Supporting the Return to Work of Breast Cancer Survivors: From a Theoretical to a Clinical Perspective

Abstract

Promoting the return to work of breast cancer survivors is of major interest to patients, healthcare and occupational health professionals, companies, governments, and researchers worldwide. We previously conducted a French consensus study resulting in a model describing the multifactorial process of the return to work of breast cancer survivors (the REWORK-BC model). Other work has identified the transtheoretical model as a relevant theoretical framework for interventions to promote the return to work of cancer survivors. In this opinion paper, we provide a theoretically-based clinical framework describing how to support breast cancer survivors at each stage of the return-to-work process. This clinical framework considers several essential aspects of supportive care for breast cancer survivors returning to work, such as: (i) helping the patient actively self-manage, by considering her to be the main decision-maker; (ii) respecting and adapting to the patient’s choice of professional project; (iii) respecting the temporality of the patient’s choices; (iv) proposing tailored interventions; (v) implementing simple tools to promote the return to work, shared representation between the patient and a multidisciplinary team, and improvement of working conditions and the knowledge of health and occupational professionals, and managers or employers; and (vi) maintaining certain flexibility aimed at proposing, but never imposing, changes in practices. This clinical framework, specific to breast cancer survivors, could be extrapolated to other tumor types, offering a practical guide for healthcare and occupational health professionals to better understand the return-to-work process of cancer survivors. This clinical framework aims to be a usable tool for any hospital or cancer care center wishing to implement a patient-centered intervention that promotes returning to work, regardless of the country.

Prospective evaluation of return to work, health-related quality of life and psychosocial distress after radical cystectomy: 1-year follow-up in 230 employed German bladder cancer patients

“…Porro et al described the multifactorial process of RTW and a theory-based clinical framework for interventions to promote RTW of cancer survivors. According to individual situations, support should be sufficiently flexible and provide a range of simple tools [ 26 ]. For the social system, the successful reintegration of patients into working life represents an essential dimension of the success of rehabilitation measures.…”

Towards Agility in Breast Cancer Treatment Principles as Adopted from Agile Software Engineering

“… 26 Return to work, for women with breast cancer, can be significant and one of the biggest motivations. 90 A clinical framework was developed specifically for BC patients to promote quality of life and acts as a practical guide for health professionals to help in understanding the process of returning to work based on expert consensus. 90 Being around family and loved ones is another significant motivation for BC patients.…”

Return to work and psychosocial trajectories after breast cancer: a longitudinal and sequential approach

“…Determinants to predict RTW after BC have been extensively studied in international literature and are currently well known [9], driving recommendations for clinical practice [10]. However, to date, it is mainly disease-related, work-related or sociodemographic variables [6], [7], [11]- [13] that have been studied in relation to the RTW, rather than psychological variables such as Health-Related Quality of Life (HRQoL; [14], depression or anxiety [15]) and RTW after BC.…”