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Corbière M, Rabouin D, Negrini A, Mazaniello-Chézol M, Sideris L, Prady C, Lachance JP. Validation of the Return-to-Work Obstacles and Self-Efficacy Scale for Women on Sick Leave Due to Breast Cancer (ROSES-BC). JOURNAL OF OCCUPATIONAL REHABILITATION 2024:10.1007/s10926-023-10169-5. [PMID: 38311709 DOI: 10.1007/s10926-023-10169-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/19/2023] [Indexed: 02/06/2024]
Abstract
PURPOSE Breast cancer (BC) is the most frequently diagnosed cancer among women. Approximately 40% of BC survivors are diagnosed during the peak years of their professional career. Women face numerous obstacles when returning to work (RTW) after BC. Their decision-making process and self-efficacy to overcome these barriers may undergo alterations. The objective of this study was to validate the Return-to-work Obstacles and Self-Efficacy Scale (ROSES) for BC survivors, with a focus on three psychometric properties: construct validity, test-retest reliability, and predictive validity. METHODS This prospective study consists of three phases: Phase 1 (baseline, during sick leave) was conducted to evaluate construct validity, Phase 2 (2 weeks later) assessed test-retest reliability, and Phase 3 (6-month follow-up, RTW or not) aimed to evaluate predictive validity. A total of 153 BC survivors participated in Phase 1 of the study, where they completed the 10 dimensions of the ROSES (e.g., fear of relapse, cognitive difficulties). Confirmatory factor analyses (CFA), Pearson correlations, and Cox regressions were performed, with respect to each phase. RESULTS The mean duration for RTW with the same employer was 62.7 weeks. CFAs confirmed the ROSES structure, which had previously been established for other health conditions, showing satisfactory coefficients. Significant Pearson correlation coefficients were observed between the ROSES dimensions from Phase 1 to Phase 2, ranging from 0.66 to 0.88. When considering various confounding variables, chemotherapy treatment and cognitive difficulties (ROSES dimension) emerged as the only significant predictors of RTW. CONCLUSION These findings support the utilization of the ROSES in clinical and research settings for BC survivors to improve their successful RTW. After an initial screening using the ROSES, occupational health professionals can further conduct a focused and thorough evaluation of specific dimensions, such as cognitive difficulties. Additional research and information are required to assist BC survivors in dealing with cognitive impairments induced by chemotherapy when they return to work.
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Affiliation(s)
- Marc Corbière
- Department of Education and Pedagogy - Career counselling, University of Quebec in Montreal, Montreal, Canada.
- Research Centre of the Institut universitaire en santé mentale de Montréal, Montreal, Canada.
| | - Daniel Rabouin
- Research Centre of the Institut universitaire en santé mentale de Montréal, Montreal, Canada
| | - Alessia Negrini
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), Montreal, Canada
| | | | - Lucas Sideris
- Department of Surgery, Maisonneuve-Rosemont Hospital, Montreal, Canada
- University of Montreal, Montreal, Canada
| | - Catherine Prady
- CISSS Montérégie Centre, Greenfield Park, Québec, Canada
- Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Jean-Philippe Lachance
- Research Centre of the Institut universitaire en santé mentale de Montréal, Montreal, Canada
- Health and Society institute, University of Quebec in Montreal, Montreal, Canada
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Walker H, Rimmer B, Dutton L, Finch T, Gallagher P, Lewis J, Burns R, Araújo-Soares V, Williams S, Sharp L. Experiences of work for people living with a grade 2/3 oligodendroglioma: a qualitative analysis within the Ways Ahead study. BMJ Open 2023; 13:e074151. [PMID: 37770270 PMCID: PMC10546132 DOI: 10.1136/bmjopen-2023-074151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 09/07/2023] [Indexed: 09/30/2023] Open
Abstract
OBJECTIVES This study aimed to explore the work experiences of people living with an oligodendroglioma. DESIGN This was a descriptive qualitative study. One-time semi-structured interviews exploring supportive care needs were conducted; work was discussed at various points throughout each interview. An inductive thematic analysis was undertaken. SETTING Participants were recruited across the UK through four National Health Service hospitals and the Brain Tumour Charity research involvement networks. PARTICIPANTS 19 people with grade 2 or 3 oligodendroglioma (mean age 52 years; male n=11). At diagnosis, 16 participants were working, 2 studying and 1 retired. At the interview (mean time since diagnosis 9.6 years; range 1-18 years), seven participants were working, eight retired (four on medical grounds) and four unable to work due to illness. RESULTS Seven themes were constructed: (1) physical and cognitive limitations; (2) work ability and productivity; (3) work accommodations; (4) changing roles; (5) attitudes of clients and coworkers; (6) feelings and ambitions; and (7) financial implications. Fatigue, seizures and cognitive deficits influenced work ability. A stressful work environment could exacerbate symptoms. Changes in job roles and work environment were often required. Employer and coworker support were integral to positive experiences. Work changes could result in financial stress and strain. CONCLUSIONS This study has highlighted, for the first time, influences on work experiences in this understudied population. These findings have implications for clinicians and employers, when considering the importance of work in rehabilitation for people with oligodendrogliomas, and the individually assessed adjustments required to accommodate them, should employment be desired.
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Affiliation(s)
- Hayley Walker
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Ben Rimmer
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Lizzie Dutton
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Tracy Finch
- Department of Nursing, Midwifery, and Health, Northumbria University, Newcastle upon Tyne, UK
| | | | - Joanne Lewis
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Richéal Burns
- Faculty of Science, Atlantic Technological University, Sligo, Ireland
- Health and Biomedical Strategic Research Centre, Atlantic Technological University, Sligo, Ireland
| | - Vera Araújo-Soares
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
- Centre for Preventive Medicine and Digital Health, Department for Prevention of Cardiovascular and Metabolic Disease, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Sophie Williams
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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3
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Porro B, Tamminga SJ, de Boer AGEM, Petit A, Roquelaure Y, Greidanus MA. Identification of actions to be taken by managers to facilitate the return to work of cancer survivors: Consensus between managers and cancer survivors. BMC Public Health 2022; 22:1905. [PMID: 36224592 PMCID: PMC9555691 DOI: 10.1186/s12889-022-14271-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 09/28/2022] [Indexed: 11/10/2022] Open
Abstract
Background Managers are considered to be main stakeholders in the return to work (RTW) of cancer survivors. However, the perspectives of cancer survivors and managers differ on what managerial actions should be taken during the RTW of cancer survivors. This difference might put effective collaboration and successful RTW at risk. Therefore, this study aims to reach consensus among managers and cancer survivors on the managerial actions to be taken during the four different RTW phases of cancer survivors (i.e., Disclosure, Treatment, RTW plan, Actual RTW). Methods The Technique for Research of Information by Animation of a Group of Experts (TRIAGE) was implemented with managers and cancer survivors (hereafter referred to as “experts”). An initial list of 24 actions was derived from a previous study. Firstly, for each action, fifteen experts were asked to indicate individually how important this action is per RTW phase (Likert scale from 1 – “Not important at all” to 6 – “Very important”). Consensus was reached when ≥ 80% (i.e., ≥ twelve experts) of the experts rated that action ≥5. Secondly, for each phase of the RTW process, the 15 actions with the highest percentage were discussed with eight experts during the collective consultation, except for the actions that already reached consensus. After discussion, the experts voted whether each action was important (“yes” / “no”) and consensus required ≥ 87.5% (i.e., ≥ seven experts) of the experts to consider an action as important. Results Twenty-five managerial actions were finally retained for at least one of the RTW phases, e.g., Disclosure: “respect privacy” and “radiate a positive attitude”, Treatment: “show appreciation” and “allow sufficient sick leave”, RTW Plan: “tailor” and “communicate”, and Actual RTW: “support practically” and “balance interest”. Conclusion Cancer survivors and managers reached consensus on the importance of 25 managerial actions, distributed into each phase of the RTW process. These actions should be considered an interplay of managerial actions by different stakeholders on the part of the employer (e.g., direct supervisor, HR-manager), and should be a responsibility that is shared by these stakeholders. The collective implementation of these actions within the company will help cancer survivors feel fully supported. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14271-w.
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Affiliation(s)
- B Porro
- Univ. Angers, CHU Angers, Univ. Rennes, Inserm, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, SFR ICAT, F-49000, Angers, France.
| | - S J Tamminga
- Department of Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.,Amsterdam Public Health research institute, Societal Participation & Health, Amsterdam, The Netherlands
| | - A G E M de Boer
- Department of Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.,Amsterdam Public Health research institute, Societal Participation & Health, Amsterdam, The Netherlands
| | - A Petit
- Univ. Angers, CHU Angers, Univ. Rennes, Inserm, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, SFR ICAT, F-49000, Angers, France
| | - Y Roquelaure
- Univ. Angers, CHU Angers, Univ. Rennes, Inserm, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, SFR ICAT, F-49000, Angers, France
| | - M A Greidanus
- Department of Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.,Amsterdam Public Health research institute, Societal Participation & Health, Amsterdam, The Netherlands
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Yılmaz M, Uyanık G, Alaşalvar FE, Dişsiz G, Alacacıoğlu A. Working Conditions and Quality of Life of Cancer Survivors: A Cross-Sectional Study. CYPRUS JOURNAL OF MEDICAL SCIENCES 2022. [DOI: 10.4274/cjms.2021.3003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Olischläger DLT, den Boer LXY, de Heus E, Brom L, Dona DJS, Klümpen HJ, Stapelfeldt CM, Duijts SFA. Rare cancer and return to work: experiences and needs of patients and (health care) professionals. Disabil Rehabil 2022:1-12. [PMID: 35850601 DOI: 10.1080/09638288.2022.2099589] [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: 11/03/2022]
Abstract
PURPOSE Patients with a rare cancer often face delays in their diagnostic and treatment trajectory, which may affect their work. In this study, we explored experiences and needs of: 1) patients with a rare cancer regarding return to work (RTW) and work retention, and 2) (health care) professionals (HCPs) regarding work-related support of patients with a rare cancer, throughout their disease trajectory. METHODS Semi-structured, in-depth interviews with working-age patients with a rare cancer (n = 16), and HCPs (n = 9) were conducted. During the interviews, a predefined topic list was used. Interviews were transcribed verbatim and analysed by means of thematic analysis. RESULTS In total, three themes emerged from the interviews: 1) Awareness in patients and HCPs as a first step towards work, 2) Being/becoming an expert is a tough job, and 3) Enhancing employability through early personalized guidance. CONCLUSIONS Patients with a rare cancer are confronted with uncertainties regarding work, due to an overall lack of knowledge and experience with these types of cancer. Raising awareness among patients, HCPs and employers about rare cancer and its implications, and providing timely individualized, supportive occupational care are required to improve rare cancer patients' ability to work.Implications for rehabilitationRecognizing and paying attention to the work-related consequences of a rare cancer diagnosis and its treatment is essential to facilitate rare cancer patients' occupational rehabilitation process.Multidisciplinary collaboration and involvement of HCPs specialized in rare cancer are required to provide suitable work-related support.A personalized approach is necessary to adequately address rare cancer patients' RTW and work retention needs.
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Affiliation(s)
- Daphne L T Olischläger
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Li Xiang Y den Boer
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Eline de Heus
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Linda Brom
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,Netherlands Association for Palliative Care (PZNL), Utrecht, The Netherlands
| | - Desiree J S Dona
- Department of Human Resources, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Heinz-Josef Klümpen
- Department of Medical Oncology, Amsterdam University Medical Centers (location VUmc), Amsterdam, The Netherlands
| | | | - Saskia F A Duijts
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,Department of Medical Psychology, Amsterdam UMC location Vrije Universiteit, Amsterdam, The Netherlands.,Cancer Center Amsterdam, Cancer treatment and Quality of life, Amsterdam, The Netherlands
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6
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Martin E, Di Meglio A, Menvielle G, Arvis J, Bourmaud A, Michiels S, Pistilli B, Vaz-Luis I, Dumas A. Informing the development of multidisciplinary interventions to help breast cancer patients return to work: a qualitative study. Support Care Cancer 2022; 30:8287-8299. [PMID: 35819520 DOI: 10.1007/s00520-022-07262-5] [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: 02/23/2022] [Accepted: 06/27/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Return to work (RTW) after breast cancer (BC) can be a major challenge for patients. Multidisciplinary interventions seem to be effective but the role of digital solutions is under-developed and therefore not evaluated. We explored the preferences, needs, and barriers regarding RTW interventions, including opinions about the use of digital approaches to deliver such interventions. METHODS We conducted a qualitative study based on interviews with 30 patients with BC and 18 healthcare providers in four French regions. Emergent themes were identified using thematic content analysis. RESULTS Most providers declared that they did not proactively address RTW with patients, mainly due to having other priorities and a lack of knowledge. The following themes emerged: several development and deployment barriers regarding RTW interventions exist, multidisciplinary interventions are preferred, and there is a need to maintain contact between the patient and workplace during sick leave, including pathways and interlocutors that can facilitate RTW. Participants had mostly positive representations of using digital tools to facilitate RTW; however, fear of loss of human contact and the exacerbation of inequalities were identified as possible risks associated with the development of digital-only interventions. CONCLUSIONS Interventions blending the needs and preferences of patients with BC and the healthcare system are warranted. A personalized multimodal approach with mixed digital and in-person features has surfaced as a possible solution to address the weaknesses of existing interventions. IMPLICATIONS FOR CANCER SURVIVORS Since most women work at the time of diagnosis, it is of particular relevance to build interventions promoting RTW.
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Affiliation(s)
- Elise Martin
- Université Paris-Saclay, Gustave Roussy, Inserm, Biomarqueurs Prédictifs Et Nouvelles Stratégies Thérapeutiques en Oncologie, 94800, Villejuif, France.
| | - Antonio Di Meglio
- Université Paris-Saclay, Gustave Roussy, Inserm, Biomarqueurs Prédictifs Et Nouvelles Stratégies Thérapeutiques en Oncologie, 94800, Villejuif, France.,Medical Oncology Department, Gustave Roussy, 94800, Villejuif, France
| | - Gwenn Menvielle
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie Et de Sante Publique, Paris, France
| | | | | | - Stefan Michiels
- Office of Biostatistics and Epidemiology, Gustave Roussy, Villejuif, France.,Oncostat U1018, Inserm, University Paris-Saclay, Labeled Ligue Contre Le Cancer, Villejuif, France
| | - Barbara Pistilli
- Medical Oncology Department, Gustave Roussy, 94800, Villejuif, France
| | - Ines Vaz-Luis
- Université Paris-Saclay, Gustave Roussy, Inserm, Biomarqueurs Prédictifs Et Nouvelles Stratégies Thérapeutiques en Oncologie, 94800, Villejuif, France.,Medical Oncology Department, Gustave Roussy, 94800, Villejuif, France
| | - Agnès Dumas
- Université Paris Cité, ECEVE, UMR 1123, INSERM, Paris, France
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7
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Porro B, Campone M, Moreau P, Roquelaure Y. Supporting the Return to Work of Breast Cancer Survivors: From a Theoretical to a Clinical Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095124. [PMID: 35564514 PMCID: PMC9105271 DOI: 10.3390/ijerph19095124] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/10/2022] [Accepted: 04/20/2022] [Indexed: 02/04/2023]
Abstract
Promoting the return to work of breast cancer survivors is of major interest to patients, healthcare and occupational health professionals, companies, governments, and researchers worldwide. We previously conducted a French consensus study resulting in a model describing the multifactorial process of the return to work of breast cancer survivors (the REWORK-BC model). Other work has identified the transtheoretical model as a relevant theoretical framework for interventions to promote the return to work of cancer survivors. In this opinion paper, we provide a theoretically-based clinical framework describing how to support breast cancer survivors at each stage of the return-to-work process. This clinical framework considers several essential aspects of supportive care for breast cancer survivors returning to work, such as: (i) helping the patient actively self-manage, by considering her to be the main decision-maker; (ii) respecting and adapting to the patient’s choice of professional project; (iii) respecting the temporality of the patient’s choices; (iv) proposing tailored interventions; (v) implementing simple tools to promote the return to work, shared representation between the patient and a multidisciplinary team, and improvement of working conditions and the knowledge of health and occupational professionals, and managers or employers; and (vi) maintaining certain flexibility aimed at proposing, but never imposing, changes in practices. This clinical framework, specific to breast cancer survivors, could be extrapolated to other tumor types, offering a practical guide for healthcare and occupational health professionals to better understand the return-to-work process of cancer survivors. This clinical framework aims to be a usable tool for any hospital or cancer care center wishing to implement a patient-centered intervention that promotes returning to work, regardless of the country.
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Affiliation(s)
- Bertrand Porro
- Univ. Angers, Univ. Rennes, Inserm, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail)—UMR_S 1085, SFR ICAT, F-49000 Angers, France;
- Correspondence:
| | - Mario Campone
- Oncology Department, Institut de Cancérologie de l’Ouest, F-44805 Saint-Herblain, France;
- Center for Research in Cancerology and Immunology Nantes-Angers, Inserm UMR 1232, Univ. Nantes and Univ. Angers, F-44307 Nantes, France
| | - Philippe Moreau
- University Hospital Hôtel-Dieu, 44000 Nantes, France;
- University of Nantes, 44035 Nantes, France
| | - Yves Roquelaure
- Univ. Angers, Univ. Rennes, Inserm, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail)—UMR_S 1085, SFR ICAT, F-49000 Angers, France;
- Univ. Angers, CHU Angers, Univ. Rennes, Inserm, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail)—UMR_S 1085, SFR ICAT, F-49000 Angers, France
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8
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Peipins LA, Dasari S, Rodriguez JL, White MC, Hodgson ME, Sandler DP. Employment After Breast Cancer Diagnosis and Treatment Among Women in the Sister and the Two Sister Studies. JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:543-551. [PMID: 33387171 PMCID: PMC8485879 DOI: 10.1007/s10926-020-09951-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/25/2020] [Indexed: 06/12/2023]
Abstract
Purpose Women undergoing diagnosis and treatment for breast cancer may face challenges in employment. We investigated the impact of demographic, clinical, workplace, and psychosocial characteristics on loss of employment after a breast cancer diagnosis and treatment. We further describe changes in work status and work environment for cancer survivors who sustain employment. Methods We analyzed responses from a survey of breast cancer survivors from the Sister Study and the Two Sister Study cohorts who reported being employed at the time of their breast cancer diagnosis and who reported employment status (lost vs. sustained employment) at the time of survey administration. Multivariate logistic regression was used to identify the effects of lymphedema, neuropathy, problems with memory or attention, social support, health insurance, and sick leave on lost employment, adjusting for demographic characteristics, cancer stage, treatment, and general health. Results Of the 1675 respondents who reported being employed at the time of diagnosis, 83.5% reported being 'currently' employed at the time of the survey. Older age, peripheral neuropathy, lack of sick leave, late stage at diagnosis, a recurrence or a new cancer, problems with memory or attention, and poor general health were significantly associated with lost employment. Conclusions The long-term effects of breast cancer treatment and workplace provisions for leave and accommodation may have a substantial effect on women's ability to sustain employment. The findings from this study highlight challenges reported by cancer survivors that may inform clinical and occupational interventions to support survivors' return to work.
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Affiliation(s)
- Lucy A Peipins
- Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
- NCCDPHP/DCPC, Mailstop S-107-4, 4770 Buford Hwy, NE, Chamblee, GA, 30341-3717, USA.
| | | | - Juan L Rodriguez
- Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mary C White
- Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
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Berger I, Beck L, Jones J, MacEachen E, Kirsh B. Exploring the Needs of Cancer Survivors When Returning to or Staying in the Workforce. JOURNAL OF OCCUPATIONAL REHABILITATION 2020; 30:480-495. [PMID: 32016649 DOI: 10.1007/s10926-020-09877-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose Cancer survivors have strong personal desires to resume work to feel productive and meet financial needs. However, they may be faced with physical and psychological challenges. This research addresses the question: "What are the needs of cancer survivors when returning to or staying in the workforce?" by (i) examining cancer survivors' perspectives on supports needed when returning to or staying in the workforce and (ii) exploring personal and employment factors that influence the return to work process. Methods An exploratory qualitative design was used. We conducted focus groups and one-on-one semi-structured interviews with cancer survivors (n = 15). Inductive thematic analysis was used to analyze the data. Results Four key themes were identified as significant aspects of the return-to-work process for cancer survivors: (1) changing perspectives on self and work; (2) managing work and social systems; (3) determining disclosure and accommodation; and (4) the importance of supports for return to work and daily life. Conclusions There is a growing interest in developing targeted interventions to improve work outcomes for cancer survivors. This study informs cancer rehabilitation research by developing an understanding of the supports and strategies that should be implemented to help cancer survivors return to work successfully and improve quality of life.
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Affiliation(s)
- Ivona Berger
- Rehabilitation Sciences Institute, University of Toronto, 500 University Ave, Toronto, ON, M5G 1V7, Canada.
| | - Lydia Beck
- Princess Margaret Cancer, Cancer Rehabilitation and Survivorship Program, Centre University Health Network, Toronto, ON, Canada
| | - Jennifer Jones
- Princess Margaret Cancer, Cancer Rehabilitation and Survivorship Program, Centre University Health Network, Toronto, ON, Canada
| | - Ellen MacEachen
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Bonnie Kirsh
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
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10
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Bae KR, Kang D, Yi JY, Ahn Y, Kim IR, Kweon SS, Ahn JS, Nam SJ, Shim YM, Chun M, Heo J, Cho J. A return-to-work intervention protocol directed at cancer patients (self-assessment, tailored information & lifestyle management for returning to work among cancer patients, START): A multi-center, randomized controlled trial. Contemp Clin Trials Commun 2020; 19:100633. [PMID: 32885089 PMCID: PMC7451719 DOI: 10.1016/j.conctc.2020.100633] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 07/21/2020] [Accepted: 08/09/2020] [Indexed: 11/27/2022] Open
Abstract
Purpose This study describes the protocol for the design and evaluation of a self-assessment based educational program supporting cancer patients’ return-to-work (RTW), prior to its complete and ongoing implementation. Methods We designed a multi-center, randomized controlled trial with three follow-up points. The study population (N = 239) includes recently diagnosed cancer patients who plan to receive active treatment at two university hospitals in Korea. A pre-test is conducted at the point of enrollment for both groups. The intervention group receives a leaflet clarifying misconceptions about RTW and is shown a video clip of patient interviews concerning RTW. The control group receives a booklet about cancer and nutrition, and is not provided with further intervention. After active treatment, the intervention group receives a one-time, face-to-face education session with an oncology nurse. Following the education session, both groups receive three follow-up phone calls. The first follow-up call occurs at the end of intervention and at the end of active treatment for intervention and control groups, respectively. The next two follow-up calls will be conducted one month and a year following the post-test. The primary outcome is whether the patient has RTW or has plans to RTW, and the secondary outcome is knowledge of RTW. Results As of April 2020, 239 patients have been enrolled in the trial. Statistical analyses will be conducted upon trial completion in December 2020. Discussion We hypothesize that the provision of RTW education near diagnosis will not only enhance patients’ intentions to RTW, but also effectively encourage them to RTW.
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Affiliation(s)
- Ka Ryeong Bae
- Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea.,Cancer Education Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Danbee Kang
- Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea.,Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jae Yoon Yi
- Department of Public Health, Graduate School of Public Health, Seoul National University, South Korea
| | - Yeojin Ahn
- Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea.,Cancer Education Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Im-Ryung Kim
- Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea.,Cancer Education Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sun-Seog Kweon
- Department of Preventive Medicine, Chonnam National University Medical School, Hwasun, South Korea
| | - Jin Seok Ahn
- Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea.,Department of Hematology & Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Seok Jin Nam
- Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea.,Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Young Mog Shim
- Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea.,Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Mison Chun
- Department of Radiation Oncology, Ajou University School of Medicine, Suwon, South Korea
| | - Jaesung Heo
- Department of Radiation Oncology, Ajou University School of Medicine, Suwon, South Korea
| | - Juhee Cho
- Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea.,Cancer Education Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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11
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Chen YJ, Lai YH, Lee YH, Tsai KY, Chen MK, Hsieh MY. Impact of illness perception, mental adjustment, and sociodemographic characteristics on return to work in patients with head and neck cancer. Support Care Cancer 2020; 29:1519-1526. [PMID: 32720008 DOI: 10.1007/s00520-020-05640-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 07/17/2020] [Indexed: 11/12/2022]
Abstract
PURPOSE To examine the effects of emotional distress, illness perception, and mental adjustment on return to work (RTW) among patients with head and neck cancer (HNC) and identify factors associated with RTW. METHODS A cross-sectional study with convenience sampling was conducted in Taiwan. Structured questionnaires were used to collect data on RTW status and to explore possible factors related to RTW. RTW status was assessed by a single question. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale, illness perception was assessed by the Brief Illness Perception Questionnaire, and mental adjustment was assessed using the Mini-mental Adjustment to Cancer Scale. Sociodemographic and disease background data were also collected and analyzed. Factors related to RTW were identified by multivariate logistic regression. RESULTS A total of 150 patients with HNC were recruited into the study. Of them, 58 (38.7%) returned to work after treatment. Compared to those who did not RTW, patients who did RTW had lower levels of emotional distress (anxiety and depression), better illness perception (cognitive illness representations and illness comprehensibility), and better mental adjustment (hopelessness and helplessness, anxious preoccupation, avoidance, and fatalism). Multivariable analysis indicated that anxiety (OR = 0.863, p < 0.05), avoidance (OR = 1.280, p < 0.001), cognitive illness representations (OR = 0.891, p < 0.01), illness comprehensibility (OR = 1.271, p < 0.05), higher education level (OR = 3.048-3.609, p < 0.05), married status (OR = 5.220, p < 0.05), tumor site in oral cavity (OR = 5.057, p < 0.05), and no reconstruction (OR = 3.415, p < 0.05) were significantly associated with RTW. CONCLUSION The issue of RTW among patients with HNC is related to multidimensional factors, including sociodemographic, psychological, and disease-related situations. We suggest that programs for emotional rehabilitation and occupational counseling need to be developed to assist patients with HNC to RTW at an early stage.
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Affiliation(s)
- Yen-Ju Chen
- Department of Nursing, Da-Yeh University, Changhua, Taiwan.
| | - Yeur-Hur Lai
- Department of Nursing, College of Medicine, National Taiwan University & Hospital, Taipei, Taiwan
| | - Yun-Hsiang Lee
- Department of Nursing, College of Medicine, National Taiwan University & Hospital, Taipei, Taiwan
| | - Kuo-Yang Tsai
- Department of Nursing, Da-Yeh University, Changhua, Taiwan.,Department of Otorhinolaryngology - Head and Neck Surgery, Changhua Christian Hospital, Changhua, Taiwan
| | - Mu-Kuan Chen
- Department of Oral and Maxillofacial Surgery, Changhua Christian Hospital, Changhua, Taiwan
| | - Ming-Yu Hsieh
- Department of Oral and Maxillofacial Surgery, Changhua Christian Hospital, Changhua, Taiwan
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12
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Salit RB, Lee SJ, Burns LJ, Shaw BE, Majhail NS, Bhatt NS, Wood WA, Syrjala KL. Return-to-Work Guidelines and Programs for Post-Hematopoietic Cell Transplantation Survivors: An Initial Survey. Biol Blood Marrow Transplant 2020; 26:1520-1526. [PMID: 32360563 DOI: 10.1016/j.bbmt.2020.04.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 04/09/2020] [Accepted: 04/18/2020] [Indexed: 11/15/2022]
Abstract
Hematopoietic cell transplantation (HCT) requires absence from work, with potential consequences of unemployment and early retirement. Risk factors for failure to return to work (RTW) following HCT have been reported, but there is little information about how transplant centers facilitate the RTW transition for their post-HCT patients. In the present study, we aimed to determine (1) whether transplant centers have guidelines for RTW post-HCT and the consistency of these guidelines and (2) whether centers have RTW programs for their patients, and the characteristics of these programs. We surveyed representatives from 150 adult transplant centers regarding their RTW guidelines and RTW programs. Centers were selected if they performed at least 50 HCTs (autologous [auto] and/or allogeneic [allo]) annually. The online survey contained 32 open-ended and closed-ended questions and 3 questions each eliciting respondents' demographic and transplant centers information. We received completed surveys from 45 centers (30% response rate). Forty-four percent of centers reported having RTW guidelines. All centers recommend RTW at 6 months or less after HCT for their auto-HCT recipients; recommendations for allo-HCT recipients ranged from 4 months to >1 year after HCT having jobs involving interactions with children, sick people, and animals was considered a reason to delay RTW by most centers. Although 87% of centers endorsed that RTW is a problem for post-HCT recipients, only 36% reported having an RTW program for their patients. The majority validated that RTW programs would be either somewhat helpful (36%) or very helpful (51%) for their patients. The majority of responding HCT centers believe that RTW is a problem for patients after HCT; however, consistent guidelines and RTW programs are lacking. With increasing numbers of HCT survivors, efforts to create standardized guidelines and to develop RTW programs are needed.
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Affiliation(s)
- Rachel B Salit
- Fred Hutchinson Cancer Research Center, Seattle, Washington; University of Washington School of Medicine, Seattle, Washington.
| | - Stephanie J Lee
- Fred Hutchinson Cancer Research Center, Seattle, Washington; University of Washington School of Medicine, Seattle, Washington
| | - Linda J Burns
- Transplant, Cellular Therapy, and Health Services Research, LLC, Stillwater, Minnesota
| | - Bronwen E Shaw
- Center for International Blood and Marrow Transplant Research and Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Navneet S Majhail
- Blood and Marrow Transplant Program, Cleveland Clinic, Cleveland Ohio
| | - Neel S Bhatt
- Fred Hutchinson Cancer Research Center, Seattle, Washington; University of Washington School of Medicine, Seattle, Washington
| | - William A Wood
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Karen L Syrjala
- Fred Hutchinson Cancer Research Center, Seattle, Washington; University of Washington School of Medicine, Seattle, Washington
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13
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Rottenberg Y, de Boer AGEM. Risk for unemployment at 10 years following cancer diagnosis among very long-term survivors: a population based study. J Cancer Surviv 2020; 14:151-157. [PMID: 32060878 DOI: 10.1007/s11764-020-00858-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 01/27/2020] [Indexed: 10/25/2022]
Abstract
PURPOSE To clarify the association between cancer diagnosis and subsequent risk of being unemployed at 10 years after diagnosis among very long-term survivors. METHODS A historical cohort study using prospectively collected data was done which included baseline measurements from the Israeli national census. Only patients who were 50 years old or younger at the time of diagnosis were included in the current study. Binary logistic regression analyses were used to assess odds ratios for unemployment at 10 years following diagnosis, while controlling for socioeconomic measurements and employment status at 2 years prior to diagnosis. RESULTS The final study population included 2493 patients who were diagnosed with cancer and 7360 persons without a history of cancer, after excluding individuals who died before the end of 2015. After controlling for confounders, positive associations were found between cancer and increased risk for unemployment at 10 years (OR = 1.31, 95% CI 1.17-1.47). Analysis by cancer type revealed that patients who were diagnosed with CNS malignancies (OR = 2.71, 95% CI 1.80-4.07), followed by patients who were diagnosed with lymphoma (OR = 1.66, 95% CI 1.16-1.28) showed the greatest magnitude of effect, while the association between unemployment at 10 years following diagnosis and breast cancer was found to weaken and actually lose significance (adjusted OR = 1.22, 95% CI 0.99-1.50). CONCLUSIONS Cancer survivors have an increased risk for long-term unemployment among very long-term survivors, mainly among patients diagnosed with CNS malignancies and lymphoma. IMPLICATIONS FOR CANCER SURVIVORS The current study emphasizes the need for tailored intervention in order to mitigate the long-term risk of unemployment.
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Affiliation(s)
- Yakir Rottenberg
- The Department of Oncology, Hadassah-Hebrew University Medical Center and Hebrew University-Hadassah Medical School, 91120, Jerusalem, Israel.
| | - Angela G E M de Boer
- Coronel Institute of Occupational Health, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
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