What Employer Actions Are Considered Most Important for the Return to Work of Employees with Cancer? A Delphi Study Among Employees and Employers

Abstract

Purpose Employers are important stakeholders in the return to work (RTW) of employees with cancer. However, it is unclear what employer actions are most important to that process. The objective, therefore, was to reach consensus on what employer actions are considered most important for the RTW of employees with cancer, by employers and employees separately. Methods A two-round online Delphi study was conducted with two expert panels: one with 23 employers and one with 29 employees with cancer. The results from each panel were analysed separately. Out of 24 suggested employer actions, participants selected the 10 they considered most important for RTW in each of the following RTW phases: (1) disclosure, (2) treatment, (3) RTW plan, and (4) actual RTW. The consensus threshold was set at ≥ 80% during the second round. Results The employer and employee expert panels both reached consensus on the importance of 'emotional support', 'practical support', 'allow sufficient sick leave', 'plan return to work', 'adjust expectations', 'assess work ability', and 'show appreciation'. Employers also reached consensus on 'communicate' and 'treat normally', and employees on 'handle unpredictability'. All these employer actions were considered to be specific for one to three RTW phases. Conclusions Employers reached consensus on the importance of nine employer actions, employees on eight. Both stakeholder perspectives showed great similarities, but did vary regarding important employer actions during the employee's treatment. We recommend developing interventions targeting the employer, meeting both employer and employee needs in each RTW phase, to enhance RTW support for employees with cancer.

Supporting employers to enhance the return to work of cancer survivors: development of a web-based intervention (MiLES intervention)

“…The abovementioned perceived barriers and facilitators were condensed into the most important employer actions, according to employers and cancer survivors [22]. The following employer actions were identified by cancer survivors and/or employers as most important for the successful RTW of cancer survivors: "emotional support," "practical support," "allow sufficient sick leave," "plan return to work," "adjust expectations," "assess work ability," "show appreciation," "communicate," "treat normally," and "handle unpredictability."…”

“…Employers and cancer survivors mostly identified corresponding employer actions, but not during the survivor's sick leave (RTW phase 2). Different perspectives might put effective collaboration between both parties at risk [22]. It is therefore of great importance to have a mutual understanding of each other's needs and preferences throughout the RTW phases [22].…”

“…Different perspectives might put effective collaboration between both parties at risk [22]. It is therefore of great importance to have a mutual understanding of each other's needs and preferences throughout the RTW phases [22]. The perspectives held by the cancer survivors also differed considerably [22].…”

“…Also, an employer's lack of knowledge of cancer and inadequate communication skills, as well as inflexible national and organizational policies, might prevent the employer from giving appropriate RTW support to the cancer survivor [17,18]. Several studies therefore recommend providing employers with guidelines and other supportive interventions to enhance the RTW of cancer survivors [2,[16][17][18][19][20][21][22][23][24][25][26][27]. As there was a lack of scientifically sound interventions targeting employerswhich might well be the missing link in efforts to optimize the work participation of cancer survivors [16,21] we developed one, namely, the MiLES ("the Missing Link: optimizing the return to work of Employees diagnosed with cancer, by Supporting employers") intervention.…”

“…A work-related intervention targeting employers is complex, considering, for example, the diversity among cancer survivors, the number of possible employer actions during the RTW trajectory of a cancer survivor, and the required degree of flexibility and tailoring concerning these actions [18,22,28]. In order to maximize the probability that an intervention will be effective, it is recommended to develop it systematically [29].…”