51
|
Return to work after surgical clipping versus endovascular treatment for ruptured intracranial aneurysms - A nationwide registry-based study. PLoS One 2022; 17:e0278528. [PMID: 36512614 PMCID: PMC9746979 DOI: 10.1371/journal.pone.0278528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 11/18/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES The aim of this study was to assess return to work following aneurysmal subarachnoid haemorrhage (SAH) and compare working status after open surgical clipping and endovascular treatment. METHODS This nationwide registry-based study included all adult patients in working age treated for a ruptured intracranial aneurysm in Norway between 2008 and 2018 who had a record of sickness leave on the day of treatment. Data from The Norwegian Patient Registry and The Norwegian Labour and Welfare Administration were linked on an individual level. Daily sickness and disability benefits recipiency one year preoperatively to one year postoperatively was analysed. Return to work after endovascular treatment and surgical clipping was compared. RESULTS 183 patients were included in the study. Among patients who worked at one year preoperatively, 57% had returned to work one year after treatment. Mean number of days from treatment to the first day back at work in a continuous 3-month working period was 298 (95% CI: 276-321) vs. 319 (95% CI: 299-339) for patients who underwent endovascular treatment compared to patients treated with clipping (p = 0.365). Older patients were less likely to return to work after treatment (hazard ratio 0.977 per year of age, 95% CI 0.956-1.000, p = 0.046). There was no significant association between return to work and patient sex or location of the aneurysm. CONCLUSIONS Aneurysmal SAH profoundly affects patient working status. This study found no significant difference in time to return to work after treatment between patients treated with endovascular techniques compared to patients undergoing open surgery.
Collapse
|
52
|
Sakki SE, Penttinen HM, Hilgert OM, Volanen SM, Saarto T, Raevuori A. Mindfulness is associated with improved psychological well-being but no change in stress biomarkers in breast cancer survivors with depression: a single group clinical pilot study. BMC Womens Health 2022; 22:518. [PMID: 36510201 PMCID: PMC9743600 DOI: 10.1186/s12905-022-02116-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 12/06/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The aim of this clinical single group pilot study was to assess mental well-being, psychological symptoms, and a set of stress biomarkers among breast cancer survivors with high depressive symptoms undergoing the Mindfulness-Based Stress Reduction (MBSR) program. METHODS Participants included 23 curatively treated breast cancer survivors from the Helsinki University Central Hospital with clinically significant symptoms of depression (Beck Depression Inventory > 13, and assessed by a psychiatrist), at 1-year post-operative follow-up. Mental wellbeing and psychological symptoms were assessed with self-reported questionnaires (Resilience Scale, Self-Compassion Scale, Five Facet Mindfulness Questionnaire, World Health Organization Quality of Life-questionnaire, Perceived Stress Scale, Beck Depression Inventory, Beck Anxiety Inventory, Insomnia Severity Index); in addition, stress response was assessed with biomarkers (cortisol, adrenocorticotropine, and high-sensitivity-CRP from blood; 24 h-cortisol from urine). All measures were addressed at baseline, mid-program (4 weeks after baseline) and at the completion of the 8-week MBSR program. Engagement to the independent mindfulness home practice was collected with a diary. RESULTS From baseline to the completion of the 8-week MBSR program, we observed significant increases in resilience (d = 0.60, p = 0.005), and quality of life (d = 0.92, p = 0.002), and significant reductions in symptoms of depression (d = - 1.17, p < 0.0001), anxiety (d = - 0.87, p < 0.0001), insomnia (d = - 0.58, p = 0.006), and marginally significant reduction in perceived stress (d = - 0.40, p = 0.09). We found no changes in self-compassion or mindfulness skills, nor in the stress biomarkers during or at the completion of the program. There was no association between the engagement time to the independent mindfulness practice and any of the outcomes. CONCLUSIONS Attending the MBSR program was associated with increased wellbeing and reduced psychological symptoms in breast cancer survivors with clinically significant symptoms of depression. However, these favorably experienced changes did not transfer to the level of stress biomarkers during the 8-week program. Lack of association between the engagement in the mindfulness home practice and change in outcomes suggests that in the studied range of practice time, other qualities of MBSR despite the amount of independent practice may have a more important role for the improved wellbeing. Trial registration ISRCTN12326308 at 16/02/2021, retrospectively registered.
Collapse
Affiliation(s)
- Silja Emilia Sakki
- grid.15485.3d0000 0000 9950 5666Comprehensive Cancer Centre, Helsinki University Hospital, Helsinki, Finland ,grid.7737.40000 0004 0410 2071Department of Oncology, Institute of Clinical Medicine, University of Helsinki, Helsinki, Finland ,grid.15485.3d0000 0000 9950 5666Palliative Centre, Helsinki University Hospital, Helsinki, Finland
| | - Heidi Marika Penttinen
- grid.15485.3d0000 0000 9950 5666Comprehensive Cancer Centre, Helsinki University Hospital, Helsinki, Finland ,grid.7737.40000 0004 0410 2071Department of Oncology, Institute of Clinical Medicine, University of Helsinki, Helsinki, Finland ,Cancer Society of Pirkanmaa, Tampere, Finland
| | | | - Salla-Maarit Volanen
- grid.7737.40000 0004 0410 2071Department of Public Health, Clinicum, University of Helsinki, Helsinki, Finland ,grid.428673.c0000 0004 0409 6302Folkhälsan Research Center, Helsinki, Finland
| | - Tiina Saarto
- grid.15485.3d0000 0000 9950 5666Comprehensive Cancer Centre, Helsinki University Hospital, Helsinki, Finland ,grid.7737.40000 0004 0410 2071Department of Oncology, Institute of Clinical Medicine, University of Helsinki, Helsinki, Finland ,grid.15485.3d0000 0000 9950 5666Palliative Centre, Helsinki University Hospital, Helsinki, Finland
| | - Anu Raevuori
- grid.7737.40000 0004 0410 2071Department of Public Health, Clinicum, University of Helsinki, Helsinki, Finland ,grid.15485.3d0000 0000 9950 5666Department of Psychiatry, Helsinki University Hospital, Helsinki, Finland
| |
Collapse
|
53
|
Sarfo MC, van Asselt KM, Frings-Dresen MH, de Jong F, van Dijk N, de Boer AGEM. Views of breast cancer survivors on work participation guidance by general practitioners: a qualitative study. BMC PRIMARY CARE 2022; 23:152. [PMID: 35715735 PMCID: PMC9205136 DOI: 10.1186/s12875-022-01768-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 05/13/2022] [Indexed: 11/10/2022]
Abstract
Background Breast cancer survivors can be at high risk of having work-related problems. Previous studies suggest that GPs could discuss work participation with cancer patients and provide guidance. The aim this study is to explore the experiences and expectations of breast cancer survivors with their GPs’ role regarding guidance on work participation and return to work. Methods A qualitative study with Dutch female breast cancer survivors was held in the Netherlands. Four focus groups with 25 participants were conducted and audio-taped. Transcripts were analysed using thematic analysis. Results Breast cancer survivors reported a wide range of experiences with guidance from their GPs regarding work participation. Patients who contacted their GPs with work-related issues felt listened to during the consultation. Some patients experienced very limited or no guidance, while others were intensively guided by their GPs. The guidance was provided in the form of counseling, psychosocial support, and referral to other health care professionals. When cancer patients experienced problems with reintegration in work, they expected GPs to have a supportive and referring role in work participation guidance. Conclusion In returning to work, breast cancer survivors expect their GPs to play a supportive role, especially when they encounter difficulties in reintegrating. However, their actual experience of guidance received from their GPs varied, from none received at all, to intensive support provided.
Collapse
|
54
|
Coutu MF, Durand MJ, Coté D, Tremblay D, Sylvain C, Gouin MM, Bilodeau K, Nastasia I, Paquette MA. Ethnocultural Minority Workers and Sustainable Return to Work Following Work Disability: A Qualitative Interpretive Description Study. JOURNAL OF OCCUPATIONAL REHABILITATION 2022; 32:773-789. [PMID: 35616770 DOI: 10.1007/s10926-022-10044-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/28/2022] [Indexed: 06/15/2023]
Abstract
Purpose This article provides a state-of-the-art review of issues and factors associated with the sustainable return to work (S-RTW) of ethnocultural minority workers experiencing disability situations attributable to one of four major causes: musculoskeletal disorders, common mental disorders, other chronic diseases or cancer. Methods Using an interpretive description method, an integrative review was conducted of the literature on ethnocultural factors influencing S-RTW issues and factors associated with these four major work-disability causes. An initial review of the 2006-2016 literature was subsequently updated for November 2016-May 2021. To explore and contextualize the results, four focus groups were held with RTW stakeholders representing workplaces, insurers, the healthcare system and workers. Qualitative thematic analysis was performed. Results A total of 56 articles were analyzed and 35 stakeholders participated in four focus groups. Two main findings emerged. First, belonging to an ethnocultural minority group appears associated with cumulative risk factors that may contribute to vulnerability situations and compound the complexity of S-RTW. Second, cultural differences with respect to the prevailing host-country culture may generate communication and trust issues, and conflicts in values and representations, in turn possibly hindering the establishment of positive relationships among all stakeholders and the ability to meet workers' needs. Being a woman in these groups and/or having a lower level of integration into the host country's culture also appear associated with greater S-RTW challenges. Conclusions Based on our findings, we recommend several possible strategies, such as the cultural humility model, for preventing differences from exacerbating the already significant vulnerability situation of some ethnocultural minority workers.
Collapse
Affiliation(s)
- Marie-France Coutu
- Centre d'action en Prévention et Réadaptation des Incapacités au Travail (CAPRIT), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada.
- Centre de Recherche Charles-le Moyne (CRCLM), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada.
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada.
| | - Marie-José Durand
- Centre d'action en Prévention et Réadaptation des Incapacités au Travail (CAPRIT), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- Centre de Recherche Charles-le Moyne (CRCLM), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
| | - Daniel Coté
- Institut de Recherche Robert-Sauvé en Santé et en Sécurité du Travail (IRSST), 505 Boulevard De Maisonneuve West, Montreal, QC, H3A 3C2, Canada
| | - Dominique Tremblay
- Centre de Recherche Charles-le Moyne (CRCLM), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- School of Nursing, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles-Le Moyne, Longueuil, QC, J4K 0A8, Canada
| | - Chantal Sylvain
- Centre d'action en Prévention et Réadaptation des Incapacités au Travail (CAPRIT), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- Centre de Recherche Charles-le Moyne (CRCLM), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
| | - Marie-Michelle Gouin
- Department of Management and Human Resource Management, School of Management, Université de Sherbrooke, 2500 Boulevard de l'Université, Sherbrooke, QC, J1K 2R1, Canada
| | - Karine Bilodeau
- Faculty of Nursing, Université de Montréal, Station Centre-ville, PO Box 6128, Montreal, QC, H3C 3J7, Canada
| | - Iuliana Nastasia
- Institut de Recherche Robert-Sauvé en Santé et en Sécurité du Travail (IRSST), 505 Boulevard De Maisonneuve West, Montreal, QC, H3A 3C2, Canada
| | - Marie-Andrée Paquette
- Centre d'action en Prévention et Réadaptation des Incapacités au Travail (CAPRIT), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- Centre de Recherche Charles-le Moyne (CRCLM), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
| |
Collapse
|
55
|
Beerda DCE, Zegers AD, van Andel ES, Becker-Commissaris A, van der Vorst MJDL, Tange D, Duijts SFA, Brom L. Experiences and perspectives of patients with advanced cancer regarding work resumption and work retention: a qualitative interview study. Support Care Cancer 2022; 30:9713-9721. [DOI: 10.1007/s00520-022-07436-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 10/27/2022] [Indexed: 11/27/2022]
|
56
|
A longitudinal study of physical activity among Malaysian breast cancer survivors. PLoS One 2022; 17:e0277982. [PMID: 36409745 PMCID: PMC9678261 DOI: 10.1371/journal.pone.0277982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 11/07/2022] [Indexed: 11/22/2022] Open
Abstract
Regular physical activity (PA) after a breast cancer diagnosis is associated with reduced mortality and better quality of life. In this prospective cohort study, we aimed to explore the trends of PA among breast cancer survivors over three years and identify factors associated with low PA. Interviews on 133 breast cancer patients were conducted at baseline, one and three years after the diagnosis of breast cancer at University Malaya Medical Centre in Kuala Lumpur. Physical activity was measured by using the Global Physical Activity Questionnaire. PA was categorised as active (≥ 600 MET-min/week) and inactive (<600 MET-min/week). We used the generalised estimating equation method to examine PA levels and factors affecting PA longitudinally. The survivors' mean age was 56.89 (±10.56) years; half were Chinese (50.4%), and 70.7% were married. At baseline, 48.1% of the patients were active, but the proportion of active patients declined to 39.8% at one year and 35.3% in the third year. The mean total PA decreased significantly from 3503±6838.3 MET-min/week to 1494.0±2679.8 MET-min/week (one year) and 792.5±1364 MET-min/week (three years) (p<0.001). Three years after diagnosis (adjusted odds ratio [AOR]: 1.74, p = 0.021); Malay ethnicity (AOR: 1.86, p = 0.042) and being underweight (AOR: 3.43, p = 0.004) were significantly associated with inactivity. We demonstrated that breast cancer survivors in Malaysia had inadequate PA levels at diagnosis, which decreased over time. Thus, it is vital to communicate about the benefits of PA on cancer outcomes and continue to encourage breast cancer survivors to be physically active throughout the extended survivorship period, especially in the Malay ethnic group and underweight patients.
Collapse
|
57
|
de Boer AGEM, de Wind A, Coenen P, van Ommen F, Greidanus MA, Zegers AD, Duijts SFA, Tamminga SJ. Cancer survivors and adverse work outcomes: associated factors and supportive interventions. Br Med Bull 2022; 145:60-71. [PMID: 36372773 PMCID: PMC10075241 DOI: 10.1093/bmb/ldac028] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/01/2022] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The number of cancer survivors in a working age is rising. An awareness of factors associated with adverse work outcomes, and of supportive interventions, is needed. SOURCES OF DATA A narrative review of research obtained via several databases, including Medline and PsycINFO, was conducted. AREAS OF AGREEMENT A range of factors is associated with adverse work outcomes such as prolonged sick leave, delayed return to work, disability pension and unemployment in cancer survivors. They include the cancer type and treatment, fatigue, cognitive functioning, work factors and elements of health care systems. Effective supportive interventions encompass physical and multicomponent interventions. AREAS OF CONTROVERSY The role of behaviour determinants and legislative and insurance systems is unclear. It is furthermore uncertain what the optimal timing of delivering supportive interventions is. GROWING POINTS Further focus on vulnerable groups, including specific cancer types and those with lower income, lower educational level and in precarious employment, is needed. AREAS TIMELY FOR DEVELOPING RESEARCH Recent developments are tailored and timely interventions.
Collapse
Affiliation(s)
- Angela G E M de Boer
- Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.,Amsterdam Public Health, Societal Participation and Health, Amsterdam, the Netherlands.,Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands
| | - Astrid de Wind
- Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.,Amsterdam Public Health, Societal Participation and Health, Amsterdam, the Netherlands
| | - Pieter Coenen
- Amsterdam Public Health, Societal Participation and Health, Amsterdam, the Netherlands.,Public and Occupational Health, Amsterdam UMC Location Vrije Universiteit, Amsterdam, De Boelelaan 1117 Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Musculoskeletal Health, Amsterdam, the Netherlands
| | - Fenna van Ommen
- Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.,Amsterdam Public Health, Societal Participation and Health, Amsterdam, the Netherlands
| | - Michiel A Greidanus
- Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.,Amsterdam Public Health, Societal Participation and Health, Amsterdam, the Netherlands
| | - Amber D Zegers
- Amsterdam Public Health, Societal Participation and Health, Amsterdam, the Netherlands.,Public and Occupational Health, Amsterdam UMC Location Vrije Universiteit, Amsterdam, De Boelelaan 1117 Amsterdam, the Netherlands
| | - Saskia F A Duijts
- Amsterdam Public Health, Societal Participation and Health, Amsterdam, the Netherlands.,Public and Occupational Health, Amsterdam UMC Location Vrije Universiteit, Amsterdam, De Boelelaan 1117 Amsterdam, the Netherlands.,Research & Development, Netherlands Comprehensive Cancer Organisation, Utrecht, the Netherlands
| | - Sietske J Tamminga
- Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.,Amsterdam Public Health, Societal Participation and Health, Amsterdam, the Netherlands.,Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands
| |
Collapse
|
58
|
The role of physical arm function and demographic disparities in breast cancer survivors’ ability to return to work. Support Care Cancer 2022; 30:10301-10310. [PMID: 36355217 PMCID: PMC9648455 DOI: 10.1007/s00520-022-07449-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 10/31/2022] [Indexed: 11/12/2022]
Abstract
Purpose Ability to return to work (RTW) is an important aspect of breast cancer that is limited for many survivors. With 90% survivorship in the USA, it is imperative that focus shifts toward the improvement of physical arm function to improve survivors’ ability to RTW. This narrative review discusses the role of physical arm function and demographic disparities in breast cancer survivor RTW. Methods Literature on physical function, arm function, and demographic disparities following breast cancer treatment and their implications for RTW is discussed. Results The ability to RTW is a key component of recovery for breast cancer survivors, but challenges and inequalities persist. Treatment effects can induce and prolong functional disability, affecting survivors’ ability to RTW. These effects may be compounded for survivors whose occupation requires physical arm function. The RTW landscape, including the occupations survivors have, the physical function required for job tasks, and availability of workplace accommodations, is also unclear. Additional demographic disparities (e.g., income, live in rural area) exist, but the extent to which these factors influence RTW is not well understood. More work is needed to understand the compounded impact of treatment effects, demographic disparities, and occupational factors on RTW. Multidisciplinary rehabilitation that includes occupational counseling and exercise is a promising approach, but widespread adoption in the US healthcare model presents an ongoing challenge. Areas for further research are highlighted. Conclusion There is an incomplete understanding of the effects of treatment on physical arm function and the role of demographic disparities on breast cancer survivor RTW.
Collapse
|
59
|
Yang ZY, Chen WL, Wu WT, Lai CH, Ho CL, Wang CC. Return to Work and Mortality in Breast Cancer Survivors: A 11-Year Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14418. [PMID: 36361291 PMCID: PMC9655987 DOI: 10.3390/ijerph192114418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/23/2022] [Accepted: 10/29/2022] [Indexed: 06/16/2023]
Abstract
Breast cancer is the most commonly occurring cancer in women, and it is a major cause of cancer death around the world. With the development of diagnostic methods and improvements in treatment methods, the incidence rate of breast cancer and the number of breast cancer survivors continue to simultaneously increase. We used national registry database to analyze the features that affect employment and return to work among breast cancer survivors. A total of 23,220 employees, who were newly diagnosed with breast cancer were recruited based on the Labor Insurance Database (LID), the Taiwan Cancer Registry (TCR), and National Health Insurance Research Database (NHIRD) during the period 2004-2015. The correlations between return to work (RTW) and independent confounding factors were examined using Cox proportional hazards model. Survival probability was analyzed using the Kaplan-Meir method. After adjusting for confounding variables, cancer stage, chemotherapy and higher income were significantly negatively correlated with RTW. Among breast cancer survivors, RTW was found to be related to a lower risk of all-cause mortality in both the unadjusted and fully adjusted model. Patients who had RTW exhibited better survival in all stages. Work-, disease- and treatment-related factors influenced RTW among employees with breast cancer. RTW was associated with better breast cancer survival. Our study demonstrates the impact of RTW and the associated factors on breast cancer survivorship.
Collapse
Affiliation(s)
- Zhe-Yu Yang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
| | - Wei-Liang Chen
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
- Division of Occupational Medicine, Department of Family & Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
| | - Wei-Te Wu
- National Institute of Environmental Health Science, National Health Research Institutes, Miaoli 350, Taiwan
| | - Ching-Huang Lai
- School of Public Health, National Defense Medical Center, Taipei 114, Taiwan
| | - Ching-Liang Ho
- Division of Hematology/Oncology, Department of Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei 114, Taiwan
| | - Chung-Ching Wang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
- Division of Occupational Medicine, Department of Family & Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
| |
Collapse
|
60
|
Inoue S, Tateishi S, Harada A, Oginosawa Y, Abe H, Saeki S, Tsukada J, Mori K. Qualitative study of barriers and facilitators encountered by individuals with physical diseases in returning and continuing to work. BMC Health Serv Res 2022; 22:1229. [PMID: 36192749 PMCID: PMC9531482 DOI: 10.1186/s12913-022-08604-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 09/26/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The number of employees with physical diseases is increasing, and there is a need for support to help them return and continue to work. To provide effective support, it is important to identify barriers and facilitators for individuals in returning and continuing to work. Previous studies have reported barriers and facilitators for specific diseases. However, few reports have dealt with these issues across various diseases. To identify a range of barriers and facilitators that may apply to different physical diseases, we conducted a qualitative analysis by interviewing patients with diverse characteristics being treated for diseases. METHODS We conducted semi-structured interviews based on the criteria for qualitative research. We investigated three disease groups to obtain details of barriers and facilitators: impairments that were visible to other people (mainly stroke); impairments invisible to others (mainly heart disease); and impairments that changed over time (mainly cancer). Interview transcripts were analyzed and the results reported using systematic text condensation. RESULTS We extracted 769 meaning units from 28 patient interviews. We categorized barriers and facilitators that were generalizable to various diseases into three themes (personal factors, workplace factors, and inter-sectoral collaboration and social resources) and 10 sub-themes (work ability, psychological impacts, health literacy, social status, family background, workplace structure, workplace system, workplace support, inter-sectoral collaboration, and social resources). CONCLUSIONS This study identified 10 sub-themes that can be applied for workers with physical diseases; those sub-themes may be used as a basis for communicating with those individuals about returning and continuing to work. Our results suggest that various barriers and facilitators for workers with physical diseases should be understood and addressed at medical institutions, workplaces, and support sites.
Collapse
Affiliation(s)
- Shunsuke Inoue
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Seiichiro Tateishi
- Disaster Occupational Health Center, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.
| | - Arisa Harada
- Department of Occupational Medicine School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Yasushi Oginosawa
- The Second Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Haruhiko Abe
- Department of Heart Rhythm Management, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Satoru Saeki
- Department of Rehabilitation Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Junichi Tsukada
- Hematology, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Koji Mori
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| |
Collapse
|
61
|
Bai X, Zhang X, Shi H, Geng G, Wu B, Lai Y, Xiang W, Wang Y, Cao Y, Shi B, Li Y. Government drivers of breast cancer prevention: A spatiotemporal analysis based on the association between breast cancer and macro factors. Front Public Health 2022; 10:954247. [PMID: 36268002 PMCID: PMC9578696 DOI: 10.3389/fpubh.2022.954247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 09/12/2022] [Indexed: 01/24/2023] Open
Abstract
Background Currently, breast cancer (BC) is ranked among the top malignant tumors in the world, and has attracted widespread attention. Compared with the traditional analysis on biological determinants of BC, this study focused on macro factors, including light at night (LAN), PM2.5, per capita consumption expenditure, economic density, population density, and number of medical beds, to provide targets for the government to implement BC interventions. Methods A total of 182 prefecture-level cities in China from 2013 to 2016 were selected as the sample of the study. The geographically and temporally weighted regression (GTWR) model was adopted to describe the spatiotemporal correlation between the scale of BC and macro factors. Results The results showed that the GTWR model can better reveal the spatiotemporal variation. In the temporal dimension, the fluctuations of the regression coefficients of each variable were significant. In the spatial dimension, the positive impacts of LAN, per capita consumption expenditure, population density and number of medical beds gradually increased from west to east, and the positive coefficient of PM2.5 gradually increased from north to south. The negative impact of economic density gradually increased from west to east. Conclusion The fact that the degree of effect of each variable fluctuates over time reminds the government to pay continuous attention to BC prevention. The spatial heterogeneity features also urge the government to focus on different macro indicators in eastern and western China or southern and northern China. In other words, our research helps drive the government to center on key regions and take targeted measures to curb the rapid growth of BC.
Collapse
Affiliation(s)
- Xiaodan Bai
- Department of Economics, School of Economics, Minzu University of China, Beijing, China
| | - Xiyu Zhang
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, China
| | - Hongping Shi
- Department of Oncology, Heze Municipal Hospital, Heze, China
| | - Guihong Geng
- Department of Economics, School of Economics, Minzu University of China, Beijing, China
| | - Bing Wu
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, China
| | - Yongqiang Lai
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, China
| | - Wenjing Xiang
- Department of Economics, School of Economics, Minzu University of China, Beijing, China
| | - Yanjie Wang
- Department of Economics, School of Economics, Minzu University of China, Beijing, China
| | - Yu Cao
- Department of Economics, School of Economics, Minzu University of China, Beijing, China
| | - Baoguo Shi
- Department of Economics, School of Economics, Minzu University of China, Beijing, China,*Correspondence: Baoguo Shi
| | - Ye Li
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, China,Ye Li
| |
Collapse
|
62
|
Bai X, Zhang X, Xiang W, Wang Y, Cao Y, Geng G, Wu B, Lai Y, Li Y, Shi B. Time tracking and multidimensional influencing factors analysis on female breast cancer mortality: Evidence from urban and rural China between 1994 to 2019. Front Public Health 2022; 10:1000892. [PMID: 36225788 PMCID: PMC9549912 DOI: 10.3389/fpubh.2022.1000892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 09/05/2022] [Indexed: 01/26/2023] Open
Abstract
Background There are huge differences in female breast cancer mortality between urban and rural China. In order to better prevent breast cancer equally in urban and rural areas, it is critical to trace the root causes of past inequities and predict how future differences will change. Moreover, carcinogenic factors from micro-individual to macro-environment also need to be analyzed in detail. However, there is no systematic research covering these two aspects in the current literature. Methods Breast cancer mortality data in urban and rural China from 1994 to 2019 are collected, which from China Health Statistical Yearbook. The Age-Period-Cohort model is used to examine the effects of different age groups, periods, and birth cohorts on breast cancer mortality. Nordpred project is used to predict breast cancer mortality from 2020 to 2039. Results The age effect gradually increases and changes from negative to positive at the age of 40-44. The period effect fluctuates very little and shows the largest difference between urban and rural areas in 2019. The birth cohort effect gradually decreases with urban-rural effects alternating between strong and weak. In the predicted results, the urban-rural mortality gap becomes first narrow and then wide and shows a trend of younger death. Conclusions From the perspective of a temporal system, the changing trend of breast cancer mortality is highly consistent with the history of social and economic structural changes in China. From the perspective of the theory of social determinants of health, individuals, families, institutions and governments need to participate in the prevention of breast cancer.
Collapse
Affiliation(s)
- Xiaodan Bai
- Department of Economics, School of Economics, Minzu University of China, Beijing, China
| | - Xiyu Zhang
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, China
| | - Wenjing Xiang
- Department of Economics, School of Economics, Minzu University of China, Beijing, China
| | - Yanjie Wang
- Department of Economics, School of Economics, Minzu University of China, Beijing, China
| | - Yu Cao
- Department of Economics, School of Economics, Minzu University of China, Beijing, China
| | - Guihong Geng
- Department of Economics, School of Economics, Minzu University of China, Beijing, China
| | - Bing Wu
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, China
| | - Yongqiang Lai
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, China
| | - Ye Li
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, China,*Correspondence: Ye Li
| | - Baoguo Shi
- Department of Economics, School of Economics, Minzu University of China, Beijing, China,Baoguo Shi
| |
Collapse
|
63
|
Viseux M, Tamminga SJ, Greidanus MA, Porro B, Roquelaure Y, Bourdon M. Enhancing Emotional Skills of Managers to Support the Return to Work of Cancer Survivors: A Research Opinion Focusing on Value, Feasibility and Challenges. Front Psychol 2022; 13:910779. [PMID: 35903738 PMCID: PMC9319043 DOI: 10.3389/fpsyg.2022.910779] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 06/13/2022] [Indexed: 11/14/2022] Open
Affiliation(s)
- Marie Viseux
- UMR INSERM 1246 SPHERE “Methods in Patient-Centered Outcomes and HEalth ResEarch”, Nantes University, University of Tours, Nantes, France
- *Correspondence: Marie Viseux
| | - Sietske J. Tamminga
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Amsterdam, Netherlands
- Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, Netherlands
| | - Michiel A. Greidanus
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Amsterdam, Netherlands
- Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, Netherlands
| | - Bertrand Porro
- University of Angers, University of Rennes, Inserm, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, SFR ICAT, Angers, France
| | - Yves Roquelaure
- UMR Inserm S 1085, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail) – University of Angers, CHU Angers, University of Rennes, SFR ICAT, Angers, France
| | - Marianne Bourdon
- UMR INSERM 1246 SPHERE “Methods in Patient-Centered Outcomes and HEalth ResEarch”, Nantes University, University of Tours, Nantes, France
- Integrated Center for Oncology, Nantes, France
| |
Collapse
|
64
|
Kamp T, Stevens M, Van Beveren J, Rijk PC, Brouwer R, Bulstra S, Brouwer S. Influence of social support on return to work after total hip or total knee arthroplasty: a prospective multicentre cohort study. BMJ Open 2022; 12:e059225. [PMID: 35623752 PMCID: PMC9150170 DOI: 10.1136/bmjopen-2021-059225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES There is strong evidence that social support is an important determinant of return to work (RTW). Little is known about the role of social support in RTW after total hip or knee arthroplasty (THA/TKA). Objective was to examine the influence of preoperative and postoperative perceived social support on RTW status 6 months postoperatively. DESIGN A prospective multicentre cohort study was conducted. SETTING Orthopaedic departments of four Dutch medical centres; a tertiary university hospital, two large teaching hospitals and a general hospital. PARTICIPANTS Patients planned to undergo THA/TKA, aged 18-63 and employed preoperatively were included. MAIN OUTCOME MEASURES Questionnaires were filled out preoperatively and 3 and 6 months postoperatively and included questions to assess patients' perceived social support targeting three sources of social support: from home (friends, family), from work (coworkers, supervisors) and from healthcare (occupational physician, general practitioner, other caregivers). Control variables included age, gender, education, type of arthroplasty and comorbidities. RTW was defined as having fully returned to work 6 months postoperatively. Univariate and multivariate logistic regression analyses were conducted. RESULTS Enrolled were 190 patients (n=77 THA, n=113 TKA, median age was 56 years, 56% women). The majority returned to work (64%). Preoperatively, social support from the occupational physician was associated with RTW (OR 2.53, 95% CI 1.15 to 5.54). Postoperatively, social support from the occupational physician (OR 3.04, 95% CI 1.43 to 6.47) and the supervisor (OR 2.56, 95% CI 1.08 to 6.06) was associated with RTW. CONCLUSIONS This study underscores the importance of work-related social support originating from the occupational physician and supervisor in facilitating RTW after primary THA/TKA, both preoperatively and postoperatively. Further research is needed to confirm our results and to understand the facilitating role of social support in RTW, as arthroplasty is being performed on a younger population for whom work participation is critical.
Collapse
Affiliation(s)
- Tamara Kamp
- Department of Orthopedics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Martin Stevens
- Department of Orthopedics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jan Van Beveren
- Department of Orthopedics, Röpcke-Zweers Hospital Hardenberg, Hardenberg, The Netherlands
| | - Paul C Rijk
- Department of Orthopedics, Medical Center Leeuwarden, Leeuwarden, The Netherlands
| | - Reinoud Brouwer
- Department of Orthopedics, Martini Hospital Groningen, Groningen, The Netherlands
| | - Sjoerd Bulstra
- Department of Orthopedics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Sandra Brouwer
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| |
Collapse
|
65
|
Altena R, Gernaat SAM, Wilking U, Kiani NA, Johnsson A, Hedayati E. Use of sickness benefits by patients with metastatic breast cancer-A Swedish cohort study. Eur J Cancer Care (Engl) 2022; 31:e13626. [PMID: 35621269 PMCID: PMC9541357 DOI: 10.1111/ecc.13626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 05/05/2022] [Accepted: 05/16/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The objective of this study is to determine the prevalence and predictors of sickness absence (SA) and disability pension (DP) in women with metastatic breast cancer (mBC). METHODS Data were obtained from Swedish registers concerning 1,240 adult women diagnosed 1997-2011 with mBC, from 1 year before (y-1) to 2 (y1) and 2 (y2) years after diagnosis. SA and DP prevalence was calculated. Odds ratios (AOR) were determined for factors associated with using long-term (SA > 180 days or DP > 0 days) sickness benefits. RESULTS Prevalence of SA and DP was 56.0% and 24.8% during y-1, 69.9% and 28.9% during y1, and 64.0% and 34.7% during y2, respectively. Odds of using long-term sickness benefits were higher y1 and y2 in patients using long-term sickness benefits the year before diagnosis (AOR = 3.82, 95% CI 2.91-5.02; AOR = 4.31, 95% CI 2.96-6.29, respectively) and y2 in patients with mBC diagnosis 1997-2000 (AOR = 1.84, 95% CI 1.10-3.08) and using long-term sickness benefits the year after diagnosis (AOR = 22.10, 95% CI 14.33-34.22). CONCLUSIONS The prevalence of sickness benefit utilisation was high and increased after mBC diagnosis, particularly for patients using long-term sickness benefits prior to diagnosis. Additional study is needed to determine factors that might reduce the need for sickness benefits and enhance work ability in these patients.
Collapse
Affiliation(s)
- Renske Altena
- Department of Oncology-Pathology, Bioclinicum, Karolinska Institutet, Stockholm, Sweden.,Breast Cancer Center, Cancer Theme, Karolinska University Hospital and Karolinska CCC, Stockholm, Sweden
| | - Sofie A M Gernaat
- Department of Medicine, Division of Clinical Epidemiology, Karolinska Institute, Stockholm, Sweden
| | - Ulla Wilking
- Department of Oncology-Pathology, Bioclinicum, Karolinska Institutet, Stockholm, Sweden
| | - Narsis A Kiani
- Department of Oncology-Pathology, Center of Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.,Algorithmic Dynamics Lab, Center of Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Aina Johnsson
- Department of Oncology-Pathology, Bioclinicum, Karolinska Institutet, Stockholm, Sweden.,Department of Neurobiology, Care Science and Society, Karolinska Institutet, Huddinge, Sweden.,Department of Oncology, South Hospital, Stockholm, Sweden
| | - Elham Hedayati
- Department of Oncology-Pathology, Bioclinicum, Karolinska Institutet, Stockholm, Sweden.,Breast Cancer Center, Cancer Theme, Karolinska University Hospital and Karolinska CCC, Stockholm, Sweden
| |
Collapse
|
66
|
So SCY, Ng DWL, Liao Q, Fielding R, Soong I, Chan KKL, Lee C, Ng AWY, Sze WK, Chan WL, Lee VHF, Lam WWT. Return to Work and Work Productivity During the First Year After Cancer Treatment. Front Psychol 2022; 13:866346. [PMID: 35496253 PMCID: PMC9039203 DOI: 10.3389/fpsyg.2022.866346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 03/24/2022] [Indexed: 01/01/2023] Open
Abstract
Objectives Working-age cancer patients face barriers to resuming work after treatment completion. Those resuming work contend with reduced productivity arising from persisting residual symptoms. Existing studies of return to work (RTW) after cancer diagnosis were done predominantly in Western countries. Given that employment and RTW in cancer survivors likely vary regionally due to healthcare provision and social security differences, we documented rates and correlates of RTW, work productivity, and activity impairment among Chinese cancer survivors in Hong Kong at one-year post-treatment. Methods Of 1,106 cancer patients assessed at six-months post-cancer treatment (baseline), 593 previously worked; detailed work status, psychological distress (HADS), physical symptom distress (MSAS-SF), supportive care needs (SCNS-SF34-C), health-related quality of life (SF12), and illness perception (B-IPQ) were assessed. Six months later (follow-up), work productivity and activity impairment were assessed (WPAI; n = 402). Descriptive analyses examined RTW rate. Fully adjusted regressions determined RTW, work productivity, and activity impairment predictors. Results At baseline, 39% (232/593) were working, 26% (153/593) on sick leave, and 35% (208/593) were unemployed. Compared to patients returning to work, unemployed participants were older, likely manual/service-oriented workers, and had lower family income, chemotherapy, fewer unmet health system and information needs, poorer physical functioning, and negative illness perceptions. Sick leave participants were likely service-oriented workers, who had head and neck cancer, chemotherapy, and poor physical functioning. At FU, baseline depressive symptoms, physical symptom distress, and negative illness perceptions predicted presenteeism and work productivity loss; gynecological cancer, fewer unmet health system and information needs, and greater unmet sexuality needs predicted absenteeism; physical symptom distress, negative illness perception, and poor physical functioning predicted activity impairment. Conclusion Cancer survivors who had more physically demanding jobs and poorer physical functioning delayed RTW. Unmanaged physical symptom and psychological distress hindered work productivity.
Collapse
Affiliation(s)
- Serana Chun Yee So
- LKS Faculty of Medicine, Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, Hong Kong SAR, China.,School of Public Health, Centre for Psycho-Oncology Research and Training, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Danielle Wing Lam Ng
- LKS Faculty of Medicine, Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, Hong Kong SAR, China.,School of Public Health, Centre for Psycho-Oncology Research and Training, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Qiuyan Liao
- School of Public Health, Centre for Psycho-Oncology Research and Training, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Richard Fielding
- LKS Faculty of Medicine, Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, Hong Kong SAR, China.,School of Public Health, Centre for Psycho-Oncology Research and Training, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Inda Soong
- Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, Hong Kong SAR, China
| | - Karen Kar Loen Chan
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Conrad Lee
- Department of Clinical Oncology, Princess Margaret Hospital, Hong Kong, Hong Kong SAR, China
| | - Alice Wan Ying Ng
- Department of Clinical Oncology, Tuen Mun Hospital, Tuen Mun, Hong Kong SAR, China
| | - Wing Kin Sze
- Department of Clinical Oncology, Tuen Mun Hospital, Tuen Mun, Hong Kong SAR, China
| | - Wing Lok Chan
- Department of Clinical Oncology, The University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Victor Ho Fun Lee
- Department of Clinical Oncology, The University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Wendy Wing Tak Lam
- LKS Faculty of Medicine, Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, Hong Kong SAR, China.,School of Public Health, Centre for Psycho-Oncology Research and Training, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| |
Collapse
|
67
|
Understanding Cancer Survivors’ Needs and Experiences Returning to Work Post-Treatment: A Longitudinal Qualitative Study. Curr Oncol 2022; 29:3013-3025. [PMID: 35621635 PMCID: PMC9139703 DOI: 10.3390/curroncol29050245] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/20/2022] [Accepted: 04/21/2022] [Indexed: 11/16/2022] Open
Abstract
Background: This study aimed to understand Canadian cancer survivors’ experiences during the return-to-work (RTW) process. Methods: A prospective qualitative longitudinal design was employed using the principles of phenomenological inquiry. Cancer survivors took part in three in-depth interviews: at the end of treatment, and 3 and 9 months after the first interview. Transcripts were analyzed using constant comparative analysis, guided by the Cancer and Work model. Results: A total of 38 in-depth interviews were conducted with 13 participants. The resultant themes were: (1) supports received or desired to enable RTW; (2) others’ limited understanding of the long-term impacts of a cancer diagnosis and its treatment; (3) worries and self-doubts about returning to work; and (4) changing perspectives on life and work after cancer. Conclusions: Cancer patients returning to work after treatment often experience challenges throughout the process, including varying levels of support from others and a range of ongoing effects and motivation to RTW. There is a clear gap in terms of the professional supports available to these individuals. Future research should focus on investigating how to improve both quality and accessibility of supports in a way that is personalized to the individual.
Collapse
|
68
|
Algeo N, Bennett K, Connolly D. Breast cancer survivorship and employment in Ireland: Legislative systems and the return to work of women with breast cancer. Work 2022; 71:927-939. [DOI: 10.3233/wor-205044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: Breast cancer is the most common invasive cancer in females worldwide. While work is important for well-being, 84% of women in Ireland temporarily or permanently cease working up to six months post-breast cancer diagnosis. Under Irish law, there is a right to reasonable work accommodations, however paid sick leave has only recently been state-mandated. Legislation internationally varies across nations. OBJECTIVE: The aim of this study was to explore the experiences of women who have had breast cancer returning to, and/or remaining in work, in the context of employment legislation. METHODS: Fifteen women with breast cancer, fifteen healthcare professionals, and nine employers nationwide participated in a qualitative-descriptive design, using semi-structured interviews. Interviews were audio-recorded, transcribed, and data analysed using thematic analysis. RESULTS: Thirty-nine participants were recruited. A prominent theme from interviews was that most women with breast cancer and healthcare professional cohorts were not aware of employment rights in the context of cancer diagnoses. This is in contrast to employers. Experiences of sick leave and pay entitlements varied amongst women with breast cancer with financial pressure and expediated the return to work evident for some participants. Most women did not report any discrimination on returning to the workplace, although there were examples of indirect discrimination where unfair expectations were being placed on women by colleagues. CONCLUSIONS: Education and awareness on employment rights and entitlements during and after cancer treatment is warranted. This could be incorporated into work-focused interventions to support those living with and beyond cancer to transition back into the workplace.
Collapse
Affiliation(s)
- Naomi Algeo
- Discipline of Occupational Therapy, Trinity College Dublin, Dublin, Ireland
| | - Kathleen Bennett
- Data Science Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Deirdre Connolly
- Discipline of Occupational Therapy, Trinity College Dublin, Dublin, Ireland
| |
Collapse
|
69
|
Hequet D, Hamy AS, Girard N, Laas E, Coussy F, Rouzier R, Preau M, Delrieu L, Dumas A, Reyal F. Variation over time of the factors influencing return to work and work capacities after a diagnosis of breast cancer: a study on the behalf of the Seintinelles research network. Support Care Cancer 2022; 30:5991-5999. [PMID: 35396963 DOI: 10.1007/s00520-022-07000-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 03/21/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE To evaluate the dynamics of the determinants of returning to work (RTW) in a population of patients treated for breast cancer (BC) in a real-world setting. METHOD We conducted a retrospective study including 1278 BC patients working or looking for work at the time of diagnosis. We performed a focused principal component analysis to highlight the dimensions of a persistent decline in work capacity. Logistic regression analyses were performed to identify correlates of non-RTW 1 and 2 years after treatment. RESULTS One-third (31%, n = 389) of patients continued working during treatment. At study inclusion, 1100 patients had returned to work (89%). Three-quarters (n = 508, 75%) of the women reported a decline in work capacity 1 year after RTW and 22% (n = 148) presented a persistent decline in work capacity 2 years after the diagnosis. The odds ratio for non-RTW at 1 year was significantly higher for patients treated with a combination of chemotherapy and trastuzumab (OR = 1.72, 95% CI [1.07-2.76]), manual workers (OR = 3.99, 95% CI [1.54-10.81]), patients with lower incomes (OR = 2.33, 95% CI [1.29-4.19]), and patients experiencing fatigue (OR = 1.81, 95% CI [1.34-2.48]). The odds ratio for non-RTW at 2 years was higher for various occupational categories (OR = 3.49, 95% CI [1.89-6.74] for clerks, OR = 4.58, 95% CI [1.48-12.82] for self-employed workers, OR = 8.98, 95% CI [2.69-27.89] for manual workers), patients with comorbidities (OR = 2.80, 95% CI [1.61-4.93]), and patients experiencing anxiety symptoms (OR = 2.54, 95% CI [1.18-5.76]), while the impact of the type of treatment was no longer significantly associated with RTW. CONCLUSION The determinants of RTW change over time. Patients should be offered supportive interventions tailored to risk factors and time from diagnosis.
Collapse
Affiliation(s)
- Delphine Hequet
- Department of Surgical Oncology, Institut Curie, Paris, France.
- INSERM U900, Institut Curie, St-Cloud, France.
- Department of Surgery, Institut Curie, Paris, France.
| | - Anne-Sophie Hamy
- Department of Surgical Oncology, Institut Curie, Paris, France
- University of Paris, Paris, France
| | - Noemie Girard
- Department of Surgical Oncology, Institut Curie, Paris, France
| | - Enora Laas
- Department of Surgical Oncology, Institut Curie, Paris, France
| | - Florence Coussy
- Department of Medical Oncology, Institut Curie, Paris, France
| | - Roman Rouzier
- Department of Surgical Oncology, Institut Curie, Paris, France
- INSERM U900, Institut Curie, St-Cloud, France
| | - Marie Preau
- Social Psychology Research Group (UR GRePS), Lyon 2 University, Lyon, France
- Inserm UMR 1296, Radiation: Defense, Health Environment, Lyon, France
| | - Lidia Delrieu
- Residual Tumor & Response To Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, Institut Curie, Paris, France
- Paris University, Paris, France
| | - Agnes Dumas
- Université de Paris, ECEVE UMR 1123, INSERM (National Institute for Health and Medical Research), Paris, France
- Clinical Research Department, Gustave Roussy, Villejuif, France
| | - Fabien Reyal
- Department of Surgical Oncology, Institut Curie, Paris, France
- INSERM U900, Institut Curie, St-Cloud, France
| |
Collapse
|
70
|
Junna L, Moustgaard H, Martikainen P. Health-related selection into employment among the unemployed. BMC Public Health 2022; 22:657. [PMID: 35382786 PMCID: PMC8985275 DOI: 10.1186/s12889-022-13023-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 03/11/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Successful transitions from unemployment to employment are an important concern, yet little is known about health-related selection into employment. We assessed the association of various physical and psychiatric conditions with finding employment, and employment stability. METHODS Using total population register data, we followed Finnish residents aged 30-60 with an unemployment spell during 2009-2018 (n = 814,085) for two years from the onset of unemployment. We predicted any, stable, and unstable employment by health status using Cox proportional hazards models. The data on specialized health care and prescription reimbursement were used to identify any alcohol-related conditions and poisonings, psychiatric conditions and self-harm, injuries, and physical conditions. We further separated physical conditions into cancer, diabetes, heart disease, and neurological conditions, and psychiatric conditions into depression, anxiety disorders and substance use disorders. RESULTS The likelihood of any employment was lower among those who had any of the assessed health conditions. It was lowest among those with alcohol-related or psychiatric conditions with an age-adjusted hazard ratio of 0.45 (95% confidence interval 0.44, 0.46) among men and 0.39 (0.38, 0.41) among women for alcohol-related and 0.64 (0.63, 0.65) and 0.66 (0.65, 0.67) for psychiatric conditions, respectively. These results were not driven by differences in socioeconomic characteristics or comorbidities. All the included conditions were detrimental to both stable and unstable employment, however alcohol-related and psychiatric conditions were more harmful for stable than for unstable employment. CONCLUSIONS The prospects of the unemployed finding employment are reduced by poor health, particularly alcohol-related and psychiatric conditions. These two conditions may also lead to unstable career trajectories. The selection process contributes to the health differentials between employed and unemployed people. Unemployed people with health problems may therefore need additional support to improve their chances of employment.
Collapse
Affiliation(s)
- Liina Junna
- Population Research Unit, University of Helsinki, Unioninkatu 35 (P.O. Box 18), 00014, Helsinki, Finland. .,Max Planck Institute for Demographic Research, Konrad-Zuse-Straße 1, 18057, Rostock, Germany.
| | - Heta Moustgaard
- Helsinki Institute for Social Sciences and Humanities, University of Helsinki, Vuorikatu 3, 00014, Helsinki, Finland
| | - Pekka Martikainen
- Population Research Unit, University of Helsinki, Unioninkatu 35 (P.O. Box 18), 00014, Helsinki, Finland.,Max Planck Institute for Demographic Research, Konrad-Zuse-Straße 1, 18057, Rostock, Germany.,Centre for Health Equity Studies, University of Stockholm and Karolinska Institute, Stockholm University, SE-106 91, Stockholm, Sweden
| |
Collapse
|
71
|
Hiltrop K, Heidkamp P, Breidenbach C, Kowalski C, Enders A, Pfaff H, Ansmann L, Geiser F, Ernstmann N. Involuntariness of job changes is related to less satisfaction with occupational development in long-term breast cancer survivors. J Cancer Surviv 2022; 16:397-407. [PMID: 33907994 PMCID: PMC8964540 DOI: 10.1007/s11764-021-01035-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 03/25/2021] [Indexed: 12/21/2022]
Abstract
PURPOSE Considering that breast cancer survivors (BCSs) have been dealing with unwanted job changes after diagnosis, this study aimed to investigate involuntary job changes (unwanted modifications in employment since diagnosis) and explore the association between job changes, involuntariness, and occupational development satisfaction in BCSs 5-6 years after diagnosis. METHODS Data were drawn from the mixed-methods breast cancer patients' return to work (B-CARE) study. We surveyed 184 female BCSs who were working at the time of study enrollment during hospitalization (T1), 10 weeks after discharge (T2), 40 weeks after discharge (T3), and 5-6 years after diagnosis (T4) and used descriptive measures and stepwise linear regression models for data analysis. RESULTS The mean age of BCSs was 57 years. A total of 105 participants reported 410 job changes, of which 16.1% were reportedly (rather) involuntary. The most commonly reported involuntary changes were increased workload (15.2%) and increased scope of work (15.2%). In the final model, significant predictors of satisfaction with occupational development 5-6 years after diagnosis were age, state of health ΔT2-T3, state of health ΔT3-T4, and involuntariness of job changes. CONCLUSIONS Although the number of job changes alone is not substantially associated with BCSs' satisfaction with occupational development, experiencing involuntary job changes is. Sociodemographic, disease-related, and work(place)-related factors may influence occupational satisfaction among BCSs. IMPLICATIONS FOR CANCER SURVIVORS The findings indicate the importance of strengthening one's ability to work as desired to prevent involuntary job changes and enable desired work participation in long-term support. The significance of workplace characteristics highlights the need for employers to encourage satisfying work participation. TRIAL REGISTRATION NUMBER German Clinical Trials Register (DRKS00016982), 12 April 2019.
Collapse
Affiliation(s)
- Kati Hiltrop
- Center for Health Communication and Health Services Research (CHSR), Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
- Center for Integrated Oncology (CIO Bonn), University Hospital Bonn, Bonn, Germany
| | - Paula Heidkamp
- Center for Health Communication and Health Services Research (CHSR), Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
- Center for Integrated Oncology (CIO Bonn), University Hospital Bonn, Bonn, Germany
| | | | | | - Anna Enders
- Federal Centre for Health Education (BZgA), Cologne, Germany
| | - Holger Pfaff
- Institute of Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), University of Cologne, Cologne, Germany
| | - Lena Ansmann
- Division for Organizational Health Services Research, Department of Health Services Research, School of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Franziska Geiser
- Center for Integrated Oncology (CIO Bonn), University Hospital Bonn, Bonn, Germany
- Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Nicole Ernstmann
- Center for Health Communication and Health Services Research (CHSR), Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
- Center for Integrated Oncology (CIO Bonn), University Hospital Bonn, Bonn, Germany
| |
Collapse
|
72
|
Paltrinieri S, Vicentini M, Mancuso P, Mazzini E, Fugazzaro S, Rossi PG, Costi S. Return to work of Italian cancer survivors: A focus on prognostic work-related factors. Work 2022; 71:681-691. [DOI: 10.3233/wor-210008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND: Return to work (RTW) enhances the general well-being and social participation of cancer survivors (CSs). OBJECTIVE: To describe the predictive value of work-related factors on the RTW process of CSs. The work accommodations, the perceived workload, and the barriers and facilitations of RTW are also reported. METHODS: This population-based cross-sectional survey was conducted in the Province of Reggio Emilia from July 2016 to July 2017. CSs who were 20–59 years old, first diagnosed with cancer, and employed at diagnosis were recruited. RESULTS: The majority of CSs (140/266, 53%) returned to work without difficulties, 42% reported difficulties, and 5% did not RTW. CSs who were shift workers (sex and age-adjusted Relative Risk [adj-RR] 1.30; 95% CI 0.94 –1.78) and who worked at night (adj-RR 1.36 95% CI 0.99 –1.86), in the evening (adj-RR 1.23; 95% CI 0.95 –1.57) and on Sundays (adj-RR 1.15; 95% CI 0.81 –1.63) perceived more difficulties. Physically demanding work and a long commute seemed to negatively impact RTW. Accommodations in work tasks (37%) or schedule (26%) were implemented. Workload was not acceptable for 18% of CSs. The main barriers concerned energy and drive functions, whereas remunerative employment was the foremost facilitation. CONCLUSIONS: Healthcare professionals should address work-related factors that might influence RTW with personalized interventions of vocational rehabilitation.
Collapse
Affiliation(s)
- Sara Paltrinieri
- Physical Medicine and Rehabilitation Unit, AziendaUnità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Massimo Vicentini
- Epidemiology Unit, Azienda Unità SanitariaLocale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Pamela Mancuso
- Epidemiology Unit, Azienda Unità SanitariaLocale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Elisa Mazzini
- Medical Directorate, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Stefania Fugazzaro
- Physical Medicine and Rehabilitation Unit, AziendaUnità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Paolo Giorgi Rossi
- Epidemiology Unit, Azienda Unità SanitariaLocale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Stefania Costi
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, Università di Modena eReggio Emilia, Reggio Emilia, Italy
- Scientific Directorate, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| |
Collapse
|
73
|
The economic impact of cancer diagnosis to individuals and their families: a systematic review. Support Care Cancer 2022; 30:6385-6404. [PMID: 35235040 PMCID: PMC9213304 DOI: 10.1007/s00520-022-06913-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 02/13/2022] [Indexed: 11/09/2022]
Abstract
Background The effect of a cancer diagnosis is wide-ranging with the potential to affect income, employment and risk of poverty. The aim of this systematic review is to identify the economic impact of a cancer diagnosis for patients and their families/caregivers. Methods The search covered peer-reviewed journals using MEDLINE, EMBASE, CINAHL, Cochrane Library, Epistemonikos and PsycINFO databases. Quality appraisal was undertaken using CASP tools. Monetary values were converted to US Dollars/2019 using a purchasing power parities (PPP) conversion factor. The review included articles up to and including January 2020, written in English language, for patients with cancer aged ≥ 18 years and focused on the costs up to 5 years following a cancer diagnosis. Results The search was run in January 2020 and updated in November 2021. Of the 7973 articles identified, 18 met the inclusion criteria. Studies were undertaken in the USA, Ireland, Canada, Australia, France, UK, Malaysia, Pakistan, China and Sri Lanka. The majority were cohort studies. Twelve reported out-of-pocket costs (range US$16–US$2523/month per patient/caregiver) consisting of medical expenses (e.g. surgery, radiotherapy and chemotherapy) and non-medical expenses (e.g. travel, food and childcare). Fourteen studies reported patient/caregiver loss of income and lost productivity (range 14–57.8%). Conclusions A high percentage of cancer patients and their families/caregivers experience out-of-pocket expenditure, loss of income and lost productivity. Future research is needed to observe the effects of continuing changes to healthcare policies and social protections on the economic burden among cancer patients and their families/caregivers.
Collapse
|
74
|
Tamminga SJ, de Wind A, Greidanus MA, Coenen P, Friberg E, Oldenburg H, Duijts SFA, de Boer AGEM. Prognostic factors for return to work in breast cancer survivors. Hippokratia 2022. [DOI: 10.1002/14651858.cd015124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Sietske J Tamminga
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health research institute; Amsterdam UMC, Location AMC; Amsterdam Netherlands
| | - Astrid de Wind
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health research institute; Amsterdam UMC, Location AMC; Amsterdam Netherlands
| | - Michiel A Greidanus
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health research institute; Amsterdam UMC, Location AMC; Amsterdam Netherlands
| | - Pieter Coenen
- Department of Public and Occupational Health, Amsterdam Public Health research institute; Amsterdam UMC, Location VUmc, Vrije Universiteit Amsterdam; Amsterdam Netherlands
| | - Emilie Friberg
- Department of Clinical Neurosciences Division of Insurance Medicine; Karolinska Institutet; Stockholm Sweden
| | - Hester Oldenburg
- Department of Surgical Oncology; The Netherlands Cancer Institute; Amsterdam Netherlands
| | - Saskia FA Duijts
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health research institute; Amsterdam UMC, Location VUmc; Amsterdam Netherlands
- The Netherlands Comprehensive Cancer Organization (IKNL); Utrecht Netherlands
| | - Angela GEM de Boer
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health research institute; Amsterdam UMC, Location AMC; Amsterdam Netherlands
| |
Collapse
|
75
|
Bu X, Jin C, Fan R, Cheng ASK, Ng PHF, Xia Y, Liu X. Unmet needs of 1210 Chinese breast cancer survivors and associated factors: a multicentre cross-sectional study. BMC Cancer 2022; 22:135. [PMID: 35109799 PMCID: PMC8811964 DOI: 10.1186/s12885-022-09224-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 01/14/2022] [Indexed: 11/23/2022] Open
Abstract
Background Breast cancer survivors (BCSs) often have potential unmet needs. Identification of the specific needs of BCSs is very significant for medical service provision. This study aimed to (1) investigate the unmet needs and quality of life (QoL) of BCSs in China, (2) explore the diverse factors associated with their unmet needs, and (3) assess the association between their unmet needs and QoL. Methods A multicentre, cross-sectional survey was administered to 1210 Chinese BCSs. The Cancer Survivor Profile-Breast Cancer and the Functional Assessment of Cancer Therapy-Breast scale were administered to survivors who gave informed consent to participate. Data were analysed using t-test, ANOVA, multiple regression analysis, and Pearson correlations. Results The 1192 participants completed questionnaires (response rate 98.51%). Our study reveals that the most prevalent unmet needs were in the ‘symptom burden domain’. The unmet needs of BCSs depend on eleven factors; age, time since diagnosis, education level, occupation, payment, family income status, stage of cancer, treatment, family history of cancer, pain, and physical activities. To ensure the provision of high-quality survivorship care and a high satisfaction level, more attention should be paid to actively identifying and addressing the unmet needs of BCSs. The problem areas identified in the Cancer Survivor Profile for breast cancer were negatively associated with all subscales of QoL except the health behaviour domain, with the correlation coefficient ranging from − 0.815 to − 0.011. Conclusion Chinese BCSs exhibit a high demand for unmet needs in this study, and the most prevalent unmet needs were in the ‘symptom burden domain’. There was a significant association between patients’ unmet needs (as defined in the Cancer Survivor Profile for breast cancer) and QoL. Future research should focus on enhancements to survivorship or follow-up care to address unmet needs and further improve QoL.
Collapse
Affiliation(s)
- Xiaofan Bu
- Nursing Teaching and Research Section, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.,Xiangya School of Nursing, Central South University, Changsha, China
| | - Cai Jin
- Nursing Teaching and Research Section, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.,Department of Nursing, Hunan Xiangya Stomatological Hospital, Central South University, Changsha, China
| | - Rongrong Fan
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Andy S K Cheng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Peter H F Ng
- Department of Computing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Yimin Xia
- Department of Health Service Center, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Xiangyu Liu
- Department of Health Service Center, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China.
| |
Collapse
|
76
|
Lieb M, Wünsch A, Schieber K, Bergelt C, Faller H, Geiser F, Goerling U, Hönig K, Hornemann B, Maatouk I, Niecke A, Stein B, Teufel M, Wickert M, Büttner-Teleagă A, Erim Y, Weis J. Return to work after cancer: Improved mental health in working cancer survivors. Psychooncology 2022; 31:893-901. [PMID: 34989051 DOI: 10.1002/pon.5877] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 12/23/2021] [Accepted: 12/26/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Aim of the study was to compare working and non-working patients over a period of 12 months regarding socio-demographic, cancer-specific and mental health parameters. METHODS This study was conducted as part of a Germany-wide longitudinal survey among 1398 patients in 13 national Comprehensive Cancer Centers. The sample used for analysis consisted of n = 430 cancer patients younger than 65 years (age M = 52.4 years, SD = 8.1; 67.0% females). Socio-demographic, cancer-specific and mental health parameters (Depression: Patient Health Questionnaire, Anxiety: Generalized Anxiety Disorder Scale, Distress: Distress Thermometer) were assessed at baseline during hospitalization and at 12 months follow-up. RESULTS 73.7% of all patients (n = 317) have returned to work after one year. While working and non-working patients did not differ in socio-demographic parameters, there were significant differences in the presence of metastases, tumor and treatment status. Mixed analysis of variances revealed significant interactions between working status and time for depression (p = 0.009), anxiety (p = 0.003) and distress (p = 0.007). Non-working patients reported higher levels of depression, anxiety and distress than working patients over time. A logistic regression showed significant associations between lower depression (p = 0.019), lower distress (p = 0.033) and the absence of a tumor (p = 0.015) with working status. CONCLUSIONS The majority of cancer survivors returned to work. Non-working patients had higher levels of depression, anxiety and distress than working patients. After controlling for cancer-specific factors, mental health parameters were still independently associated with working status. Return to work can thus be associated with an improved mental health in cancer survivors. In order to establish causality, further research is necessary.
Collapse
Affiliation(s)
- Marietta Lieb
- Department of Psychosomatic Medicine and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg, University Hospital of Erlangen, Erlangen, Germany
| | - Alexander Wünsch
- Clinic for Psychosomatic Medicine and Psychotherapy, Medical Center Freiburg, Faculty of Medicine, University Freiburg in Cooperation with Outpatient Support for Cancer Patients, Comprehensive Cancer Center Freiburg, Freiburg, Germany
| | - Katharina Schieber
- Department of Psychosomatic Medicine and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg, University Hospital of Erlangen, Erlangen, Germany
| | - Corinna Bergelt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Hamburg, Germany
| | - Hermann Faller
- Department of Medical Psychology and Psychotherapy, Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany
| | - Franziska Geiser
- University of Bonn, Clinic for Psychosomatic Medicine and Psychotherapy, Bonn, Germany
| | - Ute Goerling
- Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität and Berlin Institute of Health, Berlin, Germany
| | - Klaus Hönig
- Ulm University Clinic Department of Psychosomatic Medicine and Psychotherapy, Comprehensive Cancer Center Ulm (CCCU), Ulm, Germany
| | - Beate Hornemann
- Comprehensive Cancer Center, University Clinic Center Dresden, Dresden, Germany
| | - Imad Maatouk
- Department of General Internal Medicine and Psychosomatics, Medical University Hospital Heidelberg, Heidelberg, Germany
| | - Alexander Niecke
- Department of Psychosomatics and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Barbara Stein
- Department of Psychosomatic Medicine and Psychotherapy, Paracelsus Medical University, Nuremberg General Hospital, Nuremberg, Germany
| | - Martin Teufel
- Department of Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, Comprehensive Cancer Center Essen (WTZ) and LVR Hospital, Essen, Germany
| | - Martin Wickert
- Medical University Hospital Tuebingen, Universitätsklinikum Tübingen, Comprehensive Cancer Center Tübingen-Stuttgart, Tübingen, Germany
| | | | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg, University Hospital of Erlangen, Erlangen, Germany
| | - Joachim Weis
- Comprehensive Cancer Center, Department Self-help Research, Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| |
Collapse
|
77
|
Dunn M, Milius L, Ivarra A, Cooper M, Bhakta N. Motivations and Experiences in a Physical Activity Program for Cancer Survivors: Findings from Key Informant Interviews. Am J Health Promot 2021; 36:497-505. [PMID: 34969306 DOI: 10.1177/08901171211061939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE LIVESTRONG at the YMCA is an evidence-based 12-week physical activity (PA) program for cancer survivors. The purpose of our study was to understand the factors that motivated cancer survivors to begin the program, how the program impacted their habits, and how their experience influenced their motivation to continue with the program. APPROACH OR DESIGN Key informant interviews. SETTING Phone interviews conducted between April 15 and June 1, 2020. PARTICIPANTS 27 cancer survivors in Texas who previously participated in the LS program. METHOD Participants completed a 30- to 60-minute interview with one of four interviewers. All interviews were recorded, transcribed, and analyzed for themes. RESULTS Most interviewees were motivated to begin the program because of a desire to feel better after treatment. The most cited motivator to continue in the program was the community of cancer survivors. During the program, interviewees enjoyed learning different exercises, the community of cancer survivors, and the supportive teachers. Nearly all interviewees adopted or changed a healthy habit as a result of the program. CONCLUSION These results could be used by healthcare professionals to better understand what motivates cancer survivors to participate in a PA program. Results could also be used to plan or modify other PA programs for cancer survivors.
Collapse
Affiliation(s)
- Melissa Dunn
- Health Promotion and Chronic Disease Prevention Section, 8193Texas Department of State Health Services, Austin, TX, USA
| | - Lauren Milius
- Health Promotion and Chronic Disease Prevention Section, 8193Texas Department of State Health Services, Austin, TX, USA
| | - Amanda Ivarra
- Health Promotion and Chronic Disease Prevention Section, 8193Texas Department of State Health Services, Austin, TX, USA
| | - Maria Cooper
- Health Promotion and Chronic Disease Prevention Section, 8193Texas Department of State Health Services, Austin, TX, USA
| | - Nimisha Bhakta
- Health Promotion and Chronic Disease Prevention Section, 8193Texas Department of State Health Services, Austin, TX, USA
| |
Collapse
|
78
|
Petersen KS, Madsen LS, Nielsen CV, Labriola M, Stapelfeldt CM. "To have and then lose the safety net" - Female cancer survivors' experiences of the process of becoming ready to return to work. Work 2021; 70:1121-1130. [PMID: 34864711 DOI: 10.3233/wor-213623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Validation studies have not been able to confirm the stage-specific understanding as operationalised in the readiness for return to work (RRTW) questionnaire. OBJECTIVE To explore retrospectively how working female cancer survivors experienced the process of becoming ready to RTW during and beyond participation in an occupational rehabilitation intervention and thereby expand the understanding of the RRTW construct. METHODS A qualitative research design was employed. Thirteen female cancer survivors were included for semi-structured interviews one to two years after they had completed active treatment and returned to work. The RRTW construct guided data generation and analysis. Content analysis was performed in four analytical steps that combined a concept-driven and a data-driven analytic strategy. RESULTS Three themes were identified; "To have and then lose the safety net", "Realise a changed life situation", "Strive to balance work and everyday life". In a time span of approximately one to two years (from receiving treatment, being enrolled in an intervention and to gradually returning to work); the identified themes were interdependent of each other as one theme gradually evolved to the next theme in the process of engaging in sustained work participation. CONCLUSIONS The present study points towards continuous development of the RRTW construct and whether the addition of a preparedness dimension would improve validity.
Collapse
Affiliation(s)
- K S Petersen
- Department of Health Science and Technology, Faculty of Medicine, University of Aalborg, Aalborg, Denmark
| | - L S Madsen
- Department of Public Health, Aarhus University, Aarhus, Denmark.,DEFACTUM, Social and Health Services and Labour Market, Central Region Denmark, Aarhus, Denmark
| | - C V Nielsen
- Department of Public Health, Aarhus University, Aarhus, Denmark.,DEFACTUM, Social and Health Services and Labour Market, Central Region Denmark, Aarhus, Denmark.,Regional Hospital West Jutland, Herning, Denmark
| | - M Labriola
- Norwegian Research Centre (NORCE), Bergen, Norway
| | - C M Stapelfeldt
- Department of Public Health, Aarhus University, Aarhus, Denmark.,DEFACTUM, Social and Health Services and Labour Market, Central Region Denmark, Aarhus, Denmark
| |
Collapse
|
79
|
Bochenek-Cibor J, Zawisza K, Georgiew F, Bała MM. Assessment of Psychosocial and Functional Effects of Metastatic Breast Cancer in Tarnow Region of Poland and Among the Social Media Polish Group-Results from the Survey from Patients. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:1261-1268. [PMID: 32406046 DOI: 10.1007/s13187-020-01760-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The aim of the study was a comprehensive assessment of metastatic breast cancer patients' needs in Poland. We conducted and culturally adapted and validated "Count Us, Know Us, Join Us" Metastatic Breast Cancer Survey between November 2018 and July 2019. Two hundred ten patients treated in Tarnów completed the paper questionnaires distributed conveniently by healthcare professionals, and 110 patients completed the online survey. Almost all patients believe that new therapies are necessary, and over a half find their options of treatment limited. Support from family, friends, and healthcare professionals seems sufficient. Most patients declare a negative impact of the disease on their emotional status and ability to maintain their lifestyle, finances, and job with one-third of respondents being employed. Three-quarters of patients actively seek data about cancer. The main source of information for Polish patients is the Internet, and they are primarily interested in the ways of managing side effects and available treatment options. We identified factors related to satisfaction with communication with the healthcare professionals. The results are generally consistent with similar studies across the universe. This may indicate that several issues have not been addressed over the years, and there is an urgent need to join international forces to raise awareness and support for metastatic breast cancer patients and lobby for better treatment outcomes.
Collapse
Affiliation(s)
- Justyna Bochenek-Cibor
- Department of Radiation Oncology, St Lukas Hospital, Lwowska 178a, 33-100, Tarnow, Poland.
| | - Katarzyna Zawisza
- Department of Medical Sociology, Jagiellonian University Medical College, Kopernika 7A, 31-034, Krakow, Poland
| | - Filip Georgiew
- State Higher Vocational School in Tarnow, Mickiewicza 8, 33-100, Tarnow, Poland
| | - Małgorzata M Bała
- Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Faculty of Medicine, Jagiellonian University Medical College, Kopernika 7A, 31-034, Krakow, Poland
| |
Collapse
|
80
|
Carlson MA, Fradgley EA, Bridge P, Taylor J, Morris S, Coutts E, Paul C. The dynamic relationship between cancer and employment-related financial toxicity: an in-depth qualitative study of 21 Australian cancer survivor experiences and preferences for support. Support Care Cancer 2021; 30:3093-3103. [PMID: 34850273 DOI: 10.1007/s00520-021-06707-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 11/16/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND People with a cancer diagnosis experience physical and emotional impacts that may affect employment. Alongside cancer care costs, reduced ability to generate an income is a key contributor to financial toxicity which is associated with poor emotional wellbeing, quality of life, treatment adherence and survival. This study aimed to explore people's experiences of changes to employment and their suggestions for how cancer survivors can be better supported. METHODS Semi-structured telephone interviews were conducted with a purposive sample of 21 cancer survivors identified as part of a larger study of emotional distress. Purposive sampling was used to include a diverse group of people across age, gender, tumour type, self-reported financial difficulties and employment status. Interviews were inductively and iteratively coded by two independent coders and analysed using thematic analysis. RESULTS There is a dynamic relationship between a person's cancer treatment and their employment. For some, employment was disrupted due to physical or emotional impacts of cancer, or workplace stigma and discrimination. Others continued to work at the detriment of their health. Participants wished they had been made aware earlier how cancer might impact their capacity to work, their finances and their health. There was a lack of knowledge on the financial supports that may be available to them. CONCLUSIONS Healthcare professionals may have a role in minimising the financial impact of a cancer diagnosis through early assessment, communication of patients' potential work capacity and appropriate referrals to occupational therapy to aid return to work or financial planning. A robust government social support system specifically for households experiencing cancer is urgently required.
Collapse
Affiliation(s)
- Melissa A Carlson
- School of Medicine and Public Health, University of Newcastle, level 4 West, HMRI Building, University Drive, Callaghan, NSW, 2308, Australia.,Hunter Cancer Research Alliance, HMRI Building, New Lambton Heights, Australia
| | - Elizabeth A Fradgley
- School of Medicine and Public Health, University of Newcastle, level 4 West, HMRI Building, University Drive, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Cancer Research Innovation and Translation, University of Newcastle, Callaghan, Australia.,Hunter Cancer Research Alliance, HMRI Building, New Lambton Heights, Australia.,Priority Research Centre for Health Behavior, University of Newcastle, Callaghan, Australia
| | - Paula Bridge
- School of Medicine and Public Health, University of Newcastle, level 4 West, HMRI Building, University Drive, Callaghan, NSW, 2308, Australia.,Hunter Cancer Research Alliance, HMRI Building, New Lambton Heights, Australia.,Priority Research Centre for Health Behavior, University of Newcastle, Callaghan, Australia
| | - Jo Taylor
- School of Medicine and Public Health, University of Newcastle, level 4 West, HMRI Building, University Drive, Callaghan, NSW, 2308, Australia.,Hunter Cancer Research Alliance, HMRI Building, New Lambton Heights, Australia.,Priority Research Centre for Health Behavior, University of Newcastle, Callaghan, Australia
| | - Sarah Morris
- School of Medicine and Public Health, University of Newcastle, level 4 West, HMRI Building, University Drive, Callaghan, NSW, 2308, Australia
| | - Emily Coutts
- School of Medicine and Public Health, University of Newcastle, level 4 West, HMRI Building, University Drive, Callaghan, NSW, 2308, Australia
| | - Christine Paul
- School of Medicine and Public Health, University of Newcastle, level 4 West, HMRI Building, University Drive, Callaghan, NSW, 2308, Australia. .,Priority Research Centre for Cancer Research Innovation and Translation, University of Newcastle, Callaghan, Australia. .,Hunter Cancer Research Alliance, HMRI Building, New Lambton Heights, Australia. .,Priority Research Centre for Health Behavior, University of Newcastle, Callaghan, Australia.
| |
Collapse
|
81
|
Jansen J, van Ooijen R, Koning PWC, Boot CRL, Brouwer S. The Role of the Employer in Supporting Work Participation of Workers with Disabilities: A Systematic Literature Review Using an Interdisciplinary Approach. JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:916-949. [PMID: 33978875 PMCID: PMC8558169 DOI: 10.1007/s10926-021-09978-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/16/2021] [Indexed: 05/26/2023]
Abstract
Purpose There is growing awareness that the employer plays an important role in preventing early labor market exit of workers with poor health. This systematic review aims to explore the employer characteristics associated with work participation of workers with disabilities. An interdisciplinary approach was used to capture relevant characteristics at all organizational levels. Methods To identify relevant longitudinal observational studies, a systematic literature search was conducted in PubMed, Web of Science, PsycINFO and EconLit. Three key concepts were central to the search: (a) employer characteristics, (b) work participation, including continued employment, return to work and long-term work disability, and (c) chronic diseases. Results The search strategy resulted in 4456 articles. In total 50 articles met the inclusion criteria. We found 14 determinants clustered in four domains: work accommodations, social support, organizational culture and company characteristics. On supervisor level, strong evidence was found for an association between work accommodations and continued employment and return to work. Moderate evidence was found for an association between social support and return to work. On higher organizational level, weak evidence was found for an association between organizational culture and return to work. Inconsistent evidence was found for an association between company characteristics and the three work outcomes. Conclusions Our review indicates the importance of different employer efforts for work participation of workers with disabilities. Workplace programs aimed at facilitating work accommodations and supervisor support can contribute to the prevention of early labor market exit of workers with poor health. Further research is needed on the influence of organizational culture and company characteristics on work participation.
Collapse
Affiliation(s)
- J Jansen
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - R van Ooijen
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Economics, Econometrics and Finance, University of Groningen, Groningen, The Netherlands
| | - P W C Koning
- Department of Economics, VU University Amsterdam, Amsterdam, The Netherlands
- Department of Economics, Leiden University, Leiden, The Netherlands
| | - C R L Boot
- Department of Public and Occupational Health, Amsterdam UMC, VU University Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - S Brouwer
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| |
Collapse
|
82
|
Kirkeskov L, Carlsen RK, Lund T, Buus NH. Employment of patients with kidney failure treated with dialysis or kidney transplantation-a systematic review and meta-analysis. BMC Nephrol 2021; 22:348. [PMID: 34686138 PMCID: PMC8532382 DOI: 10.1186/s12882-021-02552-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 10/06/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Patients with kidney failure treated with dialysis or kidney transplantation experience difficulties maintaining employment due to the condition itself and the treatment. We aimed to establish the rate of employment before and after initiation of dialysis and kidney transplantation and to identify predictors of employment during dialysis and posttransplant. METHODS This systematic review and meta-analysis were carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines for studies that included employment rate in adults receiving dialysis or a kidney transplant. The literature search included cross-sectional or cohort studies published in English between January 1966 and August 2020 in the PubMed, Embase, and Cochrane Library databases. Data on employment rate, study population, age, gender, educational level, dialysis duration, kidney donor, ethnicity, dialysis modality, waiting time for transplantation, diabetes, and depression were extracted. Quality assessment was performed using the Newcastle-Ottawa Scale. Meta-analysis for predictors for employment, with odds ratios and confidence intervals, and tests for heterogeneity, using chi-square and I2 statistics, were calculated. PROSPERO registration number: CRD42020188853. RESULTS Thirty-three studies included 162,059 participants receiving dialysis, and 31 studies included 137,742 participants who received kidney transplantation. Dialysis patients were on average 52.6 years old (range: 16-79; 60.3% male), and kidney transplant patients were 46.7 years old (range: 18-78; 59.8% male). The employment rate (weighted mean) for dialysis patients was 26.3% (range: 10.5-59.7%); the employment rate was 36.9% pretransplant (range: 25-86%) and 38.2% posttransplant (range: 14.2-85%). Predictors for employment during dialysis and posttransplant were male, gender, age, being without diabetes, peritoneal dialysis, and higher educational level, and predictors of posttransplant: pretransplant employment included transplantation with a living donor kidney, and being without depression. CONCLUSIONS Patients with kidney failure had a low employment rate during dialysis and pre- and posttransplant. Kidney failure patients should be supported through a combination of clinical and social measures to ensure that they remain working.
Collapse
Affiliation(s)
- Lilli Kirkeskov
- Centre of Social Medicine, University Hospital Bispebjerg-Frederiksberg, Nordre Fasanvej 57, Vej 8, Opgang 2.2., 2000, Frederiksberg, Denmark.
| | - Rasmus K Carlsen
- Department of Transplantation Medicine, Oslo University Hospital, Sognsvannsveien 20, OUS, Rikshospitalet, 0372, Oslo, Norway
| | - Thomas Lund
- Centre of Social Medicine, University Hospital Bispebjerg-Frederiksberg, Nordre Fasanvej 57, Vej 8, Opgang 2.2., 2000, Frederiksberg, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Niels Henrik Buus
- Department of Renal Medicine, Aarhus University Hospital, Palle Juul-Jensnes Boulevard 35, indgang C, plan 2, 8200, Aarhus, Denmark
| |
Collapse
|
83
|
Tan FSI, Shorey S. Experiences of women with breast cancer while working or returning to work: a qualitative systematic review and meta-synthesis. Support Care Cancer 2021; 30:2971-2982. [PMID: 34647131 DOI: 10.1007/s00520-021-06615-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 10/03/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE This systematic review aims to consolidate the available qualitative evidence regarding the experiences of women with breast cancer while working or returning to work. METHODS Six electronic databases were searched until December 2020 for qualitative English-language articles examining the experiences of adult females with reproductive cancers while working or returning to work. The Critical Appraisal Skills Program checklist was used to assess the quality of included studies while the Sandelowski and Barroso's two step approach was used to meta-summarize and meta-synthesize the extracted data. RESULTS Four themes were derived from the 28 included studies: (i) being lost to finding meaning after the cancer diagnosis; (ii) concerns and considerations before returning to work; (iii) reasons for returning to work; and (iv) life at work after cancer diagnosis and treatment. CONCLUSIONS Current findings allowed a deeper understanding into the way the women with breast cancer coped during their cancer journey. Challenges and motivating factors faced by these women while working or returning to work were discussed. Improvements to current support systems and working policies are needed to better support this group of women.
Collapse
Affiliation(s)
- Faustine Sze Ing Tan
- KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, Singapore, 117597, Singapore.
| |
Collapse
|
84
|
Sun YS, Chen WL, Wu WT, Wang CC. The Fact of Return to Work in Cervical Cancer Survivors and the Impact of Survival Rate: An 11-Year Follow-Up Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010703. [PMID: 34682449 PMCID: PMC8535606 DOI: 10.3390/ijerph182010703] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/08/2021] [Accepted: 10/09/2021] [Indexed: 01/22/2023]
Abstract
The aim of the current cohort study was to explore the relationship between return to work (RTW) after cervical cancer treatment and different medical and occupational covariates. We also investigated the effect of RTW on all-cause mortality and survival outcomes of cervical cancer survivors. Data were collected between 2004 and 2015 from the database of the Taiwan Cancer Registry, Labor Insurance Database, and National Health Insurance Research Database. The associations between independent variables and RTW were analyzed by Cox proportional hazard models. A total of 4945 workers (82.3%) who returned to work within 5 years after being diagnosed with cervical cancer. Patients who underwent surgical treatment were more likely to RTW by the 5th year compared to other groups, with a hazard ratio (HR) of 1.21 (95% CI: 1.01~1.44). Small company size and a monthly income greater than NT 38,200 were inversely associated with RTW (HR = 0.91, 95% CI: 0.84~0.98 and HR = 0.48, 95% CI: 0.44~0.53). Furthermore, RTW showed a statistically significant decrease in the risk of all-cause mortality in the fully adjusted HR, (HR = 0.42, p < 0.001). Some medical and occupational factors are associated with RTW in cervical cancer survivors. Returning to work may have a beneficial effect on the survival of patients with cervical cancer.
Collapse
Affiliation(s)
- Yu-Shan Sun
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan; (Y.-S.S.); (W.-L.C.)
- Division of Environmental Health & Occupational Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
| | - Wei-Liang Chen
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan; (Y.-S.S.); (W.-L.C.)
- Division of Environmental Health & Occupational Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 114, Taiwan
| | - Wei-Te Wu
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli 350, Taiwan;
| | - Chung-Ching Wang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan; (Y.-S.S.); (W.-L.C.)
- Division of Environmental Health & Occupational Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 114, Taiwan
- Correspondence: ; Tel.: +886-287-923-311
| |
Collapse
|
85
|
Physiological and psychosocial correlates of cancer-related fatigue. J Cancer Surviv 2021; 16:1339-1354. [PMID: 34609702 DOI: 10.1007/s11764-021-01115-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 09/15/2021] [Indexed: 12/17/2022]
Abstract
PURPOSE Cancer-related fatigue (CRF) is a common and distressing symptom of cancer that may persist for years following treatment completion. However, little is known about the pathophysiology of CRF. Using a comprehensive group of gold-standard physiological and psychosocial assessments, this study aimed to identify correlates of CRF in a heterogenous group of cancer survivors. METHODS Using a cross-sectional design to determine the physiological and psychosocial correlates of CRF, ninety-three cancer survivors (51 fatigued, 42 non-fatigued) completed assessments of performance fatigability (i.e. the decline in muscle strength during cycling), cardiopulmonary exercise testing, venous blood samples for whole blood cell count and inflammatory markers and body composition. Participants also completed questionnaires measuring demographic, treatment-related, and psychosocial variables. RESULTS Performance fatigability, time-to-task-failure, peak oxygen uptake (V̇O2peak), tumor necrosis factor-α (TNF-α), body fat percentage, and lean mass index were associated with CRF severity. Performance fatigability, V̇O2peak, TNF-α, and age explained 35% of the variance in CRF severity. Those with clinically-relevant CRF reported more pain, more depressive symptoms, less perceived social support, and were less physically active than non-fatigued cancer survivors. CONCLUSIONS The present study utilised a comprehensive group of gold-standard physiological and psychosocial assessments and the results give potential insight into the mechanisms underpinning the association between physical inactivity, physical deconditioning and CRF. IMPLICATIONS FOR CANCER SURVIVORS Given the associations between CRF and both physiological and psychosocial measures, this study identifies targets that can be measured by rehabilitation professionals and used to guide tailored interventions to reduce fatigue.
Collapse
|
86
|
Nekhlyudov L, Campbell GB, Schmitz KH, Brooks GA, Kumar AJ, Ganz PA, Von Ah D. Cancer-related impairments and functional limitations among long-term cancer survivors: Gaps and opportunities for clinical practice. Cancer 2021; 128:222-229. [PMID: 34529268 PMCID: PMC9292035 DOI: 10.1002/cncr.33913] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 08/27/2021] [Accepted: 08/27/2021] [Indexed: 12/20/2022]
Abstract
This commentary provides a concise overview of the epidemiology of cancer survivorship and work, common functional limitations experienced by cancer survivors, and evidence‐based recommendations for interventions available to improve function. It also describes the US Social Security Administration's disability claims process, its eligibility requirements, and barriers for long‐term survivors in securing approval for disability claims, and offers insights for practicing clinicians in holistically addressing functional limitations in practice.
Collapse
Affiliation(s)
- Larissa Nekhlyudov
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Grace B Campbell
- Duquesne University School of Nursing, Pittsburgh, Pennsylvania.,Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Kathryn H Schmitz
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania
| | - Gabriel A Brooks
- Norris Cotton Cancer Center, Geisel School of Medicine, Lebanon, New Hampshire
| | - Anita J Kumar
- Department of Medicine, Tufts Medical Center, Boston, Massachusetts
| | - Patricia A Ganz
- School of Medicine, University of California Los Angeles, Los Angeles, California.,Department of Health Policy and Management, School of Public Health, University of California Los Angeles, Los Angeles, California.,Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, California
| | - Diane Von Ah
- College of Nursing, Ohio State University, Columbus, Ohio
| |
Collapse
|
87
|
Gragnano A, Miglioretti M, Magon G, Pravettoni G. Work with cancer or stop working after diagnosis? Variables affecting the decision. Work 2021; 70:177-185. [PMID: 34511522 DOI: 10.3233/wor-213563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Studies about work and cancer predominantly considered the return to work of cancer survivors. However, some studies highlighted that many patients work with cancer even immediately after the diagnosis. Little is known about the frequency, causes, and consequences of this behavior. OBJECTIVE This study aimed to estimate how many cancer patients continue working in the month after the diagnosis in an Italian context and to determine which factors affect the decision to stop working in the same period. METHODS One hundred seventy-six patients with breast, gastrointestinal, prostate, or female reproductive system cancer completed a survey with demographic, occupational, and psychosocial information. Clinical information was collected from medical records. We measured how many workers continued working in the month after cancer diagnosis without substantial interruptions and selected the best logistic regression model of this behavior's predictors. RESULTS Sixty-eight percent of the patients continued working in the month after the diagnosis. Patients were more likely to stop working with a higher level of perceived work-health incompatibility (OR = 2.64; 95%CI: 1.48-4.69), an open-ended contract (OR = 3.20; CI: 1.13-9.09), and a complex treatment (surgery+chemo-/radio-therapy, OR = 4.25; CI: 1.55-11.65) and less likely with breast cancer (OR = 0.20; CI: 0.07-0.56), and more children (OR = 0.59; CI: 0.37-0.96). CONCLUSIONS To continue working with cancer is a common practice among the newly diagnosed. The decision to suspend work activity relates to evaluating how much work activities hamper one's health care needs and the practical difficulties expected in handling cancer care and work.
Collapse
Affiliation(s)
- Andrea Gragnano
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | | | | | - Gabriella Pravettoni
- European Institute of Oncology (IEO), Milan, Italy.,Department of Oncology and Hematooncology, University of Milan, Milan, Italy
| |
Collapse
|
88
|
Wennman-Larsen A, Svärd V, Alexanderson K, Friberg E. Factors of decisive importance for being in work or not during two years after breast cancer surgery: content analysis of 462 women's open answers. BMC WOMENS HEALTH 2021; 21:332. [PMID: 34521383 PMCID: PMC8438964 DOI: 10.1186/s12905-021-01468-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 09/01/2021] [Indexed: 11/10/2022]
Abstract
Background Paid work is one of the most important aspects in life among working-aged women diagnosed with breast cancer. Despite several attempts, no previous study provides a comprehensive overview from the women’s perspective about factors of importance for being able to work or not. Therefore, the aim of this study was to gain knowledge about factors that women themselves state are of decisive importance for being able to work or not during the first two years after breast cancer surgery. Methods Data was collected in a two-year follow-up questionnaire within the frame of a prospective cohort study of working-aged women who had undergone breast cancer surgery. 749 were included in the questionnaire study and of the 616 (82%) responding women, 462 (75%) wrote statements on an open-ended question about factors of decisive importance for being able to work or not work during the past two years. The statements were analyzed with content analysis. Results Five categories of factors of importance for being able to work or not were identified, each covering several sub-categories: Health and wellbeing, Contacts and encounters, Flexibility and adjustment possibilities, Socioeconomic consequences from working/not working, and Own motivation and characteristics. A wide variety of factors were mentioned by the women and the findings give a multifaceted picture of many single but interrelated factors of decisive importance for being able to work/not work. The importance of flexibility in the return-to-work process was stressed, as well as the importance of supportive encounters from, e.g., colleagues, managers, as well as relatives. Conclusions The results give a comprehensive overview over a variety of different types of factors for being able to return to/remain in work or to not work after breast cancer surgery, adding new knowledge about e.g. the importance of colleagues, and the women’s own preferences or characteristics. These are factors that different stakeholders, both from healthcare but also from the work place and the insurance office, need to be aware of and collaborate around to support women with breast cancer during the period of treatment, rehabilitation and return to work.
Collapse
Affiliation(s)
- Agneta Wennman-Larsen
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 17177, Stockholm, Sweden. .,Department of Nursing Science, Sophiahemmet University, Box 5605, 11486, Stockholm, Sweden.
| | - Veronica Svärd
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 17177, Stockholm, Sweden.,Department of Social Work, Södertörn University, 14189, Huddinge, Sweden
| | - Kristina Alexanderson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 17177, Stockholm, Sweden
| | - Emilie Friberg
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 17177, Stockholm, Sweden
| |
Collapse
|
89
|
Liu S, Wang F, Yang Q, Wang Q, Feng D, Chen Y, Cheng ASK. Work productivity loss in breast cancer survivors and its effects on quality of life. Work 2021; 70:199-207. [PMID: 34511524 DOI: 10.3233/wor-213565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Return to work is an important process for many breast cancer survivors (BCSs) that acts as a positive step towards their reintegration into society. OBJECTIVES This study examined whether work productivity loss due to presenteeism could predict the quality of life (QOL) of employed BCSs. METHODS This study used a cross-sectional design. Seventy-five BCSs and seventy-five participants in the Non-Cancer Comparison (NCC) group were surveyed. The main outcome measures were productivity loss (as measured by the Work Limitations questionnaire) and quality of life (as measure by the European Organization for Research and Treatment Quality of Life questionnaire C30). Other measures included psychological distress (as measured by the Hospital Anxiety and Depression Scale) and cognitive limitation at work (as measured by the Cognitive Symptom Checklist). RESULTS The BCS group had a lower summary score, a lower global health related score and greater work limitation in all domains than the NCC group. The productivity loss due to presenteeism of the BCS group was 8%. The multiple regression model shows that work productivity loss and level of job stress were the significant predictors of quality of life in the BCS group. CONCLUSION These findings raise questions about the effects of level of job stress and work productivity loss on the QOL of BCSs. Longitudinal studies are needed to map these relationships.
Collapse
Affiliation(s)
- Shaxin Liu
- Rehabilitation Medicine Center, West China Hospital of Sichuan University, Chengdu, P.R. China
| | - Fengyi Wang
- Rehabilitation Medicine Center, West China Hospital of Sichuan University, Chengdu, P.R. China
| | - Qiong Yang
- Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Quan Wang
- Shanghai Sunshine Rehabilitation Centre, Shanghai, P.R. China
| | - Danling Feng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Yue Chen
- Care Alliance Rehabilitation Hospital of Chengdu, P.R. China
| | - Andy S K Cheng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| |
Collapse
|
90
|
Peipins LA, Dasari S, Rodriguez JL, White MC, Hodgson ME, Sandler DP. Employment After Breast Cancer Diagnosis and Treatment Among Women in the Sister and the Two Sister Studies. JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:543-551. [PMID: 33387171 PMCID: PMC8485879 DOI: 10.1007/s10926-020-09951-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/25/2020] [Indexed: 06/12/2023]
Abstract
Purpose Women undergoing diagnosis and treatment for breast cancer may face challenges in employment. We investigated the impact of demographic, clinical, workplace, and psychosocial characteristics on loss of employment after a breast cancer diagnosis and treatment. We further describe changes in work status and work environment for cancer survivors who sustain employment. Methods We analyzed responses from a survey of breast cancer survivors from the Sister Study and the Two Sister Study cohorts who reported being employed at the time of their breast cancer diagnosis and who reported employment status (lost vs. sustained employment) at the time of survey administration. Multivariate logistic regression was used to identify the effects of lymphedema, neuropathy, problems with memory or attention, social support, health insurance, and sick leave on lost employment, adjusting for demographic characteristics, cancer stage, treatment, and general health. Results Of the 1675 respondents who reported being employed at the time of diagnosis, 83.5% reported being 'currently' employed at the time of the survey. Older age, peripheral neuropathy, lack of sick leave, late stage at diagnosis, a recurrence or a new cancer, problems with memory or attention, and poor general health were significantly associated with lost employment. Conclusions The long-term effects of breast cancer treatment and workplace provisions for leave and accommodation may have a substantial effect on women's ability to sustain employment. The findings from this study highlight challenges reported by cancer survivors that may inform clinical and occupational interventions to support survivors' return to work.
Collapse
Affiliation(s)
- Lucy A Peipins
- Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
- NCCDPHP/DCPC, Mailstop S-107-4, 4770 Buford Hwy, NE, Chamblee, GA, 30341-3717, USA.
| | | | - Juan L Rodriguez
- Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mary C White
- Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| |
Collapse
|
91
|
Kim SY, Kissane DW, Richardson G, Senior J, Morgan J, Gregory P, Birks S, Ooi C, Lipton L, Antill Y, Vereker M, Michael N, Bobevski I. The role of depression and other psychological factors in work ability among breast cancer survivors in Australia. Psychooncology 2021; 31:167-175. [PMID: 34460129 DOI: 10.1002/pon.5802] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 07/30/2021] [Accepted: 08/16/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Identifying modifiable factors affecting work ability among cancer survivors is important. The primary aim of the present study was to examine the effects of depression and related psychological factors on work ability among breast cancer survivors in Australia. METHODS In this cross-sectional electronic and postal survey, Australian breast cancer survivors were investigated. Work status and conditions before and after cancer treatment were analysed. Work ability was measured using the Work Limitation Questionnaire©-Short Form (WLQ-SF) with its four domains (time management, physical tasks, mental-interpersonal tasks, and output tasks). Three psychological factors were investigated: depression, fear of cancer recurrence, and demoralisation. Sociodemographic and clinical data were also collected. Multivariate regression analysis was used to identify the associations of psychological factors with WLQ-SF. RESULTS Among eligible survivors, 310 (50%) responded to the survey and were analysed. Nearly one third reported their work conditions had changed after cancer treatment. The depressed group reported limited work ability in 35%-44% of the four domains of WLQ-SF, while the non-depressed group reported limited work ability in only 8%-13%. At-work productivity loss was approximately fourfold higher in the depressed group than in the non-depressed group. In multivariate analysis, at-work productivity loss was associated with depression, demoralisation, and past history of anxiety. CONCLUSIONS After breast cancer treatment, work conditions changed toward lower wages and working hours. Depression, demoralisation, and past history of anxiety were associated with lower work ability. Further evaluations of work rehabilitation in breast cancer survivors are warranted.
Collapse
Affiliation(s)
- Seon-Young Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, South Korea.,Mental Health Clinic, Chonnam National University Hwasun Hospital, Hwasun, South Korea
| | - David W Kissane
- Cabrini Health, Melbourne, Victoria, Australia.,School of Clinical Sciences, Monash University, Clayton, Victoria, Australia.,School of Medicine, University of Notre Dame Australia and Cunningham Centre, Sydney, New South Wales, Australia
| | - Gary Richardson
- Cabrini Health, Melbourne, Victoria, Australia.,Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
| | | | | | | | - Sarah Birks
- Cabrini Health, Melbourne, Victoria, Australia
| | - Corinne Ooi
- Cabrini Health, Melbourne, Victoria, Australia
| | - Lara Lipton
- Cabrini Health, Melbourne, Victoria, Australia.,Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Yoland Antill
- Cabrini Health, Melbourne, Victoria, Australia.,Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
| | | | - Natasha Michael
- Cabrini Health, Melbourne, Victoria, Australia.,School of Clinical Sciences, Monash University, Clayton, Victoria, Australia.,School of Medicine, University of Notre Dame Australia and Cunningham Centre, Sydney, New South Wales, Australia
| | - Irene Bobevski
- Cabrini Health, Melbourne, Victoria, Australia.,School of Clinical Sciences, Monash University, Clayton, Victoria, Australia
| |
Collapse
|
92
|
Algeo N, Bennett K, Connolly D. Rehabilitation interventions to support return to work for women with breast cancer: a systematic review and meta-analysis. BMC Cancer 2021; 21:895. [PMID: 34353286 PMCID: PMC8340442 DOI: 10.1186/s12885-021-08613-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 07/12/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Research recommends the development and evaluation of interventions to support women with breast cancer in returning to, or managing, work. Despite this, there has historically been a paucity of rehabilitation interventions to support women with breast cancer to maintain or return to their work role. The aim of this systematic review was to examine key characteristics of rehabilitation interventions, and their effectiveness on work outcomes for women with breast cancer, compared to usual care. METHODS A systematic review was conducted of controlled studies of rehabilitation interventions with work outcomes for women with breast cancer. Six databases were systematically searched: EMBASE, Web of Science, MEDLINE (OVID), CINAHL, PsycINFO, and the Cochrane Central Register of Controlled Trials (CENTRAL). Results are presented either as pooled odds ratio (OR) or pooled effect size (hedges g) between groups, with 95% confidence intervals (CI). Narrative synthesis was conducted on intervention outcomes not suitable for meta-analysis. RESULTS Five thousand, five hundred and thirty-five studies were identified. Nine out of 28 abstracts met inclusion criteria. Heterogeneity of interventions and outcomes precluded meta-analysis for most outcomes. Of the interventions included in meta-analysis, no significant differences compared to usual care were found for sick leave (2 studies (12 months); OR 1.11 (95% CI: 0.66 to 1.87), number of sick days taken (2 studies (six months); difference in effect: - 0.08, (95% CI: - 0.48 to 0.38) or working hours (2 studies (12 months); 0.19, (95% CI: - 0.20 to 0.64). Only one study, with a multidisciplinary intervention, showed a significant difference for work outcomes when compared to usual care. Work-specific content featured in three interventions only, none of which provided conclusive evidence for improvement in work outcomes. Enhanced physical and psychological sequalae, and quality of life was observed in some studies. CONCLUSION There remains a lack of effective and methodologically rigorous rehabilitation intervention studies for breast cancer survivors. The development and evaluation of effective rehabilitation interventions to support return to work is warranted.
Collapse
Affiliation(s)
- Naomi Algeo
- Discipline of Occupational Therapy, Trinity College Dublin, Dublin, Ireland.
| | - Kathleen Bennett
- Data Science Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Deirdre Connolly
- Discipline of Occupational Therapy, Trinity College Dublin, Dublin, Ireland
| |
Collapse
|
93
|
Greidanus MA, de Boer AGEM, de Rijk AE, Brouwers S, de Reijke TM, Kersten MJ, Klinkenbijl JHG, Lalisang RI, Lindeboom R, Zondervan PJ, Frings-Dresen MHW, Tamminga SJ. The Successful Return-To-Work Questionnaire for Cancer Survivors (I-RTW_CS): Development, Validity and Reproducibility. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2021; 13:567-582. [PMID: 32508005 PMCID: PMC7478947 DOI: 10.1007/s40271-020-00427-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background Cancer survivors’ perspectives on a successful return to work (RTW) may not be captured in the common measure of RTW, namely time until RTW. Objective The purpose of this study was therefore to develop an RTW outcome measure that reflects employed cancer survivors’ perspectives, with items that could be influenced by an employer, i.e. the Successful Return-To-Work questionnaire for Cancer Survivors (I-RTW_CS), and to assess its construct validity and reproducibility. Methods First, three focus groups with cancer survivors (n = 14) were organized to generate issues that may constitute successful RTW. Second, a two-round Delphi study among 108 cancer survivors was conducted to select the most important issues. Construct validity of the I-RTW_CS was assessed using correlations with a single-item measure of successful RTW and the Quality of Working Life Questionnaire for Cancer Survivors (QWLQ-CS; n = 57). Reproducibility (test–retest reliability) was assessed using the intraclass correlation coefficient (ICC; n = 50). Results Forty-eight issues were generated, of which seven were included: ‘enjoyment in work’; ‘work without affecting health’; ‘confidence of employer without assumptions about work ability’; ‘open communication with employer’; ‘feeling welcome at work’; ‘good work–life balance’; and ‘joint satisfaction with the situation (employer and cancer survivor)’. Correlations with single-item successful RTW and QWLQ-CS were 0.58 and 0.85, respectively. The reproducibility showed an ICC of 0.72. Conclusions The I-RTW_CS provides an RTW outcome measure that includes cancer survivors’ perspectives and weights its items on an individual basis, allowing a more meaningful evaluation of cancer survivors’ RTW. This study provides preliminary evidence for its construct validity and reproducibility.
Collapse
Affiliation(s)
- Michiel A Greidanus
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
| | - Angela G E M de Boer
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Angelique E de Rijk
- Department of Social Medicine, Faculty of Health, Medicine and Life Sciences, Research Institute Primary Care and Public Health (CAPHRI), Maastricht University, Duboisdomein 30, Maastricht, The Netherlands
| | - Sonja Brouwers
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Theo M de Reijke
- Department of Urology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Marie José Kersten
- Department of Hematology, Cancer Center Amsterdam, Lymphoma and Myeloma Center Amsterdam (LYMMCARE), Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Jean H G Klinkenbijl
- Department of Surgery, Gelre Hospital, Apeldoorn, The Netherlands
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Roy I Lalisang
- Division of Medical Oncology, Department of Internal Medicine, GROW School of Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Robert Lindeboom
- Department of Clinical Methods and Public Health, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Patricia J Zondervan
- Department of Urology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Monique H W Frings-Dresen
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Sietske J Tamminga
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| |
Collapse
|
94
|
Greidanus MA, de Rijk AE, de Boer AGEM, Bos MEMM, Plaisier PW, Smeenk RM, Frings-Dresen MHW, Tamminga SJ. A randomised feasibility trial of an employer-based intervention for enhancing successful return to work of cancer survivors (MiLES intervention). BMC Public Health 2021; 21:1433. [PMID: 34289828 PMCID: PMC8293550 DOI: 10.1186/s12889-021-11357-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 06/16/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Employers express a need for support during sickness absence and return to work (RTW) of cancer survivors. Therefore, a web-based intervention (MiLES) targeted at employers with the objective of enhancing cancer survivors' successful RTW has been developed. This study aimed to assess feasibility of a future definitive randomised controlled trial (RCT) on the effectiveness of the MiLES intervention. Also preliminary results on the effectiveness of the MiLES intervention were obtained. METHODS A randomised feasibility trial of 6 months was undertaken with cancer survivors aged 18-63 years, diagnosed with cancer < 2 years earlier, currently in paid employment, and sick-listed < 1 year. Participants were randomised to an intervention group, with their employer receiving the MiLES intervention, or to a waiting-list control group (2:1). Feasibility of a future definitive RCT was determined on the basis of predefined criteria related to method and protocol-related uncertainties (e.g. reach, retention, appropriateness). The primary effect measure (i.e. successful RTW) and secondary effect measures (e.g. quality of working life) were assessed at baseline and 3 and 6 months thereafter. RESULTS Thirty-five cancer survivors were included via medical specialists (4% of the initially invited group) and open invitations, and thereafter randomised to the intervention (n = 24) or control group (n = 11). Most participants were female (97%) with breast cancer (80%) and a permanent employment contract (94%). All predefined criteria for feasibility of a future definitive RCT were achieved, except that concerning the study's reach (90 participants). After 6 months, 92% of the intervention group and 100% of the control group returned to work (RR: 0.92, 95% CI: 0.81-1.03); no difference were found with regard to secondary effect measures. CONCLUSIONS With the current design a future definitive RCT on the effectiveness of the MiLES intervention on successful RTW of cancer survivors is not feasible, since recruitment of survivors fell short of the predefined minimum for feasibility. There was selection bias towards survivors at low risk of adverse work outcomes, which reduced generalisability of the outcomes. An alternative study design is needed to study effectiveness of the MiLES intervention. TRIAL REGISTRATION The study has been registered in the Dutch Trial Register ( NL6758/NTR7627 ).
Collapse
Affiliation(s)
- M A Greidanus
- Department Public and Occupational Health/ Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
| | - A E de Rijk
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Duboisdomein 30, Maastricht, The Netherlands
| | - A G E M de Boer
- Department Public and Occupational Health/ Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - M E M M Bos
- Department of Medical Oncology, Erasmus Medical Center, Doctor Molewaterplein 40, Rotterdam, The Netherlands
| | - P W Plaisier
- Department of Surgery, Albert Schweitzer Hospital, Albert Schweitzerplaats 25, Dordrecht, The Netherlands
| | - R M Smeenk
- Department of Surgery, Albert Schweitzer Hospital, Albert Schweitzerplaats 25, Dordrecht, The Netherlands
| | - M H W Frings-Dresen
- Department Public and Occupational Health/ Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - S J Tamminga
- Department Public and Occupational Health/ Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| |
Collapse
|
95
|
Distress among cancer patients attending rehabilitation in the community. Support Care Cancer 2021; 30:279-287. [PMID: 34273033 PMCID: PMC8636420 DOI: 10.1007/s00520-021-06422-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 07/06/2021] [Indexed: 01/30/2023]
Abstract
Purpose The aim of this study is to identify sources of distress among cancer patients attending rehabilitation in the community. Methods Participants were 430 patients recruited from a cancer rehabilitation center in Singapore between 2017 and 2018, who had rated their distress using the distress thermometer (DT) and indicated associated problems on the problem list. Chi-square tests were used to detect differences in the reported symptoms among three age groups. Exploratory factor analysis was used to identify symptom clusters. Partial correlational analysis was then performed to examine the relationship between distress, symptom clusters, and age controlling for gender and cancer type. Results About 30% of the participants reported distress ≥ 5 on the DT (mean 3.3 ± 2.5), and the mean number of problems endorsed was 8 ± 6. A higher total number of reported problems (r = .63) and younger age (r = − .21) were associated with increased distress. The younger age group also reported more problems surrounding emotions, finance, work/school, children-related issues, and physical symptoms such as sleep and nausea. Of the 12 factors identified, 9 psychosocial and physical symptom clusters correlated with distress (r ranging from .12 to .41). All results were statistically significant after adjustment (p ≤ 0.05). Conclusion Younger survivors are more at risk of distress and report greater role functioning concerns related to childcare, partner relationship, and work participation. Age-tailored and multimodal interventions may be necessary to adequately address age-related differences and help coordinate management of multiple symptom clusters across physical and psychosocial concerns.
Collapse
|
96
|
Zomkowski K, Bergmann A, Sacomori C, Dias M, Sperandio FF. Functionality and factors associated with work behaviour among Brazilian breast cancer survivors: A cross-sectional study. Work 2021; 67:917-925. [PMID: 33325438 DOI: 10.3233/wor-203342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Breast cancer treatments lead to several comorbidities in the upper limbs, such as pain and stiffness, hindering physical functions and the return to work. OBJECTIVE To explore the functionality and factors associated with work behaviour among manual and non-manual Brazilian workers who have recovered from breast cancer. METHODS This is an observational cross-sectional study involving Brazilian breast cancer survivors. The sociodemographic, work, and clinical aspects were assessed through clinical records, upper limb disability, and human functionality obtained from 62 women. Multiple and univariate logistic regressions were used to identify the association of variables on return to work, p < 0.05. RESULTS 56.5% of women did not return to work, the mean time for returning to work was 16 months (±15.21), absenteeism from work lasted 41 months (±34.58). Modified radical mastectomy (OR = 5.13, 95% CI = 1.35 to 18.66) and moderate-to-severe disability levels in the upper limbs (OR = 6.77, 95% CI = 1.86 to 24.92) were associated with not returning to work. The loss of productivity was higher among non-manual workers (21.5%) (p = 0.040). CONCLUSIONS The rates of not returning to work after breast cancer treatment are high. Women who did not return to work presented higher levels of disability.
Collapse
Affiliation(s)
- Kamilla Zomkowski
- Physical Therapy Department, South University of Santa Catarina (UNISUL) Pedra Branca, Palhoça, SC, Brazil
| | - Anke Bergmann
- Molecular Carcinogenesis Program, National CancerInstitute (INCA), Praça Cruz Vermelha, Centro, Rio de Janeiro, RJ, Brazil
| | - Cinara Sacomori
- School of Kinesiology, Universidad Bernardo O'Higgins, Santiago, Chile, Santiago, Chile
| | - Mirella Dias
- Physical Therapy Department, Oncology Research Centre (CEPON), RodoviaAdmar Gonzaga, Itacorubi, Florianópolis, SC, Brazil
| | - Fabiana Flores Sperandio
- Physical Therapy Department, College of Health and Sport Science (CEFID) Santa Catarina State University (UDESC), Coqueiros, Florianópolis, SC, Brazil
| |
Collapse
|
97
|
Van Beek FE, Wijnhoven LMA, Holtmaat K, Custers JAE, Prins JB, Verdonck-de Leeuw IM, Jansen F. Psychological problems among cancer patients in relation to healthcare and societal costs: A systematic review. Psychooncology 2021; 30:1801-1835. [PMID: 34228838 PMCID: PMC9291760 DOI: 10.1002/pon.5753] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 05/27/2021] [Accepted: 06/14/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE This study systematically reviewed the association of psychological problems among cancer patients with healthcare and societal resource use and costs. METHODS PubMed, PsycINFO, and Embase were searched (until 31 January 2021) for studies on psychological symptoms (anxiety, depression, distress, fear of recurrence) or psychiatric disorders (anxiety, depression, adjustment) and healthcare use (e.g., mental, inpatient healthcare), economic losses by patients and family, economic losses in other sectors (e.g., absence from work), and costs. The search, data extraction, and quality assessment were performed by two authors. RESULTS Of the 4157 identified records, 49 articles were included (psychological symptoms (n = 34), psychiatric disorders (n = 14), both (n = 1)) which focused on healthcare use (n = 36), economic losses by patients and family (n = 5), economic losses in other sectors (n = 8) and/or costs (n = 13). In total, for 12 of the 94 associations strong evidence was found. Psychological symptoms and psychiatric disorders were positively associated with increased healthcare use (mental, primary, inpatient, outpatient healthcare), losses in other sectors (absence from work), and costs (inpatient, outpatient, total healthcare costs). Moderate evidence was found for a positive association between (any) psychiatric disorder and depression disorder with inpatient healthcare and medication use, respectively. CONCLUSIONS Psychological problems in cancer patients are associated with increased healthcare use, healthcare costs and economic losses. Further research is needed on psychological problems in relation to understudied healthcare use or costs categories, productivity losses, and informal care costs.
Collapse
Affiliation(s)
- Florie E Van Beek
- Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Lonneke M A Wijnhoven
- Department of Medical Psychology, Radboudumc Nijmegen, Radboud Institute of Health Sciences, Nijmegen, The Netherlands
| | - Karen Holtmaat
- Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - José A E Custers
- Department of Medical Psychology, Radboudumc Nijmegen, Radboud Institute of Health Sciences, Nijmegen, The Netherlands
| | - Judith B Prins
- Department of Medical Psychology, Radboudumc Nijmegen, Radboud Institute of Health Sciences, Nijmegen, The Netherlands
| | - Irma M Verdonck-de Leeuw
- Department of Clinical, Neuro- and Developmental Psychology, Faculty of Behavioral and Movement Sciences, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Otolaryngology-Head and Neck Surgery, Amsterdam UMC, VUmc Cancer Center Amsterdam, Amsterdam, The Netherlands.,Cancer Center Amsterdam (CCA), VU University Medical Center, Amsterdam, The Netherlands
| | - Femke Jansen
- Department of Otolaryngology-Head and Neck Surgery, Amsterdam UMC, VUmc Cancer Center Amsterdam, Amsterdam, The Netherlands.,Cancer Center Amsterdam (CCA), VU University Medical Center, Amsterdam, The Netherlands
| |
Collapse
|
98
|
The assessment of returning to work following treatment and the associated personal, disease, and treatment factors among breast cancer survivors in central China. Support Care Cancer 2021; 29:7627-7636. [PMID: 34132883 PMCID: PMC8550547 DOI: 10.1007/s00520-021-06354-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 06/08/2021] [Indexed: 11/06/2022]
Abstract
Purpose To assess the status of returning to work (RTW) following breast cancer treatment and to explore its associated factors among female patients. Methods Four-hundred-forty-two eligible patients admitted in a tertiary hospital since 2012 were followed up in 2018. Information about working status after treatment, date of RTW or reason for not RTW was obtained during a 30-min interview. Patients’ sociodemographic, disease, and treatment characteristics were retrieved from the hospital record. Overall prevalence rate and probability of RTW during the follow-up were estimated using Kaplan–Meier method. Factors associated with RTW were identified using regression analyses. Results Three-hundred-ninety-six patients (89.6%) completed the follow-up. The median follow-up was 31 months. Among them, 141 patents (35.6%) RTW of whom 68.1% (n = 96) were back within 12 months after cancer treatment. The reported reasons for not RTW included: prolonged fatigue, low self-esteem, lack of support from family and working unit, or voluntarily quitting. Patients aged under 50 years, being single, having higher level of education, not having extensive axillary node procedure, or without any comorbidities were more likely to RTW. Conclusion The rate of RTW after cancer treatment in this cohort was lower than those reported in others. Both personal and treatment factors were associated with RTW.
Collapse
|
99
|
de Wind A, Tamminga SJ, Bony CAG, Diether M, Ludwig M, Velthuis MJ, Duijts SFA, de Boer AGEM. Loss of Paid Employment up to 4 Years after Colorectal Cancer Diagnosis-A Nationwide Register-Based Study with a Population-Based Reference Group. Cancers (Basel) 2021; 13:cancers13122868. [PMID: 34201371 PMCID: PMC8229293 DOI: 10.3390/cancers13122868] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 05/27/2021] [Accepted: 06/02/2021] [Indexed: 12/22/2022] Open
Abstract
Simple Summary Previous research indicated that cancer survivors have a higher risk of loss of paid employment. This is unfortunate as work is important for cancer survivors because it contributes to financial independency and quality of life. Not much work has been done on patients diagnosed with colorectal cancer while it is one of the most common cancers in the working population. We compared a group of 12,007 colorectal cancer survivors up to four years after diagnosis with the general population. We found that colorectal cancer survivors had a 56% higher risk of loss of paid employment, mainly due to work disability. Within the group of colorectal cancer survivors, those being younger, having a higher cancer stage and receiving radiotherapy, had a higher risk of loss of paid employment. Colorectal cancer survivors at high risk of loss of paid employment may benefit from work support interventions as part of cancer survivorship care. Abstract Cancer survivors consider work as a key aspect of cancer survivorship while previous research indicated that cancer survivors have a higher risk of unemployment. The objectives were to assess: (1) whether colorectal cancer survivors less often have paid employment at diagnosis compared to a population-based reference group, (2) whether colorectal cancer survivors with paid work have a higher risk of loss of employment up to 4 years after diagnosis compared to a population-based reference group and (3) which colorectal cancer survivors are at highest risk of loss of paid employment. In a nationwide register-based study, persons diagnosed with colorectal cancer (N = 12,007) as registered in the Netherlands Cancer Registry, were compared on loss of paid employment with a sex and age-matched population-based reference group (N = 48,028) from Statistics Netherlands. Cox regression analyses were conducted. Colorectal cancer survivors had a higher risk of loss of paid employment (HR 1.56 [1.42, 1.71]). Within the group of colorectal cancer survivors, risk of loss of paid employment was lower for older survivors (>60 vs. 45–55) (HR 0.64 [0.51, 0.81]) and higher for those with a more advanced cancer stage (IV vs. I) (HR 1.89 [1.33, 2.70]) and those receiving radiotherapy (HR 1.37 [1.15, 1.63]). Colorectal cancer survivors at high risk of loss of paid employment may benefit from work support interventions as part of cancer survivorship.
Collapse
Affiliation(s)
- Astrid de Wind
- Amsterdam UMC, Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health research institute, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands; (S.J.T.); (C.A.G.B.); (M.D.); (A.G.E.M.d.B.)
- Correspondence: ; Tel.: +31-020-5663279
| | - Sietske J. Tamminga
- Amsterdam UMC, Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health research institute, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands; (S.J.T.); (C.A.G.B.); (M.D.); (A.G.E.M.d.B.)
| | - Claudia A. G. Bony
- Amsterdam UMC, Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health research institute, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands; (S.J.T.); (C.A.G.B.); (M.D.); (A.G.E.M.d.B.)
- Deloitte Consulting Netherlands, Analytics & Cognitive, 1081 LA Amsterdam, The Netherlands;
| | - Maren Diether
- Amsterdam UMC, Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health research institute, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands; (S.J.T.); (C.A.G.B.); (M.D.); (A.G.E.M.d.B.)
- Deloitte Consulting Netherlands, Analytics & Cognitive, 1081 LA Amsterdam, The Netherlands;
| | - Martijn Ludwig
- Deloitte Consulting Netherlands, Analytics & Cognitive, 1081 LA Amsterdam, The Netherlands;
| | - Miranda J. Velthuis
- Netherlands Comprehensive Cancer Organisation (IKNL), 3511 DT Utrecht, The Netherlands;
| | - Saskia F. A. Duijts
- Amsterdam UMC, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands;
| | - Angela G. E. M. de Boer
- Amsterdam UMC, Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health research institute, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands; (S.J.T.); (C.A.G.B.); (M.D.); (A.G.E.M.d.B.)
| |
Collapse
|
100
|
Fujishiro K, Ahonen EQ, Gimeno Ruiz de Porras D, Chen IC, Benavides FG. Sociopolitical values and social institutions: Studying work and health equity through the lens of political economy. SSM Popul Health 2021; 14:100787. [PMID: 33898729 PMCID: PMC8056461 DOI: 10.1016/j.ssmph.2021.100787] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 03/24/2021] [Accepted: 03/29/2021] [Indexed: 11/26/2022] Open
Abstract
Work contributes to health and health inequity in complex ways. The traditional exposure-disease framework used in occupational health research is not equipped to address societal contexts in which work is embedded. The political economy approach to public health directly examines macro-level societal contexts, but the attention to work in this literature is mostly on unemployment. As a result, we have limited understanding of work as a social determinant of health and health inequity. To fill this gap, we propose a conceptual framework that facilitates research on work, health, and health equity in institutional contexts. As an illustration of different social institutions creating different work-related health, we present characteristics of work and health in the United States and the European Union using the 2015 Working Conditions Surveys data. The results also highlight limitations of the traditional exposure-disease approach used in occupational health research. Applying the proposed framework, we discuss how work and health could be investigated from a broader perspective that involves multiple social institutions and the sociopolitical values that underpin them. Such investigations would inform policy interventions that are congruent with existing social institutions and thus have the potential for being adopted and effective. Further, we clarify the role of research in generating knowledge that would contribute to institutional change in support of population health and health equity.
Collapse
Affiliation(s)
- Kaori Fujishiro
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH, USA
| | - Emily Q. Ahonen
- Department of Social and Behavioral Sciences, Richard M. Fairbanks School of Public Health, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - David Gimeno Ruiz de Porras
- Southwest Center for Occupational and Environmental Health, Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health in San Antonio, The University of Texas Health Science Center in Houston, San Antonio, TX, USA
- Center for Research in Occupational Health, Universitat Pompeu Fabra, CIBER of Epidemiology and Public Health (CIBERESP) and IMIM – Parc Salut Mar, Barcelona, Spain
| | - I-Chen Chen
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH, USA
| | - Fernando G. Benavides
- Center for Research in Occupational Health, Universitat Pompeu Fabra, CIBER of Epidemiology and Public Health (CIBERESP) and IMIM – Parc Salut Mar, Barcelona, Spain
| |
Collapse
|