Cancer in childhood can have negative impact on career readiness

(Medical Xpress) -- Young adult survivors of childhood cancer often have problems maintaining jobs and relationships, researchers have found. A new study of childhood brain tumor survivors by disability researcher David Strauser, a professor of community health at the University of Illinois, suggests that a battle with cancer during a critical developmental period in middle childhood may negatively affect career readiness and achievement as an adult by compromising children’s development of an effective work personality.

The study has been accepted for publication in the journal Disability and Rehabilitation. Related research by the same author indicates that the developmental theory of work personality has broader implications than previously thought.

 Adult survivors of childhood cancer experience significant problems finding and keeping employment. In a study of young adult survivors of central nervous system cancer in childhood, Strauser found that people who experience the most employment problems were diagnosed between the ages of 6-13, the period known as the  “industry versus inferiority” stage in psychologist Erik Erikson’s model of psychosocial development.

During these years, children hone their self-concepts by mastering increasingly complex tasks. They also adopt behaviors and attitudes toward work that later enable them to function effectively – or ineffectively – in work environments as adults through social interaction and by observing role models in their home and school environments.

Being diagnosed and treated for cancer during that period may disrupt the developmental process, depriving children of social interaction and other opportunities that affect their career readiness and formation of an effective work personality, Strauser said.

“People learn to work, and they learn to value work,” Strauser said. “If you’ve never been around anyone who works or values work, you won’t learn to value it either.”

Using a 26-item Developmental Work Personality Scale that he developed, Strauser assessed 43 cancer survivors on behaviors, role models and tasks consistent with Erikson’s industry vs. inferiority developmental model. Using another tool, Strauser assessed the extent to which the cancer survivors’ career decisions were affected by confusion, anxiety, reluctance to commit and external conflict such as self-perception and input from others.

The study sample comprised young adults ages 18-30 who had been diagnosed with brain tumors during childhood. The average age of onset was 9 1/2 years, and participants had been away from treatment more than seven years on average.

Cancer survivors’ scores were compared to those of 295 college students that ranged in age from 18-23.

“Kids who were diagnosed before the age of 6 and after the age of 13 had higher work personality than the group that was diagnosed between the age of 6-12,” Strauser said. “Those diagnosed before age 6 had some stabilization in their cancer care by the time they began school. If they were diagnosed after 13, they were already past that critical period. When they were diagnosed in the age 6-12 range, that was when their involvement in school was disrupted, and they missed a lot of the social interaction and activities that would reinforce their work personality. So that was very supportive of our theory, too, that it’s a really critical age.”

Recent studies have found that many individuals who survive childhood cancer struggle with obtaining and maintaining employment as adults. Survivors of central nervous system (CNS) tumors – who have a higher prevalence of functional limitations and participation restrictions – are especially vulnerable to career and educational problems. They are 15 times less likely to work or attend school than their siblings and five times more likely to be unemployed than peers that did not have cancer. CNS cancer survivors also are more likely to quit jobs, be employed in lower-skill positions, be socially isolated and have problems identifying appropriate career and educational goals.

Until now, the work personality theory of vocational development has been used mainly in relation to workers with disabilities, but Strauser believes that it has broader implications, influencing career readiness and achievement in the non-disabled population as well.

In a related study, which appeared in the June issue of the Journal of Employment Counseling, Strauser and his co-authors found a positive relationship between work personality, work engagement and the amount of effort that college students invested in their academic work.

“We validated our notion that work personality is important and that it accounted for a significant portion of the variance in the amount of effort that non-disabled individuals reported putting into their studies,” Strauser said. “So it is an important construct for everybody. It was predictive” of higher levels of academic effort, particularly for male students.

Work personality was an important predictor of academic effort among female students as well, but work engagement – feelings of fulfillment, dedication and absorption – had an even greater impact on women’s academic effort.

The inventories developed for the research could be used to identify vocational behaviors such as task orientation that can compromise career success, Strauser said.

“So a person that’s not as high achieving, someone that is going to work at factories, manual labor or service-related jobs who might have trouble keeping those jobs because they don’t get along with people or because they have problems showing up to work on time, we can identify some of those deficiencies and design interventions to help them,” Strauser said.