JMIR Publications

ABSTRACT

Background:

Background:

About four of ten people in Sweden get cancer during their lifetime, and approximately half of them will be diagnosed during their working life. As cancer survival rates improve, a growing number of individuals face challenges in returning to work following treatment. This increases the demand for effective return-to-work (RTW) strategies. Despite existing rehabilitation frameworks, cancer survivors often encounter barriers to sustainable work reintegration.

Objective:

This study aimed to investigate stakeholders’ perceptions of facilitators of and barriers to return to work among cancer survivors, including factors promoting work-related wellbeing during the RTW process.

Methods:

Methods:

During the development phase of a work-oriented rehabilitation intervention, semi structured interviews were conducted with 25 stakeholders involved in the RTW process, n=12 healthcare professionals, n=7 social insurance officers, n=5 employers, and n=1 employment service agency officers. Data were analyzed using qualitative content analysis.

Results:

Results:

Five overarching themes were identified that influenced return to work: collaboration and clear division of responsibilities, balancing individual adaptations, reducing structural barriers through support, views and expectations of the individual regarding RTW, and emotional significance of work. Key facilitators included flexible work arrangements, individualized adaptations, a strong desire to work, and the emotional value of work. Barriers comprised lack of collaboration among stakeholders, particularly the absence of a clear division of responsibilities, as well as structural barriers, such as sick leave bureaucracy and financial obstacles. The role of rehabilitation coordinators was highlighted as pivotal in bridging gaps between stakeholders and ensuring continuity in care.

Conclusions:

Conclusion: RTW for cancer survivors is a complex, multifactorial process requiring coordinated efforts across healthcare, insurance, and employment sectors. Enhancing collaboration, clarifying stakeholder responsibilities, and implementing flexible individualized support structures are essential to facilitating cancer survivors’ RTW. Additionally, including a designated coordinator in the process is proposed. More support during the early phase of RTW is necessary to reduce the risk of long-term labor market exclusion. Implications: To help cancer survivors RTW, clear role definitions and shared responsibilities among stakeholders are essential. Flexibility in the RTW process helps individuals reintegrate at their own pace, reduces isolation and promotes social connection. These are key considerations for future policies and support measures.