Facilitating Factors and Barriers in the Return to Work of Working Women Survivors of Breast Cancer: A Qualitative Study

Abstract

Several studies have identified the main barriers and facilitators that breast cancer survivors experience in the return to work (RTW). The authors conducted a qualitative study using focus group discussions with a group of female non-metastatic breast cancer survivors (n = 6), a group of health professionals from different medical specialties (n = 8), and a third group of company managers mainly composed of human resources managers (n = 7). The study was carried out between March and December 2021 in Zaragoza (Spain). Transcripts were analyzed using inductive content analysis to identify work-related barriers and facilitators and coded by the research team. Barriers identified included physical and cognitive symptoms, psychosocial problems, lack of knowledge and coordination (health professional, patients, and managers), legal vacuum, physical change, time constraints, work characteristics (lower skilled jobs), unsupportive supervisors and coworkers, family problems and self-demand. Facilitators included family and work support, physical activity and rehabilitation, personalized attention, interdisciplinary collaboration, legal advice for workers, knowledge about breast cancer in companies, positive aspects of work, elaboration of protocols for RTW in women with breast cancer. RTW in working women with breast cancer requires a personalized and holistic view that includes the perspectives of patients, healthcare professionals and company managers.

Supporting Return to Work after Breast Cancer: A Mixed Method Study

“…Medical examinations made it possible to objectify residual physical problems after treatment. Previous studies had already included physical limitations among the obstacles to RTW [ 43 , 44 , 46 , 55 ]. Pain—especially in the axilla and arm on the affected side—plays an important role in the quality of a patient’s life [ 41 ] and in RTW [ 56 ].…”

“…The limitations of this study include sample size, which was nevertheless larger than that of other qualitative studies [ 39 , 43 , 96 , 97 , 98 ] that were sometimes limited to just six or seven cases [ 46 , 97 ]. Apparently, ours is the largest qualitative study in the literature; what is more, none of the qualitative studies published to date were combined with quantitative analysis, and none with personalized job adaptation proposals.…”

“…Repetitive analysis using a team approach helped increase the reliability of data, and the initial coding framework included negative and positive aspects of the RTW experience themes (phase 3). According to observations collected in the literature concerning the RTW of BC women [ 8 , 10 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 ] and textual fragments collected from interviews, a thematic map was drawn up and sub-themes related to the two main themes were inserted (phase 4). Afterwards, we classified themes as ‘barriers’ (negative aspects) and ‘facilitators’ (positive aspects) (phase 5).…”