Returning to Work After Cancer Treatment: An Exploratory Sequential Mixed-Methods Study Guided by Transitions Theory

Cancer Nurs. 2025 Jan 3. doi: 10.1097/NCC.0000000000001449. Online ahead of print.

Abstract

Background: Although many individuals return to work after cancer treatment, supports to facilitate this transition are ineffective or lacking. Transitions Theory can be useful to conceptually explain the transition back to work after cancer; however, no known studies have used Transitions Theory to empirically examine this transition.

Objective: To explore how and why Transition Theory concepts can be used to understand individuals' transition back to work after cancer treatment.

Methods: Using an explanatory sequential mixed-methods design, breast or colorectal cancer survivors who had returned to work completed questionnaires aligned with Transitions Theory concepts. Spearman correlations were used to explore associations, and significant results were used to draft interview questions. One-to-one telephone interviews with a subsample of participants provided elaborations to quantitative results. Qualitative data were analyzed using template analysis.

Results: Among the 23 participants who returned questionnaires, most identified as female (n = 21 [91%]) and had been back at work for 28.9 months (range, 3-60). The sample's productivity loss was 7.42%, indicating an incomplete mastery of their return to work. Only 2 significant associations were revealed with higher productivity loss: higher anxiety (r = 0.487, P = .019) and a greater number of unmet relational needs (r = 0.416, P = .048). Twelve participants engaged in interviews wherein explanations for quantitative results were uncovered.

Conclusions: To support a smoother transition back to work after cancer, assessment and interventions should focus on individuals' psychological well-being and relationship needs.

Implications for practice: Transitions Theory can be useful in developing interventions to support a successful return to work after cancer.