Policy Implications of the Relationship of Sick Leave Benefits,Individual Characteristics,and Fatigue to Employment During Radiation Therapy for Cancer
Restricted accessResearch articleFirst published online November, 2005
Policy Implications of the Relationship of Sick Leave Benefits,Individual Characteristics,and Fatigue to Employment During Radiation Therapy for Cancer
Undergoing a course of radiation therapy for cancer does not preclude the need to work during treatment. This study examins the impact of sick leave benefits, individual characteristics, and fatigue on employment during radiation therapy. The conceptual model of nursing and health policy (CMNHP) and the Piper integrated fatigue model (IFM) guided this study. Seventy-seven study participants receiving radiation therapy were recruited from one community hospital. The study employed a prospective, longitudinal design. Data were collected at baseline prior to starting radiation therapy, weekly during treatment, and at the 1-month follow-up visit. Only 49% of study participants had paid sick leave benefits available at the start of radiation. Age, pain, gender, side effects, availability of sick leave benefits, and fatigue were associated with work along the trajectory of radiation therapy. Further research addressing the impact of paid leave policies on the relation between work and cancer-related fatigue is warranted.
Akechi, T., Kugaya, A., Okamura, H., Yamawaki, S., & Uchitomi, Y. (1999). Fatigue and its associated factors in ambulatory cancer patients: A preliminary study. Journal of Pain and Symptom Management, 17, 42-48.
2.
Albelda, R. (2004, October). Labors of lost love? The costs and benefits of paid family and medical leave in Massachusetts. Lecture presented at University of Massachusetts Boston Distinguished Scholar Lecture, Boston.
3.
Albelda, R., Clayton-Matthews, A., & Manuel, T. (2002, September). The cost of paid family and medical leave program in Massachusetts [Draft report presented to Institute for Women’s Policy Research (IWPR) and the Labor Resource Center, University of Massachusetts Boston (LRC)]. Boston: University of Massachusetts Boston and Charlotte. University of North Carolina.
4.
American Cancer Society. (2005). Cancer facts and figures 2005. Retrieved February 7, 2005, from: www.cancer.org/downloads/STT/CAFF2005f4PWSecured.pdf
5.
Armour, S. (2005). Family, medical leave act at center of hot debate. Retrieved October 3, 2005, from www.usatoday.com/printedition/money/20050526/medicalleave.art.htm
6.
Association of Women’s Health, Obstetric, & Neonatal Nurses. (2002). Policy position statement: Enhanced family medical leave protections. Retrieved September 29, 2003, from www.awhonn.org/awhonn/?pg=873-6230-7000-4810-5610
7.
Bansal, M., Mohanti, B. K., Shah, N., Chaudhry, R., Bahadur, S., & Shukla, N. K. (2004). Radiation related morbidities and their impact on quality of life in head and neck cancer patients receiving radical radiotherapy. Quality of Life Research, 13, 481-488.
8.
Berger, A., & Walker, S. N. (2001). An explanatory model of fatigue in women receiving adjuvant breast cancer chemotherapy. Nursing Research, 50, 42-52.
9.
Berger, A. M., Berry, D. L., Christopher, K. A., Greene, A. L., Maliski, S., Swenson, K. K., et al. (2005). Oncology Nursing Society 2004 Research Priorities Survey. Oncology Nursing Forum, 32, 281-290.
10.
Berger, A. M., VonEssen, S., Kuhn, B. R., Piper, B. F., Farr, L., Agrawal, S., et al. (2003). Adherence, sleep, and fatigue outcomes after adjuvant breast cancer chemotherapy: Results of a feasibility intervention study. Oncology Nursing Forum, 30, 513-522.
11.
Burns, N., & Grove, S. K. (2001). The practice of nursing research. Conduct, critique and utilization (4th ed.). Philadelphia: W. B. Saunders.
12.
Cantor, D., Waldfogel, J., Kerwin, J., McKinley Wright, M., Levin, K., Rauch, T. H., et al. (2001). Balancing the needs of families and employers: Family and Medical Leave Survey. Retrieved December 10, 2000, from www.dol/asp/fmla
13.
Christman, N. J., Oakley, M. G., & Cronin, S. N. (2001). Developing and using preparatory information for women undergoing radiation therapy for cervical or uterine cancer. Oncology Nursing Forum, 28, 93-98.
14.
Cimprich, B. (1998). Age and extent of surgery affect attention in women treated for breast cancer. Research in Nursing and Health, 21, 229-238.
15.
Curt, G., & Johnston, P. G. (2003). Cancer fatigue: The way forward. Oncologist, 8(Suppl 1), 27-30.
16.
Curt, G. A., Breitbart, W., Cella, D., Groopman, J. E., Horning, S. J., Itri, L. M., et al. (2000). Impact of cancer-related fatigue on the lives of patients: New findings from the Fatigue Coalition. Oncologist, 5, 353-360.
17.
Department of Labor. (2005). Labor force statistics from the current population survey. Retrieved February 7, 2005, from www.bls.gov/cps/home.htm%23charemp
18.
Department of Labor. (n.d.). Fact sheet 28: Family and Medical Leave Act. Retrieved September 27, 2003, from: www.dol.gov/esa/regs/compliance/whd/whdfs28.htm
19.
Der, G., & Everitt, B. (2002). A handbook of statistical analyses using SAS (2nd ed.). Boca Raton, FL: Chapman & Hall.
20.
Dillon, E., & Kelly, J. (2003). The status of cancer fatigue on the Island of Ireland: AIFC professional and interim patient surveys. Oncologist, 8(Suppl 1), 22-26.
21.
Fawcett, J., & Russell, G. (2001). A conceptual model of nursing and health policy. Policy, Politics, & Nursing Practice, 2, 108-116.
22.
Fawcett, J., & Russell, G. (2002, February). A conceptual model of nursing and health policy: Update 2002. Paper presented at the Doctoral Seminar, College of Nursing and Health Sciences, University of Massachusetts Boston.
23.
Gift, A. G., Stommel, M., Jablonski, A., & Given, W. (2003). A cluster of symptoms over time in patients with lung cancer. Nursing Research, 52, 393-400.
24.
Guren, M. G., Dueland, S., Skovlund, E., Fossa, D. D., Poulsen, J. P., & Tveit, K. M. (2003). Quality of life during radiotherapy for rectal cancer. European Journal of Cancer, 39, 587-594.
25.
Hilderly, L. (1997). Principles of teletherapy. In K. H. Dow, J. D. Bucholtz, R. Iwamoto, V. Fieler, & L. Hilderly (Eds.), Nursing care in radiation oncology (2nd ed., pp. 6-20). Philadelphia: W. B. Saunders.
26.
Hopper, M. (2002, July). Paid family leave is worse than it sounds. Retrieved October 4, 2005, from www.nfib.com/object/3400688.html
27.
H. Resolution 3192 Paid family and medical leave act of 2005. (2005). Retrieved October 4, 2005, from http://thomas.loc.gov/cgi-bin/query/query
28.
HR Tools (n.d.). FMLA quiz. Retrieved September 29, 2004, from www.hrtools.com/etoolsapplets/FMLAIQTest/FMLAIQTest.asp?func=answers
29.
Jacobs, P. (1996). The economics of health and medical care. Gaithersburg, MD: Aspen.
30.
Janda, M., Gerstner, N., Overmair, A., Fuerst, A., Wachter, S., Dieckmann, K., et al. (2000). Quality of life changes during conformal radiation therapy for prostate carcinoma. Cancer, 89, 1322-1328.
31.
King, K. B., Nail, L. M., Kreamer, K., Strohl, R. A., & Johnson, J. E. (1985). Patients’ descriptions of the experience of receiving radiation therapy. Oncology Nursing Forum, 12(4), 55-61.
32.
Landis, C. A., Frey, C. A., Lentz, M. J., Rothermel, J., Buchwald, D., & Shaver, J. L. F. (2003). Self-reported sleep quality and fatigue correlates with actigraphy in midlife women with fibromyalgia. Nursing Research, 52, 140-147.
33.
Longman, A. J., Braden, C. J., & Mishel, M. H. (1996). Side effect burden in women with breast cancer. Cancer Practice, 4, 274-280.
34.
Lovell, V. (2004, October). Estimating the costs of paid family and medical leave. Paper presented at After Birth: Policies for Health Women, Families and Workplaces, a conference of the Hubert H. Humphrey Institute of Public Affairs in collaboration with the School of Public Health, University of Minnesota. Retrieved October 4, 2005, from www.hhh.umn.edu/img/assets/6266/lovell.pdf
35.
Mendoza, T. R., Wang, X. S., Cleeland, C. S., Morrissey, M., Johnson, B. A., Wend, J. K., et al. (1999). The rapid assessment of fatigue severity in cancer patients: use of the Brief Fatigue Inventory. Cancer, 85, 1186-1196.
36.
Mock, V. (1998). Breast cancer and fatigue: Issues for the workplace. AAOHN Journal, 46, 425-431.
37.
Moccio, F., & Geier, K. (2001, March). Testimony on providing paid family and medical leave in New York State through the Temporary Disability Insurance Program. New York: Institute for Women and Work, Cornell University, New York State School of Industrial and Public Relations.
38.
Moore-Higgs, G. J., Watkins-Bruner, D., Balmer, L., Doneski-Johnson, J., Komarny, P., Mautner, B., et al. (2003). The role of licensed nursing personnel in radiation oncology Part A: Results of a descriptive study. Oncology Nursing Forum, 30, 51-58.
39.
National Employment Law Project. (n.d.). Work and family project. Retrieved October 4, 2005, at www.nelp.org/wfp/index/cfm
40.
National Partnership for Women and Children. (2003). Unprecedented paid family and medical leave clearinghouse launched. Retrieved October 4, 2005, from www.paidleave.org/CHLaunchRelease.pdf
41.
Oncology Nursing Society. (2005). 2003-2004 ONS research agenda talking points. Retrieved March 16, 2005, from: www.ons.org/research/information/documents/pdfs/TalkingPoints.pdf
42.
Paid family and medical leave: Supporting working families in Illinois: Illinois General Assembly, House Committee on Labor and Commerce, Subcommittee on Unemployment Insurance for the New Workforce (2000, September) (testimony of Vicky Lovell). Retrieved October 4, 2005, from www.iwpr.org/pdf/IL%2520testimony%25209-00/pdf
43.
Piper, B. F., Dibble, S. L., Dodd, M. J., Weiss, M. C., Slaughter, R. E., & Paul, S. M. (1998). The revised Piper Fatigue Scale: Psychometric evaluation in women with breast cancer. Oncology Nursing Forum, 25, 677-684.
44.
Piper, B. F., Lindsey, A. M., Dodd, M. J., Ferketich, S., Paul, S. M., & Weller, S. (1989). The development of an instrument to measure the subjective dimension of fatigue. In S. Funk, E. Tournquist, M. Champagne, L. Copp, & R. Weiss (Eds.), Key aspects of comfort: Management of pain, fatigue, and nausea (pp. 199-208). New York: Springer.
45.
Piper, B. F., Lindsey, A. M., & Dodd, M. J. (1987). Fatigue mechanisms in cancer patients: Developing nursing theory. Oncology Nursing Forum, 14(6), 17-23.
46.
Prah, P. M. (2002). Momentum for paid family leave grows. Retrieved October 4, 2005, from www.stateline.org/live/ViewPage.action?siteNodeId=136&languageId=1&contentId=14999
47.
Satariano, W. A., & DeLorenze, G. N. (1996). The likelihood of returning to work after breast cancer. Public Health Reports, 111, 236-241.
48.
Sitton, E. (1997). Managing side effects of skin changes and fatigue. In K. H. Dow, J. D. Bucholtz, R. Iwamoto, V. Fieler, & L. Hilderly (Eds.), Nursing care in radiation oncology (2nd ed., pp. 79-100). Philadelphia: W. B. Saunders.
49.
Social Security Administration. (n.d.-a). Age increase. Retrieved November 3, 2003, from www.socialsecurity.gov/pubs/ageincrease.htm
50.
Social Security Administration. (n.d.-b). Temporary disability insurance. Retrieved January 20, 2005, from www.ssa.gov/policy/docs/progdesc/sspus/tempdib.pdf
51.
U.S. Chamber of Commerce. (2003). Paid family and medical leave. Retrieved October 4, 2005, from www.uschamber.com/issues/index/labor/paidfmla.thm
52.
Yates, J. W., Chalmers, B., & McKegney, F. P. (1980). Evaluation of patients with advanced cancer using the Karnofsky Performance Status. Cancer, 45, 2220-2224.
