Inhibitors and Facilitators for the Continuation of Employment in Gastric Cancer Patients Who Work While Receiving Postoperative Adjuvant Chemotherapy

Abstract

The purpose of this study was to identify facilitators and inhibitors of continued employment among gastric cancer patients who are working while receiving adjuvant chemotherapy. Semi-structured interviews were conducted with eight gastric cancer patients who were working while receiving postoperative chemotherapy, and were analyzed qualitatively and inductively. Five categories of disincentives to continue working were identified: “changes in life due to gastrectomy”, “distress due to side effects of adjuvant chemotherapy”, “difficulty adjusting to social life due to treatment”, “concerns about continuing to work due to treatment”, and “lack of information necessary to continue working”. Four categories were identified as factors that promote continuation of employment: “self-care behavior aimed at balancing treatment and employment”, “systems and structures that enable balancing treatment and employment”, “surroundings that support motivation to work”, and “motivation to work”.

As disincentives to continue working, side effects from gastrectomy and postoperative adjuvant chemotherapy directly affected daily eating and defecation, resulting in physical weakness and anxiety. Due to symptoms that were difficult to predict or control, such as loss of appetite without a clear timeline for improvement, the patient’s willingness to work may have decreased and affected QWL. As a factor promoting continued employment, even though postoperative adjuvant chemotherapy was new to the patient, they had developed their coordination and coping skills through their own coping and adjustment process. The understanding and cooperation of coworkers and the work environment were conducive to increased motivation to work.