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Boersema HJ, Hoekstra T, van Ooijen R, van Zon SKR, Abma FI, Brouwer S. Inability to Work Fulltime and the Association with Paid Employment One Year After the Work Disability Assessment: A Longitudinal Register-Based Cohort Study. JOURNAL OF OCCUPATIONAL REHABILITATION 2024:10.1007/s10926-024-10212-z. [PMID: 38819462 DOI: 10.1007/s10926-024-10212-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/20/2024] [Indexed: 06/01/2024]
Abstract
OBJECTIVES Disability benefit applicants with residual work capacity are often not able to work fulltime. In Dutch work disability benefit assessments, the inability to work fulltime is an important outcome, indicating the number of hours the applicant can sustain working activities per day. This study aims to gain insight into the association between inability to work fulltime and having paid employment 1 year after the assessment. METHODS The study is a longitudinal register-based cohort study of work disability applicants who were granted a partial disability benefit (n = 8300). Multivariable logistic regression analyses were conducted to study the association between inability to work fulltime and having paid employment 1 year after the assessment, separately for working and non-working applicants. RESULTS For disability benefit applicants, whether working (31.9%) or not working (68.1%) at the time of the disability assessment, there was generally no association between inability to work fulltime and having paid employment 1 year later. However, for working applicants diagnosed with a musculoskeletal disease or cancer, inability to work fulltime was positively and negatively associated with having paid employment, respectively. For non-working applicants with a respiratory disease or with multimorbidity, inability to work fulltime was negatively associated with paid employment. CONCLUSIONS Inability to work fulltime has limited association with paid employment 1 year after the disability benefit assessment, regardless of the working status at the time of assessment. However, within certain disease groups, inability to work fulltime can either increase or decrease the odds of having paid employment after the assessment.
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Affiliation(s)
- Henk-Jan Boersema
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, PO-box 30001, Groningen, The Netherlands.
- Research Center for Insurance Medicine (KCVG), Amsterdam, The Netherlands.
- The Institute for Employee Benefit Schemes (UWV), Dutch Social Security Institute, Amsterdam, The Netherlands.
| | - Tialda Hoekstra
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, PO-box 30001, Groningen, The Netherlands
- Research Center for Insurance Medicine (KCVG), Amsterdam, The Netherlands
| | - Raun van Ooijen
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, PO-box 30001, Groningen, The Netherlands
| | - Sander K R van Zon
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, PO-box 30001, Groningen, The Netherlands
| | - Femke I Abma
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, PO-box 30001, Groningen, The Netherlands
- Research Center for Insurance Medicine (KCVG), Amsterdam, The Netherlands
| | - Sandra Brouwer
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, PO-box 30001, Groningen, The Netherlands
- Research Center for Insurance Medicine (KCVG), Amsterdam, The Netherlands
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Hagendijk ME, Zipfel N, Melles M, van der Wees PJ, Hulshof CTJ, Çölkesen EB, Hoving JL, van der Burg-Vermeulen SJ. Towards person-centred work-focused healthcare for people with cardiovascular disease: a qualitative exploration of patients' experiences and needs. Disabil Rehabil 2024:1-13. [PMID: 38676465 DOI: 10.1080/09638288.2024.2344653] [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: 07/29/2023] [Accepted: 04/13/2024] [Indexed: 04/29/2024]
Abstract
PURPOSE To explore the experiences and needs concerning work-focused healthcare of patients experiencing problems with work participation due to cardiovascular disease based on all facets of person-centred care. METHODS Nineteen patients who experienced or continue to experience problems with work participation due to cardiovascular disease participated in semi-structured interviews preceded by preparatory written assignments. The transcripts were analysed by means of directed qualitative content analysis. Adapted principles of the Picker Institute for Person-Centred Care provided a template for the analysis. RESULTS 28 experiences and needs emerged and were grouped into the eight principles for person-centred work-focused healthcare. Randomly presenting one theme for each of the eight principles, the themes included: (1) frequent encounters with occupational healthcare professionals; (2) substantive work-related advice; (3) transparency in communication; (4) support for family; (5) information provision on the work-focused healthcare process; (6) personal control during the process; (7) empathy for the personal situation; and (8) tailored work-focused support. CONCLUSIONS The identified experiences and needs for work-focused healthcare of patients experiencing problems with work participation due to cardiovascular disease clearly indicate the need to improve the delivery of person-centred work-focused healthcare to better meet the individual needs of patients.
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Affiliation(s)
- Marije E Hagendijk
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Nina Zipfel
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Marijke Melles
- Department of Human-Centred Design, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands
| | - Philip J van der Wees
- Scientific Institute for Quality of Healthcare (IQ Healthcare), Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Carel T J Hulshof
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Ersen B Çölkesen
- Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - Jan L Hoving
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Research Centre for Insurance Medicine, Amsterdam, The Netherlands
| | - Sylvia J van der Burg-Vermeulen
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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Park SY, Lee MK. Effects of a self-managed return to work intervention for colorectal cancer survivors: A prospective randomized controlled trial. Eur J Oncol Nurs 2024; 70:102593. [PMID: 38795437 DOI: 10.1016/j.ejon.2024.102593] [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: 09/13/2023] [Revised: 03/31/2024] [Accepted: 04/12/2024] [Indexed: 05/28/2024]
Abstract
PURPOSE The present study aims to assess the efficacy of stage-matched, self-managed Return to Work (RTW) interventions in enhancing RTW outcomes among colorectal cancer (CRC) survivors. METHODS This trial, conducted in South Korea, enrolled 58 unemployed survivors of colorectal cancer. Participants were randomly assigned to either an experimental or a control group. The experimental group received a self-managed return-to-work intervention based on the trans-theoretical model, while the control group received an educational booklet. Assessments were conducted at baseline and at 3, 6, and 12 months to measure changes in various factors including return-to-work status and HRQOL. RESULTS In the experimental group, 28 participants were randomly assigned, while 30 individuals were allocated to the control group. The experimental group exhibited a higher proportion of individuals achieving RTW (64.5% vs 39.3%, p = 0.013) and demonstrated greater improvements in work ability (p = 0.001), RTW self-efficacy (p = 0.035), readiness for RTW in the prepared-for-action (p < 00.0001), uncertain maintenance (p = 0.033), and proactive maintenance (p < 00.0001) stages, quality of working life (p = 0.003), HRQOL (p < 0.05), and illness perception (p < 0.05) compared to the control group at the 12-month follow-up. CONCLUSIONS Stage-matched self-managed RTW interventions incorporating TTM principles may effectively enhance RTW outcomes and work ability among CRC survivors.
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Affiliation(s)
- Soo Yeun Park
- College of Nursing, Research Institute of Nursing Science (Dr. Lee); and Colorectal Cancer Center, Kyungpook National University Chilgok Hospital, School of Medicine (Drs Park), Kyungpook National University, Daegu, South Korea.
| | - Myung Kyung Lee
- College of Nursing, Research Institute of Nursing Science (Dr. Lee); and Colorectal Cancer Center, Kyungpook National University Chilgok Hospital, School of Medicine (Drs Park), Kyungpook National University, Daegu, South Korea.
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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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Popa AE, Bejenaru A, Mitrea EC, Morândău F, Pogan L. Return to work after chronic disease: A theoretical framework for understanding the worker-employer dynamic. Chronic Illn 2023; 19:704-718. [PMID: 35912437 DOI: 10.1177/17423953221117852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Return to work after chronic disease is important for workers, employers and society. The process, however, is challenging. This article provides an analytical and theoretical framework for explaining this process informed by the person-environment fit theory. METHODS This article uses a narrative method to (1) review the key concepts, benefits and influencing factors in the literature on return to work after chronic diseases, (2) analyse and critique the most important theoretical models used for explaining return to work after chronic diseases, and (3) review the person-environment fit theory and how it has been used so far. RESULTS The existing models highlight different aspects, but they overlook the relationship between the worker and the employer. An analytical and theoretical framework is proposed to comprehensively explain the worker-employer dynamic. The framework also considers the role of broader factors (policy, labour market) and other stakeholders (health professionals, civil society actors) emphasising the idea that return to work is a phased and cyclical process. DISCUSSION The framework can be used to guide future qualitative and quantitative studies, or as a map for identifying problematic areas related to the worker or the work environment. The model should be empirically tested in future studies.
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Affiliation(s)
- Adela Elena Popa
- Faculty of Social Sciences and Humanities, Lucian Blaga University of Sibiu, Sibiu, Romania
| | - Anca Bejenaru
- Faculty of Social Sciences and Humanities, Lucian Blaga University of Sibiu, Sibiu, Romania
| | - Elena Cristina Mitrea
- Faculty of Social Sciences and Humanities, Lucian Blaga University of Sibiu, Sibiu, Romania
| | - Felicia Morândău
- Faculty of Social Sciences and Humanities, Lucian Blaga University of Sibiu, Sibiu, Romania
| | - Livia Pogan
- Faculty of Social Sciences and Humanities, Lucian Blaga University of Sibiu, Sibiu, Romania
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Zegers AD, Coenen P, Heeren A, Takke N, Ardon H, Compter A, Dona D, Kouwenhoven M, Schagen SB, de Vos F, Duijts SFA. Work-related experiences and unmet needs of patients with a malignant glioma and relevant professionals: the BrainWork study. J Cancer Surviv 2023:10.1007/s11764-023-01469-z. [PMID: 37782399 DOI: 10.1007/s11764-023-01469-z] [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: 07/12/2023] [Accepted: 09/16/2023] [Indexed: 10/03/2023]
Abstract
PURPOSE Many patients with a malignant (i.e., grade II-IV) glioma are of working age, yet they are rarely included in "cancer and work" studies. Here, we explored (1) the work-related experiences and unmet needs of patients with a malignant glioma and (2) the experiences and needs of relevant healthcare and occupational (health) professionals ("professionals") in providing work-related support to this patient group. METHODS Individual semi-structured interviews were held with patients with a malignant glioma who were of working age and had an employment contract at diagnosis, and relevant professionals. Interviews were transcribed verbatim and analysed thematically. RESULTS Patients (n = 22) were on average 46 ± 13 years of age (64% male) and diagnosed with a grade II (n = 12), III (n = 4), or IV glioma (n = 6). Professionals (n = 16) had on average 15 ± 9 years of relevant work experience with the patient group. Four themes emerged from the data: (1) having a malignant glioma: experienced consequences on work ability, (2) communicating about the consequences of a malignant glioma at work, (3) distilling the right approach: generic or tailored work-related support, and (4) accessibility of work-related support. CONCLUSIONS Glioma-specific consequences on patients' work ability necessitate better communication between, and tailored guidance for, patients, relevant professionals, and the workplace. Suggestions for improvement, e.g., the periodic use of comprehensive neuropsychological assessments, are provided in the article. IMPLICATIONS FOR CANCER SURVIVORS Patients with a malignant glioma would benefit from tailored and proactive outreach about work-related issues bv relevant professionals.
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Affiliation(s)
- Amber Daniëlle Zegers
- Department of Public and Occupational Health, Amsterdam University Medical Centers Location Vrije Universiteit, De Boelelaan 1117, Amsterdam, Netherlands
- Societal Participation and Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Pieter Coenen
- Department of Public and Occupational Health, Amsterdam University Medical Centers Location Vrije Universiteit, De Boelelaan 1117, Amsterdam, Netherlands
- Societal Participation and Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
- Musculoskeletal Health, Amsterdam Movement Sciences Research Institute, Amsterdam, Netherlands
| | - Amy Heeren
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, Netherlands
| | - Nadia Takke
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, Netherlands
| | - Hilko Ardon
- Department of Neurology, TweeSteden Hospital, Tilburg, Netherlands
| | - Annette Compter
- Department of Neurology, Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Desiree Dona
- Department of Human Resources, Radboud University Medical Center, Nijmegen, Netherlands
| | - Mathilde Kouwenhoven
- Department of Neurology, Amsterdam University Medical Centers Location Vrije Universiteit, Amsterdam, Netherlands
- Cancer Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, Netherlands
| | - Sanne B Schagen
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Filip de Vos
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Saskia F A Duijts
- Department of Public and Occupational Health, Amsterdam University Medical Centers Location Vrije Universiteit, De Boelelaan 1117, Amsterdam, Netherlands.
- Societal Participation and Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands.
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, Netherlands.
- Cancer Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, Netherlands.
- Department of Medical Psychology, Amsterdam University Medical Centers location Vrije Universiteit, Amsterdam, Netherlands.
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Hagendijk ME, Zipfel N, Oomen FJ, Hoving JL, van der Wees PJ, Hulshof CTJ, Çölkesen EB, Melles M, van der Burg-Vermeulen SJ. Work-focused healthcare from the perspective of employees living with cardiovascular disease: a patient experience journey mapping study. BMC Public Health 2023; 23:1765. [PMID: 37697261 PMCID: PMC10494386 DOI: 10.1186/s12889-023-16486-x] [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: 11/14/2022] [Accepted: 08/09/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND People living with cardiovascular diseases (CVD) often experience work participation problems. Good work-focused healthcare, defined as the received advice, treatment, and guidance focusing on work participation, can support the patient and work place. However, experiences with work-focused healthcare are generally not always positive which is a barrier for work participation. Therefore, the objective of this study is to gain insight into the work-focused healthcare journey from the perspective of patients with work participation problems due to CVD, to understand their experiences and needs, and to derive opportunities for improving work-focused healthcare service at a system level. METHODS Semi-structured interviews, preceded by preparatory assignments, were conducted with 17 patients who experience(d) work participation problems due to CVD. The patient experience journey map (PEJM) approach was used to visualize the patients' work-focused healthcare journey, including experiences and needs over time and place, from which opportunities to improve work-focused healthcare from the patient's perspective were derived. RESULTS An aggregated PEJM consisting of six phases was composed and graphically mapped. The first phase, working, represents a period in which CVD health problems and subsequent functional limitations occur. The next two phases, short- and long-term sick leave, represent a period of full sick leave. The last three phases, start-, partial-, and full vocational reintegration, focus on the process of return to work that takes place ranging from a few months up to several years after sick-listing. For each phase the touchpoints, timespan, stakeholders, activities, experiences and needs from the perspective of the patients were identified. Finally, for better work-focused healthcare nine opportunities for improvement were derived from the PEJM, e.g. emphasize the need for work adjustment prior to the medical intervention, provide more personalized advice on handling work limitations, and putting more compelling pressure on the employer to create suitable work positions for their employees. DISCUSSION/CONCLUSION This paper contributes insights to provide a more patient-centered work-focused healthcare trajectory for patients employed in paid jobs when living with CVD. The PEJM provides an understanding of the patients' perspectives throughout their work-focused healthcare journey and highlights opportunities for improvement towards a better suited and seamless patient journey, Although this research was conducted within the Dutch healthcare system, it can be assumed that the findings on integrated work-focused healthcare are largly transferable to other healthcare systems.
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Affiliation(s)
- Marije E Hagendijk
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands.
| | - Nina Zipfel
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Floor J Oomen
- Faculty of Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands
| | - Jan L Hoving
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Philip J van der Wees
- Scientific Institute for Quality of Healthcare (IQ Healthcare), Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Carel T J Hulshof
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Ersen B Çölkesen
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - Marijke Melles
- Faculty of Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands
| | - Sylvia J van der Burg-Vermeulen
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
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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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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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MacLennan SJ, Cox T, Murdoch S, Eatough V. An interpretative phenomenological analysis of the meaning of work to women living with breast cancer. Chronic Illn 2022; 18:503-516. [PMID: 33475434 DOI: 10.1177/1742395320987883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Work is an important aspect of everyday life. This remains true for those living with and beyond cancer. Less is known about how the meaning of work may change over the cancer journey, the needs of the individual in response to changes and how healthcare professionals and employing organisations can meet these needs. The aim of this study was to explore the lived experience of work after treatment for breast cancer in a group of professional working women within the UK. METHODS This article presents an Interpretative Phenomenological Analysis (IPA) of the experiences of 15 professional women diagnosed with breast cancer. RESULTS We discuss these women's journey from (1) rethinking the meaning of work to (2) making decisions about work ability and advice on work to (3) transitioning back in to the workplace and the value of continued engagement with employer. DISCUSSION The findings from this study demonstrate the complex interplay between living with cancer, treatment decisions and work. This study highlights two key areas for inclusion in practice: (1) support from Healthcare Professionals and judgements of functional ability and work ability and (2) the role of line managers in managing cancer and work.
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Affiliation(s)
- Sara J MacLennan
- Academic Urology Unit, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Thomas Cox
- Centre for Sustainable Working Life, Birkbeck University of London, London, UK
| | - Sarah Murdoch
- Academic Urology Unit, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Virginia Eatough
- Department of Psychological Sciences, Birkbeck University of London, London, UK
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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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12
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Tailoring work participation support for cancer survivors using the stages of change: perspectives of (health care) professionals and survivors. J Cancer Surviv 2022; 17:706-719. [PMID: 35275360 DOI: 10.1007/s11764-022-01196-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 02/21/2022] [Indexed: 01/03/2023]
Abstract
PURPOSE Interventions to support work participation in cancer survivors (CSs) have shown limited effectiveness. Applying a behavioral change framework (e.g., stages of change) could make work participation interventions for CSs more timely and tailored. We aimed to explore the application of the stages of change framework to work participation support for CSs and to generate stage-specific intervention content. METHODS Eighteen experts (e.g., occupational physicians, reintegration consultants) were individually interviewed, and three focus groups with CSs (n = 6, n = 5, n = 4) were conducted. Data were analyzed along the six work-related behavioral change stages purported by the readiness for return to work framework, which is based on the stages of change. RESULTS The following themes were identified: (1) pre-contemplation: emotional support and staying connected-encourage contact with the employer/colleagues; (2) contemplation: considering return to work is stressful-facilitate the deliberation process; (3) preparation self-evaluative: assess current capabilities-seek guidance from, e.g., occupational physicians; (4) preparation behavioral: planning return to work-allow for personalized solutions and encourage supervised return to work; (5) uncertain maintenance: guard against overload-train self-efficacy strategies and communication tactics; and (6) proactive maintenance: accept and prepare for the long term. CONCLUSIONS Our results support the potential utility of tailoring CSs' work participation support along the stages of change. IMPLICATIONS FOR CANCER SURVIVORS We provided recommendations for intervention content and developed a stage-specific work participation intervention for CSs, the effectiveness of which will be evaluated in an upcoming randomized controlled trial.
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Beermann LC, Alexanderson K, Chen L. Healthcare use, sickness absence, and disability pension among colorectal cancer survivors and population references in Sweden. Acta Oncol 2021; 60:1643-1650. [PMID: 34514940 DOI: 10.1080/0284186x.2021.1974551] [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]
Abstract
BACKGROUND Colorectal cancer (CRC) has negative long-term impacts on survivors' health and work capacity. We aimed to investigate specialized healthcare use and sickness absence and disability pension among CRC survivors and matched references. MATERIAL AND METHODS In this longitudinal register-based cohort study, 6679 patients with a first primary CRC in 2008-2011 (when aged 18-62) and 26,716 CRC-free matched references were followed from 2 years before up to 5 years after diagnosis date. Mean numbers of hospital days and outpatient visits were illustrated for survivors and references for the 7-year period. Crude and adjusted mean numbers of sickness absence/disability pension net days were calculated for post-diagnosis Years 3 and 5. RESULTS Survivors' healthcare use was higher compared to their references throughout the 7 years around CRC diagnosis and was mostly due to CRC, secondary neoplasms, and digestive disorders. In Year 5, survivors had 1.94 mean outpatient visits and 2.13 mean inpatient days (compared to 1.00 and 0.82 for references, respectively). Survivors' adjusted mean sickness absence/disability pension days amounted to 85 d in Year 3 and 77 in Year 5 (compared to 57 and 54 d in the references). Higher mean number of future days was found among women, lower-educated, foreign-born, with previous comorbidities or previous mental disorders. Those with many sickness absence days in 2 years pre-diagnosis had the highest number of future sickness absence/disability pension days. CONCLUSIONS Post-diagnostic healthcare use remained high among CRC survivors, mostly due to cancer (CRC and other neoplasms) and digestive diagnoses. Their sickness absence and disability pension decreased gradually over the period but remained higher than among references. Pre-morbid characteristics may be used in early work-related clinical planning for the survivors.
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Affiliation(s)
- Luisa Christine Beermann
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Kristina Alexanderson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Lingjing Chen
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Schallig MMT, Bültmann U, Ranchor AV, van Zon SKR. Does social support at home moderate the association between social support at work and work functioning among cancer patients? J Cancer Surviv 2021; 17:871-883. [PMID: 34820788 DOI: 10.1007/s11764-021-01132-5] [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: 07/15/2021] [Accepted: 11/06/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE The aims of this study were to examine (1) the longitudinal associations of supervisor and colleague social support with work functioning in cancer patients who have returned to work and (2) the moderating role of social support at home. METHODS Data from the longitudinal Work Life after Cancer study were used (n = 384). Work functioning (low versus moderate to high work functioning) was measured with the validated Work Role Functioning Questionnaire 2.0. Social support at work was measured from both supervisor and colleagues with the Copenhagen Psychosocial Questionnaire. Social support at home was measured with the Social Support List-Discrepancies. Logistic generalized estimating equations were used to analyse associations between supervisor and colleague social support and work functioning, and to examine the possible moderating effect of social support at home. RESULTS More supervisor (OR: 1.21; 95% CI: 1.10, 1.32) and colleague (1.13; 1.03, 1.24) social support were significantly associated with moderate to high work functioning. The association between colleague social support and work functioning was attenuated for those who did not experience enough social support at home but remained almost significant for supervisor social support (1.17; 1.00, 1.37). CONCLUSIONS Supervisor social support is associated with better work functioning regardless of social support at home, while colleague social support is only associated with better work functioning when cancer patients experience enough social support at home. IMPLICATIONS FOR CANCER SURVIVORS Occupational physicians may play a key role in creating awareness that social support at work and at home are beneficial for cancer patients' work functioning.
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Affiliation(s)
- Manon M T Schallig
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Hanzeplein 1, PO Box 30.001, 9700 RB, Groningen, The Netherlands
| | - Ute Bültmann
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Hanzeplein 1, PO Box 30.001, 9700 RB, Groningen, The Netherlands
| | - Adelita V Ranchor
- Department of Health Sciences, Healthy Psychology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, PO Box 30.001, 9700 RB, Groningen, The Netherlands
| | - Sander K R van Zon
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Hanzeplein 1, PO Box 30.001, 9700 RB, Groningen, The Netherlands.
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Lewis J, Mackenzie L. Cognitive changes after breast cancer: a scoping review to identify problems encountered by women when returning to work. Disabil Rehabil 2021; 44:5310-5328. [PMID: 33974469 DOI: 10.1080/09638288.2021.1919216] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE A scoping review of international literature was conducted to identify the various problems encountered by women with breast cancer associated with cognitive deficits, and the relationship to work roles and tasks. METHOD This scoping review was conducted using the structure recommended by Arksey & O'Malley in consideration of the PRISMA extension for Scoping Reviews checklist and reviewed for quality, inclusion criteria and key findings related to cognitive changes after breast and impact on work. Searches were conducted in five databases from January 2000 to December 2020. RESULTS A total of 34 studies met the inclusion criteria. There were 20 quantitative studies, 11 qualitative studies, one mixed method and two case study reports. Findings related to the type of cognitive changes that impact work performance and participation, how these are measured in a work context and the types of interventions directed towards improving cognitive function at work after breast cancer. An absence of ecologically valid assessments and interventions with a coherent approach to early identification and management of cognitive changes after breast cancer was apparent. CONCLUSION Breast cancer survivors can experience challenges in their employment due to cognitive deficits, which may lead to the loss of their employment. Health professionals need to explore breast cancer survivors work role and consider appropriate referrals to ensure women receive the necessary support and rehabilitation to address cognitive problems impacting work performance. Further research is needed to develop workplace-based cognitive assessments and interventions to improve the work performance and participation of women with breast cancer experiencing cognitive deficits.Implications for RehabilitationWork participation can be negatively impacted by unacknowledged cognitive changes that are not assessed and managed throughout the cancer survivorship journey.Health professionals in health care systems, particularly occupational therapists need to consider appropriate referrals to workplace rehabilitation providers to ensure necessary support and rehabilitation to address cognitive problems impacting on work performance.Occupational therapists performing workplace assessments for women with breast cancer, should assesses cognitive function in accordance with the cognitive demands of the job and work environment, and involve the employer and client in workplace based cognitive interventions.
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Affiliation(s)
- Joanne Lewis
- Discipline of Occupational, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Lynette Mackenzie
- Discipline of Occupational, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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Beermann LC, Alexanderson K, Martling A, Chen L. Overall and diagnosis-specific sickness absence and disability pension in colorectal cancer survivors and references in Sweden. J Cancer Surviv 2021; 16:269-278. [PMID: 33728573 PMCID: PMC8964659 DOI: 10.1007/s11764-021-01017-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2021] [Indexed: 12/29/2022]
Abstract
Purpose To longitudinally investigate overall and diagnosis-specific sickness absence (SA) and disability pension (DP) in colorectal cancer (CRC) survivors and references and to identify potential risk factors. Methods This longitudinal register-based cohort study included all patients living in Sweden, diagnosed with a first primary CRC in 2008–2011 when aged 18–62 (n=6679), and their matched references (n=26 716). Net days of SA (in SA spells >14 days) and DP were analyzed from 2 years before through 5 years after diagnosis, overall and by specific diagnoses. Among survivors, risk factors for future SADP were explored using logistic regression. Results In survivors, SA peaked in year 1 postdiagnosis, with 62.5% having at least some SA, and then gradually decreased to 20.1% in year 5. In the 2 years after diagnosis, CRC was the most common SA diagnosis in survivors, while SA due to mental diagnoses remained similar to the references. Notable risk factors for postdiagnostic SA or DP were rectal cancer diagnosis, advanced cancer stage at diagnosis, lower educational level, born outside of Sweden, and pre-diagnostic SA, mental morbidity, and comorbidities. Conclusion During 5 years after a CRC diagnosis, CRC survivors had higher levels of postdiagnostic SA and DP than the references, which was mostly due to CRC diagnoses. Although their SA lowered gradually, it did not return to pre-diagnostic levels. Implications for Cancer Survivors Our results provide valuable information for patients with CRC diagnosis, especially that most have none or low levels of SA/DP after a few years. Supplementary Information The online version contains supplementary material available at 10.1007/s11764-021-01017-7.
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Affiliation(s)
- Luisa Christine Beermann
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77, Stockholm, Sweden
| | - Kristina Alexanderson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77, Stockholm, Sweden
| | - Anna Martling
- Department of Molecular Medicine and Surgery, Karolinska Institutet, SE-171 77, Stockholm, Sweden
| | - Lingjing Chen
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77, Stockholm, Sweden.
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Ghasempour M, Shabanloei R, Rahmani A, Jafarabadi MA, Abri F, Khajehgoodari M. The Relation of Readiness for Return to Work and Return to Work Among Iranian Cancer Survivors. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2020; 35:1237-1242. [PMID: 31456144 DOI: 10.1007/s13187-019-01588-1] [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: 06/10/2023]
Abstract
Return to work after completion of cancer treatments has many benefits for patients, families, and society. Readiness for return to work (RRTW) seems to be an effective factor for return to work in cancer survivors. Therefore, the present study was to investigate return to work and its relation to RRTW among Iranian survivors of cancer. This descriptive-correlational study examined a total of 227 survived cancer patients with completed primary treatments and without active cancer symptoms. Data were collected by the return to work and RRTW questionnaires and analyzed with descriptive statistics and inferential statistics using SPSS software. Upon completion of initial treatment, 166 (73.2%) of survivor participants returned to work, of which 78 (34.4%) and 88 (38.4%) participants returned to full-time and part-time works, respectively. ANOVA test showed a significant difference between RRTW and the type of return to work. In addition, results of regression analysis revealed that there was a positive significant relationship between RRTW and the rate of return to work before and after the adjustment of variables (p ≤ 0.05). Considering the findings of the study, there is a necessary need planning for rehabilitation programs by nursing managers concerning these patients to facilitate their return to work.
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Affiliation(s)
- Mostafa Ghasempour
- Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Sina Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Shabanloei
- Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Sina Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Azad Rahmani
- Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Sina Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Asghari Jafarabadi
- Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fariba Abri
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Khajehgoodari
- Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Sina Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
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Polo KM, Ingram G, Mather T, Ragle A, Scholl N, Welch T. “It takes a village to get through cancer,” A photo-elicitation study exploring lived experiences of community cancer survivors. Br J Occup Ther 2020. [DOI: 10.1177/0308022620953002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction Cancer survivors continue to experience complications that last months to years following diagnosis and treatment, which can impact daily life. The purpose of this study was to explore the lived experiences of adult community cancer survivors related to daily activities and occupational performance. Method Phenomenology study design and photo-elicitation were utilized to blend photos and words. Thirteen adult survivors were recruited from a community-based cancer support organization. Open coding, axial and in vivo coding, and constant comparative analysis were utilized to analyze data and achieve conceptual saturation. Results Participants experienced a shift in cultural context, wherein they took on a new context defined by their cancer survivorship. This context shift is dynamic and interconnected to the sub-themes of distress, changes in perspectives, and side effects that all ultimately influence occupational performance and engagement. The cultural context shift supported participants’ ability to engage in new, meaningful occupations, supported their new identity, and ultimately created a sense of support and belonging. Conclusion Occupational therapists have a unique position to assist with the adjustment process during this cultural context shift and provide interventions in cancer support communities to assure cancer survivors’ continued performance and engagement in meaningful activities.
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Affiliation(s)
- Katie M Polo
- School of Occupational Therapy, University of Indianapolis, Indianapolis, USA
| | - Gabrielle Ingram
- School of Occupational Therapy, University of Indianapolis, Indianapolis, USA
| | - Tamzyn Mather
- School of Occupational Therapy, University of Indianapolis, Indianapolis, USA
| | - Amy Ragle
- School of Occupational Therapy, University of Indianapolis, Indianapolis, USA
| | - Nicole Scholl
- School of Occupational Therapy, University of Indianapolis, Indianapolis, USA
| | - Taylor Welch
- School of Occupational Therapy, University of Indianapolis, Indianapolis, USA
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Horsbøl TA, Dalton SO, Ammitzbøll G, Johansen C, Andersen EAW, Jensen PT, Frøding LP, Lajer H, Kjaer SK. Gynaecological cancer leads to long-term sick leave and permanently reduced working ability years after diagnosis. J Cancer Surviv 2020; 14:867-877. [PMID: 32564197 DOI: 10.1007/s11764-020-00899-3] [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] [Received: 10/07/2019] [Accepted: 05/29/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE The aim of the study was to investigate overall patterns in labour market affiliation, risk for permanently reduced work ability and prevalence of long-term sickness absence among women diagnosed with gynaecological cancer. METHODS We followed 8451 women diagnosed with ovarian, endometrial or cervical cancer, and 72,311 women with no history of cancer in nationwide registers for up to 19 years (mean 7.5 years). We computed hazards ratios for permanently reduced working ability and annual proportions of long-term sick leave. RESULTS Patterns of labour market affiliation varied by cancer diagnosis and stage. The hazard of permanently reduced working ability was increased for survivors of all three cancers but most pronounced for women diagnosed with advanced ovarian cancer. The highest hazard ratios were found 2-5 years after diagnosis, and they persisted for years in all groups and throughout the follow-up period of 19 years in women diagnosed with advanced cervical cancer. In the subgroups of women who continued to be potentially active on the labour market, long-term sick leave was more prevalent among cancer survivors than women with no history of cancer up to 10 years after diagnosis. CONCLUSIONS Women diagnosed with localised as well as advanced gynaecological cancer are at prolonged risk for permanently reduced working ability and long-term sick leave. IMPLICATIONS FOR CANCER SURVIVORS Gynaecological cancer can have long-term as well as permanent consequences for working ability, and survivors who remain active on the labour market might have to take more sick leave even years after cancer diagnosis than other women at their age.
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Affiliation(s)
- Trine Allerslev Horsbøl
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark.
| | - Susanne Oksbjerg Dalton
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark.,National Research Center for Equality in Cancer, Department of Clinical Oncology & Palliative Care, Zealand University Hospital, Rådmandsengen 5, 4700, Næstved, Denmark
| | - Gunn Ammitzbøll
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark.,National Research Center for Equality in Cancer, Department of Clinical Oncology & Palliative Care, Zealand University Hospital, Rådmandsengen 5, 4700, Næstved, Denmark
| | - Christoffer Johansen
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark.,Late Effect Research Unit CASTLE, Copenhagen University Hospital, Blegdamsvej 58, 2100, Copenhagen, Denmark
| | | | - Pernille Tine Jensen
- Department of Gynecology and Obstetrics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus, Denmark.,Faculty of Health, Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200, Aarhus, Denmark
| | | | - Henrik Lajer
- Department of Gynaecology, Copenhagen University Hospital, Juliane Maries Vej 10, 2100, Copenhagen, Denmark
| | - Susanne K Kjaer
- Department of Gynaecology, Copenhagen University Hospital, Juliane Maries Vej 10, 2100, Copenhagen, Denmark.,Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark
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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: 5] [Impact Index Per Article: 1.3] [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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Granström B, Tiblom Ehrsson Y, Holmberg E, Hammerlid E, Beran M, Tano K, Laurell G. Return to work after oropharyngeal cancer treatment-Highlighting a growing working-age population. Head Neck 2020; 42:1893-1901. [PMID: 32092226 DOI: 10.1002/hed.26123] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 01/17/2020] [Accepted: 02/11/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND To describe the frequency of patients returning to work after treatment for oropharyngeal cancer and to identify predictors and physical barriers that might interfere with the return to work process. METHODS Cross-sectional study including 295 patients. Data were collected regarding work/sick leave situation at 1 month before diagnosis and 15 months after diagnosis. The situation before diagnosis was retrospectively recalled by the patients. Two subscales and two single items from the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-H&N35 were used. Data were analyzed with multivariate logistic regression. RESULTS Fifteen months after diagnosis, 212 patients (72%) were working. To be working 15 months after diagnosis was associated with working before diagnosis. Swallowing difficulties, problems talking on the telephone, and physical appearance were negatively associated with returning to work. CONCLUSIONS The large number of individuals returning to work is encouraging for patients diagnosed with oropharyngeal cancer.
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Affiliation(s)
- Brith Granström
- Department of Clinical Science, Unit of Otorhinolaryngology, Umeå University, Umeå, Sweden
| | - Ylva Tiblom Ehrsson
- Department of Surgical Sciences, Section of Otorhinolaryngology and Head & Neck Surgery, Uppsala University, Uppsala, Sweden
| | - Erik Holmberg
- Region Västra Götaland, Regional Cancer Centre West, Gothenburg, Sweden, and Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Eva Hammerlid
- Department of Otorhinolaryngology-Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Martin Beran
- Department of ENT and Maxillofacial Surgery, NAL Medical Center Hospital, Trollhättan, Sweden
| | - Krister Tano
- Department of Clinical Science/ENT/Sunderby Research Unit, Umeå University, Umeå, Sweden
| | - Göran Laurell
- Department of Surgical Sciences, Section of Otorhinolaryngology and Head & Neck Surgery, Uppsala University, Uppsala, Sweden
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Snippen NC, de Vries HJ, de Wit M, van der Burg-Vermeulen SJ, Brouwer S, Hagedoorn M. Assessing significant others' cognitions and behavioral responses in occupational health care for workers with a chronic disease. Disabil Rehabil 2020; 43:2690-2703. [PMID: 31957498 DOI: 10.1080/09638288.2020.1711536] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Purpose: To examine current practices of occupational health professionals in assessing significant others' cognitions and behavioral responses that may influence work outcomes of workers with a chronic disease.Methods: A survey study among occupational health professionals, focusing on the assessment of illness perceptions, work-related beliefs and expectations, and behavioral responses of significant others of workers with a chronic disease. We performed linear regression analyses to investigate which factors are related to occupational health professionals' assessment practices. We used thematic analysis to analyze qualitative data on occupational health professionals' reasons to assess or overlook significant others' cognitions and behavioral responses.Results: Our study sample included 192 occupational health professionals. Most seldom asked about significant others' cognitions and behavioral responses. Organizational norms and occupational health professionals' self-efficacy were related to reported assessment practices. Reasons to assess significant others' cognitions and behavioral responses included recognizing their influence on work participation, and occurrence of stagnation. However, occupational health professionals indicated some doubt whether such assessment would always contribute to better care.Conclusions: It is not common practice for occupational health professionals to assess significant others' cognitions and behavioral responses, although they recognize the influence of these factors on work outcomes. More research is needed as to how occupational health professionals can best address the role of significant others, and apply these new insights in their daily practice.Implications for rehabilitationMost occupational health professionals do not commonly ask about significant others' cognitions and behavioral responses despite the possible influence of these factors on work outcomes.Occupational health professionals may be able to better support workers with a chronic disease by paying more attention to the influence of significant others.Aside from asking about practical support, occupational health professionals should consider asking about significant others' illness perceptions, work-related beliefs and expectations, and other behavioral responses.
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Affiliation(s)
- Nicole C Snippen
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Haitze J de Vries
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Mariska de Wit
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Sylvia J van der Burg-Vermeulen
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Sandra Brouwer
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Mariët Hagedoorn
- Department of Health Sciences, Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Brusletto B, Ihlebæk CM, Mjøsund NH, Torp S. From shaky grounds to solid foundations: A salutogenic perspective on return to work after cancer. Scand J Occup Ther 2019; 27:524-535. [PMID: 31558078 DOI: 10.1080/11038128.2019.1663922] [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: 10/25/2022]
Abstract
Background: Almost a third of employed individuals of working age fall out of work after cancer treatment.Aim: To explore cancer survivors' successful return to work, focusing on assets and resources utilized to resolve cancer- and work-related obstacles to achieve long-term employment.Methods: We interviewed eight cancer survivors who had remained at work for at least 3 years after cancer treatment. We performed interpretative phenomenological analysis and applied Antonovsky's salutogenic model of health as a framework.Results: The participants experienced uncertainty regarding cancer recurrence, impairments, and long-lasting effects on work ability. They utilized a wide range of resistance resources at personal, interpersonal, and social levels. Their determination to return to work was generally strong, but the time needed to find sustainable work and strategies to return to work varied. All participants prioritized activities that energized them and adapted actively to their new situation. When unsure about outcomes, they focused on the best alternative and controlled fear cognitively.Conclusions/Significance: Finding meaningful activities, testing actual work ability, and focusing on the best possible outcome seemed important to remain in work after cancer. It may be helpful to identify available resources and utilize them to resolve tensions resulting from cancer and cancer treatment.
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Affiliation(s)
- Birgit Brusletto
- Department of Health, Social and Welfare Studies, Faculty of Health and Social Sciences, University of South-Eastern Norway (USN), Kongsberg, Norway
| | - Camilla Martha Ihlebæk
- Department of Public Health Science, Faculty of Landscape and Society, Norwegian University of Life Sciences (NMBU), Ås, Norway.,Faculty of Health and Social Work Studies, Østfold University College, Halden, Norway
| | - Nina Helen Mjøsund
- Department of Mental Health Research and Development, Vestre Viken Hospital Trust, Drammen, Norway
| | - Steffen Torp
- Department of Health, Social and Welfare Studies, Faculty of Health and Social Sciences, University of South-Eastern Norway (USN), Kongsberg, Norway
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Morales CZ, McDowell L, Lisy K, Piper A, Jefford M. Return to Work in Survivors of Human Papillomavirus-Associated Oropharyngeal Cancer: An Australian Experience. Int J Radiat Oncol Biol Phys 2019; 106:146-156. [PMID: 31521718 DOI: 10.1016/j.ijrobp.2019.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 08/06/2019] [Accepted: 09/04/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Human papillomavirus (HPV)-associated oropharyngeal cancer (OPC) commonly affects people of working age, yet there is limited data regarding the return-to-work experience in this cohort. This study aimed to investigate the proportion of survivors currently working after completion of radiation therapy and to explore potential facilitators and barriers to working after treatment. METHODS A cross-sectional, single-institutional study was undertaken at the Peter MacCallum Cancer Centre, a comprehensive cancer center in Melbourne, Victoria, Australia. Eligible participants were 18 to 65 years old at diagnosis, were employed at or within the 3 months before diagnosis, and had completed curative treatment for HPV-associated OPC ≥4 months before enrollment. Participants completed a paper-based survey to assess baseline demographics, employment status, and quality of life (QOL; Functional Assessment of Cancer Therapy Head and Neck). Open-ended questions explored factors affecting return to work. Associations between current employment status and various disease, treatment, and demographic variables and with QOL were examined. Free-text items were analyzed by summarizing content analysis. RESULTS Of 93 participants approached, 68 responded (73.1%). Mean age was 54.1 years (range, 39-64 years), and 89.7% were male. Most participants (67.6%) had stage II disease and were treated with chemoradiation (85.3%). Mean time after treatment was 2.6 years (range, 0.3-9.1 years). Fifty-eight of 68 participants (85.3%) were working at enrollment; median time to return to work was 6.0 months (interquartile range, 4-10 months); 45 (77.6%) were in the same role and 35 (60.3%) worked the same number of hours. Ten participants were not working, 3 had retired, 5 reported persistent and significant treatment toxicity preventing employment. Survivors currently working reported higher physical, functional, and global QOL scores. Access to leave and support from treating doctors were facilitators for return to work, whereas fatigue was frequently reported as a barrier to returning to work. CONCLUSION With time, the majority of participants with HPV-associated OPC will return to work after radiation therapy. Attention to symptom management and support from the workplace may enable more successful return to work.
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Affiliation(s)
- Claudia Zecena Morales
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne Victoria, Australia
| | - Lachlan McDowell
- Division of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne Victoria, Australia
| | - Karolina Lisy
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne Victoria, Australia
| | - Amanda Piper
- Australian Cancer Survivorship Centre, A Richard Pratt Legacy, Melbourne Victoria, Australia
| | - Michael Jefford
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne Victoria, Australia; Australian Cancer Survivorship Centre, A Richard Pratt Legacy, Melbourne Victoria, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville Victoria, Australia.
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Nishikido N, Sasaki M, Yoshikawa E, Ito M. Development and evaluation of a training program for occupational health nurses regarding support for workers with cancer and their workplaces. J Occup Health 2019; 61:489-497. [PMID: 31309684 PMCID: PMC6842007 DOI: 10.1002/1348-9585.12076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 06/18/2019] [Indexed: 01/10/2023] Open
Abstract
Objectives This study aimed to develop and evaluate a training program for occupational health nurses (OHNs) regarding support for workers with cancer and their workplaces. Methods Based on our prior research, we engaged in multiple discussions on the development of training program for OHNs. For examining the effectiveness of the developed training program, we collected and analyzed the data from three repeated surveys conducted before, immediately after, and 3 months after the training on self‐confidence levels of the participants regarding 23 items associated with support for workers with cancer and their workplaces. Results We made a 3‐hour training program including a lecture and a group work. First, we gave a lecture explaining the support scheme consisting of 4 parts and the 12 hints in action phrase while using the guidebook. Second, we conducted the group work regarding the case of a female worker diagnosed with breast cancer. Of the participants who supported workers with cancer in actuality during the 3‐month post‐training, 86% acknowledged the utility of the training in implementing support. As for the pre‐post evaluation of the training program, most items of the participants’ self‐confidence significantly increased from pretraining to immediately after and 3 months post‐training. Discussion This study demonstrated that the developed training program was effective in that the participants learned the support schemes and skills and gained self‐confidence in implementing supports in real‐work settings. We hope that this training program will be extensively used in the future, enabling OHNs to contribute toward balancing cancer treatment and work.
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Park J, Gross DP, Rayani F, Norris CM, Roberts MR, James C, Guptill C, Esmail S. Model of Human Occupation as a framework for implementation of Motivational Interviewing in occupational rehabilitation. Work 2019; 62:629-641. [PMID: 31104046 DOI: 10.3233/wor-192895] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND A conceptual framework is needed to understand injured workers' decision-making and inform evidence-based interventions to address behavior change regarding return-to-work (RTW). The Model of Human Occupation (MOHO) can help with understanding how an injured worker's characteristics can generate behavior change while Motivational Interviewing (MI) can help facilitate behavior change. OBJECTIVE This theoretical paper provides an overview of how MOHO and MI can be applied and integrated in occupational rehabilitation. The objectives of this paper are to: (1) evaluate MOHO as a framework for supporting occupational therapists (OTs) in occupational rehabilitation; (2) describe MI as a suitable approach for OTs in occupational rehabilitation; and (3) compare and integrate MOHO and MI. METHOD Several important works and reviews were used to integrate MOHO and MI with occupational rehabilitation. IMPLICATIONS FOR PRACTICE The identification of a model and approach to support OT practice in occupational rehabilitation can assist OTs to determine the most appropriate interventions and contribute to standards of best practice. CONCLUSIONS Integrating MOHO and MI provides a comprehensive framework for understanding impairment and RTW change processes with the potential to reduce work disability and improve RTW outcomes.
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Affiliation(s)
- Joanne Park
- Department of Occupational Therapy, University of Alberta, Edmonton, Canada.,Workers' Compensation Board of Alberta Millard Health, Edmonton, Canada
| | - Douglas P Gross
- Department of Physical Therapy, University of Alberta, Edmonton, Canada
| | - Fahreen Rayani
- Workers' Compensation Board of Alberta Millard Health, Edmonton, Canada
| | - Colleen M Norris
- Faculty of Nursing and Faculty of Medicine, University of Alberta, Edmonton, Canada
| | | | - Carole James
- School of Health Sciences, University of Newcastle, Newcastle, Australia
| | - Christine Guptill
- Department of Occupational Therapy, University of Alberta, Edmonton, Canada
| | - Shaniff Esmail
- Department of Occupational Therapy, University of Alberta, Edmonton, Canada
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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: 12] [Impact Index Per Article: 2.4] [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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Zomkowski K, Cruz de Souza B, Moreira GM, Volkmer C, Da Silva Honório GJ, Moraes Santos G, Flores Sperandio F. Qualitative study of return to work following breast cancer treatment. Occup Med (Lond) 2019; 69:189-194. [DOI: 10.1093/occmed/kqz024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- K Zomkowski
- Physical Therapy Department, College of Health and Sport Science—CEFID, Santa Catarina State University—UDESC, Florianópolis, Santa Catarina, Brazil
| | - B Cruz de Souza
- Physical Therapy Department, College of Health and Sport Science—CEFID, Santa Catarina State University—UDESC, Florianópolis, Santa Catarina, Brazil
| | - G M Moreira
- Physical Therapy Department, College of Health and Sport Science—CEFID, Santa Catarina State University—UDESC, Florianópolis, Santa Catarina, Brazil
| | - C Volkmer
- Physical Therapy Department, Carmela Dutra Maternity—SES/SC, Santa Catarina, Brazil
| | - G J Da Silva Honório
- Physical Therapy Department, College of Health and Sport Science—CEFID, Santa Catarina State University—UDESC, Florianópolis, Santa Catarina, Brazil
| | - G Moraes Santos
- Physical Therapy Department, College of Health and Sport Science—CEFID, Santa Catarina State University—UDESC, Florianópolis, Santa Catarina, Brazil
| | - F Flores Sperandio
- Physical Therapy Department, College of Health and Sport Science—CEFID, Santa Catarina State University—UDESC, Florianópolis, Santa Catarina, Brazil
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Luo SX, Liu JE, Cheng ASK, Xiao SQ, Su YL, Feuerstein M. Breast Cancer Survivors Report Similar Concerns Related to Return to Work in Developed and Developing Nations. JOURNAL OF OCCUPATIONAL REHABILITATION 2019; 29:42-51. [PMID: 29446014 DOI: 10.1007/s10926-018-9762-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Aim To determine whether breast cancer survivors (BCS) at work following the diagnosis and/or treatment of breast cancer, in a rapidly developing country such as China experience similar to return to work challenges as reported in nations with established return to work (RTW) policy and procedures for employees with cancer. Methods Semi-structured interviews were conducted with 16 BCS who returned to work following diagnosis and/or primary cancer treatment. An Interpretative Phenomenological Analysis was used to investigate responses. Results Three recurring themes emerged: (1) challenges at work related to residual effects of diagnosis and/or primary treatment; (2) positive and negative responses from employers and/or supervisors; and (3) positive and negative responses from co-workers/colleagues. Although several participants experienced a high level of workplace support, there was a subgroup that did report challenges related to symptom burden, cognitive limitations, and both positive and negative responses by employers and co-workers were reported. Conclusions Findings indicate similar challenges in BCS who RTW during and/or following cancer treatment in both rapidly developing and developed nations. Results suggest that regardless of the existence of workplace policies and practices related to RTW for workers with a history of cancer, a subgroup of BCS experience similar challenges when returning to work. These findings highlight the international nature of RTW challenges and suggest the need for more global efforts to develop and evaluate workplace interventions to assist with these similarities.
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Affiliation(s)
- Shi-Xiang Luo
- School of Nursing, Capital Medical University, You An Men, Beijing, 100069, People's Republic of China
| | - Jun-E Liu
- School of Nursing, Capital Medical University, You An Men, Beijing, 100069, People's Republic of China.
| | - Andy S K Cheng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Shu-Qin Xiao
- School of Nursing, Capital Medical University, You An Men, Beijing, 100069, People's Republic of China
| | - Ya-Li Su
- Breast Department of General Surgery, Beijing Tiantan Hospital Affiliated to Capital Medical University, Tiantan Xili the Sixth, Dongcheng District, Beijing, 100050, People's Republic of China
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31
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Fitch MI, Nicoll I. Returning to work after cancer: Survivors', caregivers', and employers' perspectives. Psychooncology 2019; 28:792-798. [PMID: 30720242 DOI: 10.1002/pon.5021] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 01/30/2019] [Accepted: 01/31/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The Return to Work Initiative was launched to build a comprehensive understanding of issues, needs, current resources, and available supports for Canadian cancer survivors returning to work as the basis for developing a national action plan. METHODS This Initiative drew on perspectives of stakeholders through a survey and consultations with cancer survivors and caregivers to learn about challenges regarding return to work and interviews and focus groups with workplace representatives and employers to determine issues encountered in the workplace. Common perspectives across stakeholder groups were identified. RESULTS Cancer survivors (n = 410) described reduction in income, positive and negative experiences returning to work, and work-related issues regarding side effects. Caregivers (n = 60) described loss of concentration and productivity, stress, and lack of support from coworkers. Employer representatives (n = 68) revealed challenges for managers knowing how best to support cancer survivors as there are few of them of which they are aware. All stakeholders agreed that returning to work for cancer survivors is challenging. Multiple strategies are needed to achieve success: in-depth understanding of the issues, consideration of accommodation, communication among stakeholders, education, resources, and financial support. CONCLUSIONS The work provided a foundation for making decisions about how to proceed to improve return to work for Canadian cancer survivors.
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Affiliation(s)
- Margaret I Fitch
- Cancer Journey Advisory Group, Canadian Partnership Against Cancer, University of Toronto Lawrence S Bloomberg Faculty of Nursing, Canadian Association of Nurses in Oncology, Toronto, Ontario
| | - Irene Nicoll
- Cancer Journey Advisory Group, Canadian Partnership Against Cancer, University of Toronto Lawrence S Bloomberg Faculty of Nursing, Canadian Association of Nurses in Oncology, Toronto, Ontario
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Snippen NC, de Vries HJ, van der Burg-Vermeulen SJ, Hagedoorn M, Brouwer S. Influence of significant others on work participation of individuals with chronic diseases: a systematic review. BMJ Open 2019; 9:e021742. [PMID: 30670501 PMCID: PMC6347910 DOI: 10.1136/bmjopen-2018-021742] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE It is widely recognised that significant others (SOs), such as a partner, family member or friend, can influence health outcomes of individuals with a chronic disease. However, not much is known about which specific cognitions (ie, illness perceptions and expectation of work ability) and behaviours (eg, emotional and practical support) of SOs influence work participation. Therefore, we aimed to identify cognitions and behaviours of SOs that are related to work participation of individuals with a chronic disease. DESIGN A systematic review and thematic synthesis. DATA SOURCES PubMed, Embase, PsycINFO, SocINDEX and Web of Science were searched until 28 March 2017. ELIGIBILITY CRITERIA FOR SELECTING STUDIES We included studies reporting on cognitions and behaviours of SOs related to work participation in populations with various chronic diseases. DATA EXTRACTION AND SYNTHESIS Two independent reviewers extracted the data and performed a quality assessment using the Quality Assessment Tool for Quantitative Studies from the Effective Public Health Practice Project 2007 and a checklist for assessment of qualitative studies derived from the Cochrane Supplemental Handbook Guidance. Evidence was thematically synthesised. RESULTS Out of 5168 articles, 18 were included (15 qualitative and 3 quantitative) of moderate to high quality. Studies were on cancer, chronic pain, brain injuries and mental health disorders. After thematic synthesis 27 factors could be distinguished. Consistent evidence was found that SOs' positive and encouraging attitudes regarding work participation, encouragement and motivating behaviour and open communication with patients are facilitators for work participation. Consistently reported barriers were SOs' positive attitudes towards sickness absence and advise, encouragement or pressure to refrain from work. CONCLUSIONS Our findings show that several cognitions and behaviours of SOs can facilitate or hinder work participation of individuals with a chronic disease. Intervening on these factors by involving SOs in disability prevention and return to work intervention strategies may be beneficial. More prognostic studies are needed, as the current evidence is mostly based on qualitative studies.
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Affiliation(s)
- Nicole C Snippen
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, Groningen, The Netherlands
| | - Haitze J de Vries
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, Groningen, The Netherlands
| | - Sylvia J van der Burg-Vermeulen
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Mariët Hagedoorn
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Health Psychology, Groningen, The Netherlands
| | - Sandra Brouwer
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, Groningen, The Netherlands
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Abma F, Bjorner JB, Amick BC, Bültmann U. Two valid and reliable work role functioning questionnaire short versions were developed: WRFQ 5 and WRFQ 10. J Clin Epidemiol 2019; 105:101-111. [DOI: 10.1016/j.jclinepi.2018.09.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 07/30/2018] [Accepted: 09/18/2018] [Indexed: 11/28/2022]
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Return to work experiences of patients treated with stem cell transplantation for a hematologic malignancy. Support Care Cancer 2018; 27:2987-2997. [PMID: 30591967 PMCID: PMC6597586 DOI: 10.1007/s00520-018-4596-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 12/10/2018] [Indexed: 01/08/2023]
Abstract
Purpose This qualitative study aimed to identify hematopoietic stem cell transplantation (HSCT) survivors’ (1) work perceptions; (2) barriers to and facilitators of return to work (RTW); and (3) possible solutions to improve RTW. Method Fifteen patients treated with HSCT 1–5 years ago participated in face-to-face semi-structured interviews. Interviews were analyzed following the steps of thematic content analyses. Results RTW was often characterized as a complex and prolonged trajectory, and it was frequently incomplete in working hours, tasks, and/or responsibilities. Work perceptions varied between patients; most valued work as positive, but some also reported a decline in work capacity and/or in importance. Perceived barriers included the duration and side effects of cancer treatment, the presence of comorbidity and poor health before diagnosis, having difficulties commuting and doing household tasks. Perceived facilitators were financial incentives, keeping in touch with the workplace, support of other patients and family, and looking after one’s health. Proposed solutions to improve RTW included discussing RTW at the hospital, enhanced employer support, improved accessibility of rehabilitation programs, and more information about the consequences of being sick-listed. Conclusions Many HSCT survivors value work as important and they are motivated to RTW. Insight in work perceptions, RTW barriers, and solutions might help researchers, healthcare professionals, and employers to develop and/or tailor individualized multidisciplinary care to facilitate RTW.
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Musti MA, Collina N, Stivanello E, Bonfiglioli R, Giordani S, Morelli C, Pandolfi P. Perceived work ability at return to work in women treated for breast cancer: a questionnaire-based study. LA MEDICINA DEL LAVORO 2018; 109:407-419. [PMID: 30556532 PMCID: PMC7682187 DOI: 10.23749/mdl.v110i6.7241] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 11/08/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND Breast cancer survivors often perceive reduced work ability upon returning to work. OBJECTIVES To identify predictors of perceived reduced work ability following return to work among women treated for breast cancer and to describe workplace interventions and support after returning to work. METHODS A questionnaire was sent to 18-65 years-old women (no. 1578) treated for breast cancer and residing in the catchment area of the Bologna Local Health Authority between 2010 and 2012. The study population was identified through a Hospital Discharge Database. The questionnaires included items about personal characteristics, cancer and work-related factors, perceived work ability and the return to work process. A multivariable logistic regression analysis was performed to identify predictors of reduced work ability upon returning to work. RESULTS Among the 841 respondents, 503 questionnaires were evaluable. In the study, 43.5% of the respondents reported reduced work ability with respect to the pre-diagnosis period. Reduced work ability was more common in non-cohabiting (OR=1.81, 95%CI 1.10-2.98) than in cohabiting/married women, and after mastectomy (OR=2.77, 95%CI 1.26-6.11) than after breast-conserving surgery. Office staff/sales assistants and managers were less likely to report reduced work ability (OR=0.51, 95%CI 0.30-0.88 and OR=0.21, 95%CI 0.06-0.76, respectively) than labourers. Women who perceived reduced work ability reported more frequently adjustment of work assignments, consultation of an occupational physician, insufficient support from employers and colleagues and discrimination. CONCLUSIONS Reduced work ability is commonly perceived among women who return to work after treatment for breast cancer. Occupational physicians and general practitioners should be aware of a wide range of factors influencing this perception in order to facilitate a successful return to work.
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Affiliation(s)
- Muriel Assunta Musti
- Unit of Epidemiology, Health Promotion and Risk Communication, Department of Public Health, Bologna Local Health Authority, Bologna, Italy.
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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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Dorland HF, Abma FI, Roelen CAM, Stewart RE, Amick BC, Bültmann U, Ranchor AV. Work-specific cognitive symptoms and the role of work characteristics, fatigue, and depressive symptoms in cancer patients during 18 months post return to work. Psychooncology 2018; 27:2229-2236. [PMID: 29920845 DOI: 10.1002/pon.4800] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 06/05/2018] [Accepted: 06/05/2018] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Cancer patients can experience work-specific cognitive symptoms post return to work. The study aims to (1) describe the course of work-specific cognitive symptoms in the first 18 months post return to work and (2) examine the associations of work characteristics, fatigue and depressive symptoms with work-specific cognitive symptoms over time. METHODS This study used data from the 18-month longitudinal "Work Life after Cancer" cohort. The Cognitive Symptom Checklist-Work Dutch Version (CSC-W DV) was used to measure work-specific cognitive symptoms. Linear mixed models were performed to examine the course of work-specific cognitive symptoms during 18-month follow-up; linear regression analyses with generalized estimating equations were used to examine associations over time. RESULTS Working cancer patients examined with different cancer types were included (n = 378). Work-specific cognitive symptoms were stable over 18 months. At baseline, cancer patients reported more working memory symptoms (M = 32.0; CI, 30.0-34.0) compared with executive function symptoms (M = 19.3; CI, 17.6-20.9). Cancer patients holding a job with both manual and nonmanual tasks reported less work-specific cognitive symptoms (unstandardized regression coefficient b = -4.80; CI, -7.76 to -1.83) over time, compared with cancer patients with a nonmanual job. Over time, higher depressive symptoms were related to experiencing more overall work-specific cognitive symptoms (b = 1.27; CI, 1.00-1.55) and a higher fatigue score was related to more working memory symptoms (b = 0.13; CI, 0.04-0.23). CONCLUSIONS Job type should be considered when looking at work-specific cognitive symptoms over time in working cancer patients. To reduce work-specific cognitive symptoms, interventions targeted at fatigue and depressive symptoms might be promising.
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Affiliation(s)
- H F Dorland
- University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, University of Groningen, Groningen, The Netherlands
| | - F I Abma
- University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, University of Groningen, Groningen, The Netherlands
| | - C A M Roelen
- University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, University of Groningen, Groningen, The Netherlands.,HumanCapitalCare, Enschede, The Netherlands
| | - R E Stewart
- University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, University of Groningen, Groningen, The Netherlands
| | - B C Amick
- Robert Stempel College of Public Health & Social Work, Department of Health Policy and Management, Florida International University, Miami, FL, USA.,Institute for Work & Health, Toronto, Canada
| | - U Bültmann
- University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, University of Groningen, Groningen, The Netherlands
| | - A V Ranchor
- University Medical Center Groningen, Department of Health Psychology, University of Groningen, Groningen, The Netherlands
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Brusletto B, Torp S, Ihlebæk CM, Vinje HF. A five-phase process model describing the return to sustainable work of persons who survived cancer: A qualitative study. Eur J Oncol Nurs 2018; 34:21-27. [PMID: 29784134 DOI: 10.1016/j.ejon.2018.03.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 02/26/2018] [Accepted: 03/01/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE We investigated persons who survived cancer (PSC) and their experiences in returning to sustainable work. METHODS Videotaped, qualitative, in-depth interviews with previous cancer patients were analyzed directly using "Interpretative Phenomenological Analysis" (IPA). Four men and four women aged 42-59 years participated. Mean time since last treatment was nine years. All participants had worked for more than 3 years when interviewed. An advisory team of seven members with diverse cancer experiences contributed as co-researchers. RESULTS The entire trajectory from cancer diagnosis until achievement of sustainable work was analog to a journey, and a process model comprising five phases was developed, including personal situations, treatments, and work issues. The theme "return-to-work" (RTW) turned out to be difficult to separate from the entire journey that started at the time of diagnosis. PSCs were mainly concerned about fighting for life in phases 1 and 2. In phase 3 and 4, some participants had to adjust and make changes at work more than once over a period of 1-10 years before reaching sustainable work in phase 5. Overall, the ability to adapt to new circumstances, take advantage of emerging opportunities, and finding meaningful occupational activities were crucial. CONCLUSIONS Our process model may be useful as a tool when discussing the future working life of PSCs. Every individual's journey towards sustainable work was unique, and contained distinct and long-lasting efforts and difficulties. The first attempt to RTW after cancer may not be persistent.
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Affiliation(s)
- Birgit Brusletto
- Department of Health, Social and Welfare Studies, Faculty of Health and Social Sciences, University College of Southeast Norway (USN), P.O. Box 235, NO-3603, Kongsberg, Norway.
| | - Steffen Torp
- Department of Health, Social and Welfare Studies, Faculty of Health and Social Sciences, University College of Southeast Norway (USN), P.O. Box 235, NO-3603, Kongsberg, Norway.
| | - Camilla Martha Ihlebæk
- Department of Public Health Science, Faculty of Landscape and Society, Norwegian University of Life Sciences (NMBU), Universitetstunet 1, NO-1433, Ås, Norway; Faculty of Health and Social Work Studies, Østfold University College, P.O.Box 700, NO-1757, Halden, Norway.
| | - Hege Forbech Vinje
- Department of Health, Social and Welfare Studies, Faculty of Health and Social Sciences, University College of Southeast Norway (USN), P.O. Box 235, NO-3603, Kongsberg, Norway.
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Dorland HF, Abma FI, Van Zon SKR, Stewart RE, Amick BC, Ranchor AV, Roelen CAM, Bültmann U. Fatigue and depressive symptoms improve but remain negatively related to work functioning over 18 months after return to work in cancer patients. J Cancer Surviv 2018; 12:371-378. [PMID: 29404835 PMCID: PMC5956033 DOI: 10.1007/s11764-018-0676-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 01/23/2018] [Indexed: 01/27/2023]
Abstract
Purpose The aims of this study are to investigate the course of work functioning, health status, and work-related factors among cancer patients during 18 months after return to work (RTW) and to examine the associations between these variables and work functioning over time. Methods Data were used from the 18-month longitudinal “Work Life after Cancer” (WOLICA) cohort, among 384 cancer patients who resumed work. Linear mixed models were performed to examine the different courses during 18-month follow-up. Linear regression analyses with generalized estimating equations (GEE) were used to examine the associations and interactions. Results Cancer patients reported an increase of work functioning and a decrease of fatigue and depressive symptoms in the first 12 months, followed by a stable course between 12 and 18 months. Cognitive symptoms were stable during the first 18 months. Working hours increased and social support decreased during the first 6 months; both remained stable between 6 and 18 months. Fatigue, depressive, and cognitive symptoms were negatively associated with work functioning over time; working hours and supervisor social support were positively associated. Conclusions Interventions to improve cancer patients’ work functioning over time might be promising if they are aimed at reducing fatigue, depressive symptoms, cognitive symptoms, and encouraging supervisor social support. Implications for Cancer Survivors It is important to monitor cancer patients not only in the period directly after RTW but up to 18 months after RTW, allowing for timely interventions when needed.
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Affiliation(s)
- H F Dorland
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, FA10, Room 417, 9713, AV, Groningen, The Netherlands.
| | - F I Abma
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, FA10, Room 417, 9713, AV, Groningen, The Netherlands
| | - S K R Van Zon
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, FA10, Room 417, 9713, AV, Groningen, The Netherlands
| | - R E Stewart
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, FA10, Room 417, 9713, AV, Groningen, The Netherlands
| | - B C Amick
- Robert Stempel College of Public Health and Social Work, Department of Health Policy and Management, Florida International University, Miami, FL, USA.,Institute for Work and Health, Toronto, Canada
| | - A V Ranchor
- Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - C A M Roelen
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, FA10, Room 417, 9713, AV, Groningen, The Netherlands.,HumanCapitalCare, Enschede, the Netherlands
| | - U Bültmann
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, FA10, Room 417, 9713, AV, Groningen, The Netherlands
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40
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Bilodeau K, Tremblay D, Durand MJ. Exploration of the contexts surrounding the implementation of an intervention supporting return-to-work after breast cancer in a primary care setting: starting point for an intervention development. J Multidiscip Healthc 2018; 11:75-83. [PMID: 29440910 PMCID: PMC5798536 DOI: 10.2147/jmdh.s152947] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Many recommendations have been made regarding survivorship care provided by teams of primary care professionals. However, the nature of that follow-up, including support for return-to-work (RTW) after cancer, remains largely undefined. As implementation problems are frequently context-related, a pilot study was conducted to describe the contexts, according to Grol and Wensing, in which a new intervention is to be implemented. This pilot study is the first of three steps in intervention development planning. METHOD In-depth semi-structured interviews (n=6) were carried out with stakeholders selected for their knowledgeable perspective of various settings, such as hospitals, primary care, employers, and community-based organizations. Interviews focused on participants' perceptions of key contextual facilitators and barriers to consider for the deployment of an RTW intervention in a primary care setting. Data from interviews were transcribed and analyzed. A content analysis was performed based on an iterative process. RESULTS An intervention supporting the process of RTW in primary care makes sense for participants. Results suggest that important levers are present in organizational, professional, and social settings. However, many barriers, mainly related to organizational settings, have been identified, eg, distribution of tasks for survivor follow-up, continuity of information, and coordination of care between specialized oncology care and general primary care. CONCLUSION To develop and deploy the intervention, recommendations that emerged from this pilot study for overcoming barriers were identified, eg, training (professionals, survivors, and employers), the use of communication tools, and adopting a practice guide for survivor care. The results were also helpful in focusing on the relevance of an intervention supporting the RTW process as a component of primary care for survivors.
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Affiliation(s)
- Karine Bilodeau
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, QC, Canada
- Hôpital Charles-LeMoyne Research Center, Longueuil, QC, Canada
| | - Dominique Tremblay
- Hôpital Charles-LeMoyne Research Center, Longueuil, QC, Canada
- School of Nursing, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, QC, Canada
| | - Marie-José Durand
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, QC, Canada
- Centre for Action in Work Disability Prevention and Rehabilitation, Longueuil, QC, Canada
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McNeely ML, Dolgoy N, Onazi M, Suderman K. The Interdisciplinary Rehabilitation Care Team and the Role of Physical Therapy in Survivor Exercise. Clin J Oncol Nurs 2017; 20:S8-S16. [PMID: 27857275 DOI: 10.1188/16.cjon.s2.8-16] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Rehabilitation professionals offer expertise in functional assessment, treatment of impairments and functional limitations, and disability prevention. To optimize recovery, and often prior to participating in community-based exercise programming, survivors may need rehabilitation services from a range of healthcare professionals, including physiatrists, nurses, nutritionists, psychologists, and speech, occupational, and physical therapists. OBJECTIVES Survivors with physical impairments and functional limitations may benefit from interdisciplinary rehabilitation and physical therapy, including tailored therapeutic exercise interventions. METHODS A literature review was conducted using the key words cancer survivor, cancer rehabilitation, impairment, fatigue, lymphedema, chemotherapy-induced peripheral neuropathy, and exercise. MEDLINE®, EMBASE, Cochrane Database of Systematic Reviews, and CINAHL® databases were searched. FINDINGS Nurses play a critical role in identifying survivors whose function or fitness is compromised to the point where participation in community-based exercise programming would be inappropriate or unsafe. The interdisciplinary rehabilitation care team can help facilitate the survivor's transition to community-based exercise programming.
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Zaman ACGNM, Tytgat KMAJ, van Hezel S, Klinkenbijl JHG, de Boer AGEM, Frings-Dresen MHW. Development of a tailored work-related support intervention for gastrointestinal cancer patients. Eur J Cancer Care (Engl) 2017; 27:e12782. [PMID: 29024185 DOI: 10.1111/ecc.12782] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2017] [Indexed: 12/11/2022]
Abstract
Aim is the development of a work-related support intervention, tailored to the severity of work-related problems of patients diagnosed with gastrointestinal (GI) cancer treated with curative intent. Two methods were used: (1) Work-related problems were identified from the literature and submitted to an expert panel during a modified Delphi study. Experts allocated work-related problems into degrees of severity: mild, severe or complex. In addition, experts indicated which health care professional should provide the tailored support: (2) These outcomes were combined with existing interventions to design the tailored intervention. Semi-structured interviews with experts were conducted to assess whether the intervention was comprehensive, and feasible for daily practice. A decision diagram measuring severity of work-related problems was developed based on the modified Delphi study with 44 experts, encompassing social, disease and occupational problems. Based on the degree of severity, support was provided by: an oncological nurse (mild), oncological occupational physician (severe) or multidisciplinary team (complex). The intervention encompassed three individual meetings in the clinical setting and was considered comprehensive and feasible by 12 experts. The intervention is innovative in combining oncological and occupational care in the clinic and being tailored to the needs of GI cancer patients with specific work-related problems.
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Affiliation(s)
- Anne-Claire G N M Zaman
- Department Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Kristien M A J Tytgat
- Department of gastroenterology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Sanne van Hezel
- Department Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Jean H G Klinkenbijl
- Department of Surgery, Gelre Hospitals, Apeldoorn, The Netherlands.,University of Amsterdam, Amsterdam, The Netherlands
| | - Angela G E M de Boer
- Department Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Monique H W Frings-Dresen
- Department Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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43
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Greidanus M, de Boer A, de Rijk A, Tiedtke C, Dierckx de Casterlé B, Frings-Dresen M, Tamminga S. Perceived employer-related barriers and facilitators for work participation of cancer survivors: A systematic review of employers' and survivors' perspectives. Psychooncology 2017; 27:725-733. [DOI: 10.1002/pon.4514] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 07/21/2017] [Accepted: 07/25/2017] [Indexed: 11/11/2022]
Affiliation(s)
- M.A. Greidanus
- Academic Medical Center; University of Amsterdam, Department: Coronel Institute of Occupational Health, Amsterdam Public Health research institute; Amsterdam The Netherlands
| | - A.G.E.M. de Boer
- Academic Medical Center; University of Amsterdam, Department: Coronel Institute of Occupational Health, Amsterdam Public Health research institute; Amsterdam The Netherlands
| | - A.E. de Rijk
- Department of Social Medicine, Research Institute Primary Care and Public Health (CAPHRI), Faculty of Health, Medicine, and Life Sciences; Maastricht University; Maastricht The Netherlands
| | - C.M. Tiedtke
- Department of Social Medicine, Research Institute Primary Care and Public Health (CAPHRI), Faculty of Health, Medicine, and Life Sciences; Maastricht University; Maastricht The Netherlands
| | - B. Dierckx de Casterlé
- Department of Public Health and Primary Care, Academic Center for Nursing and Midwifery; Katholieke Universiteit Leuven; Leuven Belgium
| | - M.H.W. Frings-Dresen
- Academic Medical Center; University of Amsterdam, Department: Coronel Institute of Occupational Health, Amsterdam Public Health research institute; Amsterdam The Netherlands
| | - S.J. Tamminga
- Academic Medical Center; University of Amsterdam, Department: Coronel Institute of Occupational Health, Amsterdam Public Health research institute; Amsterdam The Netherlands
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44
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Peters SE, Coppieters MW, Ross M, Johnston V. Perspectives from Employers, Insurers, Lawyers and Healthcare Providers on Factors that Influence Workers' Return-to-Work Following Surgery for Non-Traumatic Upper Extremity Conditions. JOURNAL OF OCCUPATIONAL REHABILITATION 2017; 27:343-358. [PMID: 27586696 DOI: 10.1007/s10926-016-9662-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
PURPOSE Return-to-work (RTW) stakeholders have varied roles and may therefore hold their own perspectives regarding factors that may influence outcomes. This study aimed to determine stakeholders' perspectives on factors influencing RTW following surgery for non-traumatic upper extremity conditions. METHODS A questionnaire was distributed to RTW stakeholders via gatekeeper organizations. Stakeholders rated 50 potential prognostic factors from 'not' to 'extremely' influential. Data were dichotomized to establish stakeholders' level of agreement. Disagreements between stakeholder groups were analyzed using χ 2. The relationship between stakeholder demographic variables and rating of a factor was determined via regression analysis. RESULTS One thousand and eleven stakeholders completed the survey: healthcare providers (77.8 %); employer representatives (12.2 %); insurer representatives (6.8 %); and lawyers (3.2 %). Factors with the highest stakeholder agreement for influencing RTW were: self-efficacy (92.2 %); post-operative psychological status (91.8 %); supportive employer/supervisor (91.4 %); employer's willingness to accommodate job modifications (90.7 %); worker's recovery expectations (88.3 %); mood disorder diagnosis (86.6 %); post-operative pain level (86.4 %); and whether the job can be modified (86.3 %). Disagreements between stakeholder groups were found for 19 (36 %) factors. The strongest disagreements were for: age; gender; obesity; doctor's RTW recommendation; and presence of a RTW coordinator. Respondents' characteristics (e.g., age, workers' compensation jurisdiction, work experience, stakeholder group) were associated with factor rating. CONCLUSION The factors stakeholders rated as having the greatest influence on RTW were predominately psychosocial and modifiable. These variables should be the focus of future research to determine prognostic factors for RTW for workers with upper extremity conditions, and to develop effective RTW interventions.
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Affiliation(s)
- Susan E Peters
- Occupational Therapy, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia.
- Brisbane Hand and Upper Limb Research Institute, Brisbane Private Hospital, Brisbane, Australia.
| | - Michel W Coppieters
- MOVE Research Institute Amsterdam, Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
| | - Mark Ross
- Brisbane Hand and Upper Limb Research Institute, Brisbane Private Hospital, Brisbane, Australia
- Department of Orthopaedics, Princess Alexandra Hospital, Woolloongabba, Australia
- Orthopaedic Surgery, School of Medicine, The University of Queensland, St Lucia, Australia
| | - Venerina Johnston
- MOVE Research Institute Amsterdam, Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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45
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MacLennan S, Murdoch S, Cox T. Changing current practice in urological cancer care: Providing better information, advice and related support on work engagement. Eur J Cancer Care (Engl) 2017; 26. [DOI: 10.1111/ecc.12756] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2017] [Indexed: 11/27/2022]
Affiliation(s)
- S.J. MacLennan
- Academic Urology Unit; University of Aberdeen; Aberdeen UK
| | - S.E. Murdoch
- Academic Urology Unit; University of Aberdeen; Aberdeen UK
| | - T. Cox
- Centre for Sustainable Working Life; Birkbeck University of London; London UK
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46
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Gehrke AK, Feuerstein M. Cancer, comorbidity and workplace discrimination: The US experience. Eur J Cancer Care (Engl) 2017; 26. [PMID: 28809461 DOI: 10.1111/ecc.12748] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2017] [Indexed: 11/29/2022]
Abstract
Cancer survivors with comorbidities have more work-related challenges than cancer survivors without these other health problems. This study evaluated how these cancer survivors with comorbidities are faring under a newly revised workplace discrimination policy, which better accounts for the episodic nature of chronic illnesses. The sample included 18-64 year olds with a history of cancer who filed allegations of workplace discrimination in 2009-2011 (N = 1.291) in the US. Multivariable logistic regressions were used. Cancer survivors with comorbidities were more likely to file discrimination claims related to the terms of their employment (OR = 1.37, 95% CI = 1.04-1.80) than cancer survivors without comorbidities. Terms of employment-related claims were more likely to be ruled in favour of cancer survivors (versus employers), regardless of comorbidity status (OR = 1.44, 95% CI = 1.06-1.96). Despite this policy reform, alleged discrimination related to terms of employment existed at higher rates in cancer survivors with concurrent health problems. If employment is a goal in this high-risk group, replication of findings in other countries, studies on potential mechanisms and development of innovative interventions in these higher risk cases are warranted. Efforts should be made to mitigate the impact of these comorbid health problems on work-related function.
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Affiliation(s)
- Amanda K Gehrke
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Michael Feuerstein
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.,Preventive Medicine and Biometrics, Departments of Medical and Clinical Psychology, and Preventive Medicine and Biometrics, Bethesda, MD, USA
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Dorland HF, Abma FI, Roelen CAM, Stewart RE, Amick BC, Ranchor AV, Bültmann U. Work functioning trajectories in cancer patients: Results from the longitudinal Work Life after Cancer (WOLICA) study. Int J Cancer 2017; 141:1751-1762. [PMID: 28681478 DOI: 10.1002/ijc.30876] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 05/19/2017] [Accepted: 06/16/2017] [Indexed: 11/12/2022]
Abstract
More than 60% of cancer patients are able to work after cancer diagnosis. However, little is known about their functioning at work. Therefore, the aims of this study were to (1) identify work functioning trajectories in the year following return to work (RTW) in cancer patients and (2) examine baseline sociodemographic, health-related and work-related variables associated with work functioning trajectories. This longitudinal cohort study included 384 cancer patients who have returned to work after cancer diagnosis. Work functioning was measured at baseline, 3, 6, 9 and 12 months follow-up. Latent class growth modeling (LCGM) was used to identify work functioning trajectories. Associations of baseline variables with work functioning trajectories were examined using univariate and multivariate analyses. LCGM analyses with cancer patients who completed on at least three time points the Work Role Functioning Questionnaire (n = 324) identified three work functioning trajectories: "persistently high" (16% of the sample), "moderate to high" (54%) and "persistently low" work functioning (32%). Cancer patients with persistently high work functioning had less time between diagnosis and RTW and had less often a changed meaning of work, while cancer patients with persistently low work functioning reported more baseline cognitive symptoms compared to cancer patients in the other trajectories. This knowledge has implications for cancer care and guidance of cancer patients at work.
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Affiliation(s)
- Heleen F Dorland
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Femke I Abma
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Corné A M Roelen
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.,HumanCapitalCare, Enschede, the Netherlands
| | - Roy E Stewart
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Benjamin C Amick
- Department of Health Policy and Management, Florida International University, Robert Stempel College of Public Health & Social Work, Miami, Florida.,Institute for Work & Health, Toronto, Canada
| | - Adelita V Ranchor
- Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Ute Bültmann
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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48
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Feuerstein M, Gehrke AK, McMahon BT, McMahon MC. Challenges Persist Under Americans With Disabilities Act Amendments Act: How Can Oncology Providers Help? J Oncol Pract 2017; 13:e543-e551. [PMID: 28418762 DOI: 10.1200/jop.2016.016758] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To determine whether the Amendments to the hallmark Americans with Disabilities Act (ADA; effective January 2009), which provide increased access to the antidiscrimination laws for many with chronic illness, are related to changes in workplace discrimination allegations in individuals with a history of cancer. METHODS Information collected by the Equal Employment Opportunities Commission was used to compare allegations of discrimination and their merit before (2001 to 2008) and after (2009 to 2011) implementation of the Amendments Act. RESULTS Allegations related to terms of employment (eg, promotions, wages) were more likely to be filed (odds ratio [OR], 1.34; 95% CI, 1.11 to 1.61) and determined to have merit (OR, 1.35; 95% CI, 1.03 to 1.77) after implementation of the Amendments Act. Allegations related to workplace relations (eg, harassment, discipline, discharge) were also more likely to be filed post Amendments Act (OR, 1.48; 95% CI, 1.23 to 1.78), although the merit of this complaint remained stable. Filing of all other allegations of discrimination (ie, hiring, reasonable accommodation, and termination) and their merit remained unchanged post Amendments Act. CONCLUSION Despite the implementation of the Amendments Act, discrimination allegations in those with a history of cancer persisted or in certain areas increased. Although prevention of workplace discrimination rests primarily with employers, the oncology care team is uniquely qualified to provide information related to residual symptoms and function that can facilitate more personalized solutions to workplace discrimination, such as successful workplace accommodations. Information is provided that can assist the oncology team in their efforts to improve work outcomes.
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Affiliation(s)
- Michael Feuerstein
- Uniformed Services University of the Health Sciences; Walter Reed National Military Medical Center, Bethesda, MD; and Virginia Commonwealth University, Richmond, VA
| | - Amanda K Gehrke
- Uniformed Services University of the Health Sciences; Walter Reed National Military Medical Center, Bethesda, MD; and Virginia Commonwealth University, Richmond, VA
| | - Brian T McMahon
- Uniformed Services University of the Health Sciences; Walter Reed National Military Medical Center, Bethesda, MD; and Virginia Commonwealth University, Richmond, VA
| | - Megan C McMahon
- Uniformed Services University of the Health Sciences; Walter Reed National Military Medical Center, Bethesda, MD; and Virginia Commonwealth University, Richmond, VA
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Zomkowski K, Cruz de Souza B, Pinheiro da Silva F, Moreira GM, de Souza Cunha N, Sperandio FF. Physical symptoms and working performance in female breast cancer survivors: a systematic review. Disabil Rehabil 2017; 40:1485-1493. [DOI: 10.1080/09638288.2017.1300950] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Kamilla Zomkowski
- Health Sciences and Sports Center (CEFID), Santa Catarina State University (UDESC), Florianópolis, SC, Brazil
| | - Bruna Cruz de Souza
- Health Sciences and Sports Center (CEFID), Santa Catarina State University (UDESC), Florianópolis, SC, Brazil
| | - Fabiana Pinheiro da Silva
- Health Sciences and Sports Center (CEFID), Santa Catarina State University (UDESC), Florianópolis, SC, Brazil
| | - Géssica Maria Moreira
- Health Sciences and Sports Center (CEFID), Santa Catarina State University (UDESC), Florianópolis, SC, Brazil
| | - Natália de Souza Cunha
- Health Sciences and Sports Center (CEFID), Santa Catarina State University (UDESC), Florianópolis, SC, Brazil
| | - Fabiana Flores Sperandio
- Health Sciences and Sports Center (CEFID), Santa Catarina State University (UDESC), Florianópolis, SC, Brazil
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50
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Exploration of return-to-work interventions for breast cancer patients: a scoping review. Support Care Cancer 2017; 25:1993-2007. [PMID: 28054145 DOI: 10.1007/s00520-016-3526-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 12/05/2016] [Indexed: 12/16/2022]
Abstract
PURPOSE Many women who have been diagnosed with breast cancer (BC) would like to return to work after undergoing cancer treatment. This review explores the nature of interventions addressing return to work (RTW) for this population. METHOD A scoping review was conducted using the Arksey and O'Malley framework. A search was conducted in five bibliographic databases from 2005 to 2015 to identify intervention studies. Article selection and characterization were performed by two reviewers using systematic grids. Themes were identified to construct a narrative summary of the existing literature. RESULTS The literature search identified 17 articles published between 2005 and 2015. The interventions (n = 16) vary in terms of objectives, methodology, description of intervention activities, and period of deployment. Only one intervention referred to a theory linked to RTW. The results further show that nearly 44% of the interventions found provided only information on RTW (information booklet, individual meeting, group session). Only 38% of the interventions were work-directed and offered other activities, such as coordination of services and information, as well as instructions for drawing up an RTW plan. More than 80% of the interventions were provided by health care professionals. Interventions took place during the survivorship period (75%), at the hospital (44%), or an external rehabilitation center (38%). CONCLUSION The variability of interventions found indicates the need to clarify the concept of RTW after a BC diagnosis. Recommendations are made for the development of multicomponent interventions that include both the clinic and the workplace to meet the particular needs of this population.
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