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Supporting the Return to Work After Cancer in Romania: Exploring Employers’ Perspectives

  • Adela Elena PopaEmail author
  • Felicia Morândău
  • Radu-Ioan Popa
  • Mihai Stelian Rusu
  • Alexandra Sidor
Article

Abstract

Purpose Evidence shows that employers play a key role in facilitating the return to work of employees with cancer, yet little is known about the employers’ experiences in settings where no policies or regulations are available to guide this process. Against this background, we aimed (1) to understand how employers experience and manage the process of having employees with cancer and (2) to explore their reflections regarding their role in returning to work. Methods Twenty employers from various types of organisations and sectors were interviewed. Inductive thematic analysis was performed using NVivo 11. Results Employers experienced having employees with cancer as a process with three distinct phases reflected in three emerging themes: disclosure of the diagnosis and absence from work; returning to work; post-returning to work. A fourth theme emphasizes the employers’ reflections on how they conceive their own role. In the absence of a normative framework for dealing with employees with cancer, employers used commonsensical rules of thumb and immediate solutions based on ad-hoc decisions and were often compelled to innovate. They offered accommodations only if requested by the employee after returning to work. The return to work process was neither planned nor phased. Conclusion Employers need information and guidelines for effectively assisting employees with cancer. Better channels of communication and collaboration with health professionals are essential for more adequate support for the long-term consequences of cancer. A detailed return to work policy is required to tackle the inconsistencies in the support offered and this policy must also rethink how diagnosis disclosure takes place in Romanian organisations.

Keywords

Return to work Cancer Employer Qualitative research 

Notes

Funding

Project financed by Lucian Blaga University of Sibiu & Hasso Plattner Foundation research grants LBUS-IRG-2019-05. The study is also supported by a grant from the Romanian National Authority for Scientific Research, CNCS – UEFISCDI, PN-II-RU-TE-2014–4-0478.

References

  1. 1.
  2. 2.
    de Boer AGEM, Taskila TK, Tamminga SJ, Feuerstein M, Frings-Dresen MHW, Verbeek JH. Interventions to enhance return-to-work for cancer patients. Cochrane Database Syst Rev. 2015;2:CD007569.Google Scholar
  3. 3.
    Tikka C, Verbeek JHAM, Tamminga SJ, Leensen M, de Boer AGEM. Rehabilitation and return to work after cancer: Executive summary. European Agency for Safety and Health at Work—EU-OSHA; 2017. https://osha.europa.eu/en/tools-and-publications/publications/executive-summary-rehabilitation-and-return-work-after-cancer.
  4. 4.
    Roelen CAM, Koopmans PC, Schellart AJM, van der Beek AJ. Resuming work after cancer: a prospective study of occupational register data. J Occup Rehabil. 2011;21:431–440.CrossRefGoogle Scholar
  5. 5.
    Tamminga SJ, de Boer AGEM, Verbeek JHAM, Frings-Dresen MHW. Breast cancer survivors’ views of factors that influence the return-to-work process–a qualitative study. Scand J Work Environ Health. 2012;38:144–154.CrossRefGoogle Scholar
  6. 6.
    Knott V, Zrim S, Shanahan EM, Anastassiadis P, Lawn S, Kichenadasse G, et al. Returning to work following curative chemotherapy: a qualitative study of return to work barriers and preferences for intervention. Support Care Cancer. 2014;22:3263–3273.CrossRefGoogle Scholar
  7. 7.
    Braspenning I, Tamminga S, Frings-Dresen MHW, Leensen M, de Boer A, Tikka C, et al. Rehabilitation and return to work after cancer—instruments and practices. ©European Agency for Safety and Health at Work. Publication Office of the European Union; 2018. https://dspace.lboro.ac.uk/dspace-jspui/handle/2134/33414. Accessed 19 Nov 2018.
  8. 8.
    Greidanus MA, de Boer AGEM, de Rijk AE, Tiedtke CM, Dierckx de Casterlé B, Frings-Dresen MHW, et al. Perceived employer-related barriers and facilitators for work participation of cancer survivors: a systematic review of employers’ and survivors’ perspectives. Psycho-Oncology. 2018;27:725–733.CrossRefGoogle Scholar
  9. 9.
    Midtgaard J, Hansen MJ, Grandjean B. Modesty and recognition—a qualitative study of the lived experience of recovery from anal cancer. Support Care Cancer. 2009;17:1213–1222.CrossRefGoogle Scholar
  10. 10.
    Grunfeld EA, Cooper AF. A longitudinal qualitative study of the experience of working following treatment for gynaecological cancer. Psycho-Oncology. 2012;21:82–89.CrossRefGoogle Scholar
  11. 11.
    Johnsson A, Fornander T, Rutqvist LE, Olsson M. Factors influencing return to work: a narrative study of women treated for breast cancer. Eur J Cancer Care. 2010;19:317–323.CrossRefGoogle Scholar
  12. 12.
    Dorland HF, Abma FI, Roelen CAM, Smink JG, Ranchor AV, Bültmann U. Factors influencing work functioning after cancer diagnosis: a focus group study with cancer survivors and occupational health professionals. Support Care Cancer. 2016;24:261–266.CrossRefGoogle Scholar
  13. 13.
    van Egmond MP, Duijts SFA, Loyen A, Vermeulen SJ, van der Beek AJ, Anema JR. Barriers and facilitators for return to work in cancer survivors with job loss experience: a focus group study. Eur J Cancer Care. 2015;26(5):e12420.CrossRefGoogle Scholar
  14. 14.
    Mitchell T. Both sides of the couch: a qualitative exploration of the experiences of female healthcare professionals returning to work after treatment for cancer. Eur J Cancer Care. 2015;24:840–853.CrossRefGoogle Scholar
  15. 15.
    Tiedtke C, de Rijk A, de Casterlé BD, Christiaens M-R, Donceel P. Experiences and concerns about “returning to work” for women breast cancer survivors: a literature review. Psychooncology. 2010;19:677–683.CrossRefGoogle Scholar
  16. 16.
    Yarker J, Munir F, Bains M, Kalawsky K, Haslam C. The role of communication and support in return to work following cancer-related absence. Psycho-Oncology. 2010;19:1078–1085.CrossRefGoogle Scholar
  17. 17.
    Tiedtke C, de Rijk A, Donceel P, Christiaens M-R, de Casterlé BD. Survived but feeling vulnerable and insecure: a qualitative study of the mental preparation for RTW after breast cancer treatment. BMC Public Health. 2012;12:538.CrossRefGoogle Scholar
  18. 18.
    Wells M, Williams B, Firnigl D, Lang H, Coyle J, Kroll T, et al. Supporting “work-related goals” rather than “return to work” after cancer? A systematic review and meta-synthesis of 25 qualitative studies: meta-synthesis of qualitative studies on return to work after cancer. Psycho-Oncology. 2013;22:1208–1219.CrossRefGoogle Scholar
  19. 19.
    McKay G, Knott V, Delfabbro P. Return to work and cancer: the Australian experience. J Occup Rehabil. 2013;23:93–105.CrossRefGoogle Scholar
  20. 20.
    Stergiou-Kita M, Pritlove C, van Eerd D, Holness LD, Kirsh B, Duncan A, et al. The provision of workplace accommodations following cancer: survivor, provider, and employer perspectives. J Cancer Surviv. 2016;10:489–504.CrossRefGoogle Scholar
  21. 21.
    Amir Z, Popa A, Tamminga S, Yagil D, Munir F, de Boer A. Employer’s management of employees affected by cancer. Support Care Cancer. 2018;26:681–684.CrossRefGoogle Scholar
  22. 22.
    Tiedtke C, Donceel P, de Rijk A, de Casterlé BD. Return to work following breast cancer treatment: the employers’ side. J Occup Rehabil. 2013;24:399–409.Google Scholar
  23. 23.
    Tiedtke CM, de Casterlé BD, Frings-Dresen MHW, Boer AGEMD, Greidanus MA, Tamminga SJ, et al. Employers’ experience of employees with cancer: trajectories of complex communication. J Cancer Surviv. 2017;11:562–577.CrossRefGoogle Scholar
  24. 24.
    Amir Z, Wynn P, Chan F, Strauser D, Whitaker S, Luker K. Return to work after cancer in the UK: attitudes and experiences of line managers. J Occup Rehabil. 2010;20:435–442.CrossRefGoogle Scholar
  25. 25.
    Grunfeld EA, Low E, Cooper AF. Cancer survivors’ and employers’ perceptions of working following cancer treatment. Occup Med. 2010;60:611–617.CrossRefGoogle Scholar
  26. 26.
    Tiedtke C, Donceel P, Knops L, Désiron H, Dierckx de Casterlé B, de Rijk A. Supporting return-to-work in the face of legislation: stakeholders’ experiences with return-to-work after breast cancer in Belgium. J Occup Rehabil. 2012;22:241–251.CrossRefGoogle Scholar
  27. 27.
    Lindsay C, Greve B, Cabras I, Ellison N, Kellett S. Introduction: new perspectives on health, disability, welfare and the labour market. Social Policy Adm. 2015;49:139–142.CrossRefGoogle Scholar
  28. 28.
    Mbengi RK, Tiraboschi M, de Brouwer C, Bouland C. How do social security schemes and labor market policies support the return-to-work of cancer survivors? A review article. J Cancer Policy. 2018;15:128–133.CrossRefGoogle Scholar
  29. 29.
    de Boer AGEM. The European cancer and work network: CANWON. J Occup Rehabil. 2014;24:393–398.CrossRefGoogle Scholar
  30. 30.
    Leibrecht M, Klien M, Onaran O. Globalization, welfare regimes and social protection expenditures in Western and Eastern European countries. Public Choice. 2011;148:569–594.CrossRefGoogle Scholar
  31. 31.
    National Institute of Statistics. Death by causes in Romania; 2015. http://statistici.insse.ro/shop/index.jsp?page=tempo3&lang=en&ind=POP206C. Accessed 11 Aug 2016.
  32. 32.
    Vladescu C, Astarastoae V. Integrating health services within the health reform policy in Romania. Revista Romana de Bioetica. 2012;10(2):78–90.Google Scholar
  33. 33.
    Popa AE. The national cancer programme in Romania: challenges in a low-resource healthcare system. J Cancer Policy. 2017;14:33–38.CrossRefGoogle Scholar
  34. 34.
    The public pension system. Romanian Official gazette, 19; 2000. http://www.cdep.ro/pls/legis/legis_pck.htp_act_text?idt=22559.
  35. 35.
    The unitary system of public pensions. Romanian Official Gazette, 263; 2010. http://www.dreptonline.ro/legislatie/legea_263_2010_sistemul_unitar_pensii_publice.php.
  36. 36.
    Eurostat. Employment rates by sex, age and citizenship; 2018. http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=lfsq_ergan&lang=en. Accessed 19 Nov 2018.
  37. 37.
    European C. Country Report Romania 2015, Including an In-depth Review on the prevention and correction of macroeconomic imbalances; 2015. http://ec.europa.eu/europe2020/pdf/csr2015/cr2015_romania_en.pdf.
  38. 38.
    Bazeley P. Qualitative data analysis: practical strategies. Thousand Oaks: SAGE Publications; 2013.Google Scholar
  39. 39.
    Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19:349–357.CrossRefGoogle Scholar
  40. 40.
    Palinkas LA, Horwitz SM, Green CA, Wisdom JP, Duan N, Hoagwood K. Purposeful sampling for qualitative data collection and analysis in mixed method implementation research. Adm Policy Ment Health. 2015;42:533–544.CrossRefGoogle Scholar
  41. 41.
    Miles MB, Huberman AM. Qualitative Data Analysis: An Expanded Sourceboo. 2nd ed. Thousand Oaks: Sage Publications Inc.; 1994.Google Scholar
  42. 42.
    Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77–101.CrossRefGoogle Scholar
  43. 43.
    Stergiou-Kita M, Pritlove C, Kirsh B. The, “Big C”-stigma, cancer, and workplace discrimination. J Cancer Surviv. 2016;10:1035–1050.CrossRefGoogle Scholar
  44. 44.
    Gordon LG, Beesley VL, Lynch BM, Mihala G, McGrath C, Graves N, et al. The return to work experiences of middle-aged Australian workers diagnosed with colorectal cancer: a matched cohort study. BMC Public Health. 2014;14:963.CrossRefGoogle Scholar
  45. 45.
    Mintzberg H. Structure in five: designing effective organizations. Englewood Cliffs: Prentice-Hall; 1983.Google Scholar
  46. 46.
    Franche R-L, Cullen K, Clarke J, Irvin E, Sinclair S, Frank J, et al. Workplace-based return-to-work interventions: a systematic review of the quantitative literature. J Occup Rehabil. 2005;15:607–631.CrossRefGoogle Scholar
  47. 47.
    Bouknight RR. Correlates of return to work for breast cancer survivors. J Clin Oncol. 2006;24:345–353.CrossRefGoogle Scholar
  48. 48.
    Robinson L, Kocum L, Loughlin C, Bryson L, Dimoff JK. I wanted you to know: breast cancer survivors’ control of workplace communication about cancer. J Occup Health Psychol. 2015;20:446–456.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Faculty of Social Sciences and HumanitiesLucian Blaga University of SibiuSibiuRomania
  2. 2.Department of Public Health - Faculty of Political, Administrative and Communication SciencesBabes-Bolyai UniversityCluj-NapocaRomania

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