Return to work of breast cancer survivors: toward an integrative and transactional conceptual model

PURPOSE: To propose a conceptual framework of the return to work (RTW) of breast cancer survivors (BCS) according to the transactional perspective. METHODS: The Technique for Research of Information by Animation of a Group of Experts was implemented. For each determinant in an initial list established from the literature, experts selected for the consensus exercise were firstly asked to indicate their agreement level individually, via an online questionnaire. Determinants obtaining an agreement level of 80% or over during this first phase were retained. Determinants obtaining an agreement level below 80%, and additional determinants proposed by the experts, were then discussed collectively. After discussion, experts voted via a new online questionnaire to retain (or not) each determinant. Determinants obtaining an agreement level of 80% or over after this second phase were retained. Based on the determinants selected, a conceptual model was developed following the transactional approach. RESULTS: Eleven experts participated in the study. Forty of the 51 determinants listed initially from the literature achieved an agreement level over 80%, and 20 were added after the individual consultation phase. Twenty-two of the 31 determinants discussed collectively were retained. In total, 62 determinants were selected to construct the conceptual model. CONCLUSIONS: This integrative, operational, and transactional conceptual model of the RTW of BCS, constructed following an expert consensus, will help to design more efficient patient-centered intervention studies. IMPLICATIONS FOR CANCER SURVIVORS: Identification of the 62 determinants associated with the RTW of BCS will help design tools that are easily used by all stakeholders involved in the RTW process.