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Using transitions theory to examine approaches for individuals who are returning to work after cancer treatment (ON TRACK study)

Study Lead
Study Lead
Assistant Professor
Michael Brundage, MSc, FRCPC, MD, Department of Oncology, Queen's University; Radiation Oncologist, Kingston Regional Cancer Centre
Shaila Merchant, MD, Assistant Professor, Queen’s University; Surgical Oncologist, Kingston Health Sciences Centre
Sania Sahi BScH Student
Deanne McArthur RN(EC) MScN, PhD Student
Danielle Kain, MD, Assistant Professor, School of Medicine, Queen’s University; Palliative care physician, Kingston Health Science Centre
Christopher M. Booth, MD, FRCPC; Departments of Oncology and Medicine, Queen's University; Medical Oncologist, Clinician-Scientist, Cancer Centre of Southeastern Ontario
Knowledge Users
Hamza Noor, Certified Vocational Rehabilitation Professional
Debora Stark, Registered Social Worker

What?   Meleis’ Transitions Theory (TT) is useful to explain the complex interrelated factors present in any transition. Individuals who have completed cancer treatment face unique challenges, such as financial toxicity as well as emotional and overall distress that impacts decisions to forgo recommended post-treatment care. These – in addition to other concerns already experienced in the first year after treatment - may inhibit a successful transition to pre-cancer functioning. To explore this transition further, we used mixed-methods to examine TT concepts personal meanings, socioeconomic status, knowledge and preparation, as well as social supports.  Thereafter, we evaluate a TT-aligned mindfulness-based intervention to support post-treatment cancer survivors to return to their pre-cancer functioning, specifically their return to work.


Why?   Nearly half of Canadians will develop cancer in their lifetime.  The financial burden of cancer treatment is significant (i.e., annual household income is 26.5% lower among Canadians with cancer) and affects the decisions individuals make regarding their follow up care.  Return to work is, therefore, a priority outcome in post-treatment recovery. This study will generate some of the first empirical data to help guide the creation and implementation of resources to meet the needs of individuals returning to work following cancer treatment. 


How?  This two-phase sequential mixed methods study involves participants who have undergone treatment for breast or colorectal cancer.  First-phase cross-sectional surveys will be followed by qualitative interviews to expand on how and why the elements of Transition (i.e., feeling connected, personal meaning) affect mastery of return to work with quantitative data informing the interview questions. Phase two involves the implementation of a TT-aligned mindfulness-based intervention with interviews to evaluate efficacy in terms of supporting transition conditions that facilitate return to work.


Impact of findings:  Results will illuminate how TT concepts and aligned mindfulness intervention can support mastery of return to work post cancer treatment.  Our interdisciplinary study team is strengthened by the presence of a person who has lived experience returning to work post cancer treatment as well as a rehabilitation specialist who can promote the translation of our findings into practice. Finally, the online nature of the intervention can overcome geographic obstacles to obtaining this support, particularly for working individuals.



Funded By
SSHRC Insight Development Grant
Amy Wickenden, Patient Representative
Rachel Koven, Caregiver Representative