Dianhan Zheng, Ph.D., Kennesaw State University Jing Zhang, Ph.D., California State University – San Bernardino Avery Britt, Kennesaw State University
The purpose of this study is to examine the outcomes of workplace perceptions about cancer survivors who returned to work. Drawing on social cognitive theory (Bandura, 1986; Gist & Mitchell, 1992), we propose that when cancer survivors perceive that they are seen as competent at work, it serves as an external informational cue about their abilities and therefore enhances their self-efficacy (Hypothesis 1). Self-efficacious survivors should, in turn, experience greater energy at work and lower intention to quit (Hypothesis 2). However, the perception that others see them as competent workers may have a stronger impact on self-efficacy among survivors with a higher need for emotional support (NES; Hypothesis 3) because of their greater desire for comfort and support from others, especially when distressed or undergoing negative events (Hill, 1987; Hill & Christensen, 1989). Overall, the indirect effects of competence perceptions by others on survivors? engagement and turnover intention through self-efficacy are moderated by NES (Hypothesis 4).
Cancer survivors face various challenges at work, such as frequent fatigue, cognitive limitations, and coping issues (Duijts et al., 2014), which may affect other people?s perceptions about them. Based on the stereotype content model (Fiske et al., 2002), cancer survivors were stereotypically classified in the high-warmth/low-competence quadrant, resulting in discriminatory treatment when they applied for jobs (Martinez et al., 2016). Shim and colleagues (2021) also found that cancer survivors who experienced discrimination because of cancer were two times more likely to lose their job. Research is still limited on how stereotypes about cancer survivors may affect their work outcomes. Therefore, we focused on workplace perceptions about cancer survivors? competence and the related mechanisms and job outcomes (Figure 1).
Two hundred cancer survivors were recruited from Qualtrics online panels and answered a survey about their work. Participants? demographic information was included in Table 1. Competence perceptions about cancer survivors by others were measured with six items (e.g., ?At work, cancer survivors are seen as capable.?) adapted from Fiske et al. (2002). Self-efficacy was measured with an eight-item scale (Schyns & Von Collani, 2002). Need for emotional support was measured with six items from the Interpersonal Orientation Scale (Hill, 1987). Engagement was measured with three vigor items from Utrecht Work Engagement Scale (UWES) (Schaufeli et al., 2006). Turnover intention was measured with two items (e.g., ?I think about quitting my job all the time?). Age, gender, organizational tenure, time since cancer diagnosis, and the extent to which survivors had shared their cancer diagnosis with colleagues were entered as covariates.
Confirmatory factor analyses indicated that the five-factor measurement model fits the data better (?^2 (265) = 403.27, CFI = .96, TLI = .96, RMSEA = .05) than all other nested models. Table 2 shows descriptive statistics, correlation coefficients, and reliability coefficients for the variables measured. Consistent with Hypothesis 1, competence perceptions about cancer survivors by others was positively related to self-efficacy (r = .30, p < .01). Process Macro in SPSS (Model 4 and 7; Hayes, 2012) was used to analyze the conceptual model (Figure 1). The indirect effect of competence perceptions by others on survivors? engagement (Indirect effect = .15, CI = [.06, .26]) and turnover intention (Indirect effect = -.13, CI = [-.24, -.05]) through self-efficacy were both significant, supporting Hypothesis 2. There was a significant interaction between competence perceptions by others and NES on self-efficacy (Table 3 and Figure 2). Simple slope analysis (Aiken & West, 1991) indicated that the positive relationship between competence perceptions by others and self-efficacy was significant when NES was high (B = .25, SE = .07, p < .01) but not significant when NES was low (B = .05, SE = .06, ns). Hypothesis 3 was supported. The indirect effect of competence perceptions by others on engagement via self-efficacy was significant when NES was high or average but not significant when NES was low (Moderated mediation index = .06, CI = [.00, .11]). The same effects were observed when turnover intention was entered as the dependent variable (Moderated mediation index = -.05, CI = [-.10, -.00]). Hypothesis 4 was supported.
Extending previous research on stereotypes and discrimination faced by cancer survivors, our study investigated a psychological process in which workplace stereotypes about cancer survivors relate to their work outcomes. When survivors felt that they were seen as competent at work, they reported higher work engagement and lower turnover intention as a result of enhanced self-efficacy. However, this psychological process only applied to survivors with moderate to high NES. Our findings highlight the importance of considering employees with medical conditions as part of company diversity and inclusion initiatives. The study is subject to limitations due to self-reported data and cross-sectional design.
Our study showed that how cancer survivors are perceived in the workplace matters to survivors. Future research should continue to investigate other topics related to cancer-related stigma at work.