Table 2.
Characteristics and study findings of qualitative studies on functional impairments and work-related outcomes in breast cancer survivors
| Author, year [Ref.] Country |
Design | Time since diagnosis | N participants, age | Breast cancer stage | Treatment | Functional impairments | Measurement | Outcome(s) | Findings |
|---|---|---|---|---|---|---|---|---|---|
| Boykoff, 2009 [36] United States |
Cross-sectional | > 1 year | 74 BCS, age 30–89 years | Ns | Surgery, chemotherapy, radiotherapy, hormonal therapy | Cognitive and emotional functioning | Interviews, FGD | Job performance | Forgetfulness, memory loss, loss of words and concentration problems make it harder to do a job. Cognitive problems can lead to frustration and stress, which make it harder to maintain or find a job |
| Groeneveld, 2013 [37] Netherlands |
Cross-sectional | Ns | 10 CS, mean age 56 years (SD 6), of whom 7 BCS, mean age 52 years | Ns | Surgery, chemotherapy, radiotherapy | Cognitive and emotional functioning | Interviews | Work performance | Problems with concentration can lead to making more mistakes while working. Some respondents are stressed during early RTW and start crying at work for seemingly pointless reasons |
| Hinman, 2008 [38] United States |
Cross-sectional | > 1 yeara | 31 BCS, mean age 57 years (range 38–79)b | Ns | Surgery | Physical functioning | Comment section in survey | Work re-entry | Limitations in using the arm hampers work task such as carrying a heavy load and thereby inhibits RTW |
| Kennedy, 2007 [7] United Kingdom |
Cross-sectional | > 1 yeara | 29 CS, mean age 53 years, of whom 24 BCS, mean age 52 years (range 36–66) | Ns | Surgery, chemotherapy, radiotherapy and/or hormonal therapy | Cognitive and emotional functioning | Interviews, FGD | Work ability, sickness absence | Some respondents reported that they were able to return to work, function effectively and perform as they had previously. Others revealed how it was initially difficult to cope and concentrate; they worried about their reduced capability at work. For some respondents, pressure, emotional demands, insecurity and worries about appearance make it difficult to manage work |
| Munir, 2010 [39] United Kingdom |
Cross-sectional | > 1 year | 13 BCS, mean age 49 years (range 32–57) | Primary breast cancer diagnosis | Surgery, chemotherapy, radiotherapy, hormonal therapy | Cognitive and emotional functioning | FGD | Work ability | Chemotherapy-induced cognitive impairment, such as problems with memory, concentration, decision-making and multitasking, affected women’s views and experiences towards returning to work and their confidence in their work ability |
| Nilsson, 2013 [40] Sweden |
Cross-sectional | ≤ 1 yeara | 23 BCS, mean age 53 years (range 37–62) | No metastasis | Surgery, chemotherapy, radiotherapy, hormonal therapy | General functioning | FGD | Work-related issues | The women’s general functioning, including emotional consequences of treatment, influenced their decision to take actions whether to work or to be absent after diagnosis, during treatment, or after treatment. Cognitive side effects led to less work capacity than desired or to less efficiency at work |
| Tamminga, 2012 [41] Netherlands |
Cross-sectional | > 1 yeara | 12 BCS, mean age 42 years (SD 7) | Primary breast cancer diagnosis with or without metastasis | Surgery, chemotherapy, radiotherapy, hormonal therapy | Physical and cognitive functioning | Interviews | RTW | Having difficulties with mobility of joint functions, having difficulties with attention functions, retrieval of memory, pace of thought and higher-level cognitive functions were perceived as impairments to RTW |
| Tan, 2012 [42] Malaysia |
Cross-sectional | Ns | 40 BCS, mean age in RTW group 43 years (SD 10), mean age in non-RTW group 49 years (SD 5) | I, II, III | Surgery, radiotherapy, chemotherapy, hormonal therapy | Physical, cognitive and emotional functioning | FGD | RTW | Physical limitations (such as not being able to walk long distances or carry weight) caused by disease hampered RTW. Other reported impairments were related to cognitive function, such as forgetfulness and slowness in thinking. Changing emotional states like worrying and frustrations leads to low frustration tolerance and poor decision making on RTW |
| Von Ah, 2013 [43] United States |
Cross-sectional | > 1 year | 22 BCS who reported cognitive limitations, mean age 56 years (SD 9.7, range 40–74) | I–III | Chemotherapy, radiotherapy, hormonal therapy | Cognitive and emotional functioning | Interviews | Work ability | Both short-term and long-term memory problems, decreased speed of processing, limited attention, concentration, language and executive functioning were reported to impact work ability. Concerns regarding cognitive abilities and lack of confidence made some respondent leave their prior job |
BCS breast cancer survivors, CS cancer survivors, SD standard deviation, RTW return to work, FGD focus group discussion, Ns not specified
aTime since diagnosis for majority of participants
b48.8% of women worked prior to their surgery