# Qualitative insights into employment challenges faced by cancer patients and caregivers in a limited-resource country

## TL;DR

This study explores how cancer impacts employment for patients and caregivers in Jordan, highlighting systemic issues like poor leave policies and stigma.

## Contribution

The paper provides novel qualitative insights into employment challenges faced by cancer patients and caregivers in Jordan, a low-resource country.

## Key findings

- Rigid sick leave policies fail to accommodate the cyclical nature of cancer treatment.
- Workplace stigma and disclosure dilemmas lead to marginalization and altered relationships.
- Caregivers face employment conflicts and lack statutory leave protections.

## Abstract

Cancer significantly disrupts employment, particularly in low- and middle-income countries (LMICs) where labor protections and workplace accommodations are limited. Evidence from the Middle East and North Africa (MENA) region remains scarce, and no prior qualitative research in Jordan has examined how cancer affects employment for both patients and caregivers. This study explores the employment experiences of individuals affected by cancer in Jordan and identifies systemic, workplace, and interpersonal factors shaping work participation.

A qualitative descriptive design was used. Thirteen semi-structured interviews were conducted in Arabic with cancer patients, survivors, and caregivers recruited purposively from the King Hussein Cancer Center. Interviews were transcribed, translated into English, and analyzed using Braun and Clarke's reflexive thematic analysis. Trustworthiness was ensured through researcher triangulation, double-translation verification, reflexive memoing, and iterative coding.

Five themes captured the employment challenges faced by cancer-affected households: (1) rigid and insufficient sick leave provisions that fail to accommodate the prolonged and cyclical nature of cancer treatment; (2) workplace stigma and disclosure dilemmas, contributing to concealment, marginalization, or altered workplace relationships; (3) financial toxicity driven by lost income, transportation expenses, and debt accumulation; (4) limited workplace accommodations and health–job mismatches, particularly in manual and private-sector roles; and (5) the invisible burden on caregivers, who faced employment conflicts and lacked statutory caregiver leave. These findings reveal structural gaps in Jordan's labor policies and social protection systems.

Cancer patients and caregivers in Jordan experience substantial employment vulnerability shaped by inadequate leave policies, stigma, financial strain, and a lack of accommodations. Policy reforms: including extended medical leave, anti-discrimination protections, statutory caregiver leave, flexible work arrangements, and strengthened income-support mechanisms, are essential to improving the employment sustainability and wellbeing of cancer-affected households.