An integrative review: Women’s psychosocial vulnerability in relation to paid work after a breast cancer diagnosis
- Resource Type
- Authors
- Halia Melnyk; John D. Merriman; Maja Djukic; Victoria Vaughan Dickson
- Source
- Journal of Advanced Nursing. 77:2144-2154
- Subject
- 030504 nursing
Psychological intervention
Vulnerability
Social Support
Breast Neoplasms
CINAHL
Checklist
03 medical and health sciences
Critical appraisal
0302 clinical medicine
Quality of life (healthcare)
Nursing
Survivorship curve
Adaptation, Psychological
Quality of Life
Humans
Female
030212 general & internal medicine
Workplace
0305 other medical science
Psychology
Psychosocial
General Nursing
- Language
- ISSN
- 1365-2648
0309-2402
AIM The aim of this integrative review was to explore psychosocial vulnerabilities in women after a breast cancer diagnosis that are related to their paid work. DESIGN The review methodology was guided by Whittemore and Knafl. The Mehnert Cancer Survivorship and Work Model provided a lens through which to view vulnerability in working women with a focus on facilitating interventions to improve both recovery and work outcomes. DATA SOURCES PUBMED, CINAHL, Web of Science, and PsycNET databases were searched for English language papers published between January 2014-June 2020. REVIEW METHODS Titles and abstracts were screened. Inclusion/exclusion criteria were then applied to full text screen of the remaining articles following PRISMA guidelines. Thirteen studies meeting the inclusion criteria were critically appraised using the Critical Appraisal Skills Programme (CASP) checklist. A constant comparison approach was used to systematically distil findings into categories and assess their fit within the Mehnert Model subdomains. RESULTS Vulnerabilities coalesced predominantly within the following subdomains: (a) changes in identity and role functioning; (b) social reintegration; (c) coping strategies; and (d) social supports. Patterns and themes within these subdomains were related both positively and negatively to form the contours of a survivor's satisfaction/dissatisfaction with quality of life related to work and breast cancer recovery. CONCLUSION Overall, findings highlight the importance of employment and work environments in bolstering women's psychosocial health after a breast cancer diagnosis. IMPACT Findings from this review support adapting psychosocial distress screening to include vulnerabilities relating to work life. Nurses are ideally positioned to facilitate this screening and engage clinicians in a dialogue surrounding patient's support needs due to nursing's central role on the interdisciplinary team. Nurses may also foster collective accountability for implementing ongoing multidisciplinary survivorship care plans that include a return to work component.