Roanne Thomas

For many working-age cancer survivors, return to work represents a quality-of-life indicator. However, there is currently a lack of resources to assist survivors with navigating this process. As a first step toward informing resources to address this gap, 10 female survivors' return-to-work experiences were explored. Photovoice methods were combined with interviews. Photographs and text were analyzed to identify key themes. Return to work was psychosocially motivated. Survivors independently decided if they would take leave and, if so, when they would return to work. Successful work reintegration was characterized as respectful, collaborative, and customized to each survivor's ongoing limitations and variable recovery. The findings underscore a holistic, client-centred, and collaborative approach to successful return to work with cancer survivors. Occupational therapists, with their vocational rehabilitation knowledge and responsive practice philosophy, are well positioned t...

Photovoice is a newly emerging participatory method of research. In this article, we discuss findings resulting from a photovoice project completed with young Aboriginal women who had experienced breast cancer. Three key interrelated themes linked to ethnicity, age, and identity, were particularly salient for the research participants. These are conceptualized as: (1) shame and silence; (2) resilience and strength; and (3) support. Resume La photo-voix est une nouvelle technologie participative de recherche emergente. Dans cet article, nous discutons des conclusions qui resultent du projet de photo-voix complete par une jeune autochtone qui a souffert du cancer du sein. Trois themescles etroitement lies a l'ethnicite, l'âge, et l'identite, etaient saillants pour les participantes a la recherche. Les trois sont conceptualises ainsi: (1) la honte et le silence; (2) la resistance et la force; (3) le support.

OBJECTIVE To identify the essential components of a mentorship program as the first step in the ongoing development of a mentorship program for primary care physicians. DESIGN Mixed-methods study. SETTING Saskatchewan. PARTICIPANTS Forty-nine of 170 physicians responded positively to a letter of invitation. Of these, 25 physicians were purposively sampled based on location, sex, and experience. Fourteen participants practised in urban areas and 11 in rural settings; 11 were men and 14 were women; and 10 were junior physicians and 15 were senior. Junior physicians were defined as those who had graduated from medical school after 1995, and senior physicians were those who had graduated before 1980. METHODS This study employed qualitative, in-depth, semistructured interviews. Interview questions, based on an environmental scan, were developed then pilot-tested with a family physician. Interviews lasted approximately 60 minutes and were audiotaped. Digital audio files were transcribed v...

OBJECTIVE To explore and describe primary care physicians' experiences in providing care to depressed patients and to increase understanding of the possibilities and constraints around diagnosing and treating depression in primary care. DESIGN Qualitative study using personal interviews. SETTING A hospital region in eastern Canada. PARTICIPANTS A purposely diverse sample of 20 physicians chosen from among all 100 practising family physicians in the region. METHOD Invitations were mailed to all physicians practising in the region. Twenty physicians were chosen from among the 39 physicians responding positively to the invitation. Location of practice, sex, and year of graduation from medical school were used as sampling criteria. The 20 physicians were then interviewed, and the interviews were audiotaped and transcribed verbatim. Data were analyzed using a constant comparative approach involving handwritten notes on transcripts and themes created using qualitative data analysis so...

OBJECTIVE One distressing health problem facing breast cancer patients is breast cancer-related lymphedema (BCRL). This incurable condition can occur many years after treatment is completed and often causes pain and disability and interferes with work and activities of daily living. Patients at risk of BCRL are those who have received radiation therapy or axillary node dissection; higher incidence is reported among patients who have had both radiation and dissection. Our objective was to explore New Brunswick women's experiences of BCRL and its treatment. DESIGN A focus group and 15 individual in-depth interviews. SETTING Province of New Brunswick. PARTICIPANTS A diverse sample of 22 women with BCRL was obtained using age, location, time after breast cancer diagnosis, and onset of BCRL symptoms as selection criteria. METHOD The focus group discussion guided development of a semistructured interview guide that was used for 15 individual interviews exploring women's experience...

ABSTRACT Participatory research projects incorporating non-traditional, creative, and qualitative methodologies can produce results which are unexpected or divergent from original research proposals. These results are highly meaningful, yet challenging to express to an audience when the expectation is to write the findings in a linear and traditional format, such as in a graduate thesis. Within this article, we use an autoethnographic approach to describe our experiences with ethnodrama, from our perspectives as a graduate student and supervisor. We focus on a planned breast cancer ethnodrama pilot project, which developed into a healing yoga program instead. We question the traditional notion of successful research as being a linear, straightforward process. In doing so, we hope to create dialogue and support mentorship which acknowledges the "messiness" of research projects. We also assert that there is a need to embrace non-traditional methods for disseminating our "messy" research outcomes.

There has been a lack of research done on in-class teaching and learning using visual methods. The purpose of this article is to demonstrate an enriched teaching and learning experience, facilitated by a Photovoice project, in an Advanced Methodology class where sociology graduate students were exposed to various social research methods and methodologies. Students were asked to take photographs that would represent a research interest or a lived experience based in their own social world. The article weaves four students and the professor’s experiences to document the impact the Photovoice project had on each of them. Through this process, it was found that Photovoice is a successful tool for conducting research, teaching students to think critically, and introducing students to a new medium to create knowledge. Students experienced what it is like to be a researcher and a participant in a qualitative research project and discovered the overwhelming potential visual methods have to ...

Breast cancer related lymphedema (BCRL) is a disability related to breast cancer treatment which may significantly affect women's everyday lives. We used a "material discursive" lens to analyze women's accounts of BCRL. Themes which emerged are: 1) moving beyond breast loss; 2) implications of disability; and 3) beyond limitations.

Advancements in cancer survivorship care have shown that holistic approaches, tailored to people's unique survivorship needs, can decrease cancer burden and enhance well-being and quality of life. The purpose of this study was to explore the meanings of spirituality in cancer survivorship for First Nations people, the largest Indigenous population in Canada, and describe how spiritual practices are incorporated into healing. This study is part of a larger arts-based project about cancer survivorship with First Nations people. Thirty-one cancer survivors discussed spirituality as part of their cancer survivorship experiences. Data were generated through sharing sessions (n = 8) and individual interviews (n = 31). Qualitative descriptive analysis was conducted. Three themes emerged about the meaning of spirituality in cancer survivorship. Spirituality was expressed as a complex phenomenon that (1) interconnected self with traditional roots and culture, (2) merged the body and mind, and (3) gave meaning, strength, and faith in the cancer journey. First Nations people incorporated spirituality into cancer survivorship by giving thanks, attending places of spiritual connectedness, singing, praying, speaking to the Creator, and engaging the sun and moon. First Nations cancer survivors have viewed cancer as an opportunity for emotional and spiritual growth that enabled healing. Understanding the role of spirituality in cancer survivorship is important to develop and deliver culturally safe health services that reduce the burden of cancer and ultimately improve outcomes for First Nations people in Canada.

In this study, we document cancer healthcare professionals' views of patients' use of cancer-related Internet information (CRII) and their views on how it informs the ways patients interact with healthcare professionals and services from the point of view of health professionals. We used an interpretive descriptive approach, conducting interviews and focus groups with oncology healthcare professionals (n = 21) at a University-affiliated western Canadian cancer treatment centre. Data were analysed using thematic analysis. We present an initial understanding of how CRII alters, informs and modulates patients' cancer experience and relates to their interactions with healthcare professionals and services. Findings were synthesised into two thematic categories: pragmatic concerns and priorities; and processes and practices. Healthcare professionals were supportive of patients' needs for more information, particularly at key points in the cancer trajectory when information may be lacking. Participants concurred that CRII could positively benefit patients and, if shared with their healthcare professional, could benefit the patient-healthcare professional relationship. Oncology healthcare professionals provide pivotal information to patients; thus, they are well situated to engage patients in discussions about CRII and incorporate this into patient encounters. These actions may open new lines of communication with patients, strengthen the patient-professional relationship and empower patients to be engaged in their own care.

Negative health consequences of cancer and its treatments are multifaceted. Research suggests numerous psychosocial benefits may be gained by cancer survivors who engage in arts-based practices. To grasp the breadth of this literature, we undertook a scoping review exploring the intersection between arts-based practices, gender, and cancer. Three databases were searched according to the following criteria: (a) participants older than 18 years, (b) use of arts-based practices, (c) explore cancer survivorship, and (d) gender-based analysis component. A total of 1,109 studies were identified and 11 met inclusion criteria. Themes extracted illustrate four transformative moments related to gender identities postcancer diagnosis: (a) fostering reflection after a cancer diagnosis, (b) constructing new narratives of gender postcancer, (c) navigating gender norms in search of support for new identities, and (d) interrogation of perceived gender norms. Findings demonstrate potential contribut...

People diagnosed with cancer typically want information from their doctor or nurse. However, many individuals now turn to the Internet to tackle unmet information needs and to complement healthcare professional information. The purpose of this study was to qualitatively explore the content of commonly searched cancer websites from a critical nursing perspective, as this information is accessible, and allows patients to address their information needs in ways that healthcare professionals cannot. This qualitative examination of websites is informed by Carper's fundamental patterns of knowing and complemented with the critical view to technology espoused by the philosophy of technology. We conducted a review of 20 websites using a two-step interpretive descriptive approach and thematic analysis. We identified the dominant discourse to be focused on empirical information on treatment, prognosis, and cure, and a paucity of sociopolitical, ethical, personal, and esthetic information....

To evaluate the feasibility of a web-based psychosocial supportive intervention entitled Male Transition Toolkit (MaTT). 
. Randomized, controlled trial, mixed methods, concurrent feasibility design.
. Edmonton, a large metropolitan city in western Canada.
. 40 dyads (women with breast cancer and their spouse).
. Male spouse participants in the treatment group accessed MaTT for four weeks. Data on hope, quality of life, general self-efficacy, and caregiver guilt were collected at baseline and days 14, 28, and 56. Quality-of-life data were collected from the women with breast cancer at each time period. Qualitative data were collected from the usual care group in an open-ended interview and from the treatment group in an evaluation survey on days 14 and 28.
. Feasibility, as measured by the MaTT questionnaire. 
. Evaluation survey scores indicated that MaTT was feasible, acceptable, and easy to use. Male spouse quality-of-life scores were not significantly different between groups. A...

There is an important need to evaluate whether rehabilitation services effectively address the needs of minority culture populations with North America's increasingly diverse population. The objective of this paper was therefore to review and assess the state of knowledge of barriers and facilitators to cultural competence in rehabilitation services. Our scoping review focused on cultural competence in rehabilitation services. Rehabilitation services included in this review were: audiology, speech-language pathology, physiotherapy, and occupational therapy. A search strategy was developed to identify relevant articles published from inception of databases until April 2015. Titles and abstracts were screened by two independent reviewers according to specific eligibility criteria with the use of a liberal-accelerated approach. Full-text articles meeting inclusion criteria were then screened. Key study characteristics were abstracted by the first reviewer, and findings were verifie...

To generate insights into the personal meaning and value of a running/walking program for women after a diagnosis of breast cancer. After completing a 12-week running/walking program with a 5-km training goal, eight women were interviewed and seven participated in a focus group. The interviews and focus group were audio-recorded and transcribed verbatim. Data were thematically analyzed. Data portrayed the personal benefits and value of the clinic. Four themes were identified: (1) receiving practical information and addressing targeted concerns, (2) pushing personal limits, (3) enabling a committed mindset, and (4) seeing benefits and challenges of running/walking with a group. Findings provide initial understanding of how women experience a running/walking program after a diagnosis of breast cancer and what they find to be important about their experiences. The range of positive benefits experienced by women suggests a running/walking program can help fill a gap in care for women di...

First Nations people with cancer in Canada confront several critical inequities in physical and psychosocial domains. First Nations women are at a particular disadvantage as they are disproportionately affected by social determinants of health, but how they navigate these challenges within their communities is poorly understood. Our study explores survivorship experiences of First Nations women with cancer and their caregivers. Drawing from a larger data set on survivorship, we identify several major barriers to cancer communication and support in First Nations communities. Our team conducted a participatory, arts-based study using several data collection methods (interviews, sharing sessions, photovoice and other creative activities) with 43 participants (24 cancer survivors and 19 caregivers) from four First Nations communities in Canada. Two major themes have emerged out of our data analyses: 1) suffering without support leads to cycles of silence, and 2) community-based supports...

Participatory research projects incorporating non-traditional, creative, and qualitative methodologies can produce results which are unexpected or divergent from original research proposals. These results are highly meaningful, yet challenging to express to an audience when the expectation is to write the findings in a linear and traditional format, such as in a graduate thesis. Within this article, we use an autoethnographic approach to describe our experiences with ethnodrama, from our perspectives as a graduate student and supervisor. We focus on a planned breast cancer ethnodrama pilot project, which developed into a healing yoga program instead. We question the traditional notion of successful research as being a linear, straightforward process. In doing so, we hope to create dialogue and support mentorship which acknowledges the "messiness" of research projects. We also assert that there is a need to embrace non-traditional methods for disseminating our "messy&q...

Lymphedema can cause significant physical impairment and quality-of-life issues. Yet there is a gap in knowledge about lymphedema among breast cancer survivors (BCS), and health care professionals (HCP). Ethnodrama is an innovative knowledge translation strategy that uses theatrical performances for dissemination of research results. We evaluated the impact of live ethnodrama on HCP' and BCS' awareness and attitudes in relation to impact of lymphedema on BCS' lives. Ethnodrama performances were developed by script writers and a theatre director in collaboration with the investigators and BCS using data from published research and pre-performances workshops. Six interactive live performances were given to audiences of BCS, HCP, and community members in four cities across Canada. After watching these live performances, members of the audiences were asked to complete a paper-based questionnaire regarding their knowledge of lymphedema, and their attitudes and practices toward lymphedema. Of 238 audience members who participated in the survey, 55 (23%) were BCS and 85 (37.5%) were HCP. Most members rated the performances as very effective in changing their (84%) or other people's (93%) understanding of lymphedema; 96% reported being motivated to seek additional information on lymphedema, and 72% of HCP anticipated changes in their practices related to lymphedema screening. Overall no significant differences were noted in responses to ethnodrama between BCS and HCP. Open-ended responses were supportive of the findings from the closed-ended questions. Our results indicate that ethnodrama performances effectively convey information and positively affecting changes in HCP' and BCS' attitudes toward lymphedema.

The use of popular expressive arts as antidotes to the pathologies of the parallel processes of lifeworld colonization and cultural impoverishment has been under-theorized. This article enters the void with a project in which breast cancer survivors used collages and installations of everyday objects to solicit their authentic expression of the psycho-social impacts of lymphedema. The article enlists Jurgen Habermas' communicative action theory to explore the potential of these expressive arts to expand participants' meaningful engagement with their lifeworlds. The findings point to the unique non-linguistic discursivity of these non-institutional artistic forms as their liberating power to disclose silenced human needs: the images 'spoke' for themselves for group members to recognize shared subjectivities. The authenticity claims inherent in the art forms fostered collective reflexivity and spontaneous, affective responses and compelled the group to create new colle...

... Following the participatory action strategy of photovoice, as developed by Wang and Burris (1997), our goals were to work with women ... women experiencing a disproportionate burden of ill-health compared to both Aboriginal men and other Canadian women (Dion Stout, Kipling ...

To (a) describe the types of transitions experienced by male spousal caregivers of women with breast cancer and the strategies used by male spouses to deal with these transitions and (b) examine factors related to their quality of life, including demographic variables, self-efficacy, caregiver guilt, hope, the quality of life of their partner with breast cancer, and transitions.
. Cross-sectional, transformational, mixed-methods approach.
. Participants' homes.
. 105 dyads of male spouses and their female partners diagnosed with stages I-III breast cancer.
. 600 surveys were mailed to women with breast cancer and their male partners. Significant variables were entered into a multivariate model.
. Male caregiver quality of life.
. The quality of life of male spouse participants was positively influenced by hope (p < 0.01). It was negatively influenced by caregiver guilt scores (p < 0.01) and the method of dealing with their transitions by "doing what needs to be done&q...