1. Identifying Barriers to Career Development and Employment for Young Adult Survivors of Pediatric Brain Tumors
David R. Strauser, Ph.D.1, Cori Liptak , Ph.D.2 Elizabeth Fine Ph.D.2 Fong Chan, Ph.D.3, & Kanako Iwanaga, M.S.3,
University of Illinois at Urbana-Champaign1, Dana-Farber Cancer Institute2, University of Wisconsin-Madison3
Introduction/ Purpose
Items
Mean (SD)
Internal
Barrier
External h2
Transportation Issues
2.58 (1.43)
0.88
.66
Skill Deficit
2.05 (1.32)
0.80
.58
Cancer Symptoms
3.15 (1.30)
0.72
.51
Social Abilities
2.30 (1.28)
0.68
.64
Emotional Stability
2.62 (1.35)
0.63
.63
Learning Challenges
2.50 (1.30)
0.54
.61
Physical Functioning
2.52 (1.33)
0.50
.53
Family Perceptions
1.65 (1.10)
State Financial Benefits
1.71 (1.02)
0.75
.52
Lack of Career Services
1.78 (1.14)
0.73
.73
Access to Education
1.75 (1.19)
0.66
. 52
Negative Employer Attitudes
1.48 (0.98)
0.48
.36
Eigenvalues
5.84
1.11
Variance (%)
48.66
9.26
Cumulative % Variance
57.92
Reliability (Cronbach’s α)
.88
.80
Survivors of pediatric brain tumors are at high risk for not attaining developmental milestones associated with peer relationships and employment. In a study using the CCSS data of 1,101 adult survivors of pediatric brain tumors, results indicated that 26% were unemployed, 74% were unmarried, and 28% had incomes of less than $20,000 per year. While survivors of childhood cancer were twice as likely to be unemployed when compared to healthy controls, survivors of pediatric brain tumors had a 5-fold risk of being unemployed compared to other childhood cancer survivors. Research has found that emotional and physical functionoing affected a survivor’s ability to work or caused them to stop working. Utilizing a vocational counseling framework, researchers have begun to identify potential areas in which survivors of pediatric brain tumors can be categorized to better explain the challenges experienced around finding and maintaining employment. Specifically, survivors of pediatric brain tumors have been identified as having low levels of career readiness, work personality and underdeveloped vocational identities that may be inpacted by internal and external factors.
The purpose of this study was to develop an employment barriers assessment to assist in the career development and employemnt of young adult CNS survivors.
Methods
110 young adult survivors of childhood cancer aged between 18 and 30 years (M=23.05, SD=3.36). 52.7% participants were women, and 90% were Caucasian.
External Correlates
CSE
Total
Understanding communicating
Getting around
Self-Care
Getting Along with People
Life Activities-Household
Life Activities- School/Work
Participation in Society
Internal barrier
-.69**
.54**
.43**
.19*
.50**
.46**
.42**
External barrier
-.54**
.37**
.40**
.25**
.33**
.34**
.39**
*p < .05. **p < .01.
support for the construct validity of the perceived career barrier scale
Perceived Career Barriers scale
Please put information of how to create this original barrier items
Core Self-Evaluations Scale (CSES)
12 items; a 5-point Likert-type scale, from 1 (strongly disagree) to 5 (strongly agree).
Higher scores indicate greater levels of core self-evaluations.
The internal consistency reliability coefficient (Cronbach’s alpha) is ranging from .81 to .87
The WHO Disability Assessment Schedule-2
7 items; a 5-point Likert type scale, from 1 (none) to 5 (extreme).
Higher scores indicating higher levels of a health condition or disability in terms of functioning.
Cronbach’s alphas was reported to be .80
Subscales
1) understanding and communicating (6 items); 2) getting around (5 items); 3) self-care (4 items); 4) getting along with others (5 items); 5) life activities: household (4 items); 6) life activities: work/school (4 items); and 7) participation in society (8 items).
Discussion / Conclusion
Findings provide initial support regarding the development of a screening instrument that can be used in psychosocial treatment to identify internal and external barriers to employment for young adult survivors of Pediatric Brain Tumors.
Initial results indicate that the scale, which is consistent with the ICF framework, has adequate psychometric properties that would lend well to clinical application and research.
Of particular importance is that initial results support the scale’s ability to identify personal (internal) and environmental (external) risk factors that negatively impact career development and impede vocational pursuits.
Identifying and addressing internal and external barriers to education, career development and employment should be important components of a comprehensive psychosocial cancer treatment program, especially for individuals are survivors of CNS cancer.
Results
Exploratory Factor Analysis
A principal components analysis of the 12 x 12 correlation matrix was subjected to a principal components analysis. The Kaiser-Meyer-Olkin test resulted in a sampling adequacy of .88, and the Bartlett’s test of sphericity was significant (χ2 [66, N = 109] = , p < .001), indicating that it was appropriate to proceed with factor analysis. Kaiser-Guttman’s “eigenvalues greater than one” rule indicated a two-factor structure, while Cattell’s scree test showed a one-factor measurement structure. This time two factor measurement structure was employed and these two factors accounted for 57.92%. The two-factor solution was rotated using the oblique rotation.
Factor 1 – Internal barrier. 7 items. This factor reflects perception of their physical, social and affective deficits, accounting for 48.66% of the total variance. Cronbach’s alpha was computed to be .88, indicating good reliability of the items constituting this factor.
Factor 2 – External barrier. 5 items. This factor reflects perception of barrier of external support and/or others attitude, such as family and employer, accounting for 9.26% of the total variance. Cronbach’s alpha was computed to be .80, indicating good reliability of the items constituting this factor.
References
Liptak, C.(2017) Vocational Rehabilitation Services for Young Adult Survivors of Pediatric Brain Tumors: A Needs Assessment
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