Department of Health, Social & Welfare Studies, University of South-Eastern Norway, PO Box 4, 3199, Borre, Norway.
Institute of Health & Society, Newcastle University, Newcastle-upon-Tyne, UK.
J Occup Rehabil. 2020 Mar;30(1):49-58. doi: 10.1007/s10926-019-09845-2.
Purpose The proportion of self-employed people in the workforce is growing. However, most research on work participation among cancer survivors has focused on salaried workers. We aimed to explore how self-employed people experience work during and after cancer treatment. Methods In this qualitative study, we conducted semi-structured interviews with seven self-employed people who had been treated for cancer. To provide a variety of perspectives on work-related aspects of self-employed cancer survivors we also interviewed seven counselors in the Norwegian Labour and Welfare Administration (NAV) who had long experience in supporting self-employed people and cancer patients around work participation. The interviews were transcribed verbatim and thematic analysis was undertaken. Results Five themes related to owning a business during and after cancer treatment emerged: entrepreneurship and engagement; cancer treatment and late-effects; business-related worries; shame; and support. Because of high job engagement and high autonomy the self-employed survivors often worked during treatment. While working could provide a sense of normalcy and a distraction from cancer, it was also essential to keep the business running. Survivors struggled with several work-related issues (e.g. high work demands, low work ability), but financial issues related to running their business caused particular worry. Getting cancer and, consequently, struggling with financial problems elicited a sense of shame that was closely connected to their strong identity as (successful) self-employed business (wo)men. Conclusion To support self-employed cancer survivors to retain work following a cancer diagnosis it is necessary to focus on the specific challenges faced by this group of workers, particularly related to financial issues and keeping the business afloat. Support measures to secure production and thus prevent loss of customers and bankruptcy are needed. It is important for health and social care personnel to be aware that self-employed cancer survivors may suffer from shame related to the cancer, low work ability and financial struggles, but that they may have difficulties talking about this shame.
目的 劳动力中自雇人士的比例正在增长。然而，大多数关于癌症幸存者工作参与情况的研究都集中在受薪工人身上。我们旨在探讨癌症治疗期间和之后自雇人士的工作经历。
方法 在这项定性研究中，我们对七位已接受癌症治疗的自雇人士进行了半结构化访谈。为了从自雇癌症幸存者工作相关方面提供多种视角，我们还采访了挪威劳动和福利管理局（NAV）的七位顾问，他们在支持自雇人士和癌症患者参与工作方面拥有丰富的经验。访谈内容逐字记录下来，并进行了主题分析。
结果 出现了五个与癌症治疗期间和之后经营企业相关的主题：创业精神和参与度；癌症治疗和晚期效应；与业务相关的担忧；羞耻感；和支持。由于高度的工作投入和高度的自主权，自雇幸存者经常在治疗期间工作。虽然工作可以提供一种正常感和从癌症中分心的方式，但保持企业的运转也是至关重要的。幸存者面临着一些与工作相关的问题（例如高工作要求、低工作能力），但与经营企业相关的财务问题尤其令人担忧。患上癌症，因此面临财务问题，会引发一种羞耻感，这种羞耻感与他们作为（成功的）自雇企业（女）人的强烈身份密切相关。
结论 为了支持自雇癌症幸存者在诊断出癌症后继续工作，有必要关注这一群体工人所面临的具体挑战，特别是与财务问题和维持企业运转相关的挑战。需要采取支持措施来确保生产，从而防止失去客户和破产。卫生和社会保健人员必须意识到，自雇癌症幸存者可能会因癌症、低工作能力和财务困难而感到羞耻，但他们可能难以谈论这种羞耻感。
