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Fassier JB, Guittard L, Fervers B, Rouat S, Sarnin P, Carretier J, Broc G, Letrilliart L, Péron J, Lamort-Bouché M. Using intervention mapping to facilitate and sustain return-to work after breast cancer: protocol for the FASTRACS multicentre randomized controlled trial. BMC Cancer 2024; 24:1107. [PMID: 39237867 PMCID: PMC11378548 DOI: 10.1186/s12885-024-12796-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 08/12/2024] [Indexed: 09/07/2024] Open
Abstract
BACKGROUND Women with breast cancer face many barriers to return to work (RTW) after their cancer. The main objective of the FASTRACS-RCT is to evaluate the impact of the FASTRACS (Facilitate and Sustain Return to Work after Breast Cancer) intervention on the sustainable RTW of breast cancer patients, 12 months after the end of active treatment. METHODS FASTRACS-RCT is a prospective, national, multicentre, randomized, controlled and open-label study. A total of 420 patients with early breast cancer scheduled for surgery and (neo)adjuvant chemotherapy, will be randomly assigned (1:1 ratio) to: (i) the intervention arm comprising four steps over 6 months : Handing over the intervention tools; transitional medical consultation with the general practitioner (GP); pre-RTW visit with the company's occupational physician (OP); catch-up visit with a hospital-based RTW expert (if sick leave > 10 months) (ii) the control arm to receive usual care. The design of the FASTRACS intervention was informed by intervention mapping for complex interventions in health promotion planning, and involved patients and representatives of relevant stakeholders. Specific tools were developed to bridge the gap between the hospital, the GP, the OP and the workplace: a toolkit for breast cancer patients comprising a theory-based guide; specific checklists for the GP and the OP, respectively; and a theory-based guide for workplace actors (employer, manager, colleagues). The primary endpoint will associate sustainable RTW (full-time or part-time work at 50% or more of working time, for at least 28 consecutive days) and days off work. It will be assessed at 4, 8 and 12 months after the end of active oncological treatment. Secondary endpoints will include quality of life, anxiety, depression, RTW self-efficacy, physical activity, social support, job accommodations, work productivity, job status, and the usefulness and acceptability of the intervention's tools. DISCUSSION FASTRACS-RCT will be supplemented by a realist evaluation approach aimed at understanding the influence of context in activating the intervention's mechanisms and effects. If the expected impact of the intervention is confirmed, the intervention will be adapted and scaled-up for other cancers and chronic diseases to better integrate healthcare and work disability prevention. TRIAL REGISTRATION NCT04846972 ; April 15, 2021.
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Affiliation(s)
- Jean-Baptiste Fassier
- Université Claude Bernard Lyon 1, Université Gustave Eiffel, UMRESTTE UMR T9405, 8 Avenue Rockefeller, Lyon, France.
- Hospices Civils de Lyon, Service de Médecine et Santé au Travail, Pôle de Santé Publique, Lyon, France.
| | - Laure Guittard
- Hospices Civils de Lyon, Service Recherche et Epidémiologie Cliniques, Pôle de Santé Publique, Lyon, France
- Research on Healthcare Performance RESHAPE, Université Claude Bernard Lyon 1, INSERM U1290, Lyon, France
| | - Béatrice Fervers
- Centre Léon Bérard (CLB), Départment Cancer et Environment, Lyon, France
- Radiations: Defense, Health & Environment, INSERM U1296, Lyon, France
| | - Sabrina Rouat
- Université Lumière Lyon 2, GREPS EA 4163, Lyon, France
| | | | - Julien Carretier
- Université Claude Bernard Lyon 1, P2S, UR4129, Lyon, France
- Centre National des Soins Palliatifs et de La Fin de Vie, Paris, France
| | - Guillaume Broc
- Université Paul-Valéry Montpellier 3, EPSYLON EA 4556, Montpellier, France
| | - Laurent Letrilliart
- Research on Healthcare Performance RESHAPE, Université Claude Bernard Lyon 1, INSERM U1290, Lyon, France
- Université Claude Bernard Lyon 1, University General Practice Department (CUMG), Lyon, France
| | - Julien Péron
- Research on Healthcare Performance RESHAPE, Université Claude Bernard Lyon 1, INSERM U1290, Lyon, France
- Service D'oncologie médicale, Hospices Civils de Lyon, Institut de Cancérologie, Lyon, France
| | - Marion Lamort-Bouché
- Research on Healthcare Performance RESHAPE, Université Claude Bernard Lyon 1, INSERM U1290, Lyon, France
- Université Claude Bernard Lyon 1, University General Practice Department (CUMG), Lyon, France
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Greidanus MA, van Ommen F, de Boer AGEM, Coenen P, Duijts SFA. Experiences of unemployed and/or work-disabled cancer survivors who have pursued to return to paid employment: a focus group study. J Cancer Surviv 2024:10.1007/s11764-024-01657-5. [PMID: 39138713 DOI: 10.1007/s11764-024-01657-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2024] [Accepted: 07/30/2024] [Indexed: 08/15/2024]
Abstract
PURPOSE To explore experiences of unemployed and/or work-disabled cancer survivors who have pursued to return to paid employment. METHODS Four digital focus group interviews were conducted with 16 cancer survivors (< 10 years post-diagnosis) who have pursued to return to work within the last 2 years. Interview topics included motivations, facilitators of and barriers to job seeking, and returning to and maintaining paid employment. Interview audio recordings were transcribed verbatim and analyzed using conventional content analyses. RESULTS Participants were mostly female (94%), and the majority had successfully returned to paid employment (56%). Both intrinsic factors (e.g., sense of purpose, social interactions) and extrinsic factors (e.g., financial necessity) motivated their return to paid employment. During job seeking, participants experienced facilitators including support, personal qualities (e.g., life experience), and trial workplaces. Barriers included inadequate support, perceived employer discrimination, and work ability uncertainty. Returning to and maintaining employment was facilitated by flexible work, supportive colleagues, and intrinsic drive, while barriers included side effects (e.g., fatigue) and overly demanding work. CONCLUSIONS Unemployed and/or work-disabled cancer survivors are generally motivated to return to paid employment by both intrinsic and extrinsic factors, but uncertainty about their ability and inadequate support may hinder this. These findings highlight the need for trial workplaces, support during every phase of return to paid employment, and a flexible, supportive workplace. IMPLICATIONS FOR CANCER SURVIVORS Tailored interventions addressing the needs identified in this study are urgently needed. The recommendations provided offer strategies for various stakeholders to enhance support for unemployed and work-disabled cancer survivors.
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Affiliation(s)
- M A Greidanus
- Department of Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
- Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, The Netherlands.
| | - F van Ommen
- Department of Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, The Netherlands
| | - A G E M de Boer
- Department of Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, The Netherlands
| | - P Coenen
- Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, The Netherlands
- Department of Public and Occupational Health, Amsterdam UMC Location Vrije Universiteit, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Movement Sciences Research Institute, Musculoskeletal Health, Amsterdam, The Netherlands
| | - S F A Duijts
- Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, The Netherlands
- Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Rijnkade 5, Utrecht, The Netherlands
- Department of Medical Psychology, Amsterdam UMC Location Vrije Universiteit, De Boelelaan 1117, Amsterdam, The Netherlands
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Alræk T, Skjerve H, Sørensen A, Lie SA, Presterud Ødegård H, Lu W, Mao J, Deng G, Lee MS, Birch S, Lamu AN, Kim TH, MacPherson H. Acupuncture for fatigue in breast cancer survivors: a study protocol for a pragmatic, mixed method, randomised controlled trial. BMJ Open 2024; 14:e077514. [PMID: 39079925 PMCID: PMC11293412 DOI: 10.1136/bmjopen-2023-077514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 07/09/2024] [Indexed: 08/03/2024] Open
Abstract
INTRODUCTION Fatigue is a common symptom observed in post-cancer treatment, yet its underlying mechanisms remain poorly understood. Acupuncture has been employed to alleviate cancer-related fatigue (CRF); however, its effectiveness in addressing associated comorbidities that may influence fatigue is also poorly understood. This study represents the first investigation to use acupuncture as an intervention for fatigue in breast cancer survivors within a Norwegian cohort. The study will employ questionnaires to evaluate various facets of fatigue. As a pragmatic trial, it statistically assesses its clinical relevance, documents adverse events and evaluates the cost-effectiveness of the acupuncture treatment. METHODS AND ANALYSIS This assessor-blinded, pragmatic, randomised, mixed method, controlled trial with two parallel arms aims to evaluate the effectiveness, safety and cost-effectiveness of acupuncture. It will recruit 250 participants presented with CRF for 6 months or longer. Patients will be randomly allocated either to acupuncture and usual care (n=125) or to usual care alone (n=125). Acupuncture treatments (12 in total) are to be given within 12 weeks. The statistician who will analyse the data will be blinded to group allocation. The primary outcome will be changes in CRF measured by the Chalder fatigue scale. Measurements will be taken 12 weeks and 6 months after randomisation. The secondary outcomes include patient-reported outcomes of pain, anxiety, depression, hot flashes, insomnia and sleepiness. Health-related quality of life and economic evaluation will also be conducted 12 weeks and 6 months after randomisation. Nested within this randomised controlled trial are two qualitative studies and one sub-study measuring biomarkers (C-reactive protein, interleukin (IL)-1, IL-6, tumour necrosis factor alpha (TNF-α) and aPL in addition to the current genotype genes TNF-308 and IL-6-174) from blood samples (n=80). Such biomarkers can potentially address changes in CRF. ETHICS AND DISSEMINATION Ethical approval of this study has been granted by the Regional Committees for Medical and Health Research Ethics (REC southeast ID number: 112285). Written informed consent will be obtained from all participants. The outcomes of the trial will be disseminated through peer-reviewed publications. TRIAL REGISTRATION NUMBER NCT04418115.
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Affiliation(s)
- Terje Alræk
- Department of Community Medicine, The Artic University of Norway Department of Clinical Medicine, Tromso, Norway
- Department of Health and Excercise, Kristiania University College, Oslo, Norway
| | - Hilde Skjerve
- Department of Health and Excercise, Kristiania University College, Oslo, Norway
| | - Anette Sørensen
- Department of Health and Excercise, Kristiania University College, Oslo, Norway
| | - S A Lie
- Department of Dentistry, University of Bergen Faculty of Medicine and Dentistry, Bergen, Norway
| | | | - Weidong Lu
- Department of Medical Oncology, Harvard Medical School, Boston, Massachusetts, USA
| | - Jun Mao
- Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
| | - G Deng
- Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
| | - Myeong Soo Lee
- Korea Institute of Oriental Medicine, Daejeon, Korea (the Republic of)
| | - Stephen Birch
- Department of Health and Excercise, Kristiania University College, Oslo, Norway
| | | | - Tae-hun Kim
- Korean Medicine Clinical Trial Center, Kyung Hee University, Seoul, Korea (the Republic of)
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Andra O, Pintea C, Manea A, Nirestean A, Niculescu R, Gîrbovan M, Elena-Gabriela S. Quality of Life Among Breast Cancer Patients in Mures County, Romania: A Cross-Sectional Study. Cureus 2024; 16:e65870. [PMID: 39087189 PMCID: PMC11290778 DOI: 10.7759/cureus.65870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2024] [Indexed: 08/02/2024] Open
Abstract
Background and aim Psychiatric pathology does not always start on its own but may be conditioned or triggered by a comorbidity with a high impact on the human psyche. When there are comorbidities, psychiatric pathology can occur due to the high diagnostic burden. Our study aims to find out if there is a correlation between the diagnosis of breast cancer and its severity, and psychiatric symptoms such as depressive mood, atypical anxiety, or even autolytic ideation that directly influence the quality of life of patients. Materials and methods The study is a prospective, cross-sectional, single-center study carried out between December 2023 and June 2024 at the Mureș County Clinical Hospital in Romania. The sample population had to be at least 18 years old and had to be diagnosed with breast cancer recently. We applied two tests, WHODAS 2 (World Health Organization's Disability Assessment Schedule 2.0) and level 1 (level 1 of cross-sectional measurements of symptoms), to be able to measure and aid assessment of mental health domains that are important across psychiatric diagnoses and also the degree of disability triggered by breast cancer. The statistical analysis included descriptive statistics and interferential statistics. Statistical tests, such as Shapiro-Wilk, Kruskal-Wallis, and Mann-Whitney U tests with Bonferroni correction tests, were used. The p-value was set to 0.05 with a confidence interval (CI) of 95%. Results The study included 120 women diagnosed with breast cancer, with a mean age of 56.64 ± 9.46 years. Regarding the severity of the diagnosis, 44 women (36.66%) had non-invasive cancer, 58 (48.33%) had invasive cancer, and 18 (15%) had metastases. There was a statistically significant difference between three of the five selected level 1 domains across cancer types. The WHODAS 2.0 disability scores showed a significant difference between groups (p < 0.001). Subjects with non-invasive cancer had the lowest WHODAS 2.0 score, followed by the invasive group, while metastases had the highest score. Conclusions Following the application of the two tests, level 1 and WHODAS 2.0, to our group of subjects, statistically significant differences were observed between the three categories of subjects. The degree of disability and the occurrence of psychological symptoms differed according to the severity of breast cancer. Adapting to the status of an oncological patient entails multiple changes from a psycho-emotional, social, occupational, and professional point of view. Although the most recent medications prolong survival, a holistic approach that considers psychological aspects can improve patients' long-term results.
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Affiliation(s)
- Oltean Andra
- Department of Psychiatry, Emergency Clinical County Hospital of Târgu Mureș, Târgu Mureș, ROU
| | - Cezara Pintea
- Faculty of Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, Târgu Mureș, ROU
| | - Andrei Manea
- Department of Radiology, Emergency Clinical County Hospital of Târgu Mureș, Târgu Mureș, ROU
| | - Aurel Nirestean
- Department of Psychiatry, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, Târgu Mureș, ROU
| | - Raluca Niculescu
- Department of Pathophysiology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, Targu Mures, ROU
| | - Mircea Gîrbovan
- Department of Urology, Emergency Clinical County Hospital of Târgu Mureș, Târgu Mureș, ROU
| | - Strete Elena-Gabriela
- Department of Psychiatry, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, Târgu Mureș, ROU
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Guo Y, Xie H, Ding L, Shi Y, Han P. Effects of a 'Rebuilding Myself' intervention on enhancing the adaptability of cancer patients to return to work: a randomized controlled trial. BMC Cancer 2024; 24:581. [PMID: 38741043 DOI: 10.1186/s12885-024-12305-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 04/22/2024] [Indexed: 05/16/2024] Open
Abstract
OBJECTIVES To explore the effects of a 'Rebuilding Myself' intervention on enhancing the adaptability of cancer patients to return to work. METHODS A single-center, single-blind, randomized controlled trial design was used. Eligible patients who were receiving routine hospital treatment were recruited from the university-affiliated hospital in our city. Patients in the control group only received usual care, while patients in the intervention group received additional 'Rebuilding Myself' intervention. Adaptability to return to work, self-efficacy of returning to work, mental resilience, quality of life and work ability were measured at baseline, the 6th and 12th of the intervention. The general estimation equations were used to compare the overall changes of each outcome index between the two groups at different time points. Considering that there may be patient shedding and rejection, Per-Protocol and Intention-to-Treat analysis were used to analyze the data in this study. RESULTS There were statistically significant differences between the two groups of patients in the cancer patients' adaptability to return to work, self-efficacy to return to work, mental resilience, work abilities, the physical, emotional, cognitive function, fatigue, insomnia and overall health status dimensions of quality of life (P < 0.05). And no significant difference was found in other dimensions (P > 0.05). The group effect, time effect, and interaction effect of patients' return to work adaptability and return to work self-efficacy were statistically significant in both groups (P < 0.05). Mental resilience, working ability, and quality of life had obvious time effect and interaction effect (P < 0.05). CONCLUSION This intervention could improve cancer patients' adaptability to return to work, self-efficacy to return to work, mental resilience, work abilities and quality of life. And it can be further expanded to improve the adaptability of patients to return to work, then to help patients achieve comprehensive rehabilitation. IMPLICATIONS FOR CANCER SURVIVORS The application of 'Rebuilding Myself' interventions can effectively improve the adaptability of cancer patients returning to work. TRIAL REGISTRATION This study was registered at the Chinese Clinical Trial Registry (Registration number: ChiCTR2200057943) on 23 March, 2022.
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Affiliation(s)
- Yujie Guo
- School of Nursing and Rehabilitation, Nantong University, Nantong, 226001, Jiangsu Province, China.
| | - Huiwen Xie
- School of Nursing and Rehabilitation, Nantong University, Nantong, 226001, Jiangsu Province, China
| | - Lingyan Ding
- School of Nursing and Rehabilitation, Nantong University, Nantong, 226001, Jiangsu Province, China
| | - Yue Shi
- School of Nursing and Rehabilitation, Nantong University, Nantong, 226001, Jiangsu Province, China
| | - Pingping Han
- School of Nursing and Rehabilitation, Nantong University, Nantong, 226001, Jiangsu Province, China
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Bhatt NS, Goodman P, Leisenring WM, Armstrong GT, Chow EJ, Hudson MM, Krull KR, Nathan PC, Oeffinger KC, Robison LL, Kirchhoff AC, Mulrooney DA. Chronic Health Conditions and Longitudinal Employment in Survivors of Childhood Cancer. JAMA Netw Open 2024; 7:e2410731. [PMID: 38728029 PMCID: PMC11087836 DOI: 10.1001/jamanetworkopen.2024.10731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 03/11/2024] [Indexed: 05/13/2024] Open
Abstract
Importance Employment is an important factor in quality of life and provides social and economic support. Longitudinal data on employment and associations with chronic health conditions for adult survivors of childhood cancer are lacking. Objective To evaluate longitudinal trends in employment among survivors of childhood cancer. Design, Setting, and Participants Retrospective cohort study of 5-year cancer survivors diagnosed at age 20 years or younger between 1970 and 1986 enrolled in the multi-institutional Childhood Cancer Survivor Study (CCSS). Sex-stratified employment status at baseline (2002 to 2004) and follow-up (2014 to 2016) was compared with general population rates from the Behavioral Risk Factor Surveillance System cohort. Data were analyzed from July 2021 to June 2022. Exposures Cancer therapy and preexisting and newly developed chronic health conditions. Main Outcomes and Measures Standardized prevalence ratios of employment (full-time or part-time, health-related unemployment, unemployed, not in labor force) among adult (aged ≥25 years) survivors between baseline and follow-up compared with the general population. Longitudinal assessment of negative employment transitions (full-time to part-time or unemployed at follow-up). Results Female participants (3076 participants at baseline; 2852 at follow-up) were a median (range) age of 33 (25-53) years at baseline and 42 (27-65) years at follow-up; male participants (3196 participants at baseline; 2557 at follow-up) were 33 (25-54) and 43 (28-64) years, respectively. The prevalence of full-time or part-time employment at baseline and follow-up was 2215 of 3076 (71.3%) and 1933 of 2852 (64.8%) for female participants and 2753 of 3196 (85.3%) and 2079 of 2557 (77.3%) for male participants, respectively, with declining standardized prevalence ratios over time (female participant baseline, 1.01; 95% CI, 0.98-1.03; follow-up, 0.94; 95% CI, 0.90-0.98; P < .001; male participant baseline, 0.96; 95% CI, 0.94-0.97; follow-up, 0.92; 95% CI, 0.89-0.95; P = .02). While the prevalence of health-related unemployment increased (female participants, 11.6% to 17.2%; male participants, 8.1% to 17.1%), the standardized prevalence ratio remained higher than the general population and declined over time (female participant baseline, 3.78; 95% CI, 3.37-4.23; follow-up, 2.23; 95% CI, 1.97-2.51; P < .001; male participant baseline, 3.12; 95% CI, 2.71-3.60; follow-up, 2.61; 95% CI, 2.24-3.03; P = .002). Among survivors employed full-time at baseline (1488 female participants; 1933 male participants), 285 female participants (19.2%) and 248 male participants (12.8%) experienced a negative employment transition (median [range] follow-up, 11.5 [9.4-13.8] years). Higher numbers and grades of chronic health conditions were significantly associated with these transitions. Conclusions and Relevance In this retrospective analysis of adult survivors of childhood cancer, significant declines in employment and increases in health-related unemployment among cancer survivors compared with the general population were identified. A substantial portion of survivors in the midcareer age range fell out of the workforce. Awareness among clinicians, caregivers, and employers may facilitate clinical counseling and occupational provisions for supportive work accommodations.
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Affiliation(s)
- Neel S. Bhatt
- Fred Hutchinson Cancer Center, Seattle, Washington
- University of Washington School of Medicine, Seattle
| | | | | | | | - Eric J. Chow
- Fred Hutchinson Cancer Center, Seattle, Washington
| | | | - Kevin R. Krull
- St Jude Children’s Research Hospital, Memphis, Tennessee
| | - Paul C. Nathan
- The Hospital for Sick Children, The University of Toronto, Toronto, Ontario, Canada
| | | | | | - Anne C. Kirchhoff
- Huntsman Cancer Institute, and Department of Pediatrics, University of Utah, Salt Lake City
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Fauser D, Zollmann P, Streibelt M, Bethge M. [Work Participation after Multimodal Rehabilitation due to Cancer: Representative Analyses using Routine Data of the German Pension Insurance]. DIE REHABILITATION 2024; 63:107-118. [PMID: 38065547 DOI: 10.1055/a-2192-3476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/18/2024]
Abstract
PURPOSE Cancer diseases are associated with multiple physical, psychosocial, and occupational burdens that jeopardize work participation and must be specifically addressed with rehabilitative interventions. This study addressed the following questions regarding cancer patients whose rehabilitation was covered by German Pension Insurance (GPI): (a) What socio-medical risks existed prior to rehabilitation, (b) how well persons were able to return to work after rehabilitation, and (c) what conditions determined work participation? METHODS We used the rehabilitation statistics database of the German Pension Insurance and included patients with completed medical rehabilitation due to cancer in 2017. Analyses were carried out for the entire group as well as for those differentiated according to their tumor sites (breast, prostate, colon and lung). Work participation was operationalized both via a monthly state up to 24 months after rehabilitation discharge and as a rate of all persons who were employed 12 or 24 months and the 3 preceding months (stable work participation). For the analysis of the influencing factors on stable work participation, multiple logistic regression models with stepwise inclusion were calculated separately for the rates after 12 and 24 months. RESULTS A total of 63,587 data sets were included in the analysis (breast cancer: n=20,545, 32%; prostate: n=6,434, 10%; colon: n=4,727, 7%; lung: n=2,866, 5%). Of the rehabilitation participants 55% (lung), 49% (colon), 46% (breast), and 13% (prostate) had sickness absences of six or more months in the year before rehabilitation. Two years after rehabilitation, return-to-work rates were 66% (breast), 54% (prostate), 50% (colon), and 24% (lung). The strongest factors influencing stable work participation were time of sick leave, wage before rehabilitation and age. CONCLUSION Two years after cancer rehabilitation, 5 to 6 out of 10 persons returned to stable work participation. Relevant influencing factors were the length of sick leave and wages prior to cancer rehabilitation. The results suggest inclusion of more work-related aspects in cancer rehabilitation and greater suppor, especially in the first year post-rehabilitation.
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Affiliation(s)
- David Fauser
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck
| | - Pia Zollmann
- Dezernat Reha-Wissenschaften , Deutsche Rentenversicherung Bund, Berlin
| | - Marco Streibelt
- Dezernat Reha-Wissenschaften , Deutsche Rentenversicherung Bund, Berlin
| | - Matthias Bethge
- Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck
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Klaver KM, Duijts SFA, Geusgens CAV, Aarts MJB, Ponds RWHM, van der Beek AJ, Schagen SB. Neuropsychological test performance and self-reported cognitive functioning associated with work-related outcomes in occupationally active cancer survivors with cognitive complaints. J Cancer Surviv 2024; 18:412-424. [PMID: 35776235 DOI: 10.1007/s11764-022-01223-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 06/06/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE To assess cognitive functioning in occupationally active non-central nervous system cancer survivors with cognitive complaints using neuropsychological tests, and to investigate the association between (1) formally assessed cognitive functioning and self-reported work-related outcomes and (2) self-reported cognitive functioning at work and self-reported work-related outcomes. METHODS Baseline data of a multicenter, randomized controlled trial (n = 279) were used. Associations between neuropsychological test performance (Amsterdam Cognition Scan) and self-reported cognitive functioning (Cognitive Symptom Checklist-work) with work ability (Work Ability Index) and work functioning (Work Role Functioning Questionnaire) were examined using multivariate linear regression. RESULTS Thirty percent of cancer survivors had lower than expected performance on neuropsychological tests. Higher overall neuropsychological test performance was associated with better work ability (Cohen's f2 = 0.014) and physical functioning at work (Cohen's f2 = 0.13). Furthermore, higher motor performance was associated with better work ability (Cohen's f2 = 0.018). In addition, self-reported work-related cognitive complaints were associated with self-reported work-related outcomes (Cohen's f2 = 0.13-0.35). CONCLUSIONS The percentage of cancer survivors with lower than expected performance on neuropsychological tests exceeded the percentage expected in a normal population. This neuropsychological test performance was weakly associated with various aspects of work ability and work functioning. Stronger associations were found between self-reported cognitive functioning at work with self-reported work-related outcomes. IMPLICATIONS FOR CANCER SURVIVORS A cognitive rehabilitation approach that specifically aims at reducing cognitive symptoms at work could be a valuable part of interventions that aim to improve work-related outcomes. Trial registration The study is registered at ClinicalTrials.gov (NCT03900806) at 03 April 2019 (current status: ongoing), https://clinicaltrials.gov/ct2/show/NCT03900806?term=NCT03900806&draw=2&rank=1.
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Affiliation(s)
- Kete M Klaver
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
- Department of Public and Occupational Health, Amsterdam UMC location Vrije Universiteit, Amsterdam Public Health Research Institute, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Saskia F A Duijts
- Department of Public and Occupational Health, Amsterdam UMC location Vrije Universiteit, Amsterdam Public Health Research Institute, De Boelelaan 1117, Amsterdam, The Netherlands
- Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Chantal A V Geusgens
- Department of Clinical and Medical Psychology, Zuyderland Medical Center, Sittard, The Netherlands
| | - Maureen J B Aarts
- Department of Medical Oncology, GROW-School for Oncology and Reproduction, Maastricht University, MC, Maastricht, The Netherlands
| | - Rudolf W H M Ponds
- Department of Medical Psychology, Amsterdam University Medical Center location Vrije Universiteit, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam UMC location Vrije Universiteit, Amsterdam Public Health Research Institute, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Sanne B Schagen
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
- Brain and Cognition Group, University of Amsterdam, Amsterdam, The Netherlands.
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Wechsler S, Ma M, El-Jawahri A, Laws KE, Naticchioni H, Flannery K, Coleman A, Lyons K. Employment-related Education and Support for Cancer Survivors: a Content Analysis of Employment Resources Offered on National Cancer Institute-Designated Cancer Center Websites. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2024; 39:139-146. [PMID: 38051463 DOI: 10.1007/s13187-023-02386-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/11/2023] [Indexed: 12/07/2023]
Abstract
High rates of employment changes and associated concerns among cancer survivors following diagnosis and treatment suggest a need to examine what employment-related educational resources and support are currently being offered to cancer survivors and what gaps exist in those resources. In 2023, we conducted a content analysis of employment resources described on the websites of the NCI-Designated Cancer Centers that provide clinical care (N = 64) through a systematic review procedure using predetermined search terms and a standardized process to examine the availability and accessibility of such resources. Descriptive analyses were conducted to characterize the employment resources identified. In total, 175 employment resources were identified across 49 cancer center websites; 102 (58%) provided patient-facing education/information, 58 (33%) offered a consultation, 14 (8%) offered support groups/classes, and 1 (1%) was classified as "Other." Most (76%) resources were provided internally by the cancer center, and often, more than one discipline was involved, most commonly social work and medicine. These findings are encouraging as they suggest that most (77%) NCI-Designated Cancer Centers recognize employment support as a component of survivorship care. The multidisciplinary nature of the resources identified is supported by moderate evidence that multidisciplinary interventions appear to have the greatest potential to foster a return to work for cancer survivors and align with suggestions made by recent expert groups and guidelines regarding employment support for cancer survivors. Ongoing work is needed to assess the utilization, impact, and equity of available employment resources to optimize work outcomes among cancer survivors.
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Affiliation(s)
- Stephen Wechsler
- Department of Occupational Therapy, MGH Institute of Health Professions, 36 First Avenue, Boston, MA, 02129, USA.
| | - Michele Ma
- Department of Occupational Therapy, MGH Institute of Health Professions, 36 First Avenue, Boston, MA, 02129, USA
| | - Areej El-Jawahri
- Division of Hematology Oncology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Kristen Elizabeth Laws
- Department of Occupational Therapy, MGH Institute of Health Professions, 36 First Avenue, Boston, MA, 02129, USA
| | - Haley Naticchioni
- Department of Occupational Therapy, MGH Institute of Health Professions, 36 First Avenue, Boston, MA, 02129, USA
| | - Kaitlin Flannery
- Department of Occupational Therapy, MGH Institute of Health Professions, 36 First Avenue, Boston, MA, 02129, USA
| | - Alison Coleman
- Department of Occupational Therapy, MGH Institute of Health Professions, 36 First Avenue, Boston, MA, 02129, USA
| | - Kathleen Lyons
- Department of Occupational Therapy, MGH Institute of Health Professions, 36 First Avenue, Boston, MA, 02129, USA
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Heidkamp P, Hiltrop K, Breidenbach C, Kowalski C, Pfaff H, Geiser F, Ernstmann N. Coping with breast cancer during medical and occupational rehabilitation: a qualitative study of strategies and contextual factors. BMC Womens Health 2024; 24:183. [PMID: 38504261 PMCID: PMC10949761 DOI: 10.1186/s12905-024-03012-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 03/05/2024] [Indexed: 03/21/2024] Open
Abstract
PURPOSE This study aimed to gain a deeper understanding of the coping processes of breast cancer survivors (BCSs) during medical and occupational rehabilitation after acute treatment. METHODS This study is part of the mixed-methods Breast Cancer Patients' Return to Work study conducted in Germany. Data were collected through semistructured interviews with 26 female BCSs 5-6 years after their diagnosis. A qualitative content analysis was conducted to investigate the coping strategies and contextual factors of coping of BCSs. RESULTS The participants used different strategies for coping with their breast cancer, namely, approach- versus avoidance-oriented coping and emotion- versus problem-focused coping. During the medical rehabilitation process, coping behavior was used mainly to address disease management and its consequences. During the occupational rehabilitation process, most coping strategies were used to overcome discrepancies between the patient's current work capacity and the job requirements. The contextual factors of coping were in the health, healthcare, work-related, and personal domains. CONCLUSION The study findings provide in-depth insights into the coping processes for BCSs during the rehabilitation phase and highlight the importance of survivorship care after acute cancer treatment. IMPLICATIONS FOR CANCER SURVIVORS The results indicate that BCSs employ approach- and avoidance-oriented strategies to cope with their cancer during rehabilitation. As both attempts are helpful in the short term to cope with physical and emotional consequences of the cancer, healthcare and psychosocial personnel should respect the coping strategies of BCSs while also being aware of the potential long-term negative impact of avoidance-oriented coping on the rehabilitation process.
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Affiliation(s)
- Paula Heidkamp
- University Hospital Bonn, Department for Psychosomatic Medicine and Psychotherapy, Center for Health Communication and Health Services Research, Bonn, Germany.
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Chair of Health Services Research, Cologne, Germany.
- University Hospital Bonn, Center for Integrated Oncology, Bonn, Germany.
| | - Kati Hiltrop
- University Hospital Bonn, Department for Psychosomatic Medicine and Psychotherapy, Center for Health Communication and Health Services Research, Bonn, Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Chair of Health Services Research, Cologne, Germany
- University Hospital Bonn, Center for Integrated Oncology, Bonn, Germany
| | - Clara Breidenbach
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Chair of Health Services Research, Cologne, Germany
- German Cancer Society, Berlin, Germany
| | | | - Holger Pfaff
- University of Cologne, Faculty of Human Sciences & Faculty of Medicine and University Hospital Cologne, Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Chair of Quality Development and Evaluation in Rehabilitation, Cologne, Germany
| | - Franziska Geiser
- University Hospital Bonn, Department of Psychosomatic Medicine and Psychotherapy, Bonn, Germany
| | - Nicole Ernstmann
- University Hospital Bonn, Department for Psychosomatic Medicine and Psychotherapy, Center for Health Communication and Health Services Research, Bonn, Germany
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Chair of Health Services Research, Cologne, Germany
- University Hospital Bonn, Center for Integrated Oncology, Bonn, Germany
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de Boer AG, Tamminga SJ, Boschman JS, Hoving JL. Non-medical interventions to enhance return to work for people with cancer. Cochrane Database Syst Rev 2024; 3:CD007569. [PMID: 38441440 PMCID: PMC10913845 DOI: 10.1002/14651858.cd007569.pub4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
BACKGROUND People with cancer are 1.4 times more likely to be unemployed than people without a cancer diagnosis. Therefore, it is important to investigate whether programmes to enhance the return-to-work (RTW) process for people who have been diagnosed with cancer are effective. This is an update of a Cochrane review first published in 2011 and updated in 2015. OBJECTIVES To evaluate the effectiveness of non-medical interventions aimed at enhancing return to work (RTW) in people with cancer compared to alternative programmes including usual care or no intervention. SEARCH METHODS We searched CENTRAL (the Cochrane Library), MEDLINE, Embase, CINAHL, PsycINFO and three trial registers up to 18 August 2021. We also examined the reference lists of included studies and selected reviews, and contacted authors of relevant studies. SELECTION CRITERIA We included randomised controlled trials (RCTs) and cluster-RCTs on the effectiveness of psycho-educational, vocational, physical or multidisciplinary interventions enhancing RTW in people with cancer. The primary outcome was RTW measured as either RTW rate or sick leave duration measured at 12 months' follow-up. The secondary outcome was quality of life (QoL). DATA COLLECTION AND ANALYSIS Two review authors independently assessed RCTs for inclusion, extracted data and rated certainty of the evidence using GRADE. We pooled study results judged to be clinically homogeneous in different comparisons reporting risk ratios (RRs) with 95% confidence intervals (CIs) for RTW and mean differences (MD) or standardised mean differences (SMD) with 95% CIs for QoL. MAIN RESULTS We included 15 RCTs involving 1477 people with cancer with 19 evaluations because of multiple treatment groups. In this update, we added eight new RCTs and excluded seven RCTs from the previous versions of this review that were aimed at medical interventions. All included RCTs were conducted in high-income countries, and most were aimed at people with breast cancer (nine RCTs) or prostate cancer (two RCTs). Risk of bias We judged nine RCTs at low risk of bias and six at high risk of bias. The most common type of bias was a lack of blinding (9/15 RCTs). Psycho-educational interventions We found four RCTs comparing psycho-educational interventions including patient education and patient counselling versus care as usual. Psycho-educational interventions probably result in little to no difference in RTW compared to care as usual (RR 1.09, 95% CI 0.96 to 1.24; 4 RCTs, 512 participants; moderate-certainty evidence). This means that in the intervention and control groups, approximately 625 per 1000 participants may have returned to work. The psycho-educational interventions may result in little to no difference in QoL compared to care as usual (MD 1.47, 95% CI -2.38 to 5.32; 1 RCT, 124 participants; low-certainty evidence). Vocational interventions We found one RCT comparing vocational intervention versus care as usual. The evidence was very uncertain about the effect of a vocational intervention on RTW compared to care as usual (RR 0.94, 95% CI 0.78 to 1.13; 1 RCT, 34 participants; very low-certainty evidence). The study did not report QoL. Physical interventions Four RCTs compared a physical intervention programme versus care as usual. These physical intervention programmes included walking, yoga or physical exercise. Physical interventions likely increase RTW compared to care as usual (RR 1.23, 95% CI 1.08 to 1.39; 4 RCTs, 434 participants; moderate-certainty evidence). This means that in the intervention group probably 677 to 871 per 1000 participants RTW compared to 627 per 1000 in the control group (thus, 50 to 244 participants more RTW). Physical interventions may result in little to no difference in QoL compared to care as usual (SMD -0.01, 95% CI -0.33 to 0.32; 1 RCT, 173 participants; low-certainty evidence). The SMD translates back to a 1.8-point difference (95% CI -7.54 to 3.97) on the European Organisation for Research and Treatment of Cancer Quality of life Questionnaire Core 30 (EORTC QLQ-C30). Multidisciplinary interventions Six RCTs compared multidisciplinary interventions (vocational counselling, patient education, patient counselling, physical exercises) to care as usual. Multidisciplinary interventions likely increase RTW compared to care as usual (RR 1.23, 95% CI 1.09 to 1.33; 6 RCTs, 497 participants; moderate-certainty evidence). This means that in the intervention group probably 694 to 844 per 1000 participants RTW compared to 625 per 1000 in the control group (thus, 69 to 217 participants more RTW). Multidisciplinary interventions may result in little to no difference in QoL compared to care as usual (SMD 0.07, 95% CI -0.14 to 0.28; 3 RCTs, 378 participants; low-certainty evidence). The SMD translates back to a 1.4-point difference (95% CI -2.58 to 5.36) on the EORTC QLQ-C30. AUTHORS' CONCLUSIONS Physical interventions (four RCTs) and multidisciplinary interventions (six RCTs) likely increase RTW of people with cancer. Psycho-educational interventions (four RCTs) probably result in little to no difference in RTW, while the evidence from vocational interventions (one RCT) is very uncertain. Psycho-educational, physical or multidisciplinary interventions may result in little to no difference in QoL. Future research on enhancing RTW in people with cancer involving multidisciplinary interventions encompassing a physical, psycho-educational and vocational component is needed, and be preferably tailored to the needs of the patient.
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Affiliation(s)
- Angela Gem de Boer
- Department of Public and Occupational Health, University of Amsterdam, Amsterdam Public Health Research Institute, Coronel Institute of Occupational Health, Amsterdam UMC, Location AMC, Amsterdam, Netherlands
| | - Sietske J Tamminga
- Department of Public and Occupational Health, University of Amsterdam, Amsterdam Public Health Research Institute, Coronel Institute of Occupational Health, Amsterdam UMC, Location AMC, Amsterdam, Netherlands
| | - Julitta S Boschman
- Cochrane Work, Department of Public and Occupational Health, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam UMC, Location AMC, Amsterdam, Netherlands
| | - Jan L Hoving
- Cochrane Work, Department of Public and Occupational Health, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam UMC, Location AMC, Amsterdam, Netherlands
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Fauser D, Wienert J, Schmielau J, Bethge M. Work-Related Medical Rehabilitation for Cancer Patients Receiving Non-postacute Rehabilitation. DEUTSCHES ARZTEBLATT INTERNATIONAL 2023; 120:841-842. [PMID: 38261355 PMCID: PMC10824495 DOI: 10.3238/arztebl.m2023.0217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 09/20/2023] [Accepted: 09/20/2023] [Indexed: 01/24/2024]
Affiliation(s)
- David Fauser
- Universität zu Lübeck, Institut für Sozialmedizin und Epidemiologie, Lübeck,
| | | | | | - Matthias Bethge
- Universität zu Lübeck, Institut für Sozialmedizin und Epidemiologie, Lübeck,
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13
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Viseux M, Johnson S, Roquelaure Y, Bourdon M. Breast Cancer Survivors' Experiences of Managers' Actions During the Return to Work Process: A Scoping Review of Qualitative Studies. JOURNAL OF OCCUPATIONAL REHABILITATION 2023; 33:687-701. [PMID: 37010716 DOI: 10.1007/s10926-023-10101-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/03/2023] [Indexed: 06/19/2023]
Abstract
PURPOSE Managers' actions can facilitate the return to work (RTW) process for breast cancer survivors (BCS). However, data on BCS' experiences of managers' actions regarding RTW are dispersed across multiple qualitative studies and do not offer useful insights for managers to support employees returning to work. This study aimed to summarize and map managers' actions experienced by BCS over three RTW phases (before, during, after) and categorize them as facilitating or hindering RTW. METHODS A scoping review of qualitative studies was conducted. Four databases (MEDLINE, PsycINFO, Cochrane Library, EMBASE) were systematically searched for articles published between 2000 and 2022. Studies and participant characteristics were extracted using an excel spreadsheet. A thematic analysis with a predominantly deductive and semantic approach was conducted. RESULTS Twenty-nine studies were included after screening 1042 records. Five themes were generated from the data. Two themes addressed the phase 'before RTW': 'managers' interpersonal skills' and 'preparing for RTW'; three in the 'during RTW' phase: 'managers' interpersonal skills', 'offering work flexibility', and 'offering work accommodations', and only one, 'paying attention to follow-up', was addressed in the 'after RTW' phase. CONCLUSION This review mapped managers' actions experienced by BCS in three phases of the RTW process. Results suggested that, according to BCS, managers need to mobilize specific skills to provide appropriate support during the RTW process. Further research is needed to better understand the skills underlying managers' actions facilitating the RTW process.
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Affiliation(s)
- Marie Viseux
- UMR INSERM 1246 SPHERE "methodS in Patient-Centered Outcomes and HEalth ResEarch", Nantes University, University of Tours, 22 Boulevard Benoni Goullin, Nantes, France.
| | - Stacey Johnson
- Integrated Center for Oncology, Boulevard Jacques Monod, 44805, Nantes, Saint-Herblain, France
- Université Côte d'Azur, LAMHESS, 261 Boulevard du Mercantour, 06200, Nice, France
| | - Yves Roquelaure
- University of Angers, University of Rennes, Inserm, EHESP, IRSET (Institut de Recherche en Santé, Environnement Et Travail) - UMR_S 1085, SFR ICAT, F-49000, Angers, France
- UMR Inserm S 1085, EHESP, IRSET (Institut de Recherche en Santé, Environnement Et Travail) - University of Angers, CHU Angers, University of Rennes, SFR ICAT, F-49000, Angers, France
| | - Marianne Bourdon
- UMR INSERM 1246 SPHERE "methodS in Patient-Centered Outcomes and HEalth ResEarch", Nantes University, University of Tours, 22 Boulevard Benoni Goullin, Nantes, France
- Integrated Center for Oncology, Boulevard Jacques Monod, 44805, Nantes, Saint-Herblain, France
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14
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What Does Cochrane Say About Rehabilitation for Cancer? Physiother Can 2023; 75:395. [PMID: 38037583 PMCID: PMC10686307 DOI: 10.3138/ptc-75.4-cochrane] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
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15
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Hummel E, Cogne M, Lange M, Lecuyer A, Joly F, Gouranton V. VR for Vocational and Ecological Rehabilitation of Patients With Cognitive Impairment: A Survey. IEEE Trans Neural Syst Rehabil Eng 2023; 31:4167-4178. [PMID: 37862281 DOI: 10.1109/tnsre.2023.3324131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2023]
Abstract
Cognitive impairment arises from various brain injuries or diseases, such as traumatic brain injury, stroke, schizophrenia, or cancer-related cognitive impairment. Cognitive impairment can be an obstacle for patients to the return-to-work. Research suggests various interventions using technology for cognitive and vocational rehabilitation. The present work offers an overview of sixteen vocational or ecological VR-based clinical studies among patients with cognitive impairment. The objective is to analyze these studies from a VR perspective focusing on the VR apparatus and tasks, adaptivity, transferability, and immersion of the interventions. Our results highlight how a higher level of immersion could bring the participants to a deeper level of engagement and transferability, rarely assessed in current literature, and a lack of adaptivity in studies involving patients with cognitive impairments. From these considerations, we discuss the challenges of creating a standardized yet adaptive protocol and the perspectives of using immersive technologies to allow precise monitoring, personalized rehabilitation and increased commitment.
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Liu WH, Fox J, Yates P. Work-related experiences of prostate cancer survivors in Australia: a qualitative study. BMC Public Health 2023; 23:1806. [PMID: 37716940 PMCID: PMC10505317 DOI: 10.1186/s12889-023-16706-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 09/05/2023] [Indexed: 09/18/2023] Open
Abstract
BACKGROUND Prostate cancer (PCa) is the most diagnosed cancer in Australian men, and the number of survivors is growing with advances in diagnosis and treatment. Work participation following PCa diagnosis and treatment becomes a significant aspect of quality of life and survivorship. Using a qualitative phenomenological approach, we explored the work-related experiences of PCa survivors in Australia. METHODS Semi-structured telephone interviews were conducted with 16 men (6 salaried employees, 10 self-employed; 8 diagnosed ≥ 5 years) purposively sampled from a community setting. Interviews were inductively analysed. RESULTS Five main themes emerged: motivations to work; treatment decisions and work; the effects of PCa and its treatment on ability to participate in work; being an employee versus being self-employed; and personal agency. PCa and its treatment side-effects were detrimental to men's work capacity and ability, and could persist over an extended period. Most men expressed a strong desire to retain work or return to work. Discussions with healthcare professionals about work-related consequences were largely missing when treatment decisions were made. Self-employed men faced greater challenges than their salaried counterparts due to high financial burden and limited social and business support. Family, workplace and wider community support, and self-care, enhanced men's work participation experiences. CONCLUSIONS PCa and its treatment substantially and persistently impacted men's working lives, and their experiences were diverse and multifaceted. Self-employed and long-term PCa survivors face greater challenges and are at high risk of poor work outcomes. A systematic approach and involvement of stakeholders at all levels is required to support ongoing work participation.
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Affiliation(s)
- Wei-Hong Liu
- Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia.
- Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology, Kelvin Grove, QLD, 4059, Australia.
| | - Jennifer Fox
- Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Patsy Yates
- Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
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Magnavita N, Di Prinzio RR, Meraglia I, Vacca ME, Arnesano G, Merella M, Mauro I, Iuliano A, Terribile DA. Supporting Return to Work after Breast Cancer: A Mixed Method Study. Healthcare (Basel) 2023; 11:2343. [PMID: 37628540 PMCID: PMC10454012 DOI: 10.3390/healthcare11162343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/14/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023] Open
Abstract
Breast cancer (BC) is the most common invasive cancer in the world. Most BC survivors (BCSs) continue working while dealing with cancer-related disabilities. BCSs' return-to-work (RTW) after cancer treatment is an important stage of their recovery and is associated with a higher survival rate. In this study, we addressed the RTW of BCSs with the intention of facilitating this process through direct action in the workplace. Thirty-two women who requested assistance from January to December 2022 were enrolled in the study. Semi-structured interviews and medical examinations were conducted by a team of three physicians. Interviews were analyzed using Thematic Analysis. Moreover, a quantitative cross-sectional study was conducted to compare the health status of BCSs with that of a control group of 160 working women, using standardized questionnaires on work ability, fatigue, sleep problems, anxiety, depression, and happiness. BCSs were also asked to rate the level of organizational justice they perceived at work prior to their illness. From the qualitative analysis emerged three facilitating/hindering themes: (1) person-related factors, (2) company-related factors, and (3) society-related factors. In the quantitative analysis, BCSs had significantly higher scores for anxiety, depression, sleep problems and fatigue, and lower levels of happiness than controls. The RTW of BCSs entails adapting working conditions and providing adequate support. The work-related analysis of each case made it possible to highlight the measures that need to be taken in the workplace to promote RTW. The treatment of cancer should be paired with advice on the best way to regain the ability to work.
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Affiliation(s)
- Nicola Magnavita
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Reparata Rosa Di Prinzio
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
- Alta Scuola di Economia e Management dei Sistemi Sanitari (ALTEMS), Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Igor Meraglia
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
| | - Maria Eugenia Vacca
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
| | - Gabriele Arnesano
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
| | - Marco Merella
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
| | - Igor Mauro
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
| | - Angela Iuliano
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
| | - Daniela Andreina Terribile
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
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Hiltrop K, Heidkamp P, Breidenbach C, Kowalski C, Bruns G, Ernstmann N. Cancer rehabilitation support by cancer counselling centres (CARES): study protocol of a quasi-experimental feasibility study. BMJ Open 2023; 13:e067868. [PMID: 37567747 PMCID: PMC10441687 DOI: 10.1136/bmjopen-2022-067868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 07/07/2023] [Indexed: 08/13/2023] Open
Abstract
INTRODUCTION While maintaining or restoring work ability after a cancer diagnosis is an essential aim of the rehabilitation process for working-age patients, problems can arise during the return to work (RTW) or when retaining work. Counselling could provide support for patients with or after cancer with employment-related questions (eg, questions related to RTW and work retention). Outpatient psychosocial cancer counselling centres in Germany offer counselling on work-related questions; however, resources for this are limited. This protocol presents a feasibility study of an intensified needs-based counselling intervention that supports those seeking employment-related advice. METHODS AND ANALYSIS The CARES (cancer rehabilitation support by cancer counselling centres) project is a feasibility study for a newly developed counselling intervention. The intervention is being developed as part of the project and piloted in about 20 outpatient cancer counselling centres. The CARES study has a quasi-experimental pre-post design with a control cohort. First, patients who undergo regular counselling are recruited. Second, after the counsellors have been trained for the newly developed intervention, participants for the intervention group are recruited from the cancer counselling centres. Quantitative and formative evaluations will be performed in accordance with the existing guidelines. The quantitative evaluation comprises three patient surveys (at the beginning of the counselling process, 3 months into the counselling process and, for the intervention group, at the end of the counselling process) and routine data of the counselling process. The formative evaluation includes interviews with patients, counsellors and other stakeholders, as well as participatory observations of counselling sessions. ETHICS AND DISSEMINATION Approval has been obtained from the ethics committee of the Medical Faculty of the University Bonn (061/22; 09.04.2022). A data protection concept ensures adherence to data protection regulations for the handled data. The dissemination strategies include discussing the results with the cancer counselling centres. TRIAL REGISTRATION NUMBER German Clinical Trials Register (DRKS00028121); Pre-results.
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Affiliation(s)
- Kati Hiltrop
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Chair of Health Services Research, Cologne, Germany
- University Hospital Bonn, Department for Psychosomatic Medicine and Psychotherapy, Center for Health Communication and Health Services Research, Bonn, Germany
| | - Paula Heidkamp
- University Hospital Bonn, Department for Psychosomatic Medicine and Psychotherapy, Center for Health Communication and Health Services Research, Bonn, Germany
| | | | | | - Gudrun Bruns
- Cancer Counseling Center of the Tumor Network in Muensterland (TiM), Muenster, Germany
| | - Nicole Ernstmann
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Chair of Health Services Research, Cologne, Germany
- University Hospital Bonn, Department for Psychosomatic Medicine and Psychotherapy, Center for Health Communication and Health Services Research, Bonn, Germany
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Zecena Morales C, Lisy K, McDowell L, Piper A, Jefford M. Return to work in head and neck cancer survivors: a systematic review. J Cancer Surviv 2023; 17:468-483. [PMID: 36396907 DOI: 10.1007/s11764-022-01298-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 11/08/2022] [Indexed: 11/18/2022]
Abstract
PURPOSE Cancer survivors face higher rates of unemployment compared with individuals without a history of cancer. Compared to other cancer types, head and neck cancer (HNC) survivors face unique disease and treatment-specific issues that may limit return to work (RTW). This review aimed to determine employment outcomes of HNC survivors post-treatment and identify factors associated with RTW. METHODS A systematic search was conducted in MEDLINE, CINAHL and PsycINFO in December 2021. Inclusion criteria included adults (≥ 18 years); completed treatment for HNC; data available on RTW post-treatment. Both quantitative and qualitative studies were considered. Studies were critically appraised and data synthesised narratively. RESULTS Twenty-nine publications were included: 22 quantitative, four qualitative and three mixed methods. The proportion of HNC survivors who RTW ranged from 32 to 90%, with participants taking 3.6-11 months to RTW. Working in a professional role and having a supportive work environment were positively associated with RTW. CONCLUSIONS The proportion of HNC survivors who RTW varies significantly which may be due to the heterogeneity between the studies including difference in clinical characteristics of the participants and/or sample size. Future studies that are longitudinal, adequately powered and measure a range of clinical and demographic variables are needed to better understand the RTW experience and assist development of effective RTW strategies. IMPLICATIONS FOR CANCER SURVIVORS This review suggests potential areas for intervention, including enhanced symptom management and engaging with employers to foster supportive work environments to support RTW of HNC survivors.
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Affiliation(s)
- Claudia Zecena Morales
- Department of Health Services Research, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia
| | - Karolina Lisy
- Department of Health Services Research, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia
- Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, VIC, Australia
| | - Lachlan McDowell
- Division of Radiation Oncology, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia
| | - Amanda Piper
- Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia
| | - Michael Jefford
- Department of Health Services Research, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia.
- Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia.
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, VIC, Australia.
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Ritzmann R, Giuliani A, Centner C, Mauch M, Heitner A, Paul J, Egloff C, Ramsenthaler C, Wenning M. Development and validation of a clinical prediction model for return to work after arthroscopic anterior crucial ligament reconstruction. Knee 2023; 42:107-124. [PMID: 36996747 DOI: 10.1016/j.knee.2023.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 02/06/2023] [Accepted: 03/09/2023] [Indexed: 04/01/2023]
Abstract
BACKGROUND Occupational reintegration after anterior cruciate ligament (ACL) rupture is an important clinical issue including economic and health-related perspectives. This study aims to develop and validate a clinical prediction model of return to work in patients with ACL reconstruction surgery considering evidence-based clinical, anthropometric and occupational factors. METHODS Data of 562 patients with an ACL rupture receiving an arthroscopic ACL reconstruction were used for analysis. A model for the binary outcome of experiencing an inability to work period of less or more than 14 days (model 1), and a model for finding predictor variables that are linearly associated with a continuous longer inability to work period of over 14 days (model 2) was calculated. Pre-operative determinants including patient characteristics and peri-operative factors were used as predictors for both models. RESULTS For model 1, the highest increase in odds was observed for the occupational type of work, followed by injury of the medial collateral ligament together with partial weight bearing. Small protective effects were observed for female sex, meniscal suture and work with light occupational strain. The type of occupational work, together with revision surgery, a longer duration of limited range of motion and the presence of cartilage therapy were risk factors for longer inability to work. Discrimination and calibration statistics were satisfactory in internal validation. CONCLUSION Within the framework of clinical consideration, these prediction models will serve as an estimator for patients, their treating physicians and the socioeconomic partners to forecast the individual cost and benefit of ACL injury.
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Affiliation(s)
- Ramona Ritzmann
- Rennbahnklinik, Muttenz, Switzerland; University of Freiburg, Freiburg, Germany
| | | | - Christoph Centner
- Rennbahnklinik, Muttenz, Switzerland; University of Freiburg, Freiburg, Germany.
| | | | | | | | | | - Christina Ramsenthaler
- University of Freiburg, Freiburg, Germany; ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Markus Wenning
- Department of Orthopedic and Trauma Surgery, University Hospital Freiburg, Germany
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21
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Wilson TN, Nambiema A, Porro B, Descatha A, Aublet-Cuvelier A, Evanoff B, Roquelaure Y. Effectiveness of Physical Activity Interventions on Return to Work After a Cancer Diagnosis: A Systematic Review and Meta-analysis. JOURNAL OF OCCUPATIONAL REHABILITATION 2023; 33:4-19. [PMID: 35779184 PMCID: PMC10025244 DOI: 10.1007/s10926-022-10052-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 06/02/2022] [Indexed: 06/15/2023]
Abstract
Purpose The aim of this study was to assess the effectiveness of physical activity (PA) interventions on return to work (RTW) in cancer survivors, compared to usual care, and to determine the dose of PA needed to improve this outcome. Methods A systematic review and meta-analysis were conducted according to PRISMA guidelines. Six electronic databases including PubMed, Embase, Web of Science, CENTRAL, PsycINFO, and Scopus were searched to identify studies, and completed by a search of grey literature and health organization websites. Two authors performed screening, selection, and data extraction independently. Study and intervention characteristics were extracted and summarized. Pooled risk ratio (RR) was estimated using a weight random-effects model with 95% confidence intervals (CIs). Results A total of 2655 records were identified, of which 8 intervention studies were included. The sample size of the included studies varied between 41 and 240, giving a total of 1087 participants aged between 18 and 75 years. Compared with usual care, PA interventions had a significant positive effect on RTW among cancer survivors with a pooled RR of 1.29 (95% CI 1.17, 1.42). We found that PA interventions (aerobic and resistance exercises) with an exercise dose between 7.6 METs.h/week and 15 METs.h/week, consisting in 50-60 min per session of moderate to vigorous physical exercise, twice a week seems relevant in improving RTW. Conclusions Our results showed, with moderate quality evidence that PA interventions are more effective than usual care in increasing the rate of RTW in cancer survivors. SYSTEMATIC REVIEW REGISTRATION: PROSPERO Registration Number, CRD42020203614.
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Affiliation(s)
- Têtê Norbert Wilson
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, environnement et travail) - UMR_S 1085, 49000, Angers, France.
| | - Aboubakari Nambiema
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, environnement et travail) - UMR_S 1085, 49000, Angers, France
| | - Bertrand Porro
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, environnement et travail) - UMR_S 1085, 49000, Angers, France
| | - Alexis Descatha
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, environnement et travail) - UMR_S 1085, 49000, Angers, France
| | - Agnès Aublet-Cuvelier
- Direction des Etudes et de Recherches, INRS (Institut National de Recherche Et de Sécurité), 1 rue du Morvan, CS60027, 54519, Vandœuvre-lès-Nancy, France
| | - Bradley Evanoff
- Division of General Medical Sciences, Washington University School of Medicine, St. Louis, MO, 63310, USA
| | - Yves Roquelaure
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, environnement et travail) - UMR_S 1085, 49000, Angers, France
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22
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Ravinskaya M, Verbeek JH, Langendam M, Madan I, Verstappen SMM, Kunz R, Hulshof CTJ, Hoving JL. Which outcomes should always be measured in intervention studies for improving work participation for people with a health problem? An international multistakeholder Delphi study to develop a core outcome set for Work participation (COS for Work). BMJ Open 2023; 13:e069174. [PMID: 36792339 PMCID: PMC9933745 DOI: 10.1136/bmjopen-2022-069174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
OBJECTIVE Synthesising evidence of the effects of interventions to improve work participation among people with health problems is currently difficult due to heterogeneity in outcome measurements. A core outcome set for work participation is needed. STUDY DESIGN AND SETTING Following the Core Outcome Measures in Effectiveness Trials methodology, we used a five-step approach to reach international multistakeholder consensus on a core outcome set for work participation. Five subgroups of stakeholders took part in two rounds of discussions and completed two Delphi voting rounds on 26 outcomes. A consensus of ≥80% determined core outcomes and 50%-80% consensus was required for candidate outcomes. RESULTS Fifty-eight stakeholders took part in the Delphi rounds. Core outcomes were: 'any type of employment including self-employment', 'proportion of workers that return to work after being absent because of illness' and 'time to return to work'. Ten candidate outcomes were proposed, among others: 'sustainable employment', 'work productivity' and 'workers' perception of return to work'. CONCLUSION As a minimum, all studies evaluating the impact of interventions on work participation should include one employment outcome and two return to work outcomes if workers are on sick leave prior to the intervention.
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Affiliation(s)
- Margarita Ravinskaya
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Cochrane Work, Amsterdam UMC Location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Jos H Verbeek
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Cochrane Work, Amsterdam UMC Location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Miranda Langendam
- Department Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC Location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Ira Madan
- Guy's and St Thomas' NHS Foundation Trust, London, UK
- King's College London Faculty of Life Sciences and Medicine, London, UK
| | - Suzanne M M Verstappen
- Centre for Epidemiology Versus Arthritis, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Manchester University NHS Foundation Trust, NIHR Manchester Biomedical Research Centre, Manchester, UK
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
| | - Regina Kunz
- Research Unit EbIM, Evidence Based Insurance Medicine, Division of Clinical Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Carel T J Hulshof
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam UMC Location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Jan L Hoving
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Cochrane Work, Amsterdam UMC Location AMC, University of Amsterdam, Amsterdam, The Netherlands
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Kunz KR, Turcotte K, Pawer S, Zheng A, Purewal A, Wellar A, Karmali S, Garis L, Thomas LS, Pike I. Cancer in female firefighters: The clinicobiological, psychological, and social perspectives. Front Public Health 2023; 11:1126066. [PMID: 37124817 PMCID: PMC10130581 DOI: 10.3389/fpubh.2023.1126066] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 03/13/2023] [Indexed: 05/02/2023] Open
Abstract
Objectives This study explored how demographic characteristics, life experiences, and firefighting exposures have an impact on cancer among female firefighters, and described the types and biologic characteristics of cancers as reported by women in the fire service. Methods The online survey was available from June 2019 to July 2020. Questions related to demographic characteristics, lifestyle factors, firefighting exposures, and cancer diagnoses. Descriptive analyses characterized variables by the presence or absence of cancer. Qualitative data provided insight into both firefighting and cancer experiences among women. Results There were 1,344 female firefighter respondents from 12 different countries, 256 of whom provided information on their cancer diagnosis. North American respondents made up 92% of the total. Those with cancer were older, had been in the fire service longer, had more career fires and toxic exposures, and were less likely to still be in active service. They also reported more tobacco use, and more full-term pregnancies. There were no differences in family history of cancer between the two groups. The average age at diagnosis was 39.0 years. The major types of cancer reported included breast (25.4%), cervical (21.1%), melanoma (20.7%), base cell/skin (16.4%), and uterine (14.8%). The cancer was detected when seeking medical attention for symptoms (42.1%), during routine health screening (29.8%), and during specific cancer screening (28.1%). The stage of cancer was reported by 44.5%, and 30.9% included the histopathological grade. Treatments included surgery (72.7%), chemotherapy (14.8%), radiotherapy (13.7%), and observation (13.7%). Challenges associated with cancer included psychosocial (33.2%), financial (18.8%), physical (6.6%), and spiritual (6.3%). Concerns about reporting a cancer experience to their employer included the desire to keep health information private (11.3%), a feeling of vulnerability (7.4%), and being perceived as weak (7.0%). Lack of support from their employer or insurer was also noted. Conclusion Female firefighters experienced a wide variety of different types of cancers which may come earlier than similar cancers in the public. These findings can help inform resource allocation, the development of new policies, and the need for broader presumptive coverage to support female firefighters diagnosed with cancer.
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Affiliation(s)
| | - Kate Turcotte
- BC Injury Research and Prevention Unit, British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada
- *Correspondence: Kate Turcotte,
| | - Samantha Pawer
- BC Injury Research and Prevention Unit, British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Alex Zheng
- BC Injury Research and Prevention Unit, British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Amanat Purewal
- BC Injury Research and Prevention Unit, British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Alyssa Wellar
- BC Injury Research and Prevention Unit, British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Shazya Karmali
- BC Injury Research and Prevention Unit, British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Len Garis
- BC Injury Research and Prevention Unit, British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada
- School of Culture, Media, and Society, University of the Fraser Valley, Abbotsford, BC, Canada
| | | | - Ian Pike
- BC Injury Research and Prevention Unit, British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada
- Department of Pediatrics, The University of British Columbia, Vancouver, BC, Canada
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Paltrinieri S, Costi S, Pellegrini M, Díaz Crescitelli ME, Vicentini M, Mancuso P, Giorgi Rossi P, Fugazzaro S, Mazzini E, Escorpizo R, Ghirotto L. Adaptation of the Core Set for Vocational Rehabilitation for Cancer Survivors: A Qualitative Consensus-Based Study. JOURNAL OF OCCUPATIONAL REHABILITATION 2022; 32:718-730. [PMID: 35334038 PMCID: PMC8949826 DOI: 10.1007/s10926-022-10033-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/27/2022] [Indexed: 06/14/2023]
Abstract
PURPOSE The Core Set for Vocational Rehabilitation (CS-VR) of the International Classification of Functioning, Disability and Health (ICF) describes the work functioning of individuals in need of VR. We aimed to adapt the CS-VR from the perspective of cancer survivors (CSs) and stakeholders, developing a CS-VR-Onco. METHODS We held five focus groups with 17 CSs who were employed at the time of diagnosis, to discuss their work reintegration experiences. After analyzing the focus group conversations, the CS-VR-Onco was developed. During a group interview, eleven stakeholders explored barriers/facilitations in assessing the work functioning of CSs by using the CS-VR-Onco. We applied the framework method and thematic analysis. RESULTS For the focus groups, the CS-VR-Onco of 85 categories emerged, and the ICF chapters of Mental functions, Exercise and tolerance functions, Interpersonal interactions and relationships, Major life areas, General tasks and demands, Mobility, Support and relationships, and Attitudes were prioritized. For the group interview, stakeholders' perspectives can be synthetized into two themes: close to the lived experience and usability criteria. Stakeholders confirmed the categories of the CS-VR-Onco, a checklist that should be used through an integrated approach across multiple disciplines. CONCLUSIONS The adapted CS-VR-Onco reflects the CSs' lived experiences of work reintegration and the factors that have influenced this process. The CS-VR-Onco was described as complete and usable through an integrated approach.
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Affiliation(s)
- Sara Paltrinieri
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Risorgimento 80, 42123, Reggio Emilia, Italy
| | - Stefania Costi
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Risorgimento 80, 42123, Reggio Emilia, Italy.
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, Università di Modena e Reggio Emilia, 41100, Modena, Italy.
| | - Martina Pellegrini
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Risorgimento 80, 42123, Reggio Emilia, Italy
| | - Matías Eduardo Díaz Crescitelli
- Qualitative Research Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Viale Umberto I 50, 42123, Reggio Emilia, Italy
| | - Massimo Vicentini
- Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, Italy
| | - Pamela Mancuso
- Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, Italy
| | - Paolo Giorgi Rossi
- Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, Italy
| | - Stefania Fugazzaro
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Risorgimento 80, 42123, Reggio Emilia, Italy
| | - Elisa Mazzini
- Medical Directorate, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, Italy
| | - Reuben Escorpizo
- Department of Rehabilitation and Movement Science, College of Nursing and Health Sciences, University of Vermont, Burlington, VT, 05401, USA
- Swiss Paraplegic Research, Nottwil, Switzerland
| | - Luca Ghirotto
- Qualitative Research Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Viale Umberto I 50, 42123, Reggio Emilia, Italy
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25
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Chen KB, Yen T, Sun W, Tevaarwerk AJ, Wiegmann DA, Heidrich SM, Sesto ME. Usage of a Web-Based Workplace and Symptom Self-Management Intervention Tool to Improve Work Ability for Breast Cancer Survivors. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:1824-1833. [PMID: 34476769 DOI: 10.1007/s13187-021-02048-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/30/2021] [Indexed: 06/13/2023]
Abstract
This work aimed to evaluate the usage of a web-based intervention (WISE: Work ability Improvement through Symptom and Ergonomic strategies) developed to improve work ability for women recently diagnosed with breast cancer. Twenty-two women undergoing adjuvant treatment for breast cancer were provided access to WISE. This website includes content pages (e.g., information on ergonomics, symptom management, and other work-related resources) and worksheets (e.g., journals to track symptoms or goals). It could be personalized based on individual work activities and symptoms. Measures assessed at 3 months included usage of the website and perceived usefulness. Thirteen of the 22 participants (60%) accessed WISE; 11 personalized their information. Content and worksheet pages had 97 and 79 visits, respectively. Most frequently visited pages were "setting goals" (i.e., prioritize and track symptoms; 45 visits) and "steps to creating your WISE plan" (i.e., incorporate symptom and ergonomic strategies; 16 visits). Median duration time was 11.05 (range 0.35-79.55) minutes. Usefulness of the content and worksheet pages assessed via a 7-point Likert scale (1 = strongly disagree, 7 = strongly agree) was 5.08 (SD = 1.59) and 4.26 (SD = 2.03), respectively. Participants were likely to recommend WISE to other women undergoing cancer treatment (mean = 6.11; SD = 1.05). The majority of participants personalized WISE work and symptom strategies. Overall, participants agreed that WISE content pages were useful and would recommend WISE for other breast cancer survivors. Results support that majority of breast cancer survivors, undergoing treatment with curative intent, accessed a web-based intervention that provided personalized information on workplace and symptom strategies.
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Affiliation(s)
- Karen B Chen
- Fitts Department of Industrial and Systems Engineering, North Carolina State University, Fitts-Woolard Hall, 915 Partners Way, Raleigh, NC, 27695, USA.
| | - Thomas Yen
- Department of Industrial and Systems Engineering, University of Wisconsin, Engineering Centers Building, 1550 Engineering Drive, Madison, WI, 53706, USA
| | - Wenjun Sun
- Department of Industrial and Systems Engineering, University of Wisconsin, Engineering Centers Building, 1550 Engineering Drive, Madison, WI, 53706, USA
| | - Amye J Tevaarwerk
- Department of Medicine, University of Wisconsin Carbone Cancer Center, 6037 Wisconsin Institute Medical Research, 1111 Highland Ave, Madison, WI, 53705, USA
| | - Douglas A Wiegmann
- Department of Industrial and Systems Engineering, University of Wisconsin, 3214 Mechanical Engineering Building, 1513 University Avenue, Madison, WI, 53706, USA
| | - Susan M Heidrich
- School of Nursing, Clinical Science Center, University of Wisconsin, 600 Highland Avenue, Madison, WI, 53792, USA
| | - Mary E Sesto
- Department of Medicine, School of Medicine and Public Health, 6057 Wisconsin Institute Medical Research, 1111 Highland Ave, Madison, WI, 53705, USA
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Salit RB, Schoeppner K, De Biase C, Mohammed J, Gonzales AL, Hashmi SK, Gea-Banacloche J, Savani BN, Carpenter PA, Syrjala KL. American Society for Transplantation and Cellular Therapy Return to Work Guidance Committee Recommendations for Health Care Providers Who Take Care of Hematopoietic Cell Transplantation Patients. Transplant Cell Ther 2022; 28:822-828. [PMID: 36184059 DOI: 10.1016/j.jtct.2022.09.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 12/24/2022]
Abstract
Hematopoietic cell transplantation (HCT) health care providers report a desire to improve long-term outcomes and quality of life for their patients. One of the items frequently cited by patients in terms of transitioning from being a patient back to pre-HCT life is return to work (RTW). However, these patients report little support from their health care providers in facilitating this process, and only 50% to 60% achieve RTW, at a median of 3 years post-HCT. Barriers are physical, psychological, and logistical, as well as poor communication between the patient and their employer. We convened a group of experts in survivorship, rehabilitation, social work, and psychology to draft an evidence-based document to assist health care providers in guiding their patients' RTW journey. Guidance is drawn from the existing literature for HCT and general cancer patients and is divided into pre-HCT, peri-HCT, and post-HCT categories. Collaboration among health care providers, patients, and their employers is key to this transition. Suggested referrals and evaluations also are provided. The goal is for this guidance to be continually updated as we advance the field with more HCT-specific literature.
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Affiliation(s)
- Rachel B Salit
- Fred Hutchinson Cancer Center, Seattle, Washington; University of Washington Medical Center, Seattle, Washington.
| | | | | | - Jaleel Mohammed
- Rehabilitation Association for Hematopoietic Cell Transplantation, Sheffield, United Kingdom; Lincolnshire Community Health Service NHS Trust, Lincoln, United Kingdom
| | | | - Shahrukh K Hashmi
- Mayo Clinic, Rochester, Minnesota; SSMC, Abu Dhabi, United Arab Emirates
| | | | | | - Paul A Carpenter
- Vanderbilt University Medical Center, Nashville, Tennessee; Seattle Children's Medical Center, Seattle, Washington
| | - Karen L Syrjala
- Fred Hutchinson Cancer Center, Seattle, Washington; University of Washington Medical Center, Seattle, Washington
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27
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Ravinskaya M, Verbeek JH, Langendam MW, Madan I, Verstappen SMM, Kunz R, Hulshof CTJ, Hoving JL. Preferred Methods of Measuring Work Participation: An International Survey Among Trialists and Cochrane Systematic Reviewers. JOURNAL OF OCCUPATIONAL REHABILITATION 2022; 32:620-628. [PMID: 35347539 PMCID: PMC9668767 DOI: 10.1007/s10926-022-10031-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/14/2022] [Indexed: 06/14/2023]
Abstract
Purpose Heterogeneity in work participation (WP) outcomes measurements hampers large scale evidence synthesis in systematic reviews of trials. In this survey we explore authors' reasons for choosing specific WP outcomes and their measurement methods, including employment status, absence from work, at-work productivity loss, and employability. Methods We contacted authors of 260 trials and 69 systematic reviews and asked closed and open-ended questions about previously used WP outcomes and measurement methods as well as their opinion on the best way to measure WP. Results In total, 91 authors from a wide range of professional backgrounds completed the survey. The majority of authors (86%) chose WP outcomes based on their use in previous similar studies. In most studies (88%), patients had not been involved in the process of selecting the WP outcome. Authors judged feasibility to be an important factor for choosing a measurement instrument (67%). Additionally, valid measurement tools should be available, easy to administer and not too time consuming. Although authors preferred registry data for long term follow-up, the availability and validity of registries was seen as a barrier. Most of the reviewers (72%) struggled to pool data because of variation in follow-up times and cut off points and varying definitions of work outcomes. Almost all (92%) respondents support the use of a Core Outcome Set for Work. Conclusions There is strong support from authors of trials and systematic reviews to develop a core outcome set on work participation outcomes for the evaluation of interventions.
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Affiliation(s)
- Margarita Ravinskaya
- Amsterdam UMC, Academic Medical Center, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
| | - Jos H Verbeek
- Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Miranda W Langendam
- Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Department Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Ira Madan
- Guy's and St Thomas' NHS Trust and Faculty of Life Sciences and Medicine, King's College London, Centre for Musculoskeletal Health and Work, London, UK
| | - Suzanne M M Verstappen
- Centre for Epidemiology Versus Arthritis, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
| | - Regina Kunz
- Academic Unit EbIM, Evidence Based Insurance Medicine, Department of Clinical Research, University of Basel, Basel, Switzerland
| | - Carel T J Hulshof
- Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Jan L Hoving
- Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Tödt K, Engström M, Ekström M, Efverman A. Fatigue During Cancer-Related Radiotherapy and Associations with Activities, Work Ability and Quality of Life: Paying Attention to Subgroups more Likely to Experience Fatigue. Integr Cancer Ther 2022; 21:15347354221138576. [PMID: 36444775 PMCID: PMC9716605 DOI: 10.1177/15347354221138576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Having knowledge of which patients are more likely to experience fatigue during radiotherapy and the relationship between fatigue and health-related quality of life (HRQL) is important to improve identification and care of patients experiencing burdensome fatigue. OBJECTIVE To identify subgroups of patients, varying in situational, physiological, and psychological factors, who are more likely to experience fatigue an ordinary week of radiotherapy, and to compare patients experiencing and not experiencing fatigue regarding perceived HRQL and functional performance, that is, daily and physical activity and work ability. METHODS Cross-sectional study of 457 patients (52% women) undergoing radiotherapy (38% breast, 32% prostate cancer), using self-reported questionnaire data on fatigue, HRQL and functional performance analyzed using multivariable regression models. RESULTS Of the 448 patients who answered the fatigue question, 321 (72%) experienced fatigue. Patients reporting any comorbidity or depressed mood were more likely to experience fatigue, relative risk (RR) 1.56 ([95% confidence interval (CI)] 1.13-2.16) and RR 2.57 (CI 1.73-3.83), respectively. Patients with fatigue reported worse HRQL and performed less physical activity, including daily (P = .003), vigorous (P = .003) and moderate (P = .002) activity. Patients with and without fatigue reported 60% versus 40% sickness absence. CONCLUSION Patients with depressed mood or comorbidity were more likely to experience fatigue an ordinary week of radiotherapy than other patients were. Patients experiencing fatigue perceived worse HRQL and performed less daily and physical activity compared to patients not experiencing fatigue. Cancer care practitioners may consider paying extra attention to these subgroups of patients.
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Affiliation(s)
- Kristina Tödt
- University of Gävle, Gävle, Sweden,Skåne University Hospital, Lund, Sweden,Kristina Tödt, Department of Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle, Gävle 801 76, Sweden.
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Madundo F, Hübner J, Pollok I, Gündel S, Männle H, Münstedt K. Survey on the Necessity, Sensibility, and Timing of Psycho-Oncological Counseling and the Willingness to Discuss Various Topics During the Inpatient Stay in the Case of Breast Cancer. Clin Nurs Res 2022; 31:1510-1519. [PMID: 35536175 DOI: 10.1177/10547738221092104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
After the diagnosis of cancer patients require a lot of information because the disease affects all aspects of life. Some important issues regarding optimal counseling remain to be determined. This includes the time-related relevance of various topics and questions regarding who and when to consult on the topics. We analyzed the answers of 155 women with non-metastatic breast cancer undergoing primary surgery, primary chemotherapy, and having completed adjuvant treatment regarding the above-mentioned issues. We found that counseling must consider the treatment situation. Breast cancer patients in the follow-up phase reported that they preferred being counseled by female consultants. Our results largely support a counseling concept which puts the breast care nurse at the center of interest rather than psychologists and social service workers. A breast care nurse centered counseling system for women with non-metastatic breast cancer appears to meet patients' needs best.
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Tan CJ, Yip SYC, Chan RJ, Chew L, Chan A. Investigating how cancer-related symptoms influence work outcomes among cancer survivors: a systematic review. J Cancer Surviv 2022; 16:1065-1078. [PMID: 34424498 PMCID: PMC9489549 DOI: 10.1007/s11764-021-01097-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 08/09/2021] [Indexed: 01/07/2023]
Abstract
PURPOSE The purpose of this study is to investigate how different cancer-related symptoms influence work outcomes among cancer survivors. METHODS A literature search was performed in PubMed, EMBASE, CINAHL, PsycINFO, and Scopus to identify studies published between 1st January 1999 and 30th October 2020 that investigated the impact of specific cancer-related symptoms on work outcomes among cancer survivors who have completed primary antineoplastic treatment. Study findings were extracted and grouped by symptoms and work outcomes, allowing comparison of associations between these outcomes. RESULTS Seventy-three articles representing 68 studies were eligible for inclusion. From these studies, 27 cancer-related symptoms, 9 work outcomes, and 68 unique associations between specific symptoms and work outcomes were identified. Work status (return to work and employment rates) was most commonly studied, and symptom burden was mainly measured from the patient's perspective. Higher symptom burden was generally associated with trends of poorer work outcomes. Significant associations were reported in most studies evaluating body image issues and work status, oral dysfunction and work status, fatigue and work ability, and depression and work ability. CONCLUSION Several cancer-related symptoms were consistently associated with inferior work outcomes among cancer survivors. Body image issues and oral dysfunction were shown to be associated with poorer employment rates, while fatigue and depression were linked to lower levels of work performance. IMPLICATIONS FOR CANCER SURVIVORS Failure to return to work and decreased productivity post-cancer treatment can have negative consequences for cancer survivors and society at large. Findings from this review will guide the development of work rehabilitation programs for cancer survivors. PROTOCOL REGISTRATION PROSPERO identifier CRD42020187754.
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Affiliation(s)
- Chia Jie Tan
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | | | - Raymond Javan Chan
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Lita Chew
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
- Department of Pharmacy, National Cancer Centre Singapore, Singapore, Singapore
| | - Alexandre Chan
- Department of Pharmacy, National Cancer Centre Singapore, Singapore, Singapore.
- Department of Clinical Pharmacy Practice, School of Pharmacy & Pharmaceutical Sciences, University of California, 101 Theory, Suite 100, Irvine, CA, 92612, USA.
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Ghasempour M, purabdollah M, Rahmani A, dehghannezhad J, Mousavi S, Sattarpour S. The Relation of Work Ability and Return to Work Among Iranian Cancer Survivors. Asian Pac J Cancer Prev 2022; 23:3339-3346. [PMID: 36308357 PMCID: PMC9924310 DOI: 10.31557/apjcp.2022.23.10.3339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE Cancerous diseases are known to disrupt a person's ability and inflict physical, psychological, financial, and social complications on the person, thereby challenging an individual's returning to work. The aim of this study was to investigate the ability of cancer patients to work after returning to work. METHODS This descriptive-correlational study examined a total of 227 surviving cancer patients, having picked the participants through convenience sampling. Data were collected by the return to work and work ability index (WAI) questionnaires and analyzed by descriptive statistics and inferential statistics using SPSS software. RESULTS A total of 166 (73.2%) of the participants had returned to work after completing the basic treatment. The mean (standard deviation) of the work ability score was 29.52 (9.43), ranging from 9 to 43 while the average daily work hours dropped from 12.30 to 5.50. The chi-square test showed a significant relationship between the work ability score and the type of return to work. Moreover, the rank logistic regression analysis revealed that work ability was the most important predictor of return to work. CONCLUSION Survivors of cancer face reduced working hours and limited ability to work after returning to work, and it is possible to facilitate the return to work in these patients by identifying their job needs in relation to their abilities and barriers of returning to work through the appropriate interventions.
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Kobayashi M, Sezai I, Ishikawa T, Masujima M. Psychological and educational support for cancer patients who return to work: A scoping review. Work 2022; 73:291-300. [DOI: 10.3233/wor-205326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND: Many patients with cancer experience challenges when they return to work (RTW) following cancer diagnosis and treatment. Psycho-educational support is important to facilitate the RTW process. OBJECTIVE: This scoping review examined published reports on psycho-educational support for patients with cancer who RTW. METHODS: We followed the preferred reported items for systematic reviews and meta-analyses statement and the framework of Arksey and O’Malley. We searched the Cochrane Central Register of Controlled Trials database, PubMed, CINAHL (EBSCO), and ICHUSHI and performed manual searches. RESULTS: We retrieved 1,586 articles and retained 48 for analysis (published January 2000 to December 2020). Physicians, occupational physicians, nurses, social workers, and psychologists provide considerable support in hospitals. Delivery modes included individual, face-to-face, and workbook. Psychological support included emotional, stress coping, counseling, and knowledge. Educational support included information or advice provision, communication skills, problem discussion, and work planning. Employment status was typically the primary outcome. We included 50 measurement scales across quality of life, cognitive functioning and illness, self-efficacy, psychological distress, and fatigue. CONCLUSION: This review elucidated psycho-educational support for patients with cancer who RTW, and measurement tools for related effects. Based on the characteristics of the psycho-educational support revealed in this study, future studies should examine the development, intervention, and implementation of support programs for patients’ RTW.
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Affiliation(s)
- Masamitsu Kobayashi
- Faculty of Nursing, National Defense Medical College, Saitama, Japan
- Graduate School of Nursing, Chiba University, Chiba, Japan
| | - Izumi Sezai
- Faculty of Nursing, National Defense Medical College, Saitama, Japan
| | - Takako Ishikawa
- Graduate School Health Care Scienses, Tokyo Medical and Dental University, Tokyo, Japan
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Algeo N, Bennett K, Connolly D. Prioritising the content and delivery of a work-focused intervention for women with breast cancer using the nominal group technique. Work 2022; 73:1337-1345. [DOI: 10.3233/wor-211160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: Increased breast cancer survivorship has prompted a focus on optimising quality of life for this cohort, including re-integration into employment. Despite this, there remains a lack of work-focused interventions to support work outcomes for women living with and beyond breast cancer. OBJECTIVE: The aim of this study was to prioritise the content and delivery of a work-focused intervention for women living with and beyond breast cancer. METHODS: Twelve stakeholders including women living with and beyond breast cancer, healthcare professionals, cancer support centre staff, and policy informers were invited to participate in an online discussion using the Nominal Group Technique (NGT) to determine priorities for a work-focused intervention. The NGT seeks consensus through four steps; (i) idea generation, (ii) discussion among the group, (iii) refining ideas, and (iv) ranking preference for ideas through anonymised voting. RESULTS: Intervention content prioritised included managing cancer-related symptoms and work-specific factors. Consensus was made for a blended delivery format (mix of group and individual sessions), and blended delivery (face-to-face and online). Findings indicated a preference for a six-week intervention, with 90–120 minute sessions. Community-based settings were preferred over hospital-based services for the setting of a work-focused intervention. Zoom Video Communications Inc. was the preferred setting to deliver an online intervention. CONCLUSION: Stakeholder priorities informed the content and delivery of a work-focused intervention for women with breast cancer. A pilot of the proposed intervention will be conducted to test for feasibility and acceptability.
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Affiliation(s)
- Naomi Algeo
- Discipline of Occupational Therapy, Trinity College Dublin, Dublin, Ireland
| | - Kathleen Bennett
- Data Science Centre, Royal College of Surgeons Ireland, Dublin, Ireland
| | - Deirdre Connolly
- Discipline of Occupational Therapy, Trinity College Dublin, Dublin, Ireland
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Lyons KD, Forcino RC, Rotenberg S, Schiffelbein JE, Morrissette KJ, Godzik CM, Lichtenstein JD. "The Last Thing You Have to Worry About": A Thematic Analysis of Employment Challenges Faced by Cancer Survivors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811214. [PMID: 36141485 PMCID: PMC9517658 DOI: 10.3390/ijerph191811214] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 09/01/2022] [Accepted: 09/02/2022] [Indexed: 05/21/2023]
Abstract
The evidence base for interventions that support the employment goals of cancer survivors is growing but inconclusive. As the first step in initiating a community-engaged program of research aimed at developing and testing interventions to support the employment goals of cancer survivors, 23 cancer survivors, 17 healthcare providers, and 5 employers participated in individual interviews to elicit perceptions regarding local challenges and resources related to work maintenance and optimization within the context of cancer treatment. Interviews were recorded and transcribed verbatim. A thematic analysis was conducted to identify cross-cutting experiences that were voiced by all three types of participants. Three themes were found in the data: (1) the onus for identifying and articulating work-related issues is upon the cancer survivor; (2) the main support offered to cancer survivors involved time away from work and flexibility with scheduling work and treatment activities; and (3) participants voiced a lack of information regarding one or more aspects related to supporting employment goals of cancer survivors. Supportive resources designed for cancer survivors, employers, and/or healthcare providers are needed to help cancer survivors optimize their employment situations.
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Affiliation(s)
- Kathleen Doyle Lyons
- Department of Occupational Therapy, MGH Institute of Health Professions, Boston, MA 02129, USA
- Correspondence:
| | - Rachel C. Forcino
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Lebanon, NH 03756, USA
| | - Sivan Rotenberg
- Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Lebanon, NH 03756, USA
| | - Jenna E. Schiffelbein
- Norris Cotton Cancer Center, Geisel School of Medicine, Dartmouth College, Lebanon, NH 03756, USA
| | - Kali J. Morrissette
- Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Lebanon, NH 03756, USA
| | - Cassandra M. Godzik
- Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Lebanon, NH 03756, USA
| | - Jonathan D. Lichtenstein
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Lebanon, NH 03756, USA
- Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Lebanon, NH 03756, USA
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Martin E, Di Meglio A, Menvielle G, Arvis J, Bourmaud A, Michiels S, Pistilli B, Vaz-Luis I, Dumas A. Informing the development of multidisciplinary interventions to help breast cancer patients return to work: a qualitative study. Support Care Cancer 2022; 30:8287-8299. [PMID: 35819520 DOI: 10.1007/s00520-022-07262-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 06/27/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Return to work (RTW) after breast cancer (BC) can be a major challenge for patients. Multidisciplinary interventions seem to be effective but the role of digital solutions is under-developed and therefore not evaluated. We explored the preferences, needs, and barriers regarding RTW interventions, including opinions about the use of digital approaches to deliver such interventions. METHODS We conducted a qualitative study based on interviews with 30 patients with BC and 18 healthcare providers in four French regions. Emergent themes were identified using thematic content analysis. RESULTS Most providers declared that they did not proactively address RTW with patients, mainly due to having other priorities and a lack of knowledge. The following themes emerged: several development and deployment barriers regarding RTW interventions exist, multidisciplinary interventions are preferred, and there is a need to maintain contact between the patient and workplace during sick leave, including pathways and interlocutors that can facilitate RTW. Participants had mostly positive representations of using digital tools to facilitate RTW; however, fear of loss of human contact and the exacerbation of inequalities were identified as possible risks associated with the development of digital-only interventions. CONCLUSIONS Interventions blending the needs and preferences of patients with BC and the healthcare system are warranted. A personalized multimodal approach with mixed digital and in-person features has surfaced as a possible solution to address the weaknesses of existing interventions. IMPLICATIONS FOR CANCER SURVIVORS Since most women work at the time of diagnosis, it is of particular relevance to build interventions promoting RTW.
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Affiliation(s)
- Elise Martin
- Université Paris-Saclay, Gustave Roussy, Inserm, Biomarqueurs Prédictifs Et Nouvelles Stratégies Thérapeutiques en Oncologie, 94800, Villejuif, France.
| | - Antonio Di Meglio
- Université Paris-Saclay, Gustave Roussy, Inserm, Biomarqueurs Prédictifs Et Nouvelles Stratégies Thérapeutiques en Oncologie, 94800, Villejuif, France.,Medical Oncology Department, Gustave Roussy, 94800, Villejuif, France
| | - Gwenn Menvielle
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie Et de Sante Publique, Paris, France
| | | | | | - Stefan Michiels
- Office of Biostatistics and Epidemiology, Gustave Roussy, Villejuif, France.,Oncostat U1018, Inserm, University Paris-Saclay, Labeled Ligue Contre Le Cancer, Villejuif, France
| | - Barbara Pistilli
- Medical Oncology Department, Gustave Roussy, 94800, Villejuif, France
| | - Ines Vaz-Luis
- Université Paris-Saclay, Gustave Roussy, Inserm, Biomarqueurs Prédictifs Et Nouvelles Stratégies Thérapeutiques en Oncologie, 94800, Villejuif, France.,Medical Oncology Department, Gustave Roussy, 94800, Villejuif, France
| | - Agnès Dumas
- Université Paris Cité, ECEVE, UMR 1123, INSERM, Paris, France
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36
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Galica J, Saunders S, Romkey-Sinasac C, Silva A, Ethier JL, Giroux J, Jull J, Maheu C, Ross-White A, Stark D, Robb K. The needs of gynecological cancer survivors at the end of primary treatment: A scoping review and proposed model to guide clinical discussions. PATIENT EDUCATION AND COUNSELING 2022; 105:1761-1782. [PMID: 34865888 DOI: 10.1016/j.pec.2021.11.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 11/19/2021] [Accepted: 11/20/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Gynecological cancer (GC) survivors have unmet needs when they complete primary cancer treatment. Despite this, no known research has summarized these needs and survivors' suggestions to address them. We conducted a scoping review to fill these gaps and develop a model useful to guide clinical discussions and/or interventions. METHODS English, full length, and accessible primary studies describing the needs of GC survivors were included. No restrictions on date nor country of publication were applied. Two reviewers screened and extracted data, which was verified by a third reviewer. RESULTS Seventy-one studies met the inclusion criteria for data extraction. Results were thematically grouped into seven dimensions: physical needs, sexuality-related concerns, altered self-image, psychological wellbeing, social support needs, supporting the return to work, and healthcare challenges and preferences. After consulting with a stakeholder group (a GC survivor, clinicians, and researchers), the dimensions were summarized into a proposed model to guide clinical assessments and/or interventions. CONCLUSION Results illuminate the diverse needs of GC survivors as they complete primary cancer treatment and their recommendations for care to meet these needs. PRACTICE IMPLICATIONS The resulting model can be used to guide assessments, discussions and/or interventions to optimally prepare GC survivors for transition out of primary cancer treatment.
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Affiliation(s)
- Jacqueline Galica
- Queen's University School of Nursing, Kingston, Ontario, Canada; Queen's Cancer Research Institute, Division of Cancer Care and Epidemiology, Kingston, Ontario, Canada.
| | | | | | - Amina Silva
- Queen's University School of Nursing, Kingston, Ontario, Canada
| | - Josée-Lyne Ethier
- Queen's Cancer Research Institute, Division of Cancer Care and Epidemiology, Kingston, Ontario, Canada; Queen's University Department of Oncology; Kingston, Ontario, Canada
| | - Janet Giroux
- Queen's University School of Nursing, Kingston, Ontario, Canada; Kingston Health Sciences Centre, Kingston General Hospital Site and the Cancer Centre of Southeastern Ontario, Kingston, Ontario, Canada; Queen's University, Department of Obstetrics and Gynecology, Kingston, Ontario, Canada
| | - Janet Jull
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
| | - Christine Maheu
- Ingram School of Nursing, McGill University, Montréal, Québec, Canada
| | | | - Debora Stark
- Kingston Health Sciences Centre, Kingston General Hospital Site and the Cancer Centre of Southeastern Ontario, Kingston, Ontario, Canada
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A Scoping Review of Food Insecurity and Related Factors among Cancer Survivors. Nutrients 2022; 14:nu14132723. [PMID: 35807902 PMCID: PMC9269347 DOI: 10.3390/nu14132723] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/24/2022] [Accepted: 06/27/2022] [Indexed: 02/05/2023] Open
Abstract
Despite growing awareness of the financial burden that a cancer diagnosis places on a household, there is limited understanding of the risk for food insecurity among this population. The current study reviewed literature focusing on the relationship between food insecurity, cancer, and related factors among cancer survivors and their caregivers. In total, 49 articles (across 45 studies) were reviewed and spanned topic areas: patient navigation/social worker role, caregiver role, psychosocial impacts, and food insecurity/financial toxicity. Patient navigation yielded positive impacts including perceptions of better quality of care and improved health related quality of life. Caregivers served multiple roles: managing medications, emotional support, and medical advocacy. Subsequently, caregivers experience financial burden with loss of employment and work productivity. Negative psychosocial impacts experienced by cancer survivors included: cognitive impairment, financial constraints, and lack of coping skills. Financial strain experienced by cancer survivors was reported to influence ratings of physical/mental health and symptom burden. These results highlight that fields of food insecurity, obesity, and cancer control have typically grappled with these issues in isolation and have not robustly studied these factors in conjunction. There is an urgent need for well-designed studies with appropriate methods to establish key determinants of food insecurity among cancer survivors with multidisciplinary collaborators.
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Kahán Z, Szántó I, Dudás R, Kapitány Z, Molnár M, Koncz Z, Mailáth M. Breast Cancer Survivorship Programme: Follow-Up, Rehabilitation, Psychosocial Oncology Care. 1st Central-Eastern European Professional Consensus Statement on Breast Cancer. Pathol Oncol Res 2022; 28:1610391. [PMID: 35721327 PMCID: PMC9200958 DOI: 10.3389/pore.2022.1610391] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 04/29/2022] [Indexed: 02/04/2023]
Abstract
Follow-up includes ongoing contact with and health education of the patient, surveillance and control of the adverse effects of surgery, oncological therapies or radiotherapy, screening of metachronous cancers, and comprehensive (physical, psychological and social) patient rehabilitation, which may be enhanced by a healthy lifestyle. Primary attention should be paid to early detection and, when needed, curative treatment of local/regional tumour recurrences. Similarly, with the hope of curative solution, it is important to recognize the entity of a low-mass and relatively indolent recurrence or metastasis (oligometastasis); however, there is still no need to investigate distant metastases by routine diagnostic imaging or assess tumour markers. Below there is a list of possible sources of support, with respect to adjuvant hormone therapy continued during long-term care, social support resources, pivotal points and professional opportunities for physical and mental rehabilitation. Individual solutions for specific issues (breast cancer risk/genetic mutation, pregnancy) are provided by constantly widening options. Ideally, a complex breast cancer survivorship programme is practised by a specially trained expert supported by a cooperative team of oncologists, surgeons, breast radiologists, social workers, physiotherapists, psycho-oncologists and psychiatrists. The approach of follow-up should be comprehensive and holistic.
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Affiliation(s)
- Zsuzsanna Kahán
- Department of Oncotherapy, University of Szeged, Szeged, Hungary
| | - István Szántó
- St. George’s General Teaching Hospital, Székesfehérvár, Hungary
| | - Rita Dudás
- Department of Oncotherapy, University of Szeged, Szeged, Hungary
| | | | - Mária Molnár
- Oncoradiology Centre, Bács-Kiskun County Hospital, Kecskemét, Hungary
| | - Zsuzsa Koncz
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Mónika Mailáth
- Institute of Oncology, University of Debrecen, Debrecen, Hungary
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Understanding Cancer Survivors’ Needs and Experiences Returning to Work Post-Treatment: A Longitudinal Qualitative Study. Curr Oncol 2022; 29:3013-3025. [PMID: 35621635 PMCID: PMC9139703 DOI: 10.3390/curroncol29050245] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/20/2022] [Accepted: 04/21/2022] [Indexed: 11/16/2022] Open
Abstract
Background: This study aimed to understand Canadian cancer survivors’ experiences during the return-to-work (RTW) process. Methods: A prospective qualitative longitudinal design was employed using the principles of phenomenological inquiry. Cancer survivors took part in three in-depth interviews: at the end of treatment, and 3 and 9 months after the first interview. Transcripts were analyzed using constant comparative analysis, guided by the Cancer and Work model. Results: A total of 38 in-depth interviews were conducted with 13 participants. The resultant themes were: (1) supports received or desired to enable RTW; (2) others’ limited understanding of the long-term impacts of a cancer diagnosis and its treatment; (3) worries and self-doubts about returning to work; and (4) changing perspectives on life and work after cancer. Conclusions: Cancer patients returning to work after treatment often experience challenges throughout the process, including varying levels of support from others and a range of ongoing effects and motivation to RTW. There is a clear gap in terms of the professional supports available to these individuals. Future research should focus on investigating how to improve both quality and accessibility of supports in a way that is personalized to the individual.
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Algeo N, Bennett K, Connolly D. Breast cancer survivorship and employment in Ireland: Legislative systems and the return to work of women with breast cancer. Work 2022; 71:927-939. [DOI: 10.3233/wor-205044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: Breast cancer is the most common invasive cancer in females worldwide. While work is important for well-being, 84% of women in Ireland temporarily or permanently cease working up to six months post-breast cancer diagnosis. Under Irish law, there is a right to reasonable work accommodations, however paid sick leave has only recently been state-mandated. Legislation internationally varies across nations. OBJECTIVE: The aim of this study was to explore the experiences of women who have had breast cancer returning to, and/or remaining in work, in the context of employment legislation. METHODS: Fifteen women with breast cancer, fifteen healthcare professionals, and nine employers nationwide participated in a qualitative-descriptive design, using semi-structured interviews. Interviews were audio-recorded, transcribed, and data analysed using thematic analysis. RESULTS: Thirty-nine participants were recruited. A prominent theme from interviews was that most women with breast cancer and healthcare professional cohorts were not aware of employment rights in the context of cancer diagnoses. This is in contrast to employers. Experiences of sick leave and pay entitlements varied amongst women with breast cancer with financial pressure and expediated the return to work evident for some participants. Most women did not report any discrimination on returning to the workplace, although there were examples of indirect discrimination where unfair expectations were being placed on women by colleagues. CONCLUSIONS: Education and awareness on employment rights and entitlements during and after cancer treatment is warranted. This could be incorporated into work-focused interventions to support those living with and beyond cancer to transition back into the workplace.
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Affiliation(s)
- Naomi Algeo
- Discipline of Occupational Therapy, Trinity College Dublin, Dublin, Ireland
| | - Kathleen Bennett
- Data Science Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Deirdre Connolly
- Discipline of Occupational Therapy, Trinity College Dublin, Dublin, Ireland
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41
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Seifart U. [Socioeconomic risks for people with cancer-possible consequences and assistance]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2022; 65:439-445. [PMID: 35303123 DOI: 10.1007/s00103-022-03510-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 02/17/2022] [Indexed: 11/28/2022]
Abstract
Due to therapeutic progress, about 60% of all cancer patients currently survive their disease more than five years. These long-term survivors can be described as cured, but not as healthy. In particular, reduced performance and an associated reduction in working hours, loss of job, or an early retirement can lead to socioeconomic consequences. On average, tumor patients in Germany lose up to 26% of their income, although this does not seem to be necessarily linked to the stage of the disease and thus the corresponding prognosis. Due to objective and subjective financial burdens, a so-called "financial toxicity" can develop, which can have a significant impact on the quality of life and possibly also on the prognosis of the disease.In this article, the socioeconomic risks associated with cancer are presented as well as possible patient assistance and offers. This presentation intends to illustrate how financial toxicity in cancer can be prevented or alleviated. As far as scientific findings are available, they will be described and discussed.Finally, the special situation of young adults with cancer is explained, for whom many of the above-mentioned support measures are not or only partially possible.
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Affiliation(s)
- Ulf Seifart
- Klinik Sonnenblick, Amöneburger Str. 1-6, 35043, Marburg, Deutschland.
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Tailoring work participation support for cancer survivors using the stages of change: perspectives of (health care) professionals and survivors. J Cancer Surviv 2022; 17:706-719. [PMID: 35275360 DOI: 10.1007/s11764-022-01196-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 02/21/2022] [Indexed: 01/03/2023]
Abstract
PURPOSE Interventions to support work participation in cancer survivors (CSs) have shown limited effectiveness. Applying a behavioral change framework (e.g., stages of change) could make work participation interventions for CSs more timely and tailored. We aimed to explore the application of the stages of change framework to work participation support for CSs and to generate stage-specific intervention content. METHODS Eighteen experts (e.g., occupational physicians, reintegration consultants) were individually interviewed, and three focus groups with CSs (n = 6, n = 5, n = 4) were conducted. Data were analyzed along the six work-related behavioral change stages purported by the readiness for return to work framework, which is based on the stages of change. RESULTS The following themes were identified: (1) pre-contemplation: emotional support and staying connected-encourage contact with the employer/colleagues; (2) contemplation: considering return to work is stressful-facilitate the deliberation process; (3) preparation self-evaluative: assess current capabilities-seek guidance from, e.g., occupational physicians; (4) preparation behavioral: planning return to work-allow for personalized solutions and encourage supervised return to work; (5) uncertain maintenance: guard against overload-train self-efficacy strategies and communication tactics; and (6) proactive maintenance: accept and prepare for the long term. CONCLUSIONS Our results support the potential utility of tailoring CSs' work participation support along the stages of change. IMPLICATIONS FOR CANCER SURVIVORS We provided recommendations for intervention content and developed a stage-specific work participation intervention for CSs, the effectiveness of which will be evaluated in an upcoming randomized controlled trial.
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Bilodeau K, Gouin MM, Lecours A, Lederer V, Durand MJ, Kilpatrick K, Lepage D, Ladouceur-Deslauriers L, Dorta T. Co-design of a return-to-work intervention after breast cancer treatments: feasibility study protocol (Preprint). JMIR Res Protoc 2022; 11:e37009. [PMID: 35451972 PMCID: PMC9077508 DOI: 10.2196/37009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/24/2022] [Accepted: 03/29/2022] [Indexed: 12/04/2022] Open
Abstract
Background The mortality rate from breast cancer has been declining for many years, and the population size of working-age survivors is steadily increasing. However, the recurrent side effects of cancer and its treatment can result in multiple disabilities and disruptions to day-to-day life, including work disruptions. Despite the existing knowledge of best practices regarding return to work (RTW) for breast cancer survivors, only a few interdisciplinary interventions have been developed to address the individualized needs and multiple challenges of breast cancer survivors, health care professionals, and employer and insurer representatives. Thus, it seems appropriate to develop RTW interventions collaboratively by using a co-design approach with these specific stakeholders. Objective This paper presents a protocol for developing and testing an innovative, interdisciplinary pilot intervention based on a co-design approach to better support RTW and job retention after breast cancer treatment. Methods First, a participatory research approach will be used to develop the intervention in a co-design workshop with 12 to 20 participants, including people affected by cancer, employer and insurer representatives, and health care professionals. Next, a pilot intervention will be tested in a primary care setting with 6 to 8 women affected by breast cancer. The acceptability and feasibility of the pilot intervention will be pretested through semistructured interviews with participants, health care professionals, and involved patient partners. The transcribed data will undergo an iterative content analysis. Results The first phase of the project—the co-design workshop—was completed in June 2021. The pilot test of the intervention will begin in spring 2022. The results from the test will be available in late 2022. Conclusions The project will offer novel data regarding the use of the co-design approach for the development of innovative, co-designed interventions. In addition, it will be possible to document the acceptability and feasibility of the pilot intervention with a primary care team. Depending on the results obtained, the intervention could be implemented on a larger scale. International Registered Report Identifier (IRRID) DERR1-10.2196/37009
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Affiliation(s)
- Karine Bilodeau
- Faculty of Nursing, University of Montreal, Montreal, QC, Canada
- Centre de recherche Hopital Maisonneuve Rosemont, Montreal, QC, Canada
| | - Marie-Michelle Gouin
- Faculté de médecine et des sciences de la santé, University of Sherbrooke, Longueuil, QC, Canada
| | - Alexandra Lecours
- Département de relations industrielles, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Valérie Lederer
- Département de relations industrielles, Université du Québec en Outaouais, Gatineau, QC, Canada
| | - Marie-José Durand
- Faculté de médecine et des sciences de la santé, University of Sherbrooke, Longueuil, QC, Canada
| | - Kelley Kilpatrick
- Centre de recherche Hopital Maisonneuve Rosemont, Montreal, QC, Canada
- Ingram School of Nursing, Mcgill University, Montreal, QC, Canada
| | - David Lepage
- Centre intégré universitaire de santé et de services sociaux de l'Est de l'île de Montréal, Montréal, QC, Canada
| | | | - Tomas Dorta
- Faculté de l'aménagement, École de Design, Université de Montréal, Montreal, QC, Canada
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Tikka C, Verbeek J, Hoving JL, Kunz R. Evidence-informed decision about (de-)implementing return-to-work coordination to reduce sick leave: a case study. Health Res Policy Syst 2022; 20:19. [PMID: 35164766 PMCID: PMC8842546 DOI: 10.1186/s12961-022-00823-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 01/27/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Coordination of return to work (RtW) is implemented in many countries, but a Cochrane review found no considerable effect on workers' sick leave compared to usual care. The aim of the study is to analyse how the evidence from this review can be used for decisions about (de-)implementing RtW coordination in a country-specific setting, using Finland as an example. METHODS We conducted a systematic literature search and online survey with two groups of experts to compare interventions included in the Cochrane review to Finnish RtW practice using content analysis methods. We applied the evidence-to-decision (EtD) framework criteria to draw conclusions about (de-)implementing RtW coordination in Finland, including benefits, harms and costs of the intervention compared to usual care. RESULTS We included seven documents from the literature search and received data from 10 of 42 survey participants. RtW coordination included, both in Finland and in the review, at least one face-to-face meeting between the physician and the worker, a workers' needs assessment, and an individual RtW plan and its implementation. Usual care focuses on medical treatment and may include general RtW advice. RtW coordination would be cost-saving if it decreases sick leave with at least 2 days compared to usual care. The evidence in the Cochrane review was mainly of low certainty, and the effect sizes had relatively wide confidence intervals. Only a new, high-quality and large randomized controlled trial (RCT) can decrease the current uncertainty, but this is unlikely to happen. The EtD framework did not provide arguments for further implementation or for de-implementation of the intervention. CONCLUSIONS Interventions evaluated in the Cochrane review are similar to RtW coordination and usual care interventions in Finland. Considering all EtD framework criteria, including certainty of the evidence and costs, de-implementation of RtW coordination interventions in Finland seems unnecessary. Better evidence about the costs and stakeholders' values regarding RtW coordination is needed to improve decision-making.
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Affiliation(s)
- Christina Tikka
- Finnish Institute of Occupational Health, Neulaniementie 4, 70101, Kuopio, Finland.
| | - Jos Verbeek
- Department of Public and Occupational Health, Amsterdam UMC, Location AMC, University of Amsterdam, Coronel Institute of Occupational Health, Cochrane Work Review Group, Amsterdam, North Holland, The Netherlands
| | - Jan L Hoving
- Department of Public and Occupational Health, Amsterdam UMC, Location AMC, University of Amsterdam, Coronel Institute of Occupational Health, Cochrane Work Review Group, Amsterdam, North Holland, The Netherlands
| | - Regina Kunz
- Research Unit Evidence-based Insurance Medicine, Department of Clinical Research, University of Basel and University Hospital Basel, Basel, Switzerland
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Long-term outcomes among localized prostate cancer survivors: prospective predictors for return-to-work three years after cancer rehabilitation. Support Care Cancer 2022; 30:843-854. [PMID: 34392427 PMCID: PMC8636403 DOI: 10.1007/s00520-021-06376-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 06/19/2021] [Indexed: 12/02/2022]
Abstract
PURPOSE This study aimed at (1) investigating the work status of men treated by radical prostatectomy due to diagnosis of localized prostate cancer (LPCa) three years after having attended a cancer rehabilitation program and (2) identifying prospective risk factors for not working at this time point. METHODS In a longitudinal, questionnaire-based multicenter study, 519 working-age LPCa survivors reported on their work status 12 and 36 months following rehabilitation. Chi-square tests/t tests and multivariable logistic regression analysis were used to identify prospective factors associated with not working at 36 months follow-up. RESULTS Nearly three quarter of LPCa survivors (N = 377, 73%) worked 3 years after post-acute rehabilitation. Most participants (N = 365, 71%) showed continuous return-to-work (RTW) patterns as they worked both 1 and 3 years following rehabilitation. Multivariable regression analysis revealed older age, low or middle socio-economic status as well as resigned and unambitious work behavior and fatigue at the time of attending the rehabilitation program to be prospective factors for not working at 36 months follow-up. Low socio-economic status [Odds ratio (OR) 4.81, 95% confidence interval (CI) 2.07-11.16] and unambitious work behavior [OR 4.48, 95% CI 2.16-9.31] were the strongest predictors. CONCLUSION Long-term work retention is a realistic goal among LPCa survivors. The results contribute to the identification of at-risk LPCa survivors early in the RTW process. Special attention should be paid to social inequality. Further, interventions related to the management of fatigue and work-related coping styles could improve long-term RTW, as these were relevant, but potentially modifiable factors impeding work retention.
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Lim CYS, Laidsaar-Powell RC, Young JM, Steffens D, Koczwara B, Zhang Y, Butow P. Work: saviour or struggle? A qualitative study examining employment and finances in colorectal cancer survivors living with advanced cancer. Support Care Cancer 2022; 30:9057-9069. [PMID: 35972645 PMCID: PMC9378257 DOI: 10.1007/s00520-022-07307-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 07/26/2022] [Indexed: 01/05/2023]
Abstract
PURPOSE Continuing employment or returning to work (RTW) as a cancer survivor can be meaningful and financially necessary, yet challenging. However, there is a lack of qualitative research on RTW experiences and financial wellbeing of people with advanced colorectal cancer (CRC-A). This study aimed to fill this gap. METHODS Adults treated for CRC-A were recruited 0.5-2 years post-surgery (or post-diagnosis of CRC-A for palliative chemotherapy participants). Semi-structured telephone interviews, exploring RTW and finances, were subjected to framework analysis. Demographic, clinical, and quality of life data (FACT-C, Distress Thermometer, COST measure) were collected to characterise the sample and inform the framework analysis. RESULTS Analysis of 38 interviews revealed five overarching themes: work as a struggle, work as my identity, work as my saviour, work as a financial necessity, and employer and colleague response. Many survivors with CRC-A desired to, and had the capacity to, continue work or RTW, yet faced unique challenges from compounded stigma of both cancer and toileting issues. Inability to RTW negatively impacted financial and psychosocial wellbeing. Workplace support was an important facilitator of RTW. CONCLUSION For survivors with CRC-A, continuing or RTW is fraught with challenges, including physical functioning challenges, financial anxiety, and unsupportive workplace environments. Survivors require psychosocial, financial, and employer support to manage these difficulties. This paper recommends a multiprong approach, including education programmes (facilitated through workers' union groups, human resource institutions, and/or large consumer CRC groups) and policies, to support workers and for employers to understand the unique challenges of employees with CRC-A.
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Affiliation(s)
- Chloe Yi Shing Lim
- Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia.
| | - Rebekah C Laidsaar-Powell
- Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Jane M Young
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
| | - Daniel Steffens
- Surgical Outcomes Research Centre (SOuRCe), Sydney Local Health District, Sydney, NSW, Australia
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW, Australia
| | - Bogda Koczwara
- Department of Medical Oncology, Flinders Medical Center, Bedford Park, South Australia, Australia
- National Breast Cancer Foundation, Sydney, NSW, Australia
| | - Yuehan Zhang
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Phyllis Butow
- Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
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Gubler-Gut BE, Pöhlmann J, Flatz A, Schwenkglenks M, Rohrmann S. Cost-effectiveness of physical activity interventions in cancer survivors of developed countries: a systematic review. J Cancer Surviv 2021; 15:961-975. [PMID: 33624172 PMCID: PMC8521580 DOI: 10.1007/s11764-021-01002-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 02/06/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE Physical activity has been shown to improve survival and quality of life of cancer patients. Due to differences in patient populations, healthcare settings, and types of intervention, cost-effectiveness analyses of physical activity interventions in cancer survivors are difficult to compare. Available evidence from breast cancer survivor research has shown inconsistent results, and transfer of results to other types of cancer is not straightforward. This paper systematically reviewed current evidence on the cost-effectiveness of physical activity interventions in cancer survivors independent of cancer type compared to usual care or another experimental intervention. METHODS The literature search was conducted in seven databases and enhanced by a search for gray literature. Eligible studies were restricted to developed countries and assessed using the CHEERS, CHEC, and PHILIPS checklists. The study protocol was pre-published in PROSPERO. RESULTS Seven studies, five cost-utility, and two combined cost-utility/cost-effectiveness analyses fully met the inclusion criteria. They covered eight different types of cancer and various interventions. The cost-effectiveness analyses were of moderate to high methodological quality. A high probability of cost-effectiveness was reported in two analyses. One intervention appeared to be not cost-effective, and one to be cost-effective only from an organizational perspective. Three other analyses reported a cost-effectiveness better than US$ 101,195 (€ 80,000) per QALY gained. CONCLUSIONS Physical activity interventions in cancer survivors of developed countries were cost-effective in some but not all clinical trials reviewed. IMPLICATIONS FOR CANCER SURVIVORS Cost-effectiveness of physical activity interventions appear to depend upon the intensity of the activity.
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Affiliation(s)
- Barbara E. Gubler-Gut
- Institute of Physiotherapy, Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, 8400 Winterthur, Switzerland
| | - Johannes Pöhlmann
- Winterthur Institute of Health Economics, Zurich University of Applied Sciences, Gertrudstrasse15, 8401 Winterthur, Switzerland
| | - Aline Flatz
- Swiss Cancer League, Effingerstrasse 40, 3001 Berne, Switzerland
| | - Matthias Schwenkglenks
- Institute of Pharmaceutical Medicine, University of Basel, Klingenbergstrasse 61, 4056 Basel, Switzerland
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland
| | - Sabine Rohrmann
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001 Zurich, Switzerland
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Venning A, Oswald TK, Stevenson J, Tepper N, Azadi L, Lawn S, Redpath P. Determining what constitutes an effective psychosocial 'return to work' intervention: a systematic review and narrative synthesis. BMC Public Health 2021; 21:2164. [PMID: 34823501 PMCID: PMC8620530 DOI: 10.1186/s12889-021-11898-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 09/24/2021] [Indexed: 11/10/2022] Open
Abstract
PURPOSE Work can offer a myriad of social and health benefits. Long-term sick leave can be detrimental to employers, individuals, families, and societies. The burden of long-term sick leave has motivated the development of return to work (RTW) interventions. This study sought to determine what constitutes an effective psychosocial RTW intervention, which included exploring whether the level of intervention intensity and intervention characteristics matter to RTW outcomes. METHODS A systematic review and narrative synthesis were undertaken. Studies were identified through six databases (Ovid Medline, CINAHL (EBSCOhost), PsycInfo (Ovid), ProQuest, Scopus, and Google Scholar) between 2011 and 3 September 2019. Randomised controlled trials (RCTs) or reviews published in English were eligible for inclusion if they targeted adults who were on sick leave/unemployed trying to return to full-capacity employment, had at least one structured psychosocial RTW intervention, and assessed RTW. Study quality was assessed using checklists from the Joanna Briggs Institute. RESULTS Database searching yielded 12,311 records. Eighteen RCTs (comprising 42 intervention/comparison groups), seven reviews (comprising 153 studies), and five grey literature documents were included. Included studies were of moderate-to-high quality. Research was primarily conducted in Europe and focused on psychological or musculoskeletal problems. RTW outcomes included RTW status, time until RTW, insurance claims, and sick days. Participating in a RTW program was superior to care-as-usual. RTW outcomes were similar between diverse interventions of low, moderate, and high intensity. Common foundational characteristics seen across effective RTW interventions included a focus on RTW, psychoeducation, and behavioural activation. CONCLUSIONS Evidence suggests that a low intensity approach to RTW interventions may be an appropriate first option before investment in high intensity, and arguably more expensive interventions, as the latter appear to provide limited additional benefit. More high-quality RCTs, from diverse countries, are needed to provide stronger evidence.
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Affiliation(s)
- Anthony Venning
- Discipline of Behavioural Health, College of Medicine & Public Health, Flinders University, South Australia, Australia.
| | - Tassia K Oswald
- Discipline of Behavioural Health, College of Medicine & Public Health, Flinders University, South Australia, Australia
| | - Jeremy Stevenson
- Discipline of Behavioural Health, College of Medicine & Public Health, Flinders University, South Australia, Australia
| | - Nicci Tepper
- Remedy HealthCare Group, Melbourne, Victoria, Australia
| | - Leva Azadi
- Remedy HealthCare Group, Melbourne, Victoria, Australia
| | - Sharon Lawn
- Discipline of Public Health, College of Medicine & Public Health, Flinders University, South Australia, Australia
| | - Paula Redpath
- Discipline of Behavioural Health, College of Medicine & Public Health, Flinders University, South Australia, Australia
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Lo J, Ballurkar K, Fox S, Tynan K, Luu N, Boyer M, Murali-Ganesh R. A Digital Coaching Intervention for Cancer Survivors With Job Loss: Retrospective Study. JMIR Cancer 2021; 7:e31966. [PMID: 34710853 PMCID: PMC8663674 DOI: 10.2196/31966] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 10/21/2021] [Accepted: 10/28/2021] [Indexed: 01/27/2023] Open
Abstract
Background Returning to work is a key unmet need for working-age cancer survivors. Objective This study sought to evaluate return-to-work outcomes of a multidisciplinary intervention provided as routine employee support. Methods In a retrospective cohort analysis, patients with cancer and more than 3 months of absence from work were provided with an intervention consisting of digital resources and calls with a health coach. Propensity score matching was used to define a similar cohort of cancer patients absent from work, who were not offered the coaching intervention. The return-to-work rate as a percentage of all participants and secondary outcomes, such as the rate of death, were measured. The median time to return to work was compared between the cohorts using the Kaplan-Meier method. Results A total of 220 participants were enrolled in the intervention, of which 125 met the criteria for analysis. The median follow-up from cancer diagnosis was 79 weeks (IQR 60-106 weeks). In the matched control group, 22 (17.6%) participants returned to work compared with 38 (30.4%) in the intervention group (P=.02). Additionally, 19 (15.2%) matched controls died prior to claim closure compared with 13 (10.4%) in the intervention group (P=.26). The Kaplan-Meier estimated median time for the first 15% of the cohort to return to work was 87.1 weeks (95% CI 60.0-109.1 weeks) for the matched control group compared with 70.6 weeks (95% CI 52.6-79.6 weeks; P=.08) for the intervention group. Conclusions Patients receiving a remotely delivered coaching program in a real-world setting returned to work at a higher frequency than did control participants receiving usual care.
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Affiliation(s)
- Jonathon Lo
- Faculty of Medicine, University of Melbourne, Melbourne, Australia.,CancerAid, Sydney, Australia
| | | | | | | | | | - Michael Boyer
- Department of Oncology, Chris O'Brien Lifehouse, Sydney, Australia.,Faculty of Medicine, University of Sydney, Sydney, Australia
| | - Raghav Murali-Ganesh
- CancerAid, Sydney, Australia.,Faculty of Medicine, University of Sydney, Sydney, Australia.,Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, Australia
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Factors associated with returning to work and work ability of colorectal cancer survivors. Support Care Cancer 2021; 30:2349-2357. [PMID: 34743239 DOI: 10.1007/s00520-021-06638-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 10/16/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE The objective of this current study was to describe the status of returning to work and work ability of colorectal cancer survivors and identify the key factors associated with returning to work and work ability of Chinese colorectal cancer patients. METHODS A cross-sectional observational study was performed in 212 colorectal cancer survivors who have worked before their colorectal cancer diagnosis. We evaluated patient's return to work (Yes/No), work ability, and factors by questionnaires of the Work Ability Index (WAI), M. D. Anderson Symptom Inventory for Gastrointestinal (MDASI-GI), and the Self-Report Psychosocial Adjustment to Illness Scale (PAIS-SR). Logistic regression analysis and linear regression were used to find the potential predictors with returning to work and work ability. RESULTS Participants mostly 145 have returned to work (68.4%). Work ability and psychosocial adjustment of colorectal cancer survivors were at a moderate level. After completing treatment, the patient still had many symptoms, and these symptoms were distress to live. In the two models, survivors with higher family monthly income per capita and lower psychosocial adjustment scores were more likely to have higher work ability and return to work. Survivors with lower symptom distress were more likely to have higher work ability (r = - 0.038, p = 0.010). Survivors with higher work ability were more likely to return to work (OR = 1.193, 95% CI = (1.116,1.274)). CONCLUSION This study confirmed that symptom distress and psychosocial adjustment were significantly associated with colorectal cancer survivors' returning to work and work ability, which should be considered in future intervention research.
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