Cancer survivors’ perspectives and experiences regarding behavioral determinants of return to work and continuation of work

Abstract

Purpose: Supportive interventions to enhance return to work (RTW) in cancer survivors hardly showed positive effects so far. Behavioral determinants might have to be considered in the development of interventions to achieve sustained employability. This study aimed to explore cancer survivors’ perspectives and experiences regarding behavioral determinants of RTW and continuation of work.

Materials and methods: In this qualitative study, semi-structured telephone interviews were held with 28 cancer survivors. All participants were at working age, 1–2 years after diagnosis and employed at time of diagnosis. Thematic content analysis was performed.

Results: Work turned out to be a meaningful aspect of cancer survivors’ life, and most participants reported a positive attitude towards their job. Social support to RTW or to continue working was mainly received from family and friends, but pressure to RTW from the occupational physician was also experienced. Changes in expectations regarding work ability from negative to positive during the treatment process were observed. Those who applied active coping mechanisms felt equipped to deal with difficulties regarding work.

Conclusions: Behavioral determinants should be taken into account in the development of future interventions to support cancer survivors’ RTW. However, the causal relationship still has to be determined.

Implications for rehabilitation

• Factors influencing occupational motivation among cancer survivors need to be understood in more detail.

• Previous studies in non-cancer populations have demonstrated that behavioral determinants, such as a positive attitude towards work, high social support and self-efficacy may increase return to work rates or shorten the time to return to work.

• Addressing behavioral determinants in future development of work-related interventions for cancer survivors is essential in achieving sustained employability.

Keywords:

• Cancer survivors
• behavior
• determinants
• qualitative
• experiences
• return to work

Acknowledgements

We would like to thank the Dutch Cancer Society for funding the fellowship of Dr. Saskia Duijts (VU2013–5866), which made it possible to conduct this study. Also, we would like to thank Dr. Alfons Balm, Dr. Monique van Leerdam, and Dr. Hester Oldenburg of the Antoni van Leeuwenhoek Hospital for their help regarding recruitment of patients. Finally, we like to thank Anouk Rosenhart for transcribing all interviews.

Disclosure of interest

The authors report no conflicts of interest.