| The overall objective of this study was to better understand the factors that affect breast cancer survivors' ability to work during active treatment (surgery, chemotherapy and radiation therapy) using the Systems Engineering Initiative for Patient Safety (SEIPS) framework. Semi-structured, recorded interviews were conducted with 43 working age female breast cancer survivors who were undergoing active treatment. Transcripts of interviews were analyzed using inductive content analysis to identify themes regarding work-related barriers, facilitators and strategies. These themes were then further classified using the SEIPS framework into one of five work system categories: individual, task, environment, technology/tools or organizational related factors.;Results revealed that symptom burden, non-supportive employers and coworkers, and high work demands were barriers to women working during active treatment while employer accommodations, flexibility, and coworker and supervisor support were important facilitators. In order to overcome barriers during active treatment, breast cancer survivors developed several strategies such as adjusting their work schedule, performing fewer or other tasks, working from home, reducing non-work activities, and adjusting the way in which they performed certain work-related tasks.;Application of the SEIPS framework facilitated a deeper understanding of the nature and interaction among the various barriers, facilitators and strategies with regards to work system balance. Specifically, work-related barriers and facilitators were found to encompass the majority SEIPS factors (individual, task, technology, environment, and organization). However, strategies that survivors used to overcome barriers or leverage facilitators revealed several "modifiable" aspects of the SEIPS work system model that helped maintain system balance and enabled survivors to continue working during active treatment. These findings have major implications for designing strategies and modifying work systems to assist breast cancer survivors who want or need to continue working during active treatment. |
