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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 2024; 18:1384-1392. [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] [MESH Headings] [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.
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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
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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.
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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.
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Sterkens P, Sharipova A, Baert S. Disclosing the 'Big C': what does cancer survivorship signal to employers? THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2024; 25:671-688. [PMID: 37480381 DOI: 10.1007/s10198-023-01618-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 06/28/2023] [Indexed: 07/24/2023]
Abstract
To study hiring discrimination against cancer survivors, we conduct a vignette experiment in which American and British professionals recruited via Prolific evaluate fictitious job candidates. Candidates differed by periods of non-employment in their career, including non-employment due to suffering from cancer. We study the effect of cancer experiences on professionals' hirability ratings, as well as its effect on underlying candidate perceptions, related to various potential forms of stigma identified in the literature. We find that employment opportunities are lower for candidates with a history of cancer, compared to candidates without such a gap. This penalty is particularly explained by perceptions that these candidates will have higher sick leave probabilities and create additional costs. However, relative to candidates with a comparable gap due to depression or personal reasons, former cancer patients are less stigmatised, with relatively favourable assessments of their emotional abilities, social abilities, motivation and positive impact on workplace culture.
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Affiliation(s)
| | | | - Stijn Baert
- Ghent University, Ghent, Belgium
- University of Antwerp, Antwerp, Belgium
- Université Catholique de Louvain, Louvain-La-Neuve, Belgium
- GLO, Stanford, USA
- IZA, Bonn, Germany
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Forcino RC, Morrissette KJ, Stevens CJ, Lichtenstein JD, Rotenberg S, Schiffelbein JE, Connolly D, Lyons KD. Strategies to support cancer survivors at work: content analysis of cancer survivor, healthcare provider, and employer perspectives. J Cancer Surviv 2024:10.1007/s11764-024-01539-w. [PMID: 38316725 PMCID: PMC11298570 DOI: 10.1007/s11764-024-01539-w] [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: 09/01/2023] [Accepted: 01/18/2024] [Indexed: 02/07/2024]
Abstract
PURPOSE To (1) describe the challenges identified by cancer survivors, healthcare providers, and employers related to work maintenance and optimization during and after cancer treatment and (2) identify strategies that can address those challenges. METHODS We conducted content analysis of semi-structured interview data collected from cancer survivors, healthcare providers, and employers regarding workplace challenges that cancer survivors face and strategies to address them. Challenges and strategies were summarized according to whether they related to the cancer survivor, the work demands, or the work environment. RESULTS Forty-five total participants identified challenges and strategies primarily related to the cancer survivor's signs and symptoms of treatment. Healthcare providers (n = 17) focused primarily on challenges and strategies related to the cancer survivor, while employers (n = 5) focused on the work environment-especially policies and procedures that facilitate time off work and the importance of bidirectional communication between cancer survivors and employers. Cancer survivors (n = 23) identified challenges and suggestions in all three categories, though they uniquely focused on challenges relating to work demands and adjustments to those demands that would facilitate employment maintenance. CONCLUSIONS Efforts to address the many challenges that cancer survivors experience at work should include the views of cancer survivors, healthcare providers, and employers reflecting their respective domains of expertise in work demands, cancer survivors' medical care, and the work environment. IMPLICATIONS FOR CANCER SURVIVORS Survivors and healthcare providers are able to address many side effects that can create work challenges, but improved collaboration between survivors and employers may identify ways to modify work demands and environments to maximize employment maintenance.
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Affiliation(s)
- Rachel C Forcino
- Department of Population Health, School of Medicine, University of Kansas, Kansas City, KS, USA.
| | | | - Courtney J Stevens
- Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Jonathan D Lichtenstein
- Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth Geisel School of Medicine, Lebanon, NH, USA
| | - Sivan Rotenberg
- Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | | | - Deirdre Connolly
- Occupational Therapy Department, Trinity College Dublin, Dublin, Ireland
| | - Kathleen Doyle Lyons
- Occupational Therapy Department, Massachusetts General Hospital Institute of Health Professions, Boston, MA, USA
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Forbat L. Multiple myeloma in people of working age in Czechia, Germany, and Poland: findings from a qualitative interview study. J Cancer Surviv 2023:10.1007/s11764-023-01510-1. [PMID: 38114713 DOI: 10.1007/s11764-023-01510-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/04/2023] [Indexed: 12/21/2023]
Abstract
PURPOSE The study sought to understand the experiences of working age adults with myeloma and their partner/family members, living in Czechia, Germany, and Poland. METHODS Qualitative interviews were conducted with 36 working age adults living with myeloma, and three family members. Data were collected from May to October 2022. Thematic analysis was applied to the data. RESULTS Healthcare and state support within each country are described. The degree of work engagement was informed by patients' symptom burden, treatment needs, state financial aid, and family/financial obligations. Many did not conceptualise their status as involving 'return to work' as they had continued to be engaged with their jobs throughout. For some, remote working enabled them to manage treatments/side-effects and their job, while avoiding infection. In some cases, patients did not tell their employer or colleagues about their illness, for fear of discrimination. CONCLUSION While experiences varied between countries, common across accounts was a struggle to balance ongoing treatments with employment, at a time when participants were expected to finance their own households and maintain their income and roles. Implications for Cancer Survivors To improve quality of life, clinical discussions around treatment decision-making should take into account patients' attitudes/approach to work, type of work engaged in, and other activities considered important to them. European Union and national cancer plans should set out optimum standards for employers, to ensure an equitable benchmark for how employees are supported. Such approaches would improve legal protections and better enforcement of employer policies to accommodate patients' limitations in the workplace.
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Viseux M, Johnson S, Roquelaure Y, Bourdon M. Breast Cancer Survivors' Experiences of Managers' Actions During the Return to Work Process: A Scoping Review of Qualitative Studies. JOURNAL OF OCCUPATIONAL REHABILITATION 2023; 33:687-701. [PMID: 37010716 DOI: 10.1007/s10926-023-10101-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/03/2023] [Indexed: 06/19/2023]
Abstract
PURPOSE Managers' actions can facilitate the return to work (RTW) process for breast cancer survivors (BCS). However, data on BCS' experiences of managers' actions regarding RTW are dispersed across multiple qualitative studies and do not offer useful insights for managers to support employees returning to work. This study aimed to summarize and map managers' actions experienced by BCS over three RTW phases (before, during, after) and categorize them as facilitating or hindering RTW. METHODS A scoping review of qualitative studies was conducted. Four databases (MEDLINE, PsycINFO, Cochrane Library, EMBASE) were systematically searched for articles published between 2000 and 2022. Studies and participant characteristics were extracted using an excel spreadsheet. A thematic analysis with a predominantly deductive and semantic approach was conducted. RESULTS Twenty-nine studies were included after screening 1042 records. Five themes were generated from the data. Two themes addressed the phase 'before RTW': 'managers' interpersonal skills' and 'preparing for RTW'; three in the 'during RTW' phase: 'managers' interpersonal skills', 'offering work flexibility', and 'offering work accommodations', and only one, 'paying attention to follow-up', was addressed in the 'after RTW' phase. CONCLUSION This review mapped managers' actions experienced by BCS in three phases of the RTW process. Results suggested that, according to BCS, managers need to mobilize specific skills to provide appropriate support during the RTW process. Further research is needed to better understand the skills underlying managers' actions facilitating the RTW process.
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Affiliation(s)
- Marie Viseux
- UMR INSERM 1246 SPHERE "methodS in Patient-Centered Outcomes and HEalth ResEarch", Nantes University, University of Tours, 22 Boulevard Benoni Goullin, Nantes, France.
| | - Stacey Johnson
- Integrated Center for Oncology, Boulevard Jacques Monod, 44805, Nantes, Saint-Herblain, France
- Université Côte d'Azur, LAMHESS, 261 Boulevard du Mercantour, 06200, Nice, France
| | - Yves Roquelaure
- University of Angers, University of Rennes, Inserm, EHESP, IRSET (Institut de Recherche en Santé, Environnement Et Travail) - UMR_S 1085, SFR ICAT, F-49000, Angers, France
- UMR Inserm S 1085, EHESP, IRSET (Institut de Recherche en Santé, Environnement Et Travail) - University of Angers, CHU Angers, University of Rennes, SFR ICAT, F-49000, Angers, France
| | - Marianne Bourdon
- UMR INSERM 1246 SPHERE "methodS in Patient-Centered Outcomes and HEalth ResEarch", Nantes University, University of Tours, 22 Boulevard Benoni Goullin, Nantes, France
- Integrated Center for Oncology, Boulevard Jacques Monod, 44805, Nantes, Saint-Herblain, France
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Ruiz de Azua G, Kousignian I, Vaz‐Luis I, Di Meglio A, Caumette E, Havas J, Martin E, Martin A, Querel O, Vanlemmens L, Pistilli B, Coutant C, Cottu PH, Merimeche AD, Lerebours F, Tredan O, Jouannaud C, Levy C, Dumas A, Menvielle G. Sustainable return to work among breast cancer survivors. Cancer Med 2023; 12:19091-19101. [PMID: 37602836 PMCID: PMC10557874 DOI: 10.1002/cam4.6467] [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: 10/19/2022] [Revised: 06/11/2023] [Accepted: 07/14/2023] [Indexed: 08/22/2023] Open
Abstract
PURPOSE This study assessed sustainable return to work (SRTW) of breast cancer survivors (BCS). METHODS We used data from the prospective French cohort, CANTO. We included 1811 stage I-III BCS who were <57 years old and employed at the moment of diagnosis and working 2 years after diagnosis. Using logistic regression, we investigated the role of clinical, health and socio-economic factors, and the work environment on SRTW 3 years after diagnosis. We compared having any sick leave with having worked continuously and being unemployed to having worked continuously between 2 and 3 years after diagnosis. RESULTS Overall, 77% (n = 1395) worked continuously after return to work (RTW). Out of the other 416 BCS, 66% had any sick leave period, 33% had been unemployed, 4% had an early retirement, 2% a disability and 1% another status (multiple situations possible). Being on sick leave was associated with age > 50 (OR = 0.59; 95%CI = 0.43-0.82), stage III (2.56; 1.70-3.85), tumour subtype HR+/HER2+ (0.61; 0.39-0.95), severe fatigue (1.45; 1.06-1.98), workplace accommodations (1.63; 1.14-2.33) and life priorities (0.71; 0.53-0.95). Unemployment was associated with age > 50 (0.45; 0.29-0.72), working in the public sector (0.31; 0.19-0.51), for a small company (3.00; 1.74-5.20) and having a fixed-term contract (7.50; 4.74-11.86). CONCLUSIONS A high number of BCS have periods of sick leave or unemployment after RTW. The determinants differ between sick leave and unemployment. IMPLICATIONS FOR CANCER SURVIVORS BCS need to be supported even after RTW, which should be regarded as a process.
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Affiliation(s)
- Garazi Ruiz de Azua
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, Équipe de Recherche en Épidémiologie SocialeParisFrance
| | - Isabelle Kousignian
- Université Paris Cité, Unité de Recherche «Biostatistique, Traitement et Modélisation des données bio‐logiques» BioSTM, UR 7537ParisFrance
| | - Ines Vaz‐Luis
- Medical Oncology DepartmentGustave RoussyVillejuifFrance
- INSERM Unit 981—Prédicteurs moléculaires et nouvelles cibles en oncologie, Gustave RoussyVillejuifFrance
| | - Antonio Di Meglio
- INSERM Unit 981—Prédicteurs moléculaires et nouvelles cibles en oncologie, Gustave RoussyVillejuifFrance
| | - Elsa Caumette
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, Équipe de Recherche en Épidémiologie SocialeParisFrance
- Department of MaieuticsUniversité de MontpellierMontpellierFrance
| | - Julie Havas
- INSERM Unit 981—Prédicteurs moléculaires et nouvelles cibles en oncologie, Gustave RoussyVillejuifFrance
| | - Elise Martin
- INSERM Unit 981—Prédicteurs moléculaires et nouvelles cibles en oncologie, Gustave RoussyVillejuifFrance
| | | | | | | | | | - Charles Coutant
- Department of Medical OncologyCentre Georges‐François LeclercDijonFrance
| | | | | | | | | | | | | | - Agnes Dumas
- Université Paris Cité ECEVE, UMR 1123, InsermParisFrance
| | - Gwenn Menvielle
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, Équipe de Recherche en Épidémiologie SocialeParisFrance
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A Blog Text Analysis to Explore Psychosocial Support in Adolescents and Young Adults With Cancer. Cancer Nurs 2023; 46:143-151. [PMID: 35349497 DOI: 10.1097/ncc.0000000000001087] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The achievement of developmental milestones of adolescents and young adults (AYAs) is significantly challenged by a cancer diagnosis and treatment. To help with challenges in AYAs with cancer, various types of psychosocial support have been studied to cope with cancer and seek optimal well-being. However, despite differences among AYAs' developmental stages, AYAs with cancer are often treated as a homogeneous group in research and hospital settings. OBJECTIVE The aim of this study was to identify and compare psychosocial support that facilitates the well-being of AYAs with cancer. METHODS Quantitative and qualitative analyses were conducted on AYAs' perceived psychosocial support as expressed on an online cancer community. Themes were identified using qualitative content analysis, and descriptive quantitative methods were used to compare themes by age and gender. RESULTS Seven themes emerged: coping skill building, self-transcendence, family support, support from friends, professional support, peer support including online and offline support groups, and accommodation. There were no significant differences in the frequency of posts between age and gender variables by theme. However, the details of the themes were qualitatively different by age and gender. CONCLUSIONS The psychosocial support AYAs perceived may differ by age and gender. This study suggests opportunities for nurses to contribute their support to AYAs' perceived psychosocial support throughout AYAs' cancer journeys. IMPLICATION FOR PRACTICE The sources of support that can help AYAs with cancer should be routinely available rather than in response to crisis.
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Gignac MAM, Bowring J, Tonima S, Franche RL, Thompson A, Jetha A, Smith PM, Macdermid JC, Shaw WS, Van Eerd D, Beaton DE, Irvin E, Tompa E, Saunders R. A Sensibility Assessment of the Job Demands and Accommodation Planning Tool (JDAPT): A Tool to Help Workers with an Episodic Disability Plan Workplace Support. JOURNAL OF OCCUPATIONAL REHABILITATION 2023; 33:145-159. [PMID: 35835885 PMCID: PMC9282615 DOI: 10.1007/s10926-022-10057-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/27/2022] [Indexed: 06/15/2023]
Abstract
Purpose Sensibility refers to a tool's comprehensiveness, understandability, relevance, feasibility, and length. It is used in the early development phase to begin assessing a new tool or intervention. This study examined the sensibility of the job demands and accommodation planning tool (JDAPT). The JDAPT identifies job demands related to physical, cognitive, interpersonal, and working conditions to better target strategies for workplace supports and accommodations aimed at assisting individuals with chronic health conditions. Methods Workers with a chronic health condition and workplace representatives were recruited from health charities, workplaces, and newsletters using convenience sampling. Cognitive interviews assessed the JDAPT's sensibility. A 70% endorsement rate was the minimum level of acceptability for sensibility concepts. A short screening tool also was administered, and answers compared to the complete JDAPT. Results Participants were 46 workers and 23 organizational representatives (n = 69). Endorsements highly exceeded the 70% cut-off for understandability, relevance, and length. Congruence between screening questions and the complete JDAPT suggested both workers and organizational representatives overlooked job demands when completing the screener. Participants provided additional examples and three new items to improve comprehensiveness. The JDAPT was rated highly relevant and useful, although not always easy to complete for someone with an episodic condition. Conclusions This study highlights the need for tools that facilitate accommodations for workers with episodic disabilities and provides early evidence for the sensibility of the JDAPT.
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Affiliation(s)
- Monique A M Gignac
- Institute for Work and Health, 400 University Avenue, Suite 1800, Toronto, ON, M5G 1S5, Canada.
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
| | - Julie Bowring
- Institute for Work and Health, 400 University Avenue, Suite 1800, Toronto, ON, M5G 1S5, Canada
| | - Sabrina Tonima
- Institute for Work and Health, 400 University Avenue, Suite 1800, Toronto, ON, M5G 1S5, Canada
| | | | - Aaron Thompson
- Workplace Safety and Insurance Board (WSIB), Toronto, ON, Canada
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Arif Jetha
- Institute for Work and Health, 400 University Avenue, Suite 1800, Toronto, ON, M5G 1S5, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Peter M Smith
- Institute for Work and Health, 400 University Avenue, Suite 1800, Toronto, ON, M5G 1S5, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Joy C Macdermid
- School of Physical Therapy, Western University, London, ON, Canada
| | - William S Shaw
- Medicine, University of Connecticut Health, Farmington, CT, USA
| | - Dwayne Van Eerd
- Institute for Work and Health, 400 University Avenue, Suite 1800, Toronto, ON, M5G 1S5, Canada
| | - Dorcas E Beaton
- Institute for Work and Health, 400 University Avenue, Suite 1800, Toronto, ON, M5G 1S5, Canada
| | - Emma Irvin
- Institute for Work and Health, 400 University Avenue, Suite 1800, Toronto, ON, M5G 1S5, Canada
| | - Emile Tompa
- Institute for Work and Health, 400 University Avenue, Suite 1800, Toronto, ON, M5G 1S5, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Ron Saunders
- Institute for Work and Health, 400 University Avenue, Suite 1800, Toronto, ON, M5G 1S5, Canada
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Colorectal cancer survivors' experiences of return-to-work: A meta-synthesis of qualitative studies. Eur J Oncol Nurs 2023; 63:102284. [PMID: 36893577 DOI: 10.1016/j.ejon.2023.102284] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 01/29/2023] [Accepted: 02/09/2023] [Indexed: 02/13/2023]
Abstract
INTRODUCTION This review is to explore the relevant experience of colorectal cancer survivors' return-to-work, reintegrating and analyzing the promoting factors and obstacles of colorectal cancer survivors' return-to-work. METHODS This review followed PRISMA List. Databases including the Cochrane Library, PubMed, Web of Science, EM base, CINAHL, APA PsycInfo, Wangfang Database, CNKI and CBM from inception to October 2022 were searched to collect qualitative studies in the experience of colorectal cancer survivors' return-to-work. Article selection and data extraction were conducted by two researchers used the Joanna Briggs Institute Critical Appraisal Tool for qualitative researches (2016) in Australia. RESULTS Seven studies were included, the thirty-four themes distilled from the literature were grouped into eleven new categories and summed into two integrated findings: (1) facilitators to return-to-work for colorectal cancer survivors: desire and expectation for return-to-work and social dedication, economic needs, support and tolerance from employers and colleagues, work suggestions provided by professionals, health insurance policy of the workplace. (2) obstacles to return-to-work for colorectal cancer survivors: physical problems, psychological barriers, lack of family support, negative attitudes of employers and colleagues, limited information and resources available from professionals, Imperfection of related policies. CONCLUSION This study shows that colorectal cancer survivors' return-to-work is influenced by many factors. We should pay attention to and avoid obstacles, help colorectal cancer survivors recover their physical functions and maintain a positive psychological state, improve the social support for colorectal cancer survivors to return-to-work, so as to achieve comprehensive rehabilitation as soon as possible.
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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.
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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
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Tiedtke CM, Blonk RW, Van Rhenen W, Van Egmond MP, Joosen MC. Tailored support for preparing employees with cancer to return to work: Recognition and gaining new insights in an open atmosphere. Work 2023; 76:1519-1533. [PMID: 37355925 PMCID: PMC10741312 DOI: 10.3233/wor-220566] [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: 10/05/2022] [Accepted: 04/27/2023] [Indexed: 06/26/2023] Open
Abstract
BACKGROUND A considerable number of cancer survivors face difficulties in returning to work (RTW). More insight is needed on how to support employees shortly after cancer treatment and help them make the transition back to work. OBJECTIVE To gain an in-depth understanding of how and under what circumstances a Cancer & Work Support (CWS) program, which assists sick-listed employees with cancer in preparing their RTW, works. METHODS A qualitative design was used, inspired by Grounded Theory and Realist Evaluation components. Semi-structured interviews were conducted with RTW professionals (N = 8) and employees with cancer (N = 14). Interview themes covered experiences with CWS, active elements, and impeding and facilitating factors. Interviews were transcribed and analyzed by multiple researchers for contextual factors, active mechanisms, and the outcomes experienced. RESULTS Respondents experienced the support as human centered, identifying two characteristics: 'Involvement' ('how' the support was offered), and 'Approach' ('what' was offered). Four themes were perceived as important active elements: 1) open connection and communication, 2) recognition and attention, 3) guiding awareness and reflection, and 4) providing strategies for coping with the situation. Variation in the experiences and RTW outcomes, appeared to be related to the personal, medical and environmental context. CONCLUSION Both professionals and employees really appreciated the CWS because it contributed to RTW after cancer. This research shows that not only 'what' RTW professionals do, but also 'how' they do it, is important for meaningful RTW support. A good relationship in an open and understanding atmosphere can contribute to the receptiveness (of employees) for cancer support.
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Affiliation(s)
- Corine M. Tiedtke
- Tranzo-Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Roland W.B. Blonk
- Tranzo-Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
- Department of Human Resource Studies, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
- TNO Innovation for Life, Leiden, The Netherlands
- Optentia Research Unit, North-West University, Vanderbijlpark, South Africa
| | - Willem Van Rhenen
- Arbo Unie, Nieuwegein, The Netherlands
- Center for Human Resource Organization and Management Effectiveness, Nyenrode Business University, Breukelen, The Netherlands
| | | | - Margot C.W. Joosen
- Tranzo-Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
- Department of Human Resource Studies, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
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13
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Schaefer Solle N, Legros A, Jackson R, Rangan A, Beaver CC, Kling H, Khan F, Koru-Sengul T, Penedo FJ, Caban-Martinez AJ, Kobetz EN. Understanding Cancer Survivorship among Firefighters: A Mixed-Method Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:257. [PMID: 36612579 PMCID: PMC9819887 DOI: 10.3390/ijerph20010257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 12/09/2022] [Accepted: 12/15/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Firefighters are exposed to a unique set of carcinogens through their work environment that predispose them to several cancers, yet there is limited research related to cancer survivorship amongst this occupational group. METHODS A mixed-method approach was used to assess cancer survivorship amongst firefighters. Four focus groups and one in-depth interview were conducted with 29 active and retired firefighters who have been diagnosed with cancer to understand the experiences and challenges associated with cancer survivorship in the fire service and desired resources. Qualitative data were analyzed using Nvivo software. All participants completed the Functional Assessment of Cancer Therapy-General (FACT-G) survey to assess their quality of life. RESULTS The primary themes that emerged from the focus groups included managing health and well-being changes, navigating support systems in place, and accessing new resources. FACT-G scores (mean ± standard deviation) of the firefighter cancer survivor sample demonstrate relatively lower levels of emotional well-being (19.26 ± 4.67) and higher quality of life in the physical well-being (23.67 ± 5.08), social well-being (23.38 ± 4.16), and functional well-being (22.6 ± 4.966) domains. CONCLUSIONS Firefighters requested curated resources, such as support groups and department training resources, supporting the need for more cancer survivorship resources specific to firefighters.
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Affiliation(s)
- Natasha Schaefer Solle
- Departments of Medicine, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA
- Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA
- Sylvester Comprehensive Cancer Center, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - Amy Legros
- Departments of Medicine, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA
- Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - Rachael Jackson
- Departments of Medicine, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA
- Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - Apoorva Rangan
- Departments of Medicine, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA
- Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - Cynthia Campos Beaver
- Sylvester Comprehensive Cancer Center, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - Hannah Kling
- Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - Fatima Khan
- Departments of Medicine, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA
- Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - Tulay Koru-Sengul
- Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA
- Sylvester Comprehensive Cancer Center, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - Frank J. Penedo
- Sylvester Comprehensive Cancer Center, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA
- Psychology, University of Miami, Coral Gables, FL 33146, USA
| | - Alberto J. Caban-Martinez
- Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA
- Sylvester Comprehensive Cancer Center, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - Erin N. Kobetz
- Departments of Medicine, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA
- Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA
- Sylvester Comprehensive Cancer Center, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA
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14
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Paltrinieri S, Costi S, Pellegrini M, Díaz Crescitelli ME, Vicentini M, Mancuso P, Giorgi Rossi P, Fugazzaro S, Mazzini E, Escorpizo R, Ghirotto L. Adaptation of the Core Set for Vocational Rehabilitation for Cancer Survivors: A Qualitative Consensus-Based Study. JOURNAL OF OCCUPATIONAL REHABILITATION 2022; 32:718-730. [PMID: 35334038 PMCID: PMC8949826 DOI: 10.1007/s10926-022-10033-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/27/2022] [Indexed: 06/14/2023]
Abstract
PURPOSE The Core Set for Vocational Rehabilitation (CS-VR) of the International Classification of Functioning, Disability and Health (ICF) describes the work functioning of individuals in need of VR. We aimed to adapt the CS-VR from the perspective of cancer survivors (CSs) and stakeholders, developing a CS-VR-Onco. METHODS We held five focus groups with 17 CSs who were employed at the time of diagnosis, to discuss their work reintegration experiences. After analyzing the focus group conversations, the CS-VR-Onco was developed. During a group interview, eleven stakeholders explored barriers/facilitations in assessing the work functioning of CSs by using the CS-VR-Onco. We applied the framework method and thematic analysis. RESULTS For the focus groups, the CS-VR-Onco of 85 categories emerged, and the ICF chapters of Mental functions, Exercise and tolerance functions, Interpersonal interactions and relationships, Major life areas, General tasks and demands, Mobility, Support and relationships, and Attitudes were prioritized. For the group interview, stakeholders' perspectives can be synthetized into two themes: close to the lived experience and usability criteria. Stakeholders confirmed the categories of the CS-VR-Onco, a checklist that should be used through an integrated approach across multiple disciplines. CONCLUSIONS The adapted CS-VR-Onco reflects the CSs' lived experiences of work reintegration and the factors that have influenced this process. The CS-VR-Onco was described as complete and usable through an integrated approach.
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Affiliation(s)
- Sara Paltrinieri
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Risorgimento 80, 42123, Reggio Emilia, Italy
| | - Stefania Costi
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Risorgimento 80, 42123, Reggio Emilia, Italy.
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, Università di Modena e Reggio Emilia, 41100, Modena, Italy.
| | - Martina Pellegrini
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Risorgimento 80, 42123, Reggio Emilia, Italy
| | - Matías Eduardo Díaz Crescitelli
- Qualitative Research Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Viale Umberto I 50, 42123, Reggio Emilia, Italy
| | - Massimo Vicentini
- Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, Italy
| | - Pamela Mancuso
- Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, Italy
| | - Paolo Giorgi Rossi
- Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, Italy
| | - Stefania Fugazzaro
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Risorgimento 80, 42123, Reggio Emilia, Italy
| | - Elisa Mazzini
- Medical Directorate, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, Italy
| | - Reuben Escorpizo
- Department of Rehabilitation and Movement Science, College of Nursing and Health Sciences, University of Vermont, Burlington, VT, 05401, USA
- Swiss Paraplegic Research, Nottwil, Switzerland
| | - Luca Ghirotto
- Qualitative Research Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Viale Umberto I 50, 42123, Reggio Emilia, Italy
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15
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Yagil D, Cohen M. The role of perceived supervisor resistance in successful work sustainability among cancer survivors. Work 2022; 73:203-210. [DOI: 10.3233/wor-205341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: Research has indicated that managerial contact with cancer survivors during a long absence from work is related to cancer survivors’ inclination to return to work. OBJECTIVE: The present study explored the roles of cancer survivors’ perception of supervisor resistance to return to work (RTW) and symptom severity in the relationship between supervisor-initiated contact during the cancer survivors’ absence from work and successful work sustainability (SWS). METHODS: Israeli cancer survivors (N = 149) who had been working at least 6 months after the termination of treatment completed online questionnaires. The scales measured frequency of contact, perceived supervisor resistance to RTW, SWS, and symptom severity. To test the relationship between perceived and actual resistance, a partial sample of the cancer survivors’ direct supervisors (N = 49) reported their resistance to RTW of cancer survivors. RESULTS: The results show that perceived supervisor resistance mediated the relationship between supervisor-initiated contact during absence and SWS. Symptom severity moderated the negative effect of perceived supervisor resistance on SWS: The relationship was stronger for cancer survivors experiencing severe symptoms. Cancer survivors’ perception of supervisor resistance to RTW was positively related to their supervisors’ self-report of resistance. CONCLUSION: These results suggest the need for clear guidelines and managerial training programs regarding contact and communication with cancer survivors during long absences from work.
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Affiliation(s)
- Dana Yagil
- Department of Human Services, University of Haifa, Mount Carmel, Haifa, Israel
| | - Miri Cohen
- School of Social Work, University of Haifa, Mount Carmel, Haifa, Israel
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16
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Kobayashi M, Sezai I, Ishikawa T, Masujima M. Psychological and educational support for cancer patients who return to work: A scoping review. Work 2022; 73:291-300. [DOI: 10.3233/wor-205326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND: Many patients with cancer experience challenges when they return to work (RTW) following cancer diagnosis and treatment. Psycho-educational support is important to facilitate the RTW process. OBJECTIVE: This scoping review examined published reports on psycho-educational support for patients with cancer who RTW. METHODS: We followed the preferred reported items for systematic reviews and meta-analyses statement and the framework of Arksey and O’Malley. We searched the Cochrane Central Register of Controlled Trials database, PubMed, CINAHL (EBSCO), and ICHUSHI and performed manual searches. RESULTS: We retrieved 1,586 articles and retained 48 for analysis (published January 2000 to December 2020). Physicians, occupational physicians, nurses, social workers, and psychologists provide considerable support in hospitals. Delivery modes included individual, face-to-face, and workbook. Psychological support included emotional, stress coping, counseling, and knowledge. Educational support included information or advice provision, communication skills, problem discussion, and work planning. Employment status was typically the primary outcome. We included 50 measurement scales across quality of life, cognitive functioning and illness, self-efficacy, psychological distress, and fatigue. CONCLUSION: This review elucidated psycho-educational support for patients with cancer who RTW, and measurement tools for related effects. Based on the characteristics of the psycho-educational support revealed in this study, future studies should examine the development, intervention, and implementation of support programs for patients’ RTW.
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Affiliation(s)
- Masamitsu Kobayashi
- Faculty of Nursing, National Defense Medical College, Saitama, Japan
- Graduate School of Nursing, Chiba University, Chiba, Japan
| | - Izumi Sezai
- Faculty of Nursing, National Defense Medical College, Saitama, Japan
| | - Takako Ishikawa
- Graduate School Health Care Scienses, Tokyo Medical and Dental University, Tokyo, Japan
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17
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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.
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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
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18
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Maheu C, Kocum L, Parkinson M, Robinson L, Bernstein LJ, Zanchetta MS, Singh M, Hernandez C, Yashmin F, Esplen MJ. Evaluation of Usability and Satisfaction of Two Online Tools to Guide Return to Work for Cancer Survivors on the Cancer and Work Website. JOURNAL OF OCCUPATIONAL REHABILITATION 2022; 32:452-463. [PMID: 34800244 DOI: 10.1007/s10926-021-10011-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/01/2021] [Indexed: 06/13/2023]
Abstract
Prompt services and work-focused support systems are needed to aid cancer survivors returning to work or finding work. Purpose This knowledge translation and implementation project focused on the knowledge users' experience and need for refinement of three work-focused tools to support return to work and maintain work following cancer through their participation in a hands-on workshop. The tools assessed for their utility are a Job Analysis Tool (JAT), a Return to Work (RTW) tool, and a bilingual Canadian website on Cancer and Work. Methods Four workshops took place in three Canadian cities. Participants included cancer survivors, healthcare professionals, and employer representatives. Following an overview of the website and tools, workshop participants (N = 28) completed qualitative and quantitative satisfaction and usability questionnaires using the System Usability Scale and open-ended questions. Qualitative data was analyzed using content analyses from the think-aloud data and from the four open-ended questions collected during the users' use of the tools and website. Results Overall, most study participants reported high satisfaction with the JAT and RTW tools, the Cancer and work website and the workshop. Good usability scores were reported for the RTW planner (73.65 ± 12.61) and the website (74.83 ± 12.36), and only acceptable usability scores for the JAT (68.53 ± 11.90). Conclusion Overall, the study documented the value of the tools and the website to support the RTW process as assessed by several key knowledge user groups. The JAT is considered a helpful procedure to identify job demands in order to guide job accommodations. Given participants' responses that the tool is useful, the next steps are to implement the recommendations for improvement and knowledge dissemination to increase its uptake and the use of job analysis overall.
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Affiliation(s)
- Christine Maheu
- Faculty of Medicine and Health Sciences, Ingram School of Nursing, McGill University, Montreal, QC, H3A 2M7, Canada.
| | - Lucie Kocum
- Department of Psychology, Saint Mary's University, Halifax, NS, B3H 3C3, Canada
| | - Maureen Parkinson
- BC Cancer Agency, Patient & Family Counselling, Vancouver, BC, V5Z 1G1, Canada
| | - Lynne Robinson
- Faculty of Health, School of Health and Human Performance, Dalhousie University, Halifax, NS, B3H 4R2, Canada
| | - Lori J Bernstein
- Princess Margaret Cancer Centre, Department of Supportive Care, University of Toronto, Toronto, ON, M5G 2C4, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, M5S 1A1, Canada
| | - Margareth Santos Zanchetta
- Faculty of Community Services, Daphne Cockwell School of Nursing, Ryerson University, Toronto, ON, M5B 1Z5, Canada
| | - Mina Singh
- Faculty of Health, School of Nursing, York University, Toronto, ON, M3J 1P3, Canada
| | - Claudia Hernandez
- Patient Partner from the Canadian Partnership Against Cancer, Toronto, ON, M5H 1J8, Canada
| | - Fatima Yashmin
- Faculty of Medicine and Health Sciences, Ingram School of Nursing, McGill University, Montreal, QC, H3A 2M7, Canada
| | - Mary Jane Esplen
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, M5S 1A1, Canada
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19
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Xiang E, Guzman P, Mims M, Badr H. Balancing Work and Cancer Care: Challenges Faced by Employed Informal Caregivers. Cancers (Basel) 2022; 14:cancers14174146. [PMID: 36077682 PMCID: PMC9454561 DOI: 10.3390/cancers14174146] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/19/2022] [Accepted: 08/25/2022] [Indexed: 11/25/2022] Open
Abstract
Simple Summary Caregiving for a family member or close friend with cancer can be particularly demanding for employed individuals who are juggling work responsibilities while providing care. With an eye toward stimulating research to develop programs and resources to support this vulnerable subgroup of caregivers, this narrative review first describes the financial, work, and mental health impacts of cancer on employed caregivers. Next, critical knowledge gaps are identified and directions for future research are described. The article concludes by formulating an agenda for practice that includes a multipronged effort on behalf of employers, healthcare, and community-based organizations to support and empower employed cancer caregivers. Abstract Individuals with cancer commonly rely on their informal caregivers (e.g., spouse/partner, family member, close friend) to help them manage the demands of the disease and its treatment. Caregiving, including helping with patient care, performing household chores, and providing emotional and practical support, can be particularly demanding for employed caregivers, who must juggle their work responsibilities while providing care. Although a burgeoning literature describes the toll that balancing these oft-competing demands can exact, few resources exist to support employed cancer caregivers. To address this gap, we conducted a narrative review of the impacts of cancer on employed caregivers. We found that employed caregivers experience significant financial impacts in terms of lost time and income. They also experience a variety of work-related (e.g., reduced productivity, absenteeism) and mental health (e.g., stress, burden) impacts. Going forward, prospective studies are needed to characterize changes in caregiver support needs and preferences at different time points along the cancer care continuum (e.g., at diagnosis, during treatment, end-of-life) so that appropriate workplace accommodations can be provided. More population-based studies are also needed to develop models for identifying caregivers who are at increased risk for poor employment or mental health outcomes so that more targeted support programs can be developed. Ultimately, a multipronged effort on behalf of employers, healthcare, and community-based organizations may be needed to support and empower this vulnerable subgroup.
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Affiliation(s)
- Ellen Xiang
- Department of Medicine, Section of Epidemiology and Population Science, Baylor College of Medicine, Houston, TX 77030, USA
| | - Patricia Guzman
- McGovern Medical School, Health Science Center, The University of Texas, Houston, TX 77225, USA
| | - Martha Mims
- Department of Medicine, Section of Hematology & Oncology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Hoda Badr
- Department of Medicine, Section of Epidemiology and Population Science, Baylor College of Medicine, Houston, TX 77030, USA
- Correspondence: ; Tel.: +1-713-798-1588
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20
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Popa AE. Moving beyond the patients’ views on the process of return to work after cancer: A qualitative evidence synthesis on articles published between 2008 and 2017. Work 2022; 72:1299-1310. [DOI: 10.3233/wor-210554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: Important qualitative findings have accumulated on return to work after cancer from the perspective of various stakeholders. OBJECTIVE: The aim of this paper was to critically appraise the evidence produced between 2008–2017 on several key stages of the return to work process against the key stakeholders identified in the articles included. METHODS: A systematic search was done on four databases to identify relevant papers. Papers were selected based on pre-defined selection criteria. A qualitative evidence synthesis was performed on the articles included. RESULTS: A total of 57 articles were included in the analysis. Using the secondary thematic analysis, this study identified three categories of articles relative to the stakeholders included: articles focusing on patients’ experience (n = 41); articles dealing with multiple stakeholders, including patients (n = 12); and articles drawing on stakeholders other than patients (n = 4). The analysis also revealed five key stages of the return to work process which follow a sequential order and provide a comprehensive image of the process. CONCLUSIONS: More research is required on how employers view and are able to facilitate the return to work process after cancer. New forms of support must be planned and delivered by health professionals for patients who return on the labour market. The five stages model proposed in this study can help employers and policymakers to plan and deliver tailored legislation and guidance for RTW facilitation. All stakeholders must be further trained to embrace the idea that return to work is a complex process which continues long after the survivor returns to work.
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Affiliation(s)
- Adela Elena Popa
- Faculty of Social Sciences and Humanities, Lucian Blaga University of Sibiu, Sibiu, Romania E-mail:
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21
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Viseux M, Tamminga SJ, Greidanus MA, Porro B, Roquelaure Y, Bourdon M. Enhancing Emotional Skills of Managers to Support the Return to Work of Cancer Survivors: A Research Opinion Focusing on Value, Feasibility and Challenges. Front Psychol 2022; 13:910779. [PMID: 35903738 PMCID: PMC9319043 DOI: 10.3389/fpsyg.2022.910779] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 06/13/2022] [Indexed: 11/14/2022] Open
Affiliation(s)
- Marie Viseux
- UMR INSERM 1246 SPHERE “Methods in Patient-Centered Outcomes and HEalth ResEarch”, Nantes University, University of Tours, Nantes, France
- *Correspondence: Marie Viseux
| | - Sietske J. Tamminga
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Amsterdam, Netherlands
- Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, Netherlands
| | - Michiel A. Greidanus
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Amsterdam, Netherlands
- Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, Netherlands
| | - Bertrand Porro
- University of Angers, University of Rennes, Inserm, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, SFR ICAT, Angers, France
| | - Yves Roquelaure
- UMR Inserm S 1085, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail) – University of Angers, CHU Angers, University of Rennes, SFR ICAT, Angers, France
| | - Marianne Bourdon
- UMR INSERM 1246 SPHERE “Methods in Patient-Centered Outcomes and HEalth ResEarch”, Nantes University, University of Tours, Nantes, France
- Integrated Center for Oncology, Nantes, France
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22
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Paltrinieri S, Vicentini M, Mancuso P, Mazzini E, Fugazzaro S, Rossi PG, Costi S. Return to work of Italian cancer survivors: A focus on prognostic work-related factors. Work 2022; 71:681-691. [DOI: 10.3233/wor-210008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND: Return to work (RTW) enhances the general well-being and social participation of cancer survivors (CSs). OBJECTIVE: To describe the predictive value of work-related factors on the RTW process of CSs. The work accommodations, the perceived workload, and the barriers and facilitations of RTW are also reported. METHODS: This population-based cross-sectional survey was conducted in the Province of Reggio Emilia from July 2016 to July 2017. CSs who were 20–59 years old, first diagnosed with cancer, and employed at diagnosis were recruited. RESULTS: The majority of CSs (140/266, 53%) returned to work without difficulties, 42% reported difficulties, and 5% did not RTW. CSs who were shift workers (sex and age-adjusted Relative Risk [adj-RR] 1.30; 95% CI 0.94 –1.78) and who worked at night (adj-RR 1.36 95% CI 0.99 –1.86), in the evening (adj-RR 1.23; 95% CI 0.95 –1.57) and on Sundays (adj-RR 1.15; 95% CI 0.81 –1.63) perceived more difficulties. Physically demanding work and a long commute seemed to negatively impact RTW. Accommodations in work tasks (37%) or schedule (26%) were implemented. Workload was not acceptable for 18% of CSs. The main barriers concerned energy and drive functions, whereas remunerative employment was the foremost facilitation. CONCLUSIONS: Healthcare professionals should address work-related factors that might influence RTW with personalized interventions of vocational rehabilitation.
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Affiliation(s)
- Sara Paltrinieri
- Physical Medicine and Rehabilitation Unit, AziendaUnità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Massimo Vicentini
- Epidemiology Unit, Azienda Unità SanitariaLocale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Pamela Mancuso
- Epidemiology Unit, Azienda Unità SanitariaLocale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Elisa Mazzini
- Medical Directorate, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Stefania Fugazzaro
- Physical Medicine and Rehabilitation Unit, AziendaUnità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Paolo Giorgi Rossi
- Epidemiology Unit, Azienda Unità SanitariaLocale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Stefania Costi
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, Università di Modena eReggio Emilia, Reggio Emilia, Italy
- Scientific Directorate, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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Schulz IL, Stegmann R, Wegewitz U, Bethge M. The Current Practice of Gradual Return to Work in Germany: A Qualitative Study Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3740. [PMID: 35329425 PMCID: PMC8955514 DOI: 10.3390/ijerph19063740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/17/2022] [Accepted: 03/18/2022] [Indexed: 11/30/2022]
Abstract
(1) Background: The increase in working age and long-term illnesses is a challenge for society to maintain the health of employees and to support their work participation. In many countries, such as Germany, a gradual return to work (GRTW) is used frequently to support returning employees, but little is known about its facilitators and obstacles. This protocol aims to provide an overview of the national state of the art in workplace adjustments during return to work and to outline the design of a qualitative study examining current GRTW practices in Germany. (2) Methods: Our qualitative study will examine the current implementation of GRTW by means of 32 narrative interviews and 10 group discussions from different perspectives. Therefore, we will ask returning employees as well as organisational stakeholders and external experts about their experiences with GRTW and attitudes towards the measure. The verbal data obtained will be analysed using the documentary method of interpretation. (3) Discussion: This study will reveal facilitating and hindering factors for the implementation of GRTW in Germany. The findings of the study may contribute to an improved implementation of GRTW not only in Germany.
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Affiliation(s)
- Inga L. Schulz
- Department 3.5 Evidence Based Occupational Health and Workplace Health Management, Federal Institute for Occupational Safety and Health (BAuA), 10317 Berlin, Germany; (R.S.); (U.W.)
| | - Ralf Stegmann
- Department 3.5 Evidence Based Occupational Health and Workplace Health Management, Federal Institute for Occupational Safety and Health (BAuA), 10317 Berlin, Germany; (R.S.); (U.W.)
| | - Uta Wegewitz
- Department 3.5 Evidence Based Occupational Health and Workplace Health Management, Federal Institute for Occupational Safety and Health (BAuA), 10317 Berlin, Germany; (R.S.); (U.W.)
| | - Matthias Bethge
- Institute for Social Medicine and Epidemiology, University of Luebeck, 23562 Luebeck, Germany;
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Veenstra CM, Braun TM, Abrahamse PH, Wittmann D, Hawley ST. Employment outcomes in family supporters of patients with early stage breast cancer and their association with patients' health-related quality of life and financial burden. Cancer Med 2022; 11:1324-1335. [PMID: 35112499 PMCID: PMC8894687 DOI: 10.1002/cam4.4513] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 11/29/2021] [Accepted: 12/03/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Little is known about how cancer impacts the employment status of patients' family supporters, or about associations between patients' health-related quality of life, perceived financial burden, and supporters' employment trajectory. METHODS We surveyed patients with early stage breast cancer reported to the Georgia and Los Angeles SEER registries in 2014-15, and their spouse/partner or other family supporters. Patients and supporters were asked about employment impacts of the patient's cancer, and descriptive analyses of supporters' employment trajectories were generated. We measured patients' health-related quality of life (HRQoL) using the PROMIS scale for global health. We measured patients' perceived financial burden attributed to cancer by asking them two questions regarding (i) their financial status since their breast cancer diagnosis and (ii) how much it was impacted by their breast cancer and treatment. Associations between patients' HRQoL, perceived financial burden, and supporters' employment status were assessed using linear mixed model regression analyses. RESULTS In total, 2502 patients (68% response rate) and 1203 supporters (70% response rate) responded; 1057 paired patient-supporter dyads were included. Similar proportions of spouse/partner and other family supporters reported missed work and lost employment due to patients' cancer. After adjustment, lower HRQoL and an increased odds of perceived financial burden among patients were associated with changes in other family supporters' employment (both p < 0.05), but not with changes in spouses'/partners' employment. Lower HRQoL was also associated with changes in patients' own employment among patients with both types of supporters (both p < 0.001). An increased odds of perceived financial burden among patients was associated with changes in patients' employment only in those supported by other family members (p < 0.001). CONCLUSIONS Both spouse/partner and other family supporters faced adverse employment outcomes due to patients' cancer. This contributes to worse HRQoL and greater perception of financial burden among patients, especially those whose supporter is not a spouse/partner.
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Affiliation(s)
- Christine M. Veenstra
- Division of Hematology/OncologyDepartment of Internal MedicineUniversity of MichiganAnn ArborMichiganUSA
- Institute for Healthcare Policy and InnovationUniversity of MichiganAnn ArborMichiganUSA
| | - Thomas M. Braun
- Institute for Healthcare Policy and InnovationUniversity of MichiganAnn ArborMichiganUSA
- Department of BiostatisticsUniversity of MichiganAnn ArborMichiganUSA
| | - Paul H. Abrahamse
- Department of BiostatisticsUniversity of MichiganAnn ArborMichiganUSA
| | - Daniela Wittmann
- Institute for Healthcare Policy and InnovationUniversity of MichiganAnn ArborMichiganUSA
- Department of UrologyUniversity of MichiganAnn ArborMichiganUSA
| | - Sarah T. Hawley
- Institute for Healthcare Policy and InnovationUniversity of MichiganAnn ArborMichiganUSA
- Department of Internal MedicineUniversity of MichiganAnn ArborMichiganUSA
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Pituskin E. Cancer as a new chronic disease: Oncology nursing in the 21st Century. Can Oncol Nurs J 2022; 32:87-92. [PMID: 35280062 PMCID: PMC8849169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023] Open
Affiliation(s)
- Edith Pituskin
- Associate Professor, Faculty of Nursing, Associate Clinical Professor, Dept of Oncology, Tier 2 Canada Research Chair, University of Alberta, P: 780-432-8221 | F: 780-492-2551
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26
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Pituskin E. [Not Available]. Can Oncol Nurs J 2022; 32:93-99. [PMID: 35280060 PMCID: PMC8849167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023] Open
Affiliation(s)
- Edith Pituskin
- Professeure agrégée, Faculté des sciences infirmières, Professeure agrégée d'enseignement clinique, Département d'oncologie, Chaire de recherche du Canada de niveau 2, Université de l'Alberta, Tél. : 780-432-8221 | Téléc. : 780-492-2551
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Yagil D, Goldblatt H, Cohen M. Family members' experiences of the return to work of cancer survivors. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:184-192. [PMID: 33852745 DOI: 10.1111/hsc.13388] [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] [Received: 08/23/2020] [Revised: 02/14/2021] [Accepted: 03/15/2021] [Indexed: 06/12/2023]
Abstract
Although family members play an important role in various aspects of coping with cancer and are significantly affected by it, little is known about their perspectives regarding return to work (RTW). This study explored attitudes and experiences of cancer survivors' family members related to cancer survivors' RTW. The present study consists of a qualitative research design, employing in-depth semistructured interviews with first-degree family members (N = 21) of cancer survivors who were approached through online social networks: spouses, children, parents and siblings. Grounded theory techniques were used for data analysis. Four themes emerged from the interviews: (a) the family's cautious voice in return-to-work decision making; (b) work-home imbalance; (c) inhibiting or promoting the effect of work on the recovery process and (d) expectations and appreciation of unconditional workplace support. The findings suggest that psychosocial and health care professionals should help family members play an active role in the decision of RTW. Professionals should also prepare family members for potential costs of RTW for the family and help them develop realistic expectations regarding workplace support of the cancer survivor.
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Affiliation(s)
- Dana Yagil
- Department of Human Services, University of Haifa, Haifa, Israel
| | - Hadass Goldblatt
- Department of Human Services, University of Haifa, Haifa, Israel
| | - Miri Cohen
- Department of Human Services, University of Haifa, Haifa, Israel
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van der Mei SF, Alma MA, de Rijk AE, Brouwer S, Gansevoort RT, Franssen CFM, Bakker SJL, Hemmelder MH, Westerhuis R, van Buren M, Visser A. Barriers to and Facilitators of Sustained Employment: A Qualitative Study of Experiences in Dutch Patients With CKD. Am J Kidney Dis 2021; 78:780-792. [PMID: 34118302 DOI: 10.1053/j.ajkd.2021.04.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 04/02/2021] [Indexed: 02/06/2023]
Abstract
RATIONALE & OBJECTIVE Although patients with chronic kidney disease (CKD) are at risk for work disability and loss of employment, not all experience work disruption. We aimed to describe the barriers to and facilitators of sustained employment experienced by Dutch patients with CKD. STUDY DESIGN Qualitative study using semistructured interviews. SETTING & PARTICIPANTS 27 patients with CKD glomerular filtration rate categories 3b-5 (G3b-G5) from 4 nephrology outpatient clinics in The Netherlands. ANALYTICAL APPROACH Content analyses with constant comparison of interview data based on the International Classification of Functioning, Disability and Health framework. RESULTS Participants were 6 patients with CKD G3b-G4, 8 patients receiving maintenance dialysis, and 13 patients with functioning kidney transplants. We identified health-related barriers (symptoms, physical toll of dialysis/transplantation, limited work capacity) and facilitators (few physical symptoms, successful posttransplantation recovery, absence of comorbidities, good physical condition), personal barriers (psychological impact, limited work experience) and facilitators (positive disposition, job satisfaction, work attitude, person-job fit), and environmental barriers and facilitators. Environmental barriers were related to nephrology care (waiting time, use of a hemodialysis catheter) and work context (reorganization, temporary contract, working hours, physical demands); environmental facilitators were related to nephrology care (personalized dialysis, preemptive transplant), work context (large employer, social climate, job requiring mental rather than physical labor, flexible working hours, adjustment of work tasks, reduced hours, remote working, support at work, peritoneal dialysis exchange facility), and support at home. Occupational health services and social security could be barriers or facilitators. LIMITATIONS The study sample of Dutch patients may limit the transferability of these findings to other countries. CONCLUSIONS The wide range of barriers and facilitators in all International Classification of Functioning, Disability and Health components suggests great diversity among patients and their circumstances. These findings underline the importance of personalized nephrology and occupational health care as well as the importance of individually tailored workplace accommodations to promote sustained employment for patients with CKD.
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Affiliation(s)
| | - Manna A Alma
- Department of Health Sciences, Applied Health Research, Groningen
| | - Angelique E de Rijk
- Department of Social Medicine, CAPHRI Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht
| | - Sandra Brouwer
- Department of Health Sciences, Community and Occupational Medicine, Groningen
| | | | | | | | - Marc H Hemmelder
- Department of Internal Medicine, Medical Centre Leeuwarden, Leeuwarden
| | - Ralf Westerhuis
- University Medical Center Groningen, University of Groningen; Dialysis Center Groningen, Groningen
| | - Marjolijn van Buren
- Department of Internal Medicine, HagaHospital, The Hague; Department of Nephrology, Leiden University Medical Center, Leiden, The Netherlands
| | - Annemieke Visser
- Department of Health Sciences, Applied Health Research, Groningen
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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.
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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
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30
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Porro B, Durand MJ, Petit A, Bertin M, Roquelaure Y. Return to work of breast cancer survivors: toward an integrative and transactional conceptual model. J Cancer Surviv 2021; 16:590-603. [PMID: 33950477 PMCID: PMC8098638 DOI: 10.1007/s11764-021-01053-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 04/26/2021] [Indexed: 12/24/2022]
Abstract
Purpose To propose a conceptual framework of the return to work (RTW) of breast cancer survivors (BCS) according to the transactional perspective. Methods The Technique for Research of Information by Animation of a Group of Experts was implemented. For each determinant in an initial list established from the literature, experts selected for the consensus exercise were firstly asked to indicate their agreement level individually, via an online questionnaire. Determinants obtaining an agreement level of 80% or over during this first phase were retained. Determinants obtaining an agreement level below 80%, and additional determinants proposed by the experts, were then discussed collectively. After discussion, experts voted via a new online questionnaire to retain (or not) each determinant. Determinants obtaining an agreement level of 80% or over after this second phase were retained. Based on the determinants selected, a conceptual model was developed following the transactional approach. Results Eleven experts participated in the study. Forty of the 51 determinants listed initially from the literature achieved an agreement level over 80%, and 20 were added after the individual consultation phase. Twenty-two of the 31 determinants discussed collectively were retained. In total, 62 determinants were selected to construct the conceptual model. Conclusions This integrative, operational, and transactional conceptual model of the RTW of BCS, constructed following an expert consensus, will help to design more efficient patient-centered intervention studies. Implications for Cancer Survivors Identification of the 62 determinants associated with the RTW of BCS will help design tools that are easily used by all stakeholders involved in the RTW process.
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Affiliation(s)
- Bertrand Porro
- Univ Angers, Univ Rennes, Inserm, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, SFR ICAT, F-49000, Angers, France.
| | - Marie-José Durand
- Centre d'action en prévention et réadaptation des incapacités au travail (CAPRIT), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada.,Centre de recherche Charles-Le-Moyne-Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada.,School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
| | - Audrey Petit
- Univ Angers, Univ Rennes, Inserm, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, SFR ICAT, F-49000, Angers, France.,Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, SFR ICAT, F-49000, Angers, France
| | - Mélanie Bertin
- Univ Angers, Univ Rennes, Inserm, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, SFR ICAT, F-49000, Angers, France.,Univ. Rennes, EHESP, REPERES (Recherche en pharmaco-épidémiologie et recours aux soins) - EA 7449, F-35000, Rennes, France
| | - Yves Roquelaure
- Univ Angers, Univ Rennes, Inserm, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, SFR ICAT, F-49000, Angers, France.,Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, SFR ICAT, F-49000, Angers, France
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Hatton R, Wallis A, Chew A, Stanley M, Smith A. Return to work and cancer: Perspectives of occupational therapists. Aust Occup Ther J 2021; 68:298-307. [PMID: 33686685 DOI: 10.1111/1440-1630.12727] [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] [Received: 09/29/2020] [Revised: 02/04/2021] [Accepted: 02/15/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Progress in the early detection, diagnosis, and treatment of cancer has translated into more people in Australia living with and beyond cancer. Therefore, there is a larger number of people returning to work following cancer treatment while managing ongoing symptoms of cancer, and side effects of treatment. The purpose of this study was to explore the facilitators and barriers for return to work for someone with cancer, from the perspective of occupational therapists. METHOD This study used a qualitative descriptive design. Participants were recruited via key contacts within the industry and relevant interest groups, and included eight occupational therapists with experience supporting someone with cancer to return to work. Data were collected in semi-structured in-depth Interviews which were audio recorded, transcribed verbatim, and analysed thematically. FINDINGS Two main themes were developed; expectations of the cancer experience versus reality, and vulnerability during return to work. Occupational therapists perceived that the person with cancer, employers, family members, co-workers, and society underestimate the impact of ongoing cancer symptoms on return to work. Return to work was challenging as survivors face unexpected challenges due to ongoing fatigue, cognitive difficulties, or psychological factors. Fear of relapse, concerns regarding disclosure affecting how people with cancer are perceived at work, and worries of leaving the high levels of professional support during treatment, also affected return to work. CONCLUSION Findings from this study may contribute to occupational therapists and people with cancer setting realistic expectations for the return to work experience. Furthermore, it may provide support for occupational therapists to work more effectively with their clients to facilitate a smoother transition back to work as a cancer survivor.
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Affiliation(s)
| | - Amy Wallis
- Edith Cowan University, Joondalup, WA, Australia
| | - Angela Chew
- Edith Cowan University, Joondalup, WA, Australia
| | | | - Andrew Smith
- Leukaemia Foundation, North Melbourne, Vic., Australia
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Abstract
PURPOSE OF REVIEW There is a lack of evidence worldwide on return to work (RTW) in head and neck cancer (HNC), possibly because traditionally those suffering with it were typically at retirement age and survival rates were low. However, in the last 30 years, HNC survival rates have increased, resulting in more people living with the after-effects of treatment for longer, and many are of working-age. The HNC population is also changing because of a 20% increased incidence of oral and pharyngeal HNCs especially in the under 65 years of age, likely accounted for by the surge in human papilloma virus positive related HNCs. RECENT FINDINGS The literature suggests that people who have had treatment for HNC return to work less than other cancers. The knowledge base on RTW after HNC is emergent and conclusions are currently difficult to draw. The process of returning and remaining in work is complex, affected by multiple factors and interactions. There is little evidence about work-related experiences from the perspectives of HNC survivors. SUMMARY There is an urgent need for more in-depth exploration of the needs and concerns of HNC survivors returning to work after treatment, with the ultimate aim of work-related intervention development.
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Raque-Bogdan TL, Nellis R, Becker R, Solberg M, Zech O. Walking on thin ice: How cancer survivors manage disclosure at work. J Psychosoc Oncol 2020; 39:252-267. [PMID: 33355039 DOI: 10.1080/07347332.2020.1856282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
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.
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Affiliation(s)
| | | | | | - Megan Solberg
- Department of Counseling Psychology, University of Denver, Denver, CO, USA
| | - Olivia Zech
- Department of Counseling Psychology, University of Denver, Denver, CO, USA
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Online resources supporting workers with chronic episodic disabilities: an environmental scan. INTERNATIONAL JOURNAL OF WORKPLACE HEALTH MANAGEMENT 2020. [DOI: 10.1108/ijwhm-08-2020-0137] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe purpose of this research was to conduct an environmental scan describing publicly available resources focussed on working with an episodic disability and providing information and advice about communication and accommodation to support working people living with episodic disabilities.Design/methodology/approachThe authors conducted an environmental scan of English language, freely available, online resources relevant to episodic disabilities in the workplace. The authors used Google™ to conduct structured keyword searches. Resources were reviewed and data extracted about episodic health condition(s) addressed, intended audience(s), resource format and content about health, legal rights, workplace issues, and accommodation and communication needs.FindingsSearches yielded 5,300 links to websites which was supplemented by 101 links identified by partners. Screening for relevance found 210 resources for which data were extracted. Of them, 158 addressed specific episodic disabilities or episodic disabilities generally. Most resources provided useful information addressing communication and accommodation of episodic disability. However, information specific to the episodic nature of disability was not consistently available. The resources generally lacked interactivity which could potentially limit users in applying the information to their personal circumstances.Practical implicationsThe findings suggest there are good resources to help workers and managers/supervisors navigate accommodations for episodic disabilities. Research should aim to improve the interactivity of information to personalize resources to worker and workplace needs, as well as formally evaluate resources and their outcomes. Practitioners may wish to recommend resources that specifically address workplace challenges for their clients.Originality/valueThe authors believe this is one of few studies that examined publicly available resources relevant to working with episodic disabilities.
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Markovic C, Mackenzie L, Lewis J, Singh M. Working with cancer: A pilot study of work participation among cancer survivors in Western Sydney. Aust Occup Ther J 2020; 67:592-604. [PMID: 32657435 DOI: 10.1111/1440-1630.12685] [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: 04/01/2020] [Revised: 05/19/2020] [Accepted: 06/07/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Around 40% of cancers occur in working-age adults. Improvements in screening and treatment mean that most are expected to live years beyond their diagnosis. However, many experience persistent impairments from treatment such as fatigue, cognitive difficulties, and emotional distress. Work is a key occupation for this population and is an important occupational performance area for occupational therapy intervention. However, little is understood about working with cancer in the Australian context. AIM To pilot a survey to identify factors associated with work participation among cancer survivors, and to determine if the survey collected useful information to build on for further study. METHODS A cross-sectional online survey was developed to measure work participation and factors associated with successful work. Study participants aged 20-65 years, employed at diagnosis, with basic English and computer literacy were recruited from a cancer clinic in Western Sydney over a 3-month period. RESULTS Nineteen survey responses were received and analysed. Participants had returned or remained at work (n = 9, 47.4%), unsuccessfully attempted to return to work (RTW; n = 2, 10.5%), or were on leave from work (n = 8, 42.1%). Of those on leave, most did not plan to RTW (n = 6, 31.6%). Fatigue (n = 15, 78.9%), difficulty concentrating (n = 8, 42.1%), memory issues (n = 8, 42.1%), stomach upset (n = 7, 36.8%), sleep disturbance, (n = 7, 36.8%), and psychological distress (n = 7, 36.8%) impacted perceived work ability. Physically demanding work (n = 8, 42.1%), length of the workday (n = 6, 31.6%), productivity demands (n = 5, 26.3%), and commuting (n = 4, 21.1%) were challenging to manage after cancer. A supportive workplace was a facilitator for work. CONCLUSION Cancer survivors in Western Sydney may face challenges engaging in work after treatment. Work participation may be influenced by side effects of treatment, difficulty performing work demands, and the work environment. Services may be needed for cancer survivors to navigate RTW.
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Affiliation(s)
- Cresta Markovic
- Discipline of Occupational Therapy, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Lidcombe, NSW, Australia
| | - Lynette Mackenzie
- Discipline of Occupational Therapy, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Lidcombe, NSW, Australia
| | - Joanne Lewis
- Discipline of Occupational Therapy, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Lidcombe, NSW, Australia
| | - Michelle Singh
- Occupational Therapy, Blacktown Cancer and Haematology Centre, Blacktown, NSW, Australia
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de Moor JS, Kent EE, McNeel TS, Virgo KS, Swanberg J, Tracy JK, Banegas MP, Han X, Qin J, Yabroff KR. Employment Outcomes Among Cancer Survivors in the United States: Implications for Cancer Care Delivery. J Natl Cancer Inst 2020; 113:641-644. [PMID: 32533839 DOI: 10.1093/jnci/djaa084] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 05/19/2020] [Accepted: 06/08/2020] [Indexed: 11/14/2022] Open
Abstract
The national prevalence of employment changes after a cancer diagnosis has not been fully documented. Cancer survivors who worked for pay at or since diagnosis (n = 1490) were identified from the 2011, 2016, and 2017 Medical Expenditure Panel Survey and Experiences with Cancer supplement. Analyses characterized employment changes due to cancer and identified correlates of those employment changes. Employment changes were made by 41.3% (95% confidence interval [CI] = 38.0% to 44.6%) of cancer survivors, representing more than 3.5 million adults in the United States. Of these, 75.4% (95% CI = 71.3% to 79.2%) took extended paid time off and 46.1% (95% CI = 41.6% to 50.7%) made other changes, including switching to part-time or to a less demanding job. Cancer survivors who were younger, female, non-White, or multiple races and ethnicities, and younger than age 20 years since last cancer treatment were more likely to make employment changes. Findings highlight the need for patient-provider communication about the effects of cancer and its treatment on employment.
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Affiliation(s)
- Janet S de Moor
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Erin E Kent
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, NC, USA
| | | | | | - Jennifer Swanberg
- Department of Health Policy & Management, School of Professional Studies, Providence College, Providence, RI, USA
| | | | - Matthew P Banegas
- Center for Health Research, Kaiser Permanente Northwest, Portland, OR, USA
| | - Xuesong Han
- Surveillance and Health Services Research Program, Department of Intramural Research, American Cancer Society, Atlanta, GA, USA
| | - Jin Qin
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - K Robin Yabroff
- Surveillance and Health Services Research Program, Department of Intramural Research, American Cancer Society, Atlanta, GA, USA
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Abstract
PURPOSE This study explored the experiences of cancer survivors remaining in the workforce, or transitioning back into the workforce following treatment. METHODS Using an exploratory qualitative design, eight individual interviews were conducted with participants undergoing treatment for various cancer diagnoses, all of whom were employed prior to their cancer diagnosis. FINDINGS Participants revealed that work provided them with a sense of normalcy, purpose, and personal identity. All but one participant voiced the benefits of having a supportive work environment. Many also shared they had experienced financial burden and were unaware of where to seek financial assistance. CONCLUSION Future research needs to further explore how the healthcare team and employer can promote supportive work environments and increase cancer survivors' awareness and access to financial resources.
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Affiliation(s)
- Debbie Kane
- Associate Dean, Faculty of Graduate Studies, University of Windsor, 401 Sunset Ave., Windsor, ON N9B 3P4, (519) 253-3000 #2268, ,
| | - Dale Rajacich
- Professor Emeritus, Faculty of Nursing, University of Windsor, Windsor, ON
| | - Chantal Andary
- 4 year Nursing student, Faculty of Nursing, University of Windsor, Windsor, ON
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de Rijk A, Amir Z, Cohen M, Furlan T, Godderis L, Knezevic B, Miglioretti M, Munir F, Popa AE, Sedlakova M, Torp S, Yagil D, Tamminga S, de Boer A. The challenge of return to work in workers with cancer: employer priorities despite variation in social policies related to work and health. J Cancer Surviv 2020; 14:188-199. [PMID: 31758518 PMCID: PMC7182537 DOI: 10.1007/s11764-019-00829-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 10/23/2019] [Indexed: 11/26/2022]
Abstract
PURPOSE This study explored employer's perspectives on (1) their experience of good practice related to workers diagnosed with cancer and their return to work (RTW), and (2) their perceived needs necessary to achieve good practice as reported by employers from nine separate countries. METHODS Twenty-five semi-structured interviews were held in eight European countries and Israel with two to three employers typically including HR managers or line managers from both profit and non-profit organisations of different sizes and sectors. Interviews were recorded and transcribed verbatim. A grounded theory/thematic analysis approach was completed. RESULTS Employers' experience with RTW assistance for workers with cancer appears to be a dynamic process. Results indicate that good practice includes six phases: (1) reacting to disclosure, (2) collecting information, (3) decision-making related to initial actions, (4) remaining in touch, (5) decision-making on RTW, and (6) follow-up. The exact details of the process are shaped by country, employer type, and worker characteristics; however, there was consistency related to the need for (1) structured procedures, (2) collaboration, (3) communication skills training, (4) information on cancer, and (5) financial resources for realizing RTW support measures. CONCLUSIONS Notwithstanding variations at country, employer, and worker levels, the employers from all nine countries reported that good practice regarding RTW assistance in workers with a history of cancer consists of the six phases above. Employers indicate that they would benefit from shared collaboration and resources that support good practice for this human resource matter. IMPLICATIONS FOR CANCER SURVIVORS Further research and development based on the six phases of employer support as a framework for a tool or strategy to support workers with a history of cancer across countries and organisations is warranted.
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Affiliation(s)
- Angelique de Rijk
- Department of Social Medicine, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.
| | - Ziv Amir
- School of Health Sciences, University of Salford, Greater Manchester, UK
| | - Miri Cohen
- School of Social Work, University of Haifa, Haifa, Israel
| | | | - Lode Godderis
- Department of Public Health and Primary Care, Centre for Environment and Health, KU Leuven, Leuven, Belgium
- IDEWE, External Service for Prevention and Protection at Work, Heverlee, Belgium
| | - Bojana Knezevic
- Department of Quality Improvement in Health Care, University Hospital Centre Zagreb, Zagreb, Croatia
| | | | - Fehmidah Munir
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK
| | - Adela Elena Popa
- Faculty of Social Sciences and Humanities, Lucian Blaga University of Sibiu, Sibiu, Romania
| | - Maria Sedlakova
- Central European Labour Studies Institute, Bratislava, Slovakia
| | - Steffen Torp
- Department of Health, Social and Welfare Studies, University College of South-Eastern Norway, Notodden, Norway
| | - Dana Yagil
- Department of Human Services, University of Haifa, Haifa, Israel
| | - Sietske Tamminga
- Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Angela de Boer
- Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
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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.
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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
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Popa AE, Morândău F, Popa RI, Rusu MS, Sidor A. Supporting the Return to Work After Cancer in Romania: Exploring Employers' Perspectives. JOURNAL OF OCCUPATIONAL REHABILITATION 2020; 30:59-71. [PMID: 31297654 DOI: 10.1007/s10926-019-09846-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Purpose Evidence shows that employers play a key role in facilitating the return to work of employees with cancer, yet little is known about the employers' experiences in settings where no policies or regulations are available to guide this process. Against this background, we aimed (1) to understand how employers experience and manage the process of having employees with cancer and (2) to explore their reflections regarding their role in returning to work. Methods Twenty employers from various types of organisations and sectors were interviewed. Inductive thematic analysis was performed using NVivo 11. Results Employers experienced having employees with cancer as a process with three distinct phases reflected in three emerging themes: disclosure of the diagnosis and absence from work; returning to work; post-returning to work. A fourth theme emphasizes the employers' reflections on how they conceive their own role. In the absence of a normative framework for dealing with employees with cancer, employers used commonsensical rules of thumb and immediate solutions based on ad-hoc decisions and were often compelled to innovate. They offered accommodations only if requested by the employee after returning to work. The return to work process was neither planned nor phased. Conclusion Employers need information and guidelines for effectively assisting employees with cancer. Better channels of communication and collaboration with health professionals are essential for more adequate support for the long-term consequences of cancer. A detailed return to work policy is required to tackle the inconsistencies in the support offered and this policy must also rethink how diagnosis disclosure takes place in Romanian organisations.
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Affiliation(s)
- Adela Elena Popa
- Faculty of Social Sciences and Humanities, Lucian Blaga University of Sibiu, 10 Victoriei Blvd, 550024, Sibiu, Romania.
| | - Felicia Morândău
- Faculty of Social Sciences and Humanities, Lucian Blaga University of Sibiu, 10 Victoriei Blvd, 550024, Sibiu, Romania
| | - Radu-Ioan Popa
- Faculty of Social Sciences and Humanities, Lucian Blaga University of Sibiu, 10 Victoriei Blvd, 550024, Sibiu, Romania
| | - Mihai Stelian Rusu
- Faculty of Social Sciences and Humanities, Lucian Blaga University of Sibiu, 10 Victoriei Blvd, 550024, Sibiu, Romania
| | - Alexandra Sidor
- Faculty of Social Sciences and Humanities, Lucian Blaga University of Sibiu, 10 Victoriei Blvd, 550024, Sibiu, Romania
- Department of Public Health - Faculty of Political, Administrative and Communication Sciences, Babes-Bolyai University, 7 Pandurilor, 400576, Cluj-Napoca, Romania
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Leslie M, Strauser DR, McMahon B, Greco C, Rumrill PD. The Workplace Discrimination Experiences of Individuals with Cancer in the Americans with Disabilities Act Amendments Act Era. JOURNAL OF OCCUPATIONAL REHABILITATION 2020; 30:115-124. [PMID: 31359226 DOI: 10.1007/s10926-019-09851-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Background The purpose of this study was to investigate the patterns in allegations of workplace discrimination filed by individuals with cancer. Objective The goal of the research was to describe discrimination, both actual and perceived, that has occurred against individuals with cancer in comparison to a group of individuals with other general disabilities (GENDIS) through analyses of the United States 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 people with cancer from 2009 through 2016 (n = 10,848) in comparison to the GENDIS group over the same time period (n = 13,338). Results Results revealed statistically significant differences in the patterns of issues alleged by the two groups. When compared to the GENDIS group, the cancer group was significantly older and had proportionally more individuals who identified as Asian than the GENDIS group. People with cancer were more likely to allege discrimination in the areas of unlawful discharge, demotion, wages, layoff, benefits, and referrals. They were less likely to allege discrimination in areas of reasonable accommodation, hiring, and suspension. Also, the cancer group was more likely than the GENDIS group to file allegations against smaller employers and employers in the Southeast region of the United States, while employers in the Mid-Atlantic and Rocky Mountain regions were less likely to be named in allegations by people with cancer. The cancer group was also significantly more likely than the GENDIS group to find that EEOC investigations of their allegations resulted in merit-based case resolution, that is, discrimination had indeed occurred. Owing to the large sample size, some of these between-group differences were small in magnitude. Conclusion The workplace discrimination experiences of people with cancer are substantially different from those of people with other disabilities.
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Affiliation(s)
- Mykal Leslie
- Kent State University, Kent, OH, USA.
- CRC, Kent State University, 405G White Hall, P.O. Box 5190, Kent, OH, USA.
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Yabroff KR, Bradley C, Shih YCT. Understanding Financial Hardship Among Cancer Survivors in the United States: Strategies for Prevention and Mitigation. J Clin Oncol 2019; 38:292-301. [PMID: 31804869 DOI: 10.1200/jco.19.01564] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Affiliation(s)
- K Robin Yabroff
- Surveillance and Health Services Research Program, American Cancer Society, Atlanta, GA
| | - Cathy Bradley
- University of Colorado Comprehensive Cancer Center and Colorado School of Public Health, Aurora, CO
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Zamanzadeh V, Valizadeh L, Zirak M, Rahmani A. Taking an obscure path, a common concern during returning to work after cancer. JOURNAL OF VOCATIONAL REHABILITATION 2019. [DOI: 10.3233/jvr-191052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Vahid Zamanzadeh
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leila Valizadeh
- Department of Pediatric Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Zirak
- Student Research Committee, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Azad Rahmani
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
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Tamminga SJ, Wolvers MDJ, Greidanus MA, Zaman AGNM, Braspenning AM, Frings-Dresen MHW, de Boer AGEM. Employees Diagnosed with Cancer: Current Perspectives and Future Directions from an Employer's Point of View. JOURNAL OF OCCUPATIONAL REHABILITATION 2019; 29:472-474. [PMID: 30039313 PMCID: PMC6531607 DOI: 10.1007/s10926-018-9802-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Purpose and methods Cancer survivors have a higher risk of adverse work outcomes such as not being able to return to work (RTW). The process of returning to work is complex as a result of the diverse stakeholders and numerous factors involved related to the employee diagnosed with cancer, the work environment, health care system, and the legal system. One of the key stakeholders is the employer, as the employer is in the position to facilitate work accommodations. Therefore, the purpose of this brief review is to consider opportunities regarding the role of the employer to enhance the work participation of employees with cancer. Results and conclusions We currently know little about which aspects of employer support have a positive impact on the ability of employees diagnosed with cancer to retain at work or RTW. In addition, there is a lack of interventions and tools which support employers in their management of employees diagnosed with cancer. The inclusion of employer support into the workplace can help employees diagnosed with cancer with their work retention and RTW, which is an important aspect of their quality of life and benefits the society at large.
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Affiliation(s)
- Sietske J Tamminga
- Coronel Institute of Occupational Health, Academic Medical Center (AMC), University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
| | - Marije D J Wolvers
- Coronel Institute of Occupational Health, Academic Medical Center (AMC), University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Michiel A Greidanus
- Coronel Institute of Occupational Health, Academic Medical Center (AMC), University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - AnneClaire G N M Zaman
- Coronel Institute of Occupational Health, Academic Medical Center (AMC), University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Anna M Braspenning
- Coronel Institute of Occupational Health, Academic Medical Center (AMC), University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Monique H W Frings-Dresen
- Coronel Institute of Occupational Health, Academic Medical Center (AMC), University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Angela G E M de Boer
- Coronel Institute of Occupational Health, Academic Medical Center (AMC), University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Gruß I, Hanson G, Bradley C, McMullen C, Ritzwoller D, Hodge S, Varga A, Banegas MP. Colorectal cancer survivors' challenges to returning to work: A qualitative study. Eur J Cancer Care (Engl) 2019; 28:e13044. [PMID: 31006931 DOI: 10.1111/ecc.13044] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 02/22/2019] [Accepted: 03/25/2019] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To assess the challenges and needs of colorectal cancer (CRC) survivors in maintaining employment and returning to work (RTW) from the perspectives of both CRC survivors and employers in the United States. METHODS Semi-structured interviews with CRC survivors (n = 10) and employers (n = 4) were transcribed, coded and thematically analysed using NVivo 12 software. RESULTS Workplace challenges for survivors included the following: inadequate availability of paid and unpaid leave, limited availability of workplace accommodations, and employers' lack of knowledge about CRC and the recovery process. Survivors were concerned about the lack of adequate financial resources to take unpaid leave and the need to relearn control of bodily functions. Workplace challenges for employers of cancer survivors included the following: limited institutional flexibility to provide individualised accommodations, communication with frontline managers about leave availability for employees and communication with employees about legal protections and limitations. Employers perceived that employees were unwilling to take leave. CONCLUSION Colorectal cancer survivors in the US face difficult, sometimes insurmountable, challenges when trying to balance their physical and financial needs within the constraints of employment. Employers recognise challenges associated with this concern. Multi-level interventions-ranging from flexible work schedules to training for frontline managers-might facilitate the RTW process.
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Affiliation(s)
- Inga Gruß
- Kaiser Permanente Center for Health Research, Portland, Oregon
| | - Ginger Hanson
- Johns Hopkins University School of Nursing, Baltimore, Maryland
| | - Cathy Bradley
- Colorado School of Public Health, University of Colorado Denver, Aurora, Colorado
| | - Carmit McMullen
- Kaiser Permanente Center for Health Research, Portland, Oregon
| | - Debra Ritzwoller
- Kaiser Permanente Colorado Institute for Health Research, Aurora, Colorado
| | - Stephanie Hodge
- Kaiser Permanente Center for Health Research, Portland, Oregon
| | - Alexandra Varga
- Kaiser Permanente Center for Health Research, Portland, Oregon
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Return to Work Interventions for Cancer Survivors: A Systematic Review and a Methodological Critique. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16081343. [PMID: 31014004 PMCID: PMC6518012 DOI: 10.3390/ijerph16081343] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 04/11/2019] [Accepted: 04/12/2019] [Indexed: 12/24/2022]
Abstract
Cancer patients are more at risk of being unemployed or having difficulties to return to work (RTW) compared to individuals without health concerns, and is thus a major public health issue. The aim of this systematic review is to identify and describe the interventions developed specifically to help cancer patients to RTW after treatment. Two researchers independently screened the articles for inclusion and Critical Appraisal Skills Program (CASP) checklists were used to assess the methodology of the included studies. Ten manuscripts met the inclusion criteria. The type of studies were three quasi-experimental studies, three longitudinal studies, three randomized controlled trials (RCTs) and a qualitative study. RTW interventions were conducted in or outside the hospital (n = 6 and 3 respectively), or both (n = 1). Improvements in RTW were only observed in quasi-experimental studies. No improvement in RTW was noted in RCTs, nor in other measures (e.g., quality of life, fatigue). Lack of statistically significant improvement does not necessarily reflect reality, but may be attributed to non-adapted research methods. This systematic review underscores the need for researches in the RTW field to reach a consensus on RTW criteria and their assessment. Recommendations to this effect are suggested.
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Lyons KD, Newman RM, Sullivan M, Pergolotti M, Braveman B, Cheville AL. Employment Concerns and Associated Impairments of Women Living With Advanced Breast Cancer. Arch Rehabil Res Clin Transl 2019; 1:100004. [PMID: 33543044 PMCID: PMC7853337 DOI: 10.1016/j.arrct.2019.100004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective To describe the clinical and personal factors associated with work status, distress regarding work status, and the desire to resume employment and receive help to address work challenges reported by women living with advanced breast cancer. Design Descriptive statistics and univariate and multivariate logistic regression were used to explore factors related to employment challenges in this secondary analysis of an existing dataset. Setting Participants were recruited from an outpatient oncology clinic specializing in breast cancer at a free-standing comprehensive cancer center. Participants English-speaking women older than 18 years living with metastatic breast cancer with intact mental status and Karnofsky Performance Scale scores between 40 and 90 (N=163). Intervention Not applicable. Main Outcome Measures Dependent variables included (1) continued employment if working at the time of cancer diagnosis; (2) interest in resuming employment if working at the time of cancer diagnosis and now no longer working; (3) distress regarding vocational limitations; and (4) interest in receiving help to resume work. Results Seventy percent of the sample was working before their cancer diagnosis (n=114), yet only 21% (n=35) was working when surveyed. Lower functional status and higher symptom burden were strongly and consistently associated with lack of work retention, distress related to vocational role limitations, and desire for help in addressing limitations (all P values<.01). Conclusions With more people living longer with metastatic cancer, there is a need to assess and support survivors’ desire and capacity to maintain employment. Participants’ reduced employment was strongly associated with potentially actionable clinical targets (ie, higher symptom burden and lower functional status) that fall within cancer rehabilitation’s mission.
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Affiliation(s)
- Kathleen Doyle Lyons
- Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.,Department of Psychiatry, Dartmouth College, Hanover, New Hampshire
| | - Robin M Newman
- Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, Massachusetts
| | | | | | | | - Andrea L Cheville
- Physical Medicine and Rehabilitation Department, Mayo Clinic, Rochester, Minnesota
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Bradley CJ, Brown KL, Haan M, Glasgow RE, Newman LS, Rabin B, Ritzwoller DP, Tenney L. Cancer Survivorship and Employment: Intersection of Oral Agents, Changing Workforce Dynamics, and Employers’ Perspectives. J Natl Cancer Inst 2018; 110:1292-1299. [DOI: 10.1093/jnci/djy172] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 08/24/2018] [Indexed: 11/13/2022] Open
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Zamanzadeh V, Valizadeh L, Rahmani A, Zirak M, Desiron H. Cancer survivors' experiences of return to work: A qualitative study. Psychooncology 2018; 27:2398-2404. [DOI: 10.1002/pon.4840] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 07/08/2018] [Accepted: 07/13/2018] [Indexed: 01/22/2023]
Affiliation(s)
- Vahid Zamanzadeh
- Department of Medical Surgical Nursing, School of Nursing and Midwifery; Tabriz University of Medical Sciences; Tabriz Iran
| | - Leila Valizadeh
- Department of Pediatric Nursing, School of Nursing and Midwifery; Tabriz University of Medical Sciences; Tabriz Iran
| | - Azad Rahmani
- Department of Medical Surgical Nursing, School of Nursing and Midwifery; Tabriz University of Medical Sciences; Tabriz Iran
| | - Mohammad Zirak
- School of Nursing and Midwifery; Tabriz University of Medical Sciences; Tabriz Iran
| | - Huget Desiron
- Occupational Therapy Education, Department of Health Care; University College of Hasselt PXL; Hasselt Belgium
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Thomson MD, Siminoff LA. Managing work and cancer treatment: Experiences among survivors of hematological cancer. Cancer 2018; 124:2824-2831. [PMID: 29660822 DOI: 10.1002/cncr.31375] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 03/04/2018] [Accepted: 03/09/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND The current study was performed to characterize the employment status of survivors of hematological cancer who have an informal caregiver from the time of diagnosis through the first 6 months of treatment. METHODS Using a mixed methods approach, semistructured interviews with survivors of hematological cancer were conducted within 6 months of the initiation of cancer treatment. Interviews assessed cancer treatment status, barriers and facilitators to employment, financial and insurance status, and relationship with the primary caregiver. These results are part of a longitudinal study of cancer survivors and informal caregivers. RESULTS A total of 171 patients were enrolled. Within 6 months of beginning cancer treatments, approximately 35% were no longer employed. Reasons to remain employed included financial need, employee benefits, and a sense of purpose and normalcy. Employer accommodations and supportive colleagues facilitated continued employment. Logistic regression analysis demonstrated that having a higher household income, a desire to work, nonphysical job tasks, and congruent survivor-caregiver communication were associated with greater odds of remaining employed. CONCLUSIONS Within 6 months of initiating cancer treatment, the majority of survivors of hematological cancer had maintained employment. Because of the limitations imposed by the physical stress of cancer treatments, as well as the need to maintain employment to continue receiving employee benefits to cover such treatments, survivors of hematological cancer likely would benefit from employment accommodations that are sensitive to their unique needs. Cancer 2018;124:2824-2831. © 2018 American Cancer Society.
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Affiliation(s)
- Maria D Thomson
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia
| | - Laura A Siminoff
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, Pennsylvania
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