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Meaning of work and the returning process after breast cancer: a longitudinal study of 56 women
Umeå University, Faculty of Social Sciences, Department of Social Work.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
Umeå University, Faculty of Social Sciences, Department of Social Work.
Umeå University, Faculty of Social Sciences, Department of Social Work.
2013 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, ISSN 0283-9318, Vol. 27, no 2, 267-274 p.Article in journal (Refereed) Published
Abstract [en]

Background: An increasing number of women survive breast cancer and a majority return to work. However, findings based on mean values may conceal individual processes that need to be better understood to discuss meaningful rehabilitation.

Aim: The purpose of this paper is to describe the sick-leave pattern of a group of Swedish women with primary breast cancer but foremost to explore their ideas about what motivates and discourages their return to work.

Method: Fifty-six women were repeatedly interviewed over a period of 18 to 24 months. Interview sections that clearly illustrated the women’s experiences and ideas about work were categorized using the comparative similarities-differences technique.

Findings: The average length of sick leave was 410 days (range 0-942). Six months after the first day of sick leave, 29% worked at least their previous service grade. At 12 months, 55%, and at 18 months 57% did so. Those treated with chemotherapy had in average more than twice as large sick leave as those who did not. Three categories emerged. ‘Motives for not returning to work’ consists of four sub-categories: ‘I’m still too fragile to return to work’; ‘My workplace is a discouraging place’; ‘I took an opportunity to pause’ and ‘I’ve lost the taste for work’. ‘Motives for returning’ consists of two sub-categories: ‘Work generates and structures my everyday life’ and ‘I miss my workplace’. Finally, ‘Transition in work approach’ reflects a changed approach to work.

Conclusion: The meaning of work varies over time, but first and foremost work was regarded as an important part of the healing process as it restores the disruption of everyday life. Guidelines cannot be reduced to a linear relationship with biomedical variables but the individual context of everyday life must be considered.

Place, publisher, year, edition, pages
HOBOKEN, NJ, USA: Wiley-Blackwell, 2013. Vol. 27, no 2, 267-274 p.
Keyword [en]
Activity, breast cancer, chemotherapy, everyday life, guidelines, sick leave, work working life
National Category
Social Sciences
Research subject
URN: urn:nbn:se:umu:diva-54647DOI: 10.1111/j.1471-6712.2012.01026.xOAI: diva2:524761
Available from: 2012-05-03 Created: 2012-05-03 Last updated: 2013-11-14Bibliographically approved
In thesis
1. Betydelser av bröstcancer i ett livssammanhang
Open this publication in new window or tab >>Betydelser av bröstcancer i ett livssammanhang
2013 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[en]
Meanings of breast cancer in a life context
Abstract [en]

The aim of the thesis is to describe and analyse how a group of women experience that their every-day lives are affected during and after primary breast cancer treatment. The thesis is a consecutive, longitudinal study that takes an explorative qualitative approach. Seventy-one women younger than 60 years of age with primary breast cancer were consecutively included in the study. The women were interviewed four or five times over a period of 4 to 6 years from end of radiotherapy. The analyses of the interviews were inspired by grounded theory and narrative analysis. 

The thesis encompasses four papers. Paper I focused on the women’s contact with health care. The results of this study indicate that it is crucial for patients in a vulnerable situation to be admitted into a supportive system – ‘admitted into a helping plan’ – that, more or less explicitly, displays a well-thought-out plan of care. This is a process built on individual relationships with members of the health-care staff, but it ends up in a relationship to health care as a helping system, a ‘safe haven’ to attach to. Study II explored the women’s ideas about what motivated and discouraged their return to work. The results illustrate that the meaning of work fluctuates over time and that the processes of returning to work are conditioned by the patients’ individual life situations. Returning to work was regarded as an important part of the healing process because of how it generated and structured the women’s everyday lives. Returning to work meant demonstrating well-being and normalcy after breast cancer. Study III examined how life was lived and valued during and after treatment for breast cancer compared to pre-cancer life. The analysis showed that being afflicted with breast cancer was evaluated from a context of the women’s former everyday lives and stressed that how the women experienced breast cancer was a matter of personal circumstances. Study IV focused on how the women experienced and dealt with their altered bodies. The results showed that the women followed three different body-mind trajectories that depended to a significant extent on the severity of side effects and bodily alterations that resulted from their treatments.

Being afflicted by breast cancer implies vulnerability and losses, but it can also involve benefits and provide new perspectives on life. How the overall breast cancer experience is valued seems to be very much a matter of circumstances in everyday life. This thesis highlights circumstances that focus in particular on contacts with health care, the body, the work situation, and the family situation. 

Place, publisher, year, edition, pages
Umeå: Umeå universitet, 2013. 90 p.
Studier i socialt arbete vid Umeå universitet : avhandlings- och skriftserie, ISSN 0283-300X ; 80
breast cancer, psycho-oncology, oncology, everyday life, patient perspective, gender, sick leave, work, side effects, attachment, 'critical incidents', bröstcancer, psykosocial onkologi, onkologi, vardagsliv, patientperspektiv, genus, sjukskrivning, arbete, biverkningar, anknytning, 'critical incidents'
National Category
Social Work
urn:nbn:se:umu:diva-82968 (URN)978-91-7459-757-8 (ISBN)
Public defence
2013-12-06, Samhällsvetarhuset, Hörsal B, Umeå universitet, Umeå, 13:00 (Swedish)
Swedish Cancer Society
Available from: 2013-11-15 Created: 2013-11-14 Last updated: 2013-11-14Bibliographically approved

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Lilliehorn, SaraHamberg, KatarinaKero, AnneliSalander, Pär
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Department of Social WorkDepartment of Public Health and Clinical Medicine
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