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WORK: A Journal of Prevention, Assessment & Rehabilitation is an interdisciplinary, international journal which publishes high quality peer-reviewed manuscripts covering the entire scope of the occupation of work. The journal's subtitle has been deliberately laid out: The first goal is the prevention of illness, injury, and disability. When this goal is not achievable, the attention focuses on assessment to design client-centered intervention, rehabilitation, treatment, or controls that use scientific evidence to support best practice.
WORK occasionally publishes thematic issues, but in general, issues cover a wide range of topics such as ergonomic considerations with children, youth and students, the challenges facing an aging workforce, workplace violence, injury management, performing artists, ergonomic product evaluations, and the awareness of the political, cultural, and environmental determinants of health related to work.
Dr. Karen Jacobs, the founding editor, and her editorial board especially encourage the publication of research studies, clinical practice, case study reports, as well as personal narratives and critical reflections of lived work experiences (autoethnographic/autobiographic scholarship),
Sounding Board commentaries and
Speaking of Research articles which provide the foundation for better understanding research to facilitate knowledge dissemination.
Narrative Reflections on Occupational Transitions, a new column, is for persons who have successfully transitioned into, between, or out of occupations to tell their stories in a narrative form. With an internationally renowned editorial board,
WORK maintains high standards in the evaluation and publication of manuscripts. All manuscripts are reviewed expeditiously and published in a timely manner.
WORK prides itself on being an author-friendly journal.
WORK celebrates its 25th anniversary in 2015.
*WORK is affiliated with the Canadian Association of Occupational Therapists (CAOT)* *WORK is endorsed by the International Ergonomics Association (IEA)* *WORK gives out the yearly Cheryl Bennett Best Paper Award*
Abstract: BACKGROUND: While the cancer survivor rate is nearly 68% now, intervention regimens may leave residual conditions that impact engagement in work and various life tasks. Survivors are underemployed and report stigmatizing attitudes among co-workers. When late effects from cancer arise over 10 years later, the impact on individuals in the prime of their productive employment life is evident. Assisting these individuals begins with awareness of late effects in order to create work-related, adaptive strategies.…METHODS: Sixteen adult cancer survivors experiencing late effects completed the Occupational Self Assessment (Version 2.2) and the Quality of Life-Cancer Survivors (QOL-CS). Knowledge of functional problems secondary to recognized late effects medical conditions reported in the literature was utilized to sort items according to professional definitions of work, performance skills and performance patterns. RESULTS: Late effects survivors reported that cancer illness and treatment has negatively impacted their employment. Individual response to the impact of late effects is highly variant. "Getting things done" and physical energy limitations are most pronounced. CONCLUSIONS: Cancer survivors report lower competence in significant work-related skills and patterns. Quality of life associated with the aftereffects of fatigue, aches and pain, and sleep changes are the lowest. Responses range across the 16 survivors to both performance skills and performance patterns. Cancer survivorship has clearly interfered with employment. An interdisciplinary focus on meaningful engagement in life activities, particularly work is crucial to support survivors through advocacy, adaptation and positive change to focus on engaging the work talents and gifts for all cancer survivors.
Keywords: Survivorship, work, quality of life, competence, adaptation, advocacy
Abstract: OBJECTIVE: To investigate whether employment status and work experiences, assessed in terms of job resources (organizational culture and superiors' and co-workers' support), commitment to organization, work motives, and experiences of discrimination, differ between survivors of prostate or testicular cancer or lymphoma and cancer-free reference subjects. METHODS: Questionnaires were sent to 1349 male cancer survivors and 2666 referents in Denmark, Finland, Iceland, and Norway. Valid responses were 59% and 45%, respectively. Odds ratios (OR) and…95% confidence intervals (CI) were estimated with logistic regression models. RESULTS: Compared to the referents, survivors of lymphoma and prostate cancer were less likely to be employed (OR=0.53; CI: 0.30–0.95 and OR=0.50; CI: 0.35–0.73, respectively), but decreased employment was not evident among testicular cancer survivors. Testicular cancer survivors experienced less discrimination at work than did the referents, for example, testicular cancer survivors were less likely to report that their colleagues doubted their ability to carry out their work tasks (OR=0.38; CI: 0.17–0.83). Lymphoma survivors were less likely than the referents to praise their workplace as an enjoyable place to work (OR=0.48; CI: 0.26–0.88). The prostate cancer survivors were more likely than the referents to find the organizational climate competitive, distrustful, and suspicious. CONCLUSIONS: Employment participation and work experiences of male cancer survivors varied substantially according to type of cancer. Occupational therapists and other health care personnel should keep this in mind when assisting cancer survivors in identifying their strengths and limitations at work.
Abstract: OBJECTIVE: The development and evaluation of Un Abrazo Para La Familia, [A Hug for the Family] is described. Un Abrazo is discussed as an effective model of education, information-sharing, and skill-building for use with low-income co-survivors of cancer. PARTICIPANTS: Sixty co-survivors participated. The majority were women and all reported being Hispanic. METHODS: Using quantitative data (N=60), the needs, concerns, and characteristics of the co-survivor population served through Un Abrazo are presented. Further,…we offer three qualitative case studies (with one co-survivor, one survivor, and one non-participant) to illustrate the model and its impact. RESULTS: The median level of education level of co-survivors was 12 years. The majority were unemployed and/or identified as homemakers, and indicated receipt of services indicating low-income status. Half reported not having health insurance. The top four cancer-related needs or concerns were: Information, Concern for another person, Cost/health insurance, and Fears. CONCLUSIONS: Recognizing the centrality of the family in addressing cancer allows for a wider view of the disease and the needs that arise during and after treatment. Key rehabilitation strategies appropriate for intervening with co-survivors of cancer include assessing and building upon strengths and abilities and making culturally-respectful cancer-related information and support accessible.
Abstract: BACKGROUND: Since a growing number of patients are likely to return to work (RTW) after cancer diagnosis and treatment, there is an increasing recognition of the work situation, and the physical as well as psychosocial functioning among those survivors who returned to work. OBJECTIVE: To prospectively examine Health Related quality of Life (HRQoL) and different aspects of work satisfaction in cancer survivors. PARTICIPANTS: N=702 employed cancer patients (85% women) were recruited on average 11 months post…diagnosis and assessed at the beginning (t_1 ), the end (t_2 ) and 12 months after cancer rehabilitation program (t_3 ). METHODS: Participants completed validated measures assessing work satisfaction, working conditions, job strain and HRQoL. RESULTS: Participants showed a high work satisfaction and were most satisfied with job related activities and least satisfied with work organization and leadership. Total work satisfaction was significantly associated with older age, higher monthly income, higher school education, and HRQoL, but not with any cancer- or treatment related characteristics. No significant changes in work satisfaction over time were observed except for a significant deterioration in satisfaction with job related activities (p=0.002; η ^2 =0.019), professional acknowledgement (p=0.036; η ^2 =0.009), and overall work satisfaction (p < 0.001; η ^2 =0.087) with small to moderate effect sizes. CONCLUSIONS: Our findings emphasize the need for comprehensive cancer rehabilitation programs and specific vocational interventions.
Keywords: Work satisfaction, employment, cancer, quality of life, rehabilitation
Abstract: BACKGROUND: Because of improvements in diagnosis and treatment, cancer survival has increased in recent decades. Cancer survivors may experience problems when returning to their normal lives, particularly with returning to work. In the past few decades, a number of studies examining the work-return process of cancer survivors have been conducted in a select group of countries, but comparable studies are lacking in other countries, including Spain. OBJECTIVE: To review the research literature…on cancer and work in Spain and the design and methodology of the interventions studied. METHODS: A systematic literature review was performed on return to work and employment in Spanish cancer survivors with the databases PubMed, Medline and Spanish database IME. RESULTS: Eight studies were reviewed and analyzed. The studies had a mean sample size of 115 participants. Two of the studies predominantly focused on mixed cancer populations; 3 of the studies focused on breast cancer patients, 1 study focused on head and neck cancer patients, 1 study focused on colorectal cancer patients and 1 study focused on patients with lymphoma. CONCLUSIONS: Further research in Spain and other countries is necessary, and efforts should be made to support the re-employment of cancer patients.
Abstract: BACKGROUND: Increasingly, people diagnosed with cancer are surviving and continuing to participate in the work force. This trend brings with it new issues regarding survivors' employment-related needs. OBJECTIVE: The research team's objective is to explore cancer survivors' employment-related needs and supports with the ultimate goal of developing a training intervention for them. METHODS: Data were collected via an online survey. This article reports on the findings from the pilot stage of the study, which included 32…respondents. RESULTS: Many cancer survivors experience cancer symptoms at work, but do not tend to seek reasonable accommodations. Levels of awareness of possible programmatic and legal supports are low. Respondents reported that neither employers nor medical practitioners are primary sources of information regarding their individual employment-related concerns. Instead, they relied on general information from cancer advocacy organizations. CONCLUSIONS: Survivors, employers, and practitioners who treat cancer patients could benefit from training resources about how survivors might address their employment-related needs.
Keywords: Disability and cancer, work, reasonable accommodations, Americans with Disabilities Act
Abstract: BACKGROUND: Over 91,000 new cases of gynecological cancers are expected to be diagnosed in 2013 in the US alone. As cancer detection technology and treatment options improve, the number of working-age cancer survivors continues to grow. OBJECTIVE: To describe US gynecological cancer survivors' perceptions of the effects of cancer and treatment on their job tasks. PARTICIPANTS: 104 adult gynecological cancer survivors who were working at the time of their cancer diagnosis, treated at a University-based…women's health clinic, diagnosed in the previous 24 months, and spoke English. METHODS: Women completed written surveys to describe their work experiences following diagnosis. Clinical characteristics were obtained through medical record review. Descriptive statistics and cross tabulations were performed to describe characteristics and associations. RESULTS: Fifteen percent of women had chemotherapy and radiation treatment; 48% had only chemotherapy, 9% only radiation therapy, and 28% had neither. Survivors described the frequency of performing seven job tasks, such as 'intense concentration', 'analyzing data', and 'lifting heavy loads.' Women who had undergone radiation treatment were more likely to indicate limitations for physical tasks; women undergoing chemotherapy were more likely to report limitations in more analytic tasks. Only 29% of women noted an employer-based policy facilitated their return-to-work process. CONCLUSIONS: Cancer and treatment have important effects on job performance and may vary by type of treatment. Employer-based policies focusing on improved communication and work accommodations may improve the return to work process.
Abstract: Margaret*, a 56 year-old Caucasian Stage III breast cancer survivor, participated in a 5 week occupational therapy pilot program, called Take Action. This program was designed for breast cancer survivors who self-reported changes in cognitive function following completion of chemotherapy. The goals of the program were to improve participants' knowledge and use of strategies to enhance occupational performance and to improve satisfaction and performance of meaningful daily activities or occupations. Through a client-centered and…evidence-based approach, this case study highlights the importance of incorporating the survivors' sense of self into an occupation-based intervention. Occupational therapists play an important role in facilitating exploration of sense of self in the survivorship phase of care to support occupational performance in self care, productivity, work, leisure and social participation. This case study highlights the important work of redefining oneself in the survivorship phase of care. (*denotes name change)
Keywords: Breast cancer, survivorship, occupational therapy
Abstract: BACKGROUND: The effect of cancer on employment and retirement status in an older work force is not well understood. This study examines whether cancer survivors were less likely to be working than a sibling comparison group. OBJECTIVES: To compare work-related variables between older cancer survivors and a group of non-cancer sibling controls. A secondary objective was to evaluate the effect of cancer site and time since cancer diagnosis on work-related variables. METHODS:…Data from the Wisconsin Longitudinal Study (WLS) were used to assess work outcomes in cancer survivors (+CA, n=539, mean age=65.81, SD=4.75 years) and non-cancer sibling controls (-CA, n=539, mean age=63.95, SD=5.31 years). RESULTS: Survivors (+CA group) were more likely to report not working (61.8%) and to be completely retired (55%) than the -CA group (48.3% not employed; 42% retired). Controlling for age, gender and education, this effect persisted with the +CA group more likely to be not working (OR=1.40; 95% CI=1.08 to 1.83) and completely retired (OR=1.36; 95% CI=1.05 to 1.77) than the -CA group. Neither time since diagnosis nor cancer site affected work outcomes. CONCLUSIONS: In this study, older +CA survivors were less likely to be working and more likely to be completely retired than -CA sibling controls. Future research should evaluate factors affecting work status among older cancer survivors.
Keywords: Older cancer survivors, survivorship, employment, retirement, work
Abstract: BACKGROUND: Cancer and its treatment may cause physical impairments and psychological distress in survivors. Rehabilitation is a critical component of quality cancer care, returning survivors to their highest functional potential. OBJECTIVE: This overview focuses on the benefits of multidisciplinary cancer rehabilitation – including improving physical function, reducing psychological distress, promoting return to work and, therefore, decreasing the economic burden of cancer and its treatment on individuals and society in general.…METHODS: Relevant literature was identified through a search of the PubMed database and reviewed for its relevance to cancer rehabilitation and the topic of this article. Search terms included, but were not limited to, cancer rehabilitation, cancer prehabilitation, disability, return to work, employment, and unemployment. RESULTS: Cancer survivors are less likely to be employed and take more sick leave than workers without a history of cancer. Pain, musculoskeletal issues, deconditioning, fatigue, balance, psychosocial issues, and lymphedema are most amenable to rehabilitation. CONCLUSION: Overall health and the need for work accommodations must be addressed in order to improve return to work and subsequent productivity in cancer survivors. Survivors are usually best served by a multidisciplinary care team comprising members who can address the myriad impairments affecting survivor function.
Keywords: Return to work, disability, survivorship, cancer-related impairments, prehabilitation
Abstract: The purpose of this case study was to describe how the return-to-work process evolved in an employee with cancer in the Netherlands and how a work-directed intervention supported this process. The patient was a 35-year old female employee diagnosed with cervix carcinoma. After surgery, the patient experienced depression, fatigue, fear of recurrence, and low mental working capacity. Communication with the occupational physician was difficult. A social worker at the hospital provided three counselling sessions aimed to…support return to work and sent letters to the occupational physician to improve the communication. The support by the social worker helped the patient to resume work gradually and the sending of information from the treating physician and social worker improved the communication with the occupational physician. This resulted in the patient being able to achieve lasting return to work. This work-directed intervention was highly valued by the patient and could be an important addition to usual psycho-oncological care for employees with cancer.
Keywords: Oncology, psycho-oncological care, cancer survivorship care, trial registration: NTR