Employment After a Breast Cancer Diagnosis: A Qualitative Study of Ethnically Diverse Urban Women

• Published in: Journal of community health 2012-08, Vol.37 (4), p.763-772
• Main Authors: Blinder, V. S., Murphy, M. M., Vahdat, L. T., Gold, H. T., de Melo-Martin, I., Hayes, M. K., Scheff, R. J., Chuang, E., Moore, A., Mazumdar, M.
• Format: Article
• Language: English
• Subjects: Acceptances; Adaptation, Psychological; Adult; African Americans; Benefits; Breast Cancer; Breast Neoplasms - diagnosis; Breast Neoplasms - ethnology; Breast Neoplasms - psychology; Cancer; Community and Environmental Psychology; Community health services; Community Relations; Cultural Pluralism; Departments; Eligibility; Emigrants and Immigrants - psychology; Emigrants and Immigrants - statistics & numerical data; Employed Women; Employer Employee Relationship; Employment; Employment - psychology; Employment - statistics & numerical data; Employment Experience; Employment Level; Ethics; Ethnic Groups; Ethnic Groups - psychology; Ethnic Groups - statistics & numerical data; Ethnic Identity; Family; Family Structure; Female; Females; Focus Groups; Genetics; Health Promotion and Disease Prevention; History; Humans; Immigrants; Interprofessional Relations; Interviews; Medicine; Medicine & Public Health; Middle Aged; Minorities; Minority & ethnic groups; Minority Groups - psychology; Minority Groups - statistics & numerical data; Noncitizens; Original Paper; Privacy; Public Health; Qualitative Research; Quality of Life; Survivor; Survivors - psychology; Survivors - statistics & numerical data; Urban Areas; Urban Population - statistics & numerical data; Whites; Women; Work Environment; Work Experience; Working conditions; Working Women
• ISSN: 0094-5145; 1573-3610
• DOI: 10.1007/s10900-011-9509-9

Employment status is related to treatment recovery and quality of life in breast cancer survivors, yet little is known about return to work in immigrant and minority survivors. We conducted an exploratory qualitative study using ethnically cohesive focus groups of urban breast cancer survivors who were African-American, African-Caribbean, Chinese, Filipina, Latina, or non-Latina white. We audio- and video-recorded, transcribed, and thematically coded the focus group discussions and we analyzed the coded transcripts within and across ethnic groups. Seven major themes emerged related to the participants’ work experiences after diagnosis: normalcy, acceptance, identity, appearance, privacy, lack of flexibility at work, and employer support. Maintaining a sense of normalcy was cited as a benefit of working by survivors in each group. Acceptance of the cancer diagnosis was most common in the Chinese group and in participants who had a family history of breast cancer; those who described this attitude were likely to continue working throughout the treatment period. Appearance was important among all but the Chinese group and was related to privacy, which many thought was necessary to derive the benefit of normalcy at work. Employer support included schedule flexibility, medical confidentiality, and help maintaining a normal work environment, which was particularly important to our study sample. Overall, we found few differences between the different ethnic groups in our study. These results have important implications for the provision of support services to and clinical management of employed women with breast cancer, as well as for further large-scale research in disparities and employment outcomes.