Changes After Cancer Diagnosis and Return to Work: Moving Forward Without Direction

Abstract Background: The purpose of this study was to understand the unmet needs of cancer patients and identify the necessary factors to develop a vocational intervention program based on cancer patients’ work-related experience after cancer diagnosis.Methods: Semi-structured individual in-depth interviews were conducted with 50 cancer patients who were working at the time of diagnosis at a university hospital in Seoul, South Korea from July to September of 2017. Interview data were analyzed using qualitative content analysis.Results: ‘The changes patients experienced after cancer diagnosis’ were categorized into Personal and socio-environmental changes. ‘Personal changes’ were changes within the patient that were further divided into ‘physical’, ‘psychological’ and ‘spiritual’ changes while ‘socio-environmental changes’ were changes in either ‘attitude’ and ‘relationship’ of other people cancer patients encountered. In addition to these post-diagnosis changes, the following 4 major factors related to return-to-work were identified to affect patients’ experience: ‘fear of cancer recurrence’, ‘financial status’, ‘informational support’, and ‘working environment’.Conclusion: Cancer patients’ working status was determined by the interaction between the patients’ post-diagnosis changes and 4 factors related to return-to-work, with the factors’ positive or negative effect leading to return-to-work. In particular, cancer patients faced difficulties processing and appropriately responding to the potential changes occurring after cancer diagnosis due to lack of information. Based on these findings, we plan to develop an educational intervention reflecting these factors to promote cancer patients’ return-to-work. Educational materials and intervention programs informing patients on these changes and factors may facilitate their return-to-work after diagnosis.