Disparities in maintaining employment experienced by women with breast cancer: an integrative review.

Details

• Personal Author:
  Melnyk H
• Description:
  Background: Breast cancer affects 1 in 8 women in the US, 60% of whom will be of working age at the time of diagnosis. While more women are surviving, they are more likely to be unemployed than those without cancer. Gainful employment is a social determinant of health. Unemployment is associated with reduced quality of life and increased mortality in this population. Purpose: The purpose of this integrative review was to explore the nature of disparities in sustainable employment experienced by breast cancer survivors (BCS). A better understanding of the mechanisms involved in maintaining employment might help improve the process of breast cancer recovery. Methods: A systematic search of PubMed and CINAHL using key terms for breast cancer and unemployment that was limited to US-based studies and those published within the last 5 years resulted in a total of 452 citations. A final sample of 9 articles was identified after applying additional inclusion/exclusion criteria. Results: The results aligned with the Mehnert (2013) model depiction of employment outcomes in cancer survivors as a complex weave of interrelated individual, disease, and work-related factors. Variations in these factors among the studies in this review contributed to inconsistent findings. Nevertheless, several overarching themes emerged. These were the importance of examining 1) the burden of breast cancer over the life-course, 2) "hard to get at" populations and constructs, and 3) decision making / relational strategies to facilitate maintaining employment. Conclusions/Implications: The findings of this review indicated that receipt of chemotherapy and mastectomy in BCS are risk factors for unemployment. This is consistent with the findings of a systematic review and meta-analysis of observational studies (Wang, et al., 2018) showing moderate and high-quality evidence, respectively, for these associations. Findings pointing to lower income/education levels and African American ethnicity as risk factors for unemployment in BCS also concur with Wang (2018). This evidence would support the inclusion of employment circumstances for vulnerable target groups in both (1) patient-clinician discussions surrounding treatment options and 2) survivorship care plans in order to avoid potential adverse outcomes. [Description provided by NIOSH]
• Subjects:
  Healthcare Disparities Occupational Health Safety Women
• Keywords:
  Women; Breast cancer; Return to work; Cancer survivors; Unemployment; Health disparities
• ISSN:
  0029-6562
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Abstract or Summary
• Place as Subject:
  New York ; OSHA Region 2
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  69
• Issue:
  3
• NIOSHTIC Number:
  nn:20065826
• Citation:
  Nurs Res 2020 May/Jun; 69(3):E101
• Federal Fiscal Year:
  2020
• Performing Organization:
  Mount Sinai School of Medicine
• Peer Reviewed:
  False
• Start Date:
  20050701
• Source Full Name:
  Nursing Research. Eastern Nursing Research Society 2020 Conference: 32nd ENRS Annual Scientific Sessions, April 2, 2020, virtual event
• End Date:
  20270630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:cf6ee58a0403c315b2e552ed4091f6299624da135d5a55bc979c2c442e9b0594ea51acd101a0657fdc0621335b6a6de15797ff87b53e1676c33e64e310687bca
• Download URL:
  https://stacks.cdc.gov/view/cdc/248868/cdc_248868_DS1.pdf
• File Type:
  [PDF - 125.14 KB ]