Return to work after breast cancer treatments: Rebuilding everything despite feeling "in-between".

Abstract

The aim of this longitudinal qualitative study is to describe the return-to-work (RTW) journey from the end of breast cancer (BC) treatments to RTW. Nine BC survivors were recruited in the province of Quebec (Canada). The participants, francophones between 30 and 60 years old, had received chemotherapy treatments and planned to RTW in the next six months. The interviews were performed at the end of cancer treatments (n = 9), one month before RTW (n = 9), and after RTW (n = 5). A content analysis was performed based on an iterative process. The first six months after the end of treatment was identified as an "in-between" period, during which participants questioned their ability to return to normal life due to the impact of side effects and a sense of withdrawal from health-care services. A three-stage journey similar to a rite of passage process (Van Gennep, 1969) was observed. 1) BC survivors became aware of feeling on the fringes of the workplace as they awaited RTW. 2) During that waiting period, BC survivors were rebuilding a "normal routine" and taking actions on their own in order to re-enter their workplace. 3) After RTW, they needed to make adjustments to maintain a work routine. Support for BC survivors resuming their active lives needs to be optimized. BC survivors require support on side effect management, RTW decision-making, and resources for resuming daily activities. Nurses must be aware of the "in-between" period so that they can help BC survivors rebuild their confidence during this rite of passage process.