Unmet needs and problems related to employment and working as reported by survivors with metastatic breast cancer

Sesto, Mary E.; Carroll, Cibele B.; Zhang, Xiao; Terhaar, Abigail; Wilson, Athena S; Tevaarwerk, Amye J.

doi:10.1007/s00520-021-06755-z

Cited by 9 publications

(11 citation statements)

References 25 publications

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“…We asked about demographics, employment status, work ability and importance, and disability information needs. These survey data have been reported elsewhere (Sesto et al, 2022).…”

Section: Data Collectionmentioning

confidence: 74%

“…As a part of a larger research project (Sesto et al, 2022), we conducted a survey of MBC survivors; the objective of this survey was to understand the work status and needs of patients living with MBC and explore the importance of work and work-related decisions in this population. This study was approved by the institutional review board (IRB).…”

Section: Data Collectionmentioning

confidence: 99%

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Unmet Employment Related Needs of Metastatic Breast Cancer Survivors: A Work System Analysis

Salwei

Sesto

Tevaarwerk

et al. 2022

Proceedings of the International Symposium on Human Factors and

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Metastatic breast cancer (MBC) is incurable breast cancer (i.e., stage IV) affecting approximately 165,000 women in the US, some of whom will live for years with MBC. Survivors living with MBC frequently experience functional impairments and sickness relating to treatment and their disease progression. Unlike “curable” cancers, MBC survivors are likely to deal with ongoing and/or evolving impairments due to cancer and cancer treatment until end of life, which presents challenges to work and employment. Little is known about the work-related needs of MBC survivors and the factors that impact individual survivors’ decisions to stay-or-leave work. The objective of this study is to understand the work system barriers and facilitators facing MBC survivors who were working at the time of MBC diagnosis. We conducted a survey of MBC survivors as a part of a larger research project to explore the importance of work and work-related decisions in this population. We conducted a secondary, deductive content analysis of a free-text response survey question guided by the Work System model. We identified a total of 77 excerpts, grouped into 12 barriers and 5 facilitators from survey responses of 133 MBC survivors. The person work system element resulted in the most barriers and facilitators, with numerous barriers relating to a lack of information available for MBC survivors. We only identified one excerpt relating to the technology work system element. Given the rapidly growing capabilities of technologies, there is a missed opportunity to design technologies that can support MBC survivors. The increased use of dedicated personnel (e.g., social work, navigators or financial counselors) and the development of patient-facing health IT may better support the unique needs of MBC survivors.

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“…We asked about demographics, employment status, work ability and importance, and disability information needs. These survey data have been reported elsewhere (Sesto et al, 2022).…”

Section: Data Collectionmentioning

confidence: 74%

Section: Data Collectionmentioning

confidence: 99%

Unmet Employment Related Needs of Metastatic Breast Cancer Survivors: A Work System Analysis

Salwei

Sesto

Tevaarwerk

et al. 2022

Proceedings of the International Symposium on Human Factors and

Self Cite

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“…Sesto et al conducted an online survey study among 133 female respondents working at the time of mBC diagnosis; 72 were stably working, while 61 reported no‐longer‐working based on employment status at the time of the survey 28 . According to Sesto et al, women living with mBC financial and/or insurance issues and the desire to support themselves and their families are reasons for considering work 28 . A possible explanation for 180 (37%) women in our study having 0–30 WNDs could be due to the generous Swedish legislation against dismissal in the event of illness.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, being employed is, for most persons, an essential part of well‐being 25,26 and the feeling of normalcy 27 . Other reasons for considering work important are financial and insurance issuers, the importance of staying busy and the desire to support themselves and their family 28 . In Sweden, employees have legal protection against dismissal in the event of illness 29 .…”

Section: Introductionmentioning

confidence: 99%

Planning for return to work during the first year after breast cancer metastasis: A Swedish cohort study

et al. 2023

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Background Planning for return to work (RTW) is relevant among sub‐groups of metastatic breast cancer (mBC) survivors. RTW and protective factors for RTW in patients with mBC were determined. Methods Patients with mBC, ages 18–63 years, were identified in Swedish registers, and data were collected starting 1 year before their mBC diagnosis. The prevalence of working net days (WNDs) (>90 and >180) during the year after mBC diagnosis (y1) was determined. Factors associated with RTW were assessed using regression analysis. The impact of contemporary oncological treatment of mBC on RTW and 5‐year mBC‐specific survival was compared between those diagnosed in 1997–2002 and 2003–2011. Results Of 490 patients, 239 (48.8%) and 189 (36.8%) had >90 and >180 WNDs, respectively, during y1. Adjusted odds ratios (AORs) of WNDs >90 or >180 during y1 were significantly higher for patients with age ≤50 years (AOR180 = 1.54), synchronous metastasis (AOR90 = 1.68, AOR180 = 1.67), metastasis within 24 months (AOR180 = 1.51), soft tissue, visceral, brain as first metastatic site (AOR90 = 1.47) and sickness absence <90 net days in the year before mBC diagnosis, suggesting limited comorbidities (AOR90 = 1.28, AOR180 = 2.00), respectively. Mean (standard deviation) WNDs were 134.9 (140.1) and 161.3 (152.4) for patients diagnosed with mBC in 1997–2002 and 2003–2011, respectively (p = 0.046). Median (standard error) mBC‐specific survivals were 41.0 (2.5) and 62.0 (9.6) months for patients diagnosed with mBC in 1997–2002 and 2003–2011, respectively (p < 0.001). Conclusions RTW of more than 180 WNDs was associated with younger age, early development of metastases and limited comorbidities during the year before the diagnosis of mBC. Patients diagnosed with mBC in 2003 or later had more WNDs and better survival than those diagnosed earlier.

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“…Previous studies showed that patients who remained employed during treatment reported feeling financial pressure as the main reason they continued to work, and they felt pressure to adapt their work expectations to changes in their physical and mental abilities, which would likely be affected by treatment. 35,36 These pressures may lower patients’ evaluation of readiness for hospital discharge to deal with both oral chemotherapy and job-related issues at home. Also, because cancer treatment is a specialized service, most people in rural and suburban areas have less access to licensed healthcare providers and high-quality medical resources.…”

Section: Discussionmentioning

confidence: 99%

Associations of readiness for hospital discharge with symptoms and non-routine utilization of post-discharge services among cancer patients receiving oral chemotherapy at home: A prospective study

Chen

Qin

et al. 2022

J Oncol Pharm Pract

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Background Readiness for hospital discharge is associated with patients’ health outcomes after they return home. However, little is known about this association among cancer patients receiving oral chemotherapy at home. This study aimed to examine whether patients’ reported readiness for hospital discharge was associated with symptoms and non-routine utilization of post-discharge services among cancer patients receiving oral chemotherapy at home. Methods A prospective study was conducted, and 151 cancer patients receiving oral chemotherapy were recruited from a provincial level hospital in South China between October 2018 and December 2019. The primary outcome was readiness for hospital discharge assessed by the Readiness for Hospital Discharge Scale-Short Form on the day of discharge. The secondary endpoints were symptoms assessed by MD Anderson Symptom Inventory and non-routine utilization of post-discharge services within one cycle of chemotherapy at home (21 days). Results Among these 151 participants, 74.2% of them reported as ready for discharge. Patients who were employed, lived in suburban area or villages, had a higher Eastern Cooperative Oncology Group score, took Tegafur as oral chemotherapy, and took oral chemotherapy for the first time reported lower readiness for hospital discharge. These five factors explained 28.1% of variance in readiness for hospital discharge. Patients who were not ready for discharge were prone to report higher symptom severity ( p = 0.038). No differences in non-routine utilization of post-discharge services were found between the readiness versus non-readiness for discharge groups ( p = 0.891). Conclusions Most cancer patients receiving oral chemotherapy at home were ready for discharge, which was influenced by employment status, residence status, Eastern Cooperative Oncology Group score, type of oral chemotherapy drug, and the experience of taking oral chemotherapy at home. Patients with lower readiness reported worse symptom severity at home. Routine assessment was suggested to recognize unready patients, and more extensive preparations for discharge were recommended to help them manage symptoms at home.

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Unmet needs and problems related to employment and working as reported by survivors with metastatic breast cancer

Cited by 9 publications

References 25 publications

Unmet Employment Related Needs of Metastatic Breast Cancer Survivors: A Work System Analysis

Unmet Employment Related Needs of Metastatic Breast Cancer Survivors: A Work System Analysis

Planning for return to work during the first year after breast cancer metastasis: A Swedish cohort study

Associations of readiness for hospital discharge with symptoms and non-routine utilization of post-discharge services among cancer patients receiving oral chemotherapy at home: A prospective study

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