Evaluating the suitability of the Perceive, Recall, Plan and Perform System of Task Analysis (PRPP‐A) for assessing work‐related cognitive difficulties in women after breast cancer: A comparison with Cambridge Neuropsychological Test Automated Batter
Joanne Lewis, Lynette Mackenzie, Chris Chapparo, Judy RankaAbstract
Introduction
An increasing number of working‐age women are diagnosed with breast cancer, making it critical to understand cognitive difficulties that may affect their work performance. This pilot study aimed to evaluate the suitability of the Perceive, Recall, Plan and Perform System of Task Analysis Assessment (PRPP‐A) for occupational therapists assessing work performance after breast cancer, by examining its alignment with domain‐specific cognitive measures obtained from the Cambridge Neuropsychological Test Automated Battery (CANTAB) and its capacity to identify cognitive difficulties relevant to work tasks.
Methods
The pilot study involved 12 women diagnosed with breast cancer who were employed at the time of diagnosis. Participants completed cognitive assessments using the PRPP‐A (administered via semi‐structured interview) and computerised CANTAB subtests, including Rapid Visual Processing (RVP), Delayed Matching to Sample (DMS), and Spatial Working Memory (SWM). Associations between CANTAB subtests and corresponding PRPP‐A quadrants were examined, and the ability of PRPP‐A and CANTAB scores to predict work participation outcomes was explored.
Consumer and Community Involvement
Women were recruited through Breast Cancer Network Australia (BCNA). The study was advertised on the BCNA website, and a national webinar was conducted to encourage participation.
Results
The PRPP‐A showed difficulties in the following items: Continuing (mean = 47.08, SD = 17.464), Initiating (mean = 56.92, SD = 13.118), Attending (mean = 58.25, SD = 15.428) and Programming (mean = 59.42, SD = 11.204). Significant correlations were found between PRPP‐A Total Perceive and CANTAB RVP ( τ = 0.477, P = 0.036) and PRPP‐A Total Plan and CANTAB SWM ( τ = −0.735, P = 0.002). Receiver operating characteristic (ROC) analysis showed that PRPP‐A Total Cambridge Neuropsychological Test Automated Battery Perceive scores were the only testing component to predict both nonreturn to pre‐cancer roles (area under the curve [AUC] = 0.969) and hours of work (AUC = 0.719). PRPP‐A Total Plan (AUC = 0.734) and CANTAB RVP Detecting Signal test (AUC = 0.750) demonstrated acceptable sensitivity for predicting women not returning to pre‐cancer roles.
Conclusion
The PRPP‐A demonstrated suitability as a cognitive assessment for occupational therapists by aligning with domain‐specific neuropsychological measures while identifying work‐relevant functional cognitive difficulties. Its occupation‐focussed, ecologically valid approach supports clinical use in assessing work performance after breast cancer, although confirmation in larger samples is required