Adult survivors of childhood cancers’ identity disclosures in the workplace

Thinking of how you think of me: working cancer survivors' metaperceptions of competence and why they matter

Purpose

Cancer-related stigma is a troubling challenge faced by working cancer survivors and organizations aiming to promote inclusive work environments. Research suggests that a harmful stereotype faced by cancer survivors is that the cancer survivors are low in competence. Leveraging the concept of the looking glass self and social cognitive theory, the authors develop a theoretical model about psychological processes through which cancer survivors' competence metaperceptions are related to work outcomes.

Design/methodology/approach

The authors recruited 200 working cancer survivors from online research panels and empirically test a theoretical model on how cancer survivors' metaperceptions of competence are related to the survivors' turnover intention and vigor at work. The authors additionally conducted an experimental vignette study among a sample of 133 students to examine confounds concerning causal order.

Findings

The authors found that favorable competence metaperceptions were related to decreased turnover intentions and increased vigor through cancer survivors' enhanced self-efficacy, especially for survivors high in need for emotional support.

Practical implications

This study suggests that inclusive organizations should pay attention to employees with cancer histories as a hidden disadvantaged group. To protect and motivate working cancer survivors, managers need to create a positive socio-cognitive working environment where cancer survivors are respected and valued.

Originality/value

By examining cancer survivors' metaperceptions and showing that survivors may internalize others' stereotype about individuals with a history of cancer, the authors advance the understanding about cancer survivors' return-to-work challenges.

Diversity and inclusion in the legal profession: disclosure of cancer and other health conditions by lawyers with disabilities and lawyers who identify as LGBTQ +

PURPOSE

Given the training and experience of lawyers, we assumed that a study of lawyers' willingness to disclose disability in the workplace would provide an example of the actions of a group knowledgeable about disability law. The current study accounts for the effect of visibility of disability, onset and type of disability, and whether the lawyer has made an accommodation request. We also investigate the role of other individual characteristics, such as sexual orientation, gender identity, race/ethnicity, age, and job-related characteristics, in willingness to disclose.

METHODS

We use data from the first phase of a longitudinal national survey of lawyers in the USA to estimate the odds of disclosing disability to co-workers, management, and clients using proportional odds models.

RESULTS

Lawyers with less visible disabilities, those with mental health disabilities, and those who work for smaller organizations have lower odds of disclosing to co-workers, management, and clients as compared to their counterparts. Attorneys who have requested accommodations are more willing to disclose as compared to those who have not, but only to co-workers and management. Women are less likely than men to disclose to management and clients. However, gender is not a significant determinant of disclosure to co-workers. Older attorneys are more likely to disclose to clients, whereas attorneys with children are less likely to disclose to co-workers. Lastly, lower perceived prejudice and the presence of co-workers with disabilities are associated with higher disclosure scores, but not for all groups.

CONCLUSIONS

Individuals who acquired a disability at a relatively early point in life and those with more visible disabilities are more likely to disclose. However, such willingness is affected by the intersection of disability with other individual and firm-level characteristics.

IMPLICATIONS FOR CANCER SURVIVORS

The findings imply that those with less visible disabilities and with health conditions acquired later in life are less likely to disclose. The relevance of the findings is heightened by the altered work conditions and demands imposed by the COVID-19 pandemic for cancer survivors.

Walking on thin ice: How cancer survivors manage disclosure at work

Purpose: Work issues for cancer survivors are often not addressed, although many individuals are diagnosed during central years of employment. To examine the impact of dynamic factors on how survivors navigate disclosure about cancer at work, a semi-structured focus group study was conducted with 27 survivors. Method: Grounded theory was implemented to develop a disclosure model. Results: The disclosure model illustrates pre-disclosure processes, processes during disclosing, and potential outcomes of disclosure, including how perceptions of safety and choice affect the outlet, structure, and the emotional, cognitive, social, and behavioral effects of disclosure. Conclusions: Survivors' disclosure experiences are influenced by a complex interaction of factors at the level of the individual, social support system, work environment, and healthcare system, with perceptions of choice as key points of intervention by psycho-oncology providers.

Cancer-Related Self-Disclosure in the Workplace/School by Adolescent and Young Adult Cancer Survivors

Purpose: Little is known about how survivors of adolescent and young adult (AYA) cancers navigate the process of communicating their cancer history to those at work/school. The purpose of this study was to evaluate the factors impacting workplace/school disclosure decisions among AYA survivors and strategies used for self-disclosure. Two hypotheses were tested: (1) survivors would be significantly less likely to disclose their cancer history and more likely to avoid cancer-related topics at work/school versus with friends/acquaintances; (2) survivors' satisfaction with previous cancer-related self-disclosures at work/school would mediate the relationship between the reactions of others to those disclosures and the likelihood of future work/school disclosures. Methods: Online survey data, including a measure of self-disclosure adapted from the Nebraska Outness Scale, were collected from 120 survivors (age = 15 to 39 years at diagnosis, 19 to 45 years when surveyed). Data were analyzed descriptively and study hypotheses were evaluated using paired t-tests (Hypothesis 1) and multiple regression with bootstrapping (Hypothesis 2). Results: Both hypotheses were supported: participants were less likely to self-disclose at work/school than to friends/acquaintances (p < 0.001) and satisfaction with previous self-disclosure at work/school mediated the relationship between reactions to previous disclosures and likelihood of future disclosures (95% confidence interval = 0.39-0.81). Descriptive analyses indicated that participants were guided by a variety of factors when making disclosure decisions (e.g., anticipated reactions) and used a range of strategies for disclosures (e.g., humor). Conclusions: AYA survivors are cautious in their approach to workplace/school disclosure. Employers and school administrators should create supportive and inclusive environments that facilitate self-disclosure for survivors who wish to self-disclose.

Conceal or reveal? Patterns of self-disclosure of long-term conditions at work by health professionals in a large regional Australian health service

Purpose

The purpose of this paper is to describe the patterns of self-disclosure of long-term conditions at work by health professionals in a large regional health service. Recent research by the authors has reported on the self-reported long-term conditions of nursing, medical and allied health staff within a large regional hospital and health service in North Queensland, Australia. Data regarding self-disclosure of health information were gathered during those two previous studies, but has yet to be reported. This current study thus offers the opportunity to explore and describe patterns of self-disclosure by a multi-disciplinary cohort of health professionals within that regional health service.

Design/methodology/approach

This current study was a component of two larger studies, reported elsewhere, which explored long-term conditions among health professional staff at a large regional health service in North Queensland, Australia. A cross-sectional survey design was used.

Findings

Decision-making associated with self-disclosure of long-term conditions by health professional staff in the workplace is multifactorial, and affected by considerations of age, gender, workplace circumstances and nature of the health condition. It also differs according to professional grouping. The medical profession were less likely than nurses and allied health workers to disclose to their work colleagues. Respondents with a mental health condition were more cautious and selective in their disclosures, and alone in being more likely to disclose to their supervisor than to colleagues; they were also most likely to value the sympathy and understanding of their colleagues and managers.

Research limitations/implications

This study was conducted across only one large regional health service; a fuller picture of patterns of self-disclosure of long-term conditions by health professional staff would be gained by expanding the number of sites to include metropolitan hospitals, smaller rural or remote health services and non-hospital settings.

Practical implications

Healthcare organizations need to develop support strategies and communication processes so that staff with one or more long-term condition, particularly those that have associated stigma, are empowered to disclose information to line managers and colleagues without fear of discrimination, ostracism, incivility or bullying.

Originality/value

There is a paucity of evidence about self-disclosure of long-term conditions by health professionals and this study therefore makes an important contribution to the extant literature. The findings raise important questions about the culture and dynamics of health care organizations in respect to the patterns of self-disclosure of health professional staff.

Self-disclosure to peers by young adult cancer survivors

OBJECTIVE

Given the potential benefits of self-disclosure, the goal of this study was to learn more about how young adult cancer survivors navigate the process of disclosing their cancer history to peers.

METHODS

A sample of 122 young adult cancer survivors completed a brief, online survey. Data were collected to assess how and why survivors self-disclose to peers and how peers react.

RESULTS

Participants endorsed a number of reasons for disclosing their cancer history to peers (eg, felt it was important for them to know) or choosing not to disclose (eg, to avoid upsetting/burdening them). Participants used a variety of strategies during the disclosure with the most frequently endorsed being humor and providing reassurance. Mediational analyses supported the study hypothesis: The relationship between peer reactions to self-disclosure and the likelihood of future disclosure was mediated by survivors' satisfaction with the self-disclosure experience. Exploratory analyses provided some insight into which disclosure strategies were met with a more positive reaction from peers.

CONCLUSIONS

The actual and anticipated reactions from peers play a crucial role in shaping young adult cancer survivors' experience of self-disclosure. Clinicians may use these findings to help young survivors optimize their self-disclosure experiences.