Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia.
Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
Support Care Cancer. 2022 Nov;30(11):9057-9069. doi: 10.1007/s00520-022-07307-9. Epub 2022 Aug 16.
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.
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.
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.
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.
作为癌症幸存者继续就业或重返工作岗位（RTW）可能具有重要意义且在经济上有必要，但也具有挑战性。然而，对于晚期结直肠癌（CRC-A）患者的 RTW 经历和财务幸福感，缺乏定性研究。本研究旨在填补这一空白。
在手术后 0.5-2 年（或姑息化疗参与者诊断为 CRC-A 后）招募接受 CRC-A 治疗的成年人。对探讨 RTW 和财务状况的半结构化电话访谈进行框架分析。收集人口统计学、临床和生活质量数据（FACT-C、痛苦温度计、COST 量表），以描述样本并为框架分析提供信息。
对 38 次访谈的分析揭示了五个总体主题：工作是一种挣扎、工作是我的身份、工作是我的救星、工作是一种经济需要、以及雇主和同事的反应。许多患有 CRC-A 的幸存者希望并具备继续工作或 RTW 的能力，但由于癌症和排便问题的双重污名，面临着独特的挑战。无法 RTW 对财务和心理社会健康产生负面影响。工作场所的支持是 RTW 的重要促进因素。
对于患有 CRC-A 的幸存者来说，继续或 RTW 充满挑战，包括身体功能挑战、财务焦虑和不支持的工作环境。幸存者需要心理社会、财务和雇主支持来应对这些困难。本文建议采取多管齐下的方法，包括教育计划（通过工人联合会团体、人力资源机构和/或大型消费者 CRC 团体）和政策，以支持工人，并让雇主了解 CRC-A 员工的独特挑战。
