Does the Canadian Occupational Performance Measure (COPM) Capture the Complex Experiences of Cancer Survivors? A Mixed Methods Approach.
Cassandra A Winters, Hilary K Marshall, David E Victorson and 2 others
PMID 37302410WHAT IT FOUND
The COPM identifies specific daily tasks cancer survivors struggle with, but misses the complex emotional and social impacts of their diagnosis.
Survivors reported issues like fatigue and memory loss affecting work and relationships that the scores did not capture. Use it for task goals, not for understanding the whole person.
Key findings
01The COPM successfully identified occupational performance problems across self-care, productivity, and leisure, with physical activities and work tasks being the most common issues.
02Qualitative interviews revealed that the COPM failed to capture the nuances of role, responsibility, and identity, particularly regarding social stigma, relationship conflicts, and the emotional weight of disability.
03Four participants declined to complete the COPM because they had adapted their routines and saw no functional deficits, yet they still described significant challenges in daily life during interviews.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The sample was small (n=30) and disproportionately white, female, and breast cancer survivors, limiting generalizability to other groups. Participants were volunteers in an exploratory study, not clients seeking occupational therapy, which may have altered how they engaged with the COPM. The study was part of a larger project developing an app-based intervention, so the interview guide was not solely focused on testing the COPM's validity. Four participants declined the COPM, reducing the quantitative dataset to 26.
Declared interests
The authors declared no conflicts of interest. The work was supported by the National Cancer Institute.
The easy way to misread this
Do not assume that a high COPM score means the patient has no significant occupational therapy needs. Four survivors reported no functional deficits on the COPM but still described major challenges in their daily lives and relationships during interviews.