Supporting Employment After Cancer: A Mixed-Methods Evaluation of a Vocational Integration Programme for Childhood, Adolescent, and Young Adult Cancer Survivors
Abstract
Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. The Intervention
- Initial referral and Intake: The beneficiary is connected with the multidisciplinary team and referred to the designated Patchanka project manager.
- Vocational profiling and functional assessment: An initial assessment phase is conducted, involving individualised vocational guidance, curriculum vitae development, functional and disability evaluations, and mapping of skills, interests, and employment-related barriers.
- Soft-skills training: A subset of beneficiaries engages in group sessions through theatrical techniques via the JobAct® Method, aimed at enhancing soft skills such as communication, emotional regulation, and workplace self-efficacy [37].
- Internship Placement and Workplace Integration: Patchanka employment specialists identify host companies compatible with the physical, cognitive, and professional profiles of participants. They provide structured support throughout workplace integration, including onboarding facilitation and interpersonal mediation. The internship is remunerated and fully funded by UGI. Participants proceed autonomously while retaining access to the project manager for case-specific support.
- Outcome Evaluation and Employment Transition: Upon completion of the internship, outcome evaluations are performed. These may lead to an extension of the placement, direct employment, or the initiation of new job-matching procedures.
2.2. The Mixed-Methods Follow-Up Study
3. Results
3.1. Quantitative Findings
3.2. Overall Experience and Three-Words Reflection Task
3.3. Results of the Thematic Analysis
- Theme 1: Motivations and initial expectations
- Theme 2: The impact of cancer on workability
- Theme 3: Accessibility and task adequacy
- Theme 4: The importance of building self-esteem and self-efficacy
- Theme 5: The value of vocational support
- Theme 6: The power of relationships: social support and workplace integration
- Theme 7: The double-edged impact of peer and family support
- Theme 8: Critical aspects and the role of social support
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
CAYAC | Childhood, adolescent, and young adult cancers |
CNS | Central nervous system |
RTW | Return to work |
SWTP | School and Work Transitions Program |
HRQoL | Health related quality of life |
SF-12 | 12-Item Short Form Health Survey |
PCS | Physical Component Summary |
MCS | Mental Component Summary |
LE | Late effect |
CLME | Chronic and late medical health events |
CTCAE | National Cancer Institute’s Common Terminology Criteria for Adverse Events |
CV | Curriculum Vitae |
WHO | World Health Organization |
ICF | International Classification of Functioning, Disability and Health |
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No. | % | |
---|---|---|
Sex | ||
Female | 6 | 46.2 |
Male | 7 | 53.8 |
Age at diagnosis | ||
0–4 | 2 | 15.4 |
5–9 | 0 | 0.0 |
10–14 | 6 | 46.2 |
≥15 | 5 | 38.4 |
Age at the interview | ||
20–24 | 5 | 38.4 |
25–29 | 6 | 46.2 |
30–34 | 1 | 7.7 |
≥35 | 1 | 7.7 |
Off-therapy | ||
<2000 | 1 | 7.7 |
2000–2009 | 2 | 15.4 |
2010–2014 | 4 | 30.8 |
≥2015 | 6 | 46.2 |
Education | ||
Middle school | 4 | 30.8 |
High school | 8 | 61.5 |
University | 1 | 7.7 |
Diagnosis | ||
Acute Leukaemia (Myeloid or lymphoblastic) | 5 | 38.4 |
CNS Tumours | 4 | 30.8 |
Others * | 4 | 30.8 |
Chemotherapy | 12 | 92.3 |
Radiotherapy | 6 | 46.2 |
Neurosurgery | 4 | 30.8 |
Hematopoietic stem cell transplantation | 2 | 15.4 |
Disease Relapse | 1 | 7.7 |
Late effects ** | ||
Patients with ≥ 1 LE | 12 | 92.3 |
Grade 1 | 7 | 17.5 |
Grade 2 | 25 | 62.5 |
Grade 3 | 8 | 20.0 |
Second Neoplasm | 2 | 15.4 |
M | SD | Range | |
---|---|---|---|
SF-12 | |||
PCS | 45.2 | 9.1 | 33.7–64.3 |
MCS | 43.5 | 11.2 | 26.3–63.1 |
0–10 rating | 8.3 | 2.0 | 5.0–10.0 |
Codes | Beneficial | Satisfying | Relational | Educational | Stimulating | Limiting | Demanding |
---|---|---|---|---|---|---|---|
Categories | rewarding | stimulating | challenging |
Theme 1: Motivations and Expectations | |
Category 1.1: Desire for autonomy and financial independence | Hoping to get hired and have a salary. (P1) The desire to leave my home and feel more independent (P2; P9)—to be useful to others. (P2) I wanted to be independent, to stop asking my parents for money. I wanted to work! (P3) |
Category 1.2: Desire for employment and personal development | I didn’t have expectations about what I’d like to do, but they formed over time through these experiences. (P4) I made mistakes. Since it was my first real job, I didn’t behave at my best. (P6) I didn’t even know where to start looking for a job. (P6; P8) I was willing to do anything, within my limits. (P8) The desire to work, grow, learn new things, and to feel normal in a way. After being in the hospital context, doing heavy jobs isn’t ideal. (P12) |
Theme 2: The impact of cancer on workability | |
Category 2.1: Physical constraints on occupational choice | My career goals have changed a little bit. The doctor told me that certain jobs would be too demanding for me and my health, and suggested that office work would be better for me. (P2) I realized that the problems I had in the past are still affecting me: fatigue and physical health issues. I’ve always avoided and denied being limited by my illness, but then I realized I do have limitations. I’m cancer free, but I get tired very easily. (P3) I would have loved to attend a sports-focused high school, since I was really passionate about sports. Unfortunately, due to my physical conditions, I was told it wasn’t possible. (P5) I do have eye-related issues, and I think that it would affect any job. (P13) |
Category 2.2: Employment loss due to physical impairments | Some jobs are hard if you are not healthy. I had to stop [a previous job] because of severe shoulder pain. They needed someone who could function every day. (P3) I had to stop [my internship] due to a surgery that kept me in the hospital for a month. After that they weren’t able to keep me on. (P5) |
Category 2.3: Impact on emotional well-being | I always have anxiety about feeling unwell at work. (P3) A lot of us have our own struggles. (P7) Most things I’ve faced aren’t comparable to what I went through in the hospital—nothing was harder than that! (P12) |
Theme 3: Accessibility and task adequacy | |
Category 3.1: Previous work-related challenges | I found a job on my own as a construction worker for about a year, but it was very hard. Even though I earned money, I chose to quit because I wasn’t well. (P10) The shift working hours can be tough for someone with a medical past, even if it’s not physically demanding. I’d already worked in physically demanding jobs before, so I wanted to change the environment a bit. (P12) |
Category 3.2: Successful alignment with workability | They did their best to arrange the internship. (P3) They had informed me that I’d be working at the register due to my physical limitations. Occasionally, I took on other tasks, but nothing too physically demanding. (P5) [The intervention] helped me find something more stable [work]. (P7). Now I sit at a desk and don’t have to exert myself physically. (P13) |
Theme 4: The importance of building self-esteem and self-efficacy | |
Category 4.1: Increasing self-esteem | I suffer a lot from anxiety—especially when I’m around people, or when I have to talk to many people at once, or juggle a lot of tasks. This job helped me manage that. (P5) Before, I saw everything negatively—like I wasn’t good at anything. Now, even if a [job] interview doesn’t go well, I treat it as experience and not as failure. (P8) [The intervention] was short, so I’m not sure about a full self-esteem shift, but it gave me more confidence to try things on my own. (P9) I didn’t imagine myself wearing a shirt every day. It’s a formal environment. My mindset has really changed. (P12) |
Category 4.2: Enhancing self-efficacy | Now, that I’ve had a serious experience, I understand how the work world operates—how to behave with colleagues, how to collaborate with them and with managers. (P2) Now, I see my future in a more positive and autonomous way. I am definitely more autonomous in terms of work tasks. (P4) I’ve built up my skills, I feel confident and independent. I no longer need assistance. I developed skills, learning how to adapt different situations. (P5) I’ve changed for the better. Now I enjoy working, I’m active, my days are fuller, and I have a daily routine. (P10) |
Category 4.3: Occupational embeddedness | I am very happy because they asked me to stay. Now I also work night shifts. It’s more demanding and I have more responsibilities. (P5) My supervisor wants to offer me a one-year contract. (P6) Especially now that they’ve offered me a contract, I know that a company might actually want me. (P13) |
Theme 5: The value of vocational support | |
Category 5.1: Enhancing general job skills | The CV writing session was really helpful—mine needed a lot of work—and [the career coaches] helped me in improving it. (P7) It was my first time. They help you to understand and guide you in what you might want to do, your options, the pros and cons. They helped me think about other paths, other possibilities through my CV. (P12) I’d written a CV before, but something was missing, so they helped me to structure it better. (P13) |
Category 5.2: Perceived impact of the intervention | The project helped by connecting me with the right people and finding options that suited me. (P8) The tasks of the internship were aligned with what we had discussed during the individual interview. During the second interview, I got the chance to do an internship—that made it feel more concrete. The project helped me narrow things down and find what to specialize in. (P9) |
Category 5.3: Focus on personal growth | It was definitely a stimulating experience. It helped me work through the anxiety I feel when speaking in front of others, facing large audiences, and juggling several tasks simultaneously. (P5) |
Theme 6: The power of relationships: social support and workplace integration | |
Category 6.1: Growth through social interactions | Interacting with customers helped me break out of my shell. I used to be shy and awkward, but I really came to enjoy those interactions. Now, I’m much more confident in conversations with people. (P8) The most pleasant moment was when they trusted me enough to leave me in charge of the structure. Working with people and being in contact with them, it’s fulfilling. (P12) |
Category 6.2: Sense of belonging and motivation | My tutor used to stop by the office every morning and say that even if there was nothing to sign, she wanted to see my smile—it made her day better. (P2) I got along even better with my last manager than the previous one. She really taught me a lot, and I became very patient. (P3) One colleague in particular still offers help—even now that I’m working night shifts, I know I can rely on her if anything comes up. (P5) I felt supported and comfortable whenever I needed help. I think that finding good people at work makes a huge difference. One of the girls from Patchanka advocated for me, and that helped get my contract extended. (P7) My tutor is very kind and helpful, but she lets me handle things independently, too. She gives me general guidance and says ‘Go ahead, and I’ll review it.’ (P13) |
Category 6.3: Peer feedback and support | I also made friends during the project, and I still keep in touch with them. I met a girl who became my best friend. (P5) Also, group activities taught me a lot about myself. I picked up on things I hadn’t noticed before, especially through feedback from others and moments shared during group work. I became especially close with my tutor. I also learned tailoring from a colleague, and we’re still friends. (P8) |
Theme 7: The double-edged impact of family support | |
Category 7.1: Family support as a facilitator | [Family support] helped very much. They were happy because they saw I was happy, too. (P2) I used to complain a lot, and my family encouraged me to join. They were very supportive. (P8) My family supported me, both emotionally and practically, like giving me rides when they can. They supported and motivated me throughout. (P9) Yes, my family has always supported me in general and also encouraged me to continue with these projects. Even during the tough times, my mother gave me strength. From when I got sick until now, she’s always stayed close to me. (P11) |
Category 7.2: Family support as a barrier | They weren’t against it, but when I wasn’t feeling well, they advised me to stop if I wasn’t okay. (P3) My mom always worries I might be too tired, so I try to reassure her. Previous jobs were short and poorly paid. My brother wasn’t thrilled, but for me it was nevertheless a way to get out of my home. (P7) |
Theme 8: Critical aspects and the role of social support | |
Category 8.1: Critical reflections | I thought it would be more helpful in finding a job. It was useful as a personal experience—but not professionally. (P11) |
Category 8.2: Importance of social support at the workplace | There wasn’t a specific person explaining things, so I asked different people in the stores. (P1) What truly made a difference was having someone help me at the beginning to understand what I needed to do. (P2) |
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Share and Cite
Dionisi-Vici, M.; Schneider-Kamp, A.; Giacoppo, I.; Godono, A.; Biasin, E.; Varetto, A.; Arvat, E.; Felicetti, F.; Zucchetti, G.; Fagioli, F. Supporting Employment After Cancer: A Mixed-Methods Evaluation of a Vocational Integration Programme for Childhood, Adolescent, and Young Adult Cancer Survivors. Curr. Oncol. 2025, 32, 564. https://doi.org/10.3390/curroncol32100564
Dionisi-Vici M, Schneider-Kamp A, Giacoppo I, Godono A, Biasin E, Varetto A, Arvat E, Felicetti F, Zucchetti G, Fagioli F. Supporting Employment After Cancer: A Mixed-Methods Evaluation of a Vocational Integration Programme for Childhood, Adolescent, and Young Adult Cancer Survivors. Current Oncology. 2025; 32(10):564. https://doi.org/10.3390/curroncol32100564
Chicago/Turabian StyleDionisi-Vici, Margherita, Anna Schneider-Kamp, Ilenia Giacoppo, Alessandro Godono, Eleonora Biasin, Antonella Varetto, Emanuela Arvat, Francesco Felicetti, Giulia Zucchetti, and Franca Fagioli. 2025. "Supporting Employment After Cancer: A Mixed-Methods Evaluation of a Vocational Integration Programme for Childhood, Adolescent, and Young Adult Cancer Survivors" Current Oncology 32, no. 10: 564. https://doi.org/10.3390/curroncol32100564
APA StyleDionisi-Vici, M., Schneider-Kamp, A., Giacoppo, I., Godono, A., Biasin, E., Varetto, A., Arvat, E., Felicetti, F., Zucchetti, G., & Fagioli, F. (2025). Supporting Employment After Cancer: A Mixed-Methods Evaluation of a Vocational Integration Programme for Childhood, Adolescent, and Young Adult Cancer Survivors. Current Oncology, 32(10), 564. https://doi.org/10.3390/curroncol32100564