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Strauser DR, Shen S, Brehmer CE, Fine E, Liptak C. Barriers to employment for young adult central nervous system tumor survivors: The role of career readiness and core self-evaluations. JOURNAL OF VOCATIONAL REHABILITATION 2023. [DOI: 10.3233/jvr-230008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND: Although the majority of childhood cancer survivors make successful transitions to adulthood, research suggests that a significant group experiences ongoing medical concerns, such as psychological distress, that significantly impact the achievement of crucial social roles including employment. OBJECTIVE: The purpose of this study was to examine the relationship between career decision making, core self-evaluations, and perceived internal and external barriers to employment in a sample of young adult central nervous system tumor survivors. METHOD: A sample of 110 young adult survivors of pediatric central nervous system tumors was surveyed. Mediation analysis with structural equational modeling was used to correlate a number of different measures (Career Decision Making [CTI], Perceived Employment Barriers [PEB], and Core-Self Evaluations [CSE]). RESULTS: The presence of both significant direct and indirect effects of career decision making on perceived employment barriers implied that there was a partial mediating effect of core self-evaluations on the association between career readiness and employment barriers. CONCLUSION: Career decision-making is a robust construct that can be applied to young adult central nervous system tumor survivors in effort to gain more insight into the vocational psychological factors that impact career development and employment in this group. Core self-evaluations was found to be a mediator between career decision making and perceived career barriers.
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Affiliation(s)
- David R. Strauser
- University of Illinois at Urbana-Champaign, Champaign, IL, USA
- National Changhua University of Education, Changhua City, Taiwan
| | - Sa Shen
- University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | | | - Elizabeth Fine
- Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Boston, MA, USA
| | - Cori Liptak
- Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Boston, MA, USA
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Employment among Childhood Cancer Survivors: A Systematic Review and Meta-Analysis. Cancers (Basel) 2022; 14:cancers14194586. [PMID: 36230516 PMCID: PMC9559689 DOI: 10.3390/cancers14194586] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/07/2022] [Accepted: 09/19/2022] [Indexed: 11/17/2022] Open
Abstract
To date, there are heterogeneous studies related to childhood cancer survivors’ (CCS) employment rates. Given the importance of this topic, we aimed to perform a systematic review and meta-analysis to investigate the prevalence of employment among CCS and to examine its association with socio-demographic and clinical factors. We followed the PRISMA guidelines to search for pertinent articles in relevant electronic databases. Eighty-nine articles comprising 93 cohorts were included. The overall prevalence of employment was 66% (CI: 95% 0.63–0.69). Subgroup meta-analyses showed that lower rates were found for central nervous system tumor survivors (51%, CI: 95% 0.43–0.59), and for CCS treated with cranial-radiotherapy (53%, CI: 95% 0.42–0.64) or haematopoietic stem-cell transplantation (56%, CI: 95% 0.46–0.65). The studies conducted in Asia highlighted employment rates of 47% (CI: 95%, 0.34–0.60). Univariate meta-regressions identified the following socio-demographic factors associated with higher rates of employment: a female gender (p = 0.046), a higher mean age at the time of investigation (p = 0.00), a longer time since diagnosis (p = 0.00), a higher educational level (p = 0.03), and a married status (p = 0.00). In conclusion, this systematic review and meta-analysis provides evidence that two-thirds of CCS are employed worldwide. Identifying vulnerable groups of CCS may allow for the design of multidisciplinary support strategies and interventions to promote employment in this population.
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Marciniak J, Johnston CS, Steiner RS, Hirschi A. Career Preparedness Among Adolescents: A Review of Key Components and Directions for Future Research. JOURNAL OF CAREER DEVELOPMENT 2020. [DOI: 10.1177/0894845320943951] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Adolescents and students are faced with the developmental task of becoming prepared for a career and master future career transitions. Existing research has investigated a range of concepts relating to career preparedness, including predictors and outcomes. However, this body of work is fragmented as a number of different conceptualizations and measurements related to career preparedness exist. Thus, the goal of this review is to provide an overview of the different concepts that have been used to describe and measure career preparedness. Based on a comprehensive review of empirical articles on maturity, readiness, adaptability, preparedness, and preparation, we propose an organizing framework of the diverse attitudes, knowledge and competencies, and behaviors required for career preparedness. We also review the empirical research on predictors and outcomes of career preparedness. We close by identifying issues in the conceptualization and measurement of different constructs and provide suggestions for future research, and implications for theory and practice.
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Affiliation(s)
- Julian Marciniak
- Department of Work and Organizational Psychology, University of Bern, Switzerland
| | - Claire S. Johnston
- Department of Work and Organizational Psychology, University of Bern, Switzerland
| | - Rebekka S. Steiner
- Department of Work and Organizational Psychology, University of Bern, Switzerland
| | - Andreas Hirschi
- Department of Work and Organizational Psychology, University of Bern, Switzerland
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Strauser DR, Leslie MJ, Rumrill P, McMahon B, Greco C. The employment discrimination experiences of younger and older Americans with cancer under Title I of the Americans with Disabilities Act. J Cancer Surviv 2020; 14:614-623. [PMID: 32785876 DOI: 10.1007/s11764-020-00867-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 02/13/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE The goal of the research was to describe discrimination, both actual and perceived, that has occurred against younger individuals with cancer (i.e., 35 years of age and under) in comparison with older individuals with cancer (i.e., over age 35) through analysis of the US Equal Employment Opportunity Commission (EEOC) Integrated Mission System (IMS) database. METHODS An ex post facto, causal comparative quantitative design was used to examine Americans with Disabilities Act Amendments Act (ADAAA) Title I complaints received by the EEOC from younger people with cancer from 2009 through 2016 (n = 1001) in comparison with older people with cancer over the same time period (n = 8874). RESULTS Results revealed statistically significant differences in the patterns of issues alleged by the two groups. When compared with older charging parties with cancer, the younger charging parties with cancer had proportionally more individuals who were male and who identified as African American and proportionally fewer individuals who identified as Caucasian. CONCLUSIONS Younger people with cancer were more likely to allege discrimination in the areas of promotion, training, reinstatement, and referrals to other employers. They were less likely to allege discrimination in the area of benefits. The younger group was also significantly less likely than the older group to find that EEOC investigations of their allegations resulted in merit-based case resolutions, that is, discrimination had indeed occurred. IMPLICATIONS FOR CANCER SURVIVORS Psychosocial programs and vocational programming assisting young adults with career development should focus on the types of discrimination that young adults experience, which is unique compared with older adult cancer survivors.
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Affiliation(s)
- David R Strauser
- University of Illinois at Urbana-Champaign, 213A Huff Hall, MC-588, 1206 South Fourth StreetM, Champaign, IL, 61802, USA. .,National Changhua University of Education, Changhua City, Taiwan.
| | | | - Phillip Rumrill
- Kent State University, Kent, OH, USA.,Department of Early Childhood Special Education,and Counselor Education - and Human Development Institute, University of Kentucky, Lexington, KY, USA
| | | | - Chelsea Greco
- University of Illinois at Urbana-Champaign, 213A Huff Hall, MC-588, 1206 South Fourth StreetM, Champaign, IL, 61802, USA
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5
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Precision-based exercise as a new therapeutic option for children and adolescents with haematological malignancies. Sci Rep 2020; 10:12892. [PMID: 32733066 PMCID: PMC7393502 DOI: 10.1038/s41598-020-69393-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 07/03/2020] [Indexed: 11/16/2022] Open
Abstract
Children and adolescents with haematological malignancies (PedHM) are characterized by a severe loss of exercise ability during cancer treatment, lasting throughout their lives once healed and impacting their social inclusion prospects. The investigation of the effect of a precision-based exercise program on the connections between systems of the body in PedHM patients is the new frontier in clinical exercise physiology. This study is aimed at evaluating the effects of 11 weeks (3 times weekly) of combined training (cardiorespiratory, resistance, balance and flexibility) on the exercise intolerance in PedHM patients. Two-hundred twenty-six PedHM patients were recruited (47% F). High or medium frequency participation (HAd and MAd) was considered when a participant joined; > 65% or between 30% and < 64% of training sessions, respectively. The “up and down stairs'' test (TUDS), “6 min walking” test (6MWT), the “5 Repetition Maximum strength” leg extension and arm lateral raise test (5RM-LE and 5RM-ALR), flexibility (stand and reach), and balance (stabilometry), were performed and evaluated before and after training. The TUDS, the 5RM-LE and 5RM-ALR, and the flexibility exercises showed an increase in HAd and MAd groups (P < 0.05), while the 6MWT and balance tests showed improvement only in HAd group (P < 0.0001). These results support the ever-growing theory that, in the case of the treatment of PedHM, ‘exercise is medicine’ and it has the potential to increase the patient’s chances of social inclusion.
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Strauser DR, Rumrill PD, Greco C. A conceptual framework to promote career development for vocational rehabilitation consumers with traumatic brain injuries. Work 2020; 65:763-773. [PMID: 32310207 DOI: 10.3233/wor-203129] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The purpose of this article is to describe the Illinois Work and Well-being Model (ILW2M), a multi-domain framework for conceptualizing the employment development of people with traumatic brain injuries (TBIs). The model emphasizes the interaction of contextual and career development domains to improve participation in the areas of work, society, community, and home. A brief discussion of potential implications regarding vocational rehabilitation research and service is offered with the overall goal of reinforcing employment development as the foundation of vocational rehabilitation services for adults with TBIs.
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Affiliation(s)
| | | | - Chelsea Greco
- University of Illinois at Urbana-Champaign, Champaign, IL, USA
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Rumrill PD, Strauser DR, Greco C, Leslie MJ. A Vocational Rehabilitation Intervention Framework for People With Rheumatoid Arthritis. ACTA ACUST UNITED AC 2020. [DOI: 10.1891/jarc-d-19-00012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This article presents the Illinois Work and Well-Being Model (IW2M) as a framework that can be applied to facilitate vocational rehabilitation interventions for people with rheumatoid arthritis (RA). The model encompasses the interaction of contextual and career development domains to improve participation in the areas of work, society, community, and home. A discussion of the model's implications regarding vocational rehabilitation service and research is offered, with the overall goal of reinforcing career development as the foundation of vocational rehabilitation services for people with RA and other emerging age-related disabling conditions.
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Strauser DR, Rumrill SP, Rumrill PD, Greco CE, Wagner S. The Work Experience Survey: An on-the-job needs assessment tool to promote successful career outcomes for young adult central nervous system cancer survivors. JOURNAL OF VOCATIONAL REHABILITATION 2020. [DOI: 10.3233/jvr-191070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- David R. Strauser
- University of Illinois at Urbana-Champaign, Champaign, IL, USA
- National Changhua University of Education, Changhua City, Taiwan
| | | | - Phillip D. Rumrill
- University of Kentucky, Human Development Institute and Rehabilitation Counseling Program, Lexington, KY, USA
| | | | - Stacia Wagner
- Children’s Brain Tumor Foundation, New York, NY, USA
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9
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Strauser DR, Iwagana K, Chan F, Tansey TN, Carlson-Green B, Greco C, Wagner S. Impact of self-management and functioning on the career development of young adult CNS Survivors. JOURNAL OF VOCATIONAL REHABILITATION 2019. [DOI: 10.3233/jvr-191055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- David R. Strauser
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | | | - Fong Chan
- University of Wisconsin-Madison, Madison, WI, USA
| | | | | | - Chelsea Greco
- University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Stacia Wagner
- Children’s Brain Tumor Foundation, New York, NY, USA
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10
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Dames LS, Ghekiere E, Zalaquett CP, Kromrey JD, Ellerbrock CR, Exum H, Paxton RJ. Correlates of dysfunctional career thoughts in breast cancer survivors from the Bahamas. J Psychosoc Oncol 2019; 37:665-675. [PMID: 31107194 DOI: 10.1080/07347332.2019.1580330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: The purpose of this research was to examine the correlates of dysfunctional career thoughts (DCTs) in a sample of breast cancers survivors. Sample and design: A total of 195 breast cancer survivors from the Bahamas completed a cross-sectional survey. Methods: The Career Thoughts Inventory (CTI) and standard medical and demographic items were administered. Analysis of Variance and logistic regression models were used to examine associations. Findings: Total CTI scores differed by age group, marital status, surgical remedy, and employment prior to diagnosis. The odds of DCT were higher among younger (Odds Ratio [OR] = 4.4), married (OR = 2.4), who were unemployed prior to diagnosis (OR = 3.5). Conclusion: Dysfunctional career thoughts appear to be common in certain breast cancer survivors. Further research is needed to determine whether similar associations are observed in other samples. Implications for Providers: Providers should discuss DCTs after treatment.
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Affiliation(s)
- Levette S Dames
- Counseling Education Program, North Carolina Central University , Durham , NC , USA
| | - Elizabeth Ghekiere
- Counseling Education Program, North Carolina Central University , Durham , NC , USA
| | - Carlos P Zalaquett
- Department of Educational Psychology, The Pennsylvania State University , University Park , PA , USA
| | - Jeffrey D Kromrey
- College of Education, University of South Florida , Tampa , FL , USA
| | | | - Herbert Exum
- College of Education, University of South Florida , Tampa , FL , USA
| | - Raheem J Paxton
- Department of Community Medicine and Population Health, University of Alabama , Tuscaloosa , AL , USA
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11
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Strauser DR, Chan F, Fine E, Iwanaga K, Greco C, Liptak C. Development of the perceived barriers scale: a new instrument identifying barriers to career development and employment for young adult survivors of pediatric CNS tumors. J Cancer Surviv 2018; 13:1-9. [PMID: 30357721 DOI: 10.1007/s11764-018-0722-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 10/11/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE Given the significant employment disparities for survivors of pediatric brain tumors, there is increased need to conduct vocational and career research with this group. The purpose of the present study was to construct an instrument, the Perceived Barriers Scale, that is psychometrically sound and has both clinical and research application related to career and employment issues of pediatric brain tumor survivors. METHOD The participants consisted of 110 young adult central nervous system survivors of childhood cancer aged between 18 and 30 years old (M = 23.05, SD = 3.36) who were identified by the DFCI Pediatric Brain Tumor Clinic. The 12-item Perceived Barriers Scale was developed from a comprehensive literature review, clinical interviews conducted with survivors of pediatric brain tumors, and feedback from multidisciplinary providers. Exploratory factor analysis and correlations were completed to examine the initial psychometric properties of the scale. RESULTS Exploratory factors analysis identified two factors that accounted for 57.92% with the two factors labeled as internal barriers and external barriers. All factors loaded significantly onto their respective factors (.48 to .88). The results of the correlational analysis found significant relationships between both internal barrier and external barrier subscales and CSE and WHODAS-2 providing initial support for the construct validity of the Perceived Barriers Scale. CONCLUSIONS Overall, the study findings indicate good psychometrics with the brevity of the scale increasing potential application and utilization in both research and clinical settings. IMPLICATIONS FOR CANCER SURVIVORS Identification of employment barriers for brain tumor survivors provides opportunity for more targeted vocational intervention.
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Affiliation(s)
- David R Strauser
- University of Illinois at Urbana-Champaign, Champaign, IL, USA. .,Work and Disability Lab, Department of Kinesiology And Community Health, 213A Huff Hall, 1206 South Fourth Street, Champaign, IL, 61820, USA.
| | - Fong Chan
- University of Wisconsin-Madison, Madison, WI, 53706, USA
| | - Elizabeth Fine
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, 02115, USA
| | | | - Chelsea Greco
- University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Cori Liptak
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA, 02115, USA
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12
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Pedersen KJ, Boisen KA, Midtgaard J, Elsbernd A, Larsen HB. Facing the Maze: Young Cancer Survivors' Return to Education and Work—A Professional Expert Key Informant Study. J Adolesc Young Adult Oncol 2018; 7:445-452. [DOI: 10.1089/jayao.2017.0128] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Kaspar Jessen Pedersen
- Department of Pediatrics and Adolescent Medicine, Center of Pediatric Oncology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Kirsten Arntz Boisen
- Department of Pediatrics and Adolescent Medicine, Center of Pediatric Oncology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Julie Midtgaard
- The University Hospitals' Centre for Health Research (UCSF), Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Section of Social Medicine, The University Hospitals' Centre for Health Research (UCSF), University of Copenhagen, Copenhagen, Denmark
| | - Abbey Elsbernd
- University of Kansas School of Medicine, Kansas City, Kansas
| | - Hanne Baekgaard Larsen
- Department of Pediatrics and Adolescent Medicine, Center of Pediatric Oncology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
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13
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Nathan PC, Henderson TO, Kirchhoff AC, Park ER, Yabroff KR. Financial Hardship and the Economic Effect of Childhood Cancer Survivorship. J Clin Oncol 2018; 36:2198-2205. [DOI: 10.1200/jco.2017.76.4431] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In addition to the long-term physical and psychological sequelae of cancer therapy, adult survivors of childhood cancer are at an elevated risk for financial hardship. Financial hardship can have material, psychological, and behavioral effects, including high out-of-pocket medical costs, asset depletion and debt, limitations in or inability to work, job lock, elevated stress and worry, and a delaying or forgoing of medical care because of cost. Most financial hardship research has been conducted in survivors of adult cancers. The few studies focused on childhood cancer survivors have shown that these individuals are at elevated risk for having difficulties with affording needed health care and report high out-of-pocket medical expenses, difficulty with paying medical bills, or consideration of filing for bankruptcy. Childhood cancer survivors are more likely to be unable to work or to have missed work because of poor health. They are more likely to report difficulties with obtaining insurance coverage and rely more frequently on government-sponsored insurance. Globally, countries able to provide curative cancer therapies have witnessed a growing population of survivors, which places a burden on their health care systems because survivors are more likely to require hospitalization and experience a higher burden of chronic illness than the general population. Guidelines for surveillance for late effects are intended to reduce the burden of morbidity, but research is needed to determine whether such surveillance is cost effective. Of note, risk-based survivor care should include routine surveillance for financial hardship. Improved measures of financial hardship, enhanced data infrastructure, and research studies to identify survivors and families most vulnerable to financial hardship and adverse health outcomes will inform the development of targeted programs to serve as a safety net for those at greatest risk.
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Affiliation(s)
- Paul C. Nathan
- Paul C. Nathan, The Hospital for Sick Children, Toronto, Ontario, Canada; Tara O. Henderson, The University of Chicago, Chicago, IL; Anne C. Kirchhoff, University of Utah, Salt Lake City, UT; Elyse R. Park, Massachusetts General Hospital, Boston, MA; and K. Robin Yabroff, American Cancer Society, Atlanta, GA
| | - Tara O. Henderson
- Paul C. Nathan, The Hospital for Sick Children, Toronto, Ontario, Canada; Tara O. Henderson, The University of Chicago, Chicago, IL; Anne C. Kirchhoff, University of Utah, Salt Lake City, UT; Elyse R. Park, Massachusetts General Hospital, Boston, MA; and K. Robin Yabroff, American Cancer Society, Atlanta, GA
| | - Anne C. Kirchhoff
- Paul C. Nathan, The Hospital for Sick Children, Toronto, Ontario, Canada; Tara O. Henderson, The University of Chicago, Chicago, IL; Anne C. Kirchhoff, University of Utah, Salt Lake City, UT; Elyse R. Park, Massachusetts General Hospital, Boston, MA; and K. Robin Yabroff, American Cancer Society, Atlanta, GA
| | - Elyse R. Park
- Paul C. Nathan, The Hospital for Sick Children, Toronto, Ontario, Canada; Tara O. Henderson, The University of Chicago, Chicago, IL; Anne C. Kirchhoff, University of Utah, Salt Lake City, UT; Elyse R. Park, Massachusetts General Hospital, Boston, MA; and K. Robin Yabroff, American Cancer Society, Atlanta, GA
| | - K. Robin Yabroff
- Paul C. Nathan, The Hospital for Sick Children, Toronto, Ontario, Canada; Tara O. Henderson, The University of Chicago, Chicago, IL; Anne C. Kirchhoff, University of Utah, Salt Lake City, UT; Elyse R. Park, Massachusetts General Hospital, Boston, MA; and K. Robin Yabroff, American Cancer Society, Atlanta, GA
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Blanch-Hartigan D, Kinel J. Addressing Career-Related Needs in Adolescent and Young Adult Cancer Survivors: University Career Service Professionals' Experience and Resources. J Adolesc Young Adult Oncol 2017; 7:245-248. [PMID: 29271688 DOI: 10.1089/jayao.2017.0064] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Many adolescent and young adult (AYA) survivors are transitioning not only from patient to survivor but also transitioning to the workforce. AYA survivors report many career-related concerns. Career service professionals are well positioned to provide targeted resources. A survey of 40 career service professionals at colleges and universities in the United States revealed that although they have had experience working with AYA survivors, most do not feel adequately trained or aware of survivors' unique needs. However, they are highly receptive to specific resources for AYA survivors. Maximizing connections between career service professionals and AYA survivors may help address survivors' career-related concerns.
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Affiliation(s)
| | - Jesse Kinel
- Department of Natural and Applied Sciences, Bentley University , Waltham, Massachusetts
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15
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Mader L, Michel G, Roser K. Unemployment Following Childhood Cancer. DEUTSCHES ARZTEBLATT INTERNATIONAL 2017; 114:805-812. [PMID: 29229046 PMCID: PMC5736865 DOI: 10.3238/arztebl.2017.0805] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 03/24/2017] [Accepted: 08/08/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND Childhood cancer survivors are at risk of physical and mental long-term sequelae that may interfere with their employment situation in adulthood. We updated a systematic review from 2006 and assessed unemployment in adult childhood cancer survivors compared to the general population, and its predictors. METHODS Systematic literature searches for articles published between February 2006 and August 2016 were performed in CINAHL, EMBASE, PubMed, PsycINFO, and SocINDEX. We extracted unemployment rates in studies with and without population controls (controlled /uncontrolled studies). Unemployment in controlled studies was evaluated using a meta-analytic approach. RESULTS We included 56 studies, of which 27 were controlled studies. Approximately one in six survivors was unemployed. The overall meta-analysis of controlled studies showed that survivors were more likely to be unemployed than controls (Odds Ratio [OR] = 1.48, 95% confidence interval [CI]: [1.14; 1.93]). Elevated odds were found in survivors in the US and Canada (OR = 1.86, 95% CI: [1.26; 2.75]), as well as in Europe (OR = 1.39, 95% CI: [0.97; 1.97]). Survivors of brain tumors in particular were more likely to be unemployed (OR = 4.62, 95% CI: [2.56; 8.31]). Narrative synthesis across all included studies revealed younger age at study and diagnosis, female sex, radiotherapy, and physical late effects as further predictors of unemployment. CONCLUSION Childhood cancer survivors are at considerable risk of unemployment in adulthood. They may benefit from psycho-social care services along the cancer trajectory to support labor market integration.
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Affiliation(s)
- Luzius Mader
- Department of Health Sciences & Health Policy, University of Luzern, Switzerland
| | - Gisela Michel
- Department of Health Sciences & Health Policy, University of Luzern, Switzerland
| | - Katharina Roser
- Department of Health Sciences & Health Policy, University of Luzern, Switzerland
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Wong AWK, Chang TT, Christopher K, Lau SCL, Beaupin LK, Love B, Lipsey KL, Feuerstein M. Patterns of unmet needs in adolescent and young adult (AYA) cancer survivors: in their own words. J Cancer Surviv 2017; 11:751-764. [DOI: 10.1007/s11764-017-0613-4] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 03/09/2017] [Indexed: 12/13/2022]
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17
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Freyer DR, Smith AW, Wolfson JA, Barr RD. Making Ends Meet: Financial Issues from the Perspectives of Patients and Their Health-Care Team. CANCER IN ADOLESCENTS AND YOUNG ADULTS 2017. [DOI: 10.1007/978-3-319-33679-4_27] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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18
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Guy GP, Berkowitz Z, Ekwueme DU, Rim SH, Yabroff KR. Annual Economic Burden of Productivity Losses Among Adult Survivors of Childhood Cancers. Pediatrics 2016; 138:S15-S21. [PMID: 27940973 PMCID: PMC6047347 DOI: 10.1542/peds.2015-4268d] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/16/2016] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Although adult survivors of childhood cancers have poorer health and greater health limitations than other adults, substantial gaps remain in understanding the economic consequences of surviving childhood cancer. Therefore, we estimated the economic burden of productivity losses among adult survivors of childhood cancers. METHODS We examined health status, functional limitations, and productivity loss among adult survivors of childhood cancers (n = 239) diagnosed at ≤14 years of age compared with adults without a history of cancer (n = 304 265) by using the 2004-2014 National Health Interview Survey. We estimated economic burden using the productivity loss from health-related unemployment, missed work days, missed household productivity, and multivariable regression models controlling for age, sex, race/ethnicity, education, comorbidities, and survey year. RESULTS Childhood cancer survivorship is associated with a substantial economic burden. Adult survivors of childhood cancers are more likely to be in poorer health, need assistance with personal care and routine needs, have work limitations, be unable to work because of health, miss more days of work, and have greater household productivity loss compared with adults without a history of cancer (all P < .05). The annual productivity loss for adult survivors of childhood cancer is $8169 per person compared with $3083 per person for individuals without a history of cancer. CONCLUSIONS These findings underscore the importance of efforts to reduce the health and economic burden among adult survivors of childhood cancer. In addition, this study highlights the potential productivity losses that could be avoided during adulthood from the prevention of childhood cancer in the United States.
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Affiliation(s)
- Gery P Guy
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; and
| | - Zahava Berkowitz
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; and
| | - Donatus U Ekwueme
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; and
| | - Sun Hee Rim
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; and
| | - K Robin Yabroff
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland
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Kilsdonk E, Wendel E, van Dulmen-den Broeder E, van Leeuwen F, van den Berg M, Jaspers M. Participation rates of childhood cancer survivors to self-administered questionnaires: a systematic review. Eur J Cancer Care (Engl) 2016; 26. [DOI: 10.1111/ecc.12462] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2016] [Indexed: 01/10/2023]
Affiliation(s)
- E. Kilsdonk
- Department of Medical Informatics; Centre for Human Factors Engineering of Interactive Health Information Technology; Academic Medical Center; University of Amsterdam; Amsterdam
| | - E. Wendel
- Department of Pediatrics; Division of Oncology-Hematology; VU University Medical Center; Amsterdam
| | | | - F.E. van Leeuwen
- Department of Epidemiology; Netherlands Cancer Institute; Amsterdam the Netherlands
| | - M.H. van den Berg
- Department of Pediatrics; Division of Oncology-Hematology; VU University Medical Center; Amsterdam
| | - M.W. Jaspers
- Department of Medical Informatics; Centre for Human Factors Engineering of Interactive Health Information Technology; Academic Medical Center; University of Amsterdam; Amsterdam
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20
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Lown EA, Phillips F, Schwartz LA, Rosenberg AR, Jones B. Psychosocial Follow-Up in Survivorship as a Standard of Care in Pediatric Oncology. Pediatr Blood Cancer 2015; 62 Suppl 5:S514-84. [PMID: 26700918 PMCID: PMC5242467 DOI: 10.1002/pbc.25783] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 09/08/2015] [Accepted: 09/10/2015] [Indexed: 01/08/2023]
Abstract
Childhood cancer survivors (CCS) have a high risk of medical late effects following cancer therapy. Psychosocial late effects are less often recognized. Many CCS do not receive long-term follow-up (LTFU) care, and those who do are rarely screened for psychosocial late effects. An interdisciplinary team conducted a systematic review of qualitative and quantitative studies to assess social, educational, vocational, psychological, and behavioral outcomes along with factors related to receipt of LTFU care. We propose that psychosocial screening be considered a standard of care in long-term follow-up care and that education be provided to promote the use LTFU care starting early in the treatment trajectory.
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Affiliation(s)
- E. Anne Lown
- Department of Social and Behavioral Sciences, School of Nursing, University of California, San Francisco, California
| | - Farya Phillips
- School of Social Work, The University of Texas at Austin, Austin, Texas
| | - Lisa A. Schwartz
- The Children’s Hospital of Philadelphia and The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Abby R. Rosenberg
- Cancer and Blood Disorders Center, Seattle Children’s Hospital, Seattle, Washington
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
| | - Barbara Jones
- School of Social Work, The University of Texas at Austin, Austin, Texas
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