Enhancing the return to work of cancer survivors: Development and evaluation of an intervention targeted at employers

Work is one of the main pillars of cancer survivorship, but still approximately 40% of cancer survivors are not able to return to work within a year of diagnosis. Employers play a vital role in guiding employed cancer survivors during their sickness absence and return to work (RTW), but regard the guidance of cancer survivors as difficult to manage. The aim of this thesis was to develop and pilot test an intervention (called the MiLES intervention) targeting the employer that enhances the successful RTW of cancer survivors. The thesis identified the most important employer actions and the support needs of employers in guiding employed cancer survivors during their sickness absence and RTW. On this basis, the MiLES intervention was developed, which is a web-based intervention with succinct, tailored tips and information, communication videos and conversation checklists. Employers perceived the intervention to be a useful tool that well suits their daily practice. However, whether the intervention is actually effective in enhancing the successful RTW of cancer survivors cannot be concluded on the basis of the studies presented in the thesis. The thesis also revealed that, according to cancer survivors, a successful RTW comprises more than just returning to the workplace. Therefore, an outcome measure that incorporates cancer survivors’ perspectives on what is perceived as successful RTW was developed: the Successful Return-To-Work Questionnaire for Cancer Survivors (I-RTW_CS). The I-RTW_CS enables an in-depth evaluation of a cancer survivor’s RTW, taking into account individual perspectives on a successful RTW. The thesis concluded that employers are an important link in the RTW process of cancer survivors, but need to be supported to fulfill this role. The MiLES intervention provides employers a promising tool to enhance successful RTW of cancer survivors

The cancer survivor-Manager dyad during the return-to-work process: An introduction with theoretical, conceptual, and methodological considerations

International audienceObjectiveThere is a need for tailored interventions aimed at promoting the sustainable return to work (RTW) of cancer survivors. As managers have a primary role in supporting cancer survivors to return to work, a better understanding of the "cancer survivor-manager" dyadic process is much needed. The aim of this paper is to introduce the cancer survivor-manager dyad in the context of RTW of cancer survivors, and to inform future studies by presenting theoretical, conceptual, and methodological considerations. ConclusionsDifferent theoretical, conceptual, and methodological aspects are addressed that open new perspectives concerning the cancer survivor-manager dyad. Among the theoretical and conceptual aspects, we highlight the interest of developing dyadic coping models specific to the cancer survivor-manager dyad. This would allow the conceptualization of their interpersonal dynamics and to frame interventions aimed at supporting cancer survivors and managers. In addition, we encourage to study in more detail the quality of the relationship between the cancer survivor and manager, including its impact on work-related outcomes of the cancer survivor. Methodologically, the actor-partner interdependence model could be relevant to identify any interdependence in the cancer survivor-manager dyad. We also recommend using longitudinal and prospective studies to investigate the cancer survivor-manager dyad, as these studies are well suited to identify evolutive and dynamic aspects of the cancer survivor-manager dyad. Lastly, we propose a recruitment strategy of the dyad by involving a trustworthy third party, to respect the ethical framework, and the privacy and voluntary choice of cancer survivors

Enhancing Emotional Skills of Managers to Support the Return to Work of Cancer Survivors: A Research Opinion Focusing on Value, Feasibility and Challenges

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The MiLES intervention targeting employers to promote successful return to work of employees with cancer: design of a pilot randomised controlled trial

Background: Employers express a need for support to facilitate the return to work (RTW) process of employees with cancer. We have developed the MiLES intervention, an online toolbox targeting employers during the RTW of employees with cancer. To evaluate the MiLES intervention, we propose the design of a pilot randomised controlled trial (RCT). The aim of this pilot is to determine whether a future RCT to study the effectiveness of this intervention on successful RTW of employees with cancer is feasible. Secondary aims are to obtain preliminary results on the effectiveness of the intervention and to determine the sample size needed in a future definitive RCT. Methods: A pilot RCT with a 6-month follow-up will be conducted. Using medical specialists at Dutch hospitals, we aim to enrol 90 participants diagnosed with cancer (<2 years earlier) aged 18-63 years who are in paid employment with an employer and who are currently sick-listed or partly sick-listed for <1 year. Participants randomised to the intervention group will be asked to inform their employer about the online toolbox supporting employers during the RTW process of employees with cancer. Participants in the control group will receive 'care as usual' from their employer. All measures will be assessed at the level of the employee using questionnaires at baseline and after 3 and 6 months of follow-up. The feasibility of a future RCT will be determined using criteria concerning method-related uncertainties and acceptability of the study protocol. The primary effect measure will be successful RTW (that is, RTW perceived as being successful by the cancer survivor themselves). This effect measure will be used to perform the sample size calculation for a future definitive RCT. Discussion: The design is proposed to determine the feasibility to study the effectiveness of the MiLES intervention targeting employers on the successful RTW of employees diagnosed with cancer. This pilot RCT can increase the probability of a successful future definitive RCT on the effectiveness of the intervention and potentially obviate the need to carry out an unfeasible and resource-intensive study. Trial registration: Dutch Trial Register (NTR): NL6758, NTR7627. Registered on 30 October 2018

Cancer survivors and adverse work outcomes: associated factors and supportive interventions

Introduction: The number of cancer survivors in a working age is rising. An awareness of factors associated with adverse work outcomes, and of supportive interventions, is needed. Sources of data: A narrative review of research obtained via several databases, including Medline and PsycINFO, was conducted. Areas of agreement: A range of factors is associated with adverse work outcomes such as prolonged sick leave, delayed return to work, disability pension and unemployment in cancer survivors. They include the cancer type and treatment, fatigue, cognitive functioning, work factors and elements of health care systems. Effective supportive interventions encompass physical and multicomponent interventions. Areas of controversy: The role of behaviour determinants and legislative and insurance systems is unclear. It is furthermore uncertain what the optimal timing of delivering supportive interventions is. Growing points: Further focus on vulnerable groups, including specific cancer types and those with lower income, lower educational level and in precarious employment, is needed. Areas timely for developing research: Recent developments are tailored and timely interventions

Prognostic factors for return to work in breast cancer survivors

Objectives: This is a protocol for a Cochrane Review (prognosis). The objectives are as follows:. The primary objective is to systematically review and synthesise the literature on the association between sociodemographic, breast cancer-related, other health-related, personal, and work-related factors and return to work in the first 24 months after breast cancer diagnosis among those survivors having paid work at diagnosis

Prognostic factors for return to work in breast cancer survivors

Objectives: This is a protocol for a Cochrane Review (prognosis). The objectives are as follows:. The primary objective is to systematically review and synthesise the literature on the association between sociodemographic, breast cancer-related, other health-related, personal, and work-related factors and return to work in the first 24 months after breast cancer diagnosis among those survivors having paid work at diagnosis

Cancer survivors and adverse work outcomes: associated factors and supportive interventions

INTRODUCTION: The number of cancer survivors in a working age is rising. An awareness of factors associated with adverse work outcomes, and of supportive interventions, is needed. SOURCES OF DATA: A narrative review of research obtained via several databases, including Medline and PsycINFO, was conducted. AREAS OF AGREEMENT: A range of factors is associated with adverse work outcomes such as prolonged sick leave, delayed return to work, disability pension and unemployment in cancer survivors. They include the cancer type and treatment, fatigue, cognitive functioning, work factors and elements of health care systems. Effective supportive interventions encompass physical and multicomponent interventions. AREAS OF CONTROVERSY: The role of behaviour determinants and legislative and insurance systems is unclear. It is furthermore uncertain what the optimal timing of delivering supportive interventions is. GROWING POINTS: Further focus on vulnerable groups, including specific cancer types and those with lower income, lower educational level and in precarious employment, is needed. AREAS TIMELY FOR DEVELOPING RESEARCH: Recent developments are tailored and timely interventions

Employees Diagnosed with Cancer: Current Perspectives and Future Directions from an Employer’s Point of View

Purpose and methods Cancer survivors have a higher risk of adverse work outcomes such as not being able to return to work (RTW). The process of returning to work is complex as a result of the diverse stakeholders and numerous factors involved related to the employee diagnosed with cancer, the work environment, health care system, and the legal system. One of the key stakeholders is the employer, as the employer is in the position to facilitate work accommodations. Therefore, the purpose of this brief review is to consider opportunities regarding the role of the employer to enhance the work participation of employees with cancer. Results and conclusions We currently know little about which aspects of employer support have a positive impact on the ability of employees diagnosed with cancer to retain at work or RTW. In addition, there is a lack of interventions and tools which support employers in their management of employees diagnosed with cancer. The inclusion of employer support into the workplace can help employees diagnosed with cancer with their work retention and RTW, which is an important aspect of their quality of life and benefits the society at large