The provision of workplace accommodations following cancer: survivor, provider, and employer perspectives

PURPOSE: With improvements in screening, diagnosis, and treatment, the number of persons surviving cancer and staying at or returning to work is increasing. While workplace accommodations optimize workers' abilities to participate in the workforce, there has been little in-depth investigation of the types of accommodations reported to have been provided to cancer survivors and the processes relevant to ensuring their successful implementation. METHODS: We employed an exploratory qualitative method and conducted 40 semi-structured interviews with three groups: (i) cancers survivors (n = 16), (ii) health/vocational service providers (n = 16), and (iii) employer representatives (n = 8) to explore return to work and accommodation processes, successes, and challenges. An inductive thematic analysis approach was used to analyze the data. RESULTS: Four types of accommodations were recommended: (1) graduated return to work plans and flexible scheduling, (2) modification of work duties and performance expectations, (3) retraining and supports at the workplace, and (4) modification of the physical work environment and/or the provision of adaptive aids/technologies. Processes relevant to ensuring effective accommodations included: (1) developing knowledge about accommodations, (2) employer's ability to accommodate, (3) negotiating reasonable accommodations, (4) customizing accommodations, and (5) implementing and monitoring accommodation plans. Accommodation challenges included: (1) survivors' fears requesting accommodations, (2) developing clear and specific accommodations, (3) difficult to accommodate jobs, and (4) workplace challenges, including strained pre-cancer workplace relationships, insufficient/inflexible workplace policies, employer concerns regarding productivity and precedent setting, and limited modified duties. CONCLUSIONS: Accommodations need to be customized and clearly linked to survivors' specific job demands, work context, and available workplace supports. Survivors need to feel comfortable disclosing the need for accommodations. Ongoing communication and monitoring are required to ensure accommodations are implemented and changes made to the return to work plan as required. IMPLICATIONS FOR CANCER SURVIVORS: The provision of appropriate workplace accommodations can enhance survivors' abilities to stay or return to work