TY - JOUR
T1 - Work
T2 - saviour or struggle? A qualitative study examining employment and finances in colorectal cancer survivors living with advanced cancer
AU - Lim, Chloe Yi Shing
AU - Laidsaar-Powell, Rebekah C.
AU - Young, Jane M.
AU - Steffens, Daniel
AU - Koczwara, Bogda
AU - Zhang, Yuehan
AU - The advanced-CRC survivorship authorship group
AU - Solomon, Michael
AU - Koh, Cherry
AU - Ansari, Nabila
AU - Yeo, David
AU - Blinman, Prunella
AU - Beale, Philip
AU - Joshy, Grace
AU - Butow, Phyllis
PY - 2022/11
Y1 - 2022/11
N2 - Purpose: Continuing employment or returning to work (RTW) as a cancer survivor can be meaningful and financially necessary, yet challenging. However, there is a lack of qualitative research on RTW experiences and financial wellbeing of people with advanced colorectal cancer (CRC-A). This study aimed to fill this gap.Methods: Adults treated for CRC-A were recruited 0.5–2 years post-surgery (or post-diagnosis of CRC-A for palliative chemotherapy participants). Semi-structured telephone interviews, exploring RTW and finances, were subjected to framework analysis. Demographic, clinical, and quality of life data (FACT-C, Distress Thermometer, COST measure) were collected to characterise the sample and inform the framework analysis.Results: Analysis of 38 interviews revealed five overarching themes: work as a struggle, work as my identity, work as my saviour, work as a financial necessity, and employer and colleague response. Many survivors with CRC-A desired to, and had the capacity to, continue work or RTW, yet faced unique challenges from compounded stigma of both cancer and toileting issues. Inability to RTW negatively impacted financial and psychosocial wellbeing. Workplace support was an important facilitator of RTW.Conclusion: For survivors with CRC-A, continuing or RTW is fraught with challenges, including physical functioning challenges, financial anxiety, and unsupportive workplace environments. Survivors require psychosocial, financial, and employer support to manage these difficulties. This paper recommends a multiprong approach, including education programmes (facilitated through workers’ union groups, human resource institutions, and/or large consumer CRC groups) and policies, to support workers and for employers to understand the unique challenges of employees with CRC-A.
AB - Purpose: Continuing employment or returning to work (RTW) as a cancer survivor can be meaningful and financially necessary, yet challenging. However, there is a lack of qualitative research on RTW experiences and financial wellbeing of people with advanced colorectal cancer (CRC-A). This study aimed to fill this gap.Methods: Adults treated for CRC-A were recruited 0.5–2 years post-surgery (or post-diagnosis of CRC-A for palliative chemotherapy participants). Semi-structured telephone interviews, exploring RTW and finances, were subjected to framework analysis. Demographic, clinical, and quality of life data (FACT-C, Distress Thermometer, COST measure) were collected to characterise the sample and inform the framework analysis.Results: Analysis of 38 interviews revealed five overarching themes: work as a struggle, work as my identity, work as my saviour, work as a financial necessity, and employer and colleague response. Many survivors with CRC-A desired to, and had the capacity to, continue work or RTW, yet faced unique challenges from compounded stigma of both cancer and toileting issues. Inability to RTW negatively impacted financial and psychosocial wellbeing. Workplace support was an important facilitator of RTW.Conclusion: For survivors with CRC-A, continuing or RTW is fraught with challenges, including physical functioning challenges, financial anxiety, and unsupportive workplace environments. Survivors require psychosocial, financial, and employer support to manage these difficulties. This paper recommends a multiprong approach, including education programmes (facilitated through workers’ union groups, human resource institutions, and/or large consumer CRC groups) and policies, to support workers and for employers to understand the unique challenges of employees with CRC-A.
KW - Bowel cancer
KW - Cancer survivorship
KW - Financial wellbeing
KW - Qualitative interviews
KW - Return to work
UR - http://www.scopus.com/inward/record.url?scp=85136230369&partnerID=8YFLogxK
UR - http://purl.org/au-research/grants/NHMRC/1139539
U2 - 10.1007/s00520-022-07307-9
DO - 10.1007/s00520-022-07307-9
M3 - Article
C2 - 35972645
AN - SCOPUS:85136230369
SN - 0941-4355
VL - 30
SP - 9057
EP - 9069
JO - Supportive Care in Cancer
JF - Supportive Care in Cancer
IS - 11
ER -