# The Relationship Between Patient Activation, Cancer-Related Symptoms, and Job Performance Among Young Adult Cancer Survivors with Low and High Workplace Support: A Cross-Sectional Observational Study

## TL;DR

This study shows that patient activation helps young adult cancer survivors maintain job performance, especially when workplace support is low.

## Contribution

The study reveals how patient activation mitigates the negative impact of cancer-related symptoms on job performance in the absence of workplace support.

## Key findings

- Patient activation was positively linked to job performance among survivors with low workplace support.
- Cancer-related symptoms negatively affected job performance only in the low workplace support group.
- Workplace support reduced the influence of patient activation and symptoms on job performance.

## Abstract

Optimal work outcomes were crucial for young adult cancer survivors due to the formative years of their careers. Maintaining job performance and pursuing employment among young adult cancer survivors reduced financial burden and obtained a sense of normality, thereby improving health-related quality of life. However, young adult cancer survivors would be at high risk of poor job performance due to cancer-related symptoms. Our study provides a deeper understanding of the protective role of workplace support and patient activation for the adverse effects of cancer-related symptoms on job performance among young adult cancer survivors. This study’s findings suggest that healthcare staff should first assess the workplace support received by young adult cancer survivors, and if the workplace support is insufficient, healthcare staff can enhance the survivors’ self-management skills to improve job performance.

Background/Objectives: Background: Cancer survivors were at higher risk of poor job performance. Objectives: We aimed to identify differences in the relationship between patient activation, cancer-related symptoms, and job performance among young adult cancer survivors with low and high workplace support. Methods: Study Design: Our cross-sectional observational study was conducted using an online survey across Japan in January 2022. Measurement and Statistical Analysis: The survey was designed to assess demographic and clinical characteristics, patient activation, physical fatigue, depression, cognitive impairments, and job performance. Multiple-group structural equation modeling (SEM) was conducted using data from 202 survivors. Results: Of participants, 53% were aged 35–39 years and 78% were female. Patient activation was positively associated with job performance (β = 0.28, p < 0.01) and negatively related to cancer-related symptoms (β = −0.30, p = 0.01), and cancer-related symptoms were negatively associated with job performance (β = −0.29, p = 0.01), only among young adult cancer survivors with low workplace support. On the other hand, in the high support group, the path coefficients from patient activation to cancer-related symptoms (β = −0.06, p = 0.76), cancer-related symptoms to job performance (β = −0.12, p = 0.37), and patient activation to job performance (β = 0.20, p = 0.21) were not significant. Conclusions: Patient activation plays an important role in improving job performance, especially among young adult cancer survivors who lack workplace support. Even if obtaining workplace support is difficult for young adult cancer survivors, activation of self-management can improve their job performance.