Improving Employment among Gynecologic Cancer Survivors

描述（由申请人提供）：就业是许多女性生活的重要组成部分，它提供了职业身份、健康保险、经济稳定和支持性的人际关系。在被诊断出癌症后，大约有三分之一的在职男性和女性不会重返工作岗位，他们通常将缺乏支持性的工作环境作为决定的关键因素。对妇科恶性肿瘤幸存者的就业结果知之甚少，其范围可能从继续就业到有尊严地停止就业。一项前瞻性研究表明，医生的工作相关干预与癌症幸存者更早重返工作岗位有关。社会认知理论预测，妇女医疗自我效能的提高可以积极影响健康相关的结果。该项目的具体目标是：1)试点一项策略，招募诊断时在职的妇科癌症幸存者，并在白种人、拉丁裔和非裔美国人的幸存者中平均开展5个焦点小组，每个小组平均有6名参与者（估计n=90名幸存者）；2)在每个参与幸存者的丈夫或关键重要他人中以类似的方式招募和开展焦点小组（估计n=90名丈夫/重要他人）；与一名主管（估计n=60-70名主管）进行半结构化访谈，4)采访我们州的每位妇科肿瘤学家（n=4），以及由女性指定的另一名主要医疗保健提供者（估计n= 30）， 5)检验女性幸存者在医疗保健中的自我效能感与她在医疗保健系统中工作的“代理”有关的假设。医疗自我效能感将通过一种经过验证的工具来衡量，该工具评估患者自我报告的医疗保健参与情况。描述这些利益相关者的观点和行动特征，可能有助于未来制定行为干预措施，从而减少工作场所问题对家庭和照顾者的不利影响，并提高妇女的生存质量。

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.