Return to work after cancer in the UK: attitudes and experiences of line managers.

INTRODUCTION: With improvements in diagnosis, treatment and survival rates, returning to work after cancer is of increasing importance to individuals and employers. Although line managers can play a potentially important role in the return to work process, research thus far has focused on the return to work process from the perspective of cancer survivors. AIM: To explore the attitudes of line managers towards employees with a cancer diagnosis. METHODS: A short self-administered, on-line questionnaire was circulated to managers in the North East of England. Factorial structures of the line managers' attitudes survey was examined using exploratory factor analysis and the effect of demographic characteristics and organisational variable on the attitudes of line managers was examined using multivariate analysis of variance (MANOVA). RESULTS: Line managers' attitudes can be conceptualized according to five empirical factors: (a) fearful attitudes towards cancer survivors, (b) supportive attitudes, (c) line-managers' perceived burden, (d) maintaining normality, and (e) financial benefits issues. Overall, line-managers hold relatively positive attitudes toward cancer survivors and are willing to support them in their effort to return to work. However, managers tend to harbour negative attitudes regarding the individual cancer survivors' ability both to engage in work related activities and in meeting the demands of employment. MANOVA results also indicated that female managers hold more positive attitudes than male managers toward cancer diagnosis, less concerned about workload burdens of working with cancer survivors, and more willing to help cancer survivors maintain normality. CONCLUSIONS: The results of this study suggest that employers/line-managers need to be provided with training, support, and resources to help them facilitate employment and job retention of employees diagnosed with cancer.

Cancer survivorship and return to work: UK occupational physician experience.

BACKGROUND: Survivorship following diagnosis of cancer is increasing in prevalence. However, cancer survivors continue to report difficulty re-entering the workplace after diagnosis and treatment. AIMS: To survey UK occupational health physicians (OHPs) regarding their role in rehabilitation of employed survivors of cancer. METHODS: Following a pilot study, a questionnaire exploring opinions of OHPs regarding supporting cancer survivors' return to work was posted to all members of the UK Society of Occupational Medicine, with a repeat posting 2 months later. Responses were analyzed for significant correlations with OHP age, sex, qualification level, size of businesses advised and years of experience. RESULTS: There were 797 respondents (response rate 51%). Responses suggested opportunities for developing the knowledge base in relation to prognosis and functional outcomes in patients with a cancer diagnosis; instituting information resources on cancer and work for OHPs and developing communications skills training. Most respondents felt managers treated referral to occupational health (OH) differently for employees with cancer compared with management referral for employees with other diagnoses, with 45% of respondents indicating referral may take place too late to be effective in securing a return to work. A significant lack of understanding of the information requirements of employers and the role of OH by treating doctors was identified. CONCLUSIONS: This survey raises several possible significant barriers to return to work by cancer survivors. Recommendations to ameliorate these are made.

Occupational health teaching for pre registration nursing students.

The amount of time spent teaching occupational health and the methods used to teach this subject in the pre registration nursing programmes in the UK was surveyed. Questionnaires were sent to the Deans of all 66 Schools of Nursing identified from the UCAS list in 2000. Forty six responded. Five returns were rejected because they did not meet the study criteria, giving a final response rate of 67%. The 41 schools were providing 33 Nursing Diploma and 31 Nursing Degree courses. The results indicate that occupational health is taught on the majority of Nursing Diploma (88%) and Degree (80%) courses. The main method of teaching is by lectures, with a smaller number of courses offering the opportunity for seminars and project work. However, the subjects covered under this heading frequently relate to the occupational health and safety issues that nurses need to know about in order to protect their own health and safety. It is rare that the broader concept of how a patient or client's health can be affected by their work or how their health may affect their ability to work, remain in employment or, for populations, its impact on sustainable development at the community level, are addressed. It is recommended that all nurses should receive some training in the broader concepts of occupational health at the pre registration level so that they can develop an awareness of the relationship between work and health, at both the individual and community level. This survey parallels a similar exercise carried out with medical students that identified a worrying decline in the teaching of occupational health at the undergraduate level.

The role of the occupational health nurse in workplace health management

This document describes the role of the occupational health nurse in Europe, and whilst recognizing the wide variation that exists in occupational health nursing practice between different countries this document reflects the standards that have already been achieved in those countries where occupational health nursing is at its most advanced. Within the WHO European Member States the discipline of occupational health is undergoing rapid development. This is largely due to the new demands and expectations from employers, employees and their representative bodies as they recognize the economic, social and health benefits achieved by providing these services at the workplace. The rapid development of occupational health services has also, in part, been driven by the expanding program of EU legislation in the areas of health, safety and environmental protection and the need by employers to respond to this legislation. In addition occupational health services, provided at the workplace to address the health care needs of working populations have been identified as an important component of the public health strategy. These services can also make a significant contribution to other government initiatives, such as; reducing health inequalities, reducing social exclusion and sickness absence, and by protecting and promoting the health of the working population occupational health services can help to reduce the overall burden of ill health in Europe. Occupational health nurses, as the largest single group of health care professionals involved in delivering health care at the workplace, have responded to these new challenges. They have raised the standards of their professional education and training, modernized and expanded their role at the workplace, and in many situations have emerged as the central key figure involved in delivering high quality occupational health services to the working populations of Europe. Occupational health nurses, working independently or as part of a larger multiprofessional team, are at the frontline in helping to protect and promote the health of working populations