Health Literacy Supports Workforce Reintegration for Breast Cancer Survivors

By: Megan Garlapow, PhD

From: oncologynurseadvisor.com

Given the substantial impact of health literacy on return-to-work outcomes, healthcare providers should integrate educational interventions alongside psychological support strategies.

Survivors of breast cancer face significant challenges in returning to work, with fear of cancer recurrence playing a crucial role in their reintegration into the workforce, according to a study published in the Journal of Multidisciplinary Healthcare.

Health literacy served as a key mediator, partially mitigating the negative impact of recurrence-related anxiety on employment outcomes. In this study of 190 survivors of breast cancer, only 54.2% successfully resumed work, highlighting the substantial barriers to workforce participation following treatment. Structural equation modeling confirmed that health literacy positively correlated with return-to-work success (r, 0.315; P <.001), while fear of recurrence was negatively associated (r, −0.268; P <.001).

Among the surveyed patients, the average time from diagnosis to workforce reentry was 7.06±5.63 months, with 39.5% returning to full-time employment. A significant portion of survivors, 45.8%, had not resumed working, and 12.1% expressed no intention to do so. Most who returned to work engaged in mental labor (91.3%), with a reduction in work intensity (57.3%) but stable salary levels (57.3%). While some survivors experienced mild (43.7%) or no work stress (33.0%), many continued to face concerns about recurrence that hindered their professional reintegration.

Statistical analyses revealed that fear of cancer recurrence and health literacy were inversely related (r, −0.342; P <.001), reinforcing the importance of targeted interventions to improve patient knowledge and self-management skills. Structural equation modeling further demonstrated that health literacy partially mediated the relationship between fear of recurrence and return-to-work status (β, −0.024; P <.001), accounting for 21% of the total effect. These results suggest that enhancing health literacy could alleviate some of the psychological barriers preventing survivors from resuming employment.

Despite these insights, challenges remain in fully addressing the return-to-work process. While health literacy provides a pathway to mitigate fears of recurrence, its mediating role was only partial, indicating the need for additional measures of psychological and social support. Furthermore, this study’s cross-sectional design limits causal inferences, necessitating future longitudinal research to assess long-term employment trends and intervention efficacy. This study’s sample, drawn exclusively from Guangzhou, also restricts the generalizability of findings to broader populations.

Given the substantial impact of health literacy on return-to-work outcomes, healthcare providers should integrate educational interventions alongside psychological support strategies. Addressing fear of cancer recurrence through counseling, peer support programs, and workplace reintegration plans may further improve employment prospects for survivors. Tailored strategies that combine mental health resources with comprehensive health education can enhance workforce reentry and overall quality of life for breast cancer survivors.

“Health literacy serves as a mediator in the relationship between concerns about cancer recurrence and the likelihood of return to the workforce among breast cancer survivors,” said the authors. “Clinical caregivers should focus on the needs of patients and the impact of negative emotions, including fears of recurrence, on their well-being. Enhancing patients’ health literacy and developing intervention plans accordingly can help breast cancer survivors reintegrate into the workforce.”