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Twomey R, Martin T, Temesi J, Culos-Reed SN, Millet GY. Tailored exercise interventions to reduce fatigue in cancer survivors: study protocol of a randomized controlled trial. BMC Cancer 2018; 18:757. [PMID: 30041626 PMCID: PMC6057053 DOI: 10.1186/s12885-018-4668-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 07/11/2018] [Indexed: 12/29/2022] Open
Abstract
Background Cancer-related fatigue (CRF) is a common and distressing symptom of cancer and/or cancer treatment that persists for years after treatment completion in approximately one third of cancer survivors. Exercise is beneficial for the management of CRF, and general exercise guidelines for cancer survivors are available. There are multiple potential pathways by which exercise improves CRF, and cancer survivors with CRF are diverse with respect to cancer type, treatments and experienced side effects. While the general exercise guidelines are likely sufficient for most cancer survivors, tailoring of exercise interventions may be more effective in those with persistent fatigue. The primary aim of this research is to investigate the effect of a traditional vs. tailored exercise intervention on CRF severity in cancer survivors with persistent CRF. Methods/design Cancer survivors (≥ 3 months and ≤ 5 years since primary treatment) who score ≤ 34 on the Functional Assessment of Chronic Illness Therapy Fatigue Scale (FACIT-F) will be randomly allocated to one of two parallel treatment arms: traditional (active control) and tailored exercise. Participants in the traditional exercise group will engage in aerobic and resistance exercise that is consistent with exercise guidelines for cancer survivors. The tailored exercise group will be prescribed an intervention designed to address individual deficits identified at baseline, such as loss of muscular strength, cardiorespiratory deconditioning or sleep disturbance. Participants will be assessed before and after the intervention for CRF severity and other patient-reported outcomes, neuromuscular function and fatigue in response to whole-body exercise, sleep quantity and quality, physical activity levels, cardiorespiratory fitness and blood biomarkers. Discussion To our knowledge, this will be the first study to compare the effects of a traditional vs. tailored exercise intervention on CRF severity in cancer survivors with persistent CRF. Using physiological, behavioural and patient-reported outcomes, this study will add to the current knowledge about both the factors contributing to CRF, and the potential reduction in CRF severity with an exercise intervention. Trial registration The study is registered at ClinicalTrials.gov (NCT03049384), February, 2017. Electronic supplementary material The online version of this article (10.1186/s12885-018-4668-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Rosie Twomey
- Faculty of Kinesiology, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada
| | - Tristan Martin
- Faculty of Kinesiology, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada
| | - John Temesi
- Faculty of Kinesiology, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada
| | - S Nicole Culos-Reed
- Faculty of Kinesiology, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada.,Department of Oncology, Cumming School of Medicine, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada
| | - Guillaume Y Millet
- Faculty of Kinesiology, University of Calgary, 2500 University Dr NW, Calgary, AB, T2N 1N4, Canada.
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202
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The prevalence and determinants of return to work in head and neck cancer survivors. Support Care Cancer 2018; 27:539-546. [DOI: 10.1007/s00520-018-4343-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 07/06/2018] [Indexed: 10/28/2022]
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203
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Wang L, Hong BY, Kennedy SA, Chang Y, Hong CJ, Craigie S, Kwon HY, Romerosa B, Couban RJ, Reid S, Khan JS, McGillion M, Blinder V, Busse JW. Predictors of Unemployment After Breast Cancer Surgery: A Systematic Review and Meta-Analysis of Observational Studies. J Clin Oncol 2018; 36:1868-1879. [PMID: 29757686 PMCID: PMC6804906 DOI: 10.1200/jco.2017.77.3663] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Purpose Breast cancer surgery is associated with unemployment. Identifying high-risk patients could help inform strategies to promote return to work. We systematically reviewed observational studies to explore factors associated with unemployment after breast cancer surgery. Methods We searched MEDLINE, EMBASE, CINAHL, and PsycINFO to identify studies that explored risk factors for unemployment after breast cancer surgery. When possible, we pooled estimates of association for all independent variables reported by more than one study. Results Twenty-six studies (46,927 patients) reported the association of 127 variables with unemployment after breast cancer surgery. Access to universal health care was associated with higher rates of unemployment (26.6% v 15.4%; test of interaction P = .05). High-quality evidence showed that unemployment after breast cancer surgery was associated with high psychological job demands (odds ratio [OR], 4.26; 95% CI, 2.27 to 7.97), childlessness (OR, 1.30; 95% CI, 1.11 to 1.53), lower education level (OR, 1.15; 95% CI, 1.05 to 1.25), lower income level (OR, 1.46; 95% CI, 1.24 to 1.73), cancer stage II, III or IV (OR, 1.43; 95% CI, 1.13 to 1.82), and mastectomy versus breast-conserving surgery (OR, 1.18; 95% CI, 1.07 to 1.30). Moderate-quality evidence suggested an association with high physical job demands (OR, 2.11; 95%CI, 1.52 to 2.93), African-American ethnicity (OR, 1.89; 95% CI, 1.21 to 2.96), and receipt of chemotherapy (OR, 1.95; 95% CI, 1.36 to 2.79). High-quality evidence demonstrated no significant association with part-time hours, blue-collar work, tumor size, positive lymph nodes, or receipt of radiotherapy or endocrine therapy; moderate-quality evidence suggested no association with age, marital status, or axillary lymph node dissection. Conclusion Addressing high physical and psychological job demands may be important in reducing unemployment after breast cancer surgery.
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Affiliation(s)
- Li Wang
- Li Wang, Yaping Chang, Samantha Craigie, Rachel J. Couban, Susan Reid, Michael McGillion, and Jason W. Busse, McMaster University, Hamilton; Sean A. Kennedy and Chris J. Hong, University of Toronto, Toronto; Brian Y. Hong, University of Ottawa, Ottawa, Ontario, Canada; Li Wang, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; Henry Y. Kwon, Wayne State University School of Medicine, Detroit, MI; Beatriz Romerosa, University Hospital of Toledo, Toledo, Spain; James S. Khan, Stanford University, Palo Alto, CA; and Victoria Blinder, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Brian Y. Hong
- Li Wang, Yaping Chang, Samantha Craigie, Rachel J. Couban, Susan Reid, Michael McGillion, and Jason W. Busse, McMaster University, Hamilton; Sean A. Kennedy and Chris J. Hong, University of Toronto, Toronto; Brian Y. Hong, University of Ottawa, Ottawa, Ontario, Canada; Li Wang, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; Henry Y. Kwon, Wayne State University School of Medicine, Detroit, MI; Beatriz Romerosa, University Hospital of Toledo, Toledo, Spain; James S. Khan, Stanford University, Palo Alto, CA; and Victoria Blinder, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Sean A. Kennedy
- Li Wang, Yaping Chang, Samantha Craigie, Rachel J. Couban, Susan Reid, Michael McGillion, and Jason W. Busse, McMaster University, Hamilton; Sean A. Kennedy and Chris J. Hong, University of Toronto, Toronto; Brian Y. Hong, University of Ottawa, Ottawa, Ontario, Canada; Li Wang, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; Henry Y. Kwon, Wayne State University School of Medicine, Detroit, MI; Beatriz Romerosa, University Hospital of Toledo, Toledo, Spain; James S. Khan, Stanford University, Palo Alto, CA; and Victoria Blinder, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Yaping Chang
- Li Wang, Yaping Chang, Samantha Craigie, Rachel J. Couban, Susan Reid, Michael McGillion, and Jason W. Busse, McMaster University, Hamilton; Sean A. Kennedy and Chris J. Hong, University of Toronto, Toronto; Brian Y. Hong, University of Ottawa, Ottawa, Ontario, Canada; Li Wang, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; Henry Y. Kwon, Wayne State University School of Medicine, Detroit, MI; Beatriz Romerosa, University Hospital of Toledo, Toledo, Spain; James S. Khan, Stanford University, Palo Alto, CA; and Victoria Blinder, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Chris J. Hong
- Li Wang, Yaping Chang, Samantha Craigie, Rachel J. Couban, Susan Reid, Michael McGillion, and Jason W. Busse, McMaster University, Hamilton; Sean A. Kennedy and Chris J. Hong, University of Toronto, Toronto; Brian Y. Hong, University of Ottawa, Ottawa, Ontario, Canada; Li Wang, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; Henry Y. Kwon, Wayne State University School of Medicine, Detroit, MI; Beatriz Romerosa, University Hospital of Toledo, Toledo, Spain; James S. Khan, Stanford University, Palo Alto, CA; and Victoria Blinder, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Samantha Craigie
- Li Wang, Yaping Chang, Samantha Craigie, Rachel J. Couban, Susan Reid, Michael McGillion, and Jason W. Busse, McMaster University, Hamilton; Sean A. Kennedy and Chris J. Hong, University of Toronto, Toronto; Brian Y. Hong, University of Ottawa, Ottawa, Ontario, Canada; Li Wang, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; Henry Y. Kwon, Wayne State University School of Medicine, Detroit, MI; Beatriz Romerosa, University Hospital of Toledo, Toledo, Spain; James S. Khan, Stanford University, Palo Alto, CA; and Victoria Blinder, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Henry Y. Kwon
- Li Wang, Yaping Chang, Samantha Craigie, Rachel J. Couban, Susan Reid, Michael McGillion, and Jason W. Busse, McMaster University, Hamilton; Sean A. Kennedy and Chris J. Hong, University of Toronto, Toronto; Brian Y. Hong, University of Ottawa, Ottawa, Ontario, Canada; Li Wang, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; Henry Y. Kwon, Wayne State University School of Medicine, Detroit, MI; Beatriz Romerosa, University Hospital of Toledo, Toledo, Spain; James S. Khan, Stanford University, Palo Alto, CA; and Victoria Blinder, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Beatriz Romerosa
- Li Wang, Yaping Chang, Samantha Craigie, Rachel J. Couban, Susan Reid, Michael McGillion, and Jason W. Busse, McMaster University, Hamilton; Sean A. Kennedy and Chris J. Hong, University of Toronto, Toronto; Brian Y. Hong, University of Ottawa, Ottawa, Ontario, Canada; Li Wang, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; Henry Y. Kwon, Wayne State University School of Medicine, Detroit, MI; Beatriz Romerosa, University Hospital of Toledo, Toledo, Spain; James S. Khan, Stanford University, Palo Alto, CA; and Victoria Blinder, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Rachel J. Couban
- Li Wang, Yaping Chang, Samantha Craigie, Rachel J. Couban, Susan Reid, Michael McGillion, and Jason W. Busse, McMaster University, Hamilton; Sean A. Kennedy and Chris J. Hong, University of Toronto, Toronto; Brian Y. Hong, University of Ottawa, Ottawa, Ontario, Canada; Li Wang, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; Henry Y. Kwon, Wayne State University School of Medicine, Detroit, MI; Beatriz Romerosa, University Hospital of Toledo, Toledo, Spain; James S. Khan, Stanford University, Palo Alto, CA; and Victoria Blinder, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Susan Reid
- Li Wang, Yaping Chang, Samantha Craigie, Rachel J. Couban, Susan Reid, Michael McGillion, and Jason W. Busse, McMaster University, Hamilton; Sean A. Kennedy and Chris J. Hong, University of Toronto, Toronto; Brian Y. Hong, University of Ottawa, Ottawa, Ontario, Canada; Li Wang, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; Henry Y. Kwon, Wayne State University School of Medicine, Detroit, MI; Beatriz Romerosa, University Hospital of Toledo, Toledo, Spain; James S. Khan, Stanford University, Palo Alto, CA; and Victoria Blinder, Memorial Sloan Kettering Cancer Center, New York, NY
| | - James S. Khan
- Li Wang, Yaping Chang, Samantha Craigie, Rachel J. Couban, Susan Reid, Michael McGillion, and Jason W. Busse, McMaster University, Hamilton; Sean A. Kennedy and Chris J. Hong, University of Toronto, Toronto; Brian Y. Hong, University of Ottawa, Ottawa, Ontario, Canada; Li Wang, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; Henry Y. Kwon, Wayne State University School of Medicine, Detroit, MI; Beatriz Romerosa, University Hospital of Toledo, Toledo, Spain; James S. Khan, Stanford University, Palo Alto, CA; and Victoria Blinder, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Michael McGillion
- Li Wang, Yaping Chang, Samantha Craigie, Rachel J. Couban, Susan Reid, Michael McGillion, and Jason W. Busse, McMaster University, Hamilton; Sean A. Kennedy and Chris J. Hong, University of Toronto, Toronto; Brian Y. Hong, University of Ottawa, Ottawa, Ontario, Canada; Li Wang, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; Henry Y. Kwon, Wayne State University School of Medicine, Detroit, MI; Beatriz Romerosa, University Hospital of Toledo, Toledo, Spain; James S. Khan, Stanford University, Palo Alto, CA; and Victoria Blinder, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Victoria Blinder
- Li Wang, Yaping Chang, Samantha Craigie, Rachel J. Couban, Susan Reid, Michael McGillion, and Jason W. Busse, McMaster University, Hamilton; Sean A. Kennedy and Chris J. Hong, University of Toronto, Toronto; Brian Y. Hong, University of Ottawa, Ottawa, Ontario, Canada; Li Wang, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; Henry Y. Kwon, Wayne State University School of Medicine, Detroit, MI; Beatriz Romerosa, University Hospital of Toledo, Toledo, Spain; James S. Khan, Stanford University, Palo Alto, CA; and Victoria Blinder, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jason W. Busse
- Li Wang, Yaping Chang, Samantha Craigie, Rachel J. Couban, Susan Reid, Michael McGillion, and Jason W. Busse, McMaster University, Hamilton; Sean A. Kennedy and Chris J. Hong, University of Toronto, Toronto; Brian Y. Hong, University of Ottawa, Ottawa, Ontario, Canada; Li Wang, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; Henry Y. Kwon, Wayne State University School of Medicine, Detroit, MI; Beatriz Romerosa, University Hospital of Toledo, Toledo, Spain; James S. Khan, Stanford University, Palo Alto, CA; and Victoria Blinder, Memorial Sloan Kettering Cancer Center, New York, NY
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Gragnano A, Negrini A, Miglioretti M, Corbière M. Common Psychosocial Factors Predicting Return to Work After Common Mental Disorders, Cardiovascular Diseases, and Cancers: A Review of Reviews Supporting a Cross-Disease Approach. JOURNAL OF OCCUPATIONAL REHABILITATION 2018; 28:215-231. [PMID: 28589524 DOI: 10.1007/s10926-017-9714-1] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Purpose This systematic review aimed at identifying the common psychosocial factors that facilitate or hinder the return to work (RTW) after a sick leave due to common mental disorders (CMDs), cardiovascular diseases (CVDs), or cancers (CAs). Methods We conducted a review of reviews searching 13 databases from 1994 to 2016 for peer-reviewed, quantitative, cohort studies investigating factors influencing RTW after a CMD, CVD, or CA. Then, for each disease we identified additional cohort studies published after the date of the latest review included. Data were extracted following a three steps best-evidence synthesis method: the extraction of results about each predictor from studies within each single review and in the additional papers; the synthesis of results across the reviews and additional papers investigating the same disease; and the synthesis of results across the diseases. Results The search strategy identified 1029 unique records from which 27 reviews and 75 additional studies underwent comprehensive review. 14 reviews and 32 additional cohort studies met eligibility criteria. Specific predictors of RTW with different levels of evidence are provided for each disease. We found four common facilitators of RTW (job control, work ability, perceived good health and high socioeconomic status), and six barriers of RTW (job strain, anxiety, depression, comorbidity, older age and low education). Conclusion This is the first review to systematically analyze commonalities in RTW after CMDs, CVDs, or CAs. The common factors identified indicate that the RTW process presents many similarities across various diseases, thus supporting the validity of a cross-disease approach.
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Affiliation(s)
- Andrea Gragnano
- Institut de recherche Robert-Sauvé en santé et en Sécurité du travail, 505 boul. de Maisonneuve Ouest, Montreal, QC, H3A 3C2, Canada.
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montreal, QC, Canada.
- Department of Education, Career Counselling, Université du Québec à Montréal (UQAM), Montreal, QC, Canada.
| | - Alessia Negrini
- Institut de recherche Robert-Sauvé en santé et en Sécurité du travail, 505 boul. de Maisonneuve Ouest, Montreal, QC, H3A 3C2, Canada
| | | | - Marc Corbière
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montreal, QC, Canada
- Department of Education, Career Counselling, Université du Québec à Montréal (UQAM), Montreal, QC, Canada
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Arfi A, Baffert S, Soilly AL, Huchon C, Reyal F, Asselain B, Neffati S, Rouzier R, Héquet D. Determinants of return at work of breast cancer patients: results from the OPTISOINS01 French prospective study. BMJ Open 2018; 8:e020276. [PMID: 29776920 PMCID: PMC5961575 DOI: 10.1136/bmjopen-2017-020276] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Return to work (RTW) after breast cancer (BC) is still a new field of research. The factors determining shorter sick leave duration of patients with BC have not been clearly identified. The aim of this study was to describe work during BC treatment and to identify factors associated with sick leave duration. MATERIALS AND METHODS An observational, prospective, multicentre study was conducted among women with operable BC. A logbook was given to all working patients to record sociodemographic and work-related data over a 1-year period. RESULTS Work-related data after BC were available for 178 patients (60%). The median age at diagnosis was 50 years (27-77), 87.9% of patients had an invasive form of BC and 25.3% a lymph node involvement. 25.9% had a radical surgery and 24.2% had an axillary dissection. Radiotherapy was performed in 90.9% of patients and chemotherapy in 48.1%. Sick leave was prescribed for 165 patients (92.7%) for a median of 155 days. On univariate analysis, invasive BC (p=0.025), lymph node involvement (p=0.005), radical surgery (p=0.025), axillary dissection (p=0.004), chemotherapy (p<0.001), personal income <€1900/month (p=0.03) and not having received the patient information booklet on RTW (p=0.047) were found to be associated with a longer duration of sick leave. On multivariate analysis, chemotherapy was found to be associated with longer sick leave (OR: 3.5; 95% CI 1.6 to 7.9; p=0.002). The cost of sick leave to French National Health Insurance was fourfold higher in the case of chemotherapy (p<0.001). CONCLUSION Advanced disease and chemotherapy are major factors that influence sick leave duration during the management of BC. TRIAL REGISTRATION NUMBER NCT02813317.
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Affiliation(s)
- Alexandra Arfi
- Department of Surgical Oncology, Institut Curie-Centre René Huguenin, Paris, France
| | | | - Anne-Laure Soilly
- Health Economics Department, Bourgogne Franche-Comté University, Dijon, France
| | - Cyrille Huchon
- Department of Obstetrics and Gynecology, Hôpital de Poissy-St Germain, Paris, France
- Equipe d’Accueil 7285, Risk and Safety in Clinical Medicine for Women and Perinatal Health, University Versailles-Saint-Quentin, Paris, France
| | - Fabien Reyal
- Department of Surgical Oncology, Institut Curie-Centre René Huguenin, Paris, France
- Residual Tumor and Response to Treatment Lab, Translational Research Department, Institut Curie, Paris, France
| | - Bernard Asselain
- Department of Biostatistics, Institut Curie-Centre René Huguenin, Saint-Cloud, France
| | - Souhir Neffati
- Clinical Research and Innovation Department, Sponsorship Division, Institut Curie, Saint-Cloud, France
| | - Roman Rouzier
- Department of Surgical Oncology, Institut Curie-Centre René Huguenin, Paris, France
- Inserm U900 – Bioinformatics, Biostatistics, Epidemiology and Computational Systems. Cancer Biology, René-Huguenin hospital, Institut Curie, Saint-Cloud, France
| | - Delphine Héquet
- Department of Surgical Oncology, Institut Curie-Centre René Huguenin, Paris, France
- Inserm U900 – Bioinformatics, Biostatistics, Epidemiology and Computational Systems. Cancer Biology, René-Huguenin hospital, Institut Curie, Saint-Cloud, France
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206
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Klocker J, Klocker-Kaiser U, Pipam W, Geissler D. Long-term improvement of the bio-psycho-social state of cancer patients after 3 weeks of inpatient oncological rehabilitation : A long-term study at the Humanomed Zentrum Althofen. Wien Med Wochenschr 2018; 168:350-360. [PMID: 29737478 DOI: 10.1007/s10354-018-0619-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 01/25/2018] [Indexed: 12/28/2022]
Abstract
A 3-week cancer rehabilitation program was conducted at the Humanomed Zentrum Althofen, comprising therapy of organic defects, lifestyle modification, and psycho-social support. Therapeutic efficacy was assessed in comprehensive surveys before and after the therapy, and after 6 and 12 months. The study covers a 5-year period with data from 3233 patients. Parameters of subjective health assessed according to the European Quality of Life - 5 Dimensions (EuroQol EQ-5D) standard and signifying quality of life showed significant improvement both immediately after the therapy, and after 6 and 12 months. Anxiety and depression, assessed according to the Hospital Anxiety and Depression Scale, were significantly and persistently diminished, and the sense of coherence elevated. Therapeutic success was somewhat dependent on socio-economic parameters, but was largely independent of income and cancer type. This study thus clearly documents the significant efficacy of a rehabilitation treatment based on bio-psycho-social concepts, which may be further improved by additional ambulant or stationary care.
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Affiliation(s)
- Johann Klocker
- Humanomedzentrum Althofen, Moorweg 1, 9330, Althofen, Austria. .,Institut für Psychosoziale Onkologie (IPSO), Brunnengasse 3, 9020, Klagenfurt, Austria.
| | - Ursula Klocker-Kaiser
- Humanomedzentrum Althofen, Moorweg 1, 9330, Althofen, Austria.,Klinikum Klagenfurt, Klagenfurt, Austria
| | - Wolfgang Pipam
- Humanomedzentrum Althofen, Moorweg 1, 9330, Althofen, Austria.,Klinikum Klagenfurt, Klagenfurt, Austria
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207
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Ekenga CC, Pérez M, Margenthaler JA, Jeffe DB. Early-stage breast cancer and employment participation after 2 years of follow-up: A comparison with age-matched controls. Cancer 2018; 124:2026-2035. [PMID: 29437204 PMCID: PMC5910179 DOI: 10.1002/cncr.31270] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 12/04/2017] [Accepted: 12/29/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Although cancer survivors are more likely to be unemployed than individuals without a cancer history, employment participation after treatment of early-stage breast cancer has not been widely studied to date. The objectives of the current study were to evaluate employment trajectories in a cohort of patients with early-stage breast cancer and age-matched controls from the time of diagnosis to the 2-year follow-up, and identify factors associated with diminished and emerging employment participation. METHODS As part of a larger cohort study of 1096 patients with early-stage breast cancer and same-aged women without breast cancer, data from 723 working-age (aged 40-64 years) women (347 patients and 376 controls) were analyzed to evaluate 4 employment trajectories (sustained unemployment, diminished employment, emerging employment, and sustained employment). Multivariable logistic regression models were used to identify factors associated with diminished employment versus sustained employment, and emerging employment versus sustained unemployment. RESULTS Lower percentages of patients (71%) compared with controls (79%) reported full-time or part-time employment at enrollment (P<.01). Fatigue was a significant predictor of diminished employment for both patients (odds ratio [OR], 5.71; 95% confidence interval [95% CI], 2.48-13.15) and controls (OR, 2.38; 95% CI, 1.21-4.68). Among patients, African American race (OR, 4.02; 95% CI, 1.57-10.28) and public/uninsured insurance status (OR, 4.76; 95% CI, 1.34-12.38) were found to be associated with diminished employment. Among controls, high social support was associated with emerging employment (OR, 3.12; 95% CI, 1.25-7.79). CONCLUSIONS Fatigued patients, African American patients, and publicly insured/uninsured patients with cancer were more likely to experience diminished employment after 2 years of follow-up. Further investigation with longer follow-up is warranted to identify factors associated with these disparities in employment participation after treatment of early-stage breast cancer. Cancer 2018;124:2026-35. © 2018 American Cancer Society.
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Affiliation(s)
| | - Maria Pérez
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | | | - Donna B. Jeffe
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
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208
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Su TT, Azzani M, Tan FL, Loh SY. Breast cancer survivors: return to work and wage loss in selected hospitals in Malaysia. Support Care Cancer 2018; 26:1617-1624. [PMID: 29209834 DOI: 10.1007/s00520-017-3987-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 11/20/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE This study aimed, firstly, to assess the determinants of return to work (RTW), secondly, to explore the amount of annual wage loss, and finally, to discover the determinants of wage loss among breast cancer (BC) survivors. METHODS A cross-sectional study design was used in this research. The data was collected via interview using a validated questionnaire. Logistic regression models were developed to discover the significant determinants of RTW and of wage loss among BC survivors. RESULTS A total of 256 BC survivors were included in this study. The analysis showed that there was a 21% loss of or reduction in mean income within 1 year after diagnosis. The significant predictors of RTW are being a government employee, having reduced wages or wage loss, and if the case had been diagnosed 1 year or more ago. Being a private sector employee and having a late stage of cancer was a barrier to RTW. The main risk factors for reduced wages or wage loss were belonging to the age group of 40-59 years, being of Chinese or Indian ethnicity, having low educational status, and not returning to work. However, belonging to the higher monthly income group (earning > RM 2000) is a protective factor against the risk of reduced wages or wage loss. CONCLUSIONS Non-RTW and wage loss after diagnosis of BC may result in the survivors experiencing a significant financial burden. Assessment of these patients is becoming more crucial because more women participate in the workforce in Malaysia nowadays and because BC is managed using multiple treatment modalities with their consequences could lead to long absences from work.
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Affiliation(s)
- T T Su
- Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
| | - M Azzani
- Centre for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - F L Tan
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - S Y Loh
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
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209
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Şengün İnan F, Üstün B. Fear of Recurrence in Turkish Breast Cancer Survivors: A Qualitative Study. J Transcult Nurs 2018; 30:146-153. [DOI: 10.1177/1043659618771142] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Purpose: Fear of recurrence (FOR) of cancer is a distressing symptom and can negatively affect breast cancer survivors’ quality of life and psychological well-being. The purpose of this qualitative study was to explore Turkish breast cancer survivors’ experiences related to FOR. Design: The data were collected through semistructured interviews, which were conducted with 12 breast cancer survivors. Results: The data were categorized into four themes: the quality of fear, triggers, effects on life, and coping. FOR survivors’ lives in multiple aspects, and the women found it difficult to manage their fear. Implications: Nurses should be aware of FOR in survivors during follow-up care. In addition, it is essential to consider the impact of FOR on life, and survivors should be referred to appropriate resources and support services.
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Global analysis of advanced/metastatic breast cancer: Decade report (2005-2015). Breast 2018; 39:131-138. [PMID: 29679849 DOI: 10.1016/j.breast.2018.03.002] [Citation(s) in RCA: 151] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 03/03/2018] [Accepted: 03/06/2018] [Indexed: 02/05/2023] Open
Abstract
Approximately 0.5 million people worldwide die from metastatic breast cancer (mBC) every year. This manuscript provides an overview on the status of mBC in several regions of the world, highlighting the gaps in care, resources, and support available for patients with mBC. Primary research was conducted in 2015 and 2016, comprising four global qualitative and quantitative surveys of approximately 15,000 individuals in 34 countries. Secondary research was conducted using literature reviews of peer-reviewed publications, patient survey reports, and media or online articles. There have been modest improvements in mBC outcomes over the past decade. Patients are not provided with adequate information about mBC. There is a need for open discussion with patients and caregivers about realistic goals; however, physicians are not trained in communicating with patients about their disease. Maintaining patients' quality of life is a crucial goal; however, this has not improved, and in some cases, may have declined in the past decade. Public awareness and understanding of mBC is limited, with damaging consequences for patients and caregivers. Issues affecting employment remain relevant to patients with mBC and their caregivers. Globally, mBC is associated with a substantial economic burden. Relationships with caregivers are crucial to patients with mBC, and caregiver support needs are often overlooked. A strong and united global effort among healthcare professionals, including clinicians, oncologists, pharmaceutical manufacturers, payers, and policy makers, and with advocates, families, and patients, is necessary to improve the outcome and quality of life for patients with mBC.
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Ho PJ, Hartman M, Gernaat SAM, Cook AR, Lee SC, Hupkens L, Verkooijen HM. Associations between workability and patient-reported physical, psychological and social outcomes in breast cancer survivors: a cross-sectional study. Support Care Cancer 2018; 26:2815-2824. [PMID: 29511953 DOI: 10.1007/s00520-018-4132-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 02/25/2018] [Indexed: 11/12/2022]
Abstract
PURPOSE Workability is of increasing importance especially in Asia given the increasing incidence rates and young age of onset of breast cancer. This study explores the determinants of employment and suboptimal workability. And evaluate the association between workability and patient-reported physical, psychological, and social outcomes. METHODS In a hospital-based cross-sectional study, 327 breast cancer survivors, < 65 years of age and > 1 year post-diagnosis were recruited. Employed survivors filled out the workability index, which measures a person's capacity to meet work demands in relation to current health status. The EORTC-QLQ-C30, EORTC-QLQ-BR23, hospital anxiety and depression scale, multidimensional fatigue inventory, and brief pain index were administered. Fisher's exact test and Kruskal-Wallis test were used to test for associations of workability and employment status with demographic, clinical characteristics, and patient-reported outcomes. Linear models with standardised scores for patient-reported outcomes were fitted to study the associations of workability with patient-reported outcomes. RESULTS Of the 327 survivors, < 65 years of age (working age), 140 (43%) were in full-time and 34 (10%) in part-time employment. Employed survivors were younger at time of diagnosis and at time of survey. Employment status was not associated with time since diagnosis, ethnicity, or clinical characteristics. Suboptimal workability was present in 37% of employed survivors of the working age, and more common in jobs that include physical work activities. Higher level of depression, financial difficulty and physical fatigue, more breast symptoms, and poorer global health status were independently associated with poorer workability. CONCLUSIONS Lower employment and reduced workability in breast cancer survivors is common, and reduced workability is associated with higher levels of depression, financial difficulty and physical fatigue, more breast symptoms, and poorer global health status. Longitudinal research on psychosocial support with workability in Asia may find tailored approach to improve or maintain workability in employed breast cancer patients.
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Affiliation(s)
- Peh Joo Ho
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Mikael Hartman
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore. .,Department of Surgery, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, #10-01, Singapore, 117549, Singapore.
| | - Sofie A M Gernaat
- Julius Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Alex R Cook
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Soo Chin Lee
- National Health System, National University Cancer Institute, Singapore, Singapore
| | - Leon Hupkens
- Nyenrode Business University, Breukelen, The Netherlands
| | - Helena M Verkooijen
- Imaging Division, University Medical Center Utrecht, Utrecht, The Netherlands
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Fassier JB, Lamort-Bouché M, Broc G, Guittard L, Péron J, Rouat S, Carretier J, Fervers B, Letrilliart L, Sarnin P. Developing a Return to Work Intervention for Breast Cancer Survivors with the Intervention Mapping Protocol: Challenges and Opportunities of the Needs Assessment. Front Public Health 2018; 6:35. [PMID: 29527521 PMCID: PMC5829033 DOI: 10.3389/fpubh.2018.00035] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 01/31/2018] [Indexed: 01/02/2023] Open
Abstract
Return to work (RTW) is an important step for breast cancer survivors (BCSs). However, they face many barriers that affect particularly women with low socioeconomic status (SES). Health care, workplace, and insurance actors lack knowledge and collaborate poorly. No intervention to date has proven effective to reduce social disparities in employment after breast cancer. The intervention mapping (IM) protocol is being used in France to develop, implement, and evaluate an intervention to facilitate and sustain RTW after breast cancer [FAciliter et Soutenir le retour au TRAvail après un Cancer du Sein (FASTRACS) project]. The research question of this study was to elicit the needs for RTW after breast cancer from various stakeholders' point of view. The aim of this study was to describe the process and the preliminary results of the needs assessment of the FASTRACS project. Different methods were followed to (a) establish and work with a planning group and (b) conduct a needs assessment to create a logic model of the problem. A planning group was organized to gather the stakeholders with the research team. A review of the literature and indicators was conducted to identify the magnitude of the problem and the factors influencing RTW. A qualitative inquiry was conducted with 12 focus groups and 48 individual semi-structured interviews to explore the needs and experience of the stakeholders. The results of these tasks were the proposition of a charter of partnership to structure the participative process, a review of the scientific evidence and indicators, and the description by the stakeholders of their needs and experience. Many stakeholders disagreed with the concept of "early intervention." They advocated for a better support of BCSs during their RTW, emphasized as a process. Anticipation, intersectoral collaboration, and workplace accommodation were mentioned to fit the needs of the BCS and their environment. A logic model of the problem was elaborated from these data. The ability of the model to consider specific characteristics of women with low SES is discussed, with a view to developing the FASTRACS intervention through the next steps of the IM protocol.
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Affiliation(s)
- Jean-Baptiste Fassier
- UMRESTTE UMR T_9405, Unité mixte de recherche Epidémiologique et de Surveillance Transport Travail Environnement, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
- Service de médecine et santé au travail, Hospices civils de Lyon, Lyon, France
| | - Marion Lamort-Bouché
- UMRESTTE UMR T_9405, Unité mixte de recherche Epidémiologique et de Surveillance Transport Travail Environnement, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
- Collège universitaire de médecine générale, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
| | - Guillaume Broc
- UMRESTTE UMR T_9405, Unité mixte de recherche Epidémiologique et de Surveillance Transport Travail Environnement, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
| | - Laure Guittard
- HESPER, Health Services and Performance Research, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
- Pôle IMER, Hospices civils de Lyon, Lyon, France
| | - Julien Péron
- Laboratoire de Biométrie et Biologie Evolutive LBBE – UMR 5558, Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France
- Service d’oncologie médicale. Institut de Cancérologie des Hospices Civils de Lyon (IC-HCL), Hospices civils de Lyon, Pierre-Bénite, France
| | - Sabrina Rouat
- GRePS – EA 4163 (Groupe de Recherche en Psychologie Sociale), Université Lumière Lyon 2, Université de Lyon, Lyon, France
| | - Julien Carretier
- Centre Léon Bérard, Département Cancer et Environnement, Lyon, France
| | - Béatrice Fervers
- Centre Léon Bérard, Département Cancer et Environnement, Lyon, France
- Faculté Lyon Est, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
| | - Laurent Letrilliart
- Collège universitaire de médecine générale, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
- HESPER, Health Services and Performance Research, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
| | - Philippe Sarnin
- GRePS – EA 4163 (Groupe de Recherche en Psychologie Sociale), Université Lumière Lyon 2, Université de Lyon, Lyon, France
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Financial toxicity and symptom burden: what is the big deal? Support Care Cancer 2018; 26:1357-1359. [DOI: 10.1007/s00520-018-4092-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 02/04/2018] [Indexed: 10/18/2022]
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Burgmann M, Hermelink K, Farr A, van Meegen F, Heiduschk A, Engel J, Kolben T, Degenhardt T, Ditsch N, Mahner S, Harbeck N, Würstlein R. Evaluation of Reproductive Concerns and Biographical Impact of Breast Cancer in Young Patients. Breast Care (Basel) 2018; 13:126-130. [PMID: 29887790 DOI: 10.1159/000481340] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background This study evaluates interventions offered to young breast cancer (BC) patients, including fertility preservation, genetic testing, and counseling for parenthood concerns, and analyzes the effect of BC on biographical issues. Methods Women who were diagnosed with BC at the age of 18-40 years and who underwent treatment at the Breast Center, Ludwig-Maximilian University (LMU) in Munich between 2006 and 2013, were eligible for this study. Patients received a self-developed questionnaire which covered the following topics: fertility preservation, family planning, genetic testing, parenthood concerns and children's needs, partnership status, and employment situation. Results Re-evaluating their initial decision on fertility preservation, 76.4% of patients reported satisfaction with their decision. After BC diagnosis, 45.8% reported to have maternal desire, but only 21.7% actually planned to have children. 41.7% of patients missed sufficient counseling regarding parenthood concerns. Analysis of individual employment situations showed that the time period until the return to work was longer in patients who received chemotherapy. The majority of patients (71.6%) did not report changes in their partnership status. Conclusion Young BC survivors report a lack of communication related to parenthood concerns and future conception, but are satisfied with counseling regarding fertility preservation and genetics.
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Affiliation(s)
- Maximiliane Burgmann
- Breast Center, Department of Gynecology and Obstetrics and Comprehensive Cancer Center of LMU, University of Munich (LMU), Munich, Germany
| | - Kerstin Hermelink
- Breast Center, Department of Gynecology and Obstetrics and Comprehensive Cancer Center of LMU, University of Munich (LMU), Munich, Germany
| | - Alex Farr
- Breast Center (Comprehensive Cancer Center), Department of Gynecology and Obstetrics, Medical University of Vienna, Vienna, Austria
| | - Friederike van Meegen
- Breast Center, Department of Gynecology and Obstetrics and Comprehensive Cancer Center of LMU, University of Munich (LMU), Munich, Germany
| | - Annika Heiduschk
- Breast Center, Department of Gynecology and Obstetrics and Comprehensive Cancer Center of LMU, University of Munich (LMU), Munich, Germany
| | - Jutta Engel
- Breast Center, Department of Gynecology and Obstetrics and Comprehensive Cancer Center of LMU, University of Munich (LMU), Munich, Germany
| | - Thomas Kolben
- Munich Cancer Registry (MCR) of the Munich Tumor Center at the Institute for Medical Information Processing, Biometry and Epidemiology (IBE), University Hospital of Munich (LMU), Munich, Germany
| | - Tom Degenhardt
- Breast Center, Department of Gynecology and Obstetrics and Comprehensive Cancer Center of LMU, University of Munich (LMU), Munich, Germany
| | - Nina Ditsch
- Breast Center, Department of Gynecology and Obstetrics and Comprehensive Cancer Center of LMU, University of Munich (LMU), Munich, Germany
| | - Sven Mahner
- Breast Center, Department of Gynecology and Obstetrics and Comprehensive Cancer Center of LMU, University of Munich (LMU), Munich, Germany
| | - Nadia Harbeck
- Breast Center, Department of Gynecology and Obstetrics and Comprehensive Cancer Center of LMU, University of Munich (LMU), Munich, Germany
| | - Rachel Würstlein
- Breast Center, Department of Gynecology and Obstetrics and Comprehensive Cancer Center of LMU, University of Munich (LMU), Munich, Germany
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Abstract
With the favorable trend regarding survival of cancer in the Western world, there is an increasing focus among patients, clinicians, researchers, and politicians regarding cancer survivors' health and well-being. The number of survivors grows rapidly, and more than 3% of the adult populations in Western countries have survived cancer for 5 years or more. Cancer survivors are at increased risk for a variety of late effects after treatment, some life-threatening such as secondary cancer and cardiac diseases, while others mainly have negative impact on daily functioning and health-related quality of life (HRQOL). The latter factors include fatigue, anxiety disorders, sexual problems, insomnia, and reduced work ability, while depression does not seem to be more common among survivors than in the general population. Life style factors are highly relevant for cancer survivors concerning risk of relapse and somatic comorbidity. The field of cancer survivorship research has grown rapidly. How to best integrate the knowledge of the field into clinical practice with adequate follow-up of cancer survivors at risk for developing late effects, is still an unresolved question, although several models are under consideration.
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217
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Relationship of Self-reported Attentional Fatigue to Perceived Work Ability in Breast Cancer Survivors. Cancer Nurs 2017; 40:464-470. [PMID: 27782905 DOI: 10.1097/ncc.0000000000000444] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Breast cancer survivors (BCSs) have identified attentional fatigue, a decrease in the ability to focus, as a persistent daily challenge; however, little is known regarding its impact on work ability. OBJECTIVE The purpose of this study was to examine the relationship between attentional fatigue and perceived work ability in BCSs controlling for the known covariates of age, education, household income, and time posttreatment. METHODS A cross-sectional, descriptive design was used. Breast cancer survivors who were currently employed and at least 1 year post-adjuvant treatment participated. Breast cancer survivors completed the Attentional Function Index and Work Ability Index questionnaires. Descriptive statistics, linear regression, and Fisher exact test were used for analysis. RESULTS Sixty-eight female BCSs, ranging from 29 to 68 years of age (mean, 52.1 [SD, 8.6]) and on average 4.97 (SD, 3.36) years posttreatment, participated. More than one-fourth of BCSs (26.5%) reported poor to moderate perceived work ability, indicating substantial concerns regarding work performance. Attentional fatigue was found to significantly predict perceived work ability (P < .001), explaining 40% of the variance of perceived work ability. CONCLUSIONS Attentional fatigue is a prevalent symptom posttreatment that is negatively related to perceived work ability in BCSs. IMPLICATIONS FOR PRACTICE Nurses are in a prime position to assess and intervene to alleviate attentional fatigue to improve work ability. Findings suggest a need for individual, comprehensive survivorship care plans to effectively address symptoms that impact work ability and, ultimately, the quality of life of cancer survivors.
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218
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Relationship between self-reported cognitive function and work-related outcomes in breast cancer survivors. J Cancer Surviv 2017; 12:246-255. [DOI: 10.1007/s11764-017-0664-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Accepted: 11/13/2017] [Indexed: 10/18/2022]
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Petersen KS, Momsen AH, Stapelfeldt CM, Olsen PR, Nielsen CV. Return-to-work intervention during cancer treatment - The providers' experiences. Eur J Cancer Care (Engl) 2017; 27:e12793. [PMID: 29205611 DOI: 10.1111/ecc.12793] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2017] [Indexed: 11/26/2022]
Abstract
To explore in-depth understanding of providers' experiences when involved in a return-to-work (RTW) intervention offered during cancer treatment. Semi-structured individual interviews and participant observations at a hospital department and two municipal job centers were carried out, including ten providers (physicians, nurses and social workers). A phenomenological-hermeneutic approach was applied, involving coding, identification of themes and interpretation of findings. Three major themes were identified: Treatment first, Work as an integrated component in cancer rehabilitation, and Challenges in bringing up work issues. Differences in providers' experiences of the RTW intervention offered to cancer patients were found: in the hospital setting RTW was a second priority, whereas in the municipality job centers it was an integrated component. Further studies are needed to investigate how and when occupational rehabilitation services can be implemented across sectors to support cancer patients' RTW. In the future, work issues ought to be systematically presented by providers across sectors as early as possible to support cancer patients' RTW. Cancer patients' individual needs and thoughts about RTW are to be identified by both health care providers during treatment and social workers at the municipality level and shared across sectors.
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Affiliation(s)
- K S Petersen
- Department of Medicine and Health Technology, Faculty of Health Sciences, Aalborg University, Aalborg East, Denmark
| | - A H Momsen
- Department of Public Health, Section of Social Medicine and Rehabilitation, Central Region Denmark, Aarhus University and DEFACTUM, Aarhus, Denmark
| | - C M Stapelfeldt
- Department of Public Health, Section of Social Medicine and Rehabilitation, Central Region Denmark, Aarhus University and DEFACTUM, Aarhus, Denmark
| | - P R Olsen
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - C V Nielsen
- Department of Public Health, Section of Social Medicine and Rehabilitation, Central Region Denmark, Aarhus University and DEFACTUM, Aarhus, Denmark
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Lee MK, Kang HS, Lee KS, Lee ES. Three-Year Prospective Cohort Study of Factors Associated with Return to Work After Breast Cancer Diagnosis. JOURNAL OF OCCUPATIONAL REHABILITATION 2017; 27:547-558. [PMID: 27858198 DOI: 10.1007/s10926-016-9685-7] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Purpose The purpose of this prospective cohort study of breast cancer survivors was to identify factors before diagnosis, during treatment, and after treatment that are associated with return to work (RTW). Methods A total of 288 women with breast cancer (stage I-III) and whose age were 18-65 years-old answered questionnaires at 4-6, 12, 24, and 36 months after diagnosis. The surveys asked about performance of regular exercise and health-related quality of life issues. "RTW at 36 months" was assigned to patients who reported any of the following: working at least twice; no job at baseline but working more than once; job at baseline, stopped working, and then started working again; and working during all 3 years. Results We classified 107 of 288 of the women (37.1%) as having returned to work. Analysis of pre-diagnostic factors indicated that more education and practice of regular endurance exercise were positively associated with RTW. Analysis of factors during treatment indicated that appetite loss and fatigue were negatively associated with RTW. Analysis of factors at post-treatment indicated that better body image, better physical function, better existential well-being, and participation in regular endurance and resistance exercise were positively associated with RTW. Childbirth at 12-24 months was negatively associated with RTW. Conclusion Women who participate in exercise before, during, and after treatment for breast cancer are more likely to RTW. A woman's need to care for children, perceived body image, and existential well-being may also affect her RTW.
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Affiliation(s)
- Myung Kyung Lee
- College of Nursing, Research Institute of Nursing Science, Kyungpook National University, Daegu, Republic of Korea
| | - Han Sung Kang
- Center for Breast Cancer, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Republic of Korea
| | - Keun Seok Lee
- Center for Breast Cancer, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Republic of Korea
| | - Eun Sook Lee
- Center for Breast Cancer, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Republic of Korea.
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Kyriazakos S, Valentini V, Cesario A, Zachariae R. FORECAST - A cloud-based personalized intelligent virtual coaching platform for the well-being of cancer patients. Clin Transl Radiat Oncol 2017; 8:50-59. [PMID: 29594242 PMCID: PMC5862678 DOI: 10.1016/j.ctro.2017.11.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 11/17/2017] [Accepted: 11/17/2017] [Indexed: 12/24/2022] Open
Abstract
The challenges of cancer patients and the benefits of coaching are presented. Evidence of impact of coaching on the well being of cancer patients is presented. A cloud-based personalized intelligent virtual coaching platform for the well-being of cancer patients is proposed. Technology acceptance of the platform is presented, based on validation trials. Future work is discussed.
Well-being of cancer patients and survivors is a challenge worldwide, considering the often chronic nature of the disease. Today, a large number of initiatives, products and services are available that aim to provide strategies to face the challenge of well-being in cancer patients; nevertheless the proposed solutions are often non-sustainable, costly, unavailable to those in need, and less well-received by patients. These challenges were considered in designing FORECAST, a cloud-based personalized intelligent virtual coaching platform for improving the well-being of cancer patients. Personalized coaching for cancer patients focuses on physical, mental, and emotional concerns, which FORECAST is able to identify. Cancer patients can benefit from coaching that addresses their emotional problems, helps them focus on their goals, and supports them in coping with their disease-related stressors. Personalized coaching in FORECAST offers support, encouragement, motivation, confidence, and hope and is a valuable tool for the wellbeing of a patient.
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Affiliation(s)
| | - Vincenzo Valentini
- Dept of Oncology and Haematology, Fondazione Policlinico Universitario "A. Gemelli", Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alfredo Cesario
- Fondazione Policlinico Universitario "A. Gemelli", Università Cattolica del Sacro Cuore, Rome, Italy
| | - Robert Zachariae
- Dept of Psychology and Behavioural Science, Aarhus University, Denmark
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Petersson LM, Vaez M, Nilsson MI, Saboonchi F, Alexanderson K, Olsson M, Wennman-Larsen A. Sickness absence following breast cancer surgery: a two-year follow-up cohort study. Scand J Caring Sci 2017; 32:715-724. [DOI: 10.1111/scs.12502] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 06/05/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Lena-Marie Petersson
- Division of Insurance Medicine; Department of Clinical Neuroscience; Karolinska Institutet; Stockholm Sweden
- Division of Nursing; Department of Neurobiology, Care Sciences and Society; Karolinska Institutet; Stockholm Sweden
| | - Marjan Vaez
- Division of Insurance Medicine; Department of Clinical Neuroscience; Karolinska Institutet; Stockholm Sweden
| | - Marie I. Nilsson
- Division of Insurance Medicine; Department of Clinical Neuroscience; Karolinska Institutet; Stockholm Sweden
- Division of Nursing; Department of Neurobiology, Care Sciences and Society; Karolinska Institutet; Stockholm Sweden
- Division of Social Work; Department of Neurobiology, Care Sciences and Society; Karolinska Institutet; Stockholm Sweden
- Department of Social Work; Karolinska University Hospital; Stockholm Sweden
| | - Fredrik Saboonchi
- Division of Insurance Medicine; Department of Clinical Neuroscience; Karolinska Institutet; Stockholm Sweden
- Red Cross University College; Stockholm Sweden
- Stress Research Institute; University of Stockholm; Stockholm Sweden
| | - Kristina Alexanderson
- Division of Insurance Medicine; Department of Clinical Neuroscience; Karolinska Institutet; Stockholm Sweden
| | - Mariann Olsson
- Division of Social Work; Department of Neurobiology, Care Sciences and Society; Karolinska Institutet; Stockholm Sweden
| | - Agneta Wennman-Larsen
- Division of Insurance Medicine; Department of Clinical Neuroscience; Karolinska Institutet; Stockholm Sweden
- Sophiahemmet University; Stockholm Sweden
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Boing L, Araujo CDCRD, Pereira GS, Moratelli J, Benneti M, Borgatto AF, Bergmann A, Guimarães ACDA. TEMPO SENTADO, IMAGEM CORPORAL E QUALIDADE DE VIDA EM MULHERES APÓS A CIRURGIA DO CÂNCER DE MAMA. REV BRAS MED ESPORTE 2017. [DOI: 10.1590/1517-869220172305170333] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO Introdução: A cirurgia é uma das modalidades de tratamento do câncer de mama e pode ser conservadora ou radical. Esse tipo de tratamento pode trazer alterações físicas e psicológicas para a vida das pacientes. Objetivo: Analisar a influência da cirurgia radical e conservadora sobre o tempo sentado, a imagem corporal e a qualidade de vida de mulheres após diagnóstico do câncer de mama. Métodos: Participaram 172 mulheres que foram submetidas à cirurgia radical ou conservadora do câncer de mama. Aplicou-se um questionário contemplando características pessoais, medidas antropométricas, nível econômico (IBGE), características da doença, tempo sentado (IPAQ - versão curta), imagem corporal (BIBCQ) e qualidade de vida (EORTC QLQ-C30 + QLQ BR - 23). Para a análise estatística, utilizou-se o teste do Qui-quadrado ou o teste exato de Fisher e o teste t de Student para amostras independentes e o teste U de Mann-Whitney. Resultados: As mulheres que foram submetidas à cirurgia radical apresentaram maior tempo sentado nos finais de semana, mais relatos de linfedema, piores escores de qualidade de vida (função física, dor, escala funcional, imagem corporal e sintomas no braço) e pior imagem corporal (vulnerabilidade, estigma, limitações, transparência e preocupações com o braço). Conclusão: O tipo de cirurgia pode influenciar o tempo sentado e aspectos da imagem corporal e da qualidade de vida, com piores escores para as mulheres submetidas à cirurgia radical.
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Alfano CM, Kent EE, Padgett LS, Grimes M, de Moor JS. Making Cancer Rehabilitation Services Work for Cancer Patients: Recommendations for Research and Practice to Improve Employment Outcomes. PM R 2017; 9:S398-S406. [PMID: 28942911 PMCID: PMC5657535 DOI: 10.1016/j.pmrj.2017.06.019] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 06/21/2017] [Accepted: 06/23/2017] [Indexed: 12/31/2022]
Abstract
Cancer and its treatment can result in impairments that limit physical, psychosocial, and cognitive functioning, interfering with patients' ability to perform work-related functions. Because these work limitations can carry significant personal and societal costs, there is a timely need to identify and refer patients to cancer rehabilitation services to manage adverse consequences of treatment and to preserve employment. Coordinated efforts in 3 key areas will better connect patients to rehabilitation interventions that will help optimize employment. These include the following: planning for the impact of cancer on the ability to work; implementing routine screening for impairments and facilitating referrals to cancer rehabilitation specialists; and focusing rehabilitation interventions on preserving employment. Coordinated strategies are presented to achieve these 3 goals, including the following: implementing changes to clinical practice to routinely screen for impairments; working with oncology providers and patients to better understand the benefits of cancer rehabilitation to facilitate referrals and uptake; training more cancer rehabilitation providers to handle the increased need; better coordination of care across providers and with employers; and filling research gaps needed to proactively anticipate how cancer treatment would affect work for a given patient and deploy personalized interventions to preserve the ability to work.
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Affiliation(s)
- Catherine M Alfano
- American Cancer Society, Inc, 555 11th St NW, Suite 300, Washington, DC 20004(∗).
| | - Erin E Kent
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD(†)
| | | | - Melvin Grimes
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD(§)
| | - Janet S de Moor
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD(‖)
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225
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Jensen LS, Overgaard C, Garne JP, Bøggild H, Fonager K. The impact of prior psychiatric medical treatment on return to work after a diagnosis of breast cancer: A registry based study. Scand J Public Health 2017; 47:519-527. [PMID: 28789594 DOI: 10.1177/1403494817722291] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: Breast cancer and psychiatric disorders negatively impact work life, both positively associated with unemployment and early retirement. Our purpose was to assess whether being prescribed psychiatric medication, 2-4 yrs prior to a diagnosis of breast cancer, could impact the likelihood of returning to work after cancer therapy. Methods: 16,868 self-supporting women, diagnosed with breast cancer in Denmark from 2000 to 2012, were identified from a population-based clinical database, then cross-referenced to data held for psychiatric medication usage, sociodemographics, and labour-market participation. The association between historic psychiatric medication and return to work was estimated using a modified Poisson regression model. 'Return to work' was defined as being self-supporting one year after diagnosis of breast cancer. Results: 16% of our cohort had used psychiatric medical treatment 2-4 years before their diagnosis. Sixty-three per cent of these individuals had returned to work one year later, compared to 69% of the patient group with no prior history of using psychiatric medication treatments. In the fully adjusted model, prior use of psychiatric medication diminished the likelihood of returning to work one year after cancer diagnosis (RR = 0.91 (0.87-0.94)). High income and older age were positively associated with returning to work; negative correlates included those related to disease severity. Conclusions: Historic use of psychiatric medication provoked a minor, although statistically significant reduction in the resumption of working life one year after a diagnosis of breast cancer. Implications for cancer survivors: Although historic use of psychiatric medication may incur a minor effect on working life, further research is needed on the long-term social consequences for sub-groups.
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Affiliation(s)
| | | | - Jens Peter Garne
- 3 Department of Breast surgery, Aalborg University Hospital, Denmark
| | - Henrik Bøggild
- 2 Public Health and Epidemiology Group, Aalborg University, Denmark
| | - Kirsten Fonager
- 1 Department of Social Medicine, Aalborg University Hospital, Denmark.,2 Public Health and Epidemiology Group, Aalborg University, Denmark
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226
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Kvillemo P, Mittendorfer-Rutz E, Bränström R, Nilsson K, Alexanderson K. Sickness Absence and Disability Pension After Breast Cancer Diagnosis: A 5-Year Nationwide Cohort Study. J Clin Oncol 2017; 35:2044-2052. [PMID: 28459607 DOI: 10.1200/jco.2015.66.0613] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose To explore future diagnosis-specific sickness absence and disability pension among women with breast cancer compared with women without breast cancer. Also, to examine associations with disease-related and sociodemographic factors among those with breast cancer. Methods Longitudinal register data on 3,547 women living in Sweden (age 20 to 65 years) who were first diagnosed with breast cancer in 2005, and a matched comparison cohort (n = 14,188), were analyzed for the annual prevalence of diagnosis-specific sickness absence and disability pension over 5 years. Logistic regressions were used to explore associations of disease-related and sociodemographic factors with future sickness absence and disability pension among women with breast cancer. Results Immediately after being diagnosed with breast cancer, the proportion of women with sickness absence was high but decreased continuously from the 1st through 5th year after diagnosis (71%, 40%, 30%, 22%, and 19%, respectively). In comparison, the range for women without breast cancer was 17% to 11%, respectively. The higher prevalence of sickness absence after breast cancer was mainly a result of breast cancer diagnosis, not a mental diagnosis, or other somatic diagnoses. Advanced cancer at diagnosis, > 90 days sickness absence before diagnosis, low education, and being born outside Sweden were associated with higher odds ratios for sickness absence and disability pension (odds ratio range, 1.40 to 6.45). Conclusion The level of sickness absence increased substantially in women with breast cancer during the first year after diagnosis and approached the level of breast cancer-free women in the following years; however, even in the first year, most women were not on sickness absence for a substantial time, and even in high-risk groups, many were not on sickness absence or disability pension in the following years. Information about relatively low future sickness absence and disability pension levels can be used by patients when planning their work, by health care professionals, and by social insurance officers. Employers and Occupational Health Services need this information to adequately handle workplace adjustments.
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Affiliation(s)
- Pia Kvillemo
- All authors: Karolinska Institutet, Stockholm, Sweden
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227
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Cohen PA, Brennan A, Marino JL, Saunders CM, Hickey M. Managing menopausal symptoms after breast cancer - A multidisciplinary approach. Maturitas 2017; 105:4-7. [PMID: 28473176 DOI: 10.1016/j.maturitas.2017.04.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 04/06/2017] [Accepted: 04/07/2017] [Indexed: 01/01/2023]
Abstract
More than 6 million women worldwide are living with a past diagnosis of breast cancer. Most survive their illness, and management of the long-term consequences of treatment has become a priority in cancer care. Menopausal symptoms affect most breast cancer survivors and may significantly impair quality of life. We describe a multidisciplinary model to evaluate and manage these women using a patient-focused approach. The 'Multidisciplinary Menopause After Cancer Clinic' includes gynecologists, endocrinologists, GPs, a psychologist and a clinical nurse specialist. Benefits of this model include improved coordination of patient care, education, communication and evidence-based decision making.
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Affiliation(s)
- Paul A Cohen
- St. John of God Hospital Bendat Family Comprehensive Cancer Centre, 12 Salvado Road, Subiaco, Western Australia 6008, Australia; School of Women's and Infants' Health, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia; Institute for Health Research, University of Notre Dame Australia, 32 Mouat Street Fremantle, Western Australia 6160, Australia.
| | - Annabelle Brennan
- Department of Obstetrics and Gynecology, Royal Women's Hospital, 20 Flemington Road, Parkville, Victoria 3052, Australia
| | - Jennifer L Marino
- Department of Obstetrics and Gynecology, The University of Melbourne, Parkville, Victoria 3052, Australia; Department of Obstetrics and Gynecology, Royal Women's Hospital, 20 Flemington Road, Parkville, Victoria 3052, Australia
| | - Christobel M Saunders
- Division of Surgery, School of Medicine, University of Western Australia, Crawley, Western Australia, Australia
| | - Martha Hickey
- Department of Obstetrics and Gynecology, The University of Melbourne, Parkville, Victoria 3052, Australia; Department of Obstetrics and Gynecology, Royal Women's Hospital, 20 Flemington Road, Parkville, Victoria 3052, Australia
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228
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Neuromuscular fatigue during exercise: Methodological considerations, etiology and potential role in chronic fatigue. Neurophysiol Clin 2017; 47:95-110. [PMID: 28434551 DOI: 10.1016/j.neucli.2017.03.002] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The term fatigue is used to describe a distressing and persistent symptom of physical and/or mental tiredness in certain clinical populations, with distinct but ultimately complex, multifactorial and heterogenous pathophysiology. Chronic fatigue impacts on quality of life, reduces the capacity to perform activities of daily living, and is typically measured using subjective self-report tools. Fatigue also refers to an acute reduction in the ability to produce maximal force or power due to exercise. The classical measurement of exercise-induced fatigue involves neuromuscular assessments before and after a fatiguing task. The limitations and alternatives to this approach are reviewed in this paper in relation to the lower limb and whole-body exercise, given the functional relevance to locomotion, rehabilitation and activities of daily living. It is suggested that under some circumstances, alterations in the central and/or peripheral mechanisms of fatigue during exercise may be related to the sensations of chronic fatigue. As such, the neurophysiological correlates of exercise-induced fatigue are briefly examined in two clinical examples where chronic fatigue is common: cancer survivors and people with multiple sclerosis. This review highlights the relationship between objective measures of fatigability with whole-body exercise and perceptions of fatigue as a priority for future research, given the importance of exercise in relieving symptoms of chronic fatigue and/or overall disease management. As chronic fatigue is likely to be specific to the individual and unlikely to be due to a simple biological or psychosocial explanation, tailored exercise programmes are a potential target for therapeutic intervention.
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229
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Zomkowski K, Cruz de Souza B, Pinheiro da Silva F, Moreira GM, de Souza Cunha N, Sperandio FF. Physical symptoms and working performance in female breast cancer survivors: a systematic review. Disabil Rehabil 2017; 40:1485-1493. [DOI: 10.1080/09638288.2017.1300950] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Kamilla Zomkowski
- Health Sciences and Sports Center (CEFID), Santa Catarina State University (UDESC), Florianópolis, SC, Brazil
| | - Bruna Cruz de Souza
- Health Sciences and Sports Center (CEFID), Santa Catarina State University (UDESC), Florianópolis, SC, Brazil
| | - Fabiana Pinheiro da Silva
- Health Sciences and Sports Center (CEFID), Santa Catarina State University (UDESC), Florianópolis, SC, Brazil
| | - Géssica Maria Moreira
- Health Sciences and Sports Center (CEFID), Santa Catarina State University (UDESC), Florianópolis, SC, Brazil
| | - Natália de Souza Cunha
- Health Sciences and Sports Center (CEFID), Santa Catarina State University (UDESC), Florianópolis, SC, Brazil
| | - Fabiana Flores Sperandio
- Health Sciences and Sports Center (CEFID), Santa Catarina State University (UDESC), Florianópolis, SC, Brazil
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230
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van Egmond MP, Duijts SFA, van Muijen P, van der Beek AJ, Anema JR. Therapeutic Work as a Facilitator for Return to Paid Work in Cancer Survivors. JOURNAL OF OCCUPATIONAL REHABILITATION 2017; 27:148-155. [PMID: 27118124 PMCID: PMC5306222 DOI: 10.1007/s10926-016-9641-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Purpose The increase of flexible employment in European labour markets has contributed to workers' risk of job loss. For sick-listed workers with chronic illnesses, such as cancer, and especially those without an employment contract, participation in therapeutic work may be an important step towards paid employment. The purpose of this study was to determine the role of therapeutic employment as facilitator for return to paid work, in a cohort of sick-listed cancer survivors (CSs) with and without an employment contract. Methods In this longitudinal study, data were used from a cohort of Dutch CSs (N = 192), who applied for disability benefits after 2 years of sick leave. The primary outcome measure was return to paid work after 1 year. Logistic regression analysis was applied. Results Of the participating CSs (mean age 50.7 years, 33 % male), 69 % had an employment contract at baseline. CSs without an employment contract participated significantly less in therapeutic work (p < 0.001) and were less likely to return to paid work after 1 year (p = 0.001), than those with a contract. Participation in therapeutic work significantly increased the chance of return to paid work after 1 year (OR 6.97; 95 % CI 2.94-16.51), adjusted for age, gender, level of work disability and having an employment contract. Conclusions Participation in therapeutic work could be an important facilitator for return to paid work in sick-listed CSs. The effectiveness of therapeutic work as a means to return to paid employment for sick-listed workers should be studied in an experimental setting.
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Affiliation(s)
- M P van Egmond
- Department of Public and Occupational Health, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
- Dutch Research Center for Insurance Medicine, AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands
| | - S F A Duijts
- Department of Public and Occupational Health, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - P van Muijen
- Department of Public and Occupational Health, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
- Dutch Research Center for Insurance Medicine, AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands
- Dutch Social Security Agency, Amsterdam, The Netherlands
| | - A J van der Beek
- Department of Public and Occupational Health, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
- Dutch Research Center for Insurance Medicine, AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands
| | - J R Anema
- Department of Public and Occupational Health, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
- Dutch Research Center for Insurance Medicine, AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands.
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231
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A Precision Medicine Approach to Improve Cancer Rehabilitation’s Impact and Integration with Cancer Care and Optimize Patient Wellness. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2017. [DOI: 10.1007/s40141-017-0145-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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232
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Streibelt M, Bethge M, Gross T, Herrmann K, Ustaoglu F, Reichel C. Predictive Validity of a Screening Instrument for the Risk of Non-Return to Work in Patients With Internal Diseases. Arch Phys Med Rehabil 2017; 98:989-996.e1. [PMID: 28137474 DOI: 10.1016/j.apmr.2016.12.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 12/19/2016] [Accepted: 12/21/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To test the predictive validity of the SIMBO (Screening-Instrument zur Feststellung des Bedarfs an medizinisch-beruflich orientierten Maßnahmen in der medizinischen Rehabilitation [Screening Instrument for the Access to Work-Related Multimodal Rehabilitation]; total score ranges from 0 to 100 points) in patients with internal diseases in a rehabilitation setting. DESIGN Prospective multicenter study. SETTING Inpatient rehabilitation centers. PARTICIPANTS Patients (N=1366) aged 18 to 65 years with internal diseases. INTERVENTIONS Multimodal rehabilitation programs. MAIN OUTCOME MEASURES The primary outcome was occurrence of a critical return-to-work (RTW) event during the follow-up period. Receiver operating characteristic analyses were performed. Sensitivity, specificity, and positive predictive values were calculated for each disease group using the cutoff score of 27 points. RESULTS A total of 1366 patients with neoplasms (n=203); endocrine, nutritional, and metabolic diseases (n=355); and diseases of the circulatory (n=470), respiratory (n=255), and digestive (n=83) systems were included. Between 9.9% and 40.6% of the patients reported critical RTW events during the 3-month follow-up period. The area under the curve was between .849 (.754-.923) and .903 (.846-.959). Sensitivity and specificity ranged from 65.6% to 92.9% and from 80.4% to 89.9%, respectively. The positive predictive values were between 40.4% and 77.8%. CONCLUSIONS The risk score SIMBO predicts short-term RTW problems after rehabilitation in patients with internal diseases. The cutoff of 27 points was confirmed as a reasonable threshold.
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Affiliation(s)
- Marco Streibelt
- Department of Rehabilitation, German Federal Pension Insurance, Berlin, Germany.
| | - Matthias Bethge
- Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - Thomas Gross
- Rehabilitation Center Schömberg, Schömberg, Germany
| | - Klaus Herrmann
- Rehabilitation Center Bad Kissingen, Bad Kissingen, Germany
| | | | - Christoph Reichel
- Rehabilitation Center Bad Brückenau, Bad Brückenau, Germany; Institute of Hygiene and Public Health, University of Bonn, Bonn, Germany
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233
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Health-related quality of life and psychological distress among cancer survivors in Southeast Asia: results from a longitudinal study in eight low- and middle-income countries. BMC Med 2017; 15:10. [PMID: 28081724 PMCID: PMC5234136 DOI: 10.1186/s12916-016-0768-2] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 12/08/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND A better understanding of health-related quality of life (HRQoL) and psychological distress in cancer survivors can raise awareness, promote the development of policies in cancer survivorship care, and facilitate better targeted use of limited resources in low- and middle-income countries (LMICs). The main objectives of this paper were therefore to assess HRQoL and the prevalence of psychological distress amongst cancer survivors in Southeast Asia and identify risk factors of these outcomes. METHODS The ACTION study was a longitudinal study in eight LMICs in Southeast Asia with 5249 first time cancer survivors followed up at 1 year after diagnosis. HRQoL was assessed using the EORTC QLQ-C30 and EQ-5D. Psychological distress (anxiety and depression) was assessed using the Hospital Anxiety and Depression Scale. General linear models and multiple logistic regression were used to identify independent predictors of HRQoL and psychological distress. RESULTS One year after diagnosis, the mean EORTC QLQ-C30 global health score for survivors was 66.2 out of 100 (SD 22.0), the mean index score on the EQ-5D was 0.74 (SD 0.23), 37% of survivors had at least mild levels of anxiety, and 46% showed at least mild levels of depression. Poorest HRQoL and highest prevalence of anxiety and depression were seen in patients with lung cancer and lymphomas, while highest scores and least psychological distress were seen in female patients with breast and cervical cancer. The most significant predictor of poor HRQoL and psychological distress outcomes was cancer stage at diagnosis. Age, co-morbidities, treatment, and several socioeconomic factors were associated with HRQoL and psychological distress. CONCLUSIONS Cancer survivors in LMICs in Southeast Asia have impaired HRQoL and substantial proportions have psychological distress. Patients with advanced cancer stages at diagnosis and those in a poor socioeconomic position were most at risk of such poor outcomes. Supportive interventions for cancer patients that address wider aspects of patient wellbeing are needed, as well as policies that address financial and other barriers to timely treatment.
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234
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Hall A, Lynagh M, Tzelepis F, Paul C, Bryant J. How can we help haematological cancer survivors cope with the changes they experience as a result of their cancer? Ann Hematol 2016; 95:2065-2076. [PMID: 27623627 DOI: 10.1007/s00277-016-2806-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 08/23/2016] [Indexed: 10/21/2022]
Abstract
Haematological cancer often necessitates that individuals make significant lifestyle and behaviour changes to protect themselves against infections. It is essential that haematological cancer survivors receive the support and information they require to adjust to such changes. This cross-sectional survey of 259 haematological cancer survivors found that over two thirds of haematological cancer survivors would like to receive more detailed information or help with: diet and nutrition that takes into account their diagnosis and treatment, how to manage the symptoms from the cancer and/or treatment, signs and symptoms to be aware of that may indicate a possible infection and appropriate exercise. Over a third of survivors reported that they had to make changes to reduce their chance of infection, with social restriction the most commonly reported area of change survivors made. Improving communication and access to care and providing additional emotional support may assist survivors in making these additional changes. Healthcare providers should use this information to better support haematological cancer survivors in dealing with the effects haematological cancer has on their life.
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Affiliation(s)
- Alix Hall
- Priority Research Centre for Health Behaviour, Faculty of Health and Medicine, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia. .,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.
| | - Marita Lynagh
- Priority Research Centre for Health Behaviour, Faculty of Health and Medicine, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Flora Tzelepis
- Priority Research Centre for Health Behaviour, Faculty of Health and Medicine, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Chris Paul
- Priority Research Centre for Health Behaviour, Faculty of Health and Medicine, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Jamie Bryant
- Priority Research Centre for Health Behaviour, Faculty of Health and Medicine, The University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
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235
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Duijts SFA, van Egmond MP, Gits M, van der Beek AJ, Bleiker EM. Cancer survivors' perspectives and experiences regarding behavioral determinants of return to work and continuation of work. Disabil Rehabil 2016; 39:2164-2172. [PMID: 27596990 DOI: 10.1080/09638288.2016.1219924] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
PURPOSE Supportive interventions to enhance return to work (RTW) in cancer survivors hardly showed positive effects so far. Behavioral determinants might have to be considered in the development of interventions to achieve sustained employability. This study aimed to explore cancer survivors' perspectives and experiences regarding behavioral determinants of RTW and continuation of work. MATERIALS AND METHODS In this qualitative study, semi-structured telephone interviews were held with 28 cancer survivors. All participants were at working age, 1-2 years after diagnosis and employed at time of diagnosis. Thematic content analysis was performed. RESULTS Work turned out to be a meaningful aspect of cancer survivors' life, and most participants reported a positive attitude towards their job. Social support to RTW or to continue working was mainly received from family and friends, but pressure to RTW from the occupational physician was also experienced. Changes in expectations regarding work ability from negative to positive during the treatment process were observed. Those who applied active coping mechanisms felt equipped to deal with difficulties regarding work. CONCLUSIONS Behavioral determinants should be taken into account in the development of future interventions to support cancer survivors' RTW. However, the causal relationship still has to be determined. Implications for rehabilitation Factors influencing occupational motivation among cancer survivors need to be understood in more detail. Previous studies in non-cancer populations have demonstrated that behavioral determinants, such as a positive attitude towards work, high social support and self-efficacy may increase return to work rates or shorten the time to return to work. Addressing behavioral determinants in future development of work-related interventions for cancer survivors is essential in achieving sustained employability.
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Affiliation(s)
- Saskia F A Duijts
- a Department of Public and Occupational Health , EMGO+ Institute for Health and Care Research, VU University Medical Center , Amsterdam , The Netherlands.,b Division of Psychosocial Research and Epidemiology , The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Martine P van Egmond
- a Department of Public and Occupational Health , EMGO+ Institute for Health and Care Research, VU University Medical Center , Amsterdam , The Netherlands.,c Research Center for Insurance Medicine AMC-UMCG-UWV-VUmc , Amsterdam , The Netherlands
| | - Maxime Gits
- a Department of Public and Occupational Health , EMGO+ Institute for Health and Care Research, VU University Medical Center , Amsterdam , The Netherlands
| | - Allard J van der Beek
- a Department of Public and Occupational Health , EMGO+ Institute for Health and Care Research, VU University Medical Center , Amsterdam , The Netherlands.,c Research Center for Insurance Medicine AMC-UMCG-UWV-VUmc , Amsterdam , The Netherlands
| | - Eveline M Bleiker
- b Division of Psychosocial Research and Epidemiology , The Netherlands Cancer Institute , Amsterdam , The Netherlands
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236
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Désiron HAM, Crutzen R, Godderis L, Van Hoof E, de Rijk A. Bridging Health Care and the Workplace: Formulation of a Return-to-Work Intervention for Breast Cancer Patients Using an Intervention Mapping Approach. JOURNAL OF OCCUPATIONAL REHABILITATION 2016; 26:350-365. [PMID: 26728492 DOI: 10.1007/s10926-015-9620-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Purpose An increasing number of breast cancer (BC) survivors of working age require return to work (RTW) support. Objective of this paper is to describe the development of a RTW intervention to be embedded in the care process bridging the gap between hospital and workplace. Method The Intervention Mapping (IM) approach was used and combined formative research results regarding RTW in BC patients with published insights on occupational therapy (OT) and RTW. Four development steps were taken, starting from needs assessment to the development of intervention components and materials. Results A five-phased RTW intervention guided by a hospital-based occupational therapist is proposed: (1) assessing the worker, the usual work and contextual factors which impacts on (re-)employment; (2) exploration of match/differences between the worker and the usual work; (3) establishing long term goals, broken down into short term goals; (4) setting up tailored actions by carefully implementing results of preceding phases; (5) step by step, the program as described in phase 4 will be executed. The occupational therapist monitors, measures and reviews goals and program-steps in the intervention to secure the tailor-made approach of each program-step of the intervention. Conclusion The use of IM resulted in a RTW oriented OT intervention. This unique intervention succeeds in matching individual BC patient needs, the input of stakeholders at the hospital and the workplace.
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Affiliation(s)
- Huguette A M Désiron
- Centre Environment and Health, Katholieke Universiteit Leuven, Kapucijnenvoer 35, 3000, Louvain, Belgium.
- Occupational Therapy Education, Department of Health Care, University College of Hasselt PXL, Hasselt, Belgium.
| | - Rik Crutzen
- Department of Health Promotion, CAPHRI School for Public Health and Primary Care, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Lode Godderis
- Centre Environment and Health, Katholieke Universiteit Leuven, Kapucijnenvoer 35, 3000, Louvain, Belgium
- IDEWE, External Service for Prevention and Protection at Work, Interleuvenlaan 58, 3001, Heverlee, Belgium
| | - Elke Van Hoof
- Department of Experimental and Applied Psychology (EXTO), Faculty of Psychological and Educational Science, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium
| | - Angelique de Rijk
- Department of Social Medicine, Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
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Nakamura K, Masuyama H, Nishida T, Haraga J, Ida N, Saijo M, Haruma T, Kusumoto T, Seki N, Hiramatsu Y. Return to work after cancer treatment of gynecologic cancer in Japan. BMC Cancer 2016; 16:558. [PMID: 27473230 PMCID: PMC4966766 DOI: 10.1186/s12885-016-2627-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 07/26/2016] [Indexed: 11/28/2022] Open
Abstract
Background Gynecologic cancer is one of the most common malignant diseases in working-age women. This study investigated whether several characteristics influence return to work after treatment of gynecologic cancer. Methods We investigated the correlations between return to work and several other characteristics in 199 gynecologic cancer survivors. Questionnaires were distributed to patients with cancer (≥1 year after treatment and age of <65 years) who visited Okayama University. Logistic regression analysis and receiver operating characteristic curves were used to determine whether each characteristic influenced return to work (no return to work or job change) in these gynecologic cancer survivors. Results For all patients, the mean age at the time of diagnosis was 47.0 years, and the average number of years after treatment was 4.5. Forty-four patients (53.7 %) who were non-regular employees continued to be employed at the same workplace. Non-regular employment had a significantly higher area under the curve (AUC) (0.726) than other characteristics in terms of negatively affecting return to work. Additionally, non-regular employment tended to have a higher AUC (0.618) than other characteristics in terms of job changes. Conclusions Non-regular employment was the variable most likely to negatively affect return to work and job changes in employed patients who underwent treatment for gynecologic cancer.
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Affiliation(s)
- Keiichiro Nakamura
- Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
| | - Hisashi Masuyama
- Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Takeshi Nishida
- Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Junko Haraga
- Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Naoyuki Ida
- Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Masayuki Saijo
- Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Tomoko Haruma
- Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Tomoyuki Kusumoto
- Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Noriko Seki
- Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - Yuji Hiramatsu
- Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
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238
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Zanville NR, Nudelman KNH, Smith DJ, Von Ah D, McDonald BC, Champion VL, Saykin AJ. Evaluating the impact of chemotherapy-induced peripheral neuropathy symptoms (CIPN-sx) on perceived ability to work in breast cancer survivors during the first year post-treatment. Support Care Cancer 2016; 24:4779-89. [PMID: 27470258 PMCID: PMC5031751 DOI: 10.1007/s00520-016-3329-5] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 07/03/2016] [Indexed: 12/25/2022]
Abstract
Purpose To describe the impact of chemotherapy-induced peripheral neuropathy symptoms (CIPN-sx) on breast cancer survivors’ (BCS) perceived ability to work post-treatment. Methods The sample included 22 chemotherapy-treated (Ctx+) and 22 chemotherapy-naïve (Ctx−) female BCS. Data was collected at the following three time points: baseline (post-surgery, pre-chemotherapy), 1 month (1 M) post-chemotherapy, and approximately 1 year (1 Y) later. The presence, frequency, number, and severity of CIPN-sx were self-reported using the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group–Neurotoxicity questionnaire (FACT/GOG-Ntx) version 4, a validated 11-item CIPN measure. Perceived ability to work was measured using an item from the Functional Well-Being subscale of the FACT/GOG-Ntx. Results At 1 Y, more than 50 % of Ctx+ reported discomfort, numbness, or tingling in their hands or feet; weakness; or difficulty feeling small objects. The presence, number, and severity of these symptoms were correlated with being less able to work for Ctx+ at 1 M but not 1 Y. Results of a regression analysis using CIPN-sx to predict work ability found that models combining (1) hand numbness and trouble feeling small objects, (2) trouble buttoning buttons and trouble feeling small objects, (3) foot numbness and foot pain, (4) foot numbness and trouble walking, and (5) trouble hearing and hand pain each predicted survivors who were “not at all” able to work at 1 M. Conclusions Unresolved CIPN-sx may play a role in challenges working for BCS post-treatment. These findings highlight the need for research to explore the impact that CIPN-sx have on BCS’ ability to work, as well as the development of interventions to improve work function in BCS with CIPN-sx.
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Affiliation(s)
- Noah R Zanville
- Department of Community & Health Systems, School of Nursing, Indiana University, Indianapolis, IN, USA. .,Training in Research for Behavioral Oncology and Cancer Control Program, Indiana University School of Nursing, Indianapolis, IN, USA.
| | - Kelly N H Nudelman
- Training in Research for Behavioral Oncology and Cancer Control Program, Indiana University School of Nursing, Indianapolis, IN, USA.,Department of Medical and Molecular Genetics, School of Medicine, Indiana University, Indianapolis, IN, USA.,Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Dori J Smith
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Diane Von Ah
- Department of Community & Health Systems, School of Nursing, Indiana University, Indianapolis, IN, USA
| | - Brenna C McDonald
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA.,Indiana University Melvin and Bren Simon Cancer Center, Indiana University, School of Medicine, Indianapolis, IN, USA.,Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Victoria L Champion
- Department of Community & Health Systems, School of Nursing, Indiana University, Indianapolis, IN, USA.,Training in Research for Behavioral Oncology and Cancer Control Program, Indiana University School of Nursing, Indianapolis, IN, USA.,Indiana University Melvin and Bren Simon Cancer Center, Indiana University, School of Medicine, Indianapolis, IN, USA
| | - Andrew J Saykin
- Department of Medical and Molecular Genetics, School of Medicine, Indiana University, Indianapolis, IN, USA.,Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA.,Indiana University Melvin and Bren Simon Cancer Center, Indiana University, School of Medicine, Indianapolis, IN, USA.,Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA
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239
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Tian L, Lin L, Li HL, Chen KJ, Zhang XJ, Qian SJ, Hu Y. Prevalence and Associated Factors of Cancer-Related Fatigue Among Cancer Patients in Eastern China. Oncologist 2016; 21:1349-1354. [PMID: 27449523 DOI: 10.1634/theoncologist.2015-0537] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 06/09/2016] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Cancer-related fatigue (CRF) is a subjective and distressing symptom, and its associated factors in developing countries remain ambiguous. The goal of this study was to determine the prevalence of and factors associated with CRF among cancer patients in China. METHODS This study was designed as a cross-sectional study to determine the prevalence of and factors associated with CRF among cancer patients in eastern China, regardless of their diagnoses. Data were collected by using a questionnaire survey (including demographic information and brief fatigue inventory) after informed written consent was obtained. A chi-square test was used to analyze the correlations between single categorical factors and CRF, and multiple logistic regression analysis was used to evaluate the associations of potential risk factors with the presence of CRF. RESULTS Out of a total population of 1,938 cancer patients, 1,749 had completed the study questionnaire; 52.07% (n = 904) reported clinically significant fatigue (score ≥4 on Brief Fatigue Inventory). Four hundred twenty-seven (48.47%) patients younger than age 58 years (the median age) and 475 (55.69%) patients age 58 years or older reported clinically significant fatigue. In multivariate analysis, higher sleep quality (p < .01) was negatively associated with CRF, whereas never engaging in physical exercise (p < .01) and higher clinical stage of cancer (p < .01) were positively associated factors that could increase the odds of CRF. CONCLUSION The results of this study suggest that effective management of the two changeable contributing factors of CRF may reduce CRF and thus could be used as references for CRF management. IMPLICATIONS FOR PRACTICE The two modifiable factors of cancer-related fatigue (CRF)-sleep disturbance and physical exercise-should be specifically assessed and managed to mitigate CRF.
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Affiliation(s)
- Li Tian
- School of Nursing, Fudan University, Shanghai, People's Republic of China
- Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
| | - Lu Lin
- School of Nursing, Soochow University, Suzhou, People's Republic of China
| | - Hui L Li
- Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
| | - Ke J Chen
- School of Public Health, Medical College of Soochow University, Suzhou, People's Republic of China
| | - Xiao J Zhang
- School of Nursing, Fudan University, Shanghai, People's Republic of China
| | - Shu J Qian
- School of Nursing, Soochow University, Suzhou, People's Republic of China
| | - Yan Hu
- School of Nursing, Fudan University, Shanghai, People's Republic of China
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240
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Paalman CH, van Leeuwen FE, Aaronson NK, de Boer AGEM, van de Poll-Franse L, Oldenburg HSA, Schaapveld M. Employment and social benefits up to 10 years after breast cancer diagnosis: a population-based study. Br J Cancer 2016; 114:81-7. [PMID: 26757424 PMCID: PMC4716544 DOI: 10.1038/bjc.2015.431] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 10/30/2015] [Accepted: 11/05/2015] [Indexed: 11/09/2022] Open
Abstract
Background: Little is known about employment outcomes after breast cancer (BC) beyond the first years after treatment. Methods: Employment outcomes were compared with a general population comparison group (N=91 593) up to 10 years after BC for 26 120 patients, diagnosed before age 55 between 2000–2005, with income and social benefits data from Statistics Netherlands. Treatment effects were studied in 14 916 patients, with information on BC recurrences and new cancer events. Results: BC survivors experienced higher risk of losing paid employment (Hazard Ratio (HR): 1.6, 95% Confidence Interval (95% CI) 1.4–1.8) or any work-related event up to 5–7 years (HR 1.5, 95% CI 1.3–1.6) and of receiving disability benefits up to 10 years after diagnosis (HR 2.0, 95% CI 1.6–2.5), with higher risks for younger patients. Axillary lymph node dissection increased risk of disability benefits (HR 1.5, 95% CI 1.4–1.7) or losing paid employment (HR 1.3, 95% CI 1.2–1.5) during the first 5 years of follow-up. Risk of disability benefits was increased among patients receiving mastectomy and radiotherapy (HR 1.2; 95% CI 1.1–1.3) and after chemotherapy (HR 1.7; 95% CI 1.5–1.9) during the first 5 years after diagnosis. Conclusions: BC treatment at least partly explains the increased risk of adverse employment outcomes up to 10 years after BC.
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Affiliation(s)
- C H Paalman
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - F E van Leeuwen
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - N K Aaronson
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - A G E M de Boer
- Coronel Institute of Occupational Health, Academic Medical Center, Amsterdam, The Netherlands
| | - L van de Poll-Franse
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,CoRPS- Centre of Research on Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, The Netherlands
| | - H S A Oldenburg
- Department of Surgical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - M Schaapveld
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.,Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
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241
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Bondesson T, Petersson LM, Wennman-Larsen A, Alexanderson K, Kjeldgård L, Nilsson MI. A study to examine the influence of health professionals' advice and support on work capacity and sick leave after breast cancer surgery. Support Care Cancer 2016; 24:4141-8. [PMID: 27146389 DOI: 10.1007/s00520-016-3239-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 04/24/2016] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to investigate how women, shortly after breast cancer surgery, experienced encounters with, and information from, healthcare professionals regarding work and sick leave and if these experiences were associated with self-reported work capacity and sick leave. METHODS This is a cross-sectional study based on questionnaire data from 605 women who had had breast cancer surgery, aged 20-63 years. Exclusion criteria were known distant metastases, pre surgical therapy, and/or previous breast cancer. Data on age, type of surgery, global health, and work environment were included as covariates in multivariable logistic regression analysis. RESULTS Five percent of the women had not received any advice concerning work or sick leave. Women reporting receiving useful advice or support related to paid work had lower risk of reporting reduced physical or psychological/social work capacity due to the cancer or treatment (OR 0.46 (95 % CI 0.26-0.81) respective OR 0.45 (95 % CI 0.26-0.77)). There were no associations between having received useful advice or support concerning work and being on sick leave. Women encouraged to take sick leave had an OR of 2.17 (95 % CI 1.39-3.37) of being sickness absent. They also to a higher extent had reduced physical and psychological/social work capacity. Women who reported to have been encouraged to work were sickness absent to a lower extent (OR 0.64; 95 % CI 0.41-0.98) and reported higher physical work capacity. CONCLUSIONS Work and sick leave is being discussed during consultations with women with breast cancer and the advice given seems to be in line with the women's subjective work capacity.
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Affiliation(s)
- Tina Bondesson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Berzelius väg 3, plan 6, SE-171 77, Stockholm, Sweden
- Department of Oncology, Karolinska University Hospital, Södersjukhuset, Stockholm, Sweden
| | - Lena-Marie Petersson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Berzelius väg 3, plan 6, SE-171 77, Stockholm, Sweden
- Division of Nursing, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Stockholm, Sweden
| | - Agneta Wennman-Larsen
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Berzelius väg 3, plan 6, SE-171 77, Stockholm, Sweden
- Sophiahemmet University, Stockholm, Sweden
| | - Kristina Alexanderson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Berzelius väg 3, plan 6, SE-171 77, Stockholm, Sweden
| | - Linnea Kjeldgård
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Berzelius väg 3, plan 6, SE-171 77, Stockholm, Sweden
| | - Marie I Nilsson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Berzelius väg 3, plan 6, SE-171 77, Stockholm, Sweden.
- Division of Social Work, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Stockholm, Sweden.
- Division of Social Work, Karolinska University Hospital, Stockholm, Sweden.
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242
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Kiserud CE, Fagerli UM, Smeland KB, Fluge Ø, Bersvendsen H, Kvaløy S, Holte H, Dahl AA. Pattern of employment and associated factors in long-term lymphoma survivors 10 years after high-dose chemotherapy with autologous stem cell transplantation. Acta Oncol 2016; 55:547-53. [PMID: 27123741 DOI: 10.3109/0284186x.2015.1125015] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Background This study examined employment patterns and associated factors in lymphoma survivors treated with high-dose chemotherapy with autologous stem cell transplantation (HDT-ASCT) from diagnosis to a follow-up survey at a mean of 10 years after HDT-ASCT. Patients and methods All lymphoma survivors aged ≥18 years at HDT-ASCT in Norway from 1987 to 2008, and alive at the end of 2011 were eligible for this cross-sectional study performed in 2012/2013. Participants completed a mailed questionnaire. Job status was dichotomized as either employed (paid work) or not-employed (disability and retirement pension, on economic support, home-makers, or students). Results The response rate was 78%, and the sample (N = 312) contained 60% men. Mean age at HDT-ASCT was 44.3 and at survey 54.0 years. At diagnosis 85% of survivors were employed, 77% before and 77% after HDT-ASCT, and 58% at follow-up. Forty seven percent of the survivors were employed at all time points. The not-employed group at survey was significantly older and included significantly more females than the employed group. No significant between-group differences were observed for lymphoma-related variables. Fatigue, mental distress and type D personality were significantly higher among those not-employed, while quality of life was significantly lower compared to the employed group. Older age at survey, being female, work ability and presence of type D personality remained significantly related to being not-employed at survey in the multivariable analysis. Conclusions Our findings show that not-employed long-term survivors after HDT-ASCT for lymphoma have more comorbidity, cognitive problems and higher levels of anxiety/depression than employed survivors. These factors should be checked and eventually treated in order to improve work ability.
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Affiliation(s)
- C. E. Kiserud
- National Advisory Unit for Late Effects After Cancer, Department of Oncology, Oslo University Hospital, Radiumhospitalet, Oslo, Norway
| | - U-M. Fagerli
- Department of Oncology, St. Olav’s Hospital, Trondheim, Norway
- Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - K. B. Smeland
- National Advisory Unit for Late Effects After Cancer, Department of Oncology, Oslo University Hospital, Radiumhospitalet, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ø. Fluge
- Department of Oncology, Haukeland University Hospital, Bergen, Norway
| | - H. Bersvendsen
- Department of Oncology, University Hospital of North Norway, Tromsø, Norway
| | - S. Kvaløy
- National Advisory Unit for Late Effects After Cancer, Department of Oncology, Oslo University Hospital, Radiumhospitalet, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - H. Holte
- National Advisory Unit for Late Effects After Cancer, Department of Oncology, Oslo University Hospital, Radiumhospitalet, Oslo, Norway
| | - A. A. Dahl
- National Advisory Unit for Late Effects After Cancer, Department of Oncology, Oslo University Hospital, Radiumhospitalet, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
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243
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Wagner RW, Pritzker S. Cancer survivorship care-planning: Practice, research, and policy implications for social work. SOCIAL WORK IN HEALTH CARE 2016; 55:181-194. [PMID: 26933764 DOI: 10.1080/00981389.2015.1115800] [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: 06/05/2023]
Abstract
Increasing numbers of cancer survivors are living longer than 5 years from their diagnosis date. This has resulted in a growing population of cancer survivors, expected to reach 19 million by 2024. Survivors frequently experience late effects caused by cancer and its treatment, reducing survivors' quality of life in multiple domains. Survivorship care-plans may aid the many physical, psychosocial, and financial needs that emerge posttreatment. However, the lack of reimbursement mechanisms, the limited amount of effectiveness research, and minimal guidelines for content and delivery are barriers to the widespread provision of survivorship care-plans. Challenges and opportunities for social work practice, research, and policy are identified and discussed.
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Affiliation(s)
- Richard W Wagner
- a Graduate College of Social Work , University of Houston , Houston , Texas , USA
| | - Suzanne Pritzker
- a Graduate College of Social Work , University of Houston , Houston , Texas , USA
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244
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Bae KR, Kwon SY. The Workplace Experiences of Breast Cancer Survivors: A Survey of an Online Community. ASIAN ONCOLOGY NURSING 2016. [DOI: 10.5388/aon.2016.16.4.208] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
| | - Sun Young Kwon
- Knowledge Management Institute, Sungkyunkwan University, Seoul, Korea
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245
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Bradley CJ. Economic recovery: A measure of the quality of cancer treatment and survivorship? Cancer 2015; 121:4282-5. [DOI: 10.1002/cncr.29511] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 05/20/2015] [Accepted: 05/21/2015] [Indexed: 11/07/2022]
Affiliation(s)
- Cathy J. Bradley
- Department of Healthcare Policy and Research; Virginia Commonwealth University; Richmond Virginia
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246
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Loh SY, Musa AN. Methods to improve rehabilitation of patients following breast cancer surgery: a review of systematic reviews. BREAST CANCER-TARGETS AND THERAPY 2015; 7:81-98. [PMID: 25792854 PMCID: PMC4360828 DOI: 10.2147/bctt.s47012] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Context Breast cancer is the most prevalent cancer amongst women but it has the highest survival rates amongst all cancer. Rehabilitation therapy of post-treatment effects from cancer and its treatment is needed to improve functioning and quality of life. This review investigated the range of methods for improving physical, psychosocial, occupational, and social wellbeing in women with breast cancer after receiving breast cancer surgery. Method A search for articles published in English between the years 2009 and 2014 was carried out using The Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects, PubMed, and ScienceDirect. Search terms included: ‘breast cancer’, ‘breast carcinoma’, ‘surgery’, ‘mastectomy’, ‘lumpectomy’, ‘breast conservation’, ‘axillary lymph node dissection’, ‘rehabilitation’, ‘therapy’, ‘physiotherapy’, ‘occupational therapy’, ‘psychological’, ‘psychosocial’, ‘psychotherapy’, ‘exercise’, ‘physical activity’, ‘cognitive’, ‘occupational’, ‘alternative’, ‘complementary’, and ‘systematic review’. Study selection Systematic reviews on the effectiveness of rehabilitation methods in improving post-operative physical, and psychological outcomes for breast cancer were selected. Sixteen articles met all the eligibility criteria and were included in the review. Data extraction Included review year, study aim, total number of participants included, and results. Data synthesis Evidence for exercise rehabilitation is predominantly in the improvement of shoulder mobility and limb strength. Inconclusive results exist for a range of rehabilitation methods (physical, psycho-education, nutritional, alternative-complementary methods) for addressing the domains of psychosocial, cognitive, and occupational outcomes. Conclusion There is good evidence for narrowly-focused exercise rehabilitation in improving physical outcome particularly for shoulder mobility and lymphedema. There were inconclusive results for methods to improve psychosocial, cognitive, and occupational outcomes. There were no reviews on broader performance areas and lifestyle factors to enable effective living after treatment. The review suggests that comprehensiveness and effectiveness of post-operative breast cancer rehabilitation should consider patients’ self-management approaches towards lifestyle redesign, and incorporate health promotion aspects, in light of the fact that breast cancer is now taking the form of a chronic illness with longer survivorship years.
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Affiliation(s)
- Siew Yim Loh
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Aisya Nadia Musa
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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247
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Levitz NR, Haji-Jama S, Munro T, Gorey KM, Luginaah IN, Bartfay E, Zou G, Wright FC, Kanjeekal SM, Hamm C, Balagurusamy MK, Holowaty EJ. Multiplicative disadvantage of being an unmarried and inadequately insured woman living in poverty with colon cancer: historical cohort exploration in California. BMC Womens Health 2015; 15:8. [PMID: 25783640 PMCID: PMC4333264 DOI: 10.1186/s12905-015-0166-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 01/20/2015] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Many Americans diagnosed with colon cancer do not receive indicated chemotherapy. Certain unmarried women may be particularly disadvantaged. A 3-way interaction of the multiplicative disadvantages of being an unmarried and inadequately insured woman living in poverty was explored. METHODS California registry data were analyzed for 2,319 women diagnosed with stage II to IV colon cancer between 1996 and 2000 and followed until 2014. Socioeconomic data from the 2000 census classified neighborhoods as high poverty (≥30% of households poor), middle (5-29%) or low poverty (<5% poor). Primary health insurance was private, Medicare, Medicaid or none. Comparisons of chemotherapy rates used standardized rate ratios (RR). We respectively used logistic and Cox regression models to assess chemotherapy and survival. RESULTS A statistically significant 3-way marital status by health insurance by poverty interaction effect on chemotherapy receipt was observed. Chemotherapy rates did not differ between unmarried (39.0%) and married (39.7%) women who lived in lower poverty neighborhoods and were privately insured. But unmarried women (27.3%) were 26% less likely to receive chemotherapy than were married women (37.1%, RR = 0.74, 95% CI 0.58, 0.95) who lived in high poverty neighborhoods and were publicly insured or uninsured. When this interaction and the main effects of health insurance, poverty and chemotherapy were accounted for, survival did not differ by marital status. CONCLUSIONS The multiplicative barrier to colon cancer care that results from being inadequately insured and living in poverty is worse for unmarried than married women. Poverty is more prevalent among unmarried women and they have fewer assets so they are probably less able to absorb the indirect and direct, but uncovered, costs of colon cancer care. There seem to be structural inequities related to the institutions of marriage, work and health care that particularly disadvantage unmarried women that policy makers ought to be cognizant of as future reforms of the American health care system are considered.
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Affiliation(s)
- Naomi R Levitz
- />School of Social Work, University of Windsor, Windsor, Ontario Canada
| | - Sundus Haji-Jama
- />Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario Canada
| | - Tonya Munro
- />School of Social Work, University of Windsor, Windsor, Canada
| | - Kevin M Gorey
- />School of Social Work, University of Windsor, Windsor, Canada
| | - Isaac N Luginaah
- />Department of Geography, Western University, London, Ontario Canada
| | - Emma Bartfay
- />Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Ontario Canada
| | - Guangyong Zou
- />Department of Epidemiology and Biostatistics, and Robarts Research Institute, Western University, London, Ontario Canada
| | - Frances C Wright
- />Division of General Surgery, Sunnybrook Health Sciences Center and Departments of Surgery and Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario Canada
| | - Sindu M Kanjeekal
- />Medical Oncology Department, Windsor Regional Cancer Center, Windsor, Ontario Canada
| | - Caroline Hamm
- />Medical Oncology Department, Windsor Regional Cancer Center and School of Medicine and Dentistry, Department of Oncology, Western University, London, Canada
| | | | - Eric J Holowaty
- />Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario Canada
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