Abstract
Background
This study investigated the association of state vocational rehabilitation services in the USA and work outcomes of cancer survivors who were unemployed prior to receipt of services.
Methods
Administrative data obtained during fiscal year 2005 from the Rehabilitation Services Administration (RSA) database consisting of 1,201 closed cases with the diagnosis of cancer formed the sample of this study. All cancer survivors were unemployed at the time of application. Data on demographic characteristics, employment and vocational service variables were extracted and analyzed in relation to employment outcome data. Multivariate logistic regression was used to examine the relationship among services provided and work outcomes accounting for demographic characteristics of the participants.
Results
Cancer survivors represented 0.4% of the total population that received vocational services in the state-federal vocational rehabilitation program. Of the unemployed cancer survivors who received services, 903 (57%) achieved successful employment while 670 (43%) were not employed following receipt of services. Gender (women; OR = 0.77, 95% CI = 0.61–0.97), lower educational levels (OR = 0.52, 95% CI = 0.33–0.81), provision of cash or medical benefits (e.g., Social Security Disability Insurance benefits; OR = 0.64, 95% CI = 0.50–0.82) were all associated with a greater likelihood of being unemployed at the end of vocational services. Counseling (OR = 1.33, 95% CI = 1.02–1.73), miscellaneous training (OR = 1.61, 95% CI = 1.06–2.44), rehabilitation technology services (OR = 1.22, 95% CI = 0.72–2.08), job placement services (OR = 2.37, 95% CI = 1.72–3.27), job search assistance (OR = 1.43; 95% CI = 1.02–2.01) maintenance services (OR = 1.92, 95% CI = 1.29–2.86), and other services (OR = 1.43, 95% CI = 1.07–1.90) were found to be significantly associated with increased odds for employment.
Conclusion
Vocational rehabilitation services were found to be associated with employment status. Future studies investigating the specific effects of certain vocational services for unemployed cancer survivors who qualify for these services are warranted.
Implications for cancer survivors
Cancer survivors who are seeking employment or experiencing problems maintaining employment who can qualify should be encouraged to pursue services from state vocational rehabilitation agencies. Medical providers should also become familiar with services offered by state vocational rehabilitation agencies and consider the use of these services..
Similar content being viewed by others
References
American Cancer Society. Cancer Facts and figures. American Cancer Society: Altlanta, GA.2007.
SEER. Cancer Statistics Review 1975–2003. Table I-18-US complete prevalence counts, invasive cancers only, January 1, 2003 by age at prevalence. http://seer.cancer.gov/csr/1975_2003/results_merged/topic_prevalence.pdf.
Bradley C, Bednarek H. Employment patterns of longterm cancer survivors. Psycho-oncology 2002;11:188–98.
Short P, Vasey J, Tunceli K. Employment pathways in a large cohort of adult cancer survivors. Psycho-Oncology 2005;10:259–63.
Spelten E, Sprangers M, Verbeek J. Factors reported to influence the return to work of cancer survivors: A literature review. Psycho-oncology 2002;11:124–31.
Taskila T, Lindbohm M. Factors affecting cancer survivors’ employment and work ability. Acta Oncologica 2007;4:446–51.
Feuerstein M, Luff GM, Harrington CB, Olsen CH. Patterns of workplace dispute in cancer survivors: A population study of ADA claims. Journal of Cancer Survivorship 2007;1(3):185–92.
Short P, Vargo M. Responding to employment concerns of cancer survivors. J Clin Oncol 2006;24(32):5138–41.
Nachreiner N, Dagher R, McGovern P, Baker B, Alexander B, Gerberich S. Successful return to work for cancer survivors. AAOHN J 2007;55(7):290–5.
Hoffman B. Cancer survivors at work: a generation of progress. CA Cancer J Clin 2005;55:271–80.
Tate D, Kalpakjian C, Paasuke L, et al. Vocational rehabilitation, independent living, and consumerism. In: DeLisa J, Gans BM, editors. Physical Medicine and Rehabilitation: Principles and Practice (ed 4). Philadelphia, PA: Lippincott-Raven; 2005. p. 1073–83.
Parker RM, Szymanski EM, Patterson JB (eds). Rehabilitation counseling: Basics and beyond (ed. 4). Austin, TX, Pro-Ed, 2005.
Morell J, Pryce J. Work and Cancer: How Cancer Affects Working Lives. CancerBACUP: Ashford Colour Press; 2005.
Bouknight R, Bradley C, Luo Z. Correlates of return to work for breast cancer survivors. J Clin Oncol 2006;24:345–53.
Taskila T, Martikainen R, Hietanen P, Lindbohm M. Comparative study of work ability between cancer survivors and their referents. Eur J Cancer 2007;43:914–20.
Henderson P. Psychosocial adjustment of adult cancer survivors: Their needs and counselor interventions. J Couns Dev 1997;75(3):188–94.
Main D, Nowels C, Cavender T, Etschmaier M, Steiner J. A qualitative study of work and work return to in cancer survivors. Psycho-oncology 2005;14:992–1004.
Tolley N. Oncology social work, family systems theory, and workplace consultations. Health and Social Work 1994;19(3):227–30.
United States Government Accountability Office. Vocational rehabilitation: Better measures and monitoring could improve performance of the VR program. Report to Congressional Committees. Washington, DC, 2005.
Mundy R, Moore S, Mundy G. A missing link: rehabilitation counseling for persons with cancer. J Rehabil 1992;58(2):47–9.
deBoer A, Verbeek J, vanDijk F. Adult survivors of childhood cancer and unemployment: A metaanalysis. Cancer 2006;107(1):1–11.
Green D, Zevon M, Hall B. Achievement of life goals by adult survivors of modern treatment for childhood cancer. Cancer 1991;67(1):206–13.
Nagarajan R, Neglia J, Clohisy D, Yasui Y, Greenberg M, Hudon M, et al. Education, employment, insurance, and marital status among 694 survivors of pediatric lower extremity bone tumors: A report from the childhood cancer survivor study. Cancer 2003;97:2554–64.
Lustig D, Strauser D. The relationship between sense of coherence and career thoughts. Career Dev Q 2002;51:2–11.
Shrey D, Bangs S, Mark L, Hursh N, Kues J. Returning Social Security beneficiaries to the work force: A proactive disability employment model. Rehabil Couns Bull 1991;34:257–73.
Steiner J, Cavender T, Main D, Bradley C. Assessing the impact of cancer on work outcomes. Cancer 2004;101(8):1703–11.
Bolton B, Bellini J, Brookings J. Predicting client employment outcomes from personal history, functional limitations, and rehabilitation services. Rehabil Couns Bull 2000;44:10–21.
Rosenthal D, Chan F, Wong D, Kundu M, Dutta A. Predicting employment outcomes based on race, gender, disability, work disincentives, and vocational rehabilitation service patterns. J Rehabil Adm 2006;29:229–44.
Acknowledgements
Preparation of this manuscript was supported in part by funding from the Rehabilitation Research Institute for Underrepresented Populations (National Institute on Disability and Rehabilitation Research Grant #H133A031705) at Southern University, Baton Rouge, Louisiana.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Chan, F., Strauser, D., da Silva Cardoso, E. et al. State vocational services and employment in cancer survivors. J Cancer Surviv 2, 169–178 (2008). https://doi.org/10.1007/s11764-008-0057-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11764-008-0057-y