Skip to main content

Advertisement

Log in

Bridging Health Care and the Workplace: Formulation of a Return-to-Work Intervention for Breast Cancer Patients Using an Intervention Mapping Approach

  • Published:
Journal of Occupational Rehabilitation Aims and scope Submit manuscript

Abstract

Purpose An increasing number of breast cancer (BC) survivors of working age require return to work (RTW) support. Objective of this paper is to describe the development of a RTW intervention to be embedded in the care process bridging the gap between hospital and workplace. Method The Intervention Mapping (IM) approach was used and combined formative research results regarding RTW in BC patients with published insights on occupational therapy (OT) and RTW. Four development steps were taken, starting from needs assessment to the development of intervention components and materials. Results A five-phased RTW intervention guided by a hospital-based occupational therapist is proposed: (1) assessing the worker, the usual work and contextual factors which impacts on (re-)employment; (2) exploration of match/differences between the worker and the usual work; (3) establishing long term goals, broken down into short term goals; (4) setting up tailored actions by carefully implementing results of preceding phases; (5) step by step, the program as described in phase 4 will be executed. The occupational therapist monitors, measures and reviews goals and program-steps in the intervention to secure the tailor-made approach of each program-step of the intervention. Conclusion The use of IM resulted in a RTW oriented OT intervention. This unique intervention succeeds in matching individual BC patient needs, the input of stakeholders at the hospital and the workplace.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Pauwels EEJ, Charlier C, De Bourdeauhuij I, Lechner L, Van Hoof E. Care needs after primary breast cancer treatment. Survivors’ associated sociodemographic and medical characteristics. Psycho-oncology. 2011;22(1):125–32.

    Article  PubMed  Google Scholar 

  2. Tiedtke C, de Casterlé BD, de Rijk A, Christiaens MR, Donceel P. Breast cancer treatment and work disability: patient perspectives. Breast. 2011;20(6):534–8.

    PubMed  Google Scholar 

  3. Tiedtke C, Knops L, Désiron H, de Casterlé BD, Donceel P, de Rijk A. Supporting return-to-work in the face of legislation: stakeholders’ experiences with return-to-work after breast cancer in Belgium. J Occup Rehabil. 2011;22(2):241–51.

    Article  Google Scholar 

  4. Désiron HAM, Donceel P, de Rijk A, Van Hoof E. A conceptual-practice model for occupational therapy to facilitate return to work in BC patients. J Occup Rehabil. 2013;23(4):516–26.

    Article  PubMed  Google Scholar 

  5. Désiron HAM, Knippenberg E, Willems B, Neerinckx E. Occupational therapy for breast cancer survivors: improving quality of life by return-to-work assistance. J Rehabil Med. 2008;135–6.

  6. Mols F, Vingerhoets AJJM, Coebergh JW, van de Poll-Franse LV. Quality of life among breast cancer survivors: a systematic review. Eur J Cancer. 2005;2005(41):2613–9.

    Article  Google Scholar 

  7. Nachreiner NM. Successful return to work for cancer survivors. AAOHN J. 2007;55(7):290–5.

    Article  PubMed  Google Scholar 

  8. Tamminga S, de Boer A, Verbeek J, Taskila T, Frings-Dresen M. Enhancing return-to-work in cancer patients, development of an intervention and design of a randomised controlled trial. BMC Cancer. 2010;10(1):345.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Désiron HAM, Biesmans K, Reyskens A. Occupational therapy approach in oncological rehabilitation (Ergotherapeutische Methodiek in Oncologische Revalidatie / EMIOR). 2012. Report No.: ESF Project Nr 2144. http://esf-agentschap.be/nl/projectenkaart/emior-ii.

  10. Désiron HAM, Donceel P, Van Hoof E, de Rijk A. What is the value of occupational therapy in return to work for breast cancer patients? A qualitative inquiry among experts. Eur J Cancer Care (Engl). 2014;24(2):267–80.

    Article  Google Scholar 

  11. Tiedtke C, de Rijk A, Donceel P, Christiaens MR, de Casterlé BD. Survived but feeling vulnerable and insecure: a qualitative study of the mental preparation for RTW after breast cancer treatment. BMC Public Health. 2012;2012(12):538.

    Article  Google Scholar 

  12. de Boer AGEM. Work ability and return-to-work in cancer patients. Br J Cancer. 2008;98(8):1342–7.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Tiedtke C, de Rijk A, Dierckx DC, Christiaens MR, Donceel P. Experiences and concerns about ‘returning to work’ for women breast cancer survivors: a literature review. Psycho-oncology. 2009;2010(19):677–83.

    Article  Google Scholar 

  14. Tiedtke C, Donelly M, de Rijk A, de Dierckx CB. Return to work following breast cancer treatment: the employers’ side. J Occup Rehabil. 2014;24(3):399–409.

    PubMed  Google Scholar 

  15. Tiedtke C, Dierckx de CB, Donelly M, de Rijk A. Workplace support after breast cancer treatment: recognition of vulnerability. Disabil Rehabil. 2015;37(19):1770–6.

    Article  PubMed  Google Scholar 

  16. Godderis L, Johannik K, Mylle G, Bulterys S, Moens G. Epidemiological and performance indicators for occupational health services: a feasibility study in Belgium. BMC Health Serv Res. 2014;14(1):410.

    Article  PubMed  PubMed Central  Google Scholar 

  17. World Health Organisation. International classification of functioning, disability and health (ICF). 2001. http://www.who.int/classifications/icf/en/.

  18. Désiron H, Donceel P, de Rijk A, Van Hoof E. Conceptual occupational therapy model aiming on return to work in breast cancer patients. J Occup Rehabil. 2012;23(4):516–26.

    Article  Google Scholar 

  19. Désiron H. Occupational therapy and return to work for breast cancer survivors. WFOT Bull. 2010;61:45–51.

    Google Scholar 

  20. Hoving JL, Broekhuizen ML, Frings-Dresen MH. Return to work of breast cancer survivors: a systematic review of intervention studies. BMC Cancer. 2009;9:117.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Johnsson A. Predictors of return to work ten months after primary breast cancer surgery. Acta Oncol. 2009;48(1):93–8.

    Article  PubMed  Google Scholar 

  22. Johnsson A. Factors influencing return to work: a narrative study of women treated for breast cancer. Eur J Cancer Care (Engl). 2010;19(3):317–23.

    Article  CAS  Google Scholar 

  23. Nilsson M. Return to work after breast cancer: women’s experiences of encounters with different stakeholders. Eur J Oncol Nurs. 2011;15(3):267–74.

    Article  PubMed  Google Scholar 

  24. Tiedtke C. Return to work experiences after breast cancer. Leuven: Leuven University Group Biomedical Sciences; Faculty of Medicine—Department of Public Health and Primary Care, Occupational, Environmental and Insurance Medicine; 2013.

    Google Scholar 

  25. Ammendolia C, Cassidy D, Steensta I, Soklaridis S, Boyle E, Eng S, et al. Designing a workplace return-to-work program for occupational low back pain: an intervention mapping approach. BMC Musculoskelet Disord. 2009;10:65.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Detaille S, van der Gulden J, Engels J, Heerkens Y, van Dijk F. Using intervention mapping (IM) to develop a self-management programme for employees with a chronic disease in the Netherlands. BMC Public Health. 2010;10(1):353.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Munir F, Kalawsky KEA, Wallis DJ, Donaldson-Feilder E. Using intervention mapping to develop a work-related guidance tool for those affected by cancer. BMC Public Health. 2013;13:6.

    Article  PubMed  PubMed Central  Google Scholar 

  28. van Oostrom SH, Anema JR, Terluin B, Venema A, de Vet HC, van Mechelen W. Development of a workplace intervention for sick-listed employees with stress-related mental disorders: Intervention Mapping as a useful tool. BMC Health Serv Res. 2007;15(7):127.

    Article  Google Scholar 

  29. Vermeulen SJ, Anema JR, Schellart AJ, van Mechelen W, van der Beek AJ. Intervention mapping for development of a participatory return-to-work intervention for temporary agency workers and unemployed workers sick-listed due to musculoskeletal disorders. BMC Public Health. 2009;9:216.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Vonk Noordegraaf A, Huirne JAF, Pittens C, van Mechelen W, Broerse JEW, Brölmann HAM, et al. eHealth program to empower patients in returning to normal activities and work after gynecologival surgery: intervention mapping as a useful method for development. J Med Internet Res. 2012;14(5):e124.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Rick O, Kalusche EM, Dauelsberg T, König V, Korsukéwitz C, Seifart U. Reintegrating cancer patients into the workplace. Deutsches Arzteblad International. 2012;109(42):702–8.

    Google Scholar 

  32. McEachan RR, Lawton RJ, Jackson C, Conner M, Lunt J. Evidence, theory and context: using intervention mapping to develop a worksite physical activity intervention. BMC Public Health. 2008;22(8):326.

    Article  Google Scholar 

  33. World Federation of Occupational Therapists. Aims of Occupational Therapy. http://www.wfot.org. 2011 [cited 2014 Oct 5]; (World Federation of Occupational Therapists). http://www.wfot.org/Portals/0/PDF/STATEMENT%20ON%20OCCUPATIONAL%20THERAPY%20300811.pdf.

  34. Bartholomew LK, Parcel GS, Kok GJ. Intervention mapping: a process for developing theory- and evidence-based health education programs. Health Educ Behav. 1998;25:545–63.

    Article  CAS  PubMed  Google Scholar 

  35. Bartholomew LK, Parcel GS, Kok GJ, Gottlieb NH. Intervention Mapping: designing theory and evidence-based health promotion programs. 1st ed. Mountain View, California: Mayfield Publishing Company; 2001.

    Google Scholar 

  36. Bartholomew LK, Parcel GS, Kok G, Gottlieb NH. Planning health promotion programs: an intervention mapping approach. San Francisco: Jossey-Bass; 2006.

    Google Scholar 

  37. Désiron HAM, de Rijk A, Van Hoof E, Donceel P. Occupational therapy and return to work: a systematic literature review. BMC Public Health. 2011;2011(11):615.

    Article  Google Scholar 

  38. Désiron HAM, Donceel P, Van Hoof E, de Rijk A. What is the value of occupational therapy in return to work for breast cancer patients? A qualitative inquiry among experts. Eur J Cancer Care. 2014;24(2):267–80.

    Article  Google Scholar 

  39. Homl M, Rogers JC, Stone RG. Overview of intervention section II: person-task-environment interventions: a decision-making guide. In: Schell BA, Crepeau EB, Schell BAB, editors. Willard and Spackman’s occupational therapy. 10th ed. Philadelphia: Lippincott Williams & Wilkins; 2009.

    Google Scholar 

  40. Bains M, Yarker J, Amir Z, Wynn P, Munir F. Helping cancer survivors return to work: what providers tell us about the challenges in assisting cancer patients with work questions. J Occup Rehabil. 2011;22(1):71–7.

    Article  Google Scholar 

  41. Coole C, Birks E, Watson P, Drummond A. Communicating with employers: experiences of occupational therapists treating people with musculoskeletal conditions. J Occup Rehabil. 2014;24(3):585–95.

    Article  PubMed  Google Scholar 

  42. Crompton S. Occupational therapy intervention in cancer. Guidance for professionals, managers and decision-makers. London: College of Occupational Therapists, HOPE: the Specialist Section of Occupational Therapists in HIV/AIDS, Oncology, Palliative Care and Education; 2004.

  43. Rice VJ. Restoring competence for the worker role. In: Radomski MV, Latham CAT, editors. Occupational therapy for physical dysfunction. 7th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2014. p. 871–908.

    Google Scholar 

  44. Shaw L. Are you listening? External challenges in work rehabilitation practice: enabling return to work through a client-centred approach. Occup Ther Now. 2000;2(5):13–5.

    Google Scholar 

  45. Shaw W, Hong QN, Pransky G, Loisel P. A literature review describing the role of return-to-work coordinators in trial programs and interventions designed to prevent workplace disability. J Occup Rehabil. 2008;18:2–15.

    Article  PubMed  Google Scholar 

  46. Silver JK, Gilchrist LS. Cancer rehabilitation with a focus on evidence-based outpatient physical and occupational therapy interventions. Am J Phys Med Rehabil. 2011;90(5):S5–15.

    Article  PubMed  Google Scholar 

  47. Söderback I, Petterson I, Von Essen L, Stein F. Cancerpatients’ and their physicians’ perceptions of the formers’ need for occupational therapy. Scand J Occup Ther. 2000;24(7):77–86.

    Google Scholar 

  48. Amir Z, Moran T, Walsh L, Iddenden R, Luker K. Return to paid work after cancer: a British experience. J Cancer Surviv. 2007;1:129–36.

    Article  PubMed  Google Scholar 

  49. Taskila T, Lindbohm ML, Lehto US, Hakanen J, Hietanen P. Cancer survivors’ received and needed social support from their work place and the occupational health services. Support Care Cancer. 2005.

  50. Feuerstein M, Todd BL, Moskowitz MC, Bruns GL, Stoler MR, Nassif T, et al. Work in cancer survivors: a model for practice and research. J Cancer Surviv. 2010;4:415–37.

    Article  PubMed  Google Scholar 

  51. Stout NL, Binkley JM, Schmitz KH, Andrews K, Hayes SC, Campbell KL, et al. A prospective surveillance model for rehabilitation for women with breast cancer. Cancer. 2012;15(2012):2191–200.

    Article  Google Scholar 

  52. Pauwels E, Van Hoof E, Charlier C, Lechner L, Bourdeaudhuij I. Transition into survivorship. A qualitative study of breast cancer survivors’ and intimate partners’ experiences of the post-treatment phase and preferences regarding on-line support. Ghent: Social Health Sciences, Ghent University & Psychological Sciences, Free University of Brussels; 2012.

    Google Scholar 

  53. Hewitt M, Greenfield S, Stovall E. From cancer patient to cancer survivor: lost in transition. http://www.nap.edu/catalog.php?record_id=11468. http://www.nap.edu/openbook.php?record_id=11468 (2005).

  54. Tiedtke C. Survived but feeling vulnerable and insecure: a qualitative study of the mental preparation for RTW after breast cancer treatment. BMC Public Health. 2012;12:538.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Tamminga SJ. Enhancing return to work of cancer patients. Amsterdam: Faculty of Medicine of the University of Amsterdam (UvA); 2012.

    Google Scholar 

  56. de Boer AGM, Taskila T, Tamminga S, Frings-Dresen M, Feuerstein M, Verbeek J. Interventions to enhance return-to-work for cancer patients. [The Cochrane Library]. 2009. The Cochrane, Library 2009, Issue 1, The Cochrane Collaboration. Published by JohnWiley & Sons, Ltd. 4-2-2011.

  57. Mehnert A, Härter M, Koch U. Langzeitfolgen einer Krebserkrankung Anforderungen an die Nachsorge und Rehabilitation. Bundesgesundheitsblatt-Gesundheitsforschung-Gesundheitsschutz. 2012;55(4):509–15.

    Article  CAS  PubMed  Google Scholar 

  58. Mehnert A. Employment and work related issues in cancer survivors. Crit Rev Oncol/Hematol. 2011;2011(77):109–30.

    Article  Google Scholar 

  59. Roelen CAM, Koopmans PC, van Rhenen W, Groothoff JW, van der Klink JJL, Bültmann U. Trends in return to work of breast cancer survivors. Breast Cancer Res Treat. 2011;128:237–42.

    Article  CAS  PubMed  Google Scholar 

  60. Tamminga SJ, De Boer AGEM, Verbeek JHAM, Frings-Dresen MHW. Return-to-work interventions into cancer care: a systematic review. Occup Environ Med. 2010;67(9):639–48.

    Article  CAS  PubMed  Google Scholar 

  61. van Oostrom SH. Development of a workplace intervention for sick-listed employees with stress-related mental disorders: Intervention Mapping as a useful tool. BMC Health Serv Res. 2007;7:127.

    Article  PubMed  PubMed Central  Google Scholar 

  62. Grunfeld EA. The organisational perspective on the return to work of employees following treatment for cancer. J Occup Rehabil. 2008;18(4):381–8.

    Article  PubMed  Google Scholar 

  63. Pryce J. Cancer survivorship and work: symptoms, supervisor response, co-worker disclosure and work adjustment. J Occup Rehabil. 2007;17(1):83–92.

    Article  PubMed  Google Scholar 

  64. Williams RM. Perspectives on workplace disability management: a review of the literature. Work. 2002;19(1):87–93.

    PubMed  Google Scholar 

  65. Vockins H. Occupational Therapy intervention with patients with breast cancer: a survey. Eur J Cancer Care (Engl). 2004;2004(13):45–52.

    Article  Google Scholar 

  66. Baron KB, Littleton MJ. The model of human occupation: a return to work case study. Work. 1999;12(1):3–12.

    PubMed  Google Scholar 

  67. Graham J. Occupational therapy in Australia: a changing profession and changing attitudes. Br J Occup Ther. 1990;53(9):370–3.

    Article  Google Scholar 

  68. Marini I. What rehabilitation counselors should know to assist Social Security beneficiaries in becoming employed. Work. 2003;21(1):37–43.

    PubMed  Google Scholar 

  69. Paquette S. Return to work with chronic low back pain: using an evidence-based approach along with the occupational therapy framework. Work. 2008;31(1):63–71.

    PubMed  Google Scholar 

  70. Wright M. Early return to work & occupational therapy. OT Pract. 1997;2(5):36–42.

    Google Scholar 

  71. Nieuwenhuijsen K. Enhanced provider communication and patient education regarding return to work in cancer survivors following curative treatment: a pilot study. J Occup Rehabil. 2006;16(4):647–57.

    Article  PubMed  Google Scholar 

  72. Morrison TL, Thomas RL. Survivors’ experiences of return to work following cancer: a photovoice study: Expériences vécues par des survivantes á un cancer face á leur retour au travail: Une étude photovoice. Can J Occup Ther. 2014;81(3):163–72.

    Article  PubMed  Google Scholar 

  73. Islam T, Dahlui M, Majid H, Nahar A, Mohd Taib N, Su T, et al. Factors associated with return to work of breast cancer survivors: a systematic review. BMC Public Health. 2014;14(Suppl 3):S8.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Curtin M. Enabling skills and strategies. In: Curtin M, Molineux M, Supyk-Mellson J, editors. Occupational therapy and physical dysfunction/enabling occupation. 6th ed. Edinburgh: Churchill Livingstone Elsevier; 2010. p. 111–20.

    Google Scholar 

  75. Cook C, Lukersmith S. Work rehabilitation. In: Curtin M, Molineux M, Supyk-Mellson J, editors. Occupational therapy and physical dysfunction enabling occupation. 6th ed. Edingburgh: Churchill Livingstone Elsevier; 2010. p. 391–408.

    Google Scholar 

  76. Rogers JC. Occupational reasoning. In: Curtin M, Molineux M, Supyk-Mellson J, editors. Occupational therapy and physical disfunction/enabling occupation. 6th ed. Edinburgh: Churchill Livingstone Elsevier; 2010. p. 57–65.

    Google Scholar 

  77. Hoefsmit N, Houkes I, Nijhuis FJN. Intervention characteristics that facilitate return to work after sickness absence: a systematic literature review. J Occup Rehabil. 2012;22(4):462–77.

    Article  PubMed  PubMed Central  Google Scholar 

  78. Shaw W. A literature review describing the role of return-to-work coordinators in trial programs and interventions designed to prevent workplace disability. J Occup Rehabil. 2008;18(1):2–15.

    Article  PubMed  Google Scholar 

  79. Kielhofner G. Research in occupational therapy: methods of inquiry for enhancing practice. Chicago: F.A.Davis Company; 2006.

    Google Scholar 

  80. Cohn ES, Coster W. Unpacking our theoretical reasoning. In: Schell BAB, Gillen G, Scaffa ME, Cohn ES, editors. Willard and Spackan’s occupational therapy, unit IX occupational performance theories of practice. 12th ed. Wolters KLuwer/Lippincott/William & Wilkins: Philadeplhia; 2014. p. 477–93.

    Google Scholar 

  81. Duncan EAS. Shared decision-making skilss in practice. In: Duncan EAS, editor. Skills for practice in occupational therapy. Edinburgh: Churchill Livingstone Elsevie; 2009. p. 41–54.

    Google Scholar 

  82. Coutu MF, Légaré F, Durand MJ, Corbière M, Stacey D, Bainbridge L, et al. Operationalizing a shared decision making model for work rehabilitation programs: a consensus process. J Occup Rehabil. 2015;25(1):141–52.

    Article  PubMed  Google Scholar 

  83. Duncan EAS. Developing research in practice. In: Duncan EAS, editor. Skills for practice in occupational therapy. Edinburgh: Churchill Livingstone Elsevier; 2009. p. 267–78.

    Google Scholar 

  84. Carpenter C, Suto M. Qualitative research for occupational and physical therapists; a practical guide. Oxford: Blackwell Publishing; 2008.

    Google Scholar 

  85. Dixey R. Health promotion and occupational therapy. In: Curtin M, Molineux M, Supyk-Mellson J, editors. Occupational therapy and physical dysfunction/enabling occupation. 6th ed. Edinburgh: Chruchill Livingstone Elsevier; 2010. p. 239–52.

    Google Scholar 

  86. Bultmann U. Coordinated and tailored work rehabilitation: a randomized controlled trial with economic evaluation undertaken with workers on sick leave due to musculoskeletal disorders. J Occup Rehabil. 2009;19(1):81–93.

    Article  PubMed  Google Scholar 

  87. Van Hal LBE, Meershoek AM, Nijhuis FJN, Horstman K. The ‘empowered client’ in vocational rehabilitation: the excluding impact of inclusive strategies. Health Care Anal. 2012;20:213–30.

    Article  PubMed  Google Scholar 

  88. Maiwald K, Meershoek AM, de Rijk AE, Nijhuis FJN. How policy on employee involvement in work reintegration can yield its opposite: employee experiences in a Canadian setting. Disabil Rehabil. 2013;35(7):527–37.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors wish to thank “Kom Op Tegen Kanker” for funding this research. We are also very grateful for the support of the CANWON project.

Author Contributions

A.D.R., R.C. and H.D. participated intensively in the discussion sessions that are mentioned in the method section of this paper. L.G. and E.V.H. questioned the outcomes of the discussions; the choices made in the development process and, like A.D.R. and R.C., both were involved in editing the text that was written by H.D.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Huguette A. M. Désiron.

Ethics declarations

Conflict of interest

No competing interests.

Ethics Statement

For the development of the intervention, no personal data of participants or patients were collected. The article is based on the literature. Consequently, no approval was required from an ethical committee.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Désiron, H.A.M., Crutzen, R., Godderis, L. et al. Bridging Health Care and the Workplace: Formulation of a Return-to-Work Intervention for Breast Cancer Patients Using an Intervention Mapping Approach. J Occup Rehabil 26, 350–365 (2016). https://doi.org/10.1007/s10926-015-9620-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10926-015-9620-3

Keywords

Navigation