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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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Ghazal LV, Doran J, Bryant M, Zebrack B, Liang MI. Evaluation of a Conference on Cancer-Related Financial and Legal Issues: A Potential Resource to Counter Financial Toxicity. Curr Oncol 2024; 31:2817-2835. [PMID: 38785495 PMCID: PMC11119701 DOI: 10.3390/curroncol31050214] [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: 04/08/2024] [Revised: 05/09/2024] [Accepted: 05/13/2024] [Indexed: 05/25/2024] Open
Abstract
This study describes the conception, development, and growth of the Triage Cancer Conference hosted by Triage Cancer, a national nonprofit organization providing free legal and financial education to the cancer community. We conducted a retrospective analysis of post-conference participant surveys. Descriptive statistics were calculated for participant demographics, and acceptability, feasibility, and appropriateness were evaluated. From 2016-2021, 1239 participants attended the conference and completed post-conference surveys. Participants included social workers (33%), nurses (30%), and cancer patients/survivors (21%), with representation from over 48 states. Among those who reported race, 16% were Black, and 7% were Hispanic. For acceptability, more than 90% of participants felt that the conference content, instructors, and format were suitable and useful. For feasibility, more than 90% of participants felt that the material was useful, with 93-96% reporting that they were likely to share the information and 98% reporting that they would attend another triage cancer event. Appropriateness was also high, with >80-90% reporting that the sessions met the pre-defined objectives. Triage Cancer fills an important gap in mitigating financial toxicity, and formal evaluation of these programs allows us to build evidence of the role and impact of these existing resources. Future research should focus on adding validated patient-reported outcomes, longer-term follow-up, and ensuring inclusion and evaluation of outcome metrics among vulnerable populations.
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Affiliation(s)
- Lauren V. Ghazal
- School of Nursing, University of Rochester, Rochester, NY 14642, USA
- Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Joanna Doran
- Triage Cancer, Chicago, IL 60646, USA; (J.D.); (M.B.)
| | - Monica Bryant
- Triage Cancer, Chicago, IL 60646, USA; (J.D.); (M.B.)
| | - Brad Zebrack
- School of Social Work, University of Michigan, Ann Arbor, MI 48109, USA;
| | - Margaret I. Liang
- Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA;
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Wechsler S, Ma M, El-Jawahri A, Laws KE, Naticchioni H, Flannery K, Coleman A, Lyons K. Employment-related Education and Support for Cancer Survivors: a Content Analysis of Employment Resources Offered on National Cancer Institute-Designated Cancer Center Websites. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2024; 39:139-146. [PMID: 38051463 DOI: 10.1007/s13187-023-02386-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/11/2023] [Indexed: 12/07/2023]
Abstract
High rates of employment changes and associated concerns among cancer survivors following diagnosis and treatment suggest a need to examine what employment-related educational resources and support are currently being offered to cancer survivors and what gaps exist in those resources. In 2023, we conducted a content analysis of employment resources described on the websites of the NCI-Designated Cancer Centers that provide clinical care (N = 64) through a systematic review procedure using predetermined search terms and a standardized process to examine the availability and accessibility of such resources. Descriptive analyses were conducted to characterize the employment resources identified. In total, 175 employment resources were identified across 49 cancer center websites; 102 (58%) provided patient-facing education/information, 58 (33%) offered a consultation, 14 (8%) offered support groups/classes, and 1 (1%) was classified as "Other." Most (76%) resources were provided internally by the cancer center, and often, more than one discipline was involved, most commonly social work and medicine. These findings are encouraging as they suggest that most (77%) NCI-Designated Cancer Centers recognize employment support as a component of survivorship care. The multidisciplinary nature of the resources identified is supported by moderate evidence that multidisciplinary interventions appear to have the greatest potential to foster a return to work for cancer survivors and align with suggestions made by recent expert groups and guidelines regarding employment support for cancer survivors. Ongoing work is needed to assess the utilization, impact, and equity of available employment resources to optimize work outcomes among cancer survivors.
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Affiliation(s)
- Stephen Wechsler
- Department of Occupational Therapy, MGH Institute of Health Professions, 36 First Avenue, Boston, MA, 02129, USA.
| | - Michele Ma
- Department of Occupational Therapy, MGH Institute of Health Professions, 36 First Avenue, Boston, MA, 02129, USA
| | - Areej El-Jawahri
- Division of Hematology Oncology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Kristen Elizabeth Laws
- Department of Occupational Therapy, MGH Institute of Health Professions, 36 First Avenue, Boston, MA, 02129, USA
| | - Haley Naticchioni
- Department of Occupational Therapy, MGH Institute of Health Professions, 36 First Avenue, Boston, MA, 02129, USA
| | - Kaitlin Flannery
- Department of Occupational Therapy, MGH Institute of Health Professions, 36 First Avenue, Boston, MA, 02129, USA
| | - Alison Coleman
- Department of Occupational Therapy, MGH Institute of Health Professions, 36 First Avenue, Boston, MA, 02129, USA
| | - Kathleen Lyons
- Department of Occupational Therapy, MGH Institute of Health Professions, 36 First Avenue, Boston, MA, 02129, USA
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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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Sheppard DM, O’Connor M, Jefford M, Lamb G, Frost D, Ellis N, Halkett GKB. 'Beyond Cancer' Rehabilitation Program to Support Breast Cancer Survivors to Return to Health, Wellness and Work: Feasibility Study Outcomes. Curr Oncol 2023; 30:2249-2270. [PMID: 36826135 PMCID: PMC9956005 DOI: 10.3390/curroncol30020174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 02/06/2023] [Accepted: 02/09/2023] [Indexed: 02/16/2023] Open
Abstract
More women are returning to work following breast cancer treatment. Our team designed 'Beyond Cancer', a multimodal rehabilitation program to support breast cancer survivors to return to work. This study aimed to determine the feasibility of the intervention from the breast cancer survivor, employer and occupational rehabilitation provider perspectives. The feasibility design focused on implementation, acceptability and preliminary indications of efficacy. Primary outcome measures included work status, work capacity and perceived support at work. Responses were compared with an historical usual care group of mixed cancer survivors. The tailored intervention was delivered over 33 weeks (on average) by trained occupational rehabilitation consultants. Eighty-four women with breast cancer (mean age = 50.8 years, SD = 8.24) who were unable to work in their pre-diagnosis capacity for >3 months participated. Results provided preliminary indications of efficacy for primary work outcomes, including work capacity relative to the historical usual care group, and some secondary biopsychosocial variables (physical fatigue, return to work expectations). The intervention was acceptable, demonstrated strong participant engagement and high satisfaction. Feasibility has been demonstrated for this multimodal intervention focused on returning to sustainable work for women with breast cancer. Future research is required with people diagnosed with other cancer types to demonstrate broader implementation.
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Affiliation(s)
- Dianne M. Sheppard
- Monash University Accident Research Centre, Monash University, Building 70, 21 Alliance Lane, Clayton 3800, Australia
- Correspondence: (D.M.S.); (G.K.B.H.)
| | - Moira O’Connor
- School of Population Health, Curtin University, Kent St, Bentley 6102, Australia
| | - Michael Jefford
- Department of Health Services Research, Peter MacCallum Cancer Centre, 305 Grattan St, Melbourne 3000, Australia
- Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, 305 Grattan St, Melbourne 3000, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville 3010, Australia
| | - Georgina Lamb
- IPAR Rehabilitation, 485 La Trobe St, Melbourne 3000, Australia
| | - Dorothy Frost
- IPAR Rehabilitation, 485 La Trobe St, Melbourne 3000, Australia
| | - Niki Ellis
- Healthy Working Lives Research Group, School of Public Health and Preventive Medicine, Monash University, Level 2, 533 St Kilda Road, Melbourne 3004, Australia
| | - Georgia K. B. Halkett
- Curtin School of Nursing/Curtin Health Innovation Research Institute, Curtin University, Kent St, Bentley 6102, Australia
- Correspondence: (D.M.S.); (G.K.B.H.)
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