Breast cancer survivors' views of factors that influence the return-to-work process--a qualitative study

Accumulating evidence suggests that most employed breast cancer survivors are able to return to work but often experience difficulties in the process. The objective of this study was to identify: (i) factors experienced as barriers to and facilitators of the return-to-work (RTW) process, (ii) which factors were important during initial and post RTW, and (iii) possible solutions to RTW problems.

Twelve breast cancer survivors participated in semi-structured interviews. Interviews were thematically analyzed using MAXQDA, software for qualitative data analysis. We used the World Health Organization's International Classification of Functioning, Disability and Health as a conceptual framework.

Participants experienced many barriers to and facilitators of RTW. In line with previous studies, we found that work environmental factors, such as support from a supervisor, importance of work, and physical or psychological side-effects (such as fatigability), influenced RTW. In addition, we found that barriers included temperament and personality functions, "job lock", and societal attitudes, while facilitators comprised taking care of one's health, skills/coping, and support from family and healthcare professionals. During the initial RTW phase, physical or psychological side-effects hampered work resumption, while during the post RTW phase, a lack of understanding from the work environment was problematic. Participants mentioned that guidance from healthcare professionals and information for supervisors and colleagues should be improved.

To enhance RTW among breast cancer survivors, interventions should focus on barriers and facilitators for individuals at different time points in the RTW process. Better guidance from healthcare professionals and information for supervisors and colleagues could also enhance the process.