1
|
Kuai B, Huang Y, Su X, Shi Y, Feng G, Hu L, Guo Y. The experiences and perceptions of employers on cancer survivors returning to work: a meta-synthesis of qualitative studies. Support Care Cancer 2024; 32:454. [PMID: 38913103 DOI: 10.1007/s00520-024-08637-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 06/07/2024] [Indexed: 06/25/2024]
Abstract
PURPOSE Employers play an important role in the return-to-work (RTW) of cancer survivors (CSs), and recently a substantial number of qualitative studies from the employers' perspective have emerged. This meta-synthesis aims to systematically review these qualitative studies regarding employers' experiences with CSs' RTW. METHODS Five electronic databases were searched from inception to January 2024 to identify the studies. Three researchers conducted quality assessment of included. Subsequent, we performed thematic integration of the included studies with the NVivo 11 software. RESULTS Thirteen qualitative studies were included, and 16 topics were finally extracted and summarized into seven categories to form three integrated themes: employers' perspective on facilitators and obstacles for CSs' RTW, employers' response including negative emotion and positive behavior, and employers' need resources from different aspects. CONCLUSION CSs' RTW is influenced by many factors; the support employers need is also extensive and complex. Employers need more support beyond healthcare.
Collapse
Affiliation(s)
- BenXin Kuai
- Medical School of Nantong University (School of Nursing), Nantong, 226001, Jiangsu, China
| | - YanJun Huang
- Medical School of Nantong University (School of Nursing), Nantong, 226001, Jiangsu, China
| | - Xiaoqin Su
- Medical School of Nantong University (School of Nursing), Nantong, 226001, Jiangsu, China
| | - Yue Shi
- Medical School of Nantong University (School of Nursing), Nantong, 226001, Jiangsu, China
| | - Guojia Feng
- Medical School of Nantong University (School of Nursing), Nantong, 226001, Jiangsu, China
| | - Lanyue Hu
- Medical School of Nantong University (School of Nursing), Nantong, 226001, Jiangsu, China
| | - YuJie Guo
- Medical School of Nantong University (School of Nursing), Nantong, 226001, Jiangsu, China.
| |
Collapse
|
2
|
Xu W, Hu D, Chen H, Li N, Feng X, Hu M, Cao F, Jin B, Zhang C. Quality of working life and adaptability of returning to work in nurse cancer survivors: a cross-sectional study. Support Care Cancer 2024; 32:226. [PMID: 38478116 DOI: 10.1007/s00520-024-08409-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 02/26/2024] [Indexed: 04/18/2024]
Abstract
OBJECTIVE To explore the relationship between quality of working life (QWL) and adaptability of returning to work (RTW) among nurse cancer survivors (NCSs). METHOD We conducted a cross-sectional study on nurses previously diagnosed with cancer. QWL was quantified using the Quality of Working Life Scale (QWL7-32), and the level of RTW adaptability was assessed using the Adaptability of Returning to Work for Cancer Survivors (ARTW-CS) scale. Multiple linear regression analysis was used to control for confounding factors, and a simple effect analysis was performed on the interaction term. RESULTS After controlling for sociodemographic, work-related, and health-related factors, the findings indicated a significant correlation between "adaptation and planning" and QWL score (p < 0.05). Further analysis revealed that "RTW gradualness" and "support seeking" had an interaction effect (p = 0.021). The simple effect analysis demonstrated that when the "RTW gradualness" score was ≥ 16 points, nurses with a high "support seeking" score (≥ 7 points) exhibited a significantly better QWL than those with a low "support seeking" score (< 7 points) (p < 0.001). CONCLUSION The interaction between "RTW gradualness" and "support seeking" in the ARTW-CS scale significantly impacted the QWL of the NCSs, underscoring the importance of implementing a gradual career plan and seeking support to enhance QWL.
Collapse
Affiliation(s)
- Wenjing Xu
- The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Danhong Hu
- The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Hao Chen
- The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Na Li
- The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xiao Feng
- The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Miaoye Hu
- The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Fuxiao Cao
- The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Bixia Jin
- The Fifth Affiliated Hospital, Wenzhou Medical University, Lishui, Zhejiang, China
| | - Chunmei Zhang
- The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
| |
Collapse
|
3
|
Berkhout MA, Tamminga SJ, de Boer AGEM, Dewa CS, de Jong A, de Rijk AE, Greidanus MA. Pilot implementation of MiLES: a web-based intervention targeted at managers with the aim of enhancing the successful return to work of employees with cancer. Acta Oncol 2023; 62:765-773. [PMID: 37504953 DOI: 10.1080/0284186x.2023.2238886] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 07/04/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND MiLES is a web-based intervention targeted at managers with the aim of enhancing the successful return to work (RTW) of employees with cancer. The purpose of this study was to identify barriers to and facilitators of implementing MiLES in organizations, from a manager's perspective. MATERIAL AND METHODS MiLES was implemented as a pilot in four organizations for six weeks. Sixteen managers were included, of which fourteen were interviewed regarding their perceived barriers to and facilitators of implementation of MiLES in their organization. Interviews were recorded, transcribed verbatim and analyzed with content analysis. RESULTS The managers experienced barriers to and facilitators of implementation related to: (1) implementation responsibilities, (2) the intervention's content, and (3) organizational characteristics. Regarding implementation responsibilities, management board approval and an organizational infrastructure with distinct described implementation responsibilities were perceived as facilitators. Regarding the intervention's content, its accessibility, user-friendliness and completeness were perceived as facilitators. If the content did not meet the manager's specific needs, this was perceived as a barrier. Regarding organizational characteristics, several intangible (e.g., added value of MiLES within different organizations) and tangible (e.g., integration into absenteeism registration) organizational characteristics were perceived as facilitators. The absence of a quiet place to use MiLES was perceived as barrier. CONCLUSION Implementation of MiLES in organizations may benefit from an infrastructure within the organization that defines responsibilities regarding intervention delivery to managers of employees with cancer. Such an infrastructure should be aligned to existing organizational structures. As per interviewed managers, MiLES has added value in diverse organizations.
Collapse
Affiliation(s)
- M A Berkhout
- Department of Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Department of Nursing Studies, University of Applied Sciences, Utrecht, The Netherlands
| | - S J Tamminga
- Department of Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health research institute, Societal Participation and Health, Amsterdam, The Netherlands
| | - A G E M de Boer
- Department of Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health research institute, Societal Participation and Health, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Cancer treatment and Quality of life, Amsterdam, The Netherlands
| | - C S Dewa
- Department of Psychiatry and Behavioral Sciences and Department of Public Health Sciences, University of California, Davis, Sacramento, CA, USA
| | - A de Jong
- Department of Nursing Studies, University of Applied Sciences, Utrecht, The Netherlands
| | - A E de Rijk
- Department of Social Medicine, Faculty of Health, Medicine and Life Sciences, Primary Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - M A Greidanus
- Department of Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health research institute, Societal Participation and Health, Amsterdam, The Netherlands
| |
Collapse
|
4
|
Bilodeau K, Gouin MM, Fadhlaoui A, Porro B. Supporting the return to work of breast cancer survivors: perspectives from Canadian employer representatives. J Cancer Surviv 2023:10.1007/s11764-023-01382-5. [PMID: 37140676 PMCID: PMC10157121 DOI: 10.1007/s11764-023-01382-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 04/11/2023] [Indexed: 05/05/2023]
Abstract
PUR POSE: A significant proportion of women with breast cancer want to RTW (return to work) after treatment. Employers play a key role in facilitating RTW for these employees who face distinct challenges. However, the portrait of these challenges remains to be documented from the perspective of employer representatives. The purpose of this article is to describe the perceptions of Canadian employer representatives regarding the management of the RTW of BCSs (breast cancer survivors). METHODS Thirteen qualitative interviews were conducted with representatives from businesses of various sizes (< 100 employees, 100-500 employees, > 500 employees). Transcribed data were subjected to iterative data analysis. RESULTS Three major themes emerged to describe employer representatives' perceptions of managing RTW of BCS. These are (1) providing tailored support; (2) remaining 'human' while managing RTW; and (3) facing the challenges of RTW management after breast cancer. The first two themes were perceived as facilitating RTW. The challenges identified concern uncertainty, communication with the employee, maintaining a supernumerary work position, balancing employee and organizational interests, reconciling with colleagues' complaints, and collaboration among stakeholders. CONCLUSIONS Employers can adopt a humanistic management style by offering flexibility and increased accommodation for BCS who RTW. They can also be more sensitive to this diagnosis, leading some to seek more information from those around them who have experienced it. Employers require increased awareness about diagnosis and side effects, be more confident to communicate, and improved collaboration between stakeholders to facilitate the RTW of BCS. IMPLICATIONS FOR CANCER SURVIVORS Employers who focus on the individual needs of cancer survivors during RTW can facilitate creative and personalized solutions for a sustainable RTW and help survivors recover their lives after cancer.
Collapse
Affiliation(s)
- Karine Bilodeau
- University of Montreal, Montreal, Canada.
- Research Centre of Maisonneuve-Rosemont Hospital, Montreal, Canada.
| | | | - Asma Fadhlaoui
- Research Centre of Maisonneuve-Rosemont Hospital, Montreal, Canada
| | | |
Collapse
|
5
|
Sheppard DM, O’Connor M, Jefford M, Lamb G, Frost D, Ellis N, Halkett GKB. 'Beyond Cancer' Rehabilitation Program to Support Breast Cancer Survivors to Return to Health, Wellness and Work: Feasibility Study Outcomes. Curr Oncol 2023; 30:2249-2270. [PMID: 36826135 PMCID: PMC9956005 DOI: 10.3390/curroncol30020174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 02/06/2023] [Accepted: 02/09/2023] [Indexed: 02/16/2023] Open
Abstract
More women are returning to work following breast cancer treatment. Our team designed 'Beyond Cancer', a multimodal rehabilitation program to support breast cancer survivors to return to work. This study aimed to determine the feasibility of the intervention from the breast cancer survivor, employer and occupational rehabilitation provider perspectives. The feasibility design focused on implementation, acceptability and preliminary indications of efficacy. Primary outcome measures included work status, work capacity and perceived support at work. Responses were compared with an historical usual care group of mixed cancer survivors. The tailored intervention was delivered over 33 weeks (on average) by trained occupational rehabilitation consultants. Eighty-four women with breast cancer (mean age = 50.8 years, SD = 8.24) who were unable to work in their pre-diagnosis capacity for >3 months participated. Results provided preliminary indications of efficacy for primary work outcomes, including work capacity relative to the historical usual care group, and some secondary biopsychosocial variables (physical fatigue, return to work expectations). The intervention was acceptable, demonstrated strong participant engagement and high satisfaction. Feasibility has been demonstrated for this multimodal intervention focused on returning to sustainable work for women with breast cancer. Future research is required with people diagnosed with other cancer types to demonstrate broader implementation.
Collapse
Affiliation(s)
- Dianne M. Sheppard
- Monash University Accident Research Centre, Monash University, Building 70, 21 Alliance Lane, Clayton 3800, Australia
- Correspondence: (D.M.S.); (G.K.B.H.)
| | - Moira O’Connor
- School of Population Health, Curtin University, Kent St, Bentley 6102, Australia
| | - Michael Jefford
- Department of Health Services Research, Peter MacCallum Cancer Centre, 305 Grattan St, Melbourne 3000, Australia
- Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, 305 Grattan St, Melbourne 3000, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville 3010, Australia
| | - Georgina Lamb
- IPAR Rehabilitation, 485 La Trobe St, Melbourne 3000, Australia
| | - Dorothy Frost
- IPAR Rehabilitation, 485 La Trobe St, Melbourne 3000, Australia
| | - Niki Ellis
- Healthy Working Lives Research Group, School of Public Health and Preventive Medicine, Monash University, Level 2, 533 St Kilda Road, Melbourne 3004, Australia
| | - Georgia K. B. Halkett
- Curtin School of Nursing/Curtin Health Innovation Research Institute, Curtin University, Kent St, Bentley 6102, Australia
- Correspondence: (D.M.S.); (G.K.B.H.)
| |
Collapse
|
6
|
Petersen KS, Hedeager Momsen AM, Vinther-Nielsen C. Return-to-work intervention while undergoing cancer treatment: Female cancer survivors' experiences. Work 2023:WOR210421. [PMID: 36641706 DOI: 10.3233/wor-210421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND This qualitative study followed participants enrolled in a return to work (RTW) intervention, aiming to address individual physical, psychological and work-related challenges. OBJECTIVE To explore cancer survivors' experiences of receiving a tailored RTW intervention initiated parallel with chemotherapy and/or radiotherapy. METHODS Two semi-structured interviews of eight female cancer survivors in treatment for breast cancer (n = 7) or ovaria cancer (n = 1) were conducted prior or close to their RTW and 3-5 months later. Inspired by Margrit Schreier's inductive analysis coding and identification of themes guided the analysis. RESULTS Participants expressed satisfaction with the RTW intervention, which helped them to cope during the RTW process. Three themes with corresponding subthemes dominated the participants' experience of the RTW intervention. 1) Social workers made participants feel individually coached, 2) Collaboration with social workers helped over time to manage RTW, and 3) Social workers supported participants to conduct and adjust the RTW plan. CONCLUSION This study shows how the interaction with social workers were based on mutual trust and sense of being cared for, which seems to have a positive impact on how participants managed their RTW. Future research needs to address the long-term challenges in cancer survivors' RTW.
Collapse
Affiliation(s)
- Kirsten Schultz Petersen
- Public Health and Epidemiology Group, Faculty of Medicine and Health Technology, Aalborg University, Aalborg, Denmark
| | | | - Claus Vinther-Nielsen
- DEFACTUM, Central Region Denmark, Aarhus, Denmark.,Department of Public Health, Aarhus University, Aarhus, Denmark
| |
Collapse
|
7
|
Zegers AD, van Andel ES, Beerda DCE, Dona DJS, Aukema EJ, Brom L, Duijts SFA. Work resumption and retention in patients with advanced cancer: Experiences and perspectives of general and occupational health care professionals. Eur J Cancer Care (Engl) 2022; 31:e13714. [PMID: 36164925 PMCID: PMC9787025 DOI: 10.1111/ecc.13714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 09/05/2022] [Accepted: 09/14/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The objectives of this study were to explore the experiences and perspectives of general and occupational health care professionals regarding work resumption and work retention of patients with advanced cancer, and to identify barriers and facilitators these professionals may encounter. METHODS A qualitative design was applied, and individual semistructured interviews were conducted. General and occupational health care professionals were eligible to participate if they were involved in the work participation guidance of patients with advanced cancer, and were recruited through the network of the research team. Interview data were transcribed verbatim and analysed thematically via ATLAS.ti 9. RESULTS Interviewees (N = 17) had various occupational backgrounds, for example, occupational physician, reintegration consultant, and general practitioner. Four main themes emerged from the data: (1) Assumptions and hesitations, (2) Patient initiates stakeholder communication, (3) Role dispersion: who is in charge of what? and (4) Experience with legislation creates opportunities. CONCLUSION Whereas most interviewees had positive experiences with, and/or optimistic expectations of, the work resumption and work retention of patients with advanced cancer, several barriers to the work participation guidance of these patients were identified. Suggestions for improvement include creating widespread awareness of the possibility of work participation of patients with advanced cancer and developing reintegration guidelines for advanced cancer.
Collapse
Affiliation(s)
- Amber D. Zegers
- Department of Public and Occupational HealthAmsterdam UMC location Free UniversityAmsterdamThe Netherlands,Societal Participation and HealthAmsterdam Public Health Research InstituteAmsterdamThe Netherlands
| | - Emma S. van Andel
- Department of Research & DevelopmentNetherlands Comprehensive Cancer Organisation (IKNL)UtrechtThe Netherlands
| | - Donna C. E. Beerda
- Department of Research & DevelopmentNetherlands Comprehensive Cancer Organisation (IKNL)UtrechtThe Netherlands,Department of Public and Occupational HealthAmsterdam UMC location University of AmsterdamAmsterdamThe Netherlands
| | - Desiree J. S. Dona
- Department of Human ResourcesRadboud University Medical CenterNijmegenThe Netherlands
| | - Eline J. Aukema
- Center for Psycho‐OncologyIngeborg Douwes CentrumAmsterdamThe Netherlands
| | - Linda Brom
- Department of Research & DevelopmentNetherlands Comprehensive Cancer Organisation (IKNL)UtrechtThe Netherlands,Netherlands Association for Palliative Care (PZNL)UtrechtThe Netherlands
| | - Saskia F. A. Duijts
- Department of Public and Occupational HealthAmsterdam UMC location Free UniversityAmsterdamThe Netherlands,Societal Participation and HealthAmsterdam Public Health Research InstituteAmsterdamThe Netherlands,Department of Research & DevelopmentNetherlands Comprehensive Cancer Organisation (IKNL)UtrechtThe Netherlands,Department of Medical Psychology, Cancer Center AmsterdamAmsterdam UMC location Free UniversityAmsterdamThe Netherlands
| |
Collapse
|
8
|
Lyons KD, Forcino RC, Rotenberg S, Schiffelbein JE, Morrissette KJ, Godzik CM, Lichtenstein JD. "The Last Thing You Have to Worry About": A Thematic Analysis of Employment Challenges Faced by Cancer Survivors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811214. [PMID: 36141485 PMCID: PMC9517658 DOI: 10.3390/ijerph191811214] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 09/01/2022] [Accepted: 09/02/2022] [Indexed: 05/21/2023]
Abstract
The evidence base for interventions that support the employment goals of cancer survivors is growing but inconclusive. As the first step in initiating a community-engaged program of research aimed at developing and testing interventions to support the employment goals of cancer survivors, 23 cancer survivors, 17 healthcare providers, and 5 employers participated in individual interviews to elicit perceptions regarding local challenges and resources related to work maintenance and optimization within the context of cancer treatment. Interviews were recorded and transcribed verbatim. A thematic analysis was conducted to identify cross-cutting experiences that were voiced by all three types of participants. Three themes were found in the data: (1) the onus for identifying and articulating work-related issues is upon the cancer survivor; (2) the main support offered to cancer survivors involved time away from work and flexibility with scheduling work and treatment activities; and (3) participants voiced a lack of information regarding one or more aspects related to supporting employment goals of cancer survivors. Supportive resources designed for cancer survivors, employers, and/or healthcare providers are needed to help cancer survivors optimize their employment situations.
Collapse
Affiliation(s)
- Kathleen Doyle Lyons
- Department of Occupational Therapy, MGH Institute of Health Professions, Boston, MA 02129, USA
- Correspondence:
| | - Rachel C. Forcino
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Lebanon, NH 03756, USA
| | - Sivan Rotenberg
- Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Lebanon, NH 03756, USA
| | - Jenna E. Schiffelbein
- Norris Cotton Cancer Center, Geisel School of Medicine, Dartmouth College, Lebanon, NH 03756, USA
| | - Kali J. Morrissette
- Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Lebanon, NH 03756, USA
| | - Cassandra M. Godzik
- Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Lebanon, NH 03756, USA
| | - Jonathan D. Lichtenstein
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Lebanon, NH 03756, USA
- Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Lebanon, NH 03756, USA
| |
Collapse
|
9
|
Jansen J, Boot CRL, Alma MA, Brouwer S. Exploring Employer Perspectives on Their Supportive Role in Accommodating Workers with Disabilities to Promote Sustainable RTW: A Qualitative Study. JOURNAL OF OCCUPATIONAL REHABILITATION 2022; 32:1-12. [PMID: 35166974 DOI: 10.1007/s10926-021-10019-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/14/2021] [Indexed: 06/14/2023]
Abstract
PURPOSE Employers play an important role in facilitating sustainable return to work (RTW) by workers with disabilities. The aim of this qualitative study was to explore how employers who were successful in retaining workers with disabilities at work fulfilled their supportive role, and which facilitators were essential to support these workers throughout the RTW process. METHODS We conducted a semi-structured interview study among 27 employers who had experience in retaining workers with disabilities within their organization. We explored the different phases of RTW, from the onset of sick leave until the period, after 2-years of sick-leave, and when they can apply for disability benefit. We analyzed data by means of thematic analysis. RESULTS We identified three types of employer support: (1) instrumental (offering work accommodations), (2) emotional (encouragement, empathy, understanding) and (3) informational (providing information, setting boundaries). We identified three facilitators of employer support (at organizational and supervisor levels): (1) good collaboration, including (in)formal contact and (in)formal networks; (2) employer characteristics, including supportive organizational culture and leadership skills; and (3) worker characteristics, including flexibility and self-control. CONCLUSIONS Employers described three different possible types of support for the worker with disabilities: instrumental, emotional, and informational. The type and intensity of employer support varies during the different phases, which is a finding that should be further investigated. Good collaboration and flexibility of both employer and worker were reported as facilitators of optimal supervisor/worker interaction during the RTW process, which may show that sick-listed workers and their supervisors have a joint responsibility for the RTW process. More insight is needed on how this supervisor/worker interaction develops during the RTW process.
Collapse
Affiliation(s)
- J Jansen
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
| | - C R L Boot
- Department of Public and Occupational Health, Amsterdam UMC, VU University Amsterdam, Amsterdam Public Health Research institute, Amsterdam, the Netherlands
| | - M A Alma
- Department of Health Sciences, Applied Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - S Brouwer
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| |
Collapse
|
10
|
Greidanus MA, de Rijk AE, de Boer AGEM, Bos MEMM, Plaisier PW, Smeenk RM, Frings-Dresen MHW, Tamminga SJ. A randomised feasibility trial of an employer-based intervention for enhancing successful return to work of cancer survivors (MiLES intervention). BMC Public Health 2021; 21:1433. [PMID: 34289828 PMCID: PMC8293550 DOI: 10.1186/s12889-021-11357-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 06/16/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Employers express a need for support during sickness absence and return to work (RTW) of cancer survivors. Therefore, a web-based intervention (MiLES) targeted at employers with the objective of enhancing cancer survivors' successful RTW has been developed. This study aimed to assess feasibility of a future definitive randomised controlled trial (RCT) on the effectiveness of the MiLES intervention. Also preliminary results on the effectiveness of the MiLES intervention were obtained. METHODS A randomised feasibility trial of 6 months was undertaken with cancer survivors aged 18-63 years, diagnosed with cancer < 2 years earlier, currently in paid employment, and sick-listed < 1 year. Participants were randomised to an intervention group, with their employer receiving the MiLES intervention, or to a waiting-list control group (2:1). Feasibility of a future definitive RCT was determined on the basis of predefined criteria related to method and protocol-related uncertainties (e.g. reach, retention, appropriateness). The primary effect measure (i.e. successful RTW) and secondary effect measures (e.g. quality of working life) were assessed at baseline and 3 and 6 months thereafter. RESULTS Thirty-five cancer survivors were included via medical specialists (4% of the initially invited group) and open invitations, and thereafter randomised to the intervention (n = 24) or control group (n = 11). Most participants were female (97%) with breast cancer (80%) and a permanent employment contract (94%). All predefined criteria for feasibility of a future definitive RCT were achieved, except that concerning the study's reach (90 participants). After 6 months, 92% of the intervention group and 100% of the control group returned to work (RR: 0.92, 95% CI: 0.81-1.03); no difference were found with regard to secondary effect measures. CONCLUSIONS With the current design a future definitive RCT on the effectiveness of the MiLES intervention on successful RTW of cancer survivors is not feasible, since recruitment of survivors fell short of the predefined minimum for feasibility. There was selection bias towards survivors at low risk of adverse work outcomes, which reduced generalisability of the outcomes. An alternative study design is needed to study effectiveness of the MiLES intervention. TRIAL REGISTRATION The study has been registered in the Dutch Trial Register ( NL6758/NTR7627 ).
Collapse
Affiliation(s)
- M A Greidanus
- Department Public and Occupational Health/ Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
| | - A E de Rijk
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Duboisdomein 30, Maastricht, The Netherlands
| | - A G E M de Boer
- Department Public and Occupational Health/ Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - M E M M Bos
- Department of Medical Oncology, Erasmus Medical Center, Doctor Molewaterplein 40, Rotterdam, The Netherlands
| | - P W Plaisier
- Department of Surgery, Albert Schweitzer Hospital, Albert Schweitzerplaats 25, Dordrecht, The Netherlands
| | - R M Smeenk
- Department of Surgery, Albert Schweitzer Hospital, Albert Schweitzerplaats 25, Dordrecht, The Netherlands
| | - M H W Frings-Dresen
- Department Public and Occupational Health/ Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - S J Tamminga
- Department Public and Occupational Health/ Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| |
Collapse
|
11
|
Greidanus MA, de Rijk AE, Frings-Dresen MHW, Tiedtke CM, Brouwers S, de Boer AGEM, Tamminga SJ. The Use and Perceived Usefulness of an Online Toolbox Targeted at Employers (MiLES Intervention) for Enhancing Successful Return to Work of Cancer Survivors. JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:393-404. [PMID: 33090355 PMCID: PMC8172399 DOI: 10.1007/s10926-020-09929-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE The MiLES intervention is a web-based intervention targeted at employers with the objective of enhancing successful return to work (RTW) of cancer survivors. The aim of this study is to gain insight into the employers' use and perceived usefulness of the MiLES intervention. METHODS Employer representatives (e.g. Human Resource managers and supervisors) were given access to the MiLES intervention, which contains, among others, interactive videos, conversation checklists and tailored tips. After six weeks, an online questionnaire gathered data on employers' use and the perceived usefulness of the intervention. In-depth qualitative data on these topics were gathered during semi-structured interviews, which were analyzed using a content analysis. RESULTS Thirty-one eligible employers were included. Twenty-two of them filled out the questionnaire and twenty were interviewed. Typically, employers used the intervention 2-3 times, for 26 min per visit. The usefulness of the intervention scored 7.6 out of 10 points, and all employers would recommend it to colleagues. Employers' use decreased when support needs were low and when the intervention did not correspond with their specific situation (e.g. complex reintegration trajectories). Employers perceived the intervention to be supporting and practically oriented. They appreciated the fact that the intervention was web-based and combined visual and textual content. The possibility of consulting specialized services for complex situations would further enhance its usefulness. CONCLUSION The MiLES intervention provides employers with a useful tool in their daily practice. Its effectiveness for enhancing employers' managerial skills and cancer survivors' successful RTW is subject for further research.
Collapse
Affiliation(s)
- M A Greidanus
- Department Public and Occupational Health/Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
| | - A E de Rijk
- Department of Social Medicine, Faculty of Health, Medicine and Life Sciences, Research Institute Primary Care and Public Health (CAPHRI), Maastricht University, Duboisdomein 30, Maastricht, The Netherlands
| | - M H W Frings-Dresen
- Department Public and Occupational Health/Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - C M Tiedtke
- Department of Public Health and Primary Care, Centre for Environment & Health, KU Leuven, Kapucijnenvoer 35, Leuven, Belgium
| | - S Brouwers
- Department Public and Occupational Health/Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - A G E M de Boer
- Department Public and Occupational Health/Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - S J Tamminga
- Department Public and Occupational Health/Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| |
Collapse
|
12
|
Stapelfeldt CM, Momsen AMH, Jensen AB, Andersen NT, Nielsen CV. Municipal return to work management in cancer survivors: a controlled intervention study. Acta Oncol 2021; 60:370-378. [PMID: 33287597 DOI: 10.1080/0284186x.2020.1853227] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Resuming work during or after cancer treatment has become an important target in cancer rehabilitation. PURPOSE The aim was in a controlled trial to study the return to work (RTW) effect of an early, individually tailored vocational rehabilitation intervention targeted to improve readiness for RTW in cancer survivors. MATERIAL AND METHODS Participants diagnosed with breast, cervix, ovary, testicular, colon-rectal, and head-and-neck cancers as well as being employed were allocated to a vocational rehabilitation intervention provided by municipal social workers (n = 83) or to usual municipal RTW management (n = 264). The intervention contained three elements: motivational communication inspired by Acceptance and Commitment Therapy by which RTW barriers were addressed, municipal cancer rehabilitation and finally employer and workplace contact. RTW effect was assessed as relative cumulative incidence proportions (RCIP) in the control and intervention group within 52 weeks of follow-up, estimated from the week where treatment ended at the hospital. RCIP was interpreted and reported as relative risk (RR) with 95% confidence intervals (CI) adjusted for gender, age cancer diagnosis, education, comorbidity, and sick leave weeks. RESULTS Across cancer diagnoses 69 (83.1%) and 215 (81.4%) returned to work in the intervention and control group, respectively. No statistical effect was seen (RR 1.08 (95% CI 0.98-1.19)). Repeating the analyses solely for participants with breast cancer (n = 290) showed a significant effect of the intervention (RR 1.12 (95% CI 1.01-1.23)). CONCLUSION More than 80% returned to work in both groups. However, no statistical difference in RTW effect was seen across cancer diagnoses within one year from being exposed to an early, individually tailored vocational rehabilitation intervention compared with usual municipal RTW management. TRIAL REGISTRATION NUMBER ISRCTN50753764.
Collapse
Affiliation(s)
- Christina M. Stapelfeldt
- Department of Public Health, Aarhus University, Aarhus, Denmark
- DEFACTUM - Social and Health Services & Labour Market, Central Denmark Region, Aarhus, Denmark
| | - Anne-Mette H. Momsen
- DEFACTUM - Social and Health Services & Labour Market, Central Denmark Region, Aarhus, Denmark
| | | | | | - Claus Vinther Nielsen
- Department of Public Health, Aarhus University, Aarhus, Denmark
- DEFACTUM - Social and Health Services & Labour Market, Central Denmark Region, Aarhus, Denmark
- Goedstrup Hospital, Herning, Denmark
| |
Collapse
|
13
|
Greidanus MA, de Boer AGEM, Tiedtke CM, Frings-Dresen MHW, de Rijk AE, Tamminga SJ. Supporting employers to enhance the return to work of cancer survivors: development of a web-based intervention (MiLES intervention). J Cancer Surviv 2020; 14:200-210. [PMID: 31938966 PMCID: PMC7182637 DOI: 10.1007/s11764-019-00844-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 12/01/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE The purpose of this study was to develop an intervention targeting employers, with the aim of enhancing cancer survivors' return to work (RTW). METHODS Intervention Mapping was used to combine information gathered from several procedures involving numerous stakeholders, for example, employers, cancer survivors, oncological occupational physicians, and e-health experts. RESULTS Employers indicated that they require tailored support during four RTW phases: (1) disclosure, (2) treatment, (3) RTW planning, and (4) actual RTW. The most important employer actions were identified for each RTW phase, for instance, "communicate," "support practically," and "assess work ability," and thereafter formulated as the performance objectives of the intervention. The trans-theoretical model of change was used as a theoretical framework, and several methodologies were employed to induce the desired behavior change, for example modeling, tailoring, and active learning. Subsequently, a web-based intervention with interactive videos, conversation checklists, links to reliable external sources, and succinct, tailored tips and information was developed and adjusted on the basis of pre-tests with different stakeholders. CONCLUSIONS The intervention was developed with input from employers and all relevant stakeholders in the RTW of cancer survivors. The systematic, step-wise development resulted in a succinct and easily accessible intervention targeting the most important employer actions during all RTW phases. As such, the intervention corresponds with employers' needs and preferences in practice. IMPLICATIONS FOR CANCER SURVIVORS By providing employers with support, the intervention could well be the missing link in efforts to optimize the work participation of cancer survivors.
Collapse
Affiliation(s)
- M A Greidanus
- Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
| | - A G E M de Boer
- Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - C M Tiedtke
- Department of Public Health and Primary Care, Centre for Environment & Health, Katholieke Universiteit Leuven, Kapucijnenvoer 35, Leuven, Belgium
| | - M H W Frings-Dresen
- Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - A E de Rijk
- Department of Social Medicine, Faculty of Health, Medicine and Life Sciences, Research Institute Primary Care and Public Health (CAPHRI), Maastricht University, Duboisdomein 30, Maastricht, Netherlands
| | - S J Tamminga
- Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| |
Collapse
|