Positive Psychology Interventions: A Catalyst for Job Satisfaction, Work Engagement, and Withdrawal Intentions Among Remote-Working Cancer Survivors in Rural Areas

Positive Psychology Interventions: A Catalyst for Job Satisfaction, Work Engagement, and Withdrawal Intentions Among Remote-Working Cancer Survivors in Rural Areas | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Positive Psychology Interventions: A Catalyst for Job Satisfaction, Work Engagement, and Withdrawal Intentions Among Remote-Working Cancer Survivors in Rural Areas Hamid Yari Renani, Alireza Rahmanian, Zahra Saeidi, Behrooz Birashk, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5894108/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Advances in cancer treatment have significantly increased the survival rate of cancer patients, but these survivors often face challenges in the workplace. Existing literature highlights the significant influence of cancer on job performance, job satisfaction, and the increased risk of withdrawal intention. However, the effects of positive psychology interventions on cancer survivors, particularly in less urbanized settings and remote worker communities, remain underexplored. Purpose This study investigates the effects of positive psychology interventions on job satisfaction, work engagement, and withdrawal intentions among cancer survivors in rural and remote workforce communities. Methods A quasi-experimental design was employed, involving 68 cancer survivors. The study used the Minnesota Job Satisfaction Questionnaire, the Utrecht Work Engagement Scale, and the Withdrawal Intention Scale to measure outcomes following a 14-session positive psychology intervention. The results revealed statistically significant improvements in the experimental group compared to the control group. Results Job satisfaction mean scores increased from 50.23 to 58.94, work engagement mean scores rose from 26.79 to 31.05, and withdrawal intentions mean scores decreased from 48.35 to 39.05. These findings highlight the potential of positive psychology interventions to address the unique challenges faced by cancer survivors in remote workforce communities, particularly in less urbanized areas. Conclusions By enhancing job satisfaction and work engagement while reducing withdrawal intentions, these interventions can significantly contribute to the occupational well-being of cancer survivors, advocating for their integration into cancer care and organizational practices. Positive Psychology Cancer Survivors Job Satisfaction Remote Worker Communities Rural Communities Figures Figure 1 1. Introduction Job satisfaction is an employee's positive and pleasant feeling about their job, stemming from various factors such as working conditions, organizational rules, employee relations, social status, income, and cultural factors (1). Satisfied employees tend to perform their duties more effectively and efficiently (2). Work engagement is a rewarding and positive psychological condition related to work, arising from vigor, dedication, and absorption (3). Research indicates a positive correlation between job satisfaction and work engagement, with satisfied employees more likely to be engaged in their tasks (4,5). Conversely, a lack of job satisfaction can lead to increased withdrawal intentions, absenteeism, and decreased performance (6,7). Among the myriad factors influencing employee performance in organizations, illness stands out as a particularly significant and impactful element (8). Cancer, a significant factor affecting employee performance and job satisfaction, imposes substantial emotional and physical challenges, leading to long-term occupational disruptions and decreased job performance and satisfaction (9). Approximately 40-50% of cancer survivors are diagnosed during their working years, making it crucial to examine the influence of cancer on job satisfaction (10). A cancer diagnosis can cause significant emotional distress, leading to long-term occupational disruptions, interpersonal crises, and reduced job satisfaction (11). Cancer survivors, often diagnosed during working years, experience long-term occupational disruptions and decreased job performance and satisfaction (12,13). Treatments often cause side effects, leading to interpersonal crises and increased workplace tension (14,15). Dionisi-Vici et al. examined the employment status of 240 cancer survivors in various cities in Italy and found that the late effects of cancer have a negative impact on their job satisfaction (16). Moreover, Mousa et al. examined cancer survivors in urban areas of Kuala Lumpur, Malaysia, and found that cancer significantly reduces their work engagement (17). Financial toxicity refers to the economic burden cancer patients face due to reduced earnings and increased medical expenses, leading to heightened emotional distress and lower quality of life (18). Advanced financial toxicity, such as bankruptcy, is associated with a nearly twofold increase in mortality risk among cancer survivors (19). Psycho-oncologic interventions, aimed at improving mental health, can reduce disease-related symptoms, enhance mental health, and potentially extend life expectancy (20,21). Positive psychology, rooted in Seligman's work, promotes happiness through a joyful, committed, and meaningful life (22). Positive psychology interventions, such as gratitude exercises, strengths-based development, and mindfulness practices, have shown a statistically significant impact on job satisfaction and work engagement in various occupational settings (23,24). For instance, a study by Cortini et al. (23) showed that the implementation of positive psychology interventions resulted in an 8% increase in employee job satisfaction. These approaches not only promote individual well-being but also create a positive organizational culture, leading to increased productivity, improved teamwork, and overall job satisfaction among employees (25). Additionally, Musa et al. examined the impact of spirituality on 126 cancer survivors in urban areas of Kuala Lumpur and demonstrated that spirituality can lead to enhanced work engagement (17). Moreover, Positive psychology can mitigate withdrawal behaviors by promoting positive emotions, strengths, and meaningful experiences (26). Despite the documented benefits of positive psychology interventions in enhancing job satisfaction and work engagement, their effects among cancer survivors remain largely unexplored. Existing research has primarily focused on urban environments, leaving a gap in understanding the potential of positive psychology interventions for cancer survivors in rural communities and remote working conditions (16,17). Additionally, the role of positive psychology interventions in mitigating withdrawal intentions among cancer survivors has not been adequately investigated (27). Therefore, the study aims to investigate the impact of a 14-session positive psychology intervention on job satisfaction and work engagement, and its role in shaping withdrawal intentions. By focusing on cancer survivors in remote worker communities, the study addresses a significant gap in understanding how targeted interventions can support the occupational well-being of this population. Addressing these objectives can provide valuable insights into developing tailored support systems and interventions, enhancing job satisfaction, work engagement, and long-term employment prospects of cancer survivors in less urbanized regions. This study's unique contribution lies in its focus on an underserved population and its exploration of positive psychology to support the occupational well-being of cancer survivors in rural and remote communities. 2. Materials and method 2.1 Research design This study employs a quasi-experimental research design to investigate the effects of positive psychology interventions on job satisfaction, work engagement, and withdrawal intentions among cancer survivors in rural and remote communities. A quasi-experimental design is particularly suitable for this research as it allows for the examination of the intervention's impact in a real-world setting without the need for random assignment, which can be impractical in certain populations. The philosophical foundation of this research is rooted in positivism, which emphasizes the importance of observable empirical evidence in the development of knowledge (28). Positivism advocates for the use of quantitative methods to measure variables and establish cause-and-effect relationships through statistical analysis. 2.2 Procedure Following the random allocation of participants into experimental and control groups, the experimental group underwent a 14-session positive psychology intervention conducted weekly, with each session lasting 45 minutes. The intervention was delivered by licensed therapists trained and certified by the Iranian Psychological Association (IPA). Session Breakdown: 1. Introduction: Establishing a supportive group environment and outlining program objectives. 2. Gratitude Practice: Enhancing well-being through gratitude exercises and maintaining gratitude journals. 3. Identifying Personal Strengths: Recognizing and utilizing personal strengths. 4. Building Positive Relationships: Strengthening interpersonal connections through communication techniques and active listening. 5. Cultivating Optimism: Fostering a positive outlook on life through guided imagery exercises. 6. Enhancing Resilience: Developing coping strategies through problem-solving and resilience-building exercises. 7. Mindfulness and Relaxation: Reducing stress through guided mindfulness meditation and relaxation practices. 8. Achieving Flow: Experiencing flow states to enhance engagement in activities. 9. Goal Setting and Future Planning: Setting meaningful goals and creating actionable plans to achieve them. 10. Promoting Well-being Through Acts of Kindness: Planning and performing acts of kindness. 11. Cultivating Self-Compassion: Engaging in self-compassion exercises to reduce self-criticism. 12. Positive Scripting and Reframing: Reframing negative experiences positively. 13. Integration and Reflection: Integrating learned techniques and reflecting on progress. 14. Closing and Future Directions: Sharing final reflections, receiving resources for continued personal growth, and celebrating accomplishments. 2.3 Sampling method and participants 2.3.1 Sampling method This study, after registration and obtaining ethical approval (No. 51666-16476) from the Secretariat of the Biomedical Ethics Committee of Tabriz University, employed a convenience sampling method to recruit research participants from the visitors to Razi Hospital in Tabriz. Participants were recruited from individuals diagnosed with stage II cancer who sought treatment at Razi Hospital in Tabriz, Iran. Convenience sampling was selected due to its practicality and efficiency, allowing the inclusion of participants who were readily available and willing to partake in the study. This method was deemed appropriate as it facilitated the recruitment of a sufficient number of participants within a reasonable timeframe, ensuring that the sample was representative of the target population. 2.3.2 Participants The study's sample size was meticulously calculated to ensure adequate statistical power. The sample size was estimated to achieve a power of 80% and a two-tailed type I error rate of 5%. Based on these calculations, and after obtaining ethical approval and registering the research with the appropriate institutional review board, a total of 89 individuals were initially recruited to assess their ability. Inclusion Criteria: • Diagnosed with stage II cancer • Receiving chemotherapy treatment • Diagnosed within the past three to six months • Employed remotely in an organization or company from the time of cancer diagnosis to the intervention • Residing in rural communities • No history of substance abuse. • No history of serious chronic diseases, such as severe diabetes, heart disease, or kidney failure. Exclusion Criteria: • Incomplete responses to the study questionnaires • Concurrent participation in conflicting or experimental treatments • Inability to regularly follow up on sessions and complete assessments. 2.4 Informed consent and right to withdraw Potential participants were contacted and informed about the objectives, procedures, and potential benefits and risks of the study. They were assured of their rights, including the right to withdraw from the study at any time without any consequences. Informed consent was obtained from all participants, ensuring that they voluntarily agreed to participate in the research. 2.5 Randomization, blinding, confidentiality, and anonymity Participants were randomly assigned to either the experimental or control group using a computer-generated randomization sequence. To ensure balanced group allocation, randomization was stratified by baseline job satisfaction scores and gender. The allocation process was managed by an independent researcher who was not involved in recruitment or intervention delivery, ensuring strict allocation concealment. Due to the nature of the intervention, blinding participants and therapists was not feasible. However, outcome assessments were conducted by independent evaluators blinded to group assignments, and participants were instructed not to disclose their group allocation to the assessors. Assessors underwent training to minimize potential biases and uphold the integrity of the blinding process. To protect participants' privacy, all data were anonymized by assigning unique codes to each participant instead of using personal identifiers. Responses were treated confidentially and used solely for research purposes. The securely stored data were accessible only to authorized members of the research team, further ensuring the confidentiality and anonymity of all participants. 2.6 Instruments 2.6.1 Job satisfaction To assess the levels of job satisfaction among the participants, the Minnesota Job Satisfaction Questionnaire (MJSP) was employed. The MJSP is a widely recognized and validated self-report instrument that measures various facets of job satisfaction. It encompasses a comprehensive set of items that capture different aspects of an individual's satisfaction with their work environment, tasks, and conditions. The MJSQ's robustness is further evidenced by its adaptability and consistent reliability across diverse settings, including Portugal, where it exhibited high internal consistency and satisfactory convergent validity (Ferreira et al., 2009). The Minnesota Job Satisfaction Questionnaire consists of 20 items, each addressing different facets of job satisfaction. Respondents rate their agreement with each item on a Likert scale, typically ranging from 1 (very Dissatisfied) to 5 (very Satisfied). The items cover a wide range of dimensions, including the work's nature, recognition, supervision, advancement opportunities, communication, compensation, and overall job satisfaction. 2.6.2 Work engagement To assess work engagement, we used the UWES-S, the student version of the Utrecht Work Engagement Scale, which is widely used to assess work engagement (29). The UWES originally included 17 items and three dimensions (vigor, dedication, and absorption). Later, for pragmatic reasons, the UWES was reduced to a nine-item version (UWES-9) that exhibited satisfactory psychometric properties (Schaufeli et al., 2006). Validity and reliability analyses across various studies have consistently demonstrated its robust psychometric properties. For example, in Sri Lanka, the UWES-S displayed excellent judgmental validity, item-convergent validity, and item-discriminant validity, with high internal consistency (Cronbach's alpha coefficients for vigor, dedication, and absorption subscales were 0.867, 0.819, and 0.903, respectively) and strong test-retest reliability (31). In China, exploratory and confirmatory factor analyses confirmed a three-factor structure of the scale, with Cronbach's alpha values ranging from 0.82 to 0.95, further supporting its reliability and validity The Spanish version demonstrated a unidimensional structure with an alpha coefficient of 0.91, indicative of high reliability (31). 2.6.3 Withdrawal intention The withdrawal intention scale (WIS) was utilized to assess the participants' withdrawal intentions. WIS is a tool designed to assess an individual's intention to withdraw from a particular behavior, job, or substance. The WIS consists of items that typically inquire the participants' thoughts and plans related to leaving their current jobs. Participants rate their agreement with each item on a Likert scale, usually ranging from 1 (strongly disagree) to 5 (strongly agree). One study that focused on the Italian version of the WIS found it to be a valid and reliable instrument for detecting withdrawal intentions in Italian workers. The study confirmed the unidimensional structure of the WIS, demonstrating good reliability and concurrent validity (32). 2. 7 Ethical conduct during data collection The research team upheld ethical principles throughout the data collection process, including respecting participants, maximizing benefits while minimizing harm (beneficence), and ensuring fair treatment for all participants (justice). Participants were handled with care and sensitivity, particularly considering the potentially sensitive questions regarding mental health and marital satisfaction. By integrating rigorous data collection methods with strict ethical guidelines, this study ensured the acquisition of high-quality and reliable data while safeguarding participants' rights and well-being. This approach not only strengthens the credibility of the research findings but also aligns with the ethical standards expected in scientific research involving human subjects. 3. Results As shown in Figure (1), in this study, 89 individuals were initially selected to assess their eligibility. After the screening process, 9 participants were excluded, with 8 not meeting the inclusion criteria and 1 declining to participate. Consequently, 80 participants were randomly assigned to either the experimental group or the control group, each comprising 40 participants. Both groups completed pre-test questionnaires. The experimental group received a Positive Psychology Intervention, while the control group did not receive any intervention. Following the intervention period, both groups completed post-test questionnaires. In the experimental group, 6 participants were excluded from the post-test analysis, with 2 withdrawing consent and 4 failing to complete the intervention. Similarly, 6 participants from the control group were excluded from the post-test analysis, all due to withdrawing consent. Ultimately, 34 participants from each group were included in the final analysis, ensuring a balanced and unbiased sample to evaluate the effects of the Positive Psychology Intervention. Table 1 Demographic findings according to the two experimental and control groups Variables The frequency of the experimental group Percent The frequency of the control group Percent Gender Male 23 67.65 21 61.76 Female 11 32.35 13 38.24 Marital status Single 14 41.18 13 38.24 married 20 58.82 21 61.76 Age 20–29 years 8 23.53 10 29.41 30–39 years 12 35.29 11 32.35 40–49 years 14 41.18 13 38.24 Table 1 presents the demographic findings for both the experimental and control groups, providing a comprehensive view of the participant characteristics. In terms of gender distribution, the experimental group consisted of 67.65% males (23 participants) and 32.35% females (11 participants), while the control group comprised 61.76% males (21 participants) and 38.24% females (13 participants). Regarding marital status, 41.18% of the experimental group (14 participants) were single, and 58.82% (20 participants) were married. In contrast, the control group had 38.24% single participants (13 participants) and 61.76% married participants (21 participants). The age distribution for the experimental group showed that 23.53% were aged 20–29 years (8 participants), 35.29% were aged 30–39 years (12 participants), and 41.18% were aged 40–49 years (14 participants). Similarly, the control group included 29.41% of participants aged 20–29 years (10 participants), 32.35% aged 30–39 years (11 participants), and 38.24% aged 40–49 years (13 participants). This demographic data highlights the balanced distribution of participants across gender, marital status, and age categories, ensuring the representativeness and reliability of the study outcomes. In Table 2 , the descriptive statistics of the experimental and control group participants' scores in the variables of job satisfaction, work engagement, and withdrawal intentions are presented separately in the pre-test and post-test stages. Table 2 Descriptive statistics for job satisfaction, work engagement, and withdrawal intentions of the two experimental and control groups in the pre-test and post-test Experimental group Control group Variables Pre-test Post-test Pre-test Post-test M ± SD M ± SD M ± SD M ± SD job satisfaction 50.23 ± 11.26 58.94 ± 11.35 50.58 ± 13.06 48.94 ± 13.46 work engagement 26.79 ± 4.82 31.05 ± 4.57 26.91 ± 5.07 28.00 ± 4.06 withdrawal intentions 48.35 ± 10.98 39.05 ± 13.43 48.82 ± 9.44 47.52 ± 11.25 According to Table 2 . In all variables, the mean of the experimental group improved from the pre-test to the post-test. This improvement in the variable of job satisfaction and work engagement included an increase in the mean, and for the variable of withdrawal intentions, it included a decrease in the mean. In contrast, little changes were observed in the control group. Therefore, the difference between the two groups in the post-test phase is in favor of the experimental group. According to the current research design, analysis of covariance test was used to analyze the main results. First, the Shapiro-Wilk test was used to check the normality of the distribution of the dependent variables of the research. Since the statistical significance level for all research variables was greater than 0.05, the null hypothesis was rejected and as a result, the normality of the distribution of these variables was confirmed at the 95% confidence level. The results of Levin's test to check the equality of variance of the groups in the dependent variables of the research showed that the obtained statistical significance level is greater than 0.05, so the two groups are the same in terms of the dispersion of the scores of these variables in the pre-test stage. Also, the results of regression slope homogeneity test showed that factor covariance analysis of group interaction and job satisfaction variable (F = 0.308 and p = 0.613), and group interaction and job engagement variable (F = 0.527 and p = 0.419), and group interaction and job engagement variable (F = 0.443 and p = 0.529), are not statistically significant, so the assumption of homogeneity of the regression slope for the dependent variables of the research has been met. The results of univariate covariance analysis were used to determine the effectiveness of positive psychology on job satisfaction, work engagement, and withdrawal intentions. The results of univariate covariance analysis are reported in Table 3 . Table 3 The results of univariate covariance analysis of the difference between the experimental and control groups in job satisfaction, work engagement, and withdrawal intentions. Variables Source Sum of Squares df Mean Square F p Partial Eta Squared job satisfaction Pre-test 5006.05 1.00 5006.05 62.13 0.001 0.49 group 1786.35 1.00 1786.35 22.17 0.001 0.25 Error 5237.71 65.00 80.58 work engagement Pre-test 744.62 1.00 744.62 98.93 0.001 0.60 group 167.44 1.00 167.44 22.25 0.001 0.26 Error 489.26 65.00 7.53 withdrawal intentions Pre-test 1933.37 1.00 1933.37 20.20 0.001 0.24 group 1142.85 1.00 1142.85 11.94 0.001 0.16 Error 6220.98 65.00 95.71 62.13 According to the results of the univariate covariance analysis presented in Table 3 , after controlling for pre-test effects, significant differences were observed between the mean post-test scores of the experimental and control groups across the variables of job satisfaction (Partial Eta Squared η² = 0.25, p < 0.01, F = 22.17), work engagement (η² = 0.26, p < 0.01, F = 22.25), and withdrawal intentions (η² = 0.16, p < 0.01, F = 11.94). This indicates that the intervention, presumably based on positive psychology principles, significantly improved job satisfaction and work engagement among cancer survivors. Moreover, it effectively reduced their withdrawal intentions, as indicated by the decrease in mean scores for this variable in the experimental group compared to the control group. The effect sizes of 0.25 for job satisfaction, 0.26 for work engagement, and 0.16 for withdrawal intentions confirm that these differences are statistically significant within the population. Thus, it can be concluded that the positive psychology intervention statistically positively impacted job satisfaction, increased work engagement, and successfully reduced withdrawal intentions among the participants. 4. Discussion The primary aim of this study was to investigate the effect of positive psychology intervention on job satisfaction, work engagement, and withdrawal intention among remote-working cancer survivors in rural areas. The study's results revealed a statistically significant positive impact of positive psychology interventions on job satisfaction, work engagement, and withdrawal intentions among cancer survivors in remote workforce and rural communities. The current investigation observed a significant enhancement in job satisfaction, as evidenced by the increase in mean scores from 50.23 to 58.94 in the experimental group following the intervention. The study also noted a statistically significant increase in work engagement mean scores, escalating from 26.79 to 31.05. This suggests the interventions probably enhanced the participants' vigor, dedication, and absorption in their work roles. This change suggested that the cancer survivors became more psychologically resilient and motivated, demonstrating a stronger connection and commitment to their job tasks. On the other hand, withdrawal intentions’ mean scores decreased from 48.35 to 39.05, signifying a reduced desire to leave their jobs among the participants. This reduction was particularly important, as it suggested that the positive psychology interventions helped mitigate some of the emotional and psychological challenges that cancer survivors face, which might otherwise lead to job withdrawal. This observation supports the main hypothesis that applying positive psychology interventions positively affects job satisfaction and work engagement and reduces withdrawal intentions among cancer survivors in remote workforce and rural communities. 4.1 Comparison with Previous Studies The findings of this study provide significant insights into the effects of positive psychology interventions on cancer survivors who work remotely and live in rural areas, offering unique comparative perspectives. This section compares the findings with previous research to emphasize the strengths and innovative aspects of the current study while addressing the limitations of earlier works. Initially, the increase in job satisfaction in our study aligned with the findings of Cortini et al. ( 23 ), who observed an 8% rise in job satisfaction following positive psychology interventions. Our research expanded upon this by specifically highlighting the impact on cancer survivors and pinpointing the targeted benefits for this group. Furthermore, Donaldson et al. ( 24 ), demonstrated the effectiveness of positive psychology in boosting work engagement. Our findings corroborated this but also emphasized the significant effect within a specialized cohort of cancer survivors, thereby providing detailed insights into context-specific impacts. The enhancements in job satisfaction and work engagement observed in this study echoed the positive outcomes noted in previous research, like that of Cortini et al. ( 23 ). Yet, our research distinguished itself by delving into both work engagement and withdrawal intentions, thus offering a more comprehensive view of the effects of positive psychology in the workplace for cancer survivors. In reference to the foundational theories of Seligman ( 22 ), our study emphasized the importance of nurturing strengths, enhancing positive emotions, and cultivating a sense of meaning. These elements, which are pivotal in Seligman's positive psychology framework, theoretically underpinned the psychological mechanisms through which our interventions yielded their beneficial outcomes, marrying theoretical concepts with our empirical findings in improving job satisfaction, work engagement, and reducing withdrawal intentions among cancer survivors. Kaplan et al. ( 27 ) explored the connection between positive affectivity and reduced withdrawal intentions, finding a correlation between a positive work environment and lower withdrawal tendencies. Our study extended these findings by demonstrating how positive psychology interventions specifically reduced withdrawal behaviors in remote-working cancer survivors. We further elaborated on this by highlighting the mechanisms through which positive psychology fostered a supportive environment that not only enhanced positive affectivity but also directly contributed to diminishing the propensity for withdrawal among cancer survivors. This alignment with Kaplan's research underscored the broader applicability and efficacy of positive psychology principles in mitigating withdrawal intentions, particularly in the context of chronic illness and workplace integration. Previous studies, such as those by Degi ( 20 ) and Faller et al. ( 21 ), had shown improvements in mental health, quality of life, and job performance due to psycho-oncologic interventions in cancer patients. Our study built on this by zeroing in on the specific effects of positive psychology interventions on job satisfaction, work engagement, and withdrawal intentions among cancer survivors in less accessible areas. Recent studies by Dionisi-Vici et al. ( 16 ) examined the employment status of 240 cancer survivors in various cities in Italy and found that the late effects of cancer have a negative impact on their job satisfaction. Moreover, Mousa et al. ( 17 ) examined cancer survivors in urban areas of Kuala Lumpur, Malaysia, and found that cancer significantly reduces their work engagement. These studies demonstrate the negative effects of cancer on job satisfaction and work engagement, with their samples all being in urban communities and employed on-site. While Parent-Lamarche ( 33 ) showed that teleworking can lead to reduced work engagement and increased intention to quit, the present study, by examining the effects of positive psychology interventions on these aspects among cancer survivors working remotely in rural areas, demonstrated that positive psychology interventions can lead to increased work engagement and reduced intention to quit in individuals who telework. The novelty of our research lies in examining these variables in rural communities and among individuals who work remotely. Our study showed that positive psychology interventions can effectively improve job satisfaction, and work engagement, and reduce withdrawal intentions in this population, thus addressing the limitations of previous studies and filling existing research gaps. This comparison not only enhances the existing academic discourse but also provides actionable insights for customizing workplace support to meet the distinctive needs of cancer survivors in rural and remote communities. 4.2 Policy Implication These findings are significant not only in their statistical validity but also in their real-world applicability. They show that targeted psychological support can probably have a profound and positive effect on the work-related attitudes and behaviors of cancer survivors, particularly those with remote occupations who are living in areas with fewer resources and support systems. The findings from this study suggest several implications for policy and practice. First, healthcare and organizational policies should recognize and integrate positive psychology interventions as a standard component of cancer care, especially for those in the workforce. Implementing these interventions can improve job satisfaction and engagement and reduce the likelihood of job withdrawal among cancer survivors. Second, policies should be developed to support the training of psychologists and counselors in positive psychology, ensuring that these interventions are delivered effectively and are accessible to cancer survivors, particularly in remote worker communities who are in rural areas. Furthermore, workplaces can be encouraged to create environments that foster positive psychological experiences, which in turn could enhance employee engagement and satisfaction. Third, the research underscores the importance of considering the unique challenges faced by cancer survivors in rural and remote workforce communities. Policymakers and practitioners should focus on developing targeted interventions that address these challenges, ensuring that cancer survivors in these areas receive the support they need to thrive in their professional lives. Lastly, positive psychology can significantly contribute to enhancing organizational productivity by improving job satisfaction. Organizational productivity refers to the effective use of resources to produce goods or services that meet target customers' needs, influenced by management practices and organizational culture ( 34 ). Job satisfaction plays a vital role in boosting productivity as it motivates employees to work more efficiently, aiding in achieving the broader objectives of the organization ( 35 ). Satisfied employees tend to be more engaged, perform better, and are more likely to contribute positively towards organizational goals. High productivity, driven by employee satisfaction, can lead to increased profitability and enhanced customer service, thus improving the organization's reputation and stability ( 36 ). Therefore, it is evident that positive psychology, by elevating job satisfaction, can play a significant role in increasing organizational productivity. This boost in productivity not only aids in enhancing the profitability of the organization but also contributes to its sustained stability and reputation. Hence, investing in positive psychology interventions is crucial not just for the mental well-being of the employees but also for the profitability and long-term success of the organization. 4.3 Limitations the sample size of 68 participants raises concerns about the generalizability of the findings, as it may not adequately represent the broader population of cancer survivors across different regions. Additionally, the quasi-experimental design, without random assignment to groups, could introduce selection bias, potentially affecting the internal validity of the results. The use of self-report questionnaires for measuring job satisfaction, work engagement, and withdrawal intentions may also introduce response biases such as social desirability, which could skew the results. Moreover, the study’s design does not include a longitudinal follow-up, limiting insights into the long-term sustainability of the intervention’s effects. Cultural factors, given the study's location in Iran, might influence the outcomes and their applicability in different contexts, suggesting the need for cross-cultural research to validate the findings universally. Lastly, the study did not thoroughly examine the participants' psychological health status before the intervention, which could affect their response to the positive psychology treatments. 5. Conclusion The primary objective of this research was to examine the impact of positive psychology interventions on job satisfaction, work engagement, and withdrawal intentions among cancer survivors who are working remotely in communities. The innovative aspect of this study lies in its focus on applying positive psychology interventions to support this unique demographic, providing a deeper understanding of how these interventions can be tailored to enhance occupational well-being and retention among cancer survivors. • The research investigated key parameters such as job satisfaction, work engagement, and withdrawal intentions among cancer survivors. • Quantitative findings include a significant increase in job satisfaction (from 50.23 to 58.94) and work engagement (from 26.79 to 31.05), and a decrease in withdrawal intentions (from 48.35 to 39.05) post-intervention in the experimental group. In summary, the study illustrates the potent role of positive psychology in improving job satisfaction and work engagement while reducing withdrawal intentions among cancer survivors working remotely and living in less urbanized areas. Future research should explore the long-term effects of these interventions and examine cultural and regional differences in the effectiveness of positive psychology interventions. Additionally, it would be beneficial to investigate the specific components of positive psychology interventions that are most effective and to explore their applicability in different work environments and among diverse populations of cancer survivors. Declarations Author Contribution 1-Hamid Yari Renani: Conceptualization, Methodology, Supervision.2-Alireza Rahmanian: Investigation, Writing – Original Draft.3-Zahra Saeidi: Investigation, Visualization.4-Behrooz Birashk: Methodology, Writing – Review & Editing.5-Iman Saraei: Investigation, Writing – Original Draft.6-Shirin Ghodusi: Writing – Review & Editing. Acknowledgment The authors appreciate all participants who contributed to the research through their valuable engagement. 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Safety and Health at Work [Internet]. 2024 Jul 27 [cited 2024 Jul 31]; Available from: https://www.sciencedirect.com/science/article/pii/S2093791124000532 Robinson L, Kocum L, Loughlin C, Bryson L, Dimoff JK. I wanted you to know: Breast cancer survivors’ control of workplace communication about cancer. Journal of Occupational Health Psychology. 2015;20(4):446–56. Boelhouwer IG, Vermeer W, Vuuren T van. The associations between late effects of cancer treatment, work ability and job resources: a systematic review. International Archives of Occupational and Environmental Health. 2020;94:147–89. Adi NP, Nagata T, Odagami K, Nagata M, Mori K. Role of Supervisor Consultation Toward Work Engagement: A Prospective Cohort Study. Safety and Health at Work. 2024 Jun 1;15(2):147–50. Dionisi-Vici M, Godono A, Castiglione A, Gatti F, Fortunati N, Clari M, et al. Work Placement and Job Satisfaction in Long-Term Childhood Cancer Survivors: The Impact of Late Effects. Cancers (Basel). 2022 Aug 18;14(16):3984. Musa SNS, Hamzah SR, Muda Z, Asimiran S, Krauss SE. Predicting work engagement among young adult cancer survivors: A moderated mediation model. Front Sociol. 2023;8:1030518. Dusetzina SB, Winn AN, Abel GA, Huskamp HA, Keating NL. Cost sharing and adherence to tyrosine kinase inhibitors for patients with chronic myeloid leukemia. J Clin Oncol. 2014 Feb 1;32(4):306–11. Ramsey S, Bansal A, Fedorenko C, Blough D, Overstreet KA, Shankaran V, et al. Financial Insolvency as a Risk Factor for Early Mortality Among Patients With Cancer. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2016;34 9:980–6. Degi C. [Analysis of the effectiveness of psychologic interventions in oncology regarding the quality of life and survival of cancer patients]. Psychiatria Hungarica : A Magyar Pszichiatriai Tarsasag tudomanyos folyoirata. 2006;21 2:138–46. Faller H, Schuler M, Richard M, Heckl U, Weis J, Küffner R. Effects of psycho-oncologic interventions on emotional distress and quality of life in adult patients with cancer: systematic review and meta-analysis. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2013;31 6:782–93. Seligman MEP, Csikszentmihalyi M. Positive psychology: An introduction. American Psychologist. 2000;55(1):5–14. Cortini M, Converso D, Galanti T, Di Fiore T, Di Domenico A, Fantinelli S. Gratitude at Work Works! A Mix-Method Study on Different Dimensions of Gratitude, Job Satisfaction, and Job Performance. Sustainability. 2019 Jan;11(14):3902. Donaldson S, Lee J, Donaldson SI. Evaluating Positive Psychology Interventions at Work: a Systematic Review and Meta-Analysis. International Journal of Applied Positive Psychology. 2019;4:113–34. Leka S, Torres L, Jain A, Di Tecco C, Russo S, Iavicoli S. Relationship Between Occupational Safety and Health Policy Principles, Organizational Action on Work-related Stress and the Psychosocial Work Environment in Italy. Safety and Health at Work. 2023 Dec 1;14(4):425–30. Noroozi D, Masumabad SA. The role of spiritual intelligence in employees’ withdrawal behaviors in physical education organization. 2015;4:60–71. Kaplan SA, Bradley JC, Luchman JN, Haynes D. On the role of positive and negative affectivity in job performance: a meta-analytic investigation. The Journal of applied psychology. 2009;94 1:162–76. Maksimović J, Evtimov J. Positivism and post-positivism as the basis of quantitative research in pedagogy. Research in Pedagogy. 2023 Jan 1;13:208–18. Schaufeli WB, Salanova M, González-Romá V, Bakker AB. The measurement of engagement and burnout: A two sample confirmatory factor analytic approach. Journal of Happiness Studies: An Interdisciplinary Forum on Subjective Well-Being. 2002;3(1):71–92. Schaufeli W, Bakker A, Salanova M. The Measurement of Work Engagement With a Short Questionnaire. Educational and Psychological Measurement. 2006;66:701–16. Wickramasinghe ND, Dissanayake DS, Abeywardena GS. Validity and reliability of the Utrecht Work Engagement Scale-Student Version in Sri Lanka. BMC Res Notes. 2018 May 4;11(1):277. Fabio A. Withdrawal Intention Scale: Primo contributo alla validazione della versione italiana. 2020;13:0–0. Parent-Lamarche A. Teleworking, Work Engagement and Intention to Quit During the COVID-19 Pandemic: A Study Examining the Effects of Individual and Organizational Characteristics. Safety and Health at Work. 2022 Jan 1;13:S165–6. Chakladar A. Productivity in Organisation - An Alternate Model [Internet]. Rochester, NY: Social Science Research Network; 2017 [cited 2025 Jan 23]. Available from: https://papers.ssrn.com/abstract=3003766 Idris I, Adi KR, Soetjipto BE, Supriyanto AS. The mediating role of job satisfaction on compensation, work environment, and employee performance: Evidence from Indonesia. Entrepreneurship and Sustainability Issues. 2020;8(2):735–50. Swaroopa D, Prof.b.sudhir. A study on the impact of employee satisfaction on quality and profitability of organizations. International Journal of Latest Trends in Engineering and Technology [Internet]. [cited 2025 Jan 23];Volume 8(Issue 2). Available from: https://www.ijltet.org/journal_details.php?id=911&j_id=3695 Additional Declarations No competing interests reported. Supplementary Files AppendixAandb.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5894108","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":407663378,"identity":"36d4f1d8-9a93-4ad2-8baa-bd285436fa03","order_by":0,"name":"Hamid Yari Renani","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA3UlEQVRIiWNgGAWjYBACAxCRYCDBw8/AwHiAByzGRoyWChsZyQYGBhK0MJxJszE4QKwWc4nkZx8eth3mMT6/+MCBNwx28gwSaQl4tVjOSDOekQjUYnbjWcLBOQzJhg0SaQfwO+xGgjEDRMsZg8M8DMwJDBLpDQS0pH8GazGeAdZST4yWHGOGhDNpPAb8PSAth4FaCDnszJtiUCDzSNxgA/rF4LhhG8+zBPxajqdvZvxhIGHP33/44IM3FdXy/OxpBni1MAjAjJQAMQwIxgoQ8B9AZ4yCUTAKRsEoQAMAvyFIZl867qUAAAAASUVORK5CYII=","orcid":"","institution":"Goldsmiths University of London","correspondingAuthor":true,"prefix":"","firstName":"Hamid","middleName":"Yari","lastName":"Renani","suffix":""},{"id":407663379,"identity":"9ac1979a-04ca-4976-a004-51c0af2ea45a","order_by":1,"name":"Alireza Rahmanian","email":"","orcid":"","institution":"Altınbaş University","correspondingAuthor":false,"prefix":"","firstName":"Alireza","middleName":"","lastName":"Rahmanian","suffix":""},{"id":407663380,"identity":"24d23a57-0771-413f-a5fe-51d385d7683b","order_by":2,"name":"Zahra Saeidi","email":"","orcid":"","institution":"Shahid Beheshti University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Zahra","middleName":"","lastName":"Saeidi","suffix":""},{"id":407663382,"identity":"38b028f5-1f13-4d09-8c6b-13c2400f2d16","order_by":3,"name":"Behrooz Birashk","email":"","orcid":"","institution":"Iran University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Behrooz","middleName":"","lastName":"Birashk","suffix":""},{"id":407663384,"identity":"08ac4e92-ffba-4b43-8242-746a5baec68d","order_by":4,"name":"Iman Saraei","email":"","orcid":"","institution":"University of Tehran","correspondingAuthor":false,"prefix":"","firstName":"Iman","middleName":"","lastName":"Saraei","suffix":""},{"id":407663385,"identity":"35049c95-c013-49ee-a2a9-7667e0c9be10","order_by":5,"name":"Shirin Ghodusi","email":"","orcid":"","institution":"University of Tehran","correspondingAuthor":false,"prefix":"","firstName":"Shirin","middleName":"","lastName":"Ghodusi","suffix":""}],"badges":[],"createdAt":"2025-01-24 09:08:12","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5894108/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5894108/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":75312439,"identity":"041658a8-1e1d-4705-baf6-e8ebedcf2572","added_by":"auto","created_at":"2025-02-03 09:14:24","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":119982,"visible":true,"origin":"","legend":"\u003cp\u003eConsort Flow Diagram\u003c/p\u003e","description":"","filename":"Picture1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-5894108/v1/d30870c1446c110ab3ae81ad.jpg"},{"id":75315508,"identity":"2c6a6823-2298-4142-9f9d-d5690279a620","added_by":"auto","created_at":"2025-02-03 09:38:38","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":990939,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5894108/v1/a7bd9dab-def9-4a04-9c30-80258df83539.pdf"},{"id":75312995,"identity":"ac9ae1f1-f51e-481b-ab14-302529358c94","added_by":"auto","created_at":"2025-02-03 09:22:24","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":110075,"visible":true,"origin":"","legend":"","description":"","filename":"AppendixAandb.docx","url":"https://assets-eu.researchsquare.com/files/rs-5894108/v1/148fc7dc2d87a23ce95135d2.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Positive Psychology Interventions: A Catalyst for Job Satisfaction, Work Engagement, and Withdrawal Intentions Among Remote-Working Cancer Survivors in Rural Areas","fulltext":[{"header":"1.\tIntroduction ","content":"\u003cp\u003eJob satisfaction is an employee\u0026apos;s positive and pleasant feeling about their job, stemming from various factors such as working conditions, organizational rules, employee relations, social status, income, and cultural factors (1). Satisfied employees tend to perform their duties more effectively and efficiently (2). Work engagement is a rewarding and positive psychological condition related to work, arising from vigor, dedication, and absorption (3). Research indicates a positive correlation between job satisfaction and work engagement, with satisfied employees more likely to be engaged in their tasks (4,5). Conversely, a lack of job satisfaction can lead to increased withdrawal intentions, absenteeism, and decreased performance (6,7).\u003c/p\u003e\n\u003cp\u003eAmong the myriad factors influencing employee performance in organizations, illness stands out as a particularly significant and impactful element (8). Cancer, a significant factor affecting employee performance and job satisfaction, imposes substantial emotional and physical challenges, leading to long-term occupational disruptions and decreased job performance and satisfaction (9). Approximately 40-50% of cancer survivors are diagnosed during their working years, making it crucial to examine the influence of cancer on job satisfaction (10). A cancer diagnosis can cause significant emotional distress, leading to long-term occupational disruptions, interpersonal crises, and reduced job satisfaction (11).\u003c/p\u003e\n\u003cp\u003eCancer survivors, often diagnosed during working years, experience long-term occupational disruptions and decreased job performance and satisfaction (12,13). Treatments often cause side effects, leading to interpersonal crises and increased workplace tension (14,15). Dionisi-Vici et al. examined the employment status of 240 cancer survivors in various cities in Italy and found that the late effects of cancer have a negative impact on their job satisfaction (16). Moreover, Mousa et al. examined cancer survivors in urban areas of Kuala Lumpur, Malaysia, and found that cancer significantly reduces their work engagement (17).\u003c/p\u003e\n\u003cp\u003eFinancial toxicity refers to the economic burden cancer patients face due to reduced earnings and increased medical expenses, leading to heightened emotional distress and lower quality of life (18). Advanced financial toxicity, such as bankruptcy, is associated with a nearly twofold increase in mortality risk among cancer survivors (19).\u003c/p\u003e\n\u003cp\u003ePsycho-oncologic interventions, aimed at improving mental health, can reduce disease-related symptoms, enhance mental health, and potentially extend life expectancy (20,21). Positive psychology, rooted in Seligman\u0026apos;s work, promotes happiness through a joyful, committed, and meaningful life (22). Positive psychology interventions, such as gratitude exercises, strengths-based development, and mindfulness practices, have shown a statistically significant impact on job satisfaction and work engagement in various occupational settings (23,24). For instance, a study by Cortini et al. (23) showed that the implementation of positive psychology interventions resulted in an 8% increase in employee job satisfaction. These approaches not only promote individual well-being but also create a positive organizational culture, leading to increased productivity, improved teamwork, and overall job satisfaction among employees (25). Additionally, Musa et al. examined the impact of spirituality on 126 cancer survivors in urban areas of Kuala Lumpur and demonstrated that spirituality can lead to enhanced work engagement (17). Moreover, Positive psychology can mitigate withdrawal behaviors by promoting positive emotions, strengths, and meaningful experiences (26).\u003c/p\u003e\n\u003cp\u003eDespite the documented benefits of positive psychology interventions in enhancing job satisfaction and work engagement, their effects among cancer survivors remain largely unexplored. Existing research has primarily focused on urban environments, leaving a gap in understanding the potential of positive psychology interventions for cancer survivors in rural communities and remote working conditions (16,17). Additionally, the role of positive psychology interventions in mitigating withdrawal intentions among cancer survivors has not been adequately investigated (27).\u003c/p\u003e\n\u003cp\u003eTherefore, the study aims to investigate the impact of a 14-session positive psychology intervention on job satisfaction and work engagement, and its role in shaping withdrawal intentions. By focusing on cancer survivors in remote worker communities, the study addresses a significant gap in understanding how targeted interventions can support the occupational well-being of this population. Addressing these objectives can provide valuable insights into developing tailored support systems and interventions, enhancing job satisfaction, work engagement, and long-term employment prospects of cancer survivors in less urbanized regions.\u003c/p\u003e\n\u003cp\u003eThis study\u0026apos;s unique contribution lies in its focus on an underserved population and its exploration of positive psychology to support the occupational well-being of cancer survivors in rural and remote communities.\u003c/p\u003e"},{"header":"2.\tMaterials and method","content":"\u003ch2\u003e2.1 Research design\u0026nbsp;\u003c/h2\u003e\n\u003cp\u003eThis study employs a quasi-experimental research design to investigate the effects of positive psychology interventions on job satisfaction, work engagement, and withdrawal intentions among cancer survivors in rural and remote communities. A quasi-experimental design is particularly suitable for this research as it allows for the examination of the intervention\u0026apos;s impact in a real-world setting without the need for random assignment, which can be impractical in certain populations. The philosophical foundation of this research is rooted in positivism, which emphasizes the importance of observable empirical evidence in the development of knowledge (28). Positivism advocates for the use of quantitative methods to measure variables and establish cause-and-effect relationships through statistical analysis.\u003c/p\u003e\n\u003ch2\u003e2.2 Procedure\u0026nbsp;\u003c/h2\u003e\n\u003cp\u003eFollowing the random allocation of participants into experimental and control groups, the experimental group underwent a 14-session positive psychology intervention conducted weekly, with each session lasting 45 minutes. The intervention was delivered by licensed therapists trained and certified by the Iranian Psychological Association (IPA).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSession Breakdown:\u003c/p\u003e\n\u003cp\u003e1. Introduction: Establishing a supportive group environment and outlining program objectives.\u003c/p\u003e\n\u003cp\u003e2. Gratitude Practice: Enhancing well-being through gratitude exercises and maintaining gratitude journals.\u003c/p\u003e\n\u003cp\u003e3. Identifying Personal Strengths: Recognizing and utilizing personal strengths.\u003c/p\u003e\n\u003cp\u003e4. Building Positive Relationships: Strengthening interpersonal connections through communication techniques and active listening.\u003c/p\u003e\n\u003cp\u003e5. Cultivating Optimism: Fostering a positive outlook on life through guided imagery exercises.\u003c/p\u003e\n\u003cp\u003e6. Enhancing Resilience: Developing coping strategies through problem-solving and resilience-building exercises.\u003c/p\u003e\n\u003cp\u003e7. Mindfulness and Relaxation: Reducing stress through guided mindfulness meditation and relaxation practices.\u003c/p\u003e\n\u003cp\u003e8. Achieving Flow: Experiencing flow states to enhance engagement in activities.\u003c/p\u003e\n\u003cp\u003e9. Goal Setting and Future Planning: Setting meaningful goals and creating actionable plans to achieve them.\u003c/p\u003e\n\u003cp\u003e10. Promoting Well-being Through Acts of Kindness: Planning and performing acts of kindness.\u003c/p\u003e\n\u003cp\u003e11. Cultivating Self-Compassion: Engaging in self-compassion exercises to reduce self-criticism.\u003c/p\u003e\n\u003cp\u003e12. Positive Scripting and Reframing: Reframing negative experiences positively.\u003c/p\u003e\n\u003cp\u003e13. Integration and Reflection: Integrating learned techniques and reflecting on progress.\u003c/p\u003e\n\u003cp\u003e14. Closing and Future Directions: Sharing final reflections, receiving resources for continued personal growth, and celebrating accomplishments.\u003c/p\u003e\n\u003ch2\u003e2.3 Sampling method and participants\u003c/h2\u003e\n\u003ch3\u003e2.3.1 Sampling method\u003c/h3\u003e\n\u003cp\u003eThis study, after registration and obtaining ethical approval (No. 51666-16476) from the Secretariat of the Biomedical Ethics Committee of Tabriz University, employed a convenience sampling method to recruit research participants from the visitors to Razi Hospital in Tabriz. Participants were recruited from individuals diagnosed with stage II cancer who sought treatment at Razi Hospital in Tabriz, Iran. Convenience sampling was selected due to its practicality and efficiency, allowing the inclusion of participants who were readily available and willing to partake in the study. This method was deemed appropriate as it facilitated the recruitment of a sufficient number of participants within a reasonable timeframe, ensuring that the sample was representative of the target population.\u003c/p\u003e\n\u003ch3\u003e2.3.2 Participants\u003c/h3\u003e\n\u003cp\u003eThe study\u0026apos;s sample size was meticulously calculated to ensure adequate statistical power. The sample size was estimated to achieve a power of 80% and a two-tailed type I error rate of 5%. Based on these calculations, and after obtaining ethical approval and registering the research with the appropriate institutional review board, a total of 89 individuals were initially recruited to assess their ability.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInclusion Criteria:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026bull; Diagnosed with stage II cancer\u003c/p\u003e\n\u003cp\u003e\u0026bull; Receiving chemotherapy treatment\u003c/p\u003e\n\u003cp\u003e\u0026bull; Diagnosed within the past three to six months\u003c/p\u003e\n\u003cp\u003e\u0026bull; Employed remotely in an organization or company from the time of cancer diagnosis to the intervention\u003c/p\u003e\n\u003cp\u003e\u0026bull; Residing in rural communities\u003c/p\u003e\n\u003cp\u003e\u0026bull;\u003cspan dir=\"RTL\"\u003e\u0026nbsp;\u003c/span\u003eNo history of substance abuse.\u003c/p\u003e\n\u003cp\u003e\u0026bull; No history of serious chronic diseases, such as severe diabetes, heart disease, or kidney failure.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eExclusion Criteria:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026bull; Incomplete responses to the study questionnaires\u003c/p\u003e\n\u003cp\u003e\u0026bull; Concurrent participation in conflicting or experimental treatments\u003c/p\u003e\n\u003cp\u003e\u0026bull; Inability to regularly follow up on sessions and complete assessments.\u003c/p\u003e\n\u003ch2\u003e2.4 Informed consent and right to withdraw\u003c/h2\u003e\n\u003cp\u003ePotential participants were contacted and informed about the objectives, procedures, and potential benefits and risks of the study. They were assured of their rights, including the right to withdraw from the study at any time without any consequences. Informed consent was obtained from all participants, ensuring that they voluntarily agreed to participate in the research.\u003c/p\u003e\n\u003ch2\u003e2.5 Randomization, blinding, confidentiality, and anonymity\u003c/h2\u003e\n\u003cp\u003eParticipants were randomly assigned to either the experimental or control group using a computer-generated randomization sequence. To ensure balanced group allocation, randomization was stratified by baseline job satisfaction scores and gender. The allocation process was managed by an independent researcher who was not involved in recruitment or intervention delivery, ensuring strict allocation concealment. Due to the nature of the intervention, blinding participants and therapists was not feasible. However, outcome assessments were conducted by independent evaluators blinded to group assignments, and participants were instructed not to disclose their group allocation to the assessors. Assessors underwent training to minimize potential biases and uphold the integrity of the blinding process.\u003c/p\u003e\n\u003cp\u003eTo protect participants\u0026apos; privacy, all data were anonymized by assigning unique codes to each participant instead of using personal identifiers. Responses were treated confidentially and used solely for research purposes. The securely stored data were accessible only to authorized members of the research team, further ensuring the confidentiality and anonymity of all participants.\u003c/p\u003e\n\u003ch2\u003e2.6 Instruments\u003c/h2\u003e\n\u003ch3\u003e2.6.1 Job satisfaction\u003c/h3\u003e\n\u003cp\u003eTo assess the levels of job satisfaction among the participants, the Minnesota Job Satisfaction Questionnaire (MJSP) was employed. The MJSP is a widely recognized and validated self-report instrument that measures various facets of job satisfaction. It encompasses a comprehensive set of items that capture different aspects of an individual\u0026apos;s satisfaction with their work environment, tasks, and conditions. The MJSQ\u0026apos;s robustness is further evidenced by its adaptability and consistent reliability across diverse settings, including Portugal, where it exhibited high internal consistency and satisfactory convergent validity (Ferreira et al., 2009). The Minnesota Job Satisfaction Questionnaire consists of 20 items, each addressing different facets of job satisfaction. Respondents rate their agreement with each item on a Likert scale, typically ranging from 1 (very Dissatisfied) to 5 (very Satisfied). The items cover a wide range of dimensions, including the work\u0026apos;s nature, recognition, supervision, advancement opportunities, communication, compensation, and overall job satisfaction.\u003c/p\u003e\n\u003ch3\u003e2.6.2 Work engagement\u003c/h3\u003e\n\u003cp\u003eTo assess work engagement, we used the UWES-S, the student version of the Utrecht Work Engagement Scale, which is widely used to assess work engagement (29). The UWES originally included 17 items and three dimensions (vigor, dedication, and absorption). Later, for pragmatic reasons, the UWES was reduced to a nine-item version (UWES-9) that exhibited satisfactory psychometric properties (Schaufeli et al., 2006). Validity and reliability analyses across various studies have consistently demonstrated its robust psychometric properties. For example, in Sri Lanka, the UWES-S displayed excellent judgmental validity, item-convergent validity, and item-discriminant validity, with high internal consistency (Cronbach\u0026apos;s alpha coefficients for vigor, dedication, and absorption subscales were 0.867, 0.819, and 0.903, respectively) and strong test-retest reliability (31). In China, exploratory and confirmatory factor analyses confirmed a three-factor structure of the scale, with Cronbach\u0026apos;s alpha values ranging from 0.82 to 0.95, further supporting its reliability and validity The Spanish version demonstrated a unidimensional structure with an alpha coefficient of 0.91, indicative of high reliability (31).\u003c/p\u003e\n\u003ch3\u003e2.6.3 Withdrawal intention\u003c/h3\u003e\n\u003cp\u003eThe withdrawal intention scale (WIS) was utilized to assess the participants\u0026apos; withdrawal intentions. WIS is a tool designed to assess an individual\u0026apos;s intention to withdraw from a particular behavior, job, or substance. The WIS consists of items that typically inquire the participants\u0026apos; thoughts and plans related to leaving their current jobs. Participants rate their agreement with each item on a Likert scale, usually ranging from 1 (strongly disagree) to 5 (strongly agree). One study that focused on the Italian version of the WIS found it to be a valid and reliable instrument for detecting withdrawal intentions in Italian workers. The study confirmed the unidimensional structure of the WIS, demonstrating good reliability and concurrent validity (32).\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003e2.\u003cspan dir=\"RTL\"\u003e7\u003c/span\u003e Ethical conduct during data collection\u003c/h2\u003e\n\u003cp\u003eThe research team upheld ethical principles throughout the data collection process, including respecting participants, maximizing benefits while minimizing harm (beneficence), and ensuring fair treatment for all participants (justice). Participants were handled with care and sensitivity, particularly considering the potentially sensitive questions regarding mental health and marital satisfaction. By integrating rigorous data collection methods with strict ethical guidelines, this study ensured the acquisition of high-quality and reliable data while safeguarding participants\u0026apos; rights and well-being. This approach not only strengthens the credibility of the research findings but also aligns with the ethical standards expected in scientific research involving human subjects.\u003c/p\u003e"},{"header":"3. Results","content":"\u003cp\u003eAs shown in Figure (1), in this study, 89 individuals were initially selected to assess their eligibility. After the screening process, 9 participants were excluded, with 8 not meeting the inclusion criteria and 1 declining to participate. Consequently, 80 participants were randomly assigned to either the experimental group or the control group, each comprising 40 participants. Both groups completed pre-test questionnaires. The experimental group received a Positive Psychology Intervention, while the control group did not receive any intervention. Following the intervention period, both groups completed post-test questionnaires. In the experimental group, 6 participants were excluded from the post-test analysis, with 2 withdrawing consent and 4 failing to complete the intervention. Similarly, 6 participants from the control group were excluded from the post-test analysis, all due to withdrawing consent. Ultimately, 34 participants from each group were included in the final analysis, ensuring a balanced and unbiased sample to evaluate the effects of the Positive Psychology Intervention.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDemographic findings according to the two experimental and control groups\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eThe frequency of the experimental group\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercent\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eThe frequency of the control group\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003ePercent\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e67.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e61.76\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e32.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e38.24\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e41.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e38.24\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003emarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e58.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e61.76\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20\u0026ndash;29 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e23.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e29.41\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30\u0026ndash;39 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e35.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e32.35\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e40\u0026ndash;49 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e41.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e38.24\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e presents the demographic findings for both the experimental and control groups, providing a comprehensive view of the participant characteristics. In terms of gender distribution, the experimental group consisted of 67.65% males (23 participants) and 32.35% females (11 participants), while the control group comprised 61.76% males (21 participants) and 38.24% females (13 participants). Regarding marital status, 41.18% of the experimental group (14 participants) were single, and 58.82% (20 participants) were married. In contrast, the control group had 38.24% single participants (13 participants) and 61.76% married participants (21 participants). The age distribution for the experimental group showed that 23.53% were aged 20\u0026ndash;29 years (8 participants), 35.29% were aged 30\u0026ndash;39 years (12 participants), and 41.18% were aged 40\u0026ndash;49 years (14 participants). Similarly, the control group included 29.41% of participants aged 20\u0026ndash;29 years (10 participants), 32.35% aged 30\u0026ndash;39 years (11 participants), and 38.24% aged 40\u0026ndash;49 years (13 participants). This demographic data highlights the balanced distribution of participants across gender, marital status, and age categories, ensuring the representativeness and reliability of the study outcomes.\u003c/p\u003e \u003cp\u003eIn Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e, the descriptive statistics of the experimental and control group participants' scores in the variables of job satisfaction, work engagement, and withdrawal intentions are presented separately in the pre-test and post-test stages.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDescriptive statistics for job satisfaction, work engagement, and withdrawal intentions of the two experimental and control groups in the pre-test and post-test\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eExperimental group\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eControl group\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eVariables\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003ePre-test\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003ePost-test\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003ePre-test\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003ePost-test\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eM\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eM\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eM\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eM\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ejob satisfaction\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e50.23\u0026thinsp;\u0026plusmn;\u0026thinsp;11.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e58.94\u0026thinsp;\u0026plusmn;\u0026thinsp;11.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e50.58\u0026thinsp;\u0026plusmn;\u0026thinsp;13.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e48.94\u0026thinsp;\u0026plusmn;\u0026thinsp;13.46\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ework engagement\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e26.79\u0026thinsp;\u0026plusmn;\u0026thinsp;4.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31.05\u0026thinsp;\u0026plusmn;\u0026thinsp;4.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e26.91\u0026thinsp;\u0026plusmn;\u0026thinsp;5.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e28.00\u0026thinsp;\u0026plusmn;\u0026thinsp;4.06\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ewithdrawal intentions\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e48.35\u0026thinsp;\u0026plusmn;\u0026thinsp;10.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39.05\u0026thinsp;\u0026plusmn;\u0026thinsp;13.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e48.82\u0026thinsp;\u0026plusmn;\u0026thinsp;9.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e47.52\u0026thinsp;\u0026plusmn;\u0026thinsp;11.25\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAccording to Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. In all variables, the mean of the experimental group improved from the pre-test to the post-test. This improvement in the variable of job satisfaction and work engagement included an increase in the mean, and for the variable of withdrawal intentions, it included a decrease in the mean. In contrast, little changes were observed in the control group. Therefore, the difference between the two groups in the post-test phase is in favor of the experimental group.\u003c/p\u003e \u003cp\u003eAccording to the current research design, analysis of covariance test was used to analyze the main results. First, the Shapiro-Wilk test was used to check the normality of the distribution of the dependent variables of the research. Since the statistical significance level for all research variables was greater than 0.05, the null hypothesis was rejected and as a result, the normality of the distribution of these variables was confirmed at the 95% confidence level. The results of Levin's test to check the equality of variance of the groups in the dependent variables of the research showed that the obtained statistical significance level is greater than 0.05, so the two groups are the same in terms of the dispersion of the scores of these variables in the pre-test stage. Also, the results of regression slope homogeneity test showed that factor covariance analysis of group interaction and job satisfaction variable (F\u0026thinsp;=\u0026thinsp;0.308 and p\u0026thinsp;=\u0026thinsp;0.613), and group interaction and job engagement variable (F\u0026thinsp;=\u0026thinsp;0.527 and p\u0026thinsp;=\u0026thinsp;0.419), and group interaction and job engagement variable (F\u0026thinsp;=\u0026thinsp;0.443 and p\u0026thinsp;=\u0026thinsp;0.529), are not statistically significant, so the assumption of homogeneity of the regression slope for the dependent variables of the research has been met. The results of univariate covariance analysis were used to determine the effectiveness of positive psychology on job satisfaction, work engagement, and withdrawal intentions. The results of univariate covariance analysis are reported in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe results of univariate covariance analysis of the difference between the experimental and control groups in job satisfaction, work engagement, and withdrawal intentions.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eVariables\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eSource\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eSum of Squares\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003edf\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eMean Square\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eF\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cem\u003ePartial Eta Squared\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003ejob satisfaction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePre-test\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5006.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e5006.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e62.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.49\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003egroup\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1786.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1786.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e22.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.25\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eError\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5237.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e65.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e80.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003ework engagement\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePre-test\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e744.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e744.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e98.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.60\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003egroup\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e167.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e167.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e22.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.26\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eError\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e489.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e65.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e7.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003ewithdrawal intentions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePre-test\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1933.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1933.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e20.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.24\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003egroup\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1142.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1142.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e11.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e0.16\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eError\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6220.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e65.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e95.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e62.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAccording to the results of the univariate covariance analysis presented in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e, after controlling for pre-test effects, significant differences were observed between the mean post-test scores of the experimental and control groups across the variables of job satisfaction (Partial Eta Squared η\u0026sup2; = 0.25, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01, F\u0026thinsp;=\u0026thinsp;22.17), work engagement (η\u0026sup2; = 0.26, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01, F\u0026thinsp;=\u0026thinsp;22.25), and withdrawal intentions (η\u0026sup2; = 0.16, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01, F\u0026thinsp;=\u0026thinsp;11.94). This indicates that the intervention, presumably based on positive psychology principles, significantly improved job satisfaction and work engagement among cancer survivors. Moreover, it effectively reduced their withdrawal intentions, as indicated by the decrease in mean scores for this variable in the experimental group compared to the control group. The effect sizes of 0.25 for job satisfaction, 0.26 for work engagement, and 0.16 for withdrawal intentions confirm that these differences are statistically significant within the population. Thus, it can be concluded that the positive psychology intervention statistically positively impacted job satisfaction, increased work engagement, and successfully reduced withdrawal intentions among the participants.\u003c/p\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eThe primary aim of this study was to investigate the effect of positive psychology intervention on job satisfaction, work engagement, and withdrawal intention among remote-working cancer survivors in rural areas. The study's results revealed a statistically significant positive impact of positive psychology interventions on job satisfaction, work engagement, and withdrawal intentions among cancer survivors in remote workforce and rural communities. The current investigation observed a significant enhancement in job satisfaction, as evidenced by the increase in mean scores from 50.23 to 58.94 in the experimental group following the intervention. The study also noted a statistically significant increase in work engagement mean scores, escalating from 26.79 to 31.05. This suggests the interventions probably enhanced the participants' vigor, dedication, and absorption in their work roles. This change suggested that the cancer survivors became more psychologically resilient and motivated, demonstrating a stronger connection and commitment to their job tasks. On the other hand, withdrawal intentions\u0026rsquo; mean scores decreased from 48.35 to 39.05, signifying a reduced desire to leave their jobs among the participants. This reduction was particularly important, as it suggested that the positive psychology interventions helped mitigate some of the emotional and psychological challenges that cancer survivors face, which might otherwise lead to job withdrawal. This observation supports the main hypothesis that applying positive psychology interventions positively affects job satisfaction and work engagement and reduces withdrawal intentions among cancer survivors in remote workforce and rural communities.\u003c/p\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003e4.1 Comparison with Previous Studies\u003c/h2\u003e \u003cp\u003eThe findings of this study provide significant insights into the effects of positive psychology interventions on cancer survivors who work remotely and live in rural areas, offering unique comparative perspectives. This section compares the findings with previous research to emphasize the strengths and innovative aspects of the current study while addressing the limitations of earlier works.\u003c/p\u003e \u003cp\u003eInitially, the increase in job satisfaction in our study aligned with the findings of Cortini et al. (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e), who observed an 8% rise in job satisfaction following positive psychology interventions. Our research expanded upon this by specifically highlighting the impact on cancer survivors and pinpointing the targeted benefits for this group. Furthermore, Donaldson et al. (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e), demonstrated the effectiveness of positive psychology in boosting work engagement. Our findings corroborated this but also emphasized the significant effect within a specialized cohort of cancer survivors, thereby providing detailed insights into context-specific impacts.\u003c/p\u003e \u003cp\u003eThe enhancements in job satisfaction and work engagement observed in this study echoed the positive outcomes noted in previous research, like that of Cortini et al. (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). Yet, our research distinguished itself by delving into both work engagement and withdrawal intentions, thus offering a more comprehensive view of the effects of positive psychology in the workplace for cancer survivors.\u003c/p\u003e \u003cp\u003eIn reference to the foundational theories of Seligman (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e), our study emphasized the importance of nurturing strengths, enhancing positive emotions, and cultivating a sense of meaning. These elements, which are pivotal in Seligman's positive psychology framework, theoretically underpinned the psychological mechanisms through which our interventions yielded their beneficial outcomes, marrying theoretical concepts with our empirical findings in improving job satisfaction, work engagement, and reducing withdrawal intentions among cancer survivors.\u003c/p\u003e \u003cp\u003eKaplan et al. (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e) explored the connection between positive affectivity and reduced withdrawal intentions, finding a correlation between a positive work environment and lower withdrawal tendencies. Our study extended these findings by demonstrating how positive psychology interventions specifically reduced withdrawal behaviors in remote-working cancer survivors. We further elaborated on this by highlighting the mechanisms through which positive psychology fostered a supportive environment that not only enhanced positive affectivity but also directly contributed to diminishing the propensity for withdrawal among cancer survivors. This alignment with Kaplan's research underscored the broader applicability and efficacy of positive psychology principles in mitigating withdrawal intentions, particularly in the context of chronic illness and workplace integration.\u003c/p\u003e \u003cp\u003ePrevious studies, such as those by Degi (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e) and Faller et al. (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e), had shown improvements in mental health, quality of life, and job performance due to psycho-oncologic interventions in cancer patients. Our study built on this by zeroing in on the specific effects of positive psychology interventions on job satisfaction, work engagement, and withdrawal intentions among cancer survivors in less accessible areas.\u003c/p\u003e \u003cp\u003eRecent studies by Dionisi-Vici et al. (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e) examined the employment status of 240 cancer survivors in various cities in Italy and found that the late effects of cancer have a negative impact on their job satisfaction. Moreover, Mousa et al. (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e) examined cancer survivors in urban areas of Kuala Lumpur, Malaysia, and found that cancer significantly reduces their work engagement. These studies demonstrate the negative effects of cancer on job satisfaction and work engagement, with their samples all being in urban communities and employed on-site.\u003c/p\u003e \u003cp\u003eWhile Parent-Lamarche (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e) showed that teleworking can lead to reduced work engagement and increased intention to quit, the present study, by examining the effects of positive psychology interventions on these aspects among cancer survivors working remotely in rural areas, demonstrated that positive psychology interventions can lead to increased work engagement and reduced intention to quit in individuals who telework.\u003c/p\u003e \u003cp\u003eThe novelty of our research lies in examining these variables in rural communities and among individuals who work remotely. Our study showed that positive psychology interventions can effectively improve job satisfaction, and work engagement, and reduce withdrawal intentions in this population, thus addressing the limitations of previous studies and filling existing research gaps. This comparison not only enhances the existing academic discourse but also provides actionable insights for customizing workplace support to meet the distinctive needs of cancer survivors in rural and remote communities.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003e4.2 Policy Implication\u003c/h2\u003e \u003cp\u003eThese findings are significant not only in their statistical validity but also in their real-world applicability. They show that targeted psychological support can probably have a profound and positive effect on the work-related attitudes and behaviors of cancer survivors, particularly those with remote occupations who are living in areas with fewer resources and support systems.\u003c/p\u003e \u003cp\u003eThe findings from this study suggest several implications for policy and practice. First, healthcare and organizational policies should recognize and integrate positive psychology interventions as a standard component of cancer care, especially for those in the workforce. Implementing these interventions can improve job satisfaction and engagement and reduce the likelihood of job withdrawal among cancer survivors.\u003c/p\u003e \u003cp\u003eSecond, policies should be developed to support the training of psychologists and counselors in positive psychology, ensuring that these interventions are delivered effectively and are accessible to cancer survivors, particularly in remote worker communities who are in rural areas. Furthermore, workplaces can be encouraged to create environments that foster positive psychological experiences, which in turn could enhance employee engagement and satisfaction.\u003c/p\u003e \u003cp\u003eThird, the research underscores the importance of considering the unique challenges faced by cancer survivors in rural and remote workforce communities. Policymakers and practitioners should focus on developing targeted interventions that address these challenges, ensuring that cancer survivors in these areas receive the support they need to thrive in their professional lives.\u003c/p\u003e \u003cp\u003eLastly, positive psychology can significantly contribute to enhancing organizational productivity by improving job satisfaction. Organizational productivity refers to the effective use of resources to produce goods or services that meet target customers' needs, influenced by management practices and organizational culture (\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e). Job satisfaction plays a vital role in boosting productivity as it motivates employees to work more efficiently, aiding in achieving the broader objectives of the organization (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e). Satisfied employees tend to be more engaged, perform better, and are more likely to contribute positively towards organizational goals. High productivity, driven by employee satisfaction, can lead to increased profitability and enhanced customer service, thus improving the organization's reputation and stability (\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eTherefore, it is evident that positive psychology, by elevating job satisfaction, can play a significant role in increasing organizational productivity. This boost in productivity not only aids in enhancing the profitability of the organization but also contributes to its sustained stability and reputation. Hence, investing in positive psychology interventions is crucial not just for the mental well-being of the employees but also for the profitability and long-term success of the organization.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003e4.3 Limitations\u003c/h2\u003e \u003cp\u003ethe sample size of 68 participants raises concerns about the generalizability of the findings, as it may not adequately represent the broader population of cancer survivors across different regions. Additionally, the quasi-experimental design, without random assignment to groups, could introduce selection bias, potentially affecting the internal validity of the results. The use of self-report questionnaires for measuring job satisfaction, work engagement, and withdrawal intentions may also introduce response biases such as social desirability, which could skew the results.\u003c/p\u003e \u003cp\u003eMoreover, the study\u0026rsquo;s design does not include a longitudinal follow-up, limiting insights into the long-term sustainability of the intervention\u0026rsquo;s effects. Cultural factors, given the study's location in Iran, might influence the outcomes and their applicability in different contexts, suggesting the need for cross-cultural research to validate the findings universally. Lastly, the study did not thoroughly examine the participants' psychological health status before the intervention, which could affect their response to the positive psychology treatments.\u003c/p\u003e \u003c/div\u003e"},{"header":"5. Conclusion","content":"\u003cp\u003eThe primary objective of this research was to examine the impact of positive psychology interventions on job satisfaction, work engagement, and withdrawal intentions among cancer survivors who are working remotely in communities. The innovative aspect of this study lies in its focus on applying positive psychology interventions to support this unique demographic, providing a deeper understanding of how these interventions can be tailored to enhance occupational well-being and retention among cancer survivors.\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003e\u0026bull; The research investigated key parameters such as job satisfaction, work engagement, and withdrawal intentions among cancer survivors.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e\u0026bull; Quantitative findings include a significant increase in job satisfaction (from 50.23 to 58.94) and work engagement (from 26.79 to 31.05), and a decrease in withdrawal intentions (from 48.35 to 39.05) post-intervention in the experimental group.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eIn summary, the study illustrates the potent role of positive psychology in improving job satisfaction and work engagement while reducing withdrawal intentions among cancer survivors working remotely and living in less urbanized areas. Future research should explore the long-term effects of these interventions and examine cultural and regional differences in the effectiveness of positive psychology interventions. Additionally, it would be beneficial to investigate the specific components of positive psychology interventions that are most effective and to explore their applicability in different work environments and among diverse populations of cancer survivors.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003e1-Hamid Yari Renani: Conceptualization, Methodology, Supervision.2-Alireza Rahmanian: Investigation, Writing \u0026ndash; Original Draft.3-Zahra Saeidi: Investigation, Visualization.4-Behrooz Birashk: Methodology, Writing \u0026ndash; Review \u0026amp; Editing.5-Iman Saraei: Investigation, Writing \u0026ndash; Original Draft.6-Shirin Ghodusi: Writing \u0026ndash; Review \u0026amp; Editing.\u003c/p\u003e\u003ch2\u003eAcknowledgment\u003c/h2\u003e\n\u003cp\u003eThe authors appreciate all participants who contributed to the research through their valuable engagement.\u003c/p\u003e\n\u003cp\u003eThe authors declare that no funds, grants, or other support were received during the preparation of this manuscript.\u003c/p\u003e\n\u003ch2\u003eData Availability\u003c/h2\u003e\n\u003cp\u003eThe data used in this study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003ch2\u003eCompeting Interests\u003c/h2\u003e\n\u003cp\u003eThe authors have no relevant financial or non-financial interests to disclose.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eWu JR, Iwanaga K, Chan F, Lee B, Chen X, Walker R, et al. 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Journal of Occupational Health Psychology. 2024;29(2):113\u0026ndash;29. \u003c/li\u003e\n\u003cli\u003eZang L, Feng Y. Relationship between job satisfaction and work engagement in Chinese kindergarten teachers: Vocational delay of gratification as a mediator. Front Psychol. 2023 Feb 23;14:1114519. \u003c/li\u003e\n\u003cli\u003eCarleton EL, Barling J. Indirect effects of obstructive sleep apnea treatments on work withdrawal: A quasi-experimental treatment outcome study. Journal of Occupational Health Psychology. 2020;25(6):426\u0026ndash;38. \u003c/li\u003e\n\u003cli\u003eShapira-Lishchinsky O, Even-Zohar S. Withdrawal Behaviors Syndrome: An Ethical Perspective. J Bus Ethics. 2011 Oct 1;103(3):429\u0026ndash;51. \u003c/li\u003e\n\u003cli\u003eWang J, Liu S, Qu X, He X, Zhang L, Guo K, et al. Nurses\u0026rsquo; Colleague Solidarity and Job Performance: Mediating Effect of Positive Emotion and Turnover Intention. Safety and Health at Work. 2023 Sep 1;14(3):309\u0026ndash;16. \u003c/li\u003e\n\u003cli\u003eEl Amri I, Benali B. Job satisfaction among doctors in Morocco. Safety and Health at Work. 2022 Jan 1;13:S221. \u003c/li\u003e\n\u003cli\u003eDuijts S. Sustained employability of cancer patients and survivors: are we getting any closer? Eur J Cancer Care (Engl). 2017 Sep;26(5). \u003c/li\u003e\n\u003cli\u003ePaltrinieri S, Pellegrini M, Costi S, Fugazzaro S, Vicentini M, Mancuso P, et al. Validating the Core Set for Vocational Rehabilitation in a Population of Cancer Survivors: A Cross-Sectional Study. J Occup Rehabil [Internet]. 2024 Dec 11 [cited 2025 Jan 23]; Available from: https://doi.org/10.1007/s10926-024-10252-5\u003c/li\u003e\n\u003cli\u003eBuresti G, Rondinone BM, Valenti A, Boccuni F, Fortuna G, Iavicoli S, et al. Measures of work-life balance and interventions of reasonable accommodations for the return to work of cancer survivors: A Scoping Review. Safety and Health at Work [Internet]. 2024 Jul 27 [cited 2024 Jul 31]; Available from: https://www.sciencedirect.com/science/article/pii/S2093791124000532\u003c/li\u003e\n\u003cli\u003eRobinson L, Kocum L, Loughlin C, Bryson L, Dimoff JK. I wanted you to know: Breast cancer survivors\u0026rsquo; control of workplace communication about cancer. Journal of Occupational Health Psychology. 2015;20(4):446\u0026ndash;56. \u003c/li\u003e\n\u003cli\u003eBoelhouwer IG, Vermeer W, Vuuren T van. The associations between late effects of cancer treatment, work ability and job resources: a systematic review. International Archives of Occupational and Environmental Health. 2020;94:147\u0026ndash;89. \u003c/li\u003e\n\u003cli\u003eAdi NP, Nagata T, Odagami K, Nagata M, Mori K. Role of Supervisor Consultation Toward Work Engagement: A Prospective Cohort Study. Safety and Health at Work. 2024 Jun 1;15(2):147\u0026ndash;50. \u003c/li\u003e\n\u003cli\u003eDionisi-Vici M, Godono A, Castiglione A, Gatti F, Fortunati N, Clari M, et al. Work Placement and Job Satisfaction in Long-Term Childhood Cancer Survivors: The Impact of Late Effects. Cancers (Basel). 2022 Aug 18;14(16):3984. \u003c/li\u003e\n\u003cli\u003eMusa SNS, Hamzah SR, Muda Z, Asimiran S, Krauss SE. Predicting work engagement among young adult cancer survivors: A moderated mediation model. Front Sociol. 2023;8:1030518. \u003c/li\u003e\n\u003cli\u003eDusetzina SB, Winn AN, Abel GA, Huskamp HA, Keating NL. Cost sharing and adherence to tyrosine kinase inhibitors for patients with chronic myeloid leukemia. J Clin Oncol. 2014 Feb 1;32(4):306\u0026ndash;11. \u003c/li\u003e\n\u003cli\u003eRamsey S, Bansal A, Fedorenko C, Blough D, Overstreet KA, Shankaran V, et al. Financial Insolvency as a Risk Factor for Early Mortality Among Patients With Cancer. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2016;34 9:980\u0026ndash;6. \u003c/li\u003e\n\u003cli\u003eDegi C. [Analysis of the effectiveness of psychologic interventions in oncology regarding the quality of life and survival of cancer patients]. Psychiatria Hungarica : A Magyar Pszichiatriai Tarsasag tudomanyos folyoirata. 2006;21 2:138\u0026ndash;46. \u003c/li\u003e\n\u003cli\u003eFaller H, Schuler M, Richard M, Heckl U, Weis J, K\u0026uuml;ffner R. Effects of psycho-oncologic interventions on emotional distress and quality of life in adult patients with cancer: systematic review and meta-analysis. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2013;31 6:782\u0026ndash;93. \u003c/li\u003e\n\u003cli\u003eSeligman MEP, Csikszentmihalyi M. Positive psychology: An introduction. American Psychologist. 2000;55(1):5\u0026ndash;14. \u003c/li\u003e\n\u003cli\u003eCortini M, Converso D, Galanti T, Di Fiore T, Di Domenico A, Fantinelli S. Gratitude at Work Works! A Mix-Method Study on Different Dimensions of Gratitude, Job Satisfaction, and Job Performance. Sustainability. 2019 Jan;11(14):3902. \u003c/li\u003e\n\u003cli\u003eDonaldson S, Lee J, Donaldson SI. Evaluating Positive Psychology Interventions at Work: a Systematic Review and Meta-Analysis. International Journal of Applied Positive Psychology. 2019;4:113\u0026ndash;34. \u003c/li\u003e\n\u003cli\u003eLeka S, Torres L, Jain A, Di Tecco C, Russo S, Iavicoli S. Relationship Between Occupational Safety and Health Policy Principles, Organizational Action on Work-related Stress and the Psychosocial Work Environment in Italy. Safety and Health at Work. 2023 Dec 1;14(4):425\u0026ndash;30. \u003c/li\u003e\n\u003cli\u003eNoroozi D, Masumabad SA. The role of spiritual intelligence in employees\u0026rsquo; withdrawal behaviors in physical education organization. 2015;4:60\u0026ndash;71. \u003c/li\u003e\n\u003cli\u003eKaplan SA, Bradley JC, Luchman JN, Haynes D. On the role of positive and negative affectivity in job performance: a meta-analytic investigation. The Journal of applied psychology. 2009;94 1:162\u0026ndash;76. \u003c/li\u003e\n\u003cli\u003eMaksimović J, Evtimov J. Positivism and post-positivism as the basis of quantitative research in pedagogy. Research in Pedagogy. 2023 Jan 1;13:208\u0026ndash;18. \u003c/li\u003e\n\u003cli\u003eSchaufeli WB, Salanova M, Gonz\u0026aacute;lez-Rom\u0026aacute; V, Bakker AB. The measurement of engagement and burnout: A two sample confirmatory factor analytic approach. Journal of Happiness Studies: An Interdisciplinary Forum on Subjective Well-Being. 2002;3(1):71\u0026ndash;92. \u003c/li\u003e\n\u003cli\u003eSchaufeli W, Bakker A, Salanova M. The Measurement of Work Engagement With a Short Questionnaire. Educational and Psychological Measurement. 2006;66:701\u0026ndash;16. \u003c/li\u003e\n\u003cli\u003eWickramasinghe ND, Dissanayake DS, Abeywardena GS. Validity and reliability of the Utrecht Work Engagement Scale-Student Version in Sri Lanka. BMC Res Notes. 2018 May 4;11(1):277. \u003c/li\u003e\n\u003cli\u003eFabio A. Withdrawal Intention Scale: Primo contributo alla validazione della versione italiana. 2020;13:0\u0026ndash;0. \u003c/li\u003e\n\u003cli\u003eParent-Lamarche A. Teleworking, Work Engagement and Intention to Quit During the COVID-19 Pandemic: A Study Examining the Effects of Individual and Organizational Characteristics. Safety and Health at Work. 2022 Jan 1;13:S165\u0026ndash;6. \u003c/li\u003e\n\u003cli\u003eChakladar A. Productivity in Organisation - An Alternate Model [Internet]. Rochester, NY: Social Science Research Network; 2017 [cited 2025 Jan 23]. Available from: https://papers.ssrn.com/abstract=3003766\u003c/li\u003e\n\u003cli\u003eIdris I, Adi KR, Soetjipto BE, Supriyanto AS. The mediating role of job satisfaction on compensation, work environment, and employee performance: Evidence from Indonesia. Entrepreneurship and Sustainability Issues. 2020;8(2):735\u0026ndash;50. \u003c/li\u003e\n\u003cli\u003eSwaroopa D, Prof.b.sudhir. A study on the impact of employee satisfaction on quality and profitability of organizations. International Journal of Latest Trends in Engineering and Technology [Internet]. [cited 2025 Jan 23];Volume 8(Issue 2). Available from: https://www.ijltet.org/journal_details.php?id=911\u0026amp;j_id=3695\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Positive Psychology, Cancer Survivors, Job Satisfaction, Remote Worker Communities, Rural Communities","lastPublishedDoi":"10.21203/rs.3.rs-5894108/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5894108/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eAdvances in cancer treatment have significantly increased the survival rate of cancer patients, but these survivors often face challenges in the workplace. Existing literature highlights the significant influence of cancer on job performance, job satisfaction, and the increased risk of withdrawal intention. However, the effects of positive psychology interventions on cancer survivors, particularly in less urbanized settings and remote worker communities, remain underexplored.\u003c/p\u003e\u003ch2\u003ePurpose\u003c/h2\u003e \u003cp\u003eThis study investigates the effects of positive psychology interventions on job satisfaction, work engagement, and withdrawal intentions among cancer survivors in rural and remote workforce communities.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA quasi-experimental design was employed, involving 68 cancer survivors. The study used the Minnesota Job Satisfaction Questionnaire, the Utrecht Work Engagement Scale, and the Withdrawal Intention Scale to measure outcomes following a 14-session positive psychology intervention. The results revealed statistically significant improvements in the experimental group compared to the control group.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eJob satisfaction mean scores increased from 50.23 to 58.94, work engagement mean scores rose from 26.79 to 31.05, and withdrawal intentions mean scores decreased from 48.35 to 39.05. These findings highlight the potential of positive psychology interventions to address the unique challenges faced by cancer survivors in remote workforce communities, particularly in less urbanized areas.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eBy enhancing job satisfaction and work engagement while reducing withdrawal intentions, these interventions can significantly contribute to the occupational well-being of cancer survivors, advocating for their integration into cancer care and organizational practices.\u003c/p\u003e","manuscriptTitle":"Positive Psychology Interventions: A Catalyst for Job Satisfaction, Work Engagement, and Withdrawal Intentions Among Remote-Working Cancer Survivors in Rural Areas","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-02-03 09:14:19","doi":"10.21203/rs.3.rs-5894108/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"ea49c458-9c3a-4d1f-ac7b-518bd17a274e","owner":[],"postedDate":"February 3rd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-02-03T09:14:21+00:00","versionOfRecord":[],"versionCreatedAt":"2025-02-03 09:14:19","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5894108","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5894108","identity":"rs-5894108","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}