title: Functional challenges among late effects cancer survivors: a preliminary report on work engagement issues.
abstract: BACKGROUND
  While the cancer survivor rate is nearly 68% now, intervention regimens may leave residual conditions that impact engagement in work and various life tasks. Survivors are underemployed and report stigmatizing attitudes among co-workers. When late effects from cancer arise over 10 years later, the impact on individuals in the prime of their productive employment life is evident. Assisting these individuals begins with awareness of late effects in order to create work-related, adaptive strategies.
  
  
  METHODS
  Sixteen adult cancer survivors experiencing late effects completed the Occupational Self Assessment (Version 2.2) and the Quality of Life-Cancer Survivors (QOL-CS). Knowledge of functional problems secondary to recognized late effects medical conditions reported in the literature was utilized to sort items according to professional definitions of work, performance skills and performance patterns.
  
  
  RESULTS
  Late effects survivors reported that cancer illness and treatment has negatively impacted their employment. Individual response to the impact of late effects is highly variant. "Getting things done" and physical energy limitations are most pronounced.
  
  
  CONCLUSIONS
  Cancer survivors report lower competence in significant work-related skills and patterns. Quality of life associated with the aftereffects of fatigue, aches and pain, and sleep changes are the lowest. Responses range across the 16 survivors to both performance skills and performance patterns. Cancer survivorship has clearly interfered with employment. An interdisciplinary focus on meaningful engagement in life activities, particularly work is crucial to support survivors through advocacy, adaptation and positive change to focus on engaging the work talents and gifts for all cancer survivors.
authors.affiliation: Department of Occupational Therapy, College of Health and Human Services, Northern Arizona University-Phoenix Biomedical Complex, Phoenix, AZ, USA.
authors.forename: Patricia
authors.initials: P
authors.lastname: Crist
mesh_terms: D000328:Adult; D005221:Fatigue / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000523:psychology; D011788:Quality of Life; D020377:Self Efficacy; D017741:Survivors; D013997:Time Factors; D014937:Work
keywords: Survivorship; adaptation; advocacy; competence; quality of life; work