Catherine Backman

 
Prospective Graduate Students / Postdocs

This faculty member is currently not looking for graduate students or Postdoctoral Fellows. Please do not contact the faculty member with any such requests.

Professor

Research Interests

occupational balance
activity disruption
social role participation
arthritis
chronic illness
health & well-being
Occupational therapy

Relevant Degree Programs

 

Research Methodology

Mixed Methods Research
qualitative studies
intervention studies

Graduate Student Supervision

Doctoral Student Supervision (Jan 2008 - Mar 2019)
Impact of prior hysterectomy on risk of subsequent back injury in front line healthcare workers (2016)

Low back injury (LBI) is associated with altered core muscle function and studies have validated the role of these deep stabilizing muscles in prevention and treatment of back pain and injury. No previous studies have evaluated the impact of surgery such as abdominal hysterectomy (AH) on these deep stabilizers and the potential for increased risk of LBI following surgery. The aims of this research were to investigate a link between AH and LBI first with administrative health data analysis and then clinically by measuring muscle thickness with rehabilitation ultrasound imaging (RUSI) before and after surgery.A retrospective cohort of 37,057 female frontline healthcare workers, a population at high risk of occupational LBI due to the heavy nature of their work, was extracted. Exclusion of 27,987 due to a history of back pain or injury, prior hysterectomy or failure to meet the provincial residency requirement of five years left a sample size of 9,070. Within this research sample, 634 (7%) had undergone hysterectomy, a prevalence much lower than the published value of 30%. Statistical analysis revealed no increased risk of LBI in this cohort of healthcare workers without prior history of LBI. Clinical RUSI assessment of the core muscles would investigate if this was because there was no change in the muscle function post-surgically. Validity and reliability of RUSI to evaluate core muscle function have been established for intersessions up to two weeks. A group of women not undergoing AH was used to establish reliability over intervals of four, eight and twelve weeks. Intraclass correlations (ICC₃,₁) ranging from 0.75 to 0.90 for measured muscle thickness in the deep abdominal and lumbar muscles exceeded the minimum standard of 0.70 for research purposes. Percent change measures did not meet this standard. A prospective descriptive case series involving nine individuals undergoing AH found post-surgical decreases in measurements of the deep abdominal stabilizers most notably in the participants with a history of previous low back pain/injury or who were obese. These findings support continued investigation of the relationship between AH and LBI including individuals with risk factors such as prior low back pain/injury and/or obesity.

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Balance in everyday life : conceptions of men and women in dual-income couples with young children (2012)

BACKGROUND: As the social justice movement has lessened the gender gap in occupational participation, the subject of balance in life is receiving enormous attention. A growing body of literature suggests that imbalance can increase individual’s health risks. Although various theories about balance have been developed, it remains elusive as a concept. Understanding how people experience and perceive balance is essential to conceptualizing balance and promoting individual and societal health. OBJECTIVE: To better understand the ways in which men and women in dual-income couples with at least one preschool-aged child perceive and experience balance in everyday life. METHODS: The study was primarily informed by a phenomenographic approach. Fifteen heterosexual, dual-income couples living with at least one child under six years old were recruited from a metropolitan area. Each partner in each couple individually participated in two semi-structured interviews. The first interview was designed to explore participants’ overall experiences of daily life, while the second interview aimed to elicit their experiences and perceptions of balance. Phenomenographic and critical discourse analyses were applied to the interview data. The quality of the findings was assured by peer-debriefing, reflexivity, and the verification of transferability. RESULTS: Two key conceptions of balance were identified: managing life and participating in a mix of occupations. In elucidating these conceptions, parents associated the former with meeting collective needs and the latter with meeting individual needs. Trying to simultaneously satisfy these two conceptions/constructions of balance created tension. Managing life reinforced parents’ intensive commitment to parenting and led to balance, but it limited their engagement in personal occupations, which led to imbalance. Conversely, participating in a mix of occupations allowed parents to meet their own needs and was associated with balance, but as it reduced the time they spent with their families, it led to imbalance. CONCLUSION: Employed parents with young children live with two competing conceptions/constructions of balance, which can create tension and affect health. Developing health care and employment policies that help parents to attain a greater sense of balance by harmonizing collective needs of the family and their personal needs may mediate this tension.

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Early childhood before, during and after war and displacement in northern Uganda (2012)

Background: Research from numerous fields of science is providing strong evidence demonstrating that the conditions young children live within mould their health and developmental trajectories. While science and policy call for nurturing environments to preserve developmental potential, the current global reality is that war and civil unrest displace millions of children from their homes, desecrating their social supports and environments. Furthermore, little research has drawn attention to the experience of the youngest children during and after war. Objective: To holistically document the environments of young children (0 to 3 years) before, during and after a 20-year war and mass internal displacement in northern Uganda in order to deepen current understandings, address research gaps and inform interventions. Methods: This applied ethnography used purposive sampling in three sites of the Amuru District over a one-year period. Interviews, focus groups, longitudinal case studies, participant observation, document review, and photo documentation with young children, caregivers (siblings, parents, and others) and community leaders explored multiple views on early childhood health and development. Results: War and displacement seriously thwarted caregivers from employing their extensive knowledge and traditional care practices that protected and nurtured their young children in rural agrarian communities. Young children were exposed to numerous, cumulative factors that previous research has documented as risks to well-being and long-term developmental potential. This risk persisted well into post-conflict resettlement. However, despite dire conditions, there were also factors that acted to protect children and examples of children’s healthy functioning. Conclusions: Disrupted social structures and environments appear to influence young children's health and developmental futures in all phases of war, displacement and resettlement. Results suggest that the efforts by state and the international community to mitigate risk and promote positive development for vulnerable young children were insufficient and incommensurate with the degree of evidence supporting the critical importance of the early years. Future efforts must build on local culture and address the most relevant and pressing needs of children in close collaboration with families and communities. The rebuilding of healthy, peaceful societies depends upon the preservation of the immense human capital and boundless potential within children.

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First steps in developing clinical practice guidelines for post-acute rehabilitation after primary total hip and knee arthroplasty (2010)

Total hip (THA) and total knee arthroplasty (TKA) are cost-effective interventions for advanced osteoarthritis (OA) of the knee and hip. With the rapidly growing number of these procedures performed annually in Canada and the United States, greater attention needs to be directed to identify rehabilitation practices that optimize outcomes and minimize cost. Currently, there is no consensus on rehabilitation best practice and no evidence-based clinical practice guidelines to inform clinical decision-making on post-acute rehabilitation following THA and TKA. A multi-phase, mixed-method project integrated stakeholder perspectives, research evidence and expert opinion to develop best practice recommendations for THA and TKA rehabilitation. Chapter 2 involved 11 focus groups and eight interviews to identify key themes related from North American patients and health care professionals on rehabilitation practices and outcomes. Chapters 3-4 are Cochrane systematic reviews examining the strength of the evidence for post-acute physiotherapy after THA and TKA. Chapter 5-6 involved two parallel Delphi surveys with consumers, clinicians and researchers to develop consensus on a range of rehabilitation topics to inform best practice for THA and TKA rehabilitation. Chapter 2: Six key themes emerged relating to communication, patient expectations, patient attitude, forms of support, barriers to recovery, and diversity of outcomes. Chapters 3-4: Systematic reviews of THA (n=8) and TKA (n=7) trials revealed limited, low to high quality evidence with mixed findings for various forms of post-acute physiotherapy on pain, function and health-related quality of life. Trial heterogeneity prevented meta-analysis. Chapters 5-6: Consensus (80% agreement) was reached on the need for post-acute rehabilitation, types of interventions, rehabilitation providers, treatment settings, outcomes and outcome measurement. Consensus was not reached regarding timing and dosage of rehabilitation. Sub-group analysis revealed few differences comparing responses by profession, primary role and country. This thesis has taken important first steps in identifying appropriate rehabilitation interventions and health care resources to optimize individuals’ activity, participation and health-related quality of life after THA and TKA. Further, it highlights the need for more high quality research to address the knowledge gaps and inform policy on this important and understudied aspect of arthroplasty surgery.

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Master's Student Supervision (2010-2017)
Employment experiences of people with bipolar disorder (2011)

The mental illness called bipolar disorder creates enormous social, economic and health implications for Canadian society. Bipolar disorder (BD) causes fluctuating mood states ranging from depression to mania. Over half a million Canadians live with BD (Schaffer, 2006), and approximately 400,000 are working age, 25-64 years (Wilkins, 2004). In Canada, reported prevalence of unemployment for all persons living with a severe mental illness, including BD, is as high as 90% (Kirby, 2006). The aim of this study was to explore the perspectives of people living with bipolar disorder regarding their employment accomplishments and obstacles, and to understand the adaptive strategies they used to manage both BD and employment. Using a qualitative research framework based primarily on the interpretive descriptive approach, considered especially suited to inform health care practice, purposive sampling identified 10 people living with the extreme mood fluctuations of BD type I. Their experiences were described during one in-depth interview, a follow-up telephone interview, and findings verified through written feedback. Three main themes were revealed, related to (1) hypomania and mania, (2) stigma and disclosure, and (3) employment factors that supported or created obstacles to successful employment. Findings suggest a broader perspective of employment issues should be considered by practitioners and employers to help reduce limitations encountered by this sample of persons with BD type I. Inclusion of social, psychoeducational and organizational issues in the repertoire of job accommodations may improve employment for this population.

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Recent Tri-Agency Grants

The following is a selection of grants for which the faculty member was principal investigator or co-investigator. Currently, the list only covers Canadian Tri-Agency grants from years 2013/14-2016/17 and excludes grants from any other agencies.

  • Supporting physical activity & reducing sedentary behaviour in arthritis (SuPRA) - Canadian Institutes of Health Research (CIHR) - Operating Grant: Knowledge to Action (2014/2015)
  • A randomized controlled trial evaluating the effectiveness of the Making It Work program at preventing work loss and improving at work productivity in employed people with inflammatory arthritis - Canadian Institutes of Health Research (CIHR) - Operating Grant (2013/2014)

Publications

 
 

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