Abstract

PurposeConsidering that breast cancer survivors (BCSs) have been dealing with unwanted job changes after diagnosis, this study aimed to investigate involuntary job changes (unwanted modifications in employment since diagnosis) and explore the association between job changes, involuntariness, and occupational development satisfaction in BCSs 5–6 years after diagnosis.MethodsData were drawn from the mixed-methods breast cancer patients’ return to work (B-CARE) study. We surveyed 184 female BCSs who were working at the time of study enrollment during hospitalization (T1), 10 weeks after discharge (T2), 40 weeks after discharge (T3), and 5–6 years after diagnosis (T4) and used descriptive measures and stepwise linear regression models for data analysis.ResultsThe mean age of BCSs was 57 years. A total of 105 participants reported 410 job changes, of which 16.1% were reportedly (rather) involuntary. The most commonly reported involuntary changes were increased workload (15.2%) and increased scope of work (15.2%). In the final model, significant predictors of satisfaction with occupational development 5–6 years after diagnosis were age, state of health ΔT2–T3, state of health ΔT3–T4, and involuntariness of job changes.ConclusionsAlthough the number of job changes alone is not substantially associated with BCSs’ satisfaction with occupational development, experiencing involuntary job changes is. Sociodemographic, disease-related, and work(place)-related factors may influence occupational satisfaction among BCSs.Implications for Cancer SurvivorsThe findings indicate the importance of strengthening one’s ability to work as desired to prevent involuntary job changes and enable desired work participation in long-term support. The significance of workplace characteristics highlights the need for employers to encourage satisfying work participation.Trial registration numberGerman Clinical Trials Register (DRKS00016982), 12 April 2019

Highlights

  • In Germany, approximately 492,000 new cancer cases were diagnosed in 2016 [1]

  • Work-related outcomes are especially important for working-age breast cancer survivors (BCSs), considering that work can give meaning, provide financial security, allow social participation [4], and positively influence their quality of life [5]

  • Among the involuntary job changes, increased workload (15.2%) and increased scope of work (15.2%) were the most often reported changes, followed by retirement entry caused by reduced earning capacity or early retirement (12.1%) and decreased working time (12.1%)

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Summary

Introduction

In Germany, approximately 492,000 new cancer cases were diagnosed in 2016 [1]. The most common cancer type among females is breast cancer, with almost 70,000 newly diagnosed cases per year [1]. Work-related outcomes, such as the timing and determinants of return to work (RTW), of cancer survivors have been extensively researched [6,7,8,9,10]. Objective long-term workrelated outcomes such as work performance, absenteeism, and job changes in cancer survivors have been studied [11,12,13]. A multicountry study by Torp et al [14] described that 6–37% of employed cancer survivors underwent occupational changes up to 6 years following diagnosis, and given that changes in working time were analyzed separately, approximately one-quarter of these respondents reduced their working hours after diagnosis. Reduced physical and mental work abilities were associated with work changes [16]

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