Experiences of Female Breast Cancer Survivors Concerning Their Return to Work in Spain
Abstract
:1. Introduction
1.1. Literature Review
1.2. Aim of This Study
2. Methods
2.1. Ethical Approval
2.2. Participants
2.3. Data Collection
2.4. Data Analysis
3. Results
3.1. Theme 1: Self-Perception of Cancer Survivors
- “You don’t feel valued if you don’t have a breast, your arm is disfigured, you feel rejected, it affects all of us in general, when you go out, and you feel different” (FG1, P1).
- “I cried about my hair. It’s like seeing a ghost in the mirror” (FG1, P1).
- “When people see you wearing a wig, they already label you as sick, they stare at you like you’re a freak. I felt terrible, horrible” (FG2, P6).
- “The wig, in my case, gave me security” (FG2, P4).
- “You have to accept that you’re no longer the same” (FG1, P1).
- “You are also weaker” (FG1, P1).
- “But of course you don’t have the strength you used to” (FG2, P2).
- “I get very tired, anything I do makes me tired” (FG1, P1).
- “You never get back physically to how you were before. I cannot do what I used to do” (FG2, P6).
- “Your arm swells up, they measured me and told me that it wasn’t important until the inflammation reached two centimeters. You try to ignore it and lead a normal life. But I’ve had some frights” (FG1, P4).
3.2. Theme 2: Motivations to Go Back to Work
- “The doctors discharge you and tell you that you can work now. And you are very happy because you think that you have already overcome your illness. Going back to work means that you are cured” (FG1, P9).
- “Economically, everything changes a lot, it reduces your economic level. In addition, practically nothing is paid for by Social Security; you also try to change your food. You go to a corsetry to order a special bra and it’s twice or three times as expensive as a normal bra. The moisturizer that was prescribed for me cost 20 euros a jar and it ran out very soon. Well, if you buy a wig, that increases the expenses by 1.000 euros. Only the prosthesis is paid for [by Social Security]” (FG1, P1).
- “I go to the church for food, I’m not ashamed to say it but, of course, what they give you is insufficient, and the creams that they tell you to use where do you get the money for everything? I don’t think that 400 euros was enough to pay for the expenses” (FG2, P2).
- “They help with the trips, but it is very slow and involves a lot of paperwork. And the aids do not arrive” (FG2, P2).
3.3. Theme 3: Going Back to Work: The Pathways and Difficulties
- “I tell you, I’m a civil servant, I had no trouble going back to work” (FG1, P1, l.86).
- “Returning to work depends a lot on the type of job you have. If you have a job by contract, they do not renew it, as in my case” (FG2, P2).
- “I used to work in a major fish company, but I couldn’t do that job now because my body would not be capable of working every night like before. My contract ran out during my recovery, and after six months of sick leave, they did not renew me” (FG2, P7).
- “I lost my job and lost a number of offers because of the disease I used to have” (FG2, P8).
3.3.1. Going Back to the “Same Job”
- “On the labor issue, I feel very atrophied. The doctors tell you that you cannot do anything, even if you are medically discharged. I even considered quitting work, even though I have a steady job” (FG1, P1).
- “They don’t adapt anything to me. When I was discharged and the doctors said I could work, my colleagues are not going to do my job and they don’t need you just to sit in the office” (FG2, P9).
- “To go back to the previous job, you need to job to be adapted” (FG2, P4).
3.3.2. Searching for a New Job
- “A friend of mine had cancer and when she started looking for work, she was already almost bald, so she went to an interview wearing a scarf (her hair never grew back). They asked her if she was bald, and she said yes; then, they told her that she was not suitable for that job. And that job was in a factory, it wasn’t working in a boutique facing the public. (FG1, P1).
- “When I went to ask for a job in a bakery, they asked me if I was still sick because they were afraid I would ask for sick leave” (FG2, P4).
- “The last time they told me, ‘O.K. that is alright, but how many check-ups are you going to get, are you going to get sick leave, you’re not going to take any sick leave”? (FG2, P6).
- “Well, cancer is a disease like any other, it’s no shame. But at the employment level, you cannot tell them; otherwise, they do not hire you” (FG1, P10).
- “The Services’ enormous lack of coordination, by the (Health) Administration, you have to drag out the words from them, Social Security, Finance, Social Services” (FG1, P10).
- “I think, there should be a place where there were workshops to learn how to defend ourselves in our life after the disease. For example, when looking for a new job, you should have some indications, some tools” (FG2, P2).
- “Courses should be taught where we can do and learn things that are within our reach” (FG2, P8).
3.3.3. Early Retirement
- “I retired before I reached the right age, and was almost one year on sick leave” (FG2, P6).
- “But they’re not going to give me anything. I have to go back to work” (FG2, P4).
4. Discussion
4.1. Strengths, Limitations, and Suggestions for Future Research
4.2. Implications for Social Practice
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Spanish Society of Medical Oncology (SEOM). The Dates of Cancer in Spain. 2020. Available online: https://seom.org/publicaciones/generales (accessed on 15 June 2021).
- Chirlaque, M.D.; Salmerón, D.; Galceran, J.; Ameijide, A.; Mateos, A.; Torrella, A.; Jiménez, R.; Larrañaga, N.; Marcos-Gragera, R.; Ardanaz, E.; et al. Cancer survival 0in adult patients in Spain. Results from nine population-based cancer registries. Clin. Transl. Oncol. 2017, 20, 201–211. [Google Scholar] [CrossRef]
- Yélamos, C.; Montesinos, F.; Eguino, A.; Fernández, B.; González, A.; García, M. Mucho x vivir. Long by live. Psychosocial care for women with breast cancer. Psicooncología 2007, 4, 417–422. [Google Scholar]
- Lewis, P.E.; Sheng, M.; Rhodes, M.M.; Jackson, K.E.; Schover, L.R. Psychosocial concerns of young african american breast cancer survivors. J. Psychosoc. Oncol. 2012, 30, 168–184. [Google Scholar] [CrossRef] [PubMed]
- Nilsson, M.I.; Olsson, M.; Wennman-Larsen, A.; Petersson, L.-M.; Alexanderson, K. Women’s reflections and actions regarding working after breast cancer surgery—A focus group study. Psycho-Oncology 2013, 22, 1639–1644. [Google Scholar] [CrossRef] [PubMed]
- Mehnert, A. Employment and work-related issues in cancer survivors. Crit. Rev. Oncol. 2011, 77, 109–130. [Google Scholar] [CrossRef] [PubMed]
- Krok, J.L.; Baker, T.A.; McMillan, S.C. Sexual activity and body image: Examining gender variability and the influence of psychological distress in cancer patients. J. Gend. Stud. 2013, 22, 409–422. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Verbeek, J.; Spelten, E. Work. In Handbook of Cancer Survivorship; Feuerstein, M., Ed.; Springer: Berkeley, CA, USA, 2007. [Google Scholar]
- De Boer, A.G.E.M.; Taskila, T.K.; Tamminga, S.; Feuerstein, M.; Frings-Dresen, M.H.; Verbeek, J.H. Interventions to enhance return-to-work for cancer patients. Cochrane Database Syst. Rev. 2015, 2015, CD007569. [Google Scholar] [CrossRef] [PubMed]
- Rasmussen, D.M.; Elverdam, B. The meaning of work and working life after cancer: An interview study. Psycho-Oncology 2008, 17, 1232–1238. [Google Scholar] [CrossRef]
- Stergiou-Kita, M.; Grigorovich, A.; Tseung, V.; Milosevic, E.; Hebert, D.; Phan, S.; Jones, J. Qualitative meta-synthesis of survivors’ work experiences and the development of strategies to facilitate return to work. J. Cancer Surviv. 2014, 8, 657–670. [Google Scholar] [CrossRef]
- De Boer, A.G.E.M.; Taskila, T.; Ojajärvi, A.; van Dijk, F.J.H.; Verbeek, J. Cancer survivors and unemployment. JAMA 2009, 301, 753–762. [Google Scholar] [CrossRef]
- Fantoni, S.Q.; Peugniez, C.; Duhamel, A.; Skrzypczak, J.; Frimat, P.; Leroyer, A. Factors related to return to work by women with breast cancer in northern France. J. Occup. Rehabil. 2010, 20, 49–58. [Google Scholar] [CrossRef] [PubMed]
- Sun, Y.; Shigaki, C.L.; Armer, J.M. Return to work among breast cancer survivors: A literature review. Support. Care Cancer 2017, 25, 709–718. [Google Scholar] [CrossRef] [PubMed]
- Tamminga, S.J.; de Boer, A.G.E.M.; Verbeek, J.; Frings-Dresen, M.H.W. Breast cancer survivors’ views of factors that influence the return-to-work process—A qualitative study. Scand. J. Work. Environ. Health 2011, 38, 144–154. [Google Scholar] [CrossRef] [PubMed]
- Tiedtke, C.; Donceel, P.; Knops, L.; Désiron, H.; de Casterlé, B.D.; 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. [Google Scholar] [CrossRef]
- Molina, R.; Feliu, J. The return to work of cancer survivors: The experience in Spain. Work 2013, 46, 417–422. [Google Scholar] [CrossRef]
- Molina, R.; Feliu, J. La reinserción laboral: Un nuevo reto en el paciente con cáncer. Psicooncología 2011, 8, 45–51. [Google Scholar] [CrossRef] [Green Version]
- Villaverde, R.M.; Batlle, J.F.; Yllan, A.V.; Gordo, A.M.J.; Sanchez, A.R.; Valiente, B.S.J.; Baron, M.G. Employment in a cohort of breast cancer patients. Occup. Med. 2008, 58, 509–511. [Google Scholar] [CrossRef] [Green Version]
- Río, M.; Cano, C.; Villafaña, F.; Valdivia, C. Job placement in women after breast cancer: An aid to social integration. Psicooncología 2010, 7, 143–152. [Google Scholar]
- Masià, J.; Merchán-Galvis, Á.; Salas, K.; Requeijo, C.; Cánovas, E.; Quintana, M.J.; Bonfill, X. Socio-economic impact on women diagnosed and treated for breast cancer: A cross-sectional study. Clin. Transl. Oncol. 2019, 21, 1736–1745. [Google Scholar] [CrossRef]
- Vicente-Pardo, J.M.; López-Guillén García, A. Problems and psychological factors in return to work after prolonged temporary disability due to breast cancer. Med. Segur. Trab. 2017, 63, 245–259. [Google Scholar]
- Statistics National Institute (I.N.E.). Economically Active Population Survey. 2020. Available online: http://www.ine.es/jaxiT3/Tabla.htm?t=4247 (accessed on 18 June 2021).
- Jefatura del Estado. Law Orgánica 3/2007, de 22 de marzo, para la igualdad efectiva de mujeres y hombres [For the effective equality of women and men]. Agencia Estatal Boletín Of. Estado 2007, 71, 12611–12645. [Google Scholar]
- Women’s Institute. Women in Date. Available online: http://www.inmujer.gob.es/MujerCifras/EmpleoPrestaciones/Contratacion.htm (accessed on 18 June 2021).
- Ruiz-Olabuenaga, J.I.R. Qualitative Research Methodology; Universidad de Deusto: Bilbao, Spain, 2012; Volume 15. [Google Scholar]
- Kitzinger, J. Focus group research: Using group dynamics. Qual. Res. Health Care 2005, 56, 70–75. [Google Scholar]
- Barbour, R. The Discussion Groups in Qualitative Research; Morata Editions: Madrid, Spain, 2013; Volume 4. [Google Scholar]
- Barbour, R. Doing Focus Groups; Sage: New York, NY, USA, 2008. [Google Scholar]
- San-Martin, D. Grounded theory and Atlas.ti: Methodological resources for educational research. Rev. Electrónica Investig. Educ. 2014, 16, 104–122. [Google Scholar]
- Patton, M. Qualitative Research and Evaluation Methods, 3rd ed.; Sage: Thousand Oaks, CA, USA, 2002. [Google Scholar]
- Bardin, L. Análisis de Contenido; Akal: Madrid, Spain, 1986. [Google Scholar]
- Von Ah, D.; Habermann, B.; Carpenter, J.S.; Schneider, B.L. Impact of perceived cognitive impairment in breast cancer survivors. Eur. J. Oncol. Nurs. 2013, 17, 236–241. [Google Scholar] [CrossRef]
- Ranieri, J.; Guerra, F.; di Giacomo, D. Role of metacognition thinking and psychological traits in breast cancer survivorship. Behav. Sci. 2020, 10, 135. [Google Scholar] [CrossRef]
- Laranjeira, C.A.; Leao, P.P.; Leal, I. Temporal experience among women gynecological cancer survivors: A lifeworld perspective. Affil. J. Women Soc. Work 2015, 30, 170–186. [Google Scholar] [CrossRef]
- Tan, F.L.; Loh, S.Y.; Su, T.T.; Veloo, V.; Ng, L.L. Return to work in multi-ethnic breast cancer survivors—A qualitative inquiry. Asian Pac. J. Cancer Prev. 2012, 13, 5791–5797. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Fernández Sánchez, B.; del Castillo Martín, R. The Economic Impact of Cancer on Families in Spain. AECC Cancer Observatory. Spanish Association Against Cancer. Available online: https://www.aecc.es/sites/default/files/content-file/Estudio-Impacto-Economico-Pacientes-Cancer.pdf (accessed on 8 June 2021).
- Timmons, A.; Gooberman-Hill, R.; Sharp, L. “It’s at a time in your life when you are most vulnerable”: A qualitative exploration of the financial impact of a cancer diagnosis and implications for financial protection in health. PLoS ONE 2013, 8, e77549. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Van Egmond, M.; Duijts, S.; Loyen, A.; Vermeulen, S.; van der Beek, A.; Anema, J. Barriers and facilitators for return to work in cancer survivors with job loss experience: A focus group study. Eur. J. Cancer Care 2015, 26, 12420. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Torp, S.; Syse, J.; Paraponaris, A.; Gudbergsson, S. Return to work among self-employed cancer survivors. J. Cancer Surviv. 2017, 11, 189–200. [Google Scholar] [CrossRef] [PubMed]
- Mokhtari, Z.; Hekmatdoost, A.; Nourian, M. Antioxidant efficacy of vitamin D. J. Parathyr. Diesase 2017, 5, 11–16. [Google Scholar]
- Bilodeau, K.; Tremblay, D.; Durand, M.-J. Exploration of return-to-work interventions for breast cancer patients: A scoping review. Support. Care Cancer 2017, 25, 1993–2007. [Google Scholar] [CrossRef]
- Chassaing, K.; Lasne, N.; le Clainche, C.; Waser, A.M. Working with cancer: Cross-referencing the arrangements for adjusting working conditions and the resources mobilized to keep work and health together. Cent. D’études L’emploi 2011, 63, 144. [Google Scholar]
- Tiedtke, C.; de Rijk, A.; Donceel, P.; Christiaens, M.-R.; de Casterlé, B.D. 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. [Google Scholar] [CrossRef] [Green Version]
- Tighe, M.; Molassiotis, A.; Morris, J.; Richardson, J. Coping, meaning and symptom experience: A narrative approach to the overwhelming impacts of breast cancer in the first year following diagnosis. Eur. J. Oncol. Nurs. 2011, 15, 226–232. [Google Scholar] [CrossRef]
- Tison, A. Decisions on the Labor Market in a Context of Both Economic and Health Uncertainty. Empirical and Theoretical Approaches with Applications for Self-Employed Workers Diagnosed with Cancer; Aix-Marseille University: Marseille, France, 2016. [Google Scholar]
- Lundquist, M. The role of women in cancer control and cancer care in the early 20th century. Affilia 2018, 33, 317–330. [Google Scholar] [CrossRef]
Primary Category (Theme) | Secondary Category (Sub-Theme) |
---|---|
Theme 1: Self-perception of cancer survivors | |
Theme 2: Motivations to go back to work | |
Theme 3: Going back to work: the pathways and difficulties | 3.1. Going back to the “same job” 3.2. Searching for a new job 3.3. Early retirement |
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Aguiar-Fernández, F.; Rodríguez-Castro, Y.; Botija, M.; Martínez-Román, R. Experiences of Female Breast Cancer Survivors Concerning Their Return to Work in Spain. Behav. Sci. 2021, 11, 135. https://doi.org/10.3390/bs11100135
Aguiar-Fernández F, Rodríguez-Castro Y, Botija M, Martínez-Román R. Experiences of Female Breast Cancer Survivors Concerning Their Return to Work in Spain. Behavioral Sciences. 2021; 11(10):135. https://doi.org/10.3390/bs11100135
Chicago/Turabian StyleAguiar-Fernández, Francisco, Yolanda Rodríguez-Castro, Mercedes Botija, and Rosana Martínez-Román. 2021. "Experiences of Female Breast Cancer Survivors Concerning Their Return to Work in Spain" Behavioral Sciences 11, no. 10: 135. https://doi.org/10.3390/bs11100135
APA StyleAguiar-Fernández, F., Rodríguez-Castro, Y., Botija, M., & Martínez-Román, R. (2021). Experiences of Female Breast Cancer Survivors Concerning Their Return to Work in Spain. Behavioral Sciences, 11(10), 135. https://doi.org/10.3390/bs11100135