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BACKGROUND: Increased breast cancer survivorship has prompted a focus on optimising quality of life for this cohort, including reintegration into employment. Despite this, there remains a lack of work-focused interventions to support work outcomes for women living with and beyond breast cancer. OBJECTIVE: The aim of this study was to prioritise the content and delivery of a work-focused intervention for women living with and beyond breast cancer. METHODS: Twelve stakeholders including women living with and beyond breast cancer, healthcare professionals, cancer support centre staff, and policy informers were invited to participate in an online discussion using the Nominal Group Technique (NGT) to determine priorities for a work-focused intervention. The NGT seeks consensus through four steps; (i) idea generation, (ii) discussion among the group, (iii) refining ideas, and (iv) ranking preference for ideas through anonymised voting. RESULTS: Intervention content prioritised included managing cancer-related symptoms and work-specific factors. Consensus was made for a blended delivery format (mix of group and individual sessions), and blended delivery (face-to-face and online). Findings indicated a preference for a six-week intervention, with 90–120 minute sessions. Community-based settings were preferred over hospital-based services for the setting of a work-focused intervention. Zoom Video Communications Inc. was the preferred setting to deliver an online intervention. CONCLUSION: Stakeholder priorities informed the content and delivery of a work-focused intervention for women with breast cancer. A pilot of the proposed intervention will be conducted to test for feasibility and acceptability.

Purpose: Breast cancer is the most common cancer in women worldwide. Increased survivorship has prompted a focus on re-integration into employment. Research therefore recommends the development and evaluation of interventions to support women with breast cancer in returning to work. Despite this, there remain few rehabilitation interventions to support this cohort in maintaining or returning to their work role. The aim of this study was to explore preferences for the content and delivery of a work-focused intervention for women living with and beyond breast cancer.Methods: Women living with and beyond breast cancer, healthcare professionals, and employers were invited to participate in a qualitative-descriptive study, using once-off semi-structured interviews, exploring preferences for content and delivery of a work-focused intervention. Interviews were recorded, transcribed, and data were analysed using thematic analysis. Results: Thirty-nine participants were recruited. Women living with and beyond breast cancer had varied opinions on whether the intervention should be group- or individual-based. This contrasts with healthcare professionals who preferred group-based interventions for pragmatic reasons. While there were mixed views on session length, most participants identified four-to-six weeks intervention duration. Participants discussed challenges in return-to-work including the impact of ongoing side-effects, employer-employee communication, and reduced awareness of employment entitlements and rights.Conclusion: A range of barriers and enablers in return-to-work post-breast cancer were highlighted and could inform the content of a work-focused intervention. Variations in viewpoints on intervention delivery underlines a no one-size-fits all approach in return-to-work support. Further research on the development of a work-focused intervention is warranted.

COVID-19 presents many challenges to healthcare systems internationally, none more so than the significant reporting among healthcare workers (HCWs) of occupational fatigue and burnout or Long COVID related symptoms. Consensus on the extent of HCW fatigue during the pandemic remains largely unknown, as levels of Long COVID related fatigue in HCWs appears to be on the rise. What is known is that, among current levels, impacts of fatigue on HCW well-being and performance is likely. Developing strategies to mitigate fatigue are the responsibilities of all healthcare system stakeholders. Leadership that goes beyond organisational efforts of mitigating fatigue through mandated working hour limits alone are needed. A process to facilitate identification, mitigation and prevention of fatigue is likely to be best suited in this regard. This might involve development of operational systems modelled off successful industries, such as aviation, for performance optimisation. These system-based designs provide the foundation for systematic yet innovative approaches to enable effective design of macro-level to micro-level interventions for fatigue mitigation. Shifts in organisational culture have occurred in healthcare since the onset of the pandemic, with increasing agility and embracing of innovation. Creating a culture whereby we recognise and support people in being malleable through a pandemic and beyond is at the level of leadership. Leveraging this cultural shift allows an opportunity for organisational change. One focus of such a leverage within systems could be the incorporation of the evidence-based practical recommendations informed by the authors of this paper.

BACKGROUND: Breast cancer is the most common invasive cancer in females worldwide. While work is important for well-being, 84% of women in Ireland temporarily or permanently cease working up to six months post-breast cancer diagnosis. Under Irish law, there is a right to reasonable work accommodations, however paid sick leave has only recently been state-mandated. Legislation internationally varies across nations. OBJECTIVE: The aim of this study was to explore the experiences of women who have had breast cancer returning to, and/or remaining in work, in the context of employment legislation. METHODS: Fifteen women with breast cancer, fifteen healthcare professionals, and nine employers nationwide participated in a qualitative-descriptive design, using semi-structured interviews. Interviews were audio-recorded, transcribed, and data analysed using thematic analysis. RESULTS: Thirty-nine participants were recruited. A prominent theme from interviews was that most women with breast cancer and healthcare professional cohorts were not aware of employment rights in the context of cancer diagnoses. This is in contrast to employers. Experiences of sick leave and pay entitlements varied amongst women with breast cancer with financial pressure and expediated the return to work evident for some participants. Most women did not report any discrimination on returning to the workplace, although there were examples of indirect discrimination where unfair expectations were being placed on women by colleagues. CONCLUSIONS: Education and awareness on employment rights and entitlements during and after cancer treatment is warranted. This could be incorporated into work-focused interventions to support those living with and beyond cancer to transition back into the workplace.

Purpose A recent paradigm-shift in patient care advocates for long-term recovery and quality of life in survivors of critical illness. Evidence suggests that occupational therapists in critical care can contribute to recovery in areas such as functional outcomes, length of stay and delirium, although poor role understanding can limit service-utilisation. The purpose of this study is to investigate current and future roles and practices of critical care occupational therapists in the UK. Design/methodology/approach Occupational therapists with clinical experience in adult critical care were invited to participate in a mixed-methods design using a locally developed online questionnaire and semi-structured interviews, concurrently. Descriptive statistics were generated through SPSS. Qualitative data were analysed using the framework approach. Findings Twelve occupational therapists participated in the survey element, with five continuing to interview. Occupational therapists described a multifaceted role in critical care where the majority reported practice in upper limb function, seating/positioning, cognition, psychosocial sequelae and discharge planning. Role and internal characteristics impacted on service delivery. It is envisaged that earlier intervention in a greater percentage of patients, a greater evidence-base, raising awareness and adequate staffing will be features for future development. Originality/value This study provides new insight into the current role and practices of adult critical care occupational therapists in England and generates insights into their role in addressing physical and non-physical morbidity for this patient cohort. Findings are preliminary in nature; however, future research is warranted to evaluate the effectiveness of interventions.

Background: There are an estimated 4.7 million with knee osteoarthritis (OA) and 2.1 million with hip osteoarthritis in the United Kingdom. Resources to manage OA within the National Health Service are limited. National Institute for Health and Care Excellence guidelines advocate education and self-management for all people with osteoarthritis. Most recently E-health programmes via the internet are being used to deliver health services and information. . Arthritis Australia & Osteoarthritis Research Society International developed Myjointpain.org to support Australians in self-managing hip and/or knee joint pain. There is currently no equivalent UK e-health resource.. This study explored the attitudes, facilitators and barriers towards using e-health by people self-managing hip/knee OA in the UK. Method: A qualitative design using semi-structured telephone interviews was used. Patient and public involvement (PPI) members were recruited via Nottingham City Hospital. PPI members were included if they had Hip and/or Knee joint pain and internet access. Each PPI member was provided with an information sheet and consent form. All consenting members received a link to the Myjointpain,org website and given XX days to practice using the programme. Participants were then contacted for a telephone interview. The interviews were transcribed and a six step thematic analysis used. This included (1) Reading/re-reading of transcript, (2) Coding interesting features of data, (3) Categorising codes into potential themes/subthemes, (4) Reviewing themes, (5) Defining themes, (6) Producing final report. Themes identified were independently verified. Results:. Twelve PPI members wre recruited and contributed to telephone interviews. Overall PPI members were open to using an e-health initiative to self-manage their joint pain; Facilitators that encouraged PPI members to use Myjointpain.org included: . the interactive nature of the e-health programme; the personalised action plan, and participatns’ preceived trustworthiness of the content of the website. ,However excess information was reported as a barrier of use, as well as finding time to use the website due to busy lifestyles. The use of email/telephone prompting was thought may help people better engage with on line self management programmes. .. Conclusion PPI members with hip and /or knee OA in the UK report that they are receptive and open to considering using the Myjointpain.org web based e learning self management programme. Such an approach that emphasises personalised and interactive aspects to facilitate self management helps promote engagement with self management. Prompting is helpful in maintaining engagement (e.g. via e-mail) and provision of too much information may prevent people from engaging with the programme. Myjointpain.org presents an exciting opportunity for e-health strategies for people with arthritis in the UK.