Improving Employment among Gynecologic Cancer Survivors

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DESCRIPTION (provided by applicant): Employment is a crucial component of many women's lives, providing professional identity, hearth insurance, economic stability and supportive interpersonal relationships. Following a diagnosis of cancer, about one-third of employed men and women do not return to work, often citing a non-supportive work environment as a key factor in the decision. Little is known about employment outcomes among survivors of gynecologic malignancies, which may range from continued employment to cessation of employment with dignity. A prospective study has shown that job-related interventions by physicians are associated with earlier return to work by cancer survivors. Social-cognitive theory predicts that improvements in women's medical self-efficacy can positively influence health-related outcomes. The specific aims of this project are to: 1) Pilot a strategy to recruit survivors of gynecologic cancer who were employed at the time of diagnosis, and conduct an average of 5 focus groups with an average of 6 participants each among survivors with Caucasian, Latina and African-American ethnicity (estimated n=90 survivors), 2) Recruit and conduct focus groups similarly among husbands or key significant others of each participating survivor (estimated n=90 husbands/significant others), 3) For each consenting woman, conduct a semistructured interview with a supervisor (estimated n=60-70 supervisors), 4) Interview each gynecologic oncologist practicing in our state (n=4) and another key health care provider if designated by the woman (estimated n= 30), and 5) Test the hypothesis that women survivors' self-efficacy in medical care is associated with "agency" in the health care system regarding her job. Medical self-efficacy will be measured by a validated instrument that assesses her self-reported participation in her health care. Characterizing the views and actions of these stakeholders may be useful for developing behavioral interventions in the future that may increase reduce adverse effects of workplace issues on families and caregivers, and women's quality of survivorship.