From shaky grounds to solid foundations: a salutogenic perspective on return to work after cancer

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 treatmentacceptedVersionpublishedVersio

Labor-force participation and working patterns among women and men who have survived cancer: A descriptive 9-year longitudinal cohort study

Aims: Our aim was to investigate labor-force participation, working hours, job changes, and education over 9 years among persons who have survived more than 10 years after cancer, and compare it to controls. Methods: Register data on 2629 persons who survived cancer were stratified by gender and compared to data on 5258 matched controls. persons who survived cancer were aged 30–50 when diagnosed with cancer and had a work contract prior to diagnosis. Descriptive analysis and t-tests were performed. Results: The proportion of female persons who survived cancer in the labor force was reduced from 100% to 83.9% during follow-up, demonstrating a significant difference compared to controls for each year measured. The proportion of male persons who survived cancer dropped from 100% to 84.8%, but was only significantly different compared to controls in 2 years. The proportion of female persons who had survived cancer who worked full-time was lower in all years compared to both controls and male persons who survived cancer; in turn, male persons who had survived cancer worked full-time less than male controls. The proportion of female persons who had survived cancer who worked less than 20 hours per week increased compared to controls. The frequency of change of employer was higher among female persons who survived cancer compared to controls for some years, but no significant differences between male persons who survived cancer and controls were found. female persons who survived cancer were in education more often than male persons who survived cancer. Conclusions:Persons who survived cancer experienced reduced labor-force participation and working hours 9 years after diagnosis, and the reduction was more pronounced for women than for men. Working patterns were also different between genders and between persons who survived cancer and controlspublishedVersio

Subjektivt velvære, sosiale interaksjoner og aktivitet hos eldre med demens på dagsenter : en kvantitativ undersøkelse av atferdsendring ved dyreassisterte intervensjoner

Bakgrunn: Demens er en sykdom som stadig flere rammes av. Forskning har vist at dyreassisterte aktiviteter (DAA) og dyreassisterte terapier (DAT) overfor eldre med demens kan bidra til å bremse en utvikling av symptomer på negativ atferd, gi reduksjon i ensomhetsfølelse og stimulere til økt sosialt miljø blant deltakerne. Mål: Hovedmålet med denne masteroppgaven har vært å undersøke om intervensjoner med hund gir atferdsendringer som tyder på bedre helse ved større grad av velvære og økt sosial interaksjon og aktivitet blant eldre med demens. Metode: Atferd fra videoopptak med 33 deltakere i prosjektet ”Dyrebar Omsorg” ved NMBU, gjennomført ved dagsenter i Østfold, Vestfold og Akershus, ble analysert ved hjelp av et utarbeidet etogram for registrering av atferd i 2. og 10. uke av den 12 uker lange intervensjonsperioden. Dataene ble analysert med parede T-tester i SPSS. Stratifiserte analyser på kjønn, grad av demens og type intervensjon (DAA/DAT) ble også gjennomført. Det ble i tillegg registrert data fra hundeførers loggskjema tidlig og sent i intervensjonsperioden. Resultater: Varighet av aktive øvelser økte signifikant i intervensjonsperioden (p=0,004). Samtaletemaer om nåtid (p=0,011) samt signaler på velvære i form av synging, plystring, nynning og dansing (p=0,004) økte også signifikant. Det fremkom ingen signifikant endring i utvikling av negativ atferd som vandring, søvn, gjesping/sukking eller repetitive bevegelser. Agitasjon i form av gråt, rop og lignende ble ikke registrert. Blant menn økte stemning og fysisk kontakt med mennesker mest, og blant kvinner økte spesielt samtalefrekvensen om nåtidstemaer og aktive øvelser. De med mer alvorlig demens (KDV >= 2) så ut til å ha større utbytte og effekt i mer samtaler og aktive øvelser. DAT så ut til å gi størst positiv effekt på varighet av aktive øvelser (p=0,001), mens DAA ga signifikant økning i frekvens av konversasjoner (p=0,002). Loggskjemaene viste en signifikant økning (p=0,025) i variabelen ”kommunikasjon” (alle deltakere), samt i ”stemning” (menn, p=0,022). Konklusjon: Resultatene støtter tidligere forskning som viser at intervensjoner med dyr for pasienter med demens kan gi økt subjektivt velvære, sosial interaksjon og aktivitet. Det trengs imidlertid mer systematisk forskning og kontrollerte studier for å kartlegge effekten av dyreassisterte intervensjoner for denne gruppen. Abstract Background: The prevalence of dementia will increase among elderly in the future. Studies have shown that animal assisted activities (AAA) and animal assisted therapy (AAT) could inhibit development of negative behaviour like agitation, reduce feelings of loneliness and increase social interactions and activity. Aim: The aim of this master thesis is to investigate if interventions using therapy dog for elderly suffering from dementia could give changes in health in form of increased wellbeing, social interactions and activity. Method: Behaviour from videotapes of 33 participants from day care centers in the municipalities of the communities Østfold, Vestfold and Akershus in Norway were analyzed by a tailored ethogram for the 2nd and 10th week, and intervention log were also used. All data were analyzed with paired T-tests in SPSS. Stratified analyzes for gender, degree of dementia, and type of intervention (AAA/AAT) were also conducted. Results: The duration of ”Active exercise” was significantly increased during the intervention (p=0,004). Conversations about present themes increased significantly (p=0,011) as well as ”Singing, humming, whisteling, dancing” (p=0,004). There were no significant changes in negative behaviour like wandering, sleep, yawning/sighing or repetitive movements. Agitated behaviour like crying, swearing and yealling did not occur at all. Men seemed to be more likely to have increased good moods and physical contact with other people late in the period, whereas woman had an significant increase in conversation and physical activity. The participants with severe dementia (CDR >= 2) seemed to have more conversation and a higher frequence of physical activity late in the intervention period. AAT seemed to have the greatest positive effect on increased duration of physical activities (p=0,001) whereas AAA were found to significantly increase the frequence of conversations (p=0,002). The log forms variable ”Communication” increased significantly in general (p=0,025). Conclusions: The results supports earlier studies that have found that animal-assisted acitivity (AAA) or therapy (AAT) may give increased wellbeing, social interactions and activity. Systematic, randomized controlled trials are still needed to confirm the effects of animal assisted interventions

A five-phase process model describing the return to sustainable work of persons who survived cancer: A qualitative study

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

Work Experiences During and After Treatment Among Self-Employed People with Cancer

Purpose The proportion of self-employed people in the workforce is growing. However, most research on work participation among cancer survivors has focused on salaried workers. We aimed to explore how self-employed people experience work during and after cancer treatment. Methods In this qualitative study, we conducted semi-structured interviews with seven self-employed people who had been treated for cancer. To provide a variety of perspectives on work-related aspects of self-employed cancer survivors we also interviewed seven counselors in the Norwegian Labour and Welfare Administration (NAV) who had long experience in supporting self-employed people and cancer patients around work participation. The interviews were transcribed verbatim and thematic analysis was undertaken. Results Five themes related to owning a business during and after cancer treatment emerged: entrepreneurship and engagement; cancer treatment and late-effects; business-related worries; shame; and support. Because of high job engagement and high autonomy the self-employed survivors often worked during treatment. While working could provide a sense of normalcy and a distraction from cancer, it was also essential to keep the business running. Survivors struggled with several work-related issues (e.g. high work demands, low work ability), but financial issues related to running their business caused particular worry. Getting cancer and, consequently, struggling with financial problems elicited a sense of shame that was closely connected to their strong identity as (successful) self-employed business (wo)men. Conclusion To support self-employed cancer survivors to retain work following a cancer diagnosis it is necessary to focus on the specific challenges faced by this group of workers, particularly related to financial issues and keep-ing the business afloat. Support measures to secure production and thus prevent loss of customers and bankruptcy are needed. It is important for health and social care personnel to be aware that self-employed cancer survivors may suffer from shame related to the cancer, low work ability and financial struggles, but that they may have difficulties talking about this shame

Labor-force participation and working patterns among women and men who have survived cancer: A descriptive 9-year longitudinal cohort study

Aims: Our aim was to investigate labor-force participation, working hours, job changes, and education over 9 years among persons who have survived more than 10 years after cancer, and compare it to controls. Methods: Register data on 2629 persons who survived cancer were stratified by gender and compared to data on 5258 matched controls. persons who survived cancer were aged 30–50 when diagnosed with cancer and had a work contract prior to diagnosis. Descriptive analysis and t-tests were performed. Results: The proportion of female persons who survived cancer in the labor force was reduced from 100% to 83.9% during follow-up, demonstrating a significant difference compared to controls for each year measured. The proportion of male persons who survived cancer dropped from 100% to 84.8%, but was only significantly different compared to controls in 2 years. The proportion of female persons who had survived cancer who worked full-time was lower in all years compared to both controls and male persons who survived cancer; in turn, male persons who had survived cancer worked full-time less than male controls. The proportion of female persons who had survived cancer who worked less than 20 hours per week increased compared to controls. The frequency of change of employer was higher among female persons who survived cancer compared to controls for some years, but no significant differences between male persons who survived cancer and controls were found. female persons who survived cancer were in education more often than male persons who survived cancer. Conclusions: Persons who survived cancer experienced reduced labor-force participation and working hours 9 years after diagnosis, and the reduction was more pronounced for women than for men. Working patterns were also different between genders and between persons who survived cancer and controls

Labor-force participation and working patterns among women and men who have survived cancer: A descriptive 9-year longitudinal cohort study

Aims: Our aim was to investigate labor-force participation, working hours, job changes, and education over 9 years among persons who have survived more than 10 years after cancer, and compare it to controls. Methods: Register data on 2629 persons who survived cancer were stratified by gender and compared to data on 5258 matched controls. persons who survived cancer were aged 30–50 when diagnosed with cancer and had a work contract prior to diagnosis. Descriptive analysis and t-tests were performed. Results: The proportion of female persons who survived cancer in the labor force was reduced from 100% to 83.9% during follow-up, demonstrating a significant difference compared to controls for each year measured. The proportion of male persons who survived cancer dropped from 100% to 84.8%, but was only significantly different compared to controls in 2 years. The proportion of female persons who had survived cancer who worked full-time was lower in all years compared to both controls and male persons who survived cancer; in turn, male persons who had survived cancer worked full-time less than male controls. The proportion of female persons who had survived cancer who worked less than 20 hours per week increased compared to controls. The frequency of change of employer was higher among female persons who survived cancer compared to controls for some years, but no significant differences between male persons who survived cancer and controls were found. female persons who survived cancer were in education more often than male persons who survived cancer. Conclusions:Persons who survived cancer experienced reduced labor-force participation and working hours 9 years after diagnosis, and the reduction was more pronounced for women than for men. Working patterns were also different between genders and between persons who survived cancer and control

Labor-force participation and working patterns among women and men who have survived cancer: A descriptive 9-year longitudinal cohort study

Aims: Our aim was to investigate labor-force participation, working hours, job changes, and education over 9 years among persons who have survived more than 10 years after cancer, and compare it to controls. Methods: Register data on 2629 persons who survived cancer were stratified by gender and compared to data on 5258 matched controls. persons who survived cancer were aged 30–50 when diagnosed with cancer and had a work contract prior to diagnosis. Descriptive analysis and t-tests were performed. Results: The proportion of female persons who survived cancer in the labor force was reduced from 100% to 83.9% during follow-up, demonstrating a significant difference compared to controls for each year measured. The proportion of male persons who survived cancer dropped from 100% to 84.8%, but was only significantly different compared to controls in 2 years. The proportion of female persons who had survived cancer who worked full-time was lower in all years compared to both controls and male persons who survived cancer; in turn, male persons who had survived cancer worked full-time less than male controls. The proportion of female persons who had survived cancer who worked less than 20 hours per week increased compared to controls. The frequency of change of employer was higher among female persons who survived cancer compared to controls for some years, but no significant differences between male persons who survived cancer and controls were found. female persons who survived cancer were in education more often than male persons who survived cancer. Conclusions:Persons who survived cancer experienced reduced labor-force participation and working hours 9 years after diagnosis, and the reduction was more pronounced for women than for men. Working patterns were also different between genders and between persons who survived cancer and control

Labor-force participation and working patterns among women and men who have survived cancer: A descriptive 9-year longitudinal cohort study

Aims: Our aim was to investigate labor-force participation, working hours, job changes, and education over 9 years among persons who have survived more than 10 years after cancer, and compare it to controls. Methods: Register data on 2629 persons who survived cancer were stratified by gender and compared to data on 5258 matched controls. persons who survived cancer were aged 30–50 when diagnosed with cancer and had a work contract prior to diagnosis. Descriptive analysis and t-tests were performed. Results: The proportion of female persons who survived cancer in the labor force was reduced from 100% to 83.9% during follow-up, demonstrating a significant difference compared to controls for each year measured. The proportion of male persons who survived cancer dropped from 100% to 84.8%, but was only significantly different compared to controls in 2 years. The proportion of female persons who had survived cancer who worked full-time was lower in all years compared to both controls and male persons who survived cancer; in turn, male persons who had survived cancer worked full-time less than male controls. The proportion of female persons who had survived cancer who worked less than 20 hours per week increased compared to controls. The frequency of change of employer was higher among female persons who survived cancer compared to controls for some years, but no significant differences between male persons who survived cancer and controls were found. female persons who survived cancer were in education more often than male persons who survived cancer. Conclusions:Persons who survived cancer experienced reduced labor-force participation and working hours 9 years after diagnosis, and the reduction was more pronounced for women than for men. Working patterns were also different between genders and between persons who survived cancer and control