The impact of colorectal cancer, self-efficacy and social support on work ability and employment status : a longitudinal study

Each year approximately 90,000 new cases of cancer are diagnosed in people of working age in the United Kingdom (UK) (Morrell & Pryce, 2005). The potential impact of cancer and its treatment on working life is substantial, with approximately 40% of all cancer patients taking time off work during treatment and recovery (Short, Vasey & Tunceli, 2005). However, little information is available on employment outcomes for those managing colorectal cancer. Colorectal cancer is a commonly diagnosed cancer with approximately 36,000 people diagnosed each year in the UK. Although research demonstrates promising return to work outcomes for this group, not enough is known about the factors (variables) impacting their return to work intentions, work ability and employment outcomes. The aims of this research were to: examine the return to work intentions, work ability and employment outcomes of colorectal cancer patients over six months; explore the role of self-efficacy and psychosocial wellbeing, and explore the role of health professionals in providing work-related support and information to patients. Findings from these studies may help to better inform future interventions to support this cancer group. Fifty participants newly diagnosed with colorectal cancer were recruited from three Acute NHS Trusts (n = 27) across the Midlands and a support group (n = 23) affiliated to a National Cancer Charity. Participants completed questionnaires at three time points: baseline (post surgery or pre-treatment); follow-up time 1 (3 months), and follow-up time 2 (6 months). As well as illness and demographic characteristics, the questionnaires measured job self-efficacy, work ability, cancer self-efficacy, quality of life, fatigue and depression. A subsample of participants (n = 10) completed a monthly diary over six months. This captured temporal fluctuations and patterns in cancer management, return to work intentions and work ability and the factors impacting upon these (selfefficacy and social support). Finally, 18 health professionals participated in semi-structured interviews that explored the nature and type of work-related advice currently provided to colorectal cancer patients. Data were analysed using both quantitative (ANOVAs and regression) and qualitative techniques (thematic analysis).