Abstract
Purpose Implementation of return to work (RTW) programs for cancer survivors has proved to be challenging. The purpose of our study was to gather experiences about barriers to and facilitators of implementing RTW programs for cancer survivors in four European countries. Methods Separate multidisciplinary focus groups were held in Belgium (n = 8), the Netherlands (n = 8), Ireland (n = 6), and UK (n = 4) in 2017 and included among others a physician, and a representative of an employer, a cancer society, and the government. Primary focus of thematic analysis was what could be done to improve the implementation of RTW programs for cancer survivors. Analysis used the ‘Arena in work disability prevention model’ as the conceptual framework. Results Many barriers to and facilitators of implementing RTW programs for cancer survivors were described including the personal, workplace, healthcare and legislative system as well as the overall societal and political context. That is, for example cooperation between stakeholders, time, money and ability issues at the workplace, and insufficient/inadequate legislation. Insufficient knowledge of cancer and its implications for work was identified as an overarching theme in all countries leading to stigma, misconceptions and lack of communication. This was mentioned in relation to the workplace, personal and healthcare system, and in the overall societal context. Conclusions Results indicate that a prerequisite for implementing RTW programs is raising sufficient knowledge regarding cancer and its implications for work. Greater knowledge could be a first step to better implement RTW programs which may result in better supporting cancer survivors with their RTW .
Highlights
Each year, an estimated 3.7 million new cases of cancer are diagnosed in Europe with approximately half of these occurring at working age [1, 2]
The groups included a vocational rehabilitation expert, nurse/physician, employee of a reintegration bureau specialised in return to work (RTW) of cancer survivors, a researcher, an employer representative, a trade union representative, a government representative, a fund of occupational diseases representative, a worker representative, an Occupational Health (OH) representative, and included an employee of a cancer survivor society
Many barriers to and facilitators of implementing RTW programs for cancer survivors were mentioned in all focus groups including all systems of the ‘Arena in work disability prevention model’ [30] (Table 2)
Summary
An estimated 3.7 million new cases of cancer are diagnosed in Europe with approximately half of these occurring at working age [1, 2]. Many cancer survivors still face long-term symptoms and impairments after treatment such as fatigue, cognitive limitations, and/or physical or functional limitations [3, 4]. In this context, the cancer survivors’ quality of life (QOL) becomes a crucial issue [5,6,7]. Cancer survivors have a 1.4 higher risk of becoming unemployed [9] This is unfortunate, as return to work (RTW) is seen by cancer survivors as an important step in the transition from illness to normal life [10]. For employers and the society at large, it is economically important to encourage cancer survivors to RTW whenever possible [11]
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