The role of the general practitioner in return to work after cancer—a systematic review

The role of the general practitioner in return to work after cancer—a systematic review Abstract Background The number of cancer patients and survivors of working age is increasing. General Practitioners (GPs) may have a significant role in psychosocial cancer care, including work-related concerns. Therefore, we performed a systematic literature review to identify the role of the GP in work-related concerns and integration/reintegration into work of cancer patients and/or survivors. Methods We searched PubMed, Embase, Cinahl, PsycINFO and Cochrane Library, irrespective of study design. We found 4863 articles and, after removing duplicates, we screened 3388 articles by title and abstract and reviewed 66 of these in full text. The Critical Appraisal Skills Programme tool was used to assess the methodological quality of included articles. We used narrative synthesis to describe the role of the GP. Results We included four qualitative studies from three countries. Two of these studies focused on the health care professionals’ perspectives and two studies focused on patients’ perspectives regarding the role of the GP. Lack of communication between health care professionals, lack of knowledge about work-related concerns and limited resources were recurring themes in these papers. Fully establishing the role of the GP is difficult given the small number of studies on work-related concerns in cancer patients in primary care. Conclusion There is little evidence regarding the role of the general practitioner in cancer care and work guidance. Therefore, further research should focus on the role that is desired for GPs and on interventions to study the feasibility of GP involvement in the return to work of cancer patients and/or survivors. Cancer, employment, General Practitioner, survival, oncology, work Introduction Worldwide, 14 million people are diagnosed with cancer each year and this number will only increase in decades to come (1). As a result of improved treatments and health care (1), the number of cancer survivors is also expected to rise and many cancer survivors are of working age. Although numerous cancer survivors among the working population consider work as a form of social recovery (2), they experience problems with either keeping their professional positions or reintegrating after treatment (3). Participating in the labour market, specifically for this group, is a major factor influencing their quality of life. It is important not only for financial reasons, but also to reduce social isolation and increase self-esteem (4). Previous research from Europe and Japan describes the importance of considering physicians’, surgeons’ and oncologists’ advice on return to work after or during treatment for cancer (5–8). General Practitioners (GPs) would also be particularly well-suited to support patients and survivors in the follow-up of psychosocial care during and after cancer (9), including support with integration and reintegration into work. GPs know the patients and their (work) environment very well and have contact with all other health care professionals. Furthermore, the Dutch Health Council and the Dutch Cancer Foundation have both recommended greater GP involvement to enhance survivorship care, including advice, support and information concerning reintegration into labour (10,11). There are four phases in the cancer trajectory where guidance regarding return to work (RTW) could be desirable: diagnosis, treatment, rehabilitation and follow-up (12). It is likely that, in every phase, there is a role for different health care professionals (HCP), including GPs, and that communication between the various HCPs in this process is essential (13). Return to work is a relatively unexplored area in general practice. Previous research (14,15) on awareness of work-related problems in general practice and the role of the GP in work-related problems found that GPs are aware of the relationship between work and health. Nonetheless, GPs needed greater knowledge and better communication and cooperation with other HCPs in order to play an active role in RTW. Also, this research concentrated on work-related health concerns of cancer patients, rather than the consequences of whether or not they are able to work, and the possible role of GPs in supporting cancer patients and survivors. The aim of this paper is, therefore, to perform a systematic literature review in order to identify the role of the GP in work-related concerns and the reintegration into work of cancer patients and/or survivors. Methods Search strategy and selection of articles This systematic review was conducted according to the Preferred Reporting Items for Systematic reviews and meta-Analyses (PRISMA) statement guidelines (16). Inclusion criteria were: original studies and review articles (both quantitative and qualitative) describing the role of the GP in cancer care and integration/reintegration into work, cancer patients or survivors of cancer in adulthood aged ≥ 18, cancer patients or survivors who were employed or self-employed at the time of diagnosis, and articles published between January 2000 and December 2016. We used the same inclusion criteria for title and abstract (TIABS) screening as well as for full-text screening. We chose the year 2000 as a date limit because the work field of a general practitioner has changed over time, with increasing emphasis on supporting patients in psychosocial issues. There were no restrictions with regard to language. We used the following databases to perform our search: PubMed, Embase, Cinahl, PsycINFO and Cochrane Library. In these databases, we used three groups of keywords or synonyms and Medical Subject Headings (MeSH) terms combined with ‘OR’: general practitioner/family physician, cancer and work. The keywords and/or synonyms were combined with ‘AND’. The full search string is shown in Appendix 1. The database search was conducted by a professional librarian (FvE), together with the primary author (FdJ). After removing duplicates, the titles and abstracts of the retrieved articles were screened independently by two authors (FdJ and AdB or KvA), and the full-text articles were screened. Differences were resolved through discussion and, where necessary, through review by a third or fourth author (AdB, KvA or MFD), resulting in agreement on all included articles. Quality assessment To evaluate the methodological quality of the included articles, we used the Critical Appraisal Skills Programme (CASP) (17) tool. Two reviewers (FdJ and AdB or KvA) independently assessed the quality according to the CASP tool. Differences in opinion were resolved through discussion, if necessary, with a third author (AdB or KvA). If there was discussion, we described our arguments after the rating. Data extraction Data were categorized by the following criteria: study characteristics (primary author, year of publication, country); study type (e.g. RCT, observational, qualitative, etc.); sample (e.g. type of professional, survivor stage) and sample size. Further categorization was made using gender, age, response rate and type of cancer, where this information was available. As all the studies were qualitative, one author (FdJ) first extracted the data, and a second author (AdB) verified the data to make sure the extraction was carried out correctly. We focused on specific results regarding the GP’s role or relevant opinions of patients and former patients about GPs, also focusing on the communication between GPs and other HCPs. In addition to this, we gave a summary of the aim and the outcome of every study included, again focusing on GPs. Finally, we formulated the authors’ suggestions for improvement for GPs and/or improvements in general practice and combined these outcomes in the results section in order to give an overall conclusion. Results We identified 4863 articles from the database search, and after removing duplicates, 3388 articles were initially screened based on title and abstract. Of these articles, 66 studies were selected to be screened based on full text. After the full-text screening, four articles (18–21) met our inclusion criteria and were included in the systematic review. The study selection process, according to the PRISMA flowchart, as well as the arguments for excluding the remaining 62 articles is shown in Figure 1. Figure 1. View largeDownload slide Article selection according to the Preferred Reporting Items for Systematic reviews and meta-Analyses (PRISMA) (16) Flow Diagram. Figure 1. View largeDownload slide Article selection according to the Preferred Reporting Items for Systematic reviews and meta-Analyses (PRISMA) (16) Flow Diagram. All four articles report the results of qualitative research, and the study methods in all four articles were in-depth interviews. Two of the articles (18,20) represented the perspectives of patients and the other two (19,21) represented the views of HCPs. The countries where the research was carried out were the UK (18,19), Germany (20) and Canada (21). Three studies were written in English (18,19,21) and one study in German (20). Bains et al. (19) interviewed 18 HCPs, including two GPs. The HCPs treated at least one colorectal cancer patient who was an employee at the time of diagnosis. There was data saturation after the 18 interviews. The participating HCPs were interviewed face-to-face in their own workplace. The questions aimed to explore the work-related guidance given by these different HCPs to colorectal cancer patients, from point of diagnosis up to end of treatment, including how the guidance given during this period could be improved. Morrison et al. (21) also conducted interviews in person with 10 HCPs, including five GPs. While this study was carried out in Canada, two GPs were American. To guide the questions, the interviewer used vignettes on specific topics to explore the perspectives of these physicians on supporting cancer survivors with their concerns regarding work and return to work. Amir et al. (18) focused on the views of cancer survivors 3 years post diagnosis. Interviews were conducted by telephone with 41 patients and former patients presenting 16 different types of cancer. The aim of the authors was to investigate how this population has returned to work after diagnosis. One of the main themes in this study is medical advice regarding work, including advice given by the GP. Böttcher et al. (20) carried out a qualitative study by interviewing 32 cancer patients who were admitted to a cancer rehabilitation clinic. The patients were all admitted to the same clinic, and had survived different types of cancer. The authors conducted semi-structured interviews to be able to analyse the expectations of patients towards getting back to work and how work-related therapies from different HCPs may be helpful. Further characteristics of the studies, such as sample information and types of cancer, are shown in Table 1. Table 1. Data extraction from included articles: study characteristics, such as author, year, country, study type and sample, context and type of cancer Primary author; Year published Country Study type* Sample▲ Time and context Sample size; mean age; age range; % female; response rate Type of cancer Health care professionals’ view Bains; 2012 (19) UK Qualitative: semi- structured interviews face-to-face Health care professionals: 2 GPs, 5 surgeons, 3 oncologists, 3 special nurses, 3 OHPs, 2 OH-nurses Interview: face-to-face at participants’ work place. Duration: 15–40 minutes. 18 physicians (2 GPs); 46. 5 years; 34–57 years; 44% female; response rate not reported (saturation after 18 interviews) Colorectal cancer Morrison; 2015 (21) Canada Qualitative: vignette method, face-to-face interviews Health care professionals: 5 oncologists and 5 GPs. Interview: face-to-face at time and location convenient to participant. Duration: approximately 160 minutes. 10 physicians (5 GPs); NR; 39–59 years; 40% oncologist females, 0% of the GPs was female; response rate was not reported Not reported Patients’ view Amir; 2008 (18) UK Qualitative: interviews by telephone Cancer survivors three years post diagnosis Interview: telephone interview at time of convenience of participant. Duration: 30–100 minutes (average: 60 minutes). 41 patients; NR; 26–55 years; 59% female; 65% response rate 16 different types of cancer Böttcher; 2012 (20) Germany Qualitative: semi- structured interviews in person Cancer patients in rehabilitation setting Interview: face-to-face at rehabilitation centre (31) and in research institute (1). Duration: 30–105 minutes (average: 53 minutes). 32 patients; mean female age is 49.5 years, mean male age is 48,4 years; 69% female; response rate not reported Male patients: gastrointestinal cancer, female patients: breast cancer or ovarian/ uterine cancer Primary author; Year published Country Study type* Sample▲ Time and context Sample size; mean age; age range; % female; response rate Type of cancer Health care professionals’ view Bains; 2012 (19) UK Qualitative: semi- structured interviews face-to-face Health care professionals: 2 GPs, 5 surgeons, 3 oncologists, 3 special nurses, 3 OHPs, 2 OH-nurses Interview: face-to-face at participants’ work place. Duration: 15–40 minutes. 18 physicians (2 GPs); 46. 5 years; 34–57 years; 44% female; response rate not reported (saturation after 18 interviews) Colorectal cancer Morrison; 2015 (21) Canada Qualitative: vignette method, face-to-face interviews Health care professionals: 5 oncologists and 5 GPs. Interview: face-to-face at time and location convenient to participant. Duration: approximately 160 minutes. 10 physicians (5 GPs); NR; 39–59 years; 40% oncologist females, 0% of the GPs was female; response rate was not reported Not reported Patients’ view Amir; 2008 (18) UK Qualitative: interviews by telephone Cancer survivors three years post diagnosis Interview: telephone interview at time of convenience of participant. Duration: 30–100 minutes (average: 60 minutes). 41 patients; NR; 26–55 years; 59% female; 65% response rate 16 different types of cancer Böttcher; 2012 (20) Germany Qualitative: semi- structured interviews in person Cancer patients in rehabilitation setting Interview: face-to-face at rehabilitation centre (31) and in research institute (1). Duration: 30–105 minutes (average: 53 minutes). 32 patients; mean female age is 49.5 years, mean male age is 48,4 years; 69% female; response rate not reported Male patients: gastrointestinal cancer, female patients: breast cancer or ovarian/ uterine cancer *all types of articles could be included; e.g. RCT, observational, qualitative ▲ e.g. kind of professionals, survivor stage View Large Table 1. Data extraction from included articles: study characteristics, such as author, year, country, study type and sample, context and type of cancer Primary author; Year published Country Study type* Sample▲ Time and context Sample size; mean age; age range; % female; response rate Type of cancer Health care professionals’ view Bains; 2012 (19) UK Qualitative: semi- structured interviews face-to-face Health care professionals: 2 GPs, 5 surgeons, 3 oncologists, 3 special nurses, 3 OHPs, 2 OH-nurses Interview: face-to-face at participants’ work place. Duration: 15–40 minutes. 18 physicians (2 GPs); 46. 5 years; 34–57 years; 44% female; response rate not reported (saturation after 18 interviews) Colorectal cancer Morrison; 2015 (21) Canada Qualitative: vignette method, face-to-face interviews Health care professionals: 5 oncologists and 5 GPs. Interview: face-to-face at time and location convenient to participant. Duration: approximately 160 minutes. 10 physicians (5 GPs); NR; 39–59 years; 40% oncologist females, 0% of the GPs was female; response rate was not reported Not reported Patients’ view Amir; 2008 (18) UK Qualitative: interviews by telephone Cancer survivors three years post diagnosis Interview: telephone interview at time of convenience of participant. Duration: 30–100 minutes (average: 60 minutes). 41 patients; NR; 26–55 years; 59% female; 65% response rate 16 different types of cancer Böttcher; 2012 (20) Germany Qualitative: semi- structured interviews in person Cancer patients in rehabilitation setting Interview: face-to-face at rehabilitation centre (31) and in research institute (1). Duration: 30–105 minutes (average: 53 minutes). 32 patients; mean female age is 49.5 years, mean male age is 48,4 years; 69% female; response rate not reported Male patients: gastrointestinal cancer, female patients: breast cancer or ovarian/ uterine cancer Primary author; Year published Country Study type* Sample▲ Time and context Sample size; mean age; age range; % female; response rate Type of cancer Health care professionals’ view Bains; 2012 (19) UK Qualitative: semi- structured interviews face-to-face Health care professionals: 2 GPs, 5 surgeons, 3 oncologists, 3 special nurses, 3 OHPs, 2 OH-nurses Interview: face-to-face at participants’ work place. Duration: 15–40 minutes. 18 physicians (2 GPs); 46. 5 years; 34–57 years; 44% female; response rate not reported (saturation after 18 interviews) Colorectal cancer Morrison; 2015 (21) Canada Qualitative: vignette method, face-to-face interviews Health care professionals: 5 oncologists and 5 GPs. Interview: face-to-face at time and location convenient to participant. Duration: approximately 160 minutes. 10 physicians (5 GPs); NR; 39–59 years; 40% oncologist females, 0% of the GPs was female; response rate was not reported Not reported Patients’ view Amir; 2008 (18) UK Qualitative: interviews by telephone Cancer survivors three years post diagnosis Interview: telephone interview at time of convenience of participant. Duration: 30–100 minutes (average: 60 minutes). 41 patients; NR; 26–55 years; 59% female; 65% response rate 16 different types of cancer Böttcher; 2012 (20) Germany Qualitative: semi- structured interviews in person Cancer patients in rehabilitation setting Interview: face-to-face at rehabilitation centre (31) and in research institute (1). Duration: 30–105 minutes (average: 53 minutes). 32 patients; mean female age is 49.5 years, mean male age is 48,4 years; 69% female; response rate not reported Male patients: gastrointestinal cancer, female patients: breast cancer or ovarian/ uterine cancer *all types of articles could be included; e.g. RCT, observational, qualitative ▲ e.g. kind of professionals, survivor stage View Large Methodological quality All four articles clearly stated the aim of the research, and for all the articles, a qualitative methodology was an appropriate method to achieve the research goal. Furthermore, all four studies took ethics into consideration, and there was a clear statement of findings. We gave all articles a moderate-high score in being valuable to current knowledge. Less clear was the relationship between researcher and participant. Only one study (21) gave some attention to this relationship in the discussion of the article. Furthermore, the authors included a very small sample size due to the fact that this was a pilot study. A complete overview of the assessment according to the CASP tool is shown in Table 2. Table 2. Quality assessment according to the Critical Appraisal Skills Programme Included study Bains et al. Morrison et al. Amir et al. Böttcher et al. Quality criteria 1. Was there a clear statement of the aims of the research? YES YES YES YES 2. Is a qualitative methodology appropriate? YES YES YES YES 3. Was the research design appropriate to address the aims of the research? YES: goal is to explore involvement of HCPs, so this is a good design YES: good design for achieving the goal of research YES: interviews by telephone, but referred to literature as being valid for this research design YES 4. Was the recruitment strategy appropriate to the aims of the research? YES: treating at least 1 colorectal cancer patient employed at diagnosis, ensured accurate recall of information provided CAN’T TELL: oncologists all from the same department; not clear what the relationship is between the GPs; not explained why these participants were selected YES CAN’T TELL: all patients from same clinic, no clear explanation of how participants were selected 5. Was the data collected in a way that addressed the research issue? YES: the only thing missing was whether there had been any modification of the method YES YES: although the one point the researchers did not mention is saturation of the data YES 6. Has the relationship between researcher and participants been adequately considered? CAN’T TELL: not reported YES CAN’T TELL: not reported CAN’T TELL: not reported 7. Have ethical issues been taken into consideration? YES YES YES YES: informed consent, not clear about approval from ethics committee 8. Was the data analysis sufficiently rigorous? YES CAN’T TELL: no clear explanation of what themes were found in this research and whether these Vignettes were implicating a theme already YES YES 9. Is there a clear statement of findings? YES YES YES YES 10. How valuable is the research? (++ | + | +/- | -| --) + + + + Included study Bains et al. Morrison et al. Amir et al. Böttcher et al. Quality criteria 1. Was there a clear statement of the aims of the research? YES YES YES YES 2. Is a qualitative methodology appropriate? YES YES YES YES 3. Was the research design appropriate to address the aims of the research? YES: goal is to explore involvement of HCPs, so this is a good design YES: good design for achieving the goal of research YES: interviews by telephone, but referred to literature as being valid for this research design YES 4. Was the recruitment strategy appropriate to the aims of the research? YES: treating at least 1 colorectal cancer patient employed at diagnosis, ensured accurate recall of information provided CAN’T TELL: oncologists all from the same department; not clear what the relationship is between the GPs; not explained why these participants were selected YES CAN’T TELL: all patients from same clinic, no clear explanation of how participants were selected 5. Was the data collected in a way that addressed the research issue? YES: the only thing missing was whether there had been any modification of the method YES YES: although the one point the researchers did not mention is saturation of the data YES 6. Has the relationship between researcher and participants been adequately considered? CAN’T TELL: not reported YES CAN’T TELL: not reported CAN’T TELL: not reported 7. Have ethical issues been taken into consideration? YES YES YES YES: informed consent, not clear about approval from ethics committee 8. Was the data analysis sufficiently rigorous? YES CAN’T TELL: no clear explanation of what themes were found in this research and whether these Vignettes were implicating a theme already YES YES 9. Is there a clear statement of findings? YES YES YES YES 10. How valuable is the research? (++ | + | +/- | -| --) + + + + View Large Table 2. Quality assessment according to the Critical Appraisal Skills Programme Included study Bains et al. Morrison et al. Amir et al. Böttcher et al. Quality criteria 1. Was there a clear statement of the aims of the research? YES YES YES YES 2. Is a qualitative methodology appropriate? YES YES YES YES 3. Was the research design appropriate to address the aims of the research? YES: goal is to explore involvement of HCPs, so this is a good design YES: good design for achieving the goal of research YES: interviews by telephone, but referred to literature as being valid for this research design YES 4. Was the recruitment strategy appropriate to the aims of the research? YES: treating at least 1 colorectal cancer patient employed at diagnosis, ensured accurate recall of information provided CAN’T TELL: oncologists all from the same department; not clear what the relationship is between the GPs; not explained why these participants were selected YES CAN’T TELL: all patients from same clinic, no clear explanation of how participants were selected 5. Was the data collected in a way that addressed the research issue? YES: the only thing missing was whether there had been any modification of the method YES YES: although the one point the researchers did not mention is saturation of the data YES 6. Has the relationship between researcher and participants been adequately considered? CAN’T TELL: not reported YES CAN’T TELL: not reported CAN’T TELL: not reported 7. Have ethical issues been taken into consideration? YES YES YES YES: informed consent, not clear about approval from ethics committee 8. Was the data analysis sufficiently rigorous? YES CAN’T TELL: no clear explanation of what themes were found in this research and whether these Vignettes were implicating a theme already YES YES 9. Is there a clear statement of findings? YES YES YES YES 10. How valuable is the research? (++ | + | +/- | -| --) + + + + Included study Bains et al. Morrison et al. Amir et al. Böttcher et al. Quality criteria 1. Was there a clear statement of the aims of the research? YES YES YES YES 2. Is a qualitative methodology appropriate? YES YES YES YES 3. Was the research design appropriate to address the aims of the research? YES: goal is to explore involvement of HCPs, so this is a good design YES: good design for achieving the goal of research YES: interviews by telephone, but referred to literature as being valid for this research design YES 4. Was the recruitment strategy appropriate to the aims of the research? YES: treating at least 1 colorectal cancer patient employed at diagnosis, ensured accurate recall of information provided CAN’T TELL: oncologists all from the same department; not clear what the relationship is between the GPs; not explained why these participants were selected YES CAN’T TELL: all patients from same clinic, no clear explanation of how participants were selected 5. Was the data collected in a way that addressed the research issue? YES: the only thing missing was whether there had been any modification of the method YES YES: although the one point the researchers did not mention is saturation of the data YES 6. Has the relationship between researcher and participants been adequately considered? CAN’T TELL: not reported YES CAN’T TELL: not reported CAN’T TELL: not reported 7. Have ethical issues been taken into consideration? YES YES YES YES: informed consent, not clear about approval from ethics committee 8. Was the data analysis sufficiently rigorous? YES CAN’T TELL: no clear explanation of what themes were found in this research and whether these Vignettes were implicating a theme already YES YES 9. Is there a clear statement of findings? YES YES YES YES 10. How valuable is the research? (++ | + | +/- | -| --) + + + + View Large Perspectives The summary of aims, outcomes and implications of both the physicians’ and patients’ perspectives is shown in Table 3. Table 3. Data extraction from included articles: aims, outcomes and improvements Primary author; Year published Study aim Study outcome—GP related Suggestion for improvement in cancer(after)care in general practice Health care professionals’ view Bains; 2012 (19) Qualitative study to explore when (if any) advice is given to cancer patients about work / returning to work and whether HCPs require any support in providing work-related guidance. Work-related guidance given to patients is not systematic, perhaps due to the absence of guidelines. Communication between HCPs seemed to be the problem: HCPs assumed that another professional was responsible for work-related advice and so they all referred to each other. Developing guidance for providers about RTW and impacts of cancer upon work. GPs are not mentioned separately in either the conclusion or the suggestions for further research/ further implications. Morrison; 2015 (21) To explore physicians’ perspectives on supporting cancer survivors’ work integration concerns. Physicians did not consider work-related concerns to be part of their training or their mandate of care. They completed insurance forms when asked, but physicians did not routinely provide unsolicited work-related advice. This study concluded that HCPs should not provide advice on matters beyond their areas of expertise. To raise physicians’ awareness of work-related issues, GPs-in-training and oncologists-in-training could be trained in the work-related concerns of cancer patients. Consensus of which HCP is responsible for WI should be reached. Further, this article pointed out that an ideal remedy would be to make a multidisciplinary survivorship support team accessible. Patients’ view Amir; 2008 (18) Qualitative study to explore how people have returned to work after cancer. Few people declared that they received any advice regarding return to work. Where GPs gave advice, they told patients: ‘go back when you feel ready’. Suggestions are made for further research examining the role of employers, line managers and occupational health professionals. However, GPs are not mentioned again in this article. The authors suggest that there is a role for specialist nurses to provide support in RTW and to communicate with the multidisciplinary team with all HCPs. Böttcher; 2012 (20) Analyse the expectations of patients towards RTW and how helpful they estimate the work-related therapies provided during rehabilitation to be in this respect. Nearly half of the patients felt they needed information about RTW and the majority would go to the GP for this information. Further, the authors did not distinguish between the specific roles of the different HCPs. There are no specific suggestions or advice for GPs and RTW in cancer patients. Primary author; Year published Study aim Study outcome—GP related Suggestion for improvement in cancer(after)care in general practice Health care professionals’ view Bains; 2012 (19) Qualitative study to explore when (if any) advice is given to cancer patients about work / returning to work and whether HCPs require any support in providing work-related guidance. Work-related guidance given to patients is not systematic, perhaps due to the absence of guidelines. Communication between HCPs seemed to be the problem: HCPs assumed that another professional was responsible for work-related advice and so they all referred to each other. Developing guidance for providers about RTW and impacts of cancer upon work. GPs are not mentioned separately in either the conclusion or the suggestions for further research/ further implications. Morrison; 2015 (21) To explore physicians’ perspectives on supporting cancer survivors’ work integration concerns. Physicians did not consider work-related concerns to be part of their training or their mandate of care. They completed insurance forms when asked, but physicians did not routinely provide unsolicited work-related advice. This study concluded that HCPs should not provide advice on matters beyond their areas of expertise. To raise physicians’ awareness of work-related issues, GPs-in-training and oncologists-in-training could be trained in the work-related concerns of cancer patients. Consensus of which HCP is responsible for WI should be reached. Further, this article pointed out that an ideal remedy would be to make a multidisciplinary survivorship support team accessible. Patients’ view Amir; 2008 (18) Qualitative study to explore how people have returned to work after cancer. Few people declared that they received any advice regarding return to work. Where GPs gave advice, they told patients: ‘go back when you feel ready’. Suggestions are made for further research examining the role of employers, line managers and occupational health professionals. However, GPs are not mentioned again in this article. The authors suggest that there is a role for specialist nurses to provide support in RTW and to communicate with the multidisciplinary team with all HCPs. Böttcher; 2012 (20) Analyse the expectations of patients towards RTW and how helpful they estimate the work-related therapies provided during rehabilitation to be in this respect. Nearly half of the patients felt they needed information about RTW and the majority would go to the GP for this information. Further, the authors did not distinguish between the specific roles of the different HCPs. There are no specific suggestions or advice for GPs and RTW in cancer patients. View Large Table 3. Data extraction from included articles: aims, outcomes and improvements Primary author; Year published Study aim Study outcome—GP related Suggestion for improvement in cancer(after)care in general practice Health care professionals’ view Bains; 2012 (19) Qualitative study to explore when (if any) advice is given to cancer patients about work / returning to work and whether HCPs require any support in providing work-related guidance. Work-related guidance given to patients is not systematic, perhaps due to the absence of guidelines. Communication between HCPs seemed to be the problem: HCPs assumed that another professional was responsible for work-related advice and so they all referred to each other. Developing guidance for providers about RTW and impacts of cancer upon work. GPs are not mentioned separately in either the conclusion or the suggestions for further research/ further implications. Morrison; 2015 (21) To explore physicians’ perspectives on supporting cancer survivors’ work integration concerns. Physicians did not consider work-related concerns to be part of their training or their mandate of care. They completed insurance forms when asked, but physicians did not routinely provide unsolicited work-related advice. This study concluded that HCPs should not provide advice on matters beyond their areas of expertise. To raise physicians’ awareness of work-related issues, GPs-in-training and oncologists-in-training could be trained in the work-related concerns of cancer patients. Consensus of which HCP is responsible for WI should be reached. Further, this article pointed out that an ideal remedy would be to make a multidisciplinary survivorship support team accessible. Patients’ view Amir; 2008 (18) Qualitative study to explore how people have returned to work after cancer. Few people declared that they received any advice regarding return to work. Where GPs gave advice, they told patients: ‘go back when you feel ready’. Suggestions are made for further research examining the role of employers, line managers and occupational health professionals. However, GPs are not mentioned again in this article. The authors suggest that there is a role for specialist nurses to provide support in RTW and to communicate with the multidisciplinary team with all HCPs. Böttcher; 2012 (20) Analyse the expectations of patients towards RTW and how helpful they estimate the work-related therapies provided during rehabilitation to be in this respect. Nearly half of the patients felt they needed information about RTW and the majority would go to the GP for this information. Further, the authors did not distinguish between the specific roles of the different HCPs. There are no specific suggestions or advice for GPs and RTW in cancer patients. Primary author; Year published Study aim Study outcome—GP related Suggestion for improvement in cancer(after)care in general practice Health care professionals’ view Bains; 2012 (19) Qualitative study to explore when (if any) advice is given to cancer patients about work / returning to work and whether HCPs require any support in providing work-related guidance. Work-related guidance given to patients is not systematic, perhaps due to the absence of guidelines. Communication between HCPs seemed to be the problem: HCPs assumed that another professional was responsible for work-related advice and so they all referred to each other. Developing guidance for providers about RTW and impacts of cancer upon work. GPs are not mentioned separately in either the conclusion or the suggestions for further research/ further implications. Morrison; 2015 (21) To explore physicians’ perspectives on supporting cancer survivors’ work integration concerns. Physicians did not consider work-related concerns to be part of their training or their mandate of care. They completed insurance forms when asked, but physicians did not routinely provide unsolicited work-related advice. This study concluded that HCPs should not provide advice on matters beyond their areas of expertise. To raise physicians’ awareness of work-related issues, GPs-in-training and oncologists-in-training could be trained in the work-related concerns of cancer patients. Consensus of which HCP is responsible for WI should be reached. Further, this article pointed out that an ideal remedy would be to make a multidisciplinary survivorship support team accessible. Patients’ view Amir; 2008 (18) Qualitative study to explore how people have returned to work after cancer. Few people declared that they received any advice regarding return to work. Where GPs gave advice, they told patients: ‘go back when you feel ready’. Suggestions are made for further research examining the role of employers, line managers and occupational health professionals. However, GPs are not mentioned again in this article. The authors suggest that there is a role for specialist nurses to provide support in RTW and to communicate with the multidisciplinary team with all HCPs. Böttcher; 2012 (20) Analyse the expectations of patients towards RTW and how helpful they estimate the work-related therapies provided during rehabilitation to be in this respect. Nearly half of the patients felt they needed information about RTW and the majority would go to the GP for this information. Further, the authors did not distinguish between the specific roles of the different HCPs. There are no specific suggestions or advice for GPs and RTW in cancer patients. View Large Physicians’ perspectives Bains et al. (19) identified two themes, both with several subthemes. The first theme is ‘information used by providers to address work matters with patients’, divided into four subthemes. Bains et al. found that GPs are willing to give sick notes, but that they do not give special advice with the sick notes. One GP found that specialist nurses were considered to be the best HCP to discuss RTW, since every cancer patient has frequent contact with their cancer nurses. However, these nurses thought that giving advice on RTW is something that would preferably be done by the GP. This indicated that there was lack of communication between the HCPs. The second main theme, ‘obstacles in providing work-related information to patients’, described other difficulties apart from communication, such as a lack of knowledge and limited resources. For example, one GP said the following about knowledge on cancer and return to work concerns and division of tasks: “I tend to give as much information as I can, within my limitations. I will not be commenting about something I don’t know a lot about.” (from (19)) Overall, Bains concludes that work-related guidance is not systematically a subject of conversation and support in all the different HCP groups. Morrison et al. (21) found three different themes. The first is ‘the challenge of considering and providing advice for matters beyond expertise’. Several GPs thought that there are professionals who are more suitably trained in handling work integration concerns than themselves, with occupational health physicians (OHPs) being a key referral for work-related questions. However, some of them did not refer to OHPs because of questions regarding availability and insurance coverage: “We have occupational therapy available, but I do not think that it’s covered through Manitoba Health.” Morrison et al. mentioned that a collaborative team approach was identified as ideal. One GP said: “They should have an OHP assess their ability to work […] and then from a medical standpoint if there are medications that were required to manage pain or nausea, or something like that, then that would be my role.” The second theme, ‘the burden of insurance gatekeeping’, referred to the fact that physicians did not spontaneously discuss RTW, but patients brought it up, mostly because of insurance benefits. Physicians completed insurance forms as part of routine care, but some physicians complained about the large volume of forms and interference with their role as company doctor or caregiver: However, the insurance forms can trigger tension in the physician-patient relationship. “The physician is faced with this constant conflict of the bad guy: go back to work, versus the good guy: cure the cancer. It’s a constant conflict with these forms.” The final theme was ‘the tension between medical advice and guidance for living with the effect of cancer diagnosis and treatment’. GPs in this study believed that advising cancer survivors on RTW is not part of their mandate of care. For instance: “I don’t think they see that as the task of their primary care physician […] as far as RTW is concerned, I think they see that as coming from their oncologist.” However, oncologists in this study did not feel that this care fell under their area of expertise. When patients asked for advice on RTW, physicians gave general information, such as information about sequelae of treatment (e.g. fatigue) and realistic expectations of altered performance. Patients’ perspectives Amir et al. (18) found five different central themes in his qualitative study with cancer patients. Of these themes, one was related to ‘medical advice regarding work’. The authors reported that only a few participants said that they received any worthwhile medical advice from either their cancer care team or their GP concerning RTW. GPs generally give the following advice: “My GP said: Go back when you feel ready” Böttcher et al. (19) aimed to analyse the expectations of these participants towards RTW and their opinions about work-related therapies provided during rehabilitation. This study found that nearly half of the participants felt that they needed information about integration or reintegration into work. Of these patients, two-thirds would go to a GP and the remainder would go to a specialist for guidance. This article further indicated that the rehabilitation period is the perfect time to discuss RTW problems with these survivors, but the authors did not distinguish between different HCPs. Discussion Through this systematic review, we aimed to identify the role of the general practitioner in work-related concerns and integration/reintegration into work of cancer patients and/or survivors. During the search and selection of the articles, we found that there is little literature regarding the role of the General Practitioner when it comes to cancer patients and work or returning to work, either in their current role or in a role that is desirable for the future. We did identify several studies describing the role of the GP in cancer aftercare, especially the psychosocial aspects (9,22–24) but in none of these articles was advice on work-related concerns mentioned as part of psychosocial care or guidance. Regarding the role of the GP, a qualitative study from the Netherlands (25) concluded that colon cancer patients see some benefit in greater GP involvement to improve survivorship care. Possible benefits of greater GP involvement include better accessibility of care and additional guidance. Participants considered an increased workload for the already busy GP as a disadvantage. Requirements for greater GP involvement were assurance of sufficient knowledge and expertise of the GP and easy access to secondary care. These issues are similar to the provision of psychosocial care regarding work-related concerns as found in this review and should be addressed. A qualitative study conducting in-depth interviews with breast and prostate cancer survivors from the USA (9) reported that survivors believed there was a role for primary care in cancer follow-up care. Patients especially suggested the opportunity to provide follow-up medical care when ‘enough time had passed’ or when the survivors felt that they could reintegrate into the non-cancer population (9). This would be particularly significant for the role of the GP regarding work-related concerns because these concerns become most relevant when patients want to reintegrate into society. Some research has been performed on the role of the GP in providing advice to solve work-related problems in general. De Kock et al. (14,15) concluded that GPs are aware of their important role in work-related problems, but that they sometimes lack knowledge about this topic. However, this study did not focus on cancer patients and did not distinguish between work-related problems caused by illness, such as cancer, and problems caused by the nature of the work itself, or in returning to work. Moßhammer et al. (26) focused on the cooperation between a GP and an occupational health physician (OHP). They concluded that cooperation between them is necessary (but the authors did not define a role for the GP regarding work) and that GPs as well as OHPs consider their individual working fields as separate from one another. This lack of collaboration between these two physicians does not benefit the patients and might hamper the holistic view. Our systematic review describes the views of GPs and patients internationally, but every country has its own guidelines or culture on how (re)integration into is arranged. In the Netherlands, for example, cancer patients will get an appointment with an OHP a few weeks after diagnosis, as long as they are in paid employment. Self-employed patients do not have the opportunity to go to an OHP. In other countries, such as the UK and Canada, GPs are responsible for sick notes or fit notes. The fact that this type of care is arranged differently in different countries makes it harder to generalize our findings to other countries. Strengths and limitations One of our strengths is that we performed a thorough, systematic and detailed search of all existing literature. Although we used a date limit, we are positive that we included all existing articles, because we hand-searched the references of all relevant articles and the oldest article was published in 2008 without new references before that date. Despite this, there were only four articles that could answer our research question. Furthermore, all four studies were qualitative studies, and we were therefore not able to quantify any data on this topic. The included studies scored moderately high on the methodological quality assessment. However, a limitation of the study by Morrison et al. (21) is the number of participants included in the interviews, without being assured of data saturation. The authors mention in their discussion that this qualitative article is a pilot and part of a larger multistage study. Another limitation is the sample selection in the study by Böttcher et al. (20). The authors selected their participants from a single rehabilitation clinic for cancer patients. This results in a too narrowly selected sample, even if there were data saturation. In general, there was limited information about GPs in the articles, compared to other HCPs, either because only a few GPs were included (19,21), or because of the fact that GPs were mentioned less by patients/former patients compared to oncologists, nurses and/or occupational health physicians (18,20). Implications for research and practice Recommendations for further research include more qualitative research on the role of the GP in cancer care/after care including RTW, and if possible, quantitative research to support these perspectives and opinions with facts and figures. Further research should focus on the needs and desires of patients, survivors and GPs to improve RTW guidance in general practice. At the same time, communication between the different HCPs involved in the cancer process, from diagnosis to aftercare, needs to be improved so that HCPs do not assume that their colleagues have already discussed RTW or that they both do it in different ways. Further to this, the needs of patients in paid employment may be different from those of self-employed patients. A possible solution could be found by speeding up the process of information sharing, preferably with easy access, for instance by telephone. Currently, HCPs are referring to each other the responsibility for RTW guidance for cancer patients. Furthermore, when GPs do give advice on RTW, they are not consistent in their information and they lack information from specialists in the hospital. This communication or teamwork should be improved. Future research on the value of involvement of GPs in RTW could change the perspective of HCPs with regard to their own responsibilities. Establishing clarification about the contribution and the mandate that GPs could have in this process, would enable HCPs to agree on their responsibility and formalise it. Conclusion There is little evidence in the literature about the current role of the GP regarding cancer patients and work. Possible reasons for this lack of research into the role of the GP are a lack of skills or knowledge, a lack of consensus on the role of different HCPs on RTW advice, and a lack of guidelines to advise patients with consistency. Agreement on the roles of the different HCPs in different settings (e.g. hospital, family practice, occupational health institutes) is a prerequisite for improvement in order for cancer patients and former cancer patients to be able to discuss work-related problems. The implication of our study is that interventions are needed to improve communication between GPs and other HCPs concerning work-related problems and the reintegration into work of cancer patients and survivors in different phases of cancer treatment. These interventions should also include guidance about RTW in each treatment phase, and focus on the information and education GPs need in order to be able to support cancer patients and survivors in solving their work-related problems in relation to their illness. In addition to this, self-employed patients are often at a disadvantage because they do not have an OPH. Yet these patients could benefit from advice on RTW from their GP. Better communication between the different HCPs, and clarification on shared responsibilities concerning RTW, can lead to better quality patient care, and efficient and effective working practice for all HCPs. Declaration Funding: This work was supported by Pink Ribbon Foundation grant PR 2014–191 PS60. 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Google Scholar Crossref Search ADS PubMed Appendix 1 Search strategy MEDLINE (Ovid) # Searches 1 *physicians/ or general practitioners/ or general practice/ or family practice/ or physicians, family/ or physicians, primary care/ or Primary Health Care/ or Physician's Role/ 2 (family adj2 (practi* or medicine or physician*)).ti,ab,kw. 3 (primary adj2 (care or treatment or practi* or medicine or physician*)).ti,ab,kw. 4 (general adj2 (practi* or physician*)).ti,ab,kw. 5 (doctor* or GP or GPs).ti,ab,kw. 6 1 or 2 or 3 or 4 or 5 7 exp Neoplasms/ or (cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*).ti,ab,kw. 8 exp work/ or return to work/ or exp employment/ or unemployment/ or exp occupations/ or workplace/ or Rehabilitation, Vocational/ or Sick Leave/ or Absenteeism/ or Retirement/ or Workers' Compensation/ or (work or job or occupation* or employment or unemployment or unemployed or employability or reemployment or re-employment or freelance* or employee* or working status or workload or working age or working population* or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence).ti,ab,kw. or ((work* or employ* or vocational) adj1 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*)).ti,ab,kw. 9 exp Counseling/ or Vocational Guidance/ or role/ or professional role/ or physician's role/ or social support/ or "Continuity of Patient Care"/ or Practice Patterns, Physicians'/ or Person-Centered Therapy/ or Adaptation, Psychological/ or (counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*).ti,ab,kw. or ((role* or activit*) adj2 (physician* or doctor* or primary care or general practi* or family practi* or general medical practi* or family medical practi* or family medicine or GP or GPs)).ti,ab,kw. or (physician* adj3 attitude*).ti,ab,kw. 10 (adolescent/ or exp child/ or exp Pediatrics/ or (child* or adolescen* or p?ediatric*).ti,ab,kw.) not (Adult/ or adult*.ti,ab,kw.) 11 comment/ or editorial/ or letter/ or news/ or (editorial* or comment* or letter*).ti,ab,kw. 12 (6 and 7 and 8 and 9) not 10 not 11 13 limit 12 to yr = "2000 -Current" # Searches 1 *physicians/ or general practitioners/ or general practice/ or family practice/ or physicians, family/ or physicians, primary care/ or Primary Health Care/ or Physician's Role/ 2 (family adj2 (practi* or medicine or physician*)).ti,ab,kw. 3 (primary adj2 (care or treatment or practi* or medicine or physician*)).ti,ab,kw. 4 (general adj2 (practi* or physician*)).ti,ab,kw. 5 (doctor* or GP or GPs).ti,ab,kw. 6 1 or 2 or 3 or 4 or 5 7 exp Neoplasms/ or (cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*).ti,ab,kw. 8 exp work/ or return to work/ or exp employment/ or unemployment/ or exp occupations/ or workplace/ or Rehabilitation, Vocational/ or Sick Leave/ or Absenteeism/ or Retirement/ or Workers' Compensation/ or (work or job or occupation* or employment or unemployment or unemployed or employability or reemployment or re-employment or freelance* or employee* or working status or workload or working age or working population* or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence).ti,ab,kw. or ((work* or employ* or vocational) adj1 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*)).ti,ab,kw. 9 exp Counseling/ or Vocational Guidance/ or role/ or professional role/ or physician's role/ or social support/ or "Continuity of Patient Care"/ or Practice Patterns, Physicians'/ or Person-Centered Therapy/ or Adaptation, Psychological/ or (counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*).ti,ab,kw. or ((role* or activit*) adj2 (physician* or doctor* or primary care or general practi* or family practi* or general medical practi* or family medical practi* or family medicine or GP or GPs)).ti,ab,kw. or (physician* adj3 attitude*).ti,ab,kw. 10 (adolescent/ or exp child/ or exp Pediatrics/ or (child* or adolescen* or p?ediatric*).ti,ab,kw.) not (Adult/ or adult*.ti,ab,kw.) 11 comment/ or editorial/ or letter/ or news/ or (editorial* or comment* or letter*).ti,ab,kw. 12 (6 and 7 and 8 and 9) not 10 not 11 13 limit 12 to yr = "2000 -Current" View Large MEDLINE (Ovid) # 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Searches 1 *physician/ or general practitioner/ or general practice/ or exp primary health care/ or family medicine/ 2 (family adj2 (practi* or medicine or physician*)).ti,ab,kw. 3 (primary adj2 (care or treatment or practi* or medicine or physician*)).ti,ab,kw. 4 (general adj2 (practi* or physician*)).ti,ab,kw. 5 (doctor* or GP or GPs).ti,ab,kw. 6 1 or 2 or 3 or 4 or 5 7 exp *neoplasm/ or (cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*).ti,ab,kw. 8 exp work/ or return to work/ or exp employment/ or unemployment/ or employer/ or employability/ or vocational rehabilitation/ or work resumption/ or medical leave/ or absenteeism/ or retirement/ or workman compensation/ or (work or job or employment or unemployment or unemployed or employability or reemployment or re-employment or freelance* or employee or employees or employer or working status or workload or working age or working population or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence).ti,ab,kw. or ((work* or employ* or vocational) adj (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehabilitation)).ti,ab,kw. 9 exp counseling/ or vocational guidance/ or *physician attitude/ or social support/ or (counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*).ti,ab,kw. or ((role* or activit*) adj2 (physician* or doctor* or primary care or general practi* or family practi* or general medical practi* or family medical practi* or family medicine or GP or GPs)).ti,ab,kw. or (physician* adj3 attitude*).ti,ab,kw. 10 (adolescent/ or child/ or exp pediatrics/ or (child* or adolescen* or p?ediatric*).ti,ab,kw.) not (adult/ or adult*.ti,ab,kw.) 11 editorial/ or letter/ or (editorial* or comment* or letter*).ti,ab,kw. 12 (6 and 7 and 8 and 9) not 10 not 11 13 limit 12 to yr = "2000 -Current" # Searches 1 *physician/ or general practitioner/ or general practice/ or exp primary health care/ or family medicine/ 2 (family adj2 (practi* or medicine or physician*)).ti,ab,kw. 3 (primary adj2 (care or treatment or practi* or medicine or physician*)).ti,ab,kw. 4 (general adj2 (practi* or physician*)).ti,ab,kw. 5 (doctor* or GP or GPs).ti,ab,kw. 6 1 or 2 or 3 or 4 or 5 7 exp *neoplasm/ or (cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*).ti,ab,kw. 8 exp work/ or return to work/ or exp employment/ or unemployment/ or employer/ or employability/ or vocational rehabilitation/ or work resumption/ or medical leave/ or absenteeism/ or retirement/ or workman compensation/ or (work or job or employment or unemployment or unemployed or employability or reemployment or re-employment or freelance* or employee or employees or employer or working status or workload or working age or working population or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence).ti,ab,kw. or ((work* or employ* or vocational) adj (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehabilitation)).ti,ab,kw. 9 exp counseling/ or vocational guidance/ or *physician attitude/ or social support/ or (counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*).ti,ab,kw. or ((role* or activit*) adj2 (physician* or doctor* or primary care or general practi* or family practi* or general medical practi* or family medical practi* or family medicine or GP or GPs)).ti,ab,kw. or (physician* adj3 attitude*).ti,ab,kw. 10 (adolescent/ or child/ or exp pediatrics/ or (child* or adolescen* or p?ediatric*).ti,ab,kw.) not (adult/ or adult*.ti,ab,kw.) 11 editorial/ or letter/ or (editorial* or comment* or letter*).ti,ab,kw. 12 (6 and 7 and 8 and 9) not 10 not 11 13 limit 12 to yr = "2000 -Current" View Large EMBASE (Ovid) # Searches 1 *physician/ or general practitioner/ or general practice/ or exp primary health care/ or family medicine/ 2 (family adj2 (practi* or medicine or physician*)).ti,ab,kw. 3 (primary adj2 (care or treatment or practi* or medicine or physician*)).ti,ab,kw. 4 (general adj2 (practi* or physician*)).ti,ab,kw. 5 (doctor* or GP or GPs).ti,ab,kw. 6 1 or 2 or 3 or 4 or 5 7 exp *neoplasm/ or (cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*).ti,ab,kw. 8 exp work/ or return to work/ or exp employment/ or unemployment/ or employer/ or employability/ or vocational rehabilitation/ or work resumption/ or medical leave/ or absenteeism/ or retirement/ or workman compensation/ or (work or job or employment or unemployment or unemployed or employability or reemployment or re-employment or freelance* or employee or employees or employer or working status or workload or working age or working population or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence).ti,ab,kw. or ((work* or employ* or vocational) adj (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehabilitation)).ti,ab,kw. 9 exp counseling/ or vocational guidance/ or *physician attitude/ or social support/ or (counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*).ti,ab,kw. or ((role* or activit*) adj2 (physician* or doctor* or primary care or general practi* or family practi* or general medical practi* or family medical practi* or family medicine or GP or GPs)).ti,ab,kw. or (physician* adj3 attitude*).ti,ab,kw. 10 (adolescent/ or child/ or exp pediatrics/ or (child* or adolescen* or p?ediatric*).ti,ab,kw.) not (adult/ or adult*.ti,ab,kw.) 11 editorial/ or letter/ or (editorial* or comment* or letter*).ti,ab,kw. 12 (6 and 7 and 8 and 9) not 10 not 11 13 limit 12 to yr = "2000 -Current" # Searches 1 *physician/ or general practitioner/ or general practice/ or exp primary health care/ or family medicine/ 2 (family adj2 (practi* or medicine or physician*)).ti,ab,kw. 3 (primary adj2 (care or treatment or practi* or medicine or physician*)).ti,ab,kw. 4 (general adj2 (practi* or physician*)).ti,ab,kw. 5 (doctor* or GP or GPs).ti,ab,kw. 6 1 or 2 or 3 or 4 or 5 7 exp *neoplasm/ or (cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*).ti,ab,kw. 8 exp work/ or return to work/ or exp employment/ or unemployment/ or employer/ or employability/ or vocational rehabilitation/ or work resumption/ or medical leave/ or absenteeism/ or retirement/ or workman compensation/ or (work or job or employment or unemployment or unemployed or employability or reemployment or re-employment or freelance* or employee or employees or employer or working status or workload or working age or working population or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence).ti,ab,kw. or ((work* or employ* or vocational) adj (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehabilitation)).ti,ab,kw. 9 exp counseling/ or vocational guidance/ or *physician attitude/ or social support/ or (counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*).ti,ab,kw. or ((role* or activit*) adj2 (physician* or doctor* or primary care or general practi* or family practi* or general medical practi* or family medical practi* or family medicine or GP or GPs)).ti,ab,kw. or (physician* adj3 attitude*).ti,ab,kw. 10 (adolescent/ or child/ or exp pediatrics/ or (child* or adolescen* or p?ediatric*).ti,ab,kw.) not (adult/ or adult*.ti,ab,kw.) 11 editorial/ or letter/ or (editorial* or comment* or letter*).ti,ab,kw. 12 (6 and 7 and 8 and 9) not 10 not 11 13 limit 12 to yr = "2000 -Current" View Large PsycINFO (Ovid) # Searches 1 physicians/ or family physicians/ or general practitioners/ or family medicine/ or primary health care/ or (physician* or doctor* or primary care or general practi* or family practi* or general medical practi* or family medical practi* or family medicine or GP or GPs).ti,ab,id. 2 (family adj3 (practi* or medicine or physician*)).ti,ab,id. 3 (primary adj2 (care or treatment or practi* or medicine or physician*)).ti,ab,id. 4 (general adj2 (practi* or physician*)).ti,ab,id. 5 1 or 2 or 3 or 4 6 exp neoplasms/ or oncology/ or (cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*).ti,ab,id. # Searches 1 physicians/ or family physicians/ or general practitioners/ or family medicine/ or primary health care/ or (physician* or doctor* or primary care or general practi* or family practi* or general medical practi* or family medical practi* or family medicine or GP or GPs).ti,ab,id. 2 (family adj3 (practi* or medicine or physician*)).ti,ab,id. 3 (primary adj2 (care or treatment or practi* or medicine or physician*)).ti,ab,id. 4 (general adj2 (practi* or physician*)).ti,ab,id. 5 1 or 2 or 3 or 4 6 exp neoplasms/ or oncology/ or (cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*).ti,ab,id. View Large PsycINFO (Ovid) # Searches 1 physicians/ or family physicians/ or general practitioners/ or family medicine/ or primary health care/ or (physician* or doctor* or primary care or general practi* or family practi* or general medical practi* or family medical practi* or family medicine or GP or GPs).ti,ab,id. 2 (family adj3 (practi* or medicine or physician*)).ti,ab,id. 3 (primary adj2 (care or treatment or practi* or medicine or physician*)).ti,ab,id. 4 (general adj2 (practi* or physician*)).ti,ab,id. 5 1 or 2 or 3 or 4 6 exp neoplasms/ or oncology/ or (cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*).ti,ab,id. # Searches 1 physicians/ or family physicians/ or general practitioners/ or family medicine/ or primary health care/ or (physician* or doctor* or primary care or general practi* or family practi* or general medical practi* or family medical practi* or family medicine or GP or GPs).ti,ab,id. 2 (family adj3 (practi* or medicine or physician*)).ti,ab,id. 3 (primary adj2 (care or treatment or practi* or medicine or physician*)).ti,ab,id. 4 (general adj2 (practi* or physician*)).ti,ab,id. 5 1 or 2 or 3 or 4 6 exp neoplasms/ or oncology/ or (cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*).ti,ab,id. View Large PsycINFO (Ovid) # Searches 7 reemployment/ or exp vocational rehabilitation/ or exp employment status/ or retirement/ or unemployment/ or employability/ or working women/ or exp working conditions/ or work-life balance/ or work load/ or work scheduling/ or occupations/ 8 (work or job or occupation* or vocation* or employ* or unemploy* or reemploy* or re-employ* or freelance* or working status or workload or working age or working population or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence).ti,ab,id. 9 ((work* or employ* or vocational) adj3 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehabilitation)).ti,ab,id. 10 7 or 8 or 9 11 exp counseling/ or exp counselors/ or counselor role/ or rehabilitation counseling/ or exp occupational guidance/ or exp coaching/ or roles/ or counselor role/ or exp professional role/ or exp role expectations/ or role perception/ or role taking/ or therapist role/ or professional role/ or roles/ or counselor role/ or exp therapist attitudes/ or role perception/ or exp professional role/ or role taking/ or exp roles/ 12 (counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*).ti,ab,id. 13 ((role* or activit*) adj2 (physician* or doctor* or primary care or general practi* or family practi* or general medical practi* or family medical practi* or family medicine or GP or GPs)).ti,ab,id. 14 (physician* adj3 attitude*).ti,ab,id. 15 11 or 12 or 13 or 14 16 (exp pediatrics/ or (child* or adolescen* or p?ediatric*).ti,ab,id.) not adult*.ti,ab,id. 17 (5 and 6 and 10 and 15) not 16 18 limit 17 to yr = "2000 -Current" # Searches 7 reemployment/ or exp vocational rehabilitation/ or exp employment status/ or retirement/ or unemployment/ or employability/ or working women/ or exp working conditions/ or work-life balance/ or work load/ or work scheduling/ or occupations/ 8 (work or job or occupation* or vocation* or employ* or unemploy* or reemploy* or re-employ* or freelance* or working status or workload or working age or working population or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence).ti,ab,id. 9 ((work* or employ* or vocational) adj3 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehabilitation)).ti,ab,id. 10 7 or 8 or 9 11 exp counseling/ or exp counselors/ or counselor role/ or rehabilitation counseling/ or exp occupational guidance/ or exp coaching/ or roles/ or counselor role/ or exp professional role/ or exp role expectations/ or role perception/ or role taking/ or therapist role/ or professional role/ or roles/ or counselor role/ or exp therapist attitudes/ or role perception/ or exp professional role/ or role taking/ or exp roles/ 12 (counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*).ti,ab,id. 13 ((role* or activit*) adj2 (physician* or doctor* or primary care or general practi* or family practi* or general medical practi* or family medical practi* or family medicine or GP or GPs)).ti,ab,id. 14 (physician* adj3 attitude*).ti,ab,id. 15 11 or 12 or 13 or 14 16 (exp pediatrics/ or (child* or adolescen* or p?ediatric*).ti,ab,id.) not adult*.ti,ab,id. 17 (5 and 6 and 10 and 15) not 16 18 limit 17 to yr = "2000 -Current" View Large PsycINFO (Ovid) # Searches 7 reemployment/ or exp vocational rehabilitation/ or exp employment status/ or retirement/ or unemployment/ or employability/ or working women/ or exp working conditions/ or work-life balance/ or work load/ or work scheduling/ or occupations/ 8 (work or job or occupation* or vocation* or employ* or unemploy* or reemploy* or re-employ* or freelance* or working status or workload or working age or working population or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence).ti,ab,id. 9 ((work* or employ* or vocational) adj3 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehabilitation)).ti,ab,id. 10 7 or 8 or 9 11 exp counseling/ or exp counselors/ or counselor role/ or rehabilitation counseling/ or exp occupational guidance/ or exp coaching/ or roles/ or counselor role/ or exp professional role/ or exp role expectations/ or role perception/ or role taking/ or therapist role/ or professional role/ or roles/ or counselor role/ or exp therapist attitudes/ or role perception/ or exp professional role/ or role taking/ or exp roles/ 12 (counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*).ti,ab,id. 13 ((role* or activit*) adj2 (physician* or doctor* or primary care or general practi* or family practi* or general medical practi* or family medical practi* or family medicine or GP or GPs)).ti,ab,id. 14 (physician* adj3 attitude*).ti,ab,id. 15 11 or 12 or 13 or 14 16 (exp pediatrics/ or (child* or adolescen* or p?ediatric*).ti,ab,id.) not adult*.ti,ab,id. 17 (5 and 6 and 10 and 15) not 16 18 limit 17 to yr = "2000 -Current" # Searches 7 reemployment/ or exp vocational rehabilitation/ or exp employment status/ or retirement/ or unemployment/ or employability/ or working women/ or exp working conditions/ or work-life balance/ or work load/ or work scheduling/ or occupations/ 8 (work or job or occupation* or vocation* or employ* or unemploy* or reemploy* or re-employ* or freelance* or working status or workload or working age or working population or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence).ti,ab,id. 9 ((work* or employ* or vocational) adj3 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehabilitation)).ti,ab,id. 10 7 or 8 or 9 11 exp counseling/ or exp counselors/ or counselor role/ or rehabilitation counseling/ or exp occupational guidance/ or exp coaching/ or roles/ or counselor role/ or exp professional role/ or exp role expectations/ or role perception/ or role taking/ or therapist role/ or professional role/ or roles/ or counselor role/ or exp therapist attitudes/ or role perception/ or exp professional role/ or role taking/ or exp roles/ 12 (counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*).ti,ab,id. 13 ((role* or activit*) adj2 (physician* or doctor* or primary care or general practi* or family practi* or general medical practi* or family medical practi* or family medicine or GP or GPs)).ti,ab,id. 14 (physician* adj3 attitude*).ti,ab,id. 15 11 or 12 or 13 or 14 16 (exp pediatrics/ or (child* or adolescen* or p?ediatric*).ti,ab,id.) not adult*.ti,ab,id. 17 (5 and 6 and 10 and 15) not 16 18 limit 17 to yr = "2000 -Current" View Large COCHRANE LIBRARY ID Search #1 MeSH descriptor: [Physicians] this term only #2 MeSH descriptor: [General Practitioners] explode all trees #3 MeSH descriptor: [General Practice] explode all trees #4 MeSH descriptor: [Family Practice] explode all trees #5 MeSH descriptor: [Physicians, Family] explode all trees #6 MeSH descriptor: [Physicians, Primary Care] explode all trees #7 MeSH descriptor: [Primary Health Care] explode all trees #8 MeSH descriptor: [Physician's Role] explode all trees #9 family near/2 (practi* or medicine or physician*):ti,ab,kw (Word variations have been searched) #10 primary near/2 (care or treatment or practi* or medicine or physician*):ti,ab,kw (Word variations have been searched) #11 general near/2 (practi* or physician*):ti,ab,kw (Word variations have been searched) #12 doctor* or GP or GPs or physician*:ti,ab,kw (Word variations have been searched) #13 #1 r #2 or #3 or #4 or #5 or #6 or #7 or #8 or #9 or #10 or #11 or #12 #14 MeSH descriptor: [Neoplasms] explode all trees #15 cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*:ti,ab,kw (Word variations have been searched) #16 #14 or #15 #17 MeSH descriptor: [Work] explode all trees #18 MeSH descriptor: [Employment] explode all trees #19 MeSH descriptor: [Occupations] explode all trees #20 MeSH descriptor: [Rehabilitation, Vocational] explode all trees #21 MeSH descriptor: [Sick Leave] explode all trees #22 MeSH descriptor: [Absenteeism] explode all trees #23 MeSH descriptor: [Retirement] explode all trees #24 MeSH descriptor: [Workers' Compensation] explode all trees #25 work or job or occupation* or employment or unemployment or unemployed or employability or reemployment or re-employment or freelance* or employee* or working status or workload or working age or working population* or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence:ti,ab,kw (Word variations have been searched) #26 (work* or employ* or vocation*) near/3 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*):ti,ab,kw (Word variations have been searched) #27 #17 or #18 or #19 or #20 or #21 or #22 or #23 or #24 or #25 or #26 #28 MeSH descriptor: [Counseling] explode all trees #29 MeSH descriptor: [Vocational Guidance] explode all trees #30 MeSH descriptor: [Role] explode all trees #31 MeSH descriptor: [Physician's Role] explode all trees #32 MeSH descriptor: [Social Support] explode all trees #33 MeSH descriptor: [Continuity of Patient Care] explode all trees #34 MeSH descriptor: [Practice Patterns, Physicians'] explode all trees #35 MeSH descriptor: [Person-Centered Therapy] explode all trees #36 MeSH descriptor: [Adaptation, Psychological] explode all trees #37 counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*:ti,ab,kw (Word variations have been searched) #38 (role* or activit*) near/3 (physician* or doctor* or primary care or general practi* or family practi* or general medical practi* or family medical practi* or family medicine or GP or GPs):ti,ab,kw (Word variations have been searched) #39 #28 or #29 or #30 or #31 or #32 or #33 or #34 or #35 or #36 or #37 or #38 #40 #13 and #16 and #27 and #39 Publication Year from 2000 to 2016 ID Search #1 MeSH descriptor: [Physicians] this term only #2 MeSH descriptor: [General Practitioners] explode all trees #3 MeSH descriptor: [General Practice] explode all trees #4 MeSH descriptor: [Family Practice] explode all trees #5 MeSH descriptor: [Physicians, Family] explode all trees #6 MeSH descriptor: [Physicians, Primary Care] explode all trees #7 MeSH descriptor: [Primary Health Care] explode all trees #8 MeSH descriptor: [Physician's Role] explode all trees #9 family near/2 (practi* or medicine or physician*):ti,ab,kw (Word variations have been searched) #10 primary near/2 (care or treatment or practi* or medicine or physician*):ti,ab,kw (Word variations have been searched) #11 general near/2 (practi* or physician*):ti,ab,kw (Word variations have been searched) #12 doctor* or GP or GPs or physician*:ti,ab,kw (Word variations have been searched) #13 #1 r #2 or #3 or #4 or #5 or #6 or #7 or #8 or #9 or #10 or #11 or #12 #14 MeSH descriptor: [Neoplasms] explode all trees #15 cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*:ti,ab,kw (Word variations have been searched) #16 #14 or #15 #17 MeSH descriptor: [Work] explode all trees #18 MeSH descriptor: [Employment] explode all trees #19 MeSH descriptor: [Occupations] explode all trees #20 MeSH descriptor: [Rehabilitation, Vocational] explode all trees #21 MeSH descriptor: [Sick Leave] explode all trees #22 MeSH descriptor: [Absenteeism] explode all trees #23 MeSH descriptor: [Retirement] explode all trees #24 MeSH descriptor: [Workers' Compensation] explode all trees #25 work or job or occupation* or employment or unemployment or unemployed or employability or reemployment or re-employment or freelance* or employee* or working status or workload or working age or working population* or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence:ti,ab,kw (Word variations have been searched) #26 (work* or employ* or vocation*) near/3 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*):ti,ab,kw (Word variations have been searched) #27 #17 or #18 or #19 or #20 or #21 or #22 or #23 or #24 or #25 or #26 #28 MeSH descriptor: [Counseling] explode all trees #29 MeSH descriptor: [Vocational Guidance] explode all trees #30 MeSH descriptor: [Role] explode all trees #31 MeSH descriptor: [Physician's Role] explode all trees #32 MeSH descriptor: [Social Support] explode all trees #33 MeSH descriptor: [Continuity of Patient Care] explode all trees #34 MeSH descriptor: [Practice Patterns, Physicians'] explode all trees #35 MeSH descriptor: [Person-Centered Therapy] explode all trees #36 MeSH descriptor: [Adaptation, Psychological] explode all trees #37 counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*:ti,ab,kw (Word variations have been searched) #38 (role* or activit*) near/3 (physician* or doctor* or primary care or general practi* or family practi* or general medical practi* or family medical practi* or family medicine or GP or GPs):ti,ab,kw (Word variations have been searched) #39 #28 or #29 or #30 or #31 or #32 or #33 or #34 or #35 or #36 or #37 or #38 #40 #13 and #16 and #27 and #39 Publication Year from 2000 to 2016 View Large COCHRANE LIBRARY ID Search #1 MeSH descriptor: [Physicians] this term only #2 MeSH descriptor: [General Practitioners] explode all trees #3 MeSH descriptor: [General Practice] explode all trees #4 MeSH descriptor: [Family Practice] explode all trees #5 MeSH descriptor: [Physicians, Family] explode all trees #6 MeSH descriptor: [Physicians, Primary Care] explode all trees #7 MeSH descriptor: [Primary Health Care] explode all trees #8 MeSH descriptor: [Physician's Role] explode all trees #9 family near/2 (practi* or medicine or physician*):ti,ab,kw (Word variations have been searched) #10 primary near/2 (care or treatment or practi* or medicine or physician*):ti,ab,kw (Word variations have been searched) #11 general near/2 (practi* or physician*):ti,ab,kw (Word variations have been searched) #12 doctor* or GP or GPs or physician*:ti,ab,kw (Word variations have been searched) #13 #1 r #2 or #3 or #4 or #5 or #6 or #7 or #8 or #9 or #10 or #11 or #12 #14 MeSH descriptor: [Neoplasms] explode all trees #15 cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*:ti,ab,kw (Word variations have been searched) #16 #14 or #15 #17 MeSH descriptor: [Work] explode all trees #18 MeSH descriptor: [Employment] explode all trees #19 MeSH descriptor: [Occupations] explode all trees #20 MeSH descriptor: [Rehabilitation, Vocational] explode all trees #21 MeSH descriptor: [Sick Leave] explode all trees #22 MeSH descriptor: [Absenteeism] explode all trees #23 MeSH descriptor: [Retirement] explode all trees #24 MeSH descriptor: [Workers' Compensation] explode all trees #25 work or job or occupation* or employment or unemployment or unemployed or employability or reemployment or re-employment or freelance* or employee* or working status or workload or working age or working population* or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence:ti,ab,kw (Word variations have been searched) #26 (work* or employ* or vocation*) near/3 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*):ti,ab,kw (Word variations have been searched) #27 #17 or #18 or #19 or #20 or #21 or #22 or #23 or #24 or #25 or #26 #28 MeSH descriptor: [Counseling] explode all trees #29 MeSH descriptor: [Vocational Guidance] explode all trees #30 MeSH descriptor: [Role] explode all trees #31 MeSH descriptor: [Physician's Role] explode all trees #32 MeSH descriptor: [Social Support] explode all trees #33 MeSH descriptor: [Continuity of Patient Care] explode all trees #34 MeSH descriptor: [Practice Patterns, Physicians'] explode all trees #35 MeSH descriptor: [Person-Centered Therapy] explode all trees #36 MeSH descriptor: [Adaptation, Psychological] explode all trees #37 counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*:ti,ab,kw (Word variations have been searched) #38 (role* or activit*) near/3 (physician* or doctor* or primary care or general practi* or family practi* or general medical practi* or family medical practi* or family medicine or GP or GPs):ti,ab,kw (Word variations have been searched) #39 #28 or #29 or #30 or #31 or #32 or #33 or #34 or #35 or #36 or #37 or #38 #40 #13 and #16 and #27 and #39 Publication Year from 2000 to 2016 ID Search #1 MeSH descriptor: [Physicians] this term only #2 MeSH descriptor: [General Practitioners] explode all trees #3 MeSH descriptor: [General Practice] explode all trees #4 MeSH descriptor: [Family Practice] explode all trees #5 MeSH descriptor: [Physicians, Family] explode all trees #6 MeSH descriptor: [Physicians, Primary Care] explode all trees #7 MeSH descriptor: [Primary Health Care] explode all trees #8 MeSH descriptor: [Physician's Role] explode all trees #9 family near/2 (practi* or medicine or physician*):ti,ab,kw (Word variations have been searched) #10 primary near/2 (care or treatment or practi* or medicine or physician*):ti,ab,kw (Word variations have been searched) #11 general near/2 (practi* or physician*):ti,ab,kw (Word variations have been searched) #12 doctor* or GP or GPs or physician*:ti,ab,kw (Word variations have been searched) #13 #1 r #2 or #3 or #4 or #5 or #6 or #7 or #8 or #9 or #10 or #11 or #12 #14 MeSH descriptor: [Neoplasms] explode all trees #15 cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*:ti,ab,kw (Word variations have been searched) #16 #14 or #15 #17 MeSH descriptor: [Work] explode all trees #18 MeSH descriptor: [Employment] explode all trees #19 MeSH descriptor: [Occupations] explode all trees #20 MeSH descriptor: [Rehabilitation, Vocational] explode all trees #21 MeSH descriptor: [Sick Leave] explode all trees #22 MeSH descriptor: [Absenteeism] explode all trees #23 MeSH descriptor: [Retirement] explode all trees #24 MeSH descriptor: [Workers' Compensation] explode all trees #25 work or job or occupation* or employment or unemployment or unemployed or employability or reemployment or re-employment or freelance* or employee* or working status or workload or working age or working population* or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence:ti,ab,kw (Word variations have been searched) #26 (work* or employ* or vocation*) near/3 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*):ti,ab,kw (Word variations have been searched) #27 #17 or #18 or #19 or #20 or #21 or #22 or #23 or #24 or #25 or #26 #28 MeSH descriptor: [Counseling] explode all trees #29 MeSH descriptor: [Vocational Guidance] explode all trees #30 MeSH descriptor: [Role] explode all trees #31 MeSH descriptor: [Physician's Role] explode all trees #32 MeSH descriptor: [Social Support] explode all trees #33 MeSH descriptor: [Continuity of Patient Care] explode all trees #34 MeSH descriptor: [Practice Patterns, Physicians'] explode all trees #35 MeSH descriptor: [Person-Centered Therapy] explode all trees #36 MeSH descriptor: [Adaptation, Psychological] explode all trees #37 counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*:ti,ab,kw (Word variations have been searched) #38 (role* or activit*) near/3 (physician* or doctor* or primary care or general practi* or family practi* or general medical practi* or family medical practi* or family medicine or GP or GPs):ti,ab,kw (Word variations have been searched) #39 #28 or #29 or #30 or #31 or #32 or #33 or #34 or #35 or #36 or #37 or #38 #40 #13 and #16 and #27 and #39 Publication Year from 2000 to 2016 View Large CINAHL (Ebsco) # Query S6 S1 AND S2 AND S3 AND S4 Limiters—Published Date: 20160401-20170131 S5 S1 AND S2 AND S3 AND S4 S4 ((MH "Counseling+") OR (MH "Vocational Guidance") OR ((MH "Physician's Role") OR (MH "Professional Role") OR (MH "Role")) OR (MH "Continuity of Patient Care") OR (TI (counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*) OR AB (counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*))) S3 ((((MH "Work") OR (MH "Job Re-Entry") OR (MH "Employment+") OR (MH "Unemployment") OR ((MH "Occupations and Professions+")) OR (MH "Rehabilitation, Vocational") OR (MH "Sick Leave") OR (MH "Absenteeism") OR (MH "Retirement") OR (MH "Worker's Compensation"))) OR ((TI (work or job or occupation* or employment or unemployment or unemployed or employability or reemployment or re-employment or freelance* or employee* or working status or workload or working age or working population* or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence ) OR AB (work or job or occupation* or employment or unemployment or unemployed or employability or reemployment or re-employment or freelance* or employee* or working status or workload or working age or working population* or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence ) OR (TI ((work* or employ* or vocational) N1 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*)) OR AB ((work* or employ* or vocational) N1 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*))) OR (TI ((work* or employ* or vocational) N1 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*) ) OR AB ((work* or employ* or vocational) N1 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*)))) S2 ((MM "Neoplasms+") OR (MM "Oncologic Care") OR (TI (cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*) OR AB (cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*))) S1 ((MH "Physicians, Family")) OR (MH "Family Practice") OR (MH "Physicians, Family") OR (MH "Primary Health Care") OR (MH "Physician's Role")) OR (TI (family N1 (practi* or medicine or physician*) OR AB (family N1 (practi* or medicine or physician*)) OR (TI (primary N2 (care or treatment or practi* or medicine or physician*)) OR AB (primary N1 (care or treatment or practi* or medicine or physician*))) OR (TI (general N1 (practi* or physician*)) OR AB (general N1 (practi* or physician*))) OR ((doctor* or GP or GPs or physician*) OR AB (doctor* or GP or GPs or physician*))) # Query S6 S1 AND S2 AND S3 AND S4 Limiters—Published Date: 20160401-20170131 S5 S1 AND S2 AND S3 AND S4 S4 ((MH "Counseling+") OR (MH "Vocational Guidance") OR ((MH "Physician's Role") OR (MH "Professional Role") OR (MH "Role")) OR (MH "Continuity of Patient Care") OR (TI (counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*) OR AB (counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*))) S3 ((((MH "Work") OR (MH "Job Re-Entry") OR (MH "Employment+") OR (MH "Unemployment") OR ((MH "Occupations and Professions+")) OR (MH "Rehabilitation, Vocational") OR (MH "Sick Leave") OR (MH "Absenteeism") OR (MH "Retirement") OR (MH "Worker's Compensation"))) OR ((TI (work or job or occupation* or employment or unemployment or unemployed or employability or reemployment or re-employment or freelance* or employee* or working status or workload or working age or working population* or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence ) OR AB (work or job or occupation* or employment or unemployment or unemployed or employability or reemployment or re-employment or freelance* or employee* or working status or workload or working age or working population* or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence ) OR (TI ((work* or employ* or vocational) N1 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*)) OR AB ((work* or employ* or vocational) N1 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*))) OR (TI ((work* or employ* or vocational) N1 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*) ) OR AB ((work* or employ* or vocational) N1 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*)))) S2 ((MM "Neoplasms+") OR (MM "Oncologic Care") OR (TI (cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*) OR AB (cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*))) S1 ((MH "Physicians, Family")) OR (MH "Family Practice") OR (MH "Physicians, Family") OR (MH "Primary Health Care") OR (MH "Physician's Role")) OR (TI (family N1 (practi* or medicine or physician*) OR AB (family N1 (practi* or medicine or physician*)) OR (TI (primary N2 (care or treatment or practi* or medicine or physician*)) OR AB (primary N1 (care or treatment or practi* or medicine or physician*))) OR (TI (general N1 (practi* or physician*)) OR AB (general N1 (practi* or physician*))) OR ((doctor* or GP or GPs or physician*) OR AB (doctor* or GP or GPs or physician*))) View Large # Query S6 S1 AND S2 AND S3 AND S4 Limiters—Published Date: 20160401-20170131 S5 S1 AND S2 AND S3 AND S4 S4 ((MH "Counseling+") OR (MH "Vocational Guidance") OR ((MH "Physician's Role") OR (MH "Professional Role") OR (MH "Role")) OR (MH "Continuity of Patient Care") OR (TI (counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*) OR AB (counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*))) S3 ((((MH "Work") OR (MH "Job Re-Entry") OR (MH "Employment+") OR (MH "Unemployment") OR ((MH "Occupations and Professions+")) OR (MH "Rehabilitation, Vocational") OR (MH "Sick Leave") OR (MH "Absenteeism") OR (MH "Retirement") OR (MH "Worker's Compensation"))) OR ((TI (work or job or occupation* or employment or unemployment or unemployed or employability or reemployment or re-employment or freelance* or employee* or working status or workload or working age or working population* or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence ) OR AB (work or job or occupation* or employment or unemployment or unemployed or employability or reemployment or re-employment or freelance* or employee* or working status or workload or working age or working population* or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence ) OR (TI ((work* or employ* or vocational) N1 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*)) OR AB ((work* or employ* or vocational) N1 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*))) OR (TI ((work* or employ* or vocational) N1 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*) ) OR AB ((work* or employ* or vocational) N1 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*)))) S2 ((MM "Neoplasms+") OR (MM "Oncologic Care") OR (TI (cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*) OR AB (cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*))) S1 ((MH "Physicians, Family")) OR (MH "Family Practice") OR (MH "Physicians, Family") OR (MH "Primary Health Care") OR (MH "Physician's Role")) OR (TI (family N1 (practi* or medicine or physician*) OR AB (family N1 (practi* or medicine or physician*)) OR (TI (primary N2 (care or treatment or practi* or medicine or physician*)) OR AB (primary N1 (care or treatment or practi* or medicine or physician*))) OR (TI (general N1 (practi* or physician*)) OR AB (general N1 (practi* or physician*))) OR ((doctor* or GP or GPs or physician*) OR AB (doctor* or GP or GPs or physician*))) # Query S6 S1 AND S2 AND S3 AND S4 Limiters—Published Date: 20160401-20170131 S5 S1 AND S2 AND S3 AND S4 S4 ((MH "Counseling+") OR (MH "Vocational Guidance") OR ((MH "Physician's Role") OR (MH "Professional Role") OR (MH "Role")) OR (MH "Continuity of Patient Care") OR (TI (counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*) OR AB (counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*))) S3 ((((MH "Work") OR (MH "Job Re-Entry") OR (MH "Employment+") OR (MH "Unemployment") OR ((MH "Occupations and Professions+")) OR (MH "Rehabilitation, Vocational") OR (MH "Sick Leave") OR (MH "Absenteeism") OR (MH "Retirement") OR (MH "Worker's Compensation"))) OR ((TI (work or job or occupation* or employment or unemployment or unemployed or employability or reemployment or re-employment or freelance* or employee* or working status or workload or working age or working population* or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence ) OR AB (work or job or occupation* or employment or unemployment or unemployed or employability or reemployment or re-employment or freelance* or employee* or working status or workload or working age or working population* or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence ) OR (TI ((work* or employ* or vocational) N1 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*)) OR AB ((work* or employ* or vocational) N1 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*))) OR (TI ((work* or employ* or vocational) N1 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*) ) OR AB ((work* or employ* or vocational) N1 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*)))) S2 ((MM "Neoplasms+") OR (MM "Oncologic Care") OR (TI (cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*) OR AB (cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*))) S1 ((MH "Physicians, Family")) OR (MH "Family Practice") OR (MH "Physicians, Family") OR (MH "Primary Health Care") OR (MH "Physician's Role")) OR (TI (family N1 (practi* or medicine or physician*) OR AB (family N1 (practi* or medicine or physician*)) OR (TI (primary N2 (care or treatment or practi* or medicine or physician*)) OR AB (primary N1 (care or treatment or practi* or medicine or physician*))) OR (TI (general N1 (practi* or physician*)) OR AB (general N1 (practi* or physician*))) OR ((doctor* or GP or GPs or physician*) OR AB (doctor* or GP or GPs or physician*))) View Large © The Author(s) 2018. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model) http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Family Practice Oxford University Press

The role of the general practitioner in return to work after cancer—a systematic review

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Oxford University Press
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© The Author(s) 2018. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
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0263-2136
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1460-2229
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10.1093/fampra/cmx114
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Abstract

Abstract Background The number of cancer patients and survivors of working age is increasing. General Practitioners (GPs) may have a significant role in psychosocial cancer care, including work-related concerns. Therefore, we performed a systematic literature review to identify the role of the GP in work-related concerns and integration/reintegration into work of cancer patients and/or survivors. Methods We searched PubMed, Embase, Cinahl, PsycINFO and Cochrane Library, irrespective of study design. We found 4863 articles and, after removing duplicates, we screened 3388 articles by title and abstract and reviewed 66 of these in full text. The Critical Appraisal Skills Programme tool was used to assess the methodological quality of included articles. We used narrative synthesis to describe the role of the GP. Results We included four qualitative studies from three countries. Two of these studies focused on the health care professionals’ perspectives and two studies focused on patients’ perspectives regarding the role of the GP. Lack of communication between health care professionals, lack of knowledge about work-related concerns and limited resources were recurring themes in these papers. Fully establishing the role of the GP is difficult given the small number of studies on work-related concerns in cancer patients in primary care. Conclusion There is little evidence regarding the role of the general practitioner in cancer care and work guidance. Therefore, further research should focus on the role that is desired for GPs and on interventions to study the feasibility of GP involvement in the return to work of cancer patients and/or survivors. Cancer, employment, General Practitioner, survival, oncology, work Introduction Worldwide, 14 million people are diagnosed with cancer each year and this number will only increase in decades to come (1). As a result of improved treatments and health care (1), the number of cancer survivors is also expected to rise and many cancer survivors are of working age. Although numerous cancer survivors among the working population consider work as a form of social recovery (2), they experience problems with either keeping their professional positions or reintegrating after treatment (3). Participating in the labour market, specifically for this group, is a major factor influencing their quality of life. It is important not only for financial reasons, but also to reduce social isolation and increase self-esteem (4). Previous research from Europe and Japan describes the importance of considering physicians’, surgeons’ and oncologists’ advice on return to work after or during treatment for cancer (5–8). General Practitioners (GPs) would also be particularly well-suited to support patients and survivors in the follow-up of psychosocial care during and after cancer (9), including support with integration and reintegration into work. GPs know the patients and their (work) environment very well and have contact with all other health care professionals. Furthermore, the Dutch Health Council and the Dutch Cancer Foundation have both recommended greater GP involvement to enhance survivorship care, including advice, support and information concerning reintegration into labour (10,11). There are four phases in the cancer trajectory where guidance regarding return to work (RTW) could be desirable: diagnosis, treatment, rehabilitation and follow-up (12). It is likely that, in every phase, there is a role for different health care professionals (HCP), including GPs, and that communication between the various HCPs in this process is essential (13). Return to work is a relatively unexplored area in general practice. Previous research (14,15) on awareness of work-related problems in general practice and the role of the GP in work-related problems found that GPs are aware of the relationship between work and health. Nonetheless, GPs needed greater knowledge and better communication and cooperation with other HCPs in order to play an active role in RTW. Also, this research concentrated on work-related health concerns of cancer patients, rather than the consequences of whether or not they are able to work, and the possible role of GPs in supporting cancer patients and survivors. The aim of this paper is, therefore, to perform a systematic literature review in order to identify the role of the GP in work-related concerns and the reintegration into work of cancer patients and/or survivors. Methods Search strategy and selection of articles This systematic review was conducted according to the Preferred Reporting Items for Systematic reviews and meta-Analyses (PRISMA) statement guidelines (16). Inclusion criteria were: original studies and review articles (both quantitative and qualitative) describing the role of the GP in cancer care and integration/reintegration into work, cancer patients or survivors of cancer in adulthood aged ≥ 18, cancer patients or survivors who were employed or self-employed at the time of diagnosis, and articles published between January 2000 and December 2016. We used the same inclusion criteria for title and abstract (TIABS) screening as well as for full-text screening. We chose the year 2000 as a date limit because the work field of a general practitioner has changed over time, with increasing emphasis on supporting patients in psychosocial issues. There were no restrictions with regard to language. We used the following databases to perform our search: PubMed, Embase, Cinahl, PsycINFO and Cochrane Library. In these databases, we used three groups of keywords or synonyms and Medical Subject Headings (MeSH) terms combined with ‘OR’: general practitioner/family physician, cancer and work. The keywords and/or synonyms were combined with ‘AND’. The full search string is shown in Appendix 1. The database search was conducted by a professional librarian (FvE), together with the primary author (FdJ). After removing duplicates, the titles and abstracts of the retrieved articles were screened independently by two authors (FdJ and AdB or KvA), and the full-text articles were screened. Differences were resolved through discussion and, where necessary, through review by a third or fourth author (AdB, KvA or MFD), resulting in agreement on all included articles. Quality assessment To evaluate the methodological quality of the included articles, we used the Critical Appraisal Skills Programme (CASP) (17) tool. Two reviewers (FdJ and AdB or KvA) independently assessed the quality according to the CASP tool. Differences in opinion were resolved through discussion, if necessary, with a third author (AdB or KvA). If there was discussion, we described our arguments after the rating. Data extraction Data were categorized by the following criteria: study characteristics (primary author, year of publication, country); study type (e.g. RCT, observational, qualitative, etc.); sample (e.g. type of professional, survivor stage) and sample size. Further categorization was made using gender, age, response rate and type of cancer, where this information was available. As all the studies were qualitative, one author (FdJ) first extracted the data, and a second author (AdB) verified the data to make sure the extraction was carried out correctly. We focused on specific results regarding the GP’s role or relevant opinions of patients and former patients about GPs, also focusing on the communication between GPs and other HCPs. In addition to this, we gave a summary of the aim and the outcome of every study included, again focusing on GPs. Finally, we formulated the authors’ suggestions for improvement for GPs and/or improvements in general practice and combined these outcomes in the results section in order to give an overall conclusion. Results We identified 4863 articles from the database search, and after removing duplicates, 3388 articles were initially screened based on title and abstract. Of these articles, 66 studies were selected to be screened based on full text. After the full-text screening, four articles (18–21) met our inclusion criteria and were included in the systematic review. The study selection process, according to the PRISMA flowchart, as well as the arguments for excluding the remaining 62 articles is shown in Figure 1. Figure 1. View largeDownload slide Article selection according to the Preferred Reporting Items for Systematic reviews and meta-Analyses (PRISMA) (16) Flow Diagram. Figure 1. View largeDownload slide Article selection according to the Preferred Reporting Items for Systematic reviews and meta-Analyses (PRISMA) (16) Flow Diagram. All four articles report the results of qualitative research, and the study methods in all four articles were in-depth interviews. Two of the articles (18,20) represented the perspectives of patients and the other two (19,21) represented the views of HCPs. The countries where the research was carried out were the UK (18,19), Germany (20) and Canada (21). Three studies were written in English (18,19,21) and one study in German (20). Bains et al. (19) interviewed 18 HCPs, including two GPs. The HCPs treated at least one colorectal cancer patient who was an employee at the time of diagnosis. There was data saturation after the 18 interviews. The participating HCPs were interviewed face-to-face in their own workplace. The questions aimed to explore the work-related guidance given by these different HCPs to colorectal cancer patients, from point of diagnosis up to end of treatment, including how the guidance given during this period could be improved. Morrison et al. (21) also conducted interviews in person with 10 HCPs, including five GPs. While this study was carried out in Canada, two GPs were American. To guide the questions, the interviewer used vignettes on specific topics to explore the perspectives of these physicians on supporting cancer survivors with their concerns regarding work and return to work. Amir et al. (18) focused on the views of cancer survivors 3 years post diagnosis. Interviews were conducted by telephone with 41 patients and former patients presenting 16 different types of cancer. The aim of the authors was to investigate how this population has returned to work after diagnosis. One of the main themes in this study is medical advice regarding work, including advice given by the GP. Böttcher et al. (20) carried out a qualitative study by interviewing 32 cancer patients who were admitted to a cancer rehabilitation clinic. The patients were all admitted to the same clinic, and had survived different types of cancer. The authors conducted semi-structured interviews to be able to analyse the expectations of patients towards getting back to work and how work-related therapies from different HCPs may be helpful. Further characteristics of the studies, such as sample information and types of cancer, are shown in Table 1. Table 1. Data extraction from included articles: study characteristics, such as author, year, country, study type and sample, context and type of cancer Primary author; Year published Country Study type* Sample▲ Time and context Sample size; mean age; age range; % female; response rate Type of cancer Health care professionals’ view Bains; 2012 (19) UK Qualitative: semi- structured interviews face-to-face Health care professionals: 2 GPs, 5 surgeons, 3 oncologists, 3 special nurses, 3 OHPs, 2 OH-nurses Interview: face-to-face at participants’ work place. Duration: 15–40 minutes. 18 physicians (2 GPs); 46. 5 years; 34–57 years; 44% female; response rate not reported (saturation after 18 interviews) Colorectal cancer Morrison; 2015 (21) Canada Qualitative: vignette method, face-to-face interviews Health care professionals: 5 oncologists and 5 GPs. Interview: face-to-face at time and location convenient to participant. Duration: approximately 160 minutes. 10 physicians (5 GPs); NR; 39–59 years; 40% oncologist females, 0% of the GPs was female; response rate was not reported Not reported Patients’ view Amir; 2008 (18) UK Qualitative: interviews by telephone Cancer survivors three years post diagnosis Interview: telephone interview at time of convenience of participant. Duration: 30–100 minutes (average: 60 minutes). 41 patients; NR; 26–55 years; 59% female; 65% response rate 16 different types of cancer Böttcher; 2012 (20) Germany Qualitative: semi- structured interviews in person Cancer patients in rehabilitation setting Interview: face-to-face at rehabilitation centre (31) and in research institute (1). Duration: 30–105 minutes (average: 53 minutes). 32 patients; mean female age is 49.5 years, mean male age is 48,4 years; 69% female; response rate not reported Male patients: gastrointestinal cancer, female patients: breast cancer or ovarian/ uterine cancer Primary author; Year published Country Study type* Sample▲ Time and context Sample size; mean age; age range; % female; response rate Type of cancer Health care professionals’ view Bains; 2012 (19) UK Qualitative: semi- structured interviews face-to-face Health care professionals: 2 GPs, 5 surgeons, 3 oncologists, 3 special nurses, 3 OHPs, 2 OH-nurses Interview: face-to-face at participants’ work place. Duration: 15–40 minutes. 18 physicians (2 GPs); 46. 5 years; 34–57 years; 44% female; response rate not reported (saturation after 18 interviews) Colorectal cancer Morrison; 2015 (21) Canada Qualitative: vignette method, face-to-face interviews Health care professionals: 5 oncologists and 5 GPs. Interview: face-to-face at time and location convenient to participant. Duration: approximately 160 minutes. 10 physicians (5 GPs); NR; 39–59 years; 40% oncologist females, 0% of the GPs was female; response rate was not reported Not reported Patients’ view Amir; 2008 (18) UK Qualitative: interviews by telephone Cancer survivors three years post diagnosis Interview: telephone interview at time of convenience of participant. Duration: 30–100 minutes (average: 60 minutes). 41 patients; NR; 26–55 years; 59% female; 65% response rate 16 different types of cancer Böttcher; 2012 (20) Germany Qualitative: semi- structured interviews in person Cancer patients in rehabilitation setting Interview: face-to-face at rehabilitation centre (31) and in research institute (1). Duration: 30–105 minutes (average: 53 minutes). 32 patients; mean female age is 49.5 years, mean male age is 48,4 years; 69% female; response rate not reported Male patients: gastrointestinal cancer, female patients: breast cancer or ovarian/ uterine cancer *all types of articles could be included; e.g. RCT, observational, qualitative ▲ e.g. kind of professionals, survivor stage View Large Table 1. Data extraction from included articles: study characteristics, such as author, year, country, study type and sample, context and type of cancer Primary author; Year published Country Study type* Sample▲ Time and context Sample size; mean age; age range; % female; response rate Type of cancer Health care professionals’ view Bains; 2012 (19) UK Qualitative: semi- structured interviews face-to-face Health care professionals: 2 GPs, 5 surgeons, 3 oncologists, 3 special nurses, 3 OHPs, 2 OH-nurses Interview: face-to-face at participants’ work place. Duration: 15–40 minutes. 18 physicians (2 GPs); 46. 5 years; 34–57 years; 44% female; response rate not reported (saturation after 18 interviews) Colorectal cancer Morrison; 2015 (21) Canada Qualitative: vignette method, face-to-face interviews Health care professionals: 5 oncologists and 5 GPs. Interview: face-to-face at time and location convenient to participant. Duration: approximately 160 minutes. 10 physicians (5 GPs); NR; 39–59 years; 40% oncologist females, 0% of the GPs was female; response rate was not reported Not reported Patients’ view Amir; 2008 (18) UK Qualitative: interviews by telephone Cancer survivors three years post diagnosis Interview: telephone interview at time of convenience of participant. Duration: 30–100 minutes (average: 60 minutes). 41 patients; NR; 26–55 years; 59% female; 65% response rate 16 different types of cancer Böttcher; 2012 (20) Germany Qualitative: semi- structured interviews in person Cancer patients in rehabilitation setting Interview: face-to-face at rehabilitation centre (31) and in research institute (1). Duration: 30–105 minutes (average: 53 minutes). 32 patients; mean female age is 49.5 years, mean male age is 48,4 years; 69% female; response rate not reported Male patients: gastrointestinal cancer, female patients: breast cancer or ovarian/ uterine cancer Primary author; Year published Country Study type* Sample▲ Time and context Sample size; mean age; age range; % female; response rate Type of cancer Health care professionals’ view Bains; 2012 (19) UK Qualitative: semi- structured interviews face-to-face Health care professionals: 2 GPs, 5 surgeons, 3 oncologists, 3 special nurses, 3 OHPs, 2 OH-nurses Interview: face-to-face at participants’ work place. Duration: 15–40 minutes. 18 physicians (2 GPs); 46. 5 years; 34–57 years; 44% female; response rate not reported (saturation after 18 interviews) Colorectal cancer Morrison; 2015 (21) Canada Qualitative: vignette method, face-to-face interviews Health care professionals: 5 oncologists and 5 GPs. Interview: face-to-face at time and location convenient to participant. Duration: approximately 160 minutes. 10 physicians (5 GPs); NR; 39–59 years; 40% oncologist females, 0% of the GPs was female; response rate was not reported Not reported Patients’ view Amir; 2008 (18) UK Qualitative: interviews by telephone Cancer survivors three years post diagnosis Interview: telephone interview at time of convenience of participant. Duration: 30–100 minutes (average: 60 minutes). 41 patients; NR; 26–55 years; 59% female; 65% response rate 16 different types of cancer Böttcher; 2012 (20) Germany Qualitative: semi- structured interviews in person Cancer patients in rehabilitation setting Interview: face-to-face at rehabilitation centre (31) and in research institute (1). Duration: 30–105 minutes (average: 53 minutes). 32 patients; mean female age is 49.5 years, mean male age is 48,4 years; 69% female; response rate not reported Male patients: gastrointestinal cancer, female patients: breast cancer or ovarian/ uterine cancer *all types of articles could be included; e.g. RCT, observational, qualitative ▲ e.g. kind of professionals, survivor stage View Large Methodological quality All four articles clearly stated the aim of the research, and for all the articles, a qualitative methodology was an appropriate method to achieve the research goal. Furthermore, all four studies took ethics into consideration, and there was a clear statement of findings. We gave all articles a moderate-high score in being valuable to current knowledge. Less clear was the relationship between researcher and participant. Only one study (21) gave some attention to this relationship in the discussion of the article. Furthermore, the authors included a very small sample size due to the fact that this was a pilot study. A complete overview of the assessment according to the CASP tool is shown in Table 2. Table 2. Quality assessment according to the Critical Appraisal Skills Programme Included study Bains et al. Morrison et al. Amir et al. Böttcher et al. Quality criteria 1. Was there a clear statement of the aims of the research? YES YES YES YES 2. Is a qualitative methodology appropriate? YES YES YES YES 3. Was the research design appropriate to address the aims of the research? YES: goal is to explore involvement of HCPs, so this is a good design YES: good design for achieving the goal of research YES: interviews by telephone, but referred to literature as being valid for this research design YES 4. Was the recruitment strategy appropriate to the aims of the research? YES: treating at least 1 colorectal cancer patient employed at diagnosis, ensured accurate recall of information provided CAN’T TELL: oncologists all from the same department; not clear what the relationship is between the GPs; not explained why these participants were selected YES CAN’T TELL: all patients from same clinic, no clear explanation of how participants were selected 5. Was the data collected in a way that addressed the research issue? YES: the only thing missing was whether there had been any modification of the method YES YES: although the one point the researchers did not mention is saturation of the data YES 6. Has the relationship between researcher and participants been adequately considered? CAN’T TELL: not reported YES CAN’T TELL: not reported CAN’T TELL: not reported 7. Have ethical issues been taken into consideration? YES YES YES YES: informed consent, not clear about approval from ethics committee 8. Was the data analysis sufficiently rigorous? YES CAN’T TELL: no clear explanation of what themes were found in this research and whether these Vignettes were implicating a theme already YES YES 9. Is there a clear statement of findings? YES YES YES YES 10. How valuable is the research? (++ | + | +/- | -| --) + + + + Included study Bains et al. Morrison et al. Amir et al. Böttcher et al. Quality criteria 1. Was there a clear statement of the aims of the research? YES YES YES YES 2. Is a qualitative methodology appropriate? YES YES YES YES 3. Was the research design appropriate to address the aims of the research? YES: goal is to explore involvement of HCPs, so this is a good design YES: good design for achieving the goal of research YES: interviews by telephone, but referred to literature as being valid for this research design YES 4. Was the recruitment strategy appropriate to the aims of the research? YES: treating at least 1 colorectal cancer patient employed at diagnosis, ensured accurate recall of information provided CAN’T TELL: oncologists all from the same department; not clear what the relationship is between the GPs; not explained why these participants were selected YES CAN’T TELL: all patients from same clinic, no clear explanation of how participants were selected 5. Was the data collected in a way that addressed the research issue? YES: the only thing missing was whether there had been any modification of the method YES YES: although the one point the researchers did not mention is saturation of the data YES 6. Has the relationship between researcher and participants been adequately considered? CAN’T TELL: not reported YES CAN’T TELL: not reported CAN’T TELL: not reported 7. Have ethical issues been taken into consideration? YES YES YES YES: informed consent, not clear about approval from ethics committee 8. Was the data analysis sufficiently rigorous? YES CAN’T TELL: no clear explanation of what themes were found in this research and whether these Vignettes were implicating a theme already YES YES 9. Is there a clear statement of findings? YES YES YES YES 10. How valuable is the research? (++ | + | +/- | -| --) + + + + View Large Table 2. Quality assessment according to the Critical Appraisal Skills Programme Included study Bains et al. Morrison et al. Amir et al. Böttcher et al. Quality criteria 1. Was there a clear statement of the aims of the research? YES YES YES YES 2. Is a qualitative methodology appropriate? YES YES YES YES 3. Was the research design appropriate to address the aims of the research? YES: goal is to explore involvement of HCPs, so this is a good design YES: good design for achieving the goal of research YES: interviews by telephone, but referred to literature as being valid for this research design YES 4. Was the recruitment strategy appropriate to the aims of the research? YES: treating at least 1 colorectal cancer patient employed at diagnosis, ensured accurate recall of information provided CAN’T TELL: oncologists all from the same department; not clear what the relationship is between the GPs; not explained why these participants were selected YES CAN’T TELL: all patients from same clinic, no clear explanation of how participants were selected 5. Was the data collected in a way that addressed the research issue? YES: the only thing missing was whether there had been any modification of the method YES YES: although the one point the researchers did not mention is saturation of the data YES 6. Has the relationship between researcher and participants been adequately considered? CAN’T TELL: not reported YES CAN’T TELL: not reported CAN’T TELL: not reported 7. Have ethical issues been taken into consideration? YES YES YES YES: informed consent, not clear about approval from ethics committee 8. Was the data analysis sufficiently rigorous? YES CAN’T TELL: no clear explanation of what themes were found in this research and whether these Vignettes were implicating a theme already YES YES 9. Is there a clear statement of findings? YES YES YES YES 10. How valuable is the research? (++ | + | +/- | -| --) + + + + Included study Bains et al. Morrison et al. Amir et al. Böttcher et al. Quality criteria 1. Was there a clear statement of the aims of the research? YES YES YES YES 2. Is a qualitative methodology appropriate? YES YES YES YES 3. Was the research design appropriate to address the aims of the research? YES: goal is to explore involvement of HCPs, so this is a good design YES: good design for achieving the goal of research YES: interviews by telephone, but referred to literature as being valid for this research design YES 4. Was the recruitment strategy appropriate to the aims of the research? YES: treating at least 1 colorectal cancer patient employed at diagnosis, ensured accurate recall of information provided CAN’T TELL: oncologists all from the same department; not clear what the relationship is between the GPs; not explained why these participants were selected YES CAN’T TELL: all patients from same clinic, no clear explanation of how participants were selected 5. Was the data collected in a way that addressed the research issue? YES: the only thing missing was whether there had been any modification of the method YES YES: although the one point the researchers did not mention is saturation of the data YES 6. Has the relationship between researcher and participants been adequately considered? CAN’T TELL: not reported YES CAN’T TELL: not reported CAN’T TELL: not reported 7. Have ethical issues been taken into consideration? YES YES YES YES: informed consent, not clear about approval from ethics committee 8. Was the data analysis sufficiently rigorous? YES CAN’T TELL: no clear explanation of what themes were found in this research and whether these Vignettes were implicating a theme already YES YES 9. Is there a clear statement of findings? YES YES YES YES 10. How valuable is the research? (++ | + | +/- | -| --) + + + + View Large Perspectives The summary of aims, outcomes and implications of both the physicians’ and patients’ perspectives is shown in Table 3. Table 3. Data extraction from included articles: aims, outcomes and improvements Primary author; Year published Study aim Study outcome—GP related Suggestion for improvement in cancer(after)care in general practice Health care professionals’ view Bains; 2012 (19) Qualitative study to explore when (if any) advice is given to cancer patients about work / returning to work and whether HCPs require any support in providing work-related guidance. Work-related guidance given to patients is not systematic, perhaps due to the absence of guidelines. Communication between HCPs seemed to be the problem: HCPs assumed that another professional was responsible for work-related advice and so they all referred to each other. Developing guidance for providers about RTW and impacts of cancer upon work. GPs are not mentioned separately in either the conclusion or the suggestions for further research/ further implications. Morrison; 2015 (21) To explore physicians’ perspectives on supporting cancer survivors’ work integration concerns. Physicians did not consider work-related concerns to be part of their training or their mandate of care. They completed insurance forms when asked, but physicians did not routinely provide unsolicited work-related advice. This study concluded that HCPs should not provide advice on matters beyond their areas of expertise. To raise physicians’ awareness of work-related issues, GPs-in-training and oncologists-in-training could be trained in the work-related concerns of cancer patients. Consensus of which HCP is responsible for WI should be reached. Further, this article pointed out that an ideal remedy would be to make a multidisciplinary survivorship support team accessible. Patients’ view Amir; 2008 (18) Qualitative study to explore how people have returned to work after cancer. Few people declared that they received any advice regarding return to work. Where GPs gave advice, they told patients: ‘go back when you feel ready’. Suggestions are made for further research examining the role of employers, line managers and occupational health professionals. However, GPs are not mentioned again in this article. The authors suggest that there is a role for specialist nurses to provide support in RTW and to communicate with the multidisciplinary team with all HCPs. Böttcher; 2012 (20) Analyse the expectations of patients towards RTW and how helpful they estimate the work-related therapies provided during rehabilitation to be in this respect. Nearly half of the patients felt they needed information about RTW and the majority would go to the GP for this information. Further, the authors did not distinguish between the specific roles of the different HCPs. There are no specific suggestions or advice for GPs and RTW in cancer patients. Primary author; Year published Study aim Study outcome—GP related Suggestion for improvement in cancer(after)care in general practice Health care professionals’ view Bains; 2012 (19) Qualitative study to explore when (if any) advice is given to cancer patients about work / returning to work and whether HCPs require any support in providing work-related guidance. Work-related guidance given to patients is not systematic, perhaps due to the absence of guidelines. Communication between HCPs seemed to be the problem: HCPs assumed that another professional was responsible for work-related advice and so they all referred to each other. Developing guidance for providers about RTW and impacts of cancer upon work. GPs are not mentioned separately in either the conclusion or the suggestions for further research/ further implications. Morrison; 2015 (21) To explore physicians’ perspectives on supporting cancer survivors’ work integration concerns. Physicians did not consider work-related concerns to be part of their training or their mandate of care. They completed insurance forms when asked, but physicians did not routinely provide unsolicited work-related advice. This study concluded that HCPs should not provide advice on matters beyond their areas of expertise. To raise physicians’ awareness of work-related issues, GPs-in-training and oncologists-in-training could be trained in the work-related concerns of cancer patients. Consensus of which HCP is responsible for WI should be reached. Further, this article pointed out that an ideal remedy would be to make a multidisciplinary survivorship support team accessible. Patients’ view Amir; 2008 (18) Qualitative study to explore how people have returned to work after cancer. Few people declared that they received any advice regarding return to work. Where GPs gave advice, they told patients: ‘go back when you feel ready’. Suggestions are made for further research examining the role of employers, line managers and occupational health professionals. However, GPs are not mentioned again in this article. The authors suggest that there is a role for specialist nurses to provide support in RTW and to communicate with the multidisciplinary team with all HCPs. Böttcher; 2012 (20) Analyse the expectations of patients towards RTW and how helpful they estimate the work-related therapies provided during rehabilitation to be in this respect. Nearly half of the patients felt they needed information about RTW and the majority would go to the GP for this information. Further, the authors did not distinguish between the specific roles of the different HCPs. There are no specific suggestions or advice for GPs and RTW in cancer patients. View Large Table 3. Data extraction from included articles: aims, outcomes and improvements Primary author; Year published Study aim Study outcome—GP related Suggestion for improvement in cancer(after)care in general practice Health care professionals’ view Bains; 2012 (19) Qualitative study to explore when (if any) advice is given to cancer patients about work / returning to work and whether HCPs require any support in providing work-related guidance. Work-related guidance given to patients is not systematic, perhaps due to the absence of guidelines. Communication between HCPs seemed to be the problem: HCPs assumed that another professional was responsible for work-related advice and so they all referred to each other. Developing guidance for providers about RTW and impacts of cancer upon work. GPs are not mentioned separately in either the conclusion or the suggestions for further research/ further implications. Morrison; 2015 (21) To explore physicians’ perspectives on supporting cancer survivors’ work integration concerns. Physicians did not consider work-related concerns to be part of their training or their mandate of care. They completed insurance forms when asked, but physicians did not routinely provide unsolicited work-related advice. This study concluded that HCPs should not provide advice on matters beyond their areas of expertise. To raise physicians’ awareness of work-related issues, GPs-in-training and oncologists-in-training could be trained in the work-related concerns of cancer patients. Consensus of which HCP is responsible for WI should be reached. Further, this article pointed out that an ideal remedy would be to make a multidisciplinary survivorship support team accessible. Patients’ view Amir; 2008 (18) Qualitative study to explore how people have returned to work after cancer. Few people declared that they received any advice regarding return to work. Where GPs gave advice, they told patients: ‘go back when you feel ready’. Suggestions are made for further research examining the role of employers, line managers and occupational health professionals. However, GPs are not mentioned again in this article. The authors suggest that there is a role for specialist nurses to provide support in RTW and to communicate with the multidisciplinary team with all HCPs. Böttcher; 2012 (20) Analyse the expectations of patients towards RTW and how helpful they estimate the work-related therapies provided during rehabilitation to be in this respect. Nearly half of the patients felt they needed information about RTW and the majority would go to the GP for this information. Further, the authors did not distinguish between the specific roles of the different HCPs. There are no specific suggestions or advice for GPs and RTW in cancer patients. Primary author; Year published Study aim Study outcome—GP related Suggestion for improvement in cancer(after)care in general practice Health care professionals’ view Bains; 2012 (19) Qualitative study to explore when (if any) advice is given to cancer patients about work / returning to work and whether HCPs require any support in providing work-related guidance. Work-related guidance given to patients is not systematic, perhaps due to the absence of guidelines. Communication between HCPs seemed to be the problem: HCPs assumed that another professional was responsible for work-related advice and so they all referred to each other. Developing guidance for providers about RTW and impacts of cancer upon work. GPs are not mentioned separately in either the conclusion or the suggestions for further research/ further implications. Morrison; 2015 (21) To explore physicians’ perspectives on supporting cancer survivors’ work integration concerns. Physicians did not consider work-related concerns to be part of their training or their mandate of care. They completed insurance forms when asked, but physicians did not routinely provide unsolicited work-related advice. This study concluded that HCPs should not provide advice on matters beyond their areas of expertise. To raise physicians’ awareness of work-related issues, GPs-in-training and oncologists-in-training could be trained in the work-related concerns of cancer patients. Consensus of which HCP is responsible for WI should be reached. Further, this article pointed out that an ideal remedy would be to make a multidisciplinary survivorship support team accessible. Patients’ view Amir; 2008 (18) Qualitative study to explore how people have returned to work after cancer. Few people declared that they received any advice regarding return to work. Where GPs gave advice, they told patients: ‘go back when you feel ready’. Suggestions are made for further research examining the role of employers, line managers and occupational health professionals. However, GPs are not mentioned again in this article. The authors suggest that there is a role for specialist nurses to provide support in RTW and to communicate with the multidisciplinary team with all HCPs. Böttcher; 2012 (20) Analyse the expectations of patients towards RTW and how helpful they estimate the work-related therapies provided during rehabilitation to be in this respect. Nearly half of the patients felt they needed information about RTW and the majority would go to the GP for this information. Further, the authors did not distinguish between the specific roles of the different HCPs. There are no specific suggestions or advice for GPs and RTW in cancer patients. View Large Physicians’ perspectives Bains et al. (19) identified two themes, both with several subthemes. The first theme is ‘information used by providers to address work matters with patients’, divided into four subthemes. Bains et al. found that GPs are willing to give sick notes, but that they do not give special advice with the sick notes. One GP found that specialist nurses were considered to be the best HCP to discuss RTW, since every cancer patient has frequent contact with their cancer nurses. However, these nurses thought that giving advice on RTW is something that would preferably be done by the GP. This indicated that there was lack of communication between the HCPs. The second main theme, ‘obstacles in providing work-related information to patients’, described other difficulties apart from communication, such as a lack of knowledge and limited resources. For example, one GP said the following about knowledge on cancer and return to work concerns and division of tasks: “I tend to give as much information as I can, within my limitations. I will not be commenting about something I don’t know a lot about.” (from (19)) Overall, Bains concludes that work-related guidance is not systematically a subject of conversation and support in all the different HCP groups. Morrison et al. (21) found three different themes. The first is ‘the challenge of considering and providing advice for matters beyond expertise’. Several GPs thought that there are professionals who are more suitably trained in handling work integration concerns than themselves, with occupational health physicians (OHPs) being a key referral for work-related questions. However, some of them did not refer to OHPs because of questions regarding availability and insurance coverage: “We have occupational therapy available, but I do not think that it’s covered through Manitoba Health.” Morrison et al. mentioned that a collaborative team approach was identified as ideal. One GP said: “They should have an OHP assess their ability to work […] and then from a medical standpoint if there are medications that were required to manage pain or nausea, or something like that, then that would be my role.” The second theme, ‘the burden of insurance gatekeeping’, referred to the fact that physicians did not spontaneously discuss RTW, but patients brought it up, mostly because of insurance benefits. Physicians completed insurance forms as part of routine care, but some physicians complained about the large volume of forms and interference with their role as company doctor or caregiver: However, the insurance forms can trigger tension in the physician-patient relationship. “The physician is faced with this constant conflict of the bad guy: go back to work, versus the good guy: cure the cancer. It’s a constant conflict with these forms.” The final theme was ‘the tension between medical advice and guidance for living with the effect of cancer diagnosis and treatment’. GPs in this study believed that advising cancer survivors on RTW is not part of their mandate of care. For instance: “I don’t think they see that as the task of their primary care physician […] as far as RTW is concerned, I think they see that as coming from their oncologist.” However, oncologists in this study did not feel that this care fell under their area of expertise. When patients asked for advice on RTW, physicians gave general information, such as information about sequelae of treatment (e.g. fatigue) and realistic expectations of altered performance. Patients’ perspectives Amir et al. (18) found five different central themes in his qualitative study with cancer patients. Of these themes, one was related to ‘medical advice regarding work’. The authors reported that only a few participants said that they received any worthwhile medical advice from either their cancer care team or their GP concerning RTW. GPs generally give the following advice: “My GP said: Go back when you feel ready” Böttcher et al. (19) aimed to analyse the expectations of these participants towards RTW and their opinions about work-related therapies provided during rehabilitation. This study found that nearly half of the participants felt that they needed information about integration or reintegration into work. Of these patients, two-thirds would go to a GP and the remainder would go to a specialist for guidance. This article further indicated that the rehabilitation period is the perfect time to discuss RTW problems with these survivors, but the authors did not distinguish between different HCPs. Discussion Through this systematic review, we aimed to identify the role of the general practitioner in work-related concerns and integration/reintegration into work of cancer patients and/or survivors. During the search and selection of the articles, we found that there is little literature regarding the role of the General Practitioner when it comes to cancer patients and work or returning to work, either in their current role or in a role that is desirable for the future. We did identify several studies describing the role of the GP in cancer aftercare, especially the psychosocial aspects (9,22–24) but in none of these articles was advice on work-related concerns mentioned as part of psychosocial care or guidance. Regarding the role of the GP, a qualitative study from the Netherlands (25) concluded that colon cancer patients see some benefit in greater GP involvement to improve survivorship care. Possible benefits of greater GP involvement include better accessibility of care and additional guidance. Participants considered an increased workload for the already busy GP as a disadvantage. Requirements for greater GP involvement were assurance of sufficient knowledge and expertise of the GP and easy access to secondary care. These issues are similar to the provision of psychosocial care regarding work-related concerns as found in this review and should be addressed. A qualitative study conducting in-depth interviews with breast and prostate cancer survivors from the USA (9) reported that survivors believed there was a role for primary care in cancer follow-up care. Patients especially suggested the opportunity to provide follow-up medical care when ‘enough time had passed’ or when the survivors felt that they could reintegrate into the non-cancer population (9). This would be particularly significant for the role of the GP regarding work-related concerns because these concerns become most relevant when patients want to reintegrate into society. Some research has been performed on the role of the GP in providing advice to solve work-related problems in general. De Kock et al. (14,15) concluded that GPs are aware of their important role in work-related problems, but that they sometimes lack knowledge about this topic. However, this study did not focus on cancer patients and did not distinguish between work-related problems caused by illness, such as cancer, and problems caused by the nature of the work itself, or in returning to work. Moßhammer et al. (26) focused on the cooperation between a GP and an occupational health physician (OHP). They concluded that cooperation between them is necessary (but the authors did not define a role for the GP regarding work) and that GPs as well as OHPs consider their individual working fields as separate from one another. This lack of collaboration between these two physicians does not benefit the patients and might hamper the holistic view. Our systematic review describes the views of GPs and patients internationally, but every country has its own guidelines or culture on how (re)integration into is arranged. In the Netherlands, for example, cancer patients will get an appointment with an OHP a few weeks after diagnosis, as long as they are in paid employment. Self-employed patients do not have the opportunity to go to an OHP. In other countries, such as the UK and Canada, GPs are responsible for sick notes or fit notes. The fact that this type of care is arranged differently in different countries makes it harder to generalize our findings to other countries. Strengths and limitations One of our strengths is that we performed a thorough, systematic and detailed search of all existing literature. Although we used a date limit, we are positive that we included all existing articles, because we hand-searched the references of all relevant articles and the oldest article was published in 2008 without new references before that date. Despite this, there were only four articles that could answer our research question. Furthermore, all four studies were qualitative studies, and we were therefore not able to quantify any data on this topic. The included studies scored moderately high on the methodological quality assessment. However, a limitation of the study by Morrison et al. (21) is the number of participants included in the interviews, without being assured of data saturation. The authors mention in their discussion that this qualitative article is a pilot and part of a larger multistage study. Another limitation is the sample selection in the study by Böttcher et al. (20). The authors selected their participants from a single rehabilitation clinic for cancer patients. This results in a too narrowly selected sample, even if there were data saturation. In general, there was limited information about GPs in the articles, compared to other HCPs, either because only a few GPs were included (19,21), or because of the fact that GPs were mentioned less by patients/former patients compared to oncologists, nurses and/or occupational health physicians (18,20). Implications for research and practice Recommendations for further research include more qualitative research on the role of the GP in cancer care/after care including RTW, and if possible, quantitative research to support these perspectives and opinions with facts and figures. Further research should focus on the needs and desires of patients, survivors and GPs to improve RTW guidance in general practice. At the same time, communication between the different HCPs involved in the cancer process, from diagnosis to aftercare, needs to be improved so that HCPs do not assume that their colleagues have already discussed RTW or that they both do it in different ways. Further to this, the needs of patients in paid employment may be different from those of self-employed patients. A possible solution could be found by speeding up the process of information sharing, preferably with easy access, for instance by telephone. Currently, HCPs are referring to each other the responsibility for RTW guidance for cancer patients. Furthermore, when GPs do give advice on RTW, they are not consistent in their information and they lack information from specialists in the hospital. This communication or teamwork should be improved. Future research on the value of involvement of GPs in RTW could change the perspective of HCPs with regard to their own responsibilities. Establishing clarification about the contribution and the mandate that GPs could have in this process, would enable HCPs to agree on their responsibility and formalise it. Conclusion There is little evidence in the literature about the current role of the GP regarding cancer patients and work. Possible reasons for this lack of research into the role of the GP are a lack of skills or knowledge, a lack of consensus on the role of different HCPs on RTW advice, and a lack of guidelines to advise patients with consistency. Agreement on the roles of the different HCPs in different settings (e.g. hospital, family practice, occupational health institutes) is a prerequisite for improvement in order for cancer patients and former cancer patients to be able to discuss work-related problems. The implication of our study is that interventions are needed to improve communication between GPs and other HCPs concerning work-related problems and the reintegration into work of cancer patients and survivors in different phases of cancer treatment. These interventions should also include guidance about RTW in each treatment phase, and focus on the information and education GPs need in order to be able to support cancer patients and survivors in solving their work-related problems in relation to their illness. In addition to this, self-employed patients are often at a disadvantage because they do not have an OPH. Yet these patients could benefit from advice on RTW from their GP. Better communication between the different HCPs, and clarification on shared responsibilities concerning RTW, can lead to better quality patient care, and efficient and effective working practice for all HCPs. Declaration Funding: This work was supported by Pink Ribbon Foundation grant PR 2014–191 PS60. 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Designing a multifaceted survivorship care plan to meet the information and communication needs of breast cancer patients and their family physicians: results of a qualitative pilot study . BMC Med Inform Decis Mak 2013 ; 13 : 76 . Google Scholar Crossref Search ADS PubMed 24. Potosky AL , Han PK , Rowland J , et al. Differences between primary care physicians’ and oncologists’ knowledge, attitudes and practices regarding the care of cancer survivors . J Gen Intern Med 2011 ; 26 : 1403 – 10 . Google Scholar Crossref Search ADS PubMed 25. Nugteren IC , Duineveld LA , Wieldraaijer T , et al. Need for general practitioner involvement and eHealth in colon cancer survivorship care: patients’ perspectives . Fam Pract 2017 ; 34 : 473 – 478 Google Scholar PubMed 26. Moßhammer D , Michaelis M , Mehne J , et al. General practitioners’ and occupational health physicians’ views on their cooperation: a cross-sectional postal survey . Int Arch Occup Environ Health 2016 ; 89 : 449 – 59 . Google Scholar Crossref Search ADS PubMed Appendix 1 Search strategy MEDLINE (Ovid) # Searches 1 *physicians/ or general practitioners/ or general practice/ or family practice/ or physicians, family/ or physicians, primary care/ or Primary Health Care/ or Physician's Role/ 2 (family adj2 (practi* or medicine or physician*)).ti,ab,kw. 3 (primary adj2 (care or treatment or practi* or medicine or physician*)).ti,ab,kw. 4 (general adj2 (practi* or physician*)).ti,ab,kw. 5 (doctor* or GP or GPs).ti,ab,kw. 6 1 or 2 or 3 or 4 or 5 7 exp Neoplasms/ or (cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*).ti,ab,kw. 8 exp work/ or return to work/ or exp employment/ or unemployment/ or exp occupations/ or workplace/ or Rehabilitation, Vocational/ or Sick Leave/ or Absenteeism/ or Retirement/ or Workers' Compensation/ or (work or job or occupation* or employment or unemployment or unemployed or employability or reemployment or re-employment or freelance* or employee* or working status or workload or working age or working population* or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence).ti,ab,kw. or ((work* or employ* or vocational) adj1 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*)).ti,ab,kw. 9 exp Counseling/ or Vocational Guidance/ or role/ or professional role/ or physician's role/ or social support/ or "Continuity of Patient Care"/ or Practice Patterns, Physicians'/ or Person-Centered Therapy/ or Adaptation, Psychological/ or (counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*).ti,ab,kw. or ((role* or activit*) adj2 (physician* or doctor* or primary care or general practi* or family practi* or general medical practi* or family medical practi* or family medicine or GP or GPs)).ti,ab,kw. or (physician* adj3 attitude*).ti,ab,kw. 10 (adolescent/ or exp child/ or exp Pediatrics/ or (child* or adolescen* or p?ediatric*).ti,ab,kw.) not (Adult/ or adult*.ti,ab,kw.) 11 comment/ or editorial/ or letter/ or news/ or (editorial* or comment* or letter*).ti,ab,kw. 12 (6 and 7 and 8 and 9) not 10 not 11 13 limit 12 to yr = "2000 -Current" # Searches 1 *physicians/ or general practitioners/ or general practice/ or family practice/ or physicians, family/ or physicians, primary care/ or Primary Health Care/ or Physician's Role/ 2 (family adj2 (practi* or medicine or physician*)).ti,ab,kw. 3 (primary adj2 (care or treatment or practi* or medicine or physician*)).ti,ab,kw. 4 (general adj2 (practi* or physician*)).ti,ab,kw. 5 (doctor* or GP or GPs).ti,ab,kw. 6 1 or 2 or 3 or 4 or 5 7 exp Neoplasms/ or (cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*).ti,ab,kw. 8 exp work/ or return to work/ or exp employment/ or unemployment/ or exp occupations/ or workplace/ or Rehabilitation, Vocational/ or Sick Leave/ or Absenteeism/ or Retirement/ or Workers' Compensation/ or (work or job or occupation* or employment or unemployment or unemployed or employability or reemployment or re-employment or freelance* or employee* or working status or workload or working age or working population* or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence).ti,ab,kw. or ((work* or employ* or vocational) adj1 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*)).ti,ab,kw. 9 exp Counseling/ or Vocational Guidance/ or role/ or professional role/ or physician's role/ or social support/ or "Continuity of Patient Care"/ or Practice Patterns, Physicians'/ or Person-Centered Therapy/ or Adaptation, Psychological/ or (counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*).ti,ab,kw. or ((role* or activit*) adj2 (physician* or doctor* or primary care or general practi* or family practi* or general medical practi* or family medical practi* or family medicine or GP or GPs)).ti,ab,kw. or (physician* adj3 attitude*).ti,ab,kw. 10 (adolescent/ or exp child/ or exp Pediatrics/ or (child* or adolescen* or p?ediatric*).ti,ab,kw.) not (Adult/ or adult*.ti,ab,kw.) 11 comment/ or editorial/ or letter/ or news/ or (editorial* or comment* or letter*).ti,ab,kw. 12 (6 and 7 and 8 and 9) not 10 not 11 13 limit 12 to yr = "2000 -Current" View Large MEDLINE (Ovid) # Searches 1 *physicians/ or general practitioners/ or general practice/ or family practice/ or physicians, family/ or physicians, primary care/ or Primary Health Care/ or Physician's Role/ 2 (family adj2 (practi* or medicine or physician*)).ti,ab,kw. 3 (primary adj2 (care or treatment or practi* or medicine or physician*)).ti,ab,kw. 4 (general adj2 (practi* or physician*)).ti,ab,kw. 5 (doctor* or GP or GPs).ti,ab,kw. 6 1 or 2 or 3 or 4 or 5 7 exp Neoplasms/ or (cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*).ti,ab,kw. 8 exp work/ or return to work/ or exp employment/ or unemployment/ or exp occupations/ or workplace/ or Rehabilitation, Vocational/ or Sick Leave/ or Absenteeism/ or Retirement/ or Workers' Compensation/ or (work or job or occupation* or employment or unemployment or unemployed or employability or reemployment or re-employment or freelance* or employee* or working status or workload or working age or working population* or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence).ti,ab,kw. or ((work* or employ* or vocational) adj1 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*)).ti,ab,kw. 9 exp Counseling/ or Vocational Guidance/ or role/ or professional role/ or physician's role/ or social support/ or "Continuity of Patient Care"/ or Practice Patterns, Physicians'/ or Person-Centered Therapy/ or Adaptation, Psychological/ or (counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*).ti,ab,kw. or ((role* or activit*) adj2 (physician* or doctor* or primary care or general practi* or family practi* or general medical practi* or family medical practi* or family medicine or GP or GPs)).ti,ab,kw. or (physician* adj3 attitude*).ti,ab,kw. 10 (adolescent/ or exp child/ or exp Pediatrics/ or (child* or adolescen* or p?ediatric*).ti,ab,kw.) not (Adult/ or adult*.ti,ab,kw.) 11 comment/ or editorial/ or letter/ or news/ or (editorial* or comment* or letter*).ti,ab,kw. 12 (6 and 7 and 8 and 9) not 10 not 11 13 limit 12 to yr = "2000 -Current" # Searches 1 *physicians/ or general practitioners/ or general practice/ or family practice/ or physicians, family/ or physicians, primary care/ or Primary Health Care/ or Physician's Role/ 2 (family adj2 (practi* or medicine or physician*)).ti,ab,kw. 3 (primary adj2 (care or treatment or practi* or medicine or physician*)).ti,ab,kw. 4 (general adj2 (practi* or physician*)).ti,ab,kw. 5 (doctor* or GP or GPs).ti,ab,kw. 6 1 or 2 or 3 or 4 or 5 7 exp Neoplasms/ or (cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*).ti,ab,kw. 8 exp work/ or return to work/ or exp employment/ or unemployment/ or exp occupations/ or workplace/ or Rehabilitation, Vocational/ or Sick Leave/ or Absenteeism/ or Retirement/ or Workers' Compensation/ or (work or job or occupation* or employment or unemployment or unemployed or employability or reemployment or re-employment or freelance* or employee* or working status or workload or working age or working population* or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence).ti,ab,kw. or ((work* or employ* or vocational) adj1 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*)).ti,ab,kw. 9 exp Counseling/ or Vocational Guidance/ or role/ or professional role/ or physician's role/ or social support/ or "Continuity of Patient Care"/ or Practice Patterns, Physicians'/ or Person-Centered Therapy/ or Adaptation, Psychological/ or (counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*).ti,ab,kw. or ((role* or activit*) adj2 (physician* or doctor* or primary care or general practi* or family practi* or general medical practi* or family medical practi* or family medicine or GP or GPs)).ti,ab,kw. or (physician* adj3 attitude*).ti,ab,kw. 10 (adolescent/ or exp child/ or exp Pediatrics/ or (child* or adolescen* or p?ediatric*).ti,ab,kw.) not (Adult/ or adult*.ti,ab,kw.) 11 comment/ or editorial/ or letter/ or news/ or (editorial* or comment* or letter*).ti,ab,kw. 12 (6 and 7 and 8 and 9) not 10 not 11 13 limit 12 to yr = "2000 -Current" View Large EMBASE (Ovid) # Searches 1 *physician/ or general practitioner/ or general practice/ or exp primary health care/ or family medicine/ 2 (family adj2 (practi* or medicine or physician*)).ti,ab,kw. 3 (primary adj2 (care or treatment or practi* or medicine or physician*)).ti,ab,kw. 4 (general adj2 (practi* or physician*)).ti,ab,kw. 5 (doctor* or GP or GPs).ti,ab,kw. 6 1 or 2 or 3 or 4 or 5 7 exp *neoplasm/ or (cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*).ti,ab,kw. 8 exp work/ or return to work/ or exp employment/ or unemployment/ or employer/ or employability/ or vocational rehabilitation/ or work resumption/ or medical leave/ or absenteeism/ or retirement/ or workman compensation/ or (work or job or employment or unemployment or unemployed or employability or reemployment or re-employment or freelance* or employee or employees or employer or working status or workload or working age or working population or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence).ti,ab,kw. or ((work* or employ* or vocational) adj (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehabilitation)).ti,ab,kw. 9 exp counseling/ or vocational guidance/ or *physician attitude/ or social support/ or (counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*).ti,ab,kw. or ((role* or activit*) adj2 (physician* or doctor* or primary care or general practi* or family practi* or general medical practi* or family medical practi* or family medicine or GP or GPs)).ti,ab,kw. or (physician* adj3 attitude*).ti,ab,kw. 10 (adolescent/ or child/ or exp pediatrics/ or (child* or adolescen* or p?ediatric*).ti,ab,kw.) not (adult/ or adult*.ti,ab,kw.) 11 editorial/ or letter/ or (editorial* or comment* or letter*).ti,ab,kw. 12 (6 and 7 and 8 and 9) not 10 not 11 13 limit 12 to yr = "2000 -Current" # Searches 1 *physician/ or general practitioner/ or general practice/ or exp primary health care/ or family medicine/ 2 (family adj2 (practi* or medicine or physician*)).ti,ab,kw. 3 (primary adj2 (care or treatment or practi* or medicine or physician*)).ti,ab,kw. 4 (general adj2 (practi* or physician*)).ti,ab,kw. 5 (doctor* or GP or GPs).ti,ab,kw. 6 1 or 2 or 3 or 4 or 5 7 exp *neoplasm/ or (cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*).ti,ab,kw. 8 exp work/ or return to work/ or exp employment/ or unemployment/ or employer/ or employability/ or vocational rehabilitation/ or work resumption/ or medical leave/ or absenteeism/ or retirement/ or workman compensation/ or (work or job or employment or unemployment or unemployed or employability or reemployment or re-employment or freelance* or employee or employees or employer or working status or workload or working age or working population or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence).ti,ab,kw. or ((work* or employ* or vocational) adj (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehabilitation)).ti,ab,kw. 9 exp counseling/ or vocational guidance/ or *physician attitude/ or social support/ or (counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*).ti,ab,kw. or ((role* or activit*) adj2 (physician* or doctor* or primary care or general practi* or family practi* or general medical practi* or family medical practi* or family medicine or GP or GPs)).ti,ab,kw. or (physician* adj3 attitude*).ti,ab,kw. 10 (adolescent/ or child/ or exp pediatrics/ or (child* or adolescen* or p?ediatric*).ti,ab,kw.) not (adult/ or adult*.ti,ab,kw.) 11 editorial/ or letter/ or (editorial* or comment* or letter*).ti,ab,kw. 12 (6 and 7 and 8 and 9) not 10 not 11 13 limit 12 to yr = "2000 -Current" View Large EMBASE (Ovid) # Searches 1 *physician/ or general practitioner/ or general practice/ or exp primary health care/ or family medicine/ 2 (family adj2 (practi* or medicine or physician*)).ti,ab,kw. 3 (primary adj2 (care or treatment or practi* or medicine or physician*)).ti,ab,kw. 4 (general adj2 (practi* or physician*)).ti,ab,kw. 5 (doctor* or GP or GPs).ti,ab,kw. 6 1 or 2 or 3 or 4 or 5 7 exp *neoplasm/ or (cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*).ti,ab,kw. 8 exp work/ or return to work/ or exp employment/ or unemployment/ or employer/ or employability/ or vocational rehabilitation/ or work resumption/ or medical leave/ or absenteeism/ or retirement/ or workman compensation/ or (work or job or employment or unemployment or unemployed or employability or reemployment or re-employment or freelance* or employee or employees or employer or working status or workload or working age or working population or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence).ti,ab,kw. or ((work* or employ* or vocational) adj (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehabilitation)).ti,ab,kw. 9 exp counseling/ or vocational guidance/ or *physician attitude/ or social support/ or (counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*).ti,ab,kw. or ((role* or activit*) adj2 (physician* or doctor* or primary care or general practi* or family practi* or general medical practi* or family medical practi* or family medicine or GP or GPs)).ti,ab,kw. or (physician* adj3 attitude*).ti,ab,kw. 10 (adolescent/ or child/ or exp pediatrics/ or (child* or adolescen* or p?ediatric*).ti,ab,kw.) not (adult/ or adult*.ti,ab,kw.) 11 editorial/ or letter/ or (editorial* or comment* or letter*).ti,ab,kw. 12 (6 and 7 and 8 and 9) not 10 not 11 13 limit 12 to yr = "2000 -Current" # Searches 1 *physician/ or general practitioner/ or general practice/ or exp primary health care/ or family medicine/ 2 (family adj2 (practi* or medicine or physician*)).ti,ab,kw. 3 (primary adj2 (care or treatment or practi* or medicine or physician*)).ti,ab,kw. 4 (general adj2 (practi* or physician*)).ti,ab,kw. 5 (doctor* or GP or GPs).ti,ab,kw. 6 1 or 2 or 3 or 4 or 5 7 exp *neoplasm/ or (cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*).ti,ab,kw. 8 exp work/ or return to work/ or exp employment/ or unemployment/ or employer/ or employability/ or vocational rehabilitation/ or work resumption/ or medical leave/ or absenteeism/ or retirement/ or workman compensation/ or (work or job or employment or unemployment or unemployed or employability or reemployment or re-employment or freelance* or employee or employees or employer or working status or workload or working age or working population or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence).ti,ab,kw. or ((work* or employ* or vocational) adj (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehabilitation)).ti,ab,kw. 9 exp counseling/ or vocational guidance/ or *physician attitude/ or social support/ or (counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*).ti,ab,kw. or ((role* or activit*) adj2 (physician* or doctor* or primary care or general practi* or family practi* or general medical practi* or family medical practi* or family medicine or GP or GPs)).ti,ab,kw. or (physician* adj3 attitude*).ti,ab,kw. 10 (adolescent/ or child/ or exp pediatrics/ or (child* or adolescen* or p?ediatric*).ti,ab,kw.) not (adult/ or adult*.ti,ab,kw.) 11 editorial/ or letter/ or (editorial* or comment* or letter*).ti,ab,kw. 12 (6 and 7 and 8 and 9) not 10 not 11 13 limit 12 to yr = "2000 -Current" View Large PsycINFO (Ovid) # Searches 1 physicians/ or family physicians/ or general practitioners/ or family medicine/ or primary health care/ or (physician* or doctor* or primary care or general practi* or family practi* or general medical practi* or family medical practi* or family medicine or GP or GPs).ti,ab,id. 2 (family adj3 (practi* or medicine or physician*)).ti,ab,id. 3 (primary adj2 (care or treatment or practi* or medicine or physician*)).ti,ab,id. 4 (general adj2 (practi* or physician*)).ti,ab,id. 5 1 or 2 or 3 or 4 6 exp neoplasms/ or oncology/ or (cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*).ti,ab,id. # Searches 1 physicians/ or family physicians/ or general practitioners/ or family medicine/ or primary health care/ or (physician* or doctor* or primary care or general practi* or family practi* or general medical practi* or family medical practi* or family medicine or GP or GPs).ti,ab,id. 2 (family adj3 (practi* or medicine or physician*)).ti,ab,id. 3 (primary adj2 (care or treatment or practi* or medicine or physician*)).ti,ab,id. 4 (general adj2 (practi* or physician*)).ti,ab,id. 5 1 or 2 or 3 or 4 6 exp neoplasms/ or oncology/ or (cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*).ti,ab,id. View Large PsycINFO (Ovid) # Searches 1 physicians/ or family physicians/ or general practitioners/ or family medicine/ or primary health care/ or (physician* or doctor* or primary care or general practi* or family practi* or general medical practi* or family medical practi* or family medicine or GP or GPs).ti,ab,id. 2 (family adj3 (practi* or medicine or physician*)).ti,ab,id. 3 (primary adj2 (care or treatment or practi* or medicine or physician*)).ti,ab,id. 4 (general adj2 (practi* or physician*)).ti,ab,id. 5 1 or 2 or 3 or 4 6 exp neoplasms/ or oncology/ or (cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*).ti,ab,id. # Searches 1 physicians/ or family physicians/ or general practitioners/ or family medicine/ or primary health care/ or (physician* or doctor* or primary care or general practi* or family practi* or general medical practi* or family medical practi* or family medicine or GP or GPs).ti,ab,id. 2 (family adj3 (practi* or medicine or physician*)).ti,ab,id. 3 (primary adj2 (care or treatment or practi* or medicine or physician*)).ti,ab,id. 4 (general adj2 (practi* or physician*)).ti,ab,id. 5 1 or 2 or 3 or 4 6 exp neoplasms/ or oncology/ or (cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*).ti,ab,id. View Large PsycINFO (Ovid) # Searches 7 reemployment/ or exp vocational rehabilitation/ or exp employment status/ or retirement/ or unemployment/ or employability/ or working women/ or exp working conditions/ or work-life balance/ or work load/ or work scheduling/ or occupations/ 8 (work or job or occupation* or vocation* or employ* or unemploy* or reemploy* or re-employ* or freelance* or working status or workload or working age or working population or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence).ti,ab,id. 9 ((work* or employ* or vocational) adj3 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehabilitation)).ti,ab,id. 10 7 or 8 or 9 11 exp counseling/ or exp counselors/ or counselor role/ or rehabilitation counseling/ or exp occupational guidance/ or exp coaching/ or roles/ or counselor role/ or exp professional role/ or exp role expectations/ or role perception/ or role taking/ or therapist role/ or professional role/ or roles/ or counselor role/ or exp therapist attitudes/ or role perception/ or exp professional role/ or role taking/ or exp roles/ 12 (counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*).ti,ab,id. 13 ((role* or activit*) adj2 (physician* or doctor* or primary care or general practi* or family practi* or general medical practi* or family medical practi* or family medicine or GP or GPs)).ti,ab,id. 14 (physician* adj3 attitude*).ti,ab,id. 15 11 or 12 or 13 or 14 16 (exp pediatrics/ or (child* or adolescen* or p?ediatric*).ti,ab,id.) not adult*.ti,ab,id. 17 (5 and 6 and 10 and 15) not 16 18 limit 17 to yr = "2000 -Current" # Searches 7 reemployment/ or exp vocational rehabilitation/ or exp employment status/ or retirement/ or unemployment/ or employability/ or working women/ or exp working conditions/ or work-life balance/ or work load/ or work scheduling/ or occupations/ 8 (work or job or occupation* or vocation* or employ* or unemploy* or reemploy* or re-employ* or freelance* or working status or workload or working age or working population or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence).ti,ab,id. 9 ((work* or employ* or vocational) adj3 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehabilitation)).ti,ab,id. 10 7 or 8 or 9 11 exp counseling/ or exp counselors/ or counselor role/ or rehabilitation counseling/ or exp occupational guidance/ or exp coaching/ or roles/ or counselor role/ or exp professional role/ or exp role expectations/ or role perception/ or role taking/ or therapist role/ or professional role/ or roles/ or counselor role/ or exp therapist attitudes/ or role perception/ or exp professional role/ or role taking/ or exp roles/ 12 (counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*).ti,ab,id. 13 ((role* or activit*) adj2 (physician* or doctor* or primary care or general practi* or family practi* or general medical practi* or family medical practi* or family medicine or GP or GPs)).ti,ab,id. 14 (physician* adj3 attitude*).ti,ab,id. 15 11 or 12 or 13 or 14 16 (exp pediatrics/ or (child* or adolescen* or p?ediatric*).ti,ab,id.) not adult*.ti,ab,id. 17 (5 and 6 and 10 and 15) not 16 18 limit 17 to yr = "2000 -Current" View Large PsycINFO (Ovid) # Searches 7 reemployment/ or exp vocational rehabilitation/ or exp employment status/ or retirement/ or unemployment/ or employability/ or working women/ or exp working conditions/ or work-life balance/ or work load/ or work scheduling/ or occupations/ 8 (work or job or occupation* or vocation* or employ* or unemploy* or reemploy* or re-employ* or freelance* or working status or workload or working age or working population or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence).ti,ab,id. 9 ((work* or employ* or vocational) adj3 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehabilitation)).ti,ab,id. 10 7 or 8 or 9 11 exp counseling/ or exp counselors/ or counselor role/ or rehabilitation counseling/ or exp occupational guidance/ or exp coaching/ or roles/ or counselor role/ or exp professional role/ or exp role expectations/ or role perception/ or role taking/ or therapist role/ or professional role/ or roles/ or counselor role/ or exp therapist attitudes/ or role perception/ or exp professional role/ or role taking/ or exp roles/ 12 (counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*).ti,ab,id. 13 ((role* or activit*) adj2 (physician* or doctor* or primary care or general practi* or family practi* or general medical practi* or family medical practi* or family medicine or GP or GPs)).ti,ab,id. 14 (physician* adj3 attitude*).ti,ab,id. 15 11 or 12 or 13 or 14 16 (exp pediatrics/ or (child* or adolescen* or p?ediatric*).ti,ab,id.) not adult*.ti,ab,id. 17 (5 and 6 and 10 and 15) not 16 18 limit 17 to yr = "2000 -Current" # Searches 7 reemployment/ or exp vocational rehabilitation/ or exp employment status/ or retirement/ or unemployment/ or employability/ or working women/ or exp working conditions/ or work-life balance/ or work load/ or work scheduling/ or occupations/ 8 (work or job or occupation* or vocation* or employ* or unemploy* or reemploy* or re-employ* or freelance* or working status or workload or working age or working population or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence).ti,ab,id. 9 ((work* or employ* or vocational) adj3 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehabilitation)).ti,ab,id. 10 7 or 8 or 9 11 exp counseling/ or exp counselors/ or counselor role/ or rehabilitation counseling/ or exp occupational guidance/ or exp coaching/ or roles/ or counselor role/ or exp professional role/ or exp role expectations/ or role perception/ or role taking/ or therapist role/ or professional role/ or roles/ or counselor role/ or exp therapist attitudes/ or role perception/ or exp professional role/ or role taking/ or exp roles/ 12 (counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*).ti,ab,id. 13 ((role* or activit*) adj2 (physician* or doctor* or primary care or general practi* or family practi* or general medical practi* or family medical practi* or family medicine or GP or GPs)).ti,ab,id. 14 (physician* adj3 attitude*).ti,ab,id. 15 11 or 12 or 13 or 14 16 (exp pediatrics/ or (child* or adolescen* or p?ediatric*).ti,ab,id.) not adult*.ti,ab,id. 17 (5 and 6 and 10 and 15) not 16 18 limit 17 to yr = "2000 -Current" View Large COCHRANE LIBRARY ID Search #1 MeSH descriptor: [Physicians] this term only #2 MeSH descriptor: [General Practitioners] explode all trees #3 MeSH descriptor: [General Practice] explode all trees #4 MeSH descriptor: [Family Practice] explode all trees #5 MeSH descriptor: [Physicians, Family] explode all trees #6 MeSH descriptor: [Physicians, Primary Care] explode all trees #7 MeSH descriptor: [Primary Health Care] explode all trees #8 MeSH descriptor: [Physician's Role] explode all trees #9 family near/2 (practi* or medicine or physician*):ti,ab,kw (Word variations have been searched) #10 primary near/2 (care or treatment or practi* or medicine or physician*):ti,ab,kw (Word variations have been searched) #11 general near/2 (practi* or physician*):ti,ab,kw (Word variations have been searched) #12 doctor* or GP or GPs or physician*:ti,ab,kw (Word variations have been searched) #13 #1 r #2 or #3 or #4 or #5 or #6 or #7 or #8 or #9 or #10 or #11 or #12 #14 MeSH descriptor: [Neoplasms] explode all trees #15 cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*:ti,ab,kw (Word variations have been searched) #16 #14 or #15 #17 MeSH descriptor: [Work] explode all trees #18 MeSH descriptor: [Employment] explode all trees #19 MeSH descriptor: [Occupations] explode all trees #20 MeSH descriptor: [Rehabilitation, Vocational] explode all trees #21 MeSH descriptor: [Sick Leave] explode all trees #22 MeSH descriptor: [Absenteeism] explode all trees #23 MeSH descriptor: [Retirement] explode all trees #24 MeSH descriptor: [Workers' Compensation] explode all trees #25 work or job or occupation* or employment or unemployment or unemployed or employability or reemployment or re-employment or freelance* or employee* or working status or workload or working age or working population* or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence:ti,ab,kw (Word variations have been searched) #26 (work* or employ* or vocation*) near/3 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*):ti,ab,kw (Word variations have been searched) #27 #17 or #18 or #19 or #20 or #21 or #22 or #23 or #24 or #25 or #26 #28 MeSH descriptor: [Counseling] explode all trees #29 MeSH descriptor: [Vocational Guidance] explode all trees #30 MeSH descriptor: [Role] explode all trees #31 MeSH descriptor: [Physician's Role] explode all trees #32 MeSH descriptor: [Social Support] explode all trees #33 MeSH descriptor: [Continuity of Patient Care] explode all trees #34 MeSH descriptor: [Practice Patterns, Physicians'] explode all trees #35 MeSH descriptor: [Person-Centered Therapy] explode all trees #36 MeSH descriptor: [Adaptation, Psychological] explode all trees #37 counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*:ti,ab,kw (Word variations have been searched) #38 (role* or activit*) near/3 (physician* or doctor* or primary care or general practi* or family practi* or general medical practi* or family medical practi* or family medicine or GP or GPs):ti,ab,kw (Word variations have been searched) #39 #28 or #29 or #30 or #31 or #32 or #33 or #34 or #35 or #36 or #37 or #38 #40 #13 and #16 and #27 and #39 Publication Year from 2000 to 2016 ID Search #1 MeSH descriptor: [Physicians] this term only #2 MeSH descriptor: [General Practitioners] explode all trees #3 MeSH descriptor: [General Practice] explode all trees #4 MeSH descriptor: [Family Practice] explode all trees #5 MeSH descriptor: [Physicians, Family] explode all trees #6 MeSH descriptor: [Physicians, Primary Care] explode all trees #7 MeSH descriptor: [Primary Health Care] explode all trees #8 MeSH descriptor: [Physician's Role] explode all trees #9 family near/2 (practi* or medicine or physician*):ti,ab,kw (Word variations have been searched) #10 primary near/2 (care or treatment or practi* or medicine or physician*):ti,ab,kw (Word variations have been searched) #11 general near/2 (practi* or physician*):ti,ab,kw (Word variations have been searched) #12 doctor* or GP or GPs or physician*:ti,ab,kw (Word variations have been searched) #13 #1 r #2 or #3 or #4 or #5 or #6 or #7 or #8 or #9 or #10 or #11 or #12 #14 MeSH descriptor: [Neoplasms] explode all trees #15 cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*:ti,ab,kw (Word variations have been searched) #16 #14 or #15 #17 MeSH descriptor: [Work] explode all trees #18 MeSH descriptor: [Employment] explode all trees #19 MeSH descriptor: [Occupations] explode all trees #20 MeSH descriptor: [Rehabilitation, Vocational] explode all trees #21 MeSH descriptor: [Sick Leave] explode all trees #22 MeSH descriptor: [Absenteeism] explode all trees #23 MeSH descriptor: [Retirement] explode all trees #24 MeSH descriptor: [Workers' Compensation] explode all trees #25 work or job or occupation* or employment or unemployment or unemployed or employability or reemployment or re-employment or freelance* or employee* or working status or workload or working age or working population* or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence:ti,ab,kw (Word variations have been searched) #26 (work* or employ* or vocation*) near/3 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*):ti,ab,kw (Word variations have been searched) #27 #17 or #18 or #19 or #20 or #21 or #22 or #23 or #24 or #25 or #26 #28 MeSH descriptor: [Counseling] explode all trees #29 MeSH descriptor: [Vocational Guidance] explode all trees #30 MeSH descriptor: [Role] explode all trees #31 MeSH descriptor: [Physician's Role] explode all trees #32 MeSH descriptor: [Social Support] explode all trees #33 MeSH descriptor: [Continuity of Patient Care] explode all trees #34 MeSH descriptor: [Practice Patterns, Physicians'] explode all trees #35 MeSH descriptor: [Person-Centered Therapy] explode all trees #36 MeSH descriptor: [Adaptation, Psychological] explode all trees #37 counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*:ti,ab,kw (Word variations have been searched) #38 (role* or activit*) near/3 (physician* or doctor* or primary care or general practi* or family practi* or general medical practi* or family medical practi* or family medicine or GP or GPs):ti,ab,kw (Word variations have been searched) #39 #28 or #29 or #30 or #31 or #32 or #33 or #34 or #35 or #36 or #37 or #38 #40 #13 and #16 and #27 and #39 Publication Year from 2000 to 2016 View Large COCHRANE LIBRARY ID Search #1 MeSH descriptor: [Physicians] this term only #2 MeSH descriptor: [General Practitioners] explode all trees #3 MeSH descriptor: [General Practice] explode all trees #4 MeSH descriptor: [Family Practice] explode all trees #5 MeSH descriptor: [Physicians, Family] explode all trees #6 MeSH descriptor: [Physicians, Primary Care] explode all trees #7 MeSH descriptor: [Primary Health Care] explode all trees #8 MeSH descriptor: [Physician's Role] explode all trees #9 family near/2 (practi* or medicine or physician*):ti,ab,kw (Word variations have been searched) #10 primary near/2 (care or treatment or practi* or medicine or physician*):ti,ab,kw (Word variations have been searched) #11 general near/2 (practi* or physician*):ti,ab,kw (Word variations have been searched) #12 doctor* or GP or GPs or physician*:ti,ab,kw (Word variations have been searched) #13 #1 r #2 or #3 or #4 or #5 or #6 or #7 or #8 or #9 or #10 or #11 or #12 #14 MeSH descriptor: [Neoplasms] explode all trees #15 cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*:ti,ab,kw (Word variations have been searched) #16 #14 or #15 #17 MeSH descriptor: [Work] explode all trees #18 MeSH descriptor: [Employment] explode all trees #19 MeSH descriptor: [Occupations] explode all trees #20 MeSH descriptor: [Rehabilitation, Vocational] explode all trees #21 MeSH descriptor: [Sick Leave] explode all trees #22 MeSH descriptor: [Absenteeism] explode all trees #23 MeSH descriptor: [Retirement] explode all trees #24 MeSH descriptor: [Workers' Compensation] explode all trees #25 work or job or occupation* or employment or unemployment or unemployed or employability or reemployment or re-employment or freelance* or employee* or working status or workload or working age or working population* or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence:ti,ab,kw (Word variations have been searched) #26 (work* or employ* or vocation*) near/3 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*):ti,ab,kw (Word variations have been searched) #27 #17 or #18 or #19 or #20 or #21 or #22 or #23 or #24 or #25 or #26 #28 MeSH descriptor: [Counseling] explode all trees #29 MeSH descriptor: [Vocational Guidance] explode all trees #30 MeSH descriptor: [Role] explode all trees #31 MeSH descriptor: [Physician's Role] explode all trees #32 MeSH descriptor: [Social Support] explode all trees #33 MeSH descriptor: [Continuity of Patient Care] explode all trees #34 MeSH descriptor: [Practice Patterns, Physicians'] explode all trees #35 MeSH descriptor: [Person-Centered Therapy] explode all trees #36 MeSH descriptor: [Adaptation, Psychological] explode all trees #37 counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*:ti,ab,kw (Word variations have been searched) #38 (role* or activit*) near/3 (physician* or doctor* or primary care or general practi* or family practi* or general medical practi* or family medical practi* or family medicine or GP or GPs):ti,ab,kw (Word variations have been searched) #39 #28 or #29 or #30 or #31 or #32 or #33 or #34 or #35 or #36 or #37 or #38 #40 #13 and #16 and #27 and #39 Publication Year from 2000 to 2016 ID Search #1 MeSH descriptor: [Physicians] this term only #2 MeSH descriptor: [General Practitioners] explode all trees #3 MeSH descriptor: [General Practice] explode all trees #4 MeSH descriptor: [Family Practice] explode all trees #5 MeSH descriptor: [Physicians, Family] explode all trees #6 MeSH descriptor: [Physicians, Primary Care] explode all trees #7 MeSH descriptor: [Primary Health Care] explode all trees #8 MeSH descriptor: [Physician's Role] explode all trees #9 family near/2 (practi* or medicine or physician*):ti,ab,kw (Word variations have been searched) #10 primary near/2 (care or treatment or practi* or medicine or physician*):ti,ab,kw (Word variations have been searched) #11 general near/2 (practi* or physician*):ti,ab,kw (Word variations have been searched) #12 doctor* or GP or GPs or physician*:ti,ab,kw (Word variations have been searched) #13 #1 r #2 or #3 or #4 or #5 or #6 or #7 or #8 or #9 or #10 or #11 or #12 #14 MeSH descriptor: [Neoplasms] explode all trees #15 cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*:ti,ab,kw (Word variations have been searched) #16 #14 or #15 #17 MeSH descriptor: [Work] explode all trees #18 MeSH descriptor: [Employment] explode all trees #19 MeSH descriptor: [Occupations] explode all trees #20 MeSH descriptor: [Rehabilitation, Vocational] explode all trees #21 MeSH descriptor: [Sick Leave] explode all trees #22 MeSH descriptor: [Absenteeism] explode all trees #23 MeSH descriptor: [Retirement] explode all trees #24 MeSH descriptor: [Workers' Compensation] explode all trees #25 work or job or occupation* or employment or unemployment or unemployed or employability or reemployment or re-employment or freelance* or employee* or working status or workload or working age or working population* or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence:ti,ab,kw (Word variations have been searched) #26 (work* or employ* or vocation*) near/3 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*):ti,ab,kw (Word variations have been searched) #27 #17 or #18 or #19 or #20 or #21 or #22 or #23 or #24 or #25 or #26 #28 MeSH descriptor: [Counseling] explode all trees #29 MeSH descriptor: [Vocational Guidance] explode all trees #30 MeSH descriptor: [Role] explode all trees #31 MeSH descriptor: [Physician's Role] explode all trees #32 MeSH descriptor: [Social Support] explode all trees #33 MeSH descriptor: [Continuity of Patient Care] explode all trees #34 MeSH descriptor: [Practice Patterns, Physicians'] explode all trees #35 MeSH descriptor: [Person-Centered Therapy] explode all trees #36 MeSH descriptor: [Adaptation, Psychological] explode all trees #37 counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*:ti,ab,kw (Word variations have been searched) #38 (role* or activit*) near/3 (physician* or doctor* or primary care or general practi* or family practi* or general medical practi* or family medical practi* or family medicine or GP or GPs):ti,ab,kw (Word variations have been searched) #39 #28 or #29 or #30 or #31 or #32 or #33 or #34 or #35 or #36 or #37 or #38 #40 #13 and #16 and #27 and #39 Publication Year from 2000 to 2016 View Large CINAHL (Ebsco) # Query S6 S1 AND S2 AND S3 AND S4 Limiters—Published Date: 20160401-20170131 S5 S1 AND S2 AND S3 AND S4 S4 ((MH "Counseling+") OR (MH "Vocational Guidance") OR ((MH "Physician's Role") OR (MH "Professional Role") OR (MH "Role")) OR (MH "Continuity of Patient Care") OR (TI (counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*) OR AB (counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*))) S3 ((((MH "Work") OR (MH "Job Re-Entry") OR (MH "Employment+") OR (MH "Unemployment") OR ((MH "Occupations and Professions+")) OR (MH "Rehabilitation, Vocational") OR (MH "Sick Leave") OR (MH "Absenteeism") OR (MH "Retirement") OR (MH "Worker's Compensation"))) OR ((TI (work or job or occupation* or employment or unemployment or unemployed or employability or reemployment or re-employment or freelance* or employee* or working status or workload or working age or working population* or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence ) OR AB (work or job or occupation* or employment or unemployment or unemployed or employability or reemployment or re-employment or freelance* or employee* or working status or workload or working age or working population* or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence ) OR (TI ((work* or employ* or vocational) N1 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*)) OR AB ((work* or employ* or vocational) N1 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*))) OR (TI ((work* or employ* or vocational) N1 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*) ) OR AB ((work* or employ* or vocational) N1 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*)))) S2 ((MM "Neoplasms+") OR (MM "Oncologic Care") OR (TI (cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*) OR AB (cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*))) S1 ((MH "Physicians, Family")) OR (MH "Family Practice") OR (MH "Physicians, Family") OR (MH "Primary Health Care") OR (MH "Physician's Role")) OR (TI (family N1 (practi* or medicine or physician*) OR AB (family N1 (practi* or medicine or physician*)) OR (TI (primary N2 (care or treatment or practi* or medicine or physician*)) OR AB (primary N1 (care or treatment or practi* or medicine or physician*))) OR (TI (general N1 (practi* or physician*)) OR AB (general N1 (practi* or physician*))) OR ((doctor* or GP or GPs or physician*) OR AB (doctor* or GP or GPs or physician*))) # Query S6 S1 AND S2 AND S3 AND S4 Limiters—Published Date: 20160401-20170131 S5 S1 AND S2 AND S3 AND S4 S4 ((MH "Counseling+") OR (MH "Vocational Guidance") OR ((MH "Physician's Role") OR (MH "Professional Role") OR (MH "Role")) OR (MH "Continuity of Patient Care") OR (TI (counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*) OR AB (counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*))) S3 ((((MH "Work") OR (MH "Job Re-Entry") OR (MH "Employment+") OR (MH "Unemployment") OR ((MH "Occupations and Professions+")) OR (MH "Rehabilitation, Vocational") OR (MH "Sick Leave") OR (MH "Absenteeism") OR (MH "Retirement") OR (MH "Worker's Compensation"))) OR ((TI (work or job or occupation* or employment or unemployment or unemployed or employability or reemployment or re-employment or freelance* or employee* or working status or workload or working age or working population* or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence ) OR AB (work or job or occupation* or employment or unemployment or unemployed or employability or reemployment or re-employment or freelance* or employee* or working status or workload or working age or working population* or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence ) OR (TI ((work* or employ* or vocational) N1 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*)) OR AB ((work* or employ* or vocational) N1 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*))) OR (TI ((work* or employ* or vocational) N1 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*) ) OR AB ((work* or employ* or vocational) N1 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*)))) S2 ((MM "Neoplasms+") OR (MM "Oncologic Care") OR (TI (cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*) OR AB (cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*))) S1 ((MH "Physicians, Family")) OR (MH "Family Practice") OR (MH "Physicians, Family") OR (MH "Primary Health Care") OR (MH "Physician's Role")) OR (TI (family N1 (practi* or medicine or physician*) OR AB (family N1 (practi* or medicine or physician*)) OR (TI (primary N2 (care or treatment or practi* or medicine or physician*)) OR AB (primary N1 (care or treatment or practi* or medicine or physician*))) OR (TI (general N1 (practi* or physician*)) OR AB (general N1 (practi* or physician*))) OR ((doctor* or GP or GPs or physician*) OR AB (doctor* or GP or GPs or physician*))) View Large # Query S6 S1 AND S2 AND S3 AND S4 Limiters—Published Date: 20160401-20170131 S5 S1 AND S2 AND S3 AND S4 S4 ((MH "Counseling+") OR (MH "Vocational Guidance") OR ((MH "Physician's Role") OR (MH "Professional Role") OR (MH "Role")) OR (MH "Continuity of Patient Care") OR (TI (counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*) OR AB (counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*))) S3 ((((MH "Work") OR (MH "Job Re-Entry") OR (MH "Employment+") OR (MH "Unemployment") OR ((MH "Occupations and Professions+")) OR (MH "Rehabilitation, Vocational") OR (MH "Sick Leave") OR (MH "Absenteeism") OR (MH "Retirement") OR (MH "Worker's Compensation"))) OR ((TI (work or job or occupation* or employment or unemployment or unemployed or employability or reemployment or re-employment or freelance* or employee* or working status or workload or working age or working population* or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence ) OR AB (work or job or occupation* or employment or unemployment or unemployed or employability or reemployment or re-employment or freelance* or employee* or working status or workload or working age or working population* or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence ) OR (TI ((work* or employ* or vocational) N1 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*)) OR AB ((work* or employ* or vocational) N1 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*))) OR (TI ((work* or employ* or vocational) N1 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*) ) OR AB ((work* or employ* or vocational) N1 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*)))) S2 ((MM "Neoplasms+") OR (MM "Oncologic Care") OR (TI (cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*) OR AB (cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*))) S1 ((MH "Physicians, Family")) OR (MH "Family Practice") OR (MH "Physicians, Family") OR (MH "Primary Health Care") OR (MH "Physician's Role")) OR (TI (family N1 (practi* or medicine or physician*) OR AB (family N1 (practi* or medicine or physician*)) OR (TI (primary N2 (care or treatment or practi* or medicine or physician*)) OR AB (primary N1 (care or treatment or practi* or medicine or physician*))) OR (TI (general N1 (practi* or physician*)) OR AB (general N1 (practi* or physician*))) OR ((doctor* or GP or GPs or physician*) OR AB (doctor* or GP or GPs or physician*))) # Query S6 S1 AND S2 AND S3 AND S4 Limiters—Published Date: 20160401-20170131 S5 S1 AND S2 AND S3 AND S4 S4 ((MH "Counseling+") OR (MH "Vocational Guidance") OR ((MH "Physician's Role") OR (MH "Professional Role") OR (MH "Role")) OR (MH "Continuity of Patient Care") OR (TI (counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*) OR AB (counsel* or advic* or care or coach* or guide or guiding or guidanc* or support* or assist*))) S3 ((((MH "Work") OR (MH "Job Re-Entry") OR (MH "Employment+") OR (MH "Unemployment") OR ((MH "Occupations and Professions+")) OR (MH "Rehabilitation, Vocational") OR (MH "Sick Leave") OR (MH "Absenteeism") OR (MH "Retirement") OR (MH "Worker's Compensation"))) OR ((TI (work or job or occupation* or employment or unemployment or unemployed or employability or reemployment or re-employment or freelance* or employee* or working status or workload or working age or working population* or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence ) OR AB (work or job or occupation* or employment or unemployment or unemployed or employability or reemployment or re-employment or freelance* or employee* or working status or workload or working age or working population* or working life or workforce or workplace or workability or re-entry or sick leave or absenteeism or sickness absence ) OR (TI ((work* or employ* or vocational) N1 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*)) OR AB ((work* or employ* or vocational) N1 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*))) OR (TI ((work* or employ* or vocational) N1 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*) ) OR AB ((work* or employ* or vocational) N1 (ability or disability or capacity or resumption or retention or status or capacity or reintegration or re-integration or integration or recovery or rehab*)))) S2 ((MM "Neoplasms+") OR (MM "Oncologic Care") OR (TI (cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*) OR AB (cancer* or neoplasm* or tumo?r* or carcinom* or oncolog* or malignan*))) S1 ((MH "Physicians, Family")) OR (MH "Family Practice") OR (MH "Physicians, Family") OR (MH "Primary Health Care") OR (MH "Physician's Role")) OR (TI (family N1 (practi* or medicine or physician*) OR AB (family N1 (practi* or medicine or physician*)) OR (TI (primary N2 (care or treatment or practi* or medicine or physician*)) OR AB (primary N1 (care or treatment or practi* or medicine or physician*))) OR (TI (general N1 (practi* or physician*)) OR AB (general N1 (practi* or physician*))) OR ((doctor* or GP or GPs or physician*) OR AB (doctor* or GP or GPs or physician*))) View Large © The Author(s) 2018. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

Journal

Family PracticeOxford University Press

Published: Sep 18, 2018

References

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