Top

Journal of Cancer Survivorship

Published in:

01-06-2014

Function and friction at work: a multidimensional analysis of work outcomes in cancer survivors

Authors: Michal C. Moskowitz, Briana L. Todd, Rusan Chen, Michael Feuerstein

Published in: Journal of Cancer Survivorship | Issue 2/2014

Abstract

Objectives

Cancer survivors can experience difficulties returning to and/or remaining at work. Sociodemographic, health and well-being, symptom burden, functional limitations in relation to work demands, work environment, and various work policies and procedures can be related to work function.

Methods

This study analyzed cross-sectional data of a sample of cancer survivors (n = 1,525) who were diagnosed and treated for various types of cancer. The data were obtained from a survey of cancer survivors collected by the LiveStrong Foundation. Using a cancer survivorship and work model proposed in 2010, this study used structural equation modeling to predict work ability (whether survivors reported lower work ability following cancer) and work sustainability (whether survivors had ever lost or left a job because of cancer, i.e., work retention). Potential predictors included health and well-being, symptom burden (e.g., fatigue, pain, and distress), cancer-related worry, worry about family’s cancer risk, functional impairment (i.e., physical, cognitive, and interpersonal), workplace support, and workplace problems.

Results

The overall model predicting work ability (CFI = 0.961, TLI = 0.952, and RMSEA = 0.027) indicated that a greater level of functional limitations (B = 5.88, p < 0.01) and workplace problems (B = 0.22, p = 0.05) were significantly related to lower levels of work ability. Structural equation modeling (CFI = 0.961, TLI = 0.952, and RMSEA = 0.027) also indicated that workplace problems was a significant predictor (B = 0.498, p < 0.001) of the likelihood of losing or leaving a job because of cancer.

Conclusions

Functional limitations and problems at work including poor treatment, discrimination, being passed over for promotion, and lack of accommodations were directly related to the ability to work. Problems at work were associated with lower work sustainability (work retention).

Implications for Cancer Survivors

Employed cancer survivors, health care providers, and employers need to be aware of the potential implications of limitations in function (e.g., physical, cognitive, and interpersonal/social) as it relates to ability to work. In many cases, these functional limitations are responsive to rehabilitation. Workplaces also need to be educated on how to better respond to the needs of cancer survivors at work.

Available only for authorised users

Howlader N, Noone A, Krapcho M, et al. SEER Cancer Statistics Review, 1975–2010. Bethesda: National Cancer Institute; 2013.

Wells M, Williams B, Firnigl D, et al. Supporting ‘work-related goals’ rather than ‘return to work’ after cancer? A systematic review and meta-synthesis of 25 qualitative studies. Psycho-Oncol. 2013;22(6):1208–19. doi:10.1002/pon.3148.CrossRef

Calvio L, Peugeot M, Bruns GL, et al. Measures of cognitive function and work in occupationally active breast cancer survivors. J Occup Environ Med/Am Coll Occup Environ Med. 2010;52(2):219–27. doi:10.1097/JOM.0b013e3181d0bef7.CrossRef

Hansen JA, Feuerstein M, Calvio LC, et al. Breast cancer survivors at work. J Occup Environ Med/Am Coll Occup Environ Med. 2008;50(7):777–84. doi:10.1097/JOM.0b013e318165159e.CrossRef

de Boer AG, Taskila T, Ojajarvi A, et al. Cancer survivors and unemployment: a meta-analysis and meta-regression. JAMA J Am Med Assoc. 2009;301(7):753–62. doi:10.1001/jama.2009.187.CrossRef

Feuerstein M, Luff GM, Harrington CB, et al. Pattern of workplace disputes in cancer survivors: a population study of ADA claims. J Cancer Surviv Res Pract. 2007;1(3):185–92. doi:10.1007/s11764-007-0027-9.CrossRef

Steiner JF, Cavender TA, Nowels CT, et al. The impact of physical and psychosocial factors on work characteristics after cancer. Psycho-Oncol. 2008;17(2):138–47. doi:10.1002/pon.1204.CrossRef

Fantoni SQ, Peugniez C, Duhamel A, et al. Factors related to return to work by women with breast cancer in northern France. J Occup Rehabil. 2010;20(1):49–58. doi:10.1007/s10926-009-9215-y.CrossRefPubMed

Munir F, Yarker J, McDermott H. Employment and the common cancers: correlates of work ability during or following cancer treatment. Occup Med. 2009;59(6):381–9. doi:10.1093/occmed/kqp088.CrossRef

10.

Bouknight RR, Bradley CJ, Luo Z. Correlates of return to work for breast cancer survivors. J Clin Oncol Off J Am Soc Clin Oncol. 2006;24(3):345–53. doi:10.1200/JCO.2004.00.4929.CrossRef

11.

Taskila T, de Boer AG, van Dijk FJ, et al. Fatigue and its correlates in cancer patients who had returned to work—a cohort study. Psycho-Oncol. 2011;20(11):1236–41. doi:10.1002/pon.1843.CrossRef

12.

Feuerstein M, Todd BL, Moskowitz MC, et al. Work in cancer survivors: a model for practice and research. J Cancer Surviv Res Pract. 2010;4(4):415–37. doi:10.1007/s11764-010-0154-6.CrossRef

13.

Rechis R, Reynolds K, Beckjord E, et al. “I learned to live with it” is not good enough: challenges reported by post-treatment cancer survivors in the LiveStrong surveys. Austin: LiveStrong, 2011.

14.

Division of Labor Force Statistics. Labor force statistics from the current population survey. Washington, DC: U.S. Bureau of Labor Statistics, 2013.

15.

Kline RB. Principles and practice of structural equation modeling. 3rd ed. New York: The Guilford Press; 2011.

16.

de Zwart BC, Frings-Dresen MH, van Duivenbooden JC. Test-retest reliability of the Work Ability Index questionnaire. Occup Med. 2002;52(4):177–81.CrossRef

17.

Muthen LK, Muthen BO. Mplus user’s guide. Los Angeles: Muthen & Muthen; 2010.

18.

McDonald RP, Ho M. Principles and practice in reporting structural equation analysis. Psychol Methods. 2002;7:64–82.CrossRefPubMed

19.

Byrne ZS, Hochwarter WA. I get by with a little help from my friends: the interaction of chronic pain and organizational support on performance. J Occup Health Psychol. 2006;11(3):215–27. doi:10.1037/1076-8998.11.3.215. [published Online First: Epub Date]|.CrossRefPubMed

20.

Koolhaas W, van der Klink JJ, Vervoort JP, et al. In-depth study of the workers’ perspectives to enhance sustainable working life: comparison between workers with and without a chronic health condition. J Occup Rehabil. 2013;23(2):170–9. doi:10.1007/s10926-013-9449-6.CrossRefPubMed

21.

Varekamp I, van Dijk FJ. Workplace problems and solutions for employees with chronic diseases. Occup Med. 2010;60(4):287–93. doi:10.1093/occmed/kqq078.CrossRef

22.

Cooper AF, Hankins M, Rixon L, et al. Distinct work-related, clinical and psychological factors predict return to work following treatment in four different cancer types. Psycho-Oncol. 2013;22(3):659–67. doi:10.1002/pon.3049.CrossRef

23.

Kennedy F, Haslam C, Munir F, et al. Returning to work following cancer: a qualitative exploratory study into the experience of returning to work following cancer. Eur J Cancer Care. 2007;16(1):17–25. doi:10.1111/j.1365-2354.2007.00729.x.CrossRef

24.

Main DS, Nowels CT, Cavender TA, et al. A qualitative study of work and work return in cancer survivors. Psycho-Oncol. 2005;14(11):992–1004. doi:10.1002/pon.913.CrossRef

25.

Mehnert A. Employment and work-related issues in cancer survivors. Crit Rev Oncol Hematol. 2011;77(2):109–30. doi:10.1016/j.critrevonc.2010.01.004.CrossRefPubMed

26.

Yarker J, Munir F, Bains M, et al. The role of communication and support in return to work following cancer-related absence. Psycho-Oncol. 2010;19(10):1078–85. doi:10.1002/pon.1662.CrossRef

27.

Amir Z, Neary D, Luker K. Cancer survivors’ views of work 3 years post diagnosis: a UK perspective. Eur J Oncol Nurs Off J Eur Oncol Nurs Soc. 2008;12(3):190–7. doi:10.1016/j.ejon.2008.01.006.CrossRef

28.

Johnsson A, Fornander T, Rutqvist LE, et al. Factors influencing return to work: a narrative study of women treated for breast cancer. Eur J Cancer Care. 2010;19(3):317–23. doi:10.1111/j.1365-2354.2008.01043.x.CrossRef

29.

Spelten ER, Sprangers MA, Verbeek JH. Factors reported to influence the return to work of cancer survivors: a literature review. Psycho-Oncol. 2002;11(2):124–31.CrossRef

30.

Taskila T, Lindbohm ML. Factors affecting cancer survivors’ employment and work ability. Acta Oncol. 2007;46(4):446–51. doi:10.1080/02841860701355048.CrossRefPubMed

31.

Taskila T, Lindbohm ML, Martikainen R, et al. Cancer survivors’ received and needed social support from their work place and the occupational health services. Support Care Cancer Off J Multinatl Assoc Support Care Cancer. 2006;14(5):427–35. doi:10.1007/s00520-005-0005-6.

32.

Torp S, Nielsen RA, Gudbergsson SB, et al. Worksite adjustments and work ability among employed cancer survivors. Support Care Cancer Off J Multinatl Assoc Support Care Cancer. 2012;20(9):2149–56. doi:10.1007/s00520-011-1325-3.

33.

Lindbohm ML, Taskila T, Kuosma E, et al. Work ability of survivors of breast, prostate, and testicular cancer in Nordic countries: a NOCWO study. J Cancer Surviv Res Pract. 2012;6(1):72–81. doi:10.1007/s11764-011-0200-z.CrossRef

34.

Thijs KM, de Boer AG, Vreugdenhil G, et al. Rehabilitation using high-intensity physical training and long-term return-to-work in cancer survivors. J Occup Rehabil. 2012;22(2):220–9. doi:10.1007/s10926-011-9341-1.CrossRefPubMed

35.

Taskila T, Martikainen R, Hietanen P, et al. Comparative study of work ability between cancer survivors and their referents. Eur J Cancer. 2007;43(5):914–20. doi:10.1016/j.ejca.2007.01.012.CrossRefPubMed

36.

Drolet M, Maunsell E, Mondor M, et al. Work absence after breast cancer diagnosis: a population-based study. CMAJ Can Med Assoc J Journal de l’Association Medicale Canadienne. 2005;173(7):765–71. doi:10.1503/cmaj.050178.CrossRef

37.

Clarke TC, Soler-Vila H, Lee DJ, et al. Working with cancer: health and disability disparities among employed cancer survivors in the U.S. Prev Med. 2011;53(4–5):331–4. doi:10.1016/j.ypmed.2011.07.022.PubMedCentralCrossRefPubMed

38.

Hewitt M, Rowland JH, Yancik R. Cancer survivors in the United States: age, health, and disability. J Gerontol A Biol Sci Med Sci. 2003;58(1):82–91.CrossRefPubMed

39.

Bradley CJ, Bednarek HL. Employment patterns of long-term cancer survivors. Psycho-Oncol. 2002;11(3):188–98. doi:10.1002/pon.544.CrossRef

40.

Nieuwenhuijsen K, Verbeek JH, de Boer AG, et al. Supervisory behaviour as a predictor of return to work in employees absent from work due to mental health problems. Occup Environ Med. 2004;61(10):817–23. doi:10.1136/oem.2003.009688.PubMedCentralCrossRefPubMed

41.

Brown RF, Owens M, Bradley C. Employee to employer communication skills: balancing cancer treatment and employment. Psycho-Oncol. 2013;22(2):426–33. doi:10.1002/pon.2107.

42.

Loisel P, Anema JR. Handbook of work disability. New York: Springer; 2013.CrossRef

43.

Chan F, da Silva CE, Copeland J, et al. Workplace accommodations. In: Feuerstein M, editor. Work and cancer survivors. New York: Springer; 2011. p. 233–54.

44.

Mehnert A, de Boer A, Feuerstein M. Employment challenges for cancer survivors. Cancer. 2013;119 Suppl 11:2151–9. doi:10.1002/cncr.28067.CrossRefPubMed

Title: Function and friction at work: a multidimensional analysis of work outcomes in cancer survivors
Authors: Michal C. Moskowitz
Briana L. Todd
Rusan Chen
Michael Feuerstein
Publication date: 01-06-2014
Publisher: Springer US
Published in: Journal of Cancer Survivorship / Issue 2/2014
Print ISSN: 1932-2259
Electronic ISSN: 1932-2267
DOI: https://doi.org/10.1007/s11764-013-0340-4

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras

Prof. Fabrice Barlesi

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Implications for Cancer Survivors

Please log in to get access to this content

Other articles of this Issue 2/2014

Evaluation of traditional and novel measures of cardiac function to detect anthracycline-induced cardiotoxicity in survivors of childhood cancer

A multidimensional scale to measure the reproductive concerns of young adult female cancer survivors

Unintended consequences: the social context of cancer survivors and work

It’s who you know: patient-sharing, quality, and costs of cancer survivorship care

Influence of weight training on skeletal health of breast cancer survivors with or at risk for breast cancer-related lymphedema

Measurement of physical activity in cancer survivors: a validity study

Keynote webinar | Spotlight on antibody–drug conjugates in cancer