extracted concepts, and most rational appraisals fell in the biological (B) domain. The concepts that required emotional appraisal were classified in Psychology (P).

Conclusion

Psychological and emotional factors were pivotal in defining functioning in patients with BC.

IMPLICATIONS FOR REHABILITATION

1. Rehabilitation specialists need to consider a holistic approach to breast cancer survivor care that addresses physical functioning and social, emotional, and environmental factors that may affect their overall well-being.

2. The findings suggest that rehabilitation interventions that aim to improve the functioning of breast cancer survivors should target a range of areas, including body functioning, physical functioning, social functioning, and mental functioning.

3. It is important for rehabilitation professionals to consider personal, emotional, and environmental factors that influence the functioning of breast cancer survivors when designing interventions.

4. Using the ICF Core Set for Breast Cancer and the IPF can help rehabilitation specialists better understand the functioning of breast cancer survivors and develop more effective interventions.

Keywords:

• Breast cancer survivors
• ICF
• function
• Item-Perspective Classification Framework
• core set

Acknowledgements

Joy MacDermid was supported by a Canada Research Chair and the Dr James Roth Chair (both in Musculoskeletal Measurement and Knowledge Translation).

Ethics approval

To begin sampling, the necessary permits and an ethical code (IR.USWR.REC.1398.198) were obtained from the ethics committee at the University of Social Welfare and Rehabilitation Sciences (Tehran) for the necessary coordination.

Consent form

Informed consent was obtained from all individual participants included in the study.

Authors’ contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by FJ, MF and SAH. The first draft of the manuscript was written by MF and FJ and all authors commented on previous versions of the manuscript. The methodology was designed and checked by JCM. Data analysis was checked by MHA, MF and JCM and did the final review. All authors read and approved the final manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.