Therapeutic Work as a Facilitator for Return to Paid Work in Cancer Survivors

Measures of Work-life Balance and Interventions of Reasonable Accommodations for the Return to Work of Cancer Survivors: A Scoping Review

Background

Nearly half of patients diagnosed with cancer are in the middle of their traditional working age. The return to work after cancer entails challenges because of the cancer or treatments and associated with the workplace. The study aimed at providing more insight into the occupational outcomes encountered by workers with cancer and to provide interventions, programs, and practices to support their return to work.

Methods

A scoping review was conducted using the Arksey and O'Malley framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for scoping review guidelines. Relevant studies were systematically searched in PubMed/MEDLINE, SCOPUS and Grey literature from 01 January 2000 to 22 February 2024.

Results

The literature search generated 3,017 articles; 53 studies were considered eligible for this review. Most of the studies were longitudinal and conducted in Europe. Three macroarea were identified: studies on the impact of cancer on workers in terms of sick leave, employment, return to work, etc.; studies reporting wider issues that may affect workers, such as the compatibility of treatment and work and employment; studies reporting interventions or policies aiming to promote the return to work.

Conclusion

There is a lack in the literature in defining multidisciplinary interventions combining physical, psycho-behavioural, educational, and vocational components that could increase the return-to-work rates. Future studies should focus on interdisciplinary return to work efforts with multiple stakeholders with the involvement of an interdisciplinary teamwork (healthcare workers and employers) to combine these multidisciplinary interventions at the beginning of sick leave period.

Return to work and cancer: Perspectives of occupational therapists

INTRODUCTION

Progress in the early detection, diagnosis, and treatment of cancer has translated into more people in Australia living with and beyond cancer. Therefore, there is a larger number of people returning to work following cancer treatment while managing ongoing symptoms of cancer, and side effects of treatment. The purpose of this study was to explore the facilitators and barriers for return to work for someone with cancer, from the perspective of occupational therapists.

METHOD

This study used a qualitative descriptive design. Participants were recruited via key contacts within the industry and relevant interest groups, and included eight occupational therapists with experience supporting someone with cancer to return to work. Data were collected in semi-structured in-depth Interviews which were audio recorded, transcribed verbatim, and analysed thematically.

FINDINGS

Two main themes were developed; expectations of the cancer experience versus reality, and vulnerability during return to work. Occupational therapists perceived that the person with cancer, employers, family members, co-workers, and society underestimate the impact of ongoing cancer symptoms on return to work. Return to work was challenging as survivors face unexpected challenges due to ongoing fatigue, cognitive difficulties, or psychological factors. Fear of relapse, concerns regarding disclosure affecting how people with cancer are perceived at work, and worries of leaving the high levels of professional support during treatment, also affected return to work.

CONCLUSION

Findings from this study may contribute to occupational therapists and people with cancer setting realistic expectations for the return to work experience. Furthermore, it may provide support for occupational therapists to work more effectively with their clients to facilitate a smoother transition back to work as a cancer survivor.

[Occupational therapy in oncology: experiences in academic practices and literature review]

OBJECTIVE

To inquire about the training of occupational therapists in oncology in a university program, and to identify updated literature as evidence for training and professional practice.

MATERIALS AND METHODS

Cross-sectional exploratory study, with a sample of 29 students of occupational therapy from the National University of Colombia. Systematic review of literature 2010-2015 on occupational therapy interventions in oncology. Results In the survey, less than a quarter of the students reported having received training on clinical management of this diagnosis, and on the intervention of the occupational therapist with such cases (24.1%). Little more than this percentage (27.6%), has had users with cancer in their academic practices. In the literature review no national publications were found, although there were unpublished products from Colombian universities. Fifty-four international publications were recovered, especially in rehabilitation, it followed by psychosocial and socio-occupational areas. The palliative care, the multidisciplinarity, the subjective experience of the patient in relation to the diagnosis and treatment, the humanized and integral care from the different areas of the therapeutic task and work with caregivers are considered as relevant issues in the oncological patient's approach.

CONCLUSIONS

Reference points are made for the occupational therapy curriculum development and for professional updating processes, which are both competence of the academy and of the guild. It is important to intervene in cancer not only during, but in the preparation to treatment and subsequently with survivors. Professional publications should be encouraged, making sure they provide powerful evidence of the impact of occupational therapy and oncological rehabilitation.