title: Breast cancer survivors' views of factors that influence the return-to-work process--a qualitative study.
abstract: OBJECTIVE
  Accumulating evidence suggests that most employed breast cancer survivors are able to return to         work but often experience difficulties in the process. The objective of this study was to identify: (i) factors         experienced as barriers to and facilitators of the return-to-work (RTW) process, (ii) which factors were important         during initial and post RTW, and (iii) possible solutions to RTW problems.
  
  
  METHODS
  Twelve breast cancer survivors         participated in semi-structured interviews. Interviews were thematically analyzed using MAXQDA, software for         qualitative data analysis. We used the World Health Organization's International Classification of Functioning,         Disability and Health as a conceptual framework.
  
  
  RESULTS
  Participants experienced many barriers to and facilitators of         RTW. In line with previous studies, we found that work environmental factors, such as support from a supervisor,         importance of work, and physical or psychological side-effects (such as fatigability), influenced RTW. In addition, we         found that barriers included temperament and personality functions, "job lock", and societal attitudes,         while facilitators comprised taking care of one's health, skills/coping, and support from family and healthcare         professionals. During the initial RTW phase, physical or psychological side-effects hampered work resumption, while         during the post RTW phase, a lack of understanding from the work environment was problematic. Participants mentioned         that guidance from healthcare professionals and information for supervisors and colleagues should be improved.
  
  
  CONCLUSIONS
  To enhance RTW among breast cancer survivors, interventions should focus on barriers and facilitators for         individuals at different time points in the RTW process. Better guidance from healthcare professionals and information         for supervisors and colleagues could also enhance the process.
authors: Coronel Institute of Occupational Health/Academic Medical Center, University of Amsterdam, PO Box 22700, 1100 DE Amsterdam, the Netherlands. S.J.Tamminga@amc.uva.nl
authors: Sietske J
authors: SJ
authors: Tamminga
authors: Angela G E M
authors: AG
authors: de Boer
authors: Jos H A M
authors: JH
authors: Verbeek
authors: Monique H W
authors: MH
authors: Frings-Dresen
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D007406:Interview, Psychological; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010147:Pain Measurement; D011287:Prejudice; D011594:Psychometrics; D036301:Qualitative Research; D012307:Risk Factors; D012938:Social Perception; D012944:Social Support; D013315:Stress, Psychological; D017741:Survivors / Q000523:psychology*; D014938:Work Capacity Evaluation