Employer accommodations defined by women undergoing treatment for breast cancer

Medical advances have decreased the physical burden of cancer therapies, allowing an increasing number of patients to maintain regular activities, including work, during treatment. In addition to improving financial stability, patients report that working during treatment helps maintain their sense of identity and normalcy. Employer accommodation is a requirement of the Americans with Disabilities Act and has been identified as an important predictor of return to work in cancer patients. However the types and scope of accommodation patients require have not been defined. This qualitative study describes definitions of employer accommodation given by women receiving treatment with curative intent who were employed at the time of breast cancer diagnosis. Sixty-eight patients from the Breast Cancer and the Workforce study, an ongoing longitudinal study in New York City breast cancer survivors, described their definition of employer accommodation, regardless of whether they had received accommodation, during one-on-one cognitive debriefing interviews while self-administering an online survey. Patients completed the survey and interview in their primary language – 41 English, 9 Korean, 9 Mandarin and 9 Spanish. Two coders independently identified themes in their responses and then reconciled discordant codes. Themes identified include accommodating treatment schedules (coded separately as leave time and flexible schedule at work), ability to work from home, physical accommodations, reduced responsibilities, social support, job security and benefits. Accommodating treatment schedules was the most commonly identified theme, with 53% of patients identifying leave time and 46% citing flexible schedules. These results have important implications for employers and researchers investigating survivorship outcomes.