Table 3.

Quotes illustrating job demands and cancer demands as well as workplace and cancer care resources or strategies to manage these demands among ovarian cancer patients experiencing financial distress during treatment

Construct 1: Job Demands	Construct 2: Cancer Demands
Theme 1: Patients noted the negative impact of cancer treatment on work productivity, promotion opportunities, and ability to return to work.	Theme 1: Patients experience significant physical and cognitive limitations due to cancer symptoms and treatment.
“Being sick at work and having to leave early sometimes, or missing the whole day, missing out on training… I have missed maybe two promotions.” [Age 42, COST score 9]	“A lot changed. I was no longer able to work. Just my whole way of living my lifestyle. Not able to do a lot of the things physically that I was able to do because I just wasn’t physically able, as far as I experienced a lot of fatigueness. So getting around was – was hard. Socialization changed, I didn’t socialize as much with people during that time especially.” [Age 57, COST score 12]
“Prior to [my cancer diagnosis], I was an ER nurse... And then I've been on disability since trying to go back to work. But every time I go back to work or try to go back full time, the cancer returns... my body canť do what it used to… So, no, I donť know if I'll ever get to go back to work. I want to because I love what I do.” [Age 44, COST score 11]	“When the… effects of the chemo had me so down where I couldnť get out of bed, [my husband] had to stay home” [Age 56, COST score 7]
Theme 2: Patients worried about job loss and loss of benefits, including employer-based health insurance coverage.	Theme 2: Patients felt psychological distress from reliance on caregivers, especially for transportation needs.
“After I was diagnosed, I did go back to work, and I worked in a maximum-security prison as a guard and slash supervisor… They would not work with me… So they more or less basically pretty much said, hey, we don’t have anywhere to put you due to your circumstance. You really need to fill out these papers and retire out.” [Age 77, COST score 20]	“I have to have someone drive me because I can’t drive now… my husband will try to take some time… if my mother is feeling well, which she has cancer also. She’ll try to bring me… and my sister, she’s let her business slide trying to bring me at times.” [Age 58, COST score 9]
“The threat, that when you come back, you donť know if you're going to have a job. [I] talked to them. But, like I said, the way they just treat you overall. All they can say is, "We canť guarantee you your job when you come back." [Age 53, COST score 10]	“'Man, I hate having to have somebody come down here and wait nine hours. You know, thaťs a long time to wait for somebody… It took my independence away from me…” [Age 54, COST score 0]
“If you're out of work, you get to keep that insurance, but you have to pay what the hospital would normally pay plus. So it was like six or eight-hundred dollars a month for me to be able to keep that on just myself” [Age 44, COST score 11]	“When you can’t do the things, it’s humiliating. I’ve always been on the other side of the fence working with my children and helping them with those things. But it sure is a lot harder being on this side now.” [Age 58, COST score 9]
Construct 3: Workplace Resources and Strategies	Construct 4: Cancer Care Resources and Strategies
Theme 1: Patients felt supportive employers and the ability to make workplace accommodations were important and that work provided meaning in their lives.	Theme 1: Patients described how they were able to make their appointment weeks in advance around their own schedule.
“Well, knowing that I have a job no matter what. They reassured me at my job that, no matter how time I need to take off, that I still have a job to come back to. And that has been a big weight lifted off my chest. And the same thing with my husband, they reassured him that any time he needs to be with me and our family.” [Age 48, COST score 21]	“If I can schedule my doctor appointments… to fall on a pay week, then that helps cushion that out-of-pocket expense where we’re coving gas, and like you said, lodging, and food, and what not, that we have to pay while we’re out. And that also really keeps us from getting in a bind. We just have to manipulate my appointments to fall on those specific days.” [Age 48, COST score 21]
“They did not really believe me. They just thought I wanted to be off work… They gave me a really hard time. I had to go to a higher office. It was embarrassing. I got mistreated a little bit, also. It was a just a very, very difficult time. I am in a new department now. They are a little bit more understanding, but it is still—I still feel that I had to miss work and I just got promoted.” [Age 42, COST score 6]	“They make my appointment usually a month ahead of time and I drive myself… I try to coordinate as many appointments on one day as possible instead of making two or three trips in a week. Sometimes… my husband also still goes to see his doctors for… We try to coordinate his appointments with mine, but sometimes that doctor’s clinic days are not the same as mine.” [Age 77, COST score 20]
“This time where I work has been more gracious, and just let me take days off… you donť get paid. This time, now I still…. They just gave me a laptop. I'm doing laptop here. I'm still doing stuff today, but not in the office. By me changing jobs, now I'm at a sit-down job. That has helped.” [Age 53, COST score 10]	Theme 2: Patients described how their care team was able to connect them to resources, such as disability.
“My [daughter’s] job allows me independence in terms of… scheduling and my position… if [she] takes off to do something…medically, [she’ll] work the weekend or do something to make up the time or…do my project the week before. [She has] a lot of flexibility to manage [her] own schedule.” [Age 53, COST score 16]	“The social workers in the hospital, and everybody got together … and they got in contact with disability and let them know that I am in the hospital and what I’m going through. And, you know, do a reconsideration of—getting my disability… They really helped. I feel the social workers and whoever else at the hospital who helped in that part, they played a big part in my getting my disability.” [Age 48, COST score 13]
“It gave me a purpose to get up… It was real easy to be pitiful. If you get up and get focused, even if you can only piddle for a little bit, it keeps your mentally. It gets me up. It gets me motivated and going. Iťs not hard to be sorry for yourself.” [Age 58, COST score 9]	“Well, I talked to [my doctor] and she said she thought it would be good for me to go ahead and [apply for disability] because… employees have to be able to lift 50 pounds and I couldnť do that.” [Age 58, COST score 15]
Theme 2: Patients reported family medical leave was a helpful tool, but also noted its limitations.	“They were very good, they would schedule a night at the Hope Lodge so I could come down here and take my treatment, and then just go straight up to the Hope Lodge and spend the night.” [Age 54, COST score 0]
“I had to request time off from work. I had to get on FMLA, and my time has ran out at work, so I do not have any more time. So I am on family medical leave. They said they would hold my job, but I am not getting paid when I am off.” [Age 42, COST score 9]
“When I first was diagnosed, I did apply for family medical leave… then when the FMLA time ran out I had to request for donated time to cover me. And then I can only do donated time up to a certain point after I had ran out of time that I could use.” [Age 57, COST score 12]