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Establishing a UK/Ireland network for research
on cancer and employment
Ziv Amir, Gail Eva, Diana Greenfield, Catherine Hayden, Gill Hubbard, Thilo Kroll,
Richard Kyle, Linda Sharp, Taina Taskila, Mary Wells, Theresa Wiseman,
Penny Wright
CanWork:
The CanWork Research Network was established in May 2011. It brings together 12 researchers from 10 institutions across the UK and Ireland with a shared interest in the employment experiences and outcomes of people living with cancer. Here we showcase the diverse range of research currently being conducted by CanWorkresearchers.
Researcher ProfileDr Gail EvaResearch Fellow, UCL Institute of Neurology
Dr Eva is an occupational therapist specialising in cancer and palliative care rehabilitation. Her research work centres on the social, psychological and occupational consequences of disability for people with cancer, with a particular focus on fatigue, goal-setting and employment.
Study Profile
Our research team, based at UCL and led by Dr Diane Playford, is currently undertaking a realistic and cost evaluation of the National Cancer Survivorship Initiative (NCSI) pilot projects on vocational rehabilitation for people with cancer (2010–2012). This study is funded by the NCSI, and aims to identify a model of vocational rehabilitation for people with cancer that has good outcomes with demonstrated cost effectiveness. On the basis of this research, we are developing a specific cancer vocational rehabilitation intervention – the REJOIN intervention – which we will evaluate in a feasibility study of a randomised controlled trial. This follow-on study will be funded by an NIHR Post-doctoral Fellowship (2012-2014) awarded to Dr Gail Eva.
Researcher ProfileDr Taina TaskilaResearch Fellow, University of Birmingham
Prior to her current appointment in 2007, from 2002 Dr Taskila worked as a researcher at the Finnish Institute of Occupational Health in Helsinki where she completed her PhD examining factors affecting employment after cancer diagnosis. Her main interests include developing interventions that improve return to work after cancer and identifying factors that cause disability.
Dr Taskila holds an honorary contract with Coronel Institute of Occupational Health in Amsterdam. The research team recently published a Cochrane Review of interventions that enhance return to work after cancer (De Boer A, Taskila T et al. The Cochrane Library 2011, Issue 2.). Fourteen articles reporting 14 RCTs and 4 CBAs were included, involving a total of 1652 participants. Moderate quality evidence showed multidisciplinary interventions involving physical, psychological and vocational components led to higher return-to-work rates than care as usual (OR = 1.87, 95% CI 1.07 to 3.27). No differences in the effect of psychological, physical, medical or multidisciplinary interventions compared to care as usual were found on return to work.
Study Profile
Catherine HaydenMacmillan Senior Occupational Therapist, Sheffield Teaching Hospitals NHS Trust
Catherine works in the Late Effects Research Team and her research interests focus on the role of Occupational Therapy in Cancer Care and specifically with respect to return to work. She has previously worked in various acute teaching hospitals in London and specialised in oncology for several years.
Researcher ProfileDr Diana Greenfield Clinical Lead in Late Effects, Sheffield Teaching Hospitals NHS TrustHonorary Senior Lecturer, Late Effects Research Team , University of Sheffield
Dr Greenfield is a Consultant Nurse in Late Effects at Sheffield Teaching Hospitals NHS Foundation Trust and leads the Late Effects Research Team in the Academic Unit of Clinical Oncology at the University of Sheffield. Diana is also a member of the Consequences of Cancer Treatment Collaborative (CCaT) convened to influence and improve care for cancer survivors with treatment consequences.
Study Profile
This Macmillan funded research is being undertaken by the Late Effects Research Team in Sheffield. The AT WORK study aims to identify the physical, functional and psychosocial barriers adult cancer survivors face upon their return to work and to examine resource use and the health care cost in adult cancer survivors who are/should be economically active. This observational descriptive study will use questionnaires and clinical assessments, carried out by an Occupational Therapist, to meet these aims. Recruitment opened in July 2011. Results will be available on completion of the study. It is planned that this work will contribute to evidence-based guidelines for all clinicians and employers in supporting cancer survivors‟ return to work.
Researcher Profile
Researcher ProfileDr Mary WellsSenior Lecturer, SDHI, University of Dundee
Dr Wells is a cancer nurse and researcher at the School of Nursing and Midwifery / Social Dimensions of Health Institute, University of Dundee (www.sdhi.ac.uk). Mary is also a member of the Consequences of Cancer Treatment Collaborative (CCaT), set up by UK charity Macmillan Cancer Support and the Department of Health for England, to influence and improve care for cancer survivors suffering side effects of treatment (www.cancerconsequences.org).
Study Profile
Dr Wells and Dr Thilo Kroll (Director, SDHI) have recently conducted a systematic review and meta-synthesis of the qualitative evidence on cancer and employment. The review aimed to synthesise findings from studies exploring cancer survivors‟, family/carers‟, and employers‟ attitudes, experiences, problems and strategies in relation to employment, retention and/or return to work. Twenty-five papers were included, none of which investigated the experiences and views of family members or employers, identifying substantial gaps in the literature. Synthesised findings have produced a new conceptual model to guide future research representing the impact of cancer on self-identity, friends and family context, meaning of work, work performance and environment.
Researcher ProfileDr Penny WrightMacmillan Principal Research Fellow, University of Leeds
Dr Wright is a social worker by background. Her main research interests include assessment of social difficulties, use of the internet to assess and support patients and application of electronic methods to collect and link Patient Reported Outcomes to other datasets to map the patient experience.
Study Profile
Systematic assessment of cancer patients within the social domain is a requirement within UK cancer care but is not easy to implement. We have developed and evaluated a questionnaire “The Social Difficulties Inventory (SDI-21)” for use in clinical practice. Subscales include ‘Everyday living’, ‘Money matters’ (including finance and employment issues) and ‘self and others’. Psychometric properties and clinical utility have been tested in addition to development of a hierarchy of intervention for use in cancer care. Currently we are running a study to test the impact of SDI-21 use in routine cancer nursing practice.
CanWork exists to co-ordinate and drive forward research into cancer and employment with the aim of generating new evidence and insight to inform the development of interventions to support people with cancer access, remain in, or return to work. For more information about the CanWork Research Network visit: http://canceremploymentresearch.wordpress.com/
Researcher ProfileDr Theresa WisemanLead for Health Service Research, Royal Marsden NHS Foundation Trust
Prior to her current post Dr Wiseman held a joint appointment between King‟s College London and Guy‟s and St Thomas‟ NHS Foundation Trust as Senior Lecturer/Research Fellow. Her research focuses on the experience of cancer and treatment and translating findings into developing services to improve the experience. Theresa is also a member of the Consequences of Cancer Treatment Collaborative (CCaT), set up by Macmillan Cancer Support and the Department of Health for England, to influence and improve care for cancer survivors suffering side effects of treatment (www.cancerconsequences.org).
Study Profile
Dr Wiseman is currently conducting a qualitative study (funded by MacMillan Cancer Support) that explores return to work following cancer treatment from the perspective of the workplaceincorporating patients‟ experience and that of occupational health services. Participants are from three well established organisations (finance institution, department store and a public sector organisation). It was thought that these organisations provide a range of personnel in terms of role, resources available and demands on the person. Data are being collected through semi-structured interviews. It is hoped that the findings of the study will identify what would constitute the important components of a short supportive intervention to promote functional and psychological adjustment in order to return to work after cancer treatment.
Researcher ProfileDr Gill HubbardReader and Co-Director, Cancer Care Research Centre (CCRC), University of Stirling
Dr Hubbard leads the „Cancer as a long-term condition‟ research programme which includes a „Cancer and Employment‟ workstream. She currently is Principal Investigator on an evaluation of a vocational rehabilitation service in Scotland and a member of EUROCHIP, which is defining a list of indicators on cancer rehabilitation for European countries. She sits on the NCRI Primary Care and the Psychosocial Oncology Clinical Studies Groups.
Researcher ProfileDr Richard KyleLecturer, Cancer Care Research Centre (CCRC), University of Stirling
Dr Kyle is a human geographer by background. His research interests include cancer awareness and vocational rehabilitation for cancer survivors. He is currently running an evaluation of Working Health Services Scotland for people with cancer funded by Macmillan Cancer Support and the Scottish Centre for Healthy Working Lives.
Study Profile
Dr Kyle and Dr Hubbard are conducting a feasibility study of the effectiveness of a vocational rehabilitation service – Working Health Service – for people with cancer in Scotland. The evaluation incorporates a pilot randomised controlled trial (RCT) among women with breast cancer following surgery and a qualitative study examining the employment experiences of people with breast, prostateand lung cancer. Additional interviews with health professionals are determining the content of employment conversations in clinic, clinician‟s confidence to discuss work-related issues, and awareness of available support services and referral practice. This pilot work will inform the development of a more definitive RCT of vocational rehabilitation services in Scotland involving people with breast, prostate and lung cancer and shape future service design and delivery.
[email protected] / [email protected]
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[email protected]@bham.ac.uk
CanWork gratefully acknowledges Macmillan Cancer Support for funding several of the showcased studies.
Researcher ProfileDr Ziv AmirPrincipal Research Fellow, University of ManchesterHonorary Professor, University of Salford
Dr Amir (PhD, MSc, BSc, Certificate in Health Economics) is Principal Research Fellow, University of Manchester, and Honorary Professor, University of Salford UK. His programme of research has been developed and undertaken in partnership with people affected by cancer and is mainly focused on issues around living with cancer as a chronic disease: issues involved in returning to paid employment; financial support and advice; the role and effectiveness of self help/support
groups, and responsive and flexible cancer services.
Almost half of all cancer survivors are younger than 65 years and many are at an age where cancer and its treatment could affect their employment opportunities. Many people with cancer diagnoses want to regain routine rhythms of family and work life; however, one difficult issue for many families is maintaining financial stability during and after cancer treatment. We are conducting a national survey to: Estimate the risk of unemployment which will enhance the identification of prognostic factors and vulnerable subgroups for unemployment among cancer survivors, assess the available sources of advice and support and compare with other chronic diseases. This work will inform the decisions of cancer survivors and the clinicians who provide their treatment.
Study [email protected]
Researcher ProfileDr Linda SharpResearch Team Lead, National Cancer Registry Ireland
Dr Sharp is a cancer epidemiologist. She leads the research team at the National Cancer Registry Ireland (NCRI). This team is the largest group working on population-based cancer research in Ireland. Dr Sharp has a strong research interest in cancer survivorship issues, including the financial and economic impact of cancer on survivors themselves, and how these issues reach out to impact on the wider family. Many of her research studies use the Registry as population-based sampling frame to identify potential participants.
NCRI research on employment and cancer falls into two major workstreams: cancer survivorship and economic impact of cancer. Dr Sharp and her team have recently completed two mixed-methods studies investigating the impact of cancer on employment among cancer survivors in Ireland. These studies demonstrated the strong influence that the social welfare and legal setting has on workforce participation. They also revealed the emotional impact on survivors and their families of the drop in income that often follows a cancer diagnosis. The team has also shown the high costs to employers and society of early workforce departure, work absence, and decreases in working hours resulting from cancer. Dr Sharp is currently leading, in collaboration with Professor Cathy Bradley at Virginia Commonwealth University in the USA, a large, longitudinal, study investigating the impact of colorectal, breast and prostate cancer on work departure, absence, resumption, (dis)ability, and attitudes.
Study [email protected]
