Function and friction at work: a multidimensional analysis of work outcomes in cancer survivors.
OBJECTIVE
Cancer survivors can experience difficulties returning to and/or remaining at work. Sociodemographic, health and well-being, symptom burden, functional limitations in relation to work demands, work environment, and various work policies and procedures can be related to work function.


METHODS
This study analyzed cross-sectional data of a sample of cancer survivors (n = 1,525) who were diagnosed and treated for various types of cancer. The data were obtained from a survey of cancer survivors collected by the LiveStrong Foundation. Using a cancer survivorship and work model proposed in 2010, this study used structural equation modeling to predict work ability (whether survivors reported lower work ability following cancer) and work sustainability (whether survivors had ever lost or left a job because of cancer, i.e., work retention). Potential predictors included health and well-being, symptom burden (e.g., fatigue, pain, and distress), cancer-related worry, worry about family's cancer risk, functional impairment (i.e., physical, cognitive, and interpersonal), workplace support, and workplace problems.


RESULTS
The overall model predicting work ability (CFI = 0.961, TLI = 0.952, and RMSEA = 0.027) indicated that a greater level of functional limitations (B = 5.88, p < 0.01) and workplace problems (B = 0.22, p = 0.05) were significantly related to lower levels of work ability. Structural equation modeling (CFI = 0.961, TLI = 0.952, and RMSEA = 0.027) also indicated that workplace problems was a significant predictor (B = 0.498, p < 0.001) of the likelihood of losing or leaving a job because of cancer.


CONCLUSIONS
Functional limitations and problems at work including poor treatment, discrimination, being passed over for promotion, and lack of accommodations were directly related to the ability to work. Problems at work were associated with lower work sustainability (work retention).


CONCLUSIONS
Employed cancer survivors, health care providers, and employers need to be aware of the potential implications of limitations in function (e.g., physical, cognitive, and interpersonal/social) as it relates to ability to work. In many cases, these functional limitations are responsive to rehabilitation. Workplaces also need to be educated on how to better respond to the needs of cancer survivors at work.
Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
Michal C
MC
Moskowitz
Briana L
BL
Todd
Rusan
R
Chen
Michael
M
Feuerstein
D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004651:Employment; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality*; D017741:Survivors; D017132:Workplace