Returning to work: The cancer survivor’s transformational journey of adjustment and coping

Abstract

The aim of this study was to explore cancer survivors’ return to work (RTW) experience with a specific focus on the adjustment and coping process underlying their journey. The study was conducted in the Southern Cape, South Africa, with eight cancer survivors having returned to work following successful treatment of various types of cancer. Unstructured interviews were conducted and data were analysed following the principles of hermeneutic phenomenological reflection and analysis. Four themes emerged, representing the changing adjustment responses and coping during the RTW journey. Participants evolve from being overwhelmed with emotions and applying avoidant coping to seeking understanding and positive affectivity in their attempt to comprehend the reality of their situation. Participants’ external locus of control change to a more active approach and problem-solving orientation, demonstrating a need to take control and responsibility. Ultimately, adjustment and coping become most constructive when cancer survivors resolve to re-assess life and self through meaning-making, resulting in renewed appreciation of life, appropriate life style changes, and regained confidence in their relational role. A process perspective is proposed to facilitate an understanding of, and working with, cancer survivors’ transition through the RTW journey towards optimal coping phases.

Work functioning trajectories in cancer patients: Results from the longitudinal Work Life after Cancer (WOLICA) study

“…When back at work, cancer patients often have to cope with declined physical and cognitive capacity, emotional concerns, self-confidence issues, a limited understanding of the effects of cancer by colleagues and employers and sometimes changes in the work environment. 17,18 Return to work (RTW) might therefore be seen as a process rather than a state, with healthrelated work functioning (hereafter referred to as work functioning) as a highly valuable outcome. Work functioning moves beyond employment status as it provides detailed information about experienced difficulties in meeting the demands of work given a health status.…”

Assessment of psychosocial dimensions of return to work after a cancer diagnosis: Current perspectives and future opportunities

“…Previous studies have also shown that conscientiousness and neuroticism were associated with a longer duration of unemployment and non‐RTW for healthy individuals . However, personality traits probably not only affect patients' RTW but also influence their coping efforts . A specific aspect of coping and positive reappraisal, akin to the concept of benefit finding, remains also to be investigated.…”

“…A specific aspect of coping and positive reappraisal, akin to the concept of benefit finding, remains also to be investigated. The qualitative study conducted by Barnard et al concluded that coping becomes constructive for RTW when a cancer survivor resolves to reassess his/her life and self through meaning‐making . This results in a renewed appreciation of life, appropriate lifestyle changes, and regained confidence in one's relational role .…”

“…8 However, personality traits probably not only affect patients' RTW but also influence their coping efforts. 9 A specific aspect of coping and positive reappraisal, akin to the concept of benefit finding, remains also to be investigated. The qualitative study conducted by Barnard et al concluded that coping becomes constructive for RTW when a cancer survivor resolves to reassess his/her life and self through meaning-making.…”

Culture, identity, strength and spirituality: A qualitative study to understand experiences of African American women breast cancer survivors and recommendations for intervention development

“…This social cognitive model of restorative well-being was one of Lent's (Lent, 2004) two models of subjective well-being (SWB), which aimed at how people restore emotional equilibrium when confronted with particularly stressful conditions. Cancer is documented as a traumatic and life-changing event (Smith, Klassen, Coa, & Hannum, 2016) that results in a chronic condition (Ellis et al, 2017;Hoffman, Lent, & Raque-Bogdan, 2013) to which cancer survivors have to make adjustments and find ways of coping (Barnard, Clur, & Joubert, 2016). Because Hoffman and colleagues conceptually extended Lent's restorative well-being model to cancer coping (Hoffman et al, 2013), we see the model as having a particular utility for enhancing our understanding of the psychological adjustment mechanisms that cancer survivors' use as a basis for optimising their coping and for building well-being interventions.…”