From shaky grounds to solid foundations: A salutogenic perspective on return to work after cancer.

Background: Almost a third of employed individuals of working age fall out of work after cancer treatment.Aim: To explore cancer survivors' successful return to work, focusing on assets and resources utilized to resolve cancer- and work-related obstacles to achieve long-term employment.Methods: We interviewed eight cancer survivors who had remained at work for at least 3 years after cancer treatment. We performed interpretative phenomenological analysis and applied Antonovsky's salutogenic model of health as a framework.Results: The participants experienced uncertainty regarding cancer recurrence, impairments, and long-lasting effects on work ability. They utilized a wide range of resistance resources at personal, interpersonal, and social levels. Their determination to return to work was generally strong, but the time needed to find sustainable work and strategies to return to work varied. All participants prioritized activities that energized them and adapted actively to their new situation. When unsure about outcomes, they focused on the best alternative and controlled fear cognitively.Conclusions/Significance: Finding meaningful activities, testing actual work ability, and focusing on the best possible outcome seemed important to remain in work after cancer. It may be helpful to identify available resources and utilize them to resolve tensions resulting from cancer and cancer treatment.

A five-phase process model describing the return to sustainable work of persons who survived cancer: A qualitative study.

PURPOSE: We investigated persons who survived cancer (PSC) and their experiences in returning to sustainable work. METHODS: Videotaped, qualitative, in-depth interviews with previous cancer patients were analyzed directly using "Interpretative Phenomenological Analysis" (IPA). Four men and four women aged 42-59 years participated. Mean time since last treatment was nine years. All participants had worked for more than 3 years when interviewed. An advisory team of seven members with diverse cancer experiences contributed as co-researchers. RESULTS: The entire trajectory from cancer diagnosis until achievement of sustainable work was analog to a journey, and a process model comprising five phases was developed, including personal situations, treatments, and work issues. The theme "return-to-work" (RTW) turned out to be difficult to separate from the entire journey that started at the time of diagnosis. PSCs were mainly concerned about fighting for life in phases 1 and 2. In phase 3 and 4, some participants had to adjust and make changes at work more than once over a period of 1-10 years before reaching sustainable work in phase 5. Overall, the ability to adapt to new circumstances, take advantage of emerging opportunities, and finding meaningful occupational activities were crucial. CONCLUSIONS: Our process model may be useful as a tool when discussing the future working life of PSCs. Every individual's journey towards sustainable work was unique, and contained distinct and long-lasting efforts and difficulties. The first attempt to RTW after cancer may not be persistent.

Subjective Health Complaints in Individuals with Psoriasis and Psoriatic Arthritis: Associations with the Severity of the Skin Condition and Illness Perceptions - A Cross-Sectional Study.

PURPOSE: High comorbidity has been reported among persons with psoriasis and psoriatic arthritis (PsA), but the occurrence of subjective health complaints (SHCs) in these patient groups is poorly understood. The study aimed to describe the prevalence of SHCs among individuals with psoriasis and PsA in Norway, and investigate whether the severity of their skin condition and their illness perceptions were associated with the number and severity of health complaints. METHOD: Participants were recruited through the Psoriasis and Eczema Association of Norway (PEF) (n = 942). The participants answered a self-administered questionnaire covering subjective health complaints, the severity of their skin condition, and their illness perceptions measured with the Brief Illness Perception Questionnaire (BIPQ-R). RESULTS: The prevalence and severity of SHCs were high. Participants with PsA reported more complaints and higher severity of complaints compared with participants with psoriasis. In both groups, the severity of the skin condition was associated with the number and severity of SHCs. Cognitive illness perceptions (consequences) and emotional illness perceptions (emotional affect) were associated with SHCs in participants with psoriasis, whereas only cognitive illness perceptions (consequences and identity) were associated with SHCs in participants with PsA. CONCLUSION: The high prevalence and severity of SHCs among individuals with psoriasis and PsA were associated with the severity of the skin condition and illness perceptions. Somatic and cognitive sensitizations are proposed as possible mechanisms. The findings suggest that holistic approaches are essential when managing these patient groups in health care institutions and clinical practice.

Modern health worries, subjective health complaints, health care utilization, and sick leave in the Norwegian working population.

BACKGROUND: Modern health worries (concerns about aspects of modern life affecting health) heve been associated with subjective health complaints and health care utilization. PURPOSE: The aim of this study was to investigate the association between modern health worries (MHW) and subjective health complaints (SHC), health care utilization, and sick leave related to such complaints in the Norwegian working population. METHODS: A sample of the Norwegian working population (N = 569) answered a questionnaire which included the Subjective Health Complaints Inventory and a Norwegian version of the Modern Health Worries Scale. RESULTS: Ninety-one percent of the participants reported at least one complaint in the past 30 days, and 96 % of the participants reported concerns for at least one of the items in the MHW scale. Women reported significantly more and more severe complaints compared to men and significantly more concern about aspects of modern life affecting health. Participants who reported a high level of MHW showed nearly twice the risk of reporting a high level of SHC (odds ratio (OR) = 1.83; 95 % confidence interval (CI) = 1.30-2.71; p = 0.001), and they showed twice the risk for self-certified sick leave related to SHC (OR = 2.04; 95 % CI = 1.01-3.92; p = 0.048). High levels of MHW showed no significant association with health care utilization or doctor-certified sick leave. CONCLUSIONS: Subjective health complaints and concerns about aspects of modern life affecting health are very common, even among healthy workers. Women have more complaints and more concerns compared to men. Within the health care system, it may be advantageous to pay close attention to the association between high levels of MHW and high levels of SHC.