Return to work

Return to work (RTW) can be a challenging occupational health (OH) issue among previously-employed
colorectal cancer survivors. This study aimed to explore the various perceived barriers and facilitators encountered during
the RTW process in cancer survivorship, from the perception of healthcare professionals (HCP). Face to face, semistructured
interviews were carried out on twelve HCP (government and private sectors) from various disciplines. Data
collected were transcribed verbatim and data management was aided by NVivo software 8.0. A new theory from contextual
data was generated using open coding, axial coding and selective coding. The HCP shared numerous barriers and
facilitators associated with RTW, under four categories. The key barriers were disturbing side effects, psychological barriers
(personal factor), compensation (financial factor), poor ability to multitask (work-related factor), long paid medical
leaves policy, employer’s lackadaisical attitude, lack of knowledge and awareness of RTW (environmental factor). Key
facilitators identified were desire to resume working life and to contribute to society (personal factor), financial pressure,
maintain organizational health insurance (financial factor), less physically demanding job (work-related factor), supportive
workplace and strict organizational policy on medical leaves (environmental factor). While not all HCP were trained
in RTW, they all agreed that RTW is important for survivors and workplace. Occupational health doctors have a direct
role in helping survivors RTW. Early Intervention on RTW during survivorship should involve occupational health
doctors and employers, targeting the modifiable factors (environmental and work-related) to improve RTW after cancer.

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