Improving Employment among Gynecologic Cancer Survivors

描述（由申请人提供）：就业是许多妇女生活的重要组成部分，提供职业身份，壁炉保险，经济稳定和支持性的人际关系。在诊断出癌症后，大约三分之一的就业男女不会重返工作岗位，他们往往将不支持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，医生进行的与工作有关的干预与癌症幸存者早日重返工作岗位有关。社会认知理论预测，妇女的医疗自我效能的改善可以积极影响健康相关的结果。该项目的具体目标是：1）试行一项策略，招募诊断时就业的妇科癌症幸存者，并在白人、拉丁裔和非裔美国人幸存者中平均进行5个焦点小组，每个小组平均6名参与者（估计n=90名幸存者），2）在每位参与幸存者的丈夫或关键重要他人中招募并进行类似的焦点小组（估计n=90位丈夫/重要他人），3）对于每位同意的女性，与主管进行半结构化访谈（估计n=60-70名主管），4）采访在我们州执业的每位妇科肿瘤学家（n=4）和另一位关键的医疗保健提供者（如果由女性指定）（估计n= 30），和5）测试的假设，即女性幸存者的自我效能感在医疗保健系统中的“代理”与她的工作。医疗自我效能将通过一种经验证的工具来测量，该工具评估她自我报告的参与医疗保健的情况。这些利益相关者的观点和行动的特点可能是有用的，在未来的发展行为干预，可能会增加减少工作场所的问题对家庭和照顾者的不利影响，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.