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Berkhout MA, Tamminga SJ, de Boer AGEM, Dewa CS, de Jong A, de Rijk AE, Greidanus MA. Pilot implementation of MiLES: a web-based intervention targeted at managers with the aim of enhancing the successful return to work of employees with cancer. Acta Oncol 2023; 62:765-773. [PMID: 37504953 DOI: 10.1080/0284186x.2023.2238886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 07/04/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND MiLES is a web-based intervention targeted at managers with the aim of enhancing the successful return to work (RTW) of employees with cancer. The purpose of this study was to identify barriers to and facilitators of implementing MiLES in organizations, from a manager's perspective. MATERIAL AND METHODS MiLES was implemented as a pilot in four organizations for six weeks. Sixteen managers were included, of which fourteen were interviewed regarding their perceived barriers to and facilitators of implementation of MiLES in their organization. Interviews were recorded, transcribed verbatim and analyzed with content analysis. RESULTS The managers experienced barriers to and facilitators of implementation related to: (1) implementation responsibilities, (2) the intervention's content, and (3) organizational characteristics. Regarding implementation responsibilities, management board approval and an organizational infrastructure with distinct described implementation responsibilities were perceived as facilitators. Regarding the intervention's content, its accessibility, user-friendliness and completeness were perceived as facilitators. If the content did not meet the manager's specific needs, this was perceived as a barrier. Regarding organizational characteristics, several intangible (e.g., added value of MiLES within different organizations) and tangible (e.g., integration into absenteeism registration) organizational characteristics were perceived as facilitators. The absence of a quiet place to use MiLES was perceived as barrier. CONCLUSION Implementation of MiLES in organizations may benefit from an infrastructure within the organization that defines responsibilities regarding intervention delivery to managers of employees with cancer. Such an infrastructure should be aligned to existing organizational structures. As per interviewed managers, MiLES has added value in diverse organizations.
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Affiliation(s)
- M A Berkhout
- Department of Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Department of Nursing Studies, University of Applied Sciences, Utrecht, The Netherlands
| | - S J Tamminga
- Department of Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health research institute, Societal Participation and Health, Amsterdam, The Netherlands
| | - A G E M de Boer
- Department of Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health research institute, Societal Participation and Health, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Cancer treatment and Quality of life, Amsterdam, The Netherlands
| | - C S Dewa
- Department of Psychiatry and Behavioral Sciences and Department of Public Health Sciences, University of California, Davis, Sacramento, CA, USA
| | - A de Jong
- Department of Nursing Studies, University of Applied Sciences, Utrecht, The Netherlands
| | - A E de Rijk
- Department of Social Medicine, Faculty of Health, Medicine and Life Sciences, Primary Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - M A Greidanus
- Department of Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health research institute, Societal Participation and Health, Amsterdam, The Netherlands
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Porro B, Tamminga SJ, de Boer AGEM, Petit A, Roquelaure Y, Greidanus MA. Identification of actions to be taken by managers to facilitate the return to work of cancer survivors: Consensus between managers and cancer survivors. BMC Public Health 2022; 22:1905. [PMID: 36224592 PMCID: PMC9555691 DOI: 10.1186/s12889-022-14271-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 09/28/2022] [Indexed: 11/10/2022] Open
Abstract
Background Managers are considered to be main stakeholders in the return to work (RTW) of cancer survivors. However, the perspectives of cancer survivors and managers differ on what managerial actions should be taken during the RTW of cancer survivors. This difference might put effective collaboration and successful RTW at risk. Therefore, this study aims to reach consensus among managers and cancer survivors on the managerial actions to be taken during the four different RTW phases of cancer survivors (i.e., Disclosure, Treatment, RTW plan, Actual RTW). Methods The Technique for Research of Information by Animation of a Group of Experts (TRIAGE) was implemented with managers and cancer survivors (hereafter referred to as “experts”). An initial list of 24 actions was derived from a previous study. Firstly, for each action, fifteen experts were asked to indicate individually how important this action is per RTW phase (Likert scale from 1 – “Not important at all” to 6 – “Very important”). Consensus was reached when ≥ 80% (i.e., ≥ twelve experts) of the experts rated that action ≥5. Secondly, for each phase of the RTW process, the 15 actions with the highest percentage were discussed with eight experts during the collective consultation, except for the actions that already reached consensus. After discussion, the experts voted whether each action was important (“yes” / “no”) and consensus required ≥ 87.5% (i.e., ≥ seven experts) of the experts to consider an action as important. Results Twenty-five managerial actions were finally retained for at least one of the RTW phases, e.g., Disclosure: “respect privacy” and “radiate a positive attitude”, Treatment: “show appreciation” and “allow sufficient sick leave”, RTW Plan: “tailor” and “communicate”, and Actual RTW: “support practically” and “balance interest”. Conclusion Cancer survivors and managers reached consensus on the importance of 25 managerial actions, distributed into each phase of the RTW process. These actions should be considered an interplay of managerial actions by different stakeholders on the part of the employer (e.g., direct supervisor, HR-manager), and should be a responsibility that is shared by these stakeholders. The collective implementation of these actions within the company will help cancer survivors feel fully supported. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14271-w.
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Affiliation(s)
- B Porro
- 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.
| | - S J Tamminga
- Department of Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.,Amsterdam Public Health research institute, Societal Participation & Health, Amsterdam, The Netherlands
| | - A G E M de Boer
- Department of Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.,Amsterdam Public Health research institute, Societal Participation & Health, Amsterdam, The Netherlands
| | - A Petit
- 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
| | - Y Roquelaure
- 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
| | - M A Greidanus
- Department of Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.,Amsterdam Public Health research institute, Societal Participation & Health, Amsterdam, The Netherlands
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Greidanus MA, de Rijk AE, de Boer AGEM, Bos MEMM, Plaisier PW, Smeenk RM, Frings-Dresen MHW, Tamminga SJ. A randomised feasibility trial of an employer-based intervention for enhancing successful return to work of cancer survivors (MiLES intervention). BMC Public Health 2021; 21:1433. [PMID: 34289828 PMCID: PMC8293550 DOI: 10.1186/s12889-021-11357-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 06/16/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Employers express a need for support during sickness absence and return to work (RTW) of cancer survivors. Therefore, a web-based intervention (MiLES) targeted at employers with the objective of enhancing cancer survivors' successful RTW has been developed. This study aimed to assess feasibility of a future definitive randomised controlled trial (RCT) on the effectiveness of the MiLES intervention. Also preliminary results on the effectiveness of the MiLES intervention were obtained. METHODS A randomised feasibility trial of 6 months was undertaken with cancer survivors aged 18-63 years, diagnosed with cancer < 2 years earlier, currently in paid employment, and sick-listed < 1 year. Participants were randomised to an intervention group, with their employer receiving the MiLES intervention, or to a waiting-list control group (2:1). Feasibility of a future definitive RCT was determined on the basis of predefined criteria related to method and protocol-related uncertainties (e.g. reach, retention, appropriateness). The primary effect measure (i.e. successful RTW) and secondary effect measures (e.g. quality of working life) were assessed at baseline and 3 and 6 months thereafter. RESULTS Thirty-five cancer survivors were included via medical specialists (4% of the initially invited group) and open invitations, and thereafter randomised to the intervention (n = 24) or control group (n = 11). Most participants were female (97%) with breast cancer (80%) and a permanent employment contract (94%). All predefined criteria for feasibility of a future definitive RCT were achieved, except that concerning the study's reach (90 participants). After 6 months, 92% of the intervention group and 100% of the control group returned to work (RR: 0.92, 95% CI: 0.81-1.03); no difference were found with regard to secondary effect measures. CONCLUSIONS With the current design a future definitive RCT on the effectiveness of the MiLES intervention on successful RTW of cancer survivors is not feasible, since recruitment of survivors fell short of the predefined minimum for feasibility. There was selection bias towards survivors at low risk of adverse work outcomes, which reduced generalisability of the outcomes. An alternative study design is needed to study effectiveness of the MiLES intervention. TRIAL REGISTRATION The study has been registered in the Dutch Trial Register ( NL6758/NTR7627 ).
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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, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Duboisdomein 30, Maastricht, The Netherlands
| | - A G E M de Boer
- Department Public and Occupational Health/ Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - M E M M Bos
- Department of Medical Oncology, Erasmus Medical Center, Doctor Molewaterplein 40, Rotterdam, The Netherlands
| | - P W Plaisier
- Department of Surgery, Albert Schweitzer Hospital, Albert Schweitzerplaats 25, Dordrecht, The Netherlands
| | - R M Smeenk
- Department of Surgery, Albert Schweitzer Hospital, Albert Schweitzerplaats 25, Dordrecht, The Netherlands
| | - M H W Frings-Dresen
- Department Public and Occupational Health/ Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - S J Tamminga
- Department Public and Occupational Health/ Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
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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. J Occup Rehabil 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] [What about the content of this article? (0)] [Affiliation(s)] [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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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] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [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. Electronic supplementary material The online version of this article (10.1007/s11764-019-00844-z) contains supplementary material, which is available to authorized users.
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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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Tamminga SJ, Verbeek JHAM, Bos MMEM, Fons G, Kitzen JJEM, Plaisier PW, Frings-Dresen MHW, de Boer AGEM. Two-Year Follow-Up of a Multi-centre Randomized Controlled Trial to Study Effectiveness of a Hospital-Based Work Support Intervention for Cancer Patients. J Occup Rehabil 2019; 29:701-710. [PMID: 30778742 PMCID: PMC6838305 DOI: 10.1007/s10926-019-09831-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Purpose Purpose is to: (1) study effectiveness of the hospital-based work support intervention for cancer patients at two years of follow-up compared to usual care and (2) identify which early factors predict time to return-to-work (RTW). Methods In this multi-center randomised controlled trial (RCT), 106 (self-)employed cancer patients were randomized to an intervention group or control group and provided 2 years of follow-up data. The intervention group received patient education and work-related support at the hospital. Primary outcome was RTW (rate and time) and quality of life (SF-36), and secondary outcomes were, work ability (WAI), and work functioning (WLQ). Univariate Cox regression analyses were performed to study which early factors predict time to full RTW. Results Participants were diagnosed with breast (61%), gynaecological cancer (35%), or other type of cancer (4%). RTW rates were 84% and 90% for intervention versus control group. They were high compared to national register-based studies. No differences between groups were found on any of the outcomes. Receiving chemotherapy (HR = 2.43, 95% CI 1.59-3.73 p < 0.001), low level of education (HR = 1.65, 95% CI 1.076-2.52 p = 0.02) and low work ability (HR = 1.09 [95% CI 1.04-1.17] p = 0.02) were associated with longer time to full RTW. Conclusions We found high RTW rates compared to national register-based studies and we found no differences between groups. Future studies should therefore focus on reaching the group at risk, which consist of patients who receive chemotherapy, have a low level of education and have a low work ability at diagnosis. TRIAL REGISTRATION: Netherlands Trial Registry (NTR) (http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1658): NTR1658.
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Affiliation(s)
- S J Tamminga
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - J H A M Verbeek
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Finnish Institute of Occupational Health, Kuopio, Finland
| | - M M E M Bos
- Department of Internal Medicine, Reinier de Graaf Groep, Delft, The Netherlands
| | - G Fons
- Department of Gynaecology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - J J E M Kitzen
- Department of Internal Medicine, Albert Schweitzer Hospital, Dordrecht, The Netherlands
| | - P W Plaisier
- Department of Surgery, Albert Schweitzer Hospital, Dordrecht, The Netherlands
| | - 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 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.
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Greidanus MA, Tamminga SJ, de Rijk AE, Frings-Dresen MHW, de Boer AGEM. What Employer Actions Are Considered Most Important for the Return to Work of Employees with Cancer? A Delphi Study Among Employees and Employers. J Occup Rehabil 2019; 29:406-422. [PMID: 30027426 PMCID: PMC6531608 DOI: 10.1007/s10926-018-9800-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Purpose Employers are important stakeholders in the return to work (RTW) of employees with cancer. However, it is unclear what employer actions are most important to that process. The objective, therefore, was to reach consensus on what employer actions are considered most important for the RTW of employees with cancer, by employers and employees separately. Methods A two-round online Delphi study was conducted with two expert panels: one with 23 employers and one with 29 employees with cancer. The results from each panel were analysed separately. Out of 24 suggested employer actions, participants selected the 10 they considered most important for RTW in each of the following RTW phases: (1) disclosure, (2) treatment, (3) RTW plan, and (4) actual RTW. The consensus threshold was set at ≥ 80% during the second round. Results The employer and employee expert panels both reached consensus on the importance of 'emotional support', 'practical support', 'allow sufficient sick leave', 'plan return to work', 'adjust expectations', 'assess work ability', and 'show appreciation'. Employers also reached consensus on 'communicate' and 'treat normally', and employees on 'handle unpredictability'. All these employer actions were considered to be specific for one to three RTW phases. Conclusions Employers reached consensus on the importance of nine employer actions, employees on eight. Both stakeholder perspectives showed great similarities, but did vary regarding important employer actions during the employee's treatment. We recommend developing interventions targeting the employer, meeting both employer and employee needs in each RTW phase, to enhance RTW support for employees with cancer.
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Affiliation(s)
- M A Greidanus
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Meibergdreef 9, Amsterdam, The Netherlands.
| | - S J Tamminga
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health research institute, 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, Universiteitssingel 40, Maastricht, The Netherlands
| | - M H W Frings-Dresen
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Meibergdreef 9, Amsterdam, The Netherlands
| | - A G E M de Boer
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Meibergdreef 9, Amsterdam, The Netherlands
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Tiedtke CM, Dierckx de Casterlé B, Frings-Dresen MHW, De Boer AGEM, Greidanus MA, Tamminga SJ, De Rijk AE. Employers' experience of employees with cancer: trajectories of complex communication. J Cancer Surviv 2017; 11:562-577. [PMID: 28710544 PMCID: PMC5602070 DOI: 10.1007/s11764-017-0626-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 06/23/2017] [Indexed: 01/25/2023]
Abstract
Purpose Remaining in paid work is of great importance for cancer survivors, and employers play a crucial role in achieving this. Return to work (RTW) is best seen as a process. This study aims to provide insight into (1) Dutch employers’ experiences with RTW of employees with cancer and (2) the employers’ needs for support regarding this process. Methods Thirty employer representatives of medium and large for-profit and non-profit organizations were interviewed to investigate their experiences and needs in relation to employees with cancer. A Grounded Theory approach was used. Results We revealed a trajectory of complex communication and decision-making during different stages, from the moment the employee disclosed that they had been diagnosed to the period after RTW, permanent disability, or the employee’s passing away. Employers found this process demanding due to various dilemmas. Dealing with an unfavorable diagnosis and balancing both the employer’s and the employee’s interests were found to be challenging. Two types of approach to support RTW of employees with cancer were distinguished: (1) a business-oriented approach and (2) a care-oriented approach. Differences in approach were related to differences in organizational structure and employer and employee characteristics. Employers expressed a need for communication skills, information, and decision-making skills to support employees with cancer. Conclusions The employers interviewed stated that dealing with an employee with cancer is demanding and that the extensive Dutch legislation on RTW did not offer all the support needed. We recommend providing them with easily accessible information on communication and leadership training to better support employees with cancer. Implications for cancer survivors • Supporting employers by training communication and decision-making skills and providing information on cancer will contribute to improving RTW support for employees with cancer. • Knowing that the employer will usually be empathic when an employee reveals that they have been diagnosed with cancer, and that the employer also experiences difficulties and dilemmas, might lower the threshold to discuss wishes regarding disclosure, communication, and work issues. • The interests of employer and employee in relation to RTW are interrelated; both have responsibility and a role to play, and are in need of support.
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Affiliation(s)
- C M Tiedtke
- Department of Social Medicine, Faculty of Health Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands.
| | - B Dierckx de Casterlé
- Department of Public Health & Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium
| | - M H W Frings-Dresen
- Academic Medical Center, Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands
| | - A G E M De Boer
- Academic Medical Center, Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands
| | - M A Greidanus
- Academic Medical Center, Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands
| | - S J Tamminga
- Academic Medical Center, Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands
| | - A E De Rijk
- Department of Social Medicine, Faculty of Health Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands
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Tamminga SJ, Bültmann U, Husson O, Kuijpens JLP, Frings-Dresen MHW, de Boer AGEM. Employment and insurance outcomes and factors associated with employment among long-term thyroid cancer survivors: a population-based study from the PROFILES registry. Qual Life Res 2015; 25:997-1005. [PMID: 26395276 PMCID: PMC4830855 DOI: 10.1007/s11136-015-1135-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2015] [Indexed: 02/05/2023]
Abstract
Purpose To obtain insight into employment and insurance outcomes of thyroid cancer survivors and to examine the association between not having employment and other factors including quality of life. Methods In this cross-sectional population-based study, long-term thyroid cancer survivors from the Netherlands participated. Clinical data were collected from the cancer registry. Information on employment, insurance, socio-demographic characteristics, long-term side effects, and quality of life was collected with questionnaires. Results Of the 223 cancer survivors (response rate 87 %), 71 % were employed. Of the cancer survivors who tried to obtain insurance, 6 % reported problems with obtaining health care insurance, 62 % with life insurance, and 16 % with a mortgage. In a multivariate logistic regression analysis, higher age (OR 1.07, CI 1.02–1.11), higher level of fatigue (OR 1.07, CI 1.01–1.14), and lower educational level (OR 3.22, CI 1.46–7.09) were associated with not having employment. Employment was associated with higher quality of life. Conclusions Many thyroid cancer survivors face problems when obtaining a life insurance, and older, fatigued, and lower educated thyroid cancer survivors may be at risk for not having employment.
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Affiliation(s)
- S J Tamminga
- Coronel Institute of Occupational Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - U Bültmann
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - O Husson
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands. .,Comprehensive Cancer Center Netherlands South, Eindhoven Cancer Registry, Eindhoven, The Netherlands.
| | - J L P Kuijpens
- VGZ Health Insurance Company, Eindhoven, The Netherlands
| | - M H W Frings-Dresen
- Coronel Institute of Occupational Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - A G E M de Boer
- Coronel Institute of Occupational Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
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Tamminga SJ, de Boer AGEM, Bos MMEM, Fons G, Kitzen JJEM, Plaisier PW, Verbeek JHAM, Frings-Dresen MHW. A hospital-based work support intervention to enhance the return to work of cancer patients: a process evaluation. J Occup Rehabil 2012; 22:565-78. [PMID: 22699884 PMCID: PMC3484279 DOI: 10.1007/s10926-012-9372-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
PURPOSE To perform a process evaluation of a hospital-based work support intervention for cancer patients aimed at enhancing return to work and quality of life. The intervention involves the delivery of patient education and support at the hospital and involves the improvement of the communication between the treating physician and the occupational physician. In addition, the research team asked patient's occupational physician to organise a meeting with the patient and the supervisor to make a concrete gradual return-to-work plan. METHODS Eligible were cancer patients treated with curative intent and who have paid work. Data were collected from patients assigned to the intervention group (N = 65) and from nurses who delivered the patient education and support at the hospital (N = 4) by means of questionnaires, nurses' reports, and checklists. Data were quantitatively and qualitatively analysed. RESULTS A total of 47 % of all eligible patients participated. Nurses delivered the patient education and support in 85 % of the cases according to the protocol. In 100 % of the cases at least one letter was sent to the occupational physician. In 10 % of the cases the meeting with the patient, the occupational physician and the supervisor took place. Patients found the intervention in general very useful and nurses found the intervention feasible to deliver. CONCLUSIONS We found that a hospital- based work support intervention was easily accepted in usual psycho-oncological care but that it proved difficult to involve the occupational physician. Patients were highly satisfied and nurses found the intervention feasible.
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Affiliation(s)
- S J Tamminga
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, PO Box 22700, 1100 DE, Amsterdam, The Netherlands.
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Tamminga SJ, de Boer AGEM, Verbeek JHAM, Frings-Dresen MHW. Return-to-work interventions integrated into cancer care: a systematic review. Occup Environ Med 2010; 67:639-48. [DOI: 10.1136/oem.2009.050070] [Citation(s) in RCA: 102] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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