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van Ommen F, Duijts SFA, Coenen P, Dalton SO, Kliffen A, van Hummel R, de Boer AGEM, Greidanus MA. Protocol of a randomized controlled trial on the effectiveness and cost-effectiveness of the PLACES intervention: a supported employment intervention aimed at enhancing work participation of unemployed and/or work-disabled cancer survivors. Trials 2024; 25:603. [PMID: 39252084 PMCID: PMC11384714 DOI: 10.1186/s13063-024-08441-x] [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: 05/06/2024] [Accepted: 08/29/2024] [Indexed: 09/11/2024] Open
Abstract
BACKGROUND Approximately onethird of cancer survivors encounter challenges reintegrating into the workforce, often experiencing involuntary unemployment and/or partial or full work disability following diagnosis and treatment. Returning to paid employment presents evident challenges due to uncertainties regarding work ability, perceived employer discrimination, and a lack of support, thereby risking social exclusion. However, interventions addressing return to paid employment among unemployed and/or work-disabled cancer survivors are scarce. Here, we describe the protocol of a randomized controlled trial (RCT), including a process and economic evaluation, evaluating the effectiveness and cost-effectiveness of the PLACES (unemPLoyed cAnCEr survivors Support) intervention aimed at supporting unemployed and/or work-disabled cancer survivors returning to paid employment. METHODS A two-armed RCT with a 12-month follow-up period will be conducted. Eligible participants: (1) are of working age (18-65 years), (2) are diagnosed with cancer between 6 months and 10 years ago, (3) are unemployed and/or partially or fully work-disabled, (4) have completed cancer treatment, and (5) are seeking paid employment and are motivated to initiate work immediately. Participants will primarily be identified through the Dutch Social Security Agency and the Netherlands Cancer Registry and recruited via healthcare professionals. Participants randomly allocated to the intervention group (n = 82) will receive the PLACES intervention: a tailored supported employment intervention based on the principles of Individual Placement and Support (IPS). This includes support in seeking, returning to, and maintaining paid employment. Participants allocated to the control group (n = 82) will receive care as usual. All participants will be asked to complete questionnaires, at baseline (T0), and after 3 (T1), 6 (T2), and 12 (T3) months of follow-up. The primary outcome is paid employment [yes/no]. Secondary outcomes are time until paid employment, change in working hours, work ability, quality of (working) life, and self-efficacy regarding return to work. Additionally, process and economic evaluations will be conducted. DISCUSSION We hypothesize that the PLACES intervention will be effective in obtaining paid employment, enhancing work ability, and improving quality of life. In addition, we expect the intervention to be cost-effective. If proven effective and cost-effective, actions should be taken to implement the intervention in usual care. TRIAL REGISTRATION NCT06028048.
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Affiliation(s)
- F van Ommen
- Amsterdam UMC, Department of Public and Occupational Health, Location University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands.
- Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, the Netherlands.
| | - S F A Duijts
- Netherlands Comprehensive Cancer Organisation (IKNL), Department of Research & Development, Utrecht, the Netherlands
- Amsterdam UMC, Location Vrije Universiteit, Department of Medical Psychology, Amsterdam, the Netherlands
- Cancer Centre Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands
| | - P Coenen
- Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, the Netherlands
- UMC, Location Vrije Universiteit, Department of Public and Occupational Health, Amsterdam, the Netherlands
- Amsterdam Movement Sciences Research Institute, Musculoskeletal Health, Amsterdam, the Netherlands
| | - S O Dalton
- Danish Cancer Institute, Cancer Survivorship, Copenhagen, Denmark
- Department for Clinical Oncology & Palliative Care, Danish Research Center for Equality in Cancer (COMPAS), Zealand University Hospital, Næstved, Denmark
| | - A Kliffen
- Dutch Social Security Institute, Haarlem, the Netherlands
| | - R van Hummel
- Cancer-Related Return-To-Work Consultancy and Guidance, Utrecht, The Netherlands
| | - A G E M de Boer
- Amsterdam UMC, Department of Public and Occupational Health, Location University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, the Netherlands
- Cancer Centre Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands
| | - M A Greidanus
- Amsterdam UMC, Department of Public and Occupational Health, Location University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, the Netherlands
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Wolfe DM, Hamel C, Rice D, Veroniki AA, Skidmore B, Kanji S, Rabheru K, McGee SF, Forbes L, Liu M, Saunders D, Vandermeer L, de Lima IM, Clemons M, Hutton B. Comparative effectiveness of interventions for cancer treatment-related cognitive impairment in adult cancer survivors: protocol for a systematic review. Syst Rev 2024; 13:207. [PMID: 39103943 PMCID: PMC11299411 DOI: 10.1186/s13643-024-02602-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 07/04/2024] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND Cancer treatment-related cognitive impairment (CTRCI) can substantially reduce the quality of life of cancer survivors. Many treatments of CTRCI have been evaluated in randomized controlled trials (RCTs), including psychological interventions, pharmacologic interventions, and other therapies. There is a pressing need to establish the benefits and harms of previously studied CTRCI treatments. The proposed systematic review and network meta-analyses will assess the relative efficacy and safety of competing interventions for the management of CTRCI. METHODS In consultation with the review team, an experienced medical information specialist will draft electronic search strategies for MEDLINE®, Embase, CINAHL, PsycINFO, and the Cochrane Trials Registry. We will seek RCTs of interventions for the treatment of CTRCI in adults with any cancer, except cancers/metastases of the central nervous system. Due to the anticipated high search yields, dual independent screening of citations will be expedited by use of an artificial intelligence/machine learning tool. The co-primary outcomes of interest will be subjective and objective cognitive function. Secondary outcomes of interest will include measures of quality of life, mental and physical health symptoms, adherence to treatment, and harms (overall and treatment-related harms and harms associated with study withdrawal), where feasible, random-effects meta-analyses and network meta-analyses will be pursued. We will address the anticipated high clinical and methodological heterogeneity through meta-regressions, subgroup analyses, and/or sensitivity analyses. DISCUSSION The proposed systematic review will deliver a robust comparative evaluation of the efficacy and safety of existing therapies for the management of CTRCI. These findings will inform clinical decisions, identify evidence gaps, and identify promising therapies for future evaluation in RCTs.
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Affiliation(s)
- D M Wolfe
- Ottawa Hospital Research Institute, 501 Smyth Road, Box 201B, Ottawa, ON, K1H 8L6, Canada
| | - C Hamel
- Ottawa Hospital Research Institute, 501 Smyth Road, Box 201B, Ottawa, ON, K1H 8L6, Canada
- Canadian Association of Radiologists, Ottawa, Canada
| | - D Rice
- Ottawa Hospital Research Institute, 501 Smyth Road, Box 201B, Ottawa, ON, K1H 8L6, Canada
| | - A A Veroniki
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
- Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada
| | - B Skidmore
- Ottawa Hospital Research Institute, 501 Smyth Road, Box 201B, Ottawa, ON, K1H 8L6, Canada
| | - S Kanji
- Ottawa Hospital Research Institute, 501 Smyth Road, Box 201B, Ottawa, ON, K1H 8L6, Canada
- Department of Pharmacy, The Ottawa Hospital, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada
| | - K Rabheru
- Department of Psychiatry, University of Ottawa, Ottawa, Canada
| | - S F McGee
- Division of Medical Oncology, The Ottawa Hospital, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada
- Department of Medicine, University of Ottawa, Ottawa, Canada
| | - L Forbes
- Ontario Health (Cancer Care Ontario), Toronto, Canada
- Division of Medical Oncology, Durham Regional Cancer Centre, Lakeridge Health, Oshawa, Canada
| | - M Liu
- Ottawa Hospital Research Institute, 501 Smyth Road, Box 201B, Ottawa, ON, K1H 8L6, Canada
| | - D Saunders
- Ottawa Hospital Research Institute, 501 Smyth Road, Box 201B, Ottawa, ON, K1H 8L6, Canada
| | - L Vandermeer
- Ottawa Hospital Research Institute, 501 Smyth Road, Box 201B, Ottawa, ON, K1H 8L6, Canada
| | - I Machado de Lima
- Division of Medical Oncology, The Ottawa Hospital, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada
| | - M Clemons
- Ottawa Hospital Research Institute, 501 Smyth Road, Box 201B, Ottawa, ON, K1H 8L6, Canada
- Division of Medical Oncology, The Ottawa Hospital, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada
- Department of Medicine, University of Ottawa, Ottawa, Canada
| | - B Hutton
- Ottawa Hospital Research Institute, 501 Smyth Road, Box 201B, Ottawa, ON, K1H 8L6, Canada.
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada.
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Breidenbach C, Ernstmann N, Schellack S, Degenhardt M, Heidkamp P, Heier L, Hiltrop K, Rick O, Soff J, Kowalski C. [Return to Work after Cancer - a Systematic Review of Predictors in Germany]. DIE REHABILITATION 2024; 63:229-237. [PMID: 38917850 DOI: 10.1055/a-2300-3524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
INTRODUCTION More than one third of cancer survivors are of working age. Return to work (RTW) with and after cancer treatment is therefore an important issue for this group - but this is often accompanied with many challenges. The aim of this systematic review was to identify predictors of RTW after cancer from the literature specifically for Germany and to place these factors chronologically in the oncological course of treatment. METHODS A systematic search was performed using PubMed in June 2022. Included were all papers original published in German or English between 2000 and 2022 and referring to a German sample, regardless of study design. RESULTS From a total of 8,381 hits in the meta-database, 30 publications were finally considered in the synthesis of results. Higher age, lower education, lower socioeconomic status, higher disease stage, more progressive disease course, more severe side effects of treatment, (more severe) fatigue, higher psychological distress, worse health status, occupational status as a blue collar worker and manual labor, unemployment prior to diagnosis, more negative perceptions of the work(place) environment, and lower intention to work and lower work ability/ subjective prognosis of employability were associated with lower likelihood of RTW after cancer in the literature. Treatment type and use of rehabilitation were also found to be associated with RTW. DISCUSSION Sociodemographic, disease-related, psychosocial, and work-related predictors of RTW after cancer in Germany were identified. The results may help to develop targeted support measures that can be applied in specific phases of treatment. The comparability of the literature on predictors for RTW is limited due to a high heterogeneity in the operationalization of RTW and methodological approaches. There is need for further standardization in this area.
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Affiliation(s)
- Clara Breidenbach
- Deutsche Krebsgesellschaft eV, Berlin
- Universität zu Köln, Medizinische Fakultät und Uniklinik Köln, Institut für Medizinsoziologie, Versorgungsforschung und Rehabilitationswissenschaft, Lehrstuhl für Versorgungsforschung, Köln
| | - Nicole Ernstmann
- Universität zu Köln, Medizinische Fakultät und Uniklinik Köln, Institut für Medizinsoziologie, Versorgungsforschung und Rehabilitationswissenschaft, Lehrstuhl für Versorgungsforschung, Köln
- Forschungsstelle für Gesundheitskommunikation und Versorgungsforschung (CHSR), Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Uniklinik Bonn
| | | | - Marie Degenhardt
- Forschungsstelle für Gesundheitskommunikation und Versorgungsforschung (CHSR), Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Uniklinik Bonn
| | - Paula Heidkamp
- Forschungsstelle für Gesundheitskommunikation und Versorgungsforschung (CHSR), Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Uniklinik Bonn
- Universität zu Köln, Medizinische Fakultät und Uniklinik Köln, Institut für Medizinsoziologie, Versorgungsforschung und Rehabilitationswissenschaft, Lehrstuhl für Versorgungsforschung, Köln
| | - Lina Heier
- Forschungsstelle für Gesundheitskommunikation und Versorgungsforschung (CHSR), Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Uniklinik Bonn
- Universität zu Köln, Medizinische Fakultät und Uniklinik Köln, Institut für Medizinsoziologie, Versorgungsforschung und Rehabilitationswissenschaft, Lehrstuhl für Versorgungsforschung, Köln
- Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Center, Maastricht, Netherlands
- CARIM School for Cardiovascular Disease, Maastricht University, Maastricht, Netherlands
| | - Kati Hiltrop
- Universität zu Köln, Medizinische Fakultät und Uniklinik Köln, Institut für Medizinsoziologie, Versorgungsforschung und Rehabilitationswissenschaft, Lehrstuhl für Versorgungsforschung, Köln
- Forschungsstelle für Gesundheitskommunikation und Versorgungsforschung (CHSR), Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Uniklinik Bonn
| | - Oliver Rick
- Fachklinik für onkologische Rehabilitation, Klinik Reinhardshöhe, Bad Wildungen
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Sterkens P, Sharipova A, Baert S. Disclosing the 'Big C': what does cancer survivorship signal to employers? THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2024; 25:671-688. [PMID: 37480381 DOI: 10.1007/s10198-023-01618-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 06/28/2023] [Indexed: 07/24/2023]
Abstract
To study hiring discrimination against cancer survivors, we conduct a vignette experiment in which American and British professionals recruited via Prolific evaluate fictitious job candidates. Candidates differed by periods of non-employment in their career, including non-employment due to suffering from cancer. We study the effect of cancer experiences on professionals' hirability ratings, as well as its effect on underlying candidate perceptions, related to various potential forms of stigma identified in the literature. We find that employment opportunities are lower for candidates with a history of cancer, compared to candidates without such a gap. This penalty is particularly explained by perceptions that these candidates will have higher sick leave probabilities and create additional costs. However, relative to candidates with a comparable gap due to depression or personal reasons, former cancer patients are less stigmatised, with relatively favourable assessments of their emotional abilities, social abilities, motivation and positive impact on workplace culture.
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Affiliation(s)
| | | | - Stijn Baert
- Ghent University, Ghent, Belgium
- University of Antwerp, Antwerp, Belgium
- Université Catholique de Louvain, Louvain-La-Neuve, Belgium
- GLO, Stanford, USA
- IZA, Bonn, Germany
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Kim K, Yoon H. Effectiveness of a mobile-based return to work program for decent return to work, fatigue, stress, and quality of working life among cancer survivors. J Cancer Surviv 2024:10.1007/s11764-024-01570-x. [PMID: 38769245 DOI: 10.1007/s11764-024-01570-x] [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: 10/05/2023] [Accepted: 03/13/2024] [Indexed: 05/22/2024]
Abstract
PURPOSE This study aimed to develop a smartphone mobile application-based supportive return to work (RTW) program for cancer survivors and evaluate its effects on their RTW, fatigue, stress, and quality of working life. This program was developed through a comprehensive process involving literature review, interviews with cancer survivors, and consultations with experts. METHODS A non-equivalent control group pre- and post-test design was used, with 41 participants assigned to the experimental (n = 18) and control (n = 23) groups based on recruitment timing. The experimental group received a 6-week smartphone mobile application-based supportive RTW program comprising "Counseling and Education" and "Self-Management." Participants completed assessments of decent RTW, fatigue, stress, and quality of working life at baseline and 6 months later. The experimental group completed an additional post-program completion survey. RESULTS During the 6-week program, no experimental group participants dropped out. The program's impact on decent RTW remains unclear. Fatigue (F = 2.52, p = 0.095) and quality of working life (F = 0.86, p = 0.434) did not show statistically significant differences. However, there was a significant reduction in stress (F = 4.59, p = 0.017). CONCLUSION The smartphone application-based RTW program, focusing on self-management and counseling, effectively reduced participants' stress levels. To further evaluate the effectiveness of the program, a more diverse range of interventions and ongoing programs should be implemented. IMPLICATIONS FOR CANCER SURVIVORS This study underscores the importance of tailored digital interventions to support the RTW of cancer survivors. The use of mobile smartphone applications allows temporal and spatial flexibility in program participation. Interventions involving various activities should be implemented to ensure ongoing participation.
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Affiliation(s)
- Kisook Kim
- Department of Nursing, Chung-Ang University, 84, Heukseok-Ro, Dongjak-Gu, Seoul, 06974, Republic of Korea
| | - Hyohyeon Yoon
- Department of Nursing, Chung-Ang University, 84, Heukseok-Ro, Dongjak-Gu, Seoul, 06974, Republic of Korea.
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Guo YJ, Xue P, Gu WW, Su XQ, Li JM, Kuai BX, Xu JS, Xie HW, Han PP. Development and validation of Adaptability to Return-to-Work Scale (ARTWS) for cancer patients. Front Psychol 2024; 14:1275331. [PMID: 38741785 PMCID: PMC11090167 DOI: 10.3389/fpsyg.2023.1275331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 11/21/2023] [Indexed: 05/16/2024] Open
Abstract
Introduction The research on cancer patients returning to work in China is still in its infancy, and there is no research and discussion on the adaptability to return-to-work for cancer patients. It is critical to develop the Adaptability to Return-to-Work Scale (ARTWS) for cancer patients and evaluate its psychometric properties. Methods The items of the initial scale were compiled based on the theoretical model and literature review results. Through two rounds of Delphi expert consultation (N = 15) and a pilot survey (N = 40), the initial scale was further checked and revised. Conduct a large sample survey (N = 376) and the construct validity and reliability of the ARTWS were assessed by confirmatory factor analysis (CFA) and exploratory factor analysis (EFA). Results The final ARTWS consisted of 24 items. "Focusing on rehabilitation," "Rebuilding Self-efficiency," and "Adjusting plans" as common factors in determining adaptability to return to work for cancer patients, and the cumulative variance contribution rate for these three factors was 66.6%. The S-CVI of the total scale was 0.979. The Cronbach's α coefficient was 0.937 and the 2-week test-retest reliability was 0.814. Discussion ARTWS has good correlation validity and can be used as a tool to measure the adaptability of cancer patients' return to work. The presentation of the manuscript in Research Square (https://doi.org/10.21203/rs.3.rs-2323264/v1).
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Affiliation(s)
- Yu-Jie Guo
- School of Nursing and Rehabilitation, Nantong university, Nantong, Jiangsu, China
| | - Ping Xue
- School of Nursing and Rehabilitation, Nantong university, Nantong, Jiangsu, China
- Office of Joint Medicine, Taizhou Second People’s Hospital, Jiangyan District, Taizhou, Jiangsu, China
| | - Wen-wen Gu
- School of Nursing and Rehabilitation, Nantong university, Nantong, Jiangsu, China
- Department of Neurosurgery, Rudong People’s Hospital, Nantong, Jiangsu, China
| | - Xiao-qin Su
- School of Nursing and Rehabilitation, Nantong university, Nantong, Jiangsu, China
| | - Jia-mei Li
- School of Nursing and Rehabilitation, Nantong university, Nantong, Jiangsu, China
| | - Ben-xin Kuai
- School of Nursing and Rehabilitation, Nantong university, Nantong, Jiangsu, China
| | - Jia-shuo Xu
- School of Nursing and Rehabilitation, Nantong university, Nantong, Jiangsu, China
| | - Hui-wen Xie
- School of Nursing and Rehabilitation, Nantong university, Nantong, Jiangsu, China
| | - Ping-ping Han
- School of Nursing and Rehabilitation, Nantong university, Nantong, Jiangsu, China
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Park SY, Lee MK. Effects of a self-managed return to work intervention for colorectal cancer survivors: A prospective randomized controlled trial. Eur J Oncol Nurs 2024; 70:102593. [PMID: 38795437 DOI: 10.1016/j.ejon.2024.102593] [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: 09/13/2023] [Revised: 03/31/2024] [Accepted: 04/12/2024] [Indexed: 05/28/2024]
Abstract
PURPOSE The present study aims to assess the efficacy of stage-matched, self-managed Return to Work (RTW) interventions in enhancing RTW outcomes among colorectal cancer (CRC) survivors. METHODS This trial, conducted in South Korea, enrolled 58 unemployed survivors of colorectal cancer. Participants were randomly assigned to either an experimental or a control group. The experimental group received a self-managed return-to-work intervention based on the trans-theoretical model, while the control group received an educational booklet. Assessments were conducted at baseline and at 3, 6, and 12 months to measure changes in various factors including return-to-work status and HRQOL. RESULTS In the experimental group, 28 participants were randomly assigned, while 30 individuals were allocated to the control group. The experimental group exhibited a higher proportion of individuals achieving RTW (64.5% vs 39.3%, p = 0.013) and demonstrated greater improvements in work ability (p = 0.001), RTW self-efficacy (p = 0.035), readiness for RTW in the prepared-for-action (p < 00.0001), uncertain maintenance (p = 0.033), and proactive maintenance (p < 00.0001) stages, quality of working life (p = 0.003), HRQOL (p < 0.05), and illness perception (p < 0.05) compared to the control group at the 12-month follow-up. CONCLUSIONS Stage-matched self-managed RTW interventions incorporating TTM principles may effectively enhance RTW outcomes and work ability among CRC survivors.
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Affiliation(s)
- Soo Yeun Park
- College of Nursing, Research Institute of Nursing Science (Dr. Lee); and Colorectal Cancer Center, Kyungpook National University Chilgok Hospital, School of Medicine (Drs Park), Kyungpook National University, Daegu, South Korea.
| | - Myung Kyung Lee
- College of Nursing, Research Institute of Nursing Science (Dr. Lee); and Colorectal Cancer Center, Kyungpook National University Chilgok Hospital, School of Medicine (Drs Park), Kyungpook National University, Daegu, South Korea.
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Brink E, Pilegaard MS, Bonnesen TG, Nielsen CV, Pedersen P. Employment status in cancer patients the first five years after diagnosis-a register-based study. J Cancer Surviv 2024:10.1007/s11764-024-01576-5. [PMID: 38587762 DOI: 10.1007/s11764-024-01576-5] [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: 12/07/2023] [Accepted: 03/25/2024] [Indexed: 04/09/2024]
Abstract
PURPOSE Work is important for identity formation, social status, and economic independency. Although some evidence within the field of work and cancer survivorship exists, no study has so far investigated employment status across all cancer diagnoses. Thus, the aim of the present study was to investigate the impact of all cancer diagnoses on employment status. METHODS Danish cancer patients aged 20-60 years, diagnosed between 2000 and 2015, were identified through Danish registers and matched 1:5 with cancer-free controls. Logistic and linear regression was performed separately in 11 cancer types to assess and compare work status and work participation between cancer patients and cancer-free controls one, three, and five years after diagnosis. RESULTS A total of 111,770 cancer patients and 507,003 cancer-free controls were included. All cancer types had lower chances of working one year after diagnosis (ORs between 0.05 and 0.76), with lung, colorectal, upper gastrointestinal, and blood cancer patients having the lowest chances. After three years, 10 of 11 cancer types had lower chances (ORs between 0.39 and 0.84). After five years, there were minimal differences between cancer patients and controls among most cancer types (ORs between 0.75 and 1.36). CONCLUSION Most cancer patients had lower chances of working compared with the general population until five years after diagnosis. However, patients with certain cancer types experienced lower chances of working all years, despite improvement over time. IMPLICATIONS FOR CANCER SURVIVORS The knowledge will help increase awareness on challenges regarding work-life after cancer. Furthermore, the distinguishing between diagnoses can inform to more targeted vocational rehabilitation.
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Affiliation(s)
- E Brink
- Department of Public Health, Aarhus University, Aarhus, Denmark.
- DEFACTUM, Central Denmark Region, Aarhus, Denmark.
| | - M S Pilegaard
- DEFACTUM, Central Denmark Region, Aarhus, Denmark
- Department of Social Medicine and Rehabilitation, Goedstrup Hospital, Herning, Denmark
| | - T G Bonnesen
- Department of Social Medicine and Rehabilitation, Goedstrup Hospital, Herning, Denmark
| | - C V Nielsen
- Department of Public Health, Aarhus University, Aarhus, Denmark
- DEFACTUM, Central Denmark Region, Aarhus, Denmark
- Department of Social Medicine and Rehabilitation, Goedstrup Hospital, Herning, Denmark
| | - P Pedersen
- Department of Public Health, Aarhus University, Aarhus, Denmark
- DEFACTUM, Central Denmark Region, Aarhus, Denmark
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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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Yagil D, Cohen M. Self-employed workers with chronic health conditions: A qualitative study. J Health Psychol 2024:13591053241239462. [PMID: 38520040 DOI: 10.1177/13591053241239462] [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: 03/25/2024] Open
Abstract
Chronic health conditions affect many individuals of working age, who cope with physical, psychological, and social difficulties that often involve limited work ability. This qualitative study explored experiences of self-employed individuals with chronic health conditions to advance our understanding of the effect of chronic illness on work. In-depth semi-structured interviews were conducted with 23 self-employed individuals coping with cancer, heart disease, inflammatory bowel disease, lung disease, or asthma. Data were analyzed with thematic analysis. Analysis of the interviews revealed four themes: uncertainty in planning work and committing to customers, acceptance versus denial of reduced work abilities, disclosure of health status to workers and customers, and temporal substitutes as a source of both support and concern. The results indicate that self-employed workers with a chronic health condition cope with unique challenges due to the need to sustain their business in the face of illness and a sense of sole responsibility.
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11
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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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12
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Ng DWL, So SCY, Fielding R, Mehnert-Theuerkauf A, Kwong A, Suen D, Wong L, Fung SWW, Chun OK, Fong DYT, Chan S, Molasiotis A, So WKW, Lam WWT. Return to work, work productivity loss and activity impairment in Chinese breast cancer survivors 12-month post-surgery: a longitudinal study. Front Public Health 2024; 12:1340920. [PMID: 38463159 PMCID: PMC10920332 DOI: 10.3389/fpubh.2024.1340920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 02/05/2024] [Indexed: 03/12/2024] Open
Abstract
Introduction Existing evidence of returning-to-work (RTW) after cancer comes predominately from Western settings, with none prospectively examined since the initial diagnostic phase. This study prospectively documents RTW-rate, time-to-RTW, work productivity loss, and activity impairment, within the first-year post-surgery among Chinese women with breast cancer (BCW) and identify potential causal co-variants. Methods This observational longitudinal study followed 371 Chinese BCW who were employed/self-employed at the time of diagnosis at 4-week post-surgery (baseline). RTW-status and time-to-RTW were assessed at baseline (T1), 4-month (T2), 6-month (T3), and 12-month (T4) post-baseline. WPAI work productivity loss and activity impairment were assessed at T4. Baseline covariates included demographics, medical-related factors, work satisfaction, perceived work demand, work condition, RTW self-efficacy, B-IPQ illness perception, COST financial well-being, EORTC QLQ-C30 and QLQ-BR23 physical and psychosocial functioning, and HADS psychological distress. Results A 68.2% RTW-rate (at 12-month post-surgery), prolonged delay in RTW (median = 183 days), and significant proportions of T4 work productivity loss (20%), and activity impairment (26%), were seen. BCW who were blue-collar workers with lower household income, poorer financial well-being, lower RTW self-efficacy, poorer job satisfaction, poorer illness perception, greater physical symptom distress, impaired physical functioning, and unfavorable work conditions were more likely to experience undesired work-related outcomes. Discussion Using a multifactorial approach, effective RTW interventions should focus on not only symptom management, but also to address psychosocial and work-environmental concerns. An organizational or policy level intervention involving a multidisciplinary team comprising nurses, psychologists, occupational health professionals, and relevant stakeholders in the workplace might be helpful in developing a tailored organizational policy promoting work-related outcomes in BCW.
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Affiliation(s)
- Danielle Wing Lam Ng
- LKS Faculty of Medicine, School of Public Health, Centre for Psycho-Oncology Research and Training, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- LKS Faculty of Medicine, Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Serana Chun Yee So
- LKS Faculty of Medicine, School of Public Health, Centre for Psycho-Oncology Research and Training, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- LKS Faculty of Medicine, Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Richard Fielding
- LKS Faculty of Medicine, School of Public Health, Centre for Psycho-Oncology Research and Training, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- LKS Faculty of Medicine, Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Anja Mehnert-Theuerkauf
- University Medical Center Leipzig, Department of Medical Psychology and Medical Sociology, The University of Leipzig, Leipzig, Germany
| | - Ava Kwong
- LKS Faculty of Medicine, School of Clinical Medicine, Department of Surgery, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Dacita Suen
- LKS Faculty of Medicine, School of Clinical Medicine, Department of Surgery, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Ling Wong
- Department of Surgery, Tung Wah Hospital, Hospital Authority, Hong Kong, Hong Kong SAR, China
| | - Sara Wai Wun Fung
- Department of Surgery, Kwong Wah Hospital, Hospital Authority, Hong Kong, Hong Kong SAR, China
| | - Oi Kwan Chun
- Department of Surgery, Kwong Wah Hospital, Hospital Authority, Hong Kong, Hong Kong SAR, China
| | - Daniel Y. T. Fong
- LKS Faculty of Medicine, School of Nursing, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Sharon Chan
- Department of Surgery, United Christian Hospital, Hospital Authority, Hong Kong, Hong Kong SAR, China
| | - Alex Molasiotis
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
- College of Arts, Humanities and Education, University of Derby, Derby, United Kingdom
| | - Winnie K. W. So
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Wendy Wing Tak Lam
- LKS Faculty of Medicine, School of Public Health, Centre for Psycho-Oncology Research and Training, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- LKS Faculty of Medicine, Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
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13
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Le GH, Hermansen Å, Dahl E. Return to work after cancer-the impact of working conditions: A Norwegian Register-based Study. J Cancer Surviv 2023:10.1007/s11764-023-01503-0. [PMID: 38114712 DOI: 10.1007/s11764-023-01503-0] [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: 06/02/2023] [Accepted: 11/15/2023] [Indexed: 12/21/2023]
Abstract
PURPOSE The purpose of this study is to compare a cohort of cancer survivors with a cohort of cancer-free employees (1) with respect to employment prospects over a 15-year period and (2) with respect to the differential impact of working conditions on employment over this time period. METHODS The cancer cohort is retrieved from the Cancer Registry of Norway, while data on the non-cancer cohort are retrieved from register data managed by Statistics Norway. Job exposure matrices were used to remedy the lack of working-conditions information in the register data. We use nearest-neighbor matching to match the non-cancer cohort (the control group) to the cancer-survivor cohort (the treatment group). Cox regression analysis was applied to examine the relationships between working conditions, employment, and cancer. The results are reported separately for mechanical-job exposures and psychosocial exposures, as well as by gender. RESULTS Cancer survivors are more likely to experience reduced employment as compared to individuals without a history of cancer. Male cancer survivors in physically demanding occupations have an increased risk of reduced employment after being diagnosed with cancer. This does not apply to female cancer survivors. Regarding the impact of psychosocial exposures on employment, we find no differences over time between cancer survivors and the non-cancer population. CONCLUSIONS Male cancer survivors in physically demanding occupations have an increased risk of reduced employment after being diagnosed with cancer, whereas this is not the case for female cancer survivors. Psychosocial exposures do not impact the relative risk of reduced employment over time. IMPLICATIONS FOR CANCER SURVIVORS We suggest that return to work after cancer should be considered a process rather than only the re-entry step of resuming work. Thus, it is important to provide long-term support for cancer survivors. We recommend providing more attention to working conditions, particularly in occupations that involve a high level of mechanical-job exposures.
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Affiliation(s)
- Giang Huong Le
- Department of Social Work, Child Welfare and Social Policy, OsloMet - Oslo Metropolitan University, Faculty of Social Sciences, Oslo, Norway.
| | - Åsmund Hermansen
- Department of Social Work, Child Welfare and Social Policy, OsloMet - Oslo Metropolitan University, Faculty of Social Sciences, Oslo, Norway
| | - Espen Dahl
- Department of Social Work, Child Welfare and Social Policy, OsloMet - Oslo Metropolitan University, Faculty of Social Sciences, Oslo, Norway
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14
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Schneider J, Hernandez D, Schlander M, Arndt V. Out-of-pocket payments and loss of income among long-term breast cancer survivors in Germany: a multi-regional population-based study. J Cancer Surviv 2023; 17:1639-1659. [PMID: 36459378 PMCID: PMC10539192 DOI: 10.1007/s11764-022-01293-x] [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: 06/24/2022] [Accepted: 11/03/2022] [Indexed: 12/03/2022]
Abstract
PURPOSE This study aims to examine the magnitude of out of pocket (OOP) payments and income loss, as well as to identify socioeconomic and clinical factors among long-term breast cancer (BC) survivors in Germany. METHODS We examine data from 2654 long-term BC survivors in Germany that participated in the "CAncEr Survivorship - A multi-Regional population-based study" (CAESAR) and who were at least 5 years post diagnosis. BC-related OOP payments and income loss both within the 12 months prior to the survey were analyzed. Two-part regression models were performed to identify socioeconomic and clinical factors. RESULTS OOP payments were incurred by 51.9% of survivors with a total mean spending of 566 euros. Income loss was present among 9.6% of survivors and averaged 5463 euros among those reporting such. Socioeconomic and clinical factors associated with higher OOP payments (p ≤ 0.05) included age at time of diagnosis (65-79 years), education (10-11 years), (early) retirement, stage of diagnosis (stage III), time from diagnosis (more than 10 years), comorbidities (at least 1), and the use of rehabilitation services. Regarding income loss, age at time of diagnosis (50-59 years), (early) retirement, stage of diagnosis (stage II), time from diagnosis (5-7 years), comorbidities (at least 1), and receiving chemotherapy treatment were associated with higher losses. CONCLUSIONS For some survivors in Germany, financial burden can be considerably high despite comprehensive healthcare and support from social security. IMPLICATIONS FOR CANCER SURVIVORS OOP payments related to domestic help and nursing staff as well as to outpatient care are most frequent.
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Affiliation(s)
- Jana Schneider
- Medical Faculty Heidelberg, Heidelberg University, Heidelberg, Germany
- Division of Health Economics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Diego Hernandez
- Division of Health Economics, German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - Michael Schlander
- Division of Health Economics, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Volker Arndt
- Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
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15
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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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16
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Siebinga TM, Janssen SHM, Boumans AW, Van Eenbergen MC, Siflinger B, Van Der Graaf WTA, Husson O. Financial outcomes of adolescent and young adult cancer survivors: a longitudinal population-based registry study. J Natl Cancer Inst 2023; 115:1294-1301. [PMID: 37280086 DOI: 10.1093/jnci/djad107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 04/05/2023] [Accepted: 06/04/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND The patterns and determinants of long-term income among adolescent and young adult (AYA) cancer survivors, and the differences compared with peers, have not yet been fully explored. This study investigated the long-term effects of cancer on the income of AYA cancer survivors. METHODS The Netherlands Cancer Registry identified all AYA cancer patients (aged 18-39 years) diagnosed in 2013 and alive 5 years postdiagnosis. Clinical data of the selected AYA patients were linked to individual, administrative real-world labor market data of Statistics Netherlands. The control group consisted of a random sample of individuals of the same age, sex, and migration background without cancer. Data on 2434 AYA cancer patients and 9736 controls were collected annually from 2011 until 2019. Changes in income level were measured and compared with the control group using difference-in-difference regression models. RESULTS AYA cancer survivors experience, on average, an 8.5% decrease in annual earnings, relative to the control population. The effects are statistically significant and permanent (P < .01). Younger AYAs (those aged 18-25 years 15.5% income reduction), married cancer survivors (12.3%), females (11.6%), those diagnosed with stage IV disease (38.1%), and central nervous system (15.7%) cancer patients experienced the largest decline in income, on average, relative to controls, all else constant. CONCLUSION Although dependent on the sociodemographic and clinical characteristics, a cancer diagnosis at AYA age has significant implications on the income of cancer patients. Awareness of vulnerable groups and the development of policies to mitigate the financial impact of cancer are critical.
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Affiliation(s)
- Ties M Siebinga
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, the Netherlands
| | - Silvie H M Janssen
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, the Netherlands
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Anke W Boumans
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, the Netherlands
| | - Mies C Van Eenbergen
- Department of Research and Development, Netherlands Comprehensive Cancer Organization, Utrecht, the Netherlands
- Department of Communication and Cognition, Tilburg University, Tilburg, the Netherlands
| | - Bettina Siflinger
- Department of Econometrics and Operations Research, Tilburg University, Tilburg, the Netherlands
| | - Winette T A Van Der Graaf
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, the Netherlands
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Olga Husson
- Department of Medical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, the Netherlands
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, the Netherlands
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17
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Chapman B, Grunfeld EA, Derakshan N. Quality of working life can protect against cognitive and emotional vulnerability in women living with metastatic breast cancer: a cross-sectional study. J Cancer Surviv 2023; 17:1295-1308. [PMID: 35038120 PMCID: PMC8761843 DOI: 10.1007/s11764-022-01169-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 01/10/2022] [Indexed: 02/05/2023]
Abstract
PURPOSE Research focusing on the cognitive and emotional health of women with metastatic breast cancer (MBC) is limited. The focal aim of the current study was to explore how quality of working life was related to global health, perceived cognitive function, anxiety and depression. To this end, women's experience of employers after MBC diagnosis and its relationship to quality of working life was also explored. METHODS Women living with MBC (N = 88) completed online questionnaires assessing their global health status, perceived cognitive and emotional vulnerability and their experience of employers following diagnosis. Women working at the time of the study also reported on their quality of working life. RESULTS Women's experience of employers after MBC diagnosis was positively related to their quality of working life. Importantly, greater quality of working life met with better perceived cognitive function and global health, as well as lower levels of depression in working women. CONCLUSIONS Our study is the first to establish the role of quality of working life in protecting against levels of cognitive vulnerability and emotional vulnerability to depression in women with MBC. We also highlight the importance of having a positive experience with employers. Our findings suggest that educational programmes can be provided to employers to enhance their understanding and awareness of the needs of women with MBC. IMPLICATIONS FOR CANCER SURVIVORS Women with MBC may benefit from employers accessing educational (or support) programmes that can increase their awareness of the treatment-related sequelae and needs of women with MBC in the workplace.
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Affiliation(s)
- Bethany Chapman
- Department of Psychological Sciences, The BRiC Centre (Birkbeck Centre for Building Resilience in Breast Cancer), Birkbeck University of London, Malet Street, London, WC1E 7HX, UK.
| | - Elizabeth A Grunfeld
- Department of Psychological Sciences, The BRiC Centre (Birkbeck Centre for Building Resilience in Breast Cancer), Birkbeck University of London, Malet Street, London, WC1E 7HX, UK
| | - Nazanin Derakshan
- Department of Psychological Sciences, The BRiC Centre (Birkbeck Centre for Building Resilience in Breast Cancer), Birkbeck University of London, Malet Street, London, WC1E 7HX, UK
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Sears-Smith M, Knight TG. Financial Toxicity in Patients with Hematologic Malignancies: a Review and Need for Interventions. Curr Hematol Malig Rep 2023; 18:158-166. [PMID: 37490228 DOI: 10.1007/s11899-023-00707-6] [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] [Accepted: 06/28/2023] [Indexed: 07/26/2023]
Abstract
INTRODUCTION Financial toxicity is a developing research area to quantify the financial stress experienced by patients and caregivers, as well as the mechanisms by which they manage the costs associated with treatment and the very real harms that this stress can inflict upon cancer care. Patients with blood malignancies experience increased costs associated with their diagnosis due to possible inpatient admissions for treatment, frequent office visits, and even more frequent lab evaluations and testing. PURPOSE OF REVIEW Multiple studies have examined the causes and effects of financial toxicity on patient care and outcomes, and there have been several validated tools developed to identify patients experiencing or at risk for financial harm. DISCUSSION However, few studies to date have focused on implementing successful interventions to assist in mitigating financial difficulties for patients diagnosed with hematologic malignancies and their families. In this review, we examine the current literature with an emphasis on levels of care, including providers, systems, and policies. Specifically, we discuss published interventions including physician education about treatment costs, financial navigation in cancer centers, and novel institutional multidisciplinary review of patients' financial concerns. We also discuss the urgent need for societal and governmental interventions to lessen financial distress experienced by these highly vulnerable blood cancer patients.
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Affiliation(s)
- Megan Sears-Smith
- Levine Cancer Institute, Atrium Health, 1020 Morehead Medical Drive, Charlotte, NC, 28204, USA
| | - Thomas G Knight
- Levine Cancer Institute, Atrium Health, 1021 Morehead Medical Drive, LCI Building 2, Suite 60100, Charlotte, NC, 28204, USA.
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Tiblom Ehrsson Y, Kisiel MA, Yang Y, Laurell G. Predicting Return to Work after Head and Neck Cancer Treatment Is Challenging Due to Factors That Affect Work Ability. Cancers (Basel) 2023; 15:4705. [PMID: 37835399 PMCID: PMC10571884 DOI: 10.3390/cancers15194705] [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: 08/07/2023] [Revised: 09/19/2023] [Accepted: 09/22/2023] [Indexed: 10/15/2023] Open
Abstract
Striving to return to work is of great importance to many cancer survivors. The purpose of the study is to prospectively investigate the factors that hinder and facilitate return to work (RTW) at 3 and 12 months after the end of treatment in head and neck cancer (HNC) survivors and whether these factors influence the ability to continue working after treatment. Participants (n = 227) aged ≤ 65 years at diagnosis with HNC were included. Data were collected before the start of treatment and at 3 and 12 months after the end of treatment. The Rubin causal model was used for statistical analysis. Within the 3-month follow-up period, 92 participants had RTW and 30 had retired. At the 12-month follow-up, 80 of these participants were still working, another 51 participants had RTW, and five participants working still suffered from cancer. The hindrance to RTW within 3 months was advanced tumour stage (stage III and IV) (p = 0.0038). Hindrances to RTW at the 12-month follow-up were oral cancer (p = 0.0210) and larynx cancer (p = 0.0041), and facilitators were living in a relationship (p = 0.0445) and a white-collar job (p = 0.00267). Participants with early tumour stage (stage I and II) (p = 0.0019) and a white-collar job (p = 0.0185) had earlier RTW. The conclusion is that disease factors were the most important hindrances to RTW, and type of work and living with a spouse or partner were nonclinical factors influencing RTW.
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Affiliation(s)
- Ylva Tiblom Ehrsson
- Department of Surgical Sciences, Section of Otorhinolaryngology and Head & Neck Surgery, Uppsala University, 751 85 Uppsala, Sweden;
| | - Marta A. Kisiel
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, 751 85 Uppsala, Sweden;
| | - Yukai Yang
- Department of Statistics, Uppsala University, 751 20 Uppsala, Sweden;
| | - Göran Laurell
- Department of Surgical Sciences, Section of Otorhinolaryngology and Head & Neck Surgery, Uppsala University, 751 85 Uppsala, Sweden;
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20
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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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21
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Greidanus MA, Porro B. The cancer survivor-Manager dyad during the return-to-work process: An introduction with theoretical, conceptual, and methodological considerations. Psychooncology 2023; 32:1359-1362. [PMID: 37469255 DOI: 10.1002/pon.6178] [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: 01/31/2023] [Revised: 05/18/2023] [Accepted: 05/30/2023] [Indexed: 07/21/2023]
Abstract
OBJECTIVE There is a need for tailored interventions aimed at promoting the sustainable return to work (RTW) of cancer survivors. As managers have a primary role in supporting cancer survivors to return to work, a better understanding of the "cancer survivor-manager" dyadic process is much needed. The aim of this paper is to introduce the cancer survivor-manager dyad in the context of RTW of cancer survivors, and to inform future studies by presenting theoretical, conceptual, and methodological considerations. CONCLUSIONS Different theoretical, conceptual, and methodological aspects are addressed that open new perspectives concerning the cancer survivor-manager dyad. Among the theoretical and conceptual aspects, we highlight the interest of developing dyadic coping models specific to the cancer survivor-manager dyad. This would allow the conceptualization of their interpersonal dynamics and to frame interventions aimed at supporting cancer survivors and managers. In addition, we encourage to study in more detail the quality of the relationship between the cancer survivor and manager, including its impact on work-related outcomes of the cancer survivor. Methodologically, the actor-partner interdependence model could be relevant to identify any interdependence in the cancer survivor-manager dyad. We also recommend using longitudinal and prospective studies to investigate the cancer survivor-manager dyad, as these studies are well suited to identify evolutive and dynamic aspects of the cancer survivor-manager dyad. Lastly, we propose a recruitment strategy of the dyad by involving a trustworthy third party, to respect the ethical framework, and the privacy and voluntary choice of cancer survivors.
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Affiliation(s)
- Michiel A Greidanus
- Department of Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health research institute, Societal Participation & Health, Amsterdam, The Netherlands
| | - Bertrand Porro
- Univ. Angers, Univ. Rennes, Inserm, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail), Angers, France
- Department of Human and Social Sciences, Institut de Cancérologie de l'Ouest (ICO), Angers, France
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22
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Halpern MT, de Moor JS, Han X, Zhao J, Zheng Z, Yabroff KR. Association of Employment Disruptions and Financial Hardship Among Individuals Diagnosed with Cancer in the United States: Findings from a Nationally Representative Study. CANCER RESEARCH COMMUNICATIONS 2023; 3:1830-1839. [PMID: 37705562 PMCID: PMC10496757 DOI: 10.1158/2767-9764.crc-23-0157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 04/21/2023] [Accepted: 08/15/2023] [Indexed: 09/15/2023]
Abstract
Financial hardship (FH), defined as adverse patient effects due to cancer costs, is experienced by approximately half of individuals diagnosed with cancer. Many individuals diagnosed with cancer also experience disruptions with their employment. This study examines associations of employment disruptions and FH among a nationally representative sample of individuals diagnosed with cancer in the United States. We utilized 2016/2017 Medical Expenditure Panel Survey Experiences with Cancer data from individuals who worked for pay following cancer diagnosis. Employment disruption included taking extended paid time off work; switching to part-time/less demanding jobs; and/or retiring early due to cancer diagnosis/treatment. FH domains included: material (e.g., borrowing money/financial sacrifices); psychologic (e.g., worrying about medical bills/income); and behavioral (delaying/forgoing healthcare services because of cost). Multivariable logistic regression analyses determined associations of employment disruption and FH. Among 732 individuals with a cancer history, 47.4% experienced employment disruptions; 55.9% experienced any FH. Any FH was significantly more common among individuals with versus without employment disruptions across multiple measures and domains (68.7% vs. 44.5%; P value of difference <0.0001). Individuals with employment disruptions were more likely to have any FH [OR, 2.38; 95% confidence interval (CI), 1.62-3.52] and more FHs (OR, 2.76; 95% CI, 1.96-3.89]. This study highlights that employment disruptions are common and significantly associated with multiple domains of FH among individuals with a cancer history. Employer workplace accommodation, physician discussions regarding potential impacts of cancer care on employment, and other policies to minimize employment disruptions among individuals diagnosed with cancer may reduce FH in this vulnerable population. Significance Individuals diagnosed with cancer may have employment disruptions; they may also develop FHs. People with cancer who have employment changes are more likely to also have FHs. Physicians and employers can help individuals with cancer through advancing planning, workplace assistance, and improved medical leave and insurance policies.
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Affiliation(s)
| | | | - Xuesong Han
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Jingxuan Zhao
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Zhiyuan Zheng
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - K. Robin Yabroff
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
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23
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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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24
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Dahl AA, Smeland KB, Eikeland S, Fagerli UM, Bersvendsen HS, Fosså A, Kiserud CE. Work ability and work status changes in long-term Hodgkin lymphoma survivors with focus on late adverse effects. J Cancer Surviv 2023:10.1007/s11764-023-01432-y. [PMID: 37526861 DOI: 10.1007/s11764-023-01432-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 07/14/2023] [Indexed: 08/02/2023]
Abstract
PURPOSE We studied work-related issues in long-term survivors of Hodgkin lymphoma [HLSs] who had undergone treatment according to contemporary stage risk-adapted approaches. At survey, work changes and problems since diagnosis, comparisons of HLSs with low/moderate versus high work ability, associations between work issues, and late adverse effects [LAEs] were examined. METHODS This cross-sectional questionnaire-based study included HLSs treated from 1997 to 2006 and alive at the end of 2016. They completed a mailed questionnaire including work and health-related issues. RESULTS Among 518 invited HLSs, 297 (58%) completed the work-related issues, and 48% of them were females. Mean age at survey was 45.9 years, and mean time was 16.7 years since diagnosis. At follow-up, 71% of the HLSs held paid work and 19% were on disability pension. Only 3% of HLSs did not hold paid work at any time after diagnosis. In total, 43% HLSs had low/moderate and 57% high work ability at follow-up. Low/moderate work ability was significantly associated with older age, female sex, more LAEs, disability pension, lower household income, distressed personality, obesity, fatigue, and mental disorders. More LAEs were significantly associated with more work problems. CONCLUSIONS Many HLSs manage to stay in the work force. Several health problems and LAEs amenable for interventions are significantly associated with low/moderate work ability and emphasize the importance of focus on these issues in long-term follow-up. IMPLICATIONS FOR CANCER SURVIVORS HLSs in paid work at diagnosis can be optimistic as to their future participation in work life. Screening and treatment for health problems such as LAEs may improve work ability.
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Affiliation(s)
- Alv A Dahl
- National Advisory Unit for Late Effects after Cancer Therapy, Oslo University Hospital, Oslo, Norway.
- Department of Oncology, Oslo University Hospital, Oslo, Norway.
| | - Knut B Smeland
- National Advisory Unit for Late Effects after Cancer Therapy, Oslo University Hospital, Oslo, Norway
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Siri Eikeland
- National Advisory Unit for Late Effects after Cancer Therapy, Oslo University Hospital, Oslo, Norway
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | | | - Hanne S Bersvendsen
- Department of Oncology, University Hospital of Northern Norway, Tromsø, Norway
| | - Alexander Fosså
- Department of Oncology, Oslo University Hospital, Oslo, Norway
- KG Jebsen Center for B-Cell Malignancies, University of Oslo, Oslo, Norway
| | - Cecilie E Kiserud
- National Advisory Unit for Late Effects after Cancer Therapy, Oslo University Hospital, Oslo, Norway
- Department of Oncology, Oslo University Hospital, Oslo, Norway
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25
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Pail O, Knight TG. Financial toxicity in patients with leukemia undergoing hematopoietic stem cell transplantation: A systematic review. Best Pract Res Clin Haematol 2023; 36:101469. [PMID: 37353293 DOI: 10.1016/j.beha.2023.101469] [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: 02/17/2023] [Revised: 04/06/2023] [Accepted: 04/11/2023] [Indexed: 06/25/2023]
Abstract
Financial toxicity (FT) is a term used to describe the objective financial burden of cancer care including the associated coping behaviors used by patients and their caregivers. FT has been shown to result in both direct financial burdens and in clinically relevant outcomes, such as non-adherence with care, diminished quality of life, and even decreased overall survival. Much of the data has been described in solid tumors, with limited investigations in the malignant hematology population. Patients with hematologic malignancies undergoing hematopoietic stem cell transplantation (HSCT) face a unique financial burden driven by lengthy hospitalizations and acute and chronic morbidity that have downstream implications on their income and costs. In this review, we discuss the prevalence of FT in patients with leukemia who are eligible for HSCT. We review the impact of FT on financial and clinical outcomes and the role of various interventions that have been studied within this population.
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Affiliation(s)
- Orrin Pail
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
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26
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Andreu Y, Picazo C, Murgui S, Soto-Rubio A, García-Conde A, Romero R. Exploring the independent association of employment status to cancer survivors' health-related quality of life. Health Qual Life Outcomes 2023; 21:44. [PMID: 37170308 PMCID: PMC10176702 DOI: 10.1186/s12955-023-02124-y] [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: 05/20/2022] [Accepted: 04/29/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND Having a job has been associated with better Health-Related Quality of Life (HRQOL) in cancer survivors. However, the sociodemographic and disease-related profiles characterizing the survivors being employed and those having better HRQOL largely overlap. The present study aims to discern the degree to which employment status is independently associated with cancer survivors' HRQOL or if it mainly reflects the impact of other sociodemographic and cancer-related variables. METHODS Cross-sectional study on a heterogeneous sample of 772 working-age survivors of adult-onset cancer. An instrument specifically designed to assess HRQOL in cancer survivors and Multivariate Variance Analysis (MANOVA) were used. RESULTS Survival phase, cancer type, and employment status showed the main effects on cancer survivors' HRQOL. In particular, being employed (vs unemployed) had the greatest positive association with HRQOL, affecting ten of the twelve HRQOL domains considered. Also, interaction effects highlighted the role of age (younger) and marital status (single) as risk factors for a greater negative impact of variables affecting the survivor's HRQOL. CONCLUSIONS The application of a multivariate methodology sheds new light on two relevant issues for the cancer survivor's HRQOL: (i) the existence of differences between diagnostic groups that are not attributed to other variables such as sex, and (ii) the important and independent role that employment status plays. Comprehensive cancer survivorship care should focus more on high-risk groups and include having a job as an essential aspect to consider and prompt. The fact that the employment status is susceptible to change represents a valuable opportunity to care for the wellbeing of this population.
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Affiliation(s)
- Y Andreu
- Personality, Assessment and Psychological Treatments Department, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - C Picazo
- Psychology and Sociology Department, University of Zaragoza, Zaragoza, Spain.
| | - S Murgui
- Social Psychology Department, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - A Soto-Rubio
- Development and Education Psychology Department, Faculty of Psychology and Speech Therapy, University of Valencia, Valencia, Spain
| | - A García-Conde
- Psychology Unit - Valencian Institute of Oncology Foundation, Valencia, Spain
| | - R Romero
- Psychology Unit - Valencian Institute of Oncology Foundation, Valencia, Spain
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27
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Li JM, Su XQ, Xu XP, Xue P, Guo YJ. Influencing factors analysis of adaptability of cancer patients to return-to-work. Support Care Cancer 2023; 31:302. [PMID: 37099274 DOI: 10.1007/s00520-023-07768-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 04/17/2023] [Indexed: 04/27/2023]
Abstract
OBJECTIVES To clarify the adaptability of cancer patients to return to work and explore its influencing factors. DESIGN A cross-sectional study. SETTINGS/PARTICIPANTS From March to October 2021, 283 cancer patients in the follow-up period were recruited from the oncology departments of four secondary and above hospitals and cancer friendship associations in Nantong city using self-developed scale of adaptability to return to work for cancer patients by convenience sampling method. METHODS The contents included general sociodemographic data, disease-related data, cancer patients' readability to work Scale, Medical Coping Style Questionnaire, Social Support Rating Scale, Family Closeness and Readability Scale, General self-efficacy Scale and Social impact Scale. Paper questionnaires were used for face-to-face data collection, and SPSS17.0 was used for statistical analysis. Univariable analyses and multiple linear regression analysis were conducted. RESULTS The overall score of cancer patients' adaptability to return to work was (87.05±20.255), (22.54±4.234) for the dimension of focused rehabilitation, (32.02±9.013) for the dimension of reconstruction effectiveness, and (32.49±9.023) for the dimension of adjustment planning. Multiple linear regression analysis showed that the current return to full-time work (β =0.226, P 0.05), the current return to non-full-time work (β =0.184, P 0.05), yield response (β = -0.132, P 0.05), and general self-efficacy (β =0.226, P 0.05) could affect their return to work adaptation. CONCLUSION The results of status quo and influencing factors showed that the adaptability of cancer patients to return to work was generally higher in this study. Cancer patients who had participated in work, had lower yield coping scores and stigma scores, and higher self-efficacy scores and family adjustment and intimacy scores had better adaptability to return to work again. ETHICAL APPROVAL It has been approved by the Human Research Ethics Committee of the Affiliated Hospital of Nantong University (Project No.202065).
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Affiliation(s)
- Jia-Mei Li
- School of Medicine (School of Nursing) Nantong University, Nantong, 226001, Jiangsu, China
| | - Xiao-Qin Su
- School of Medicine (School of Nursing) Nantong University, Nantong, 226001, Jiangsu, China
| | - Xiao-Ping Xu
- Imaging department, Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, 226001, China
| | - Ping Xue
- Taizhou Second People's Hospital, Taizhou, 225511, Jiangsu, China
| | - Yu-Jie Guo
- School of Medicine (School of Nursing) Nantong University, Nantong, 226001, Jiangsu, China.
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Musa SNS, Hamzah SR, Muda Z, Asimiran S, Krauss SE. Predicting work engagement among young adult cancer survivors: A moderated mediation model. FRONTIERS IN SOCIOLOGY 2023; 8:1030518. [PMID: 36949863 PMCID: PMC10025462 DOI: 10.3389/fsoc.2023.1030518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 01/30/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Early research on cancer survivors was focused on exploring cancer treatments. More recently, attention has shifted to cancer survivorship research, focusing on cancer survivors as individual persons, including the multiple facets of survivors' quality of life but is inapplicable in the context of work-related role played in the young adult cancer survivors' lives. However, in recent studies on the outcomes of long-term survivorship, some of the main areas of cancer survivorship research revolves around employment issues of young adult cancer survivors. In the present study, the focus is given on the role of workplace spirituality as a mediator on the association of employee resilience and workplace social support on work engagement in a Malaysian setting, taking into consideration gender and age differences. METHODS Using a quantitative research paradigm, data were collected from 270 respondents at Pediatric Institute Kuala Lumpur Hospital. Data were analyzed using descriptive statistics and the Partial Least Square-Structural Equation Model (PLS-SEM) to test the direct, indirect, and mediation effects. RESULTS AND DISCUSSION The findings revealed that workplace spirituality did mediate the influence of employee resilience and workplace social support on work engagement. The findings also indicated that gender and age moderated the association of employee resilience and work engagement via workplace spirituality.
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Affiliation(s)
| | - Siti Raba'ah Hamzah
- Faculty of Educational Studies, Universiti Putra Malaysia, Serdang, Malaysia
| | - Zulaiha Muda
- Institute of Pediatric, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
| | - Soaib Asimiran
- Faculty of Educational Studies, Universiti Putra Malaysia, Serdang, Malaysia
| | - Steven E. Krauss
- Institute for Social Science Studies, Universiti Putra Malaysia, Serdang, Malaysia
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Lee SE, Park EY. Employees' attitudes toward cancer, cancer survivors, and cancer survivors' return to work. Asia Pac J Oncol Nurs 2023; 10:100197. [PMID: 36910426 PMCID: PMC9995287 DOI: 10.1016/j.apjon.2023.100197] [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: 11/04/2022] [Accepted: 01/24/2023] [Indexed: 02/05/2023] Open
Abstract
Objective This study aimed to evaluate employees' attitudes toward cancer, patients with cancer, and cancer survivors' return to work. Methods This study used a cross-sectional survey with online questionnaires to collect data during a 1-month period in April 2022. A stratified sampling method was used to select 237 participants. The data were analyzed using Pearson correlation coefficients and an independent t-test. Results The following trends were observed regarding attitudes toward cancer and patients with cancer: impossibility of recovery: 9.00 ± 2.10 (4-16); stereotypes: 8.08 ± 2.12 (4-16); discrimination: 6.98 ± 2.26 (4-16); and financial instability: 7.37 ± 1.87 (3-12). Regarding public attitudes toward cancer survivors' return to work, the following results were confirmed: gender and living with family members/acquaintances who had survived cancer significantly impacted perceptions toward cancer survivors' return to work.For both variables (gender and job type), a significant difference was observed. Men had significantly higher negative perceptions of patients with cancer and their return to work than women, and there were significant differences between professional group and labor group. Moreover, participants living with cancer survivors (either among their family members or acquaintances) showed a significant difference in terms of attitudes toward cancer and patients with cancer and a greater recognition of such survivors' return to the workplace. Conclusions Despite a reduction in social stigma attached to cancer and cancer survivors, survivors may find returning to the workplace difficult. Public efforts and strategies are necessary for increasing awareness and reducing discrimination in society. This study's results could be used as basic data for establishing a social support system in the workplace and developing policies and educational programs to increase awareness about cancer survivors' issues.
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Affiliation(s)
- Si Eun Lee
- College of Nursing, Gachon University, Incheon, Republic of Korea
| | - Eun Young Park
- College of Nursing, Gachon University, Incheon, Republic of Korea
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Unemployment Status Subsequent to Cancer Diagnosis and Therapies: A Systematic Review and Meta-Analysis. Cancers (Basel) 2023; 15:cancers15051513. [PMID: 36900304 PMCID: PMC10000747 DOI: 10.3390/cancers15051513] [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: 01/27/2023] [Revised: 02/25/2023] [Accepted: 02/26/2023] [Indexed: 03/04/2023] Open
Abstract
The purpose of our study is to examine whether cancer and treatments are associated with job loss or changes in employment status. Eight prospective studies were included in the systematic review and meta-analysis, with a population aged 18-65 years, analyzing treatment regimen and psychophysical and social status in post-cancer follow-up of at least 2 years. In the meta-analysis, a comparison was made between recovered unemployed cases and cases from a standard reference population. Results are summarized graphically using a forest plot. We showed that cancer and subsequent treatment are risk factors for unemployment with an overall relative risk of 7.24 (lnRR: 1.98, 95% CI: 1.32-2.63) or for change in employment status. Individuals undergoing chemotherapy and/or radiation treatment and those with brain and colorectal cancers are more likely to develop disabilities that negatively affect the risk of unemployment. Finally, variables such as low level education, female sex, older age, and being overweight before starting therapy are associated with higher risk of unemployment. In the future, it will be necessary for people with cancer to have access to specific health, social welfare, and employment support programs. In addition, it is desirable that they become more involved in their choice of therapeutic treatment.
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Sheppard DM, O’Connor M, Jefford M, Lamb G, Frost D, Ellis N, Halkett GKB. 'Beyond Cancer' Rehabilitation Program to Support Breast Cancer Survivors to Return to Health, Wellness and Work: Feasibility Study Outcomes. Curr Oncol 2023; 30:2249-2270. [PMID: 36826135 PMCID: PMC9956005 DOI: 10.3390/curroncol30020174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 02/06/2023] [Accepted: 02/09/2023] [Indexed: 02/16/2023] Open
Abstract
More women are returning to work following breast cancer treatment. Our team designed 'Beyond Cancer', a multimodal rehabilitation program to support breast cancer survivors to return to work. This study aimed to determine the feasibility of the intervention from the breast cancer survivor, employer and occupational rehabilitation provider perspectives. The feasibility design focused on implementation, acceptability and preliminary indications of efficacy. Primary outcome measures included work status, work capacity and perceived support at work. Responses were compared with an historical usual care group of mixed cancer survivors. The tailored intervention was delivered over 33 weeks (on average) by trained occupational rehabilitation consultants. Eighty-four women with breast cancer (mean age = 50.8 years, SD = 8.24) who were unable to work in their pre-diagnosis capacity for >3 months participated. Results provided preliminary indications of efficacy for primary work outcomes, including work capacity relative to the historical usual care group, and some secondary biopsychosocial variables (physical fatigue, return to work expectations). The intervention was acceptable, demonstrated strong participant engagement and high satisfaction. Feasibility has been demonstrated for this multimodal intervention focused on returning to sustainable work for women with breast cancer. Future research is required with people diagnosed with other cancer types to demonstrate broader implementation.
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Affiliation(s)
- Dianne M. Sheppard
- Monash University Accident Research Centre, Monash University, Building 70, 21 Alliance Lane, Clayton 3800, Australia
- Correspondence: (D.M.S.); (G.K.B.H.)
| | - Moira O’Connor
- School of Population Health, Curtin University, Kent St, Bentley 6102, Australia
| | - Michael Jefford
- Department of Health Services Research, Peter MacCallum Cancer Centre, 305 Grattan St, Melbourne 3000, Australia
- Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, 305 Grattan St, Melbourne 3000, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville 3010, Australia
| | - Georgina Lamb
- IPAR Rehabilitation, 485 La Trobe St, Melbourne 3000, Australia
| | - Dorothy Frost
- IPAR Rehabilitation, 485 La Trobe St, Melbourne 3000, Australia
| | - Niki Ellis
- Healthy Working Lives Research Group, School of Public Health and Preventive Medicine, Monash University, Level 2, 533 St Kilda Road, Melbourne 3004, Australia
| | - Georgia K. B. Halkett
- Curtin School of Nursing/Curtin Health Innovation Research Institute, Curtin University, Kent St, Bentley 6102, Australia
- Correspondence: (D.M.S.); (G.K.B.H.)
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Chapman B, Derakshan N, Grunfeld EA. Experiences of cognitive training on primary breast cancer survivor's cognitive impairments at work: A longitudinal qualitative study. Br J Health Psychol 2023; 28:252-270. [PMID: 36086995 DOI: 10.1111/bjhp.12623] [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: 01/11/2022] [Accepted: 07/27/2022] [Indexed: 01/10/2023]
Abstract
OBJECTIVES Cancer-related cognitive impairment (CRCI) is associated with adverse work-related outcomes in women living with a history of primary breast cancer. We explored the perceived impact of receiving adaptive cognitive training (dual n-back training) or active control training (dual 1-back training) on CRCI. Furthermore, we explored the perceived transfer effects of cognitive training on work-related self-management methods for cognitive impairment and work-related outcomes such as career development. DESIGN Longitudinal qualitative study. METHODS A 'framework' analysis approach was used to analyse semi-structured telephone interviews completed by women with a history of primary breast cancer before training (N = 40), one month (N = 30) and six months (N = 29) post-training. RESULTS Four main themes were identified: (1) impact of cognitive impairment at work, (2) perceived impact of cognitive training on impaired cognitive function, (3) perceived effects of training on work-related self-management methods for cognitive impairment and (4) perceived impact on women's career development and progression. Compared to baseline, women who received adaptive dual n-back training reported sustained improvement in multiple cognitive domains including memory and attention up to six months post-training when the follow-up interviews were conducted. Perceived improvements in cognitive function were associated with greater self-confidence and better emotional well-being in work. These improvements were found to lower dependency on self-management methods for cognitive impairment and enhance effectiveness as well as prompt career development or progression for many women. Although some findings of a similar nature were reported in the active control dual 1-back training group the perceived effects were more pronounced and consistent in the dual n-back group. CONCLUSIONS Adaptive cognitive training (dual n-back training) improves perceived CRCI experienced by women in the workplace, enhancing their self-confidence and general emotional well-being. These perceived improvements, in turn, can decrease reliance on self-management methods for cognitive impairment and improve work efficiency and contribute to career development and progression.
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Affiliation(s)
- Bethany Chapman
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, UK
| | - Nazanin Derakshan
- School of Psychology & Clinical Language Sciences, University of Reading, Reading, UK
| | - Elizabeth A Grunfeld
- Department of Psychological Sciences, Birkbeck, University of London, London, UK
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Kim YA, Choi HR, Choi M, Park AK, Kim HR, Lee C, Lee E, Kim KO, Kwak MY, Chang YJ, Jung SY. Examining the Effectiveness of the Discharge Plan Model on the South Korean Patients with Cancer Completed Cancer Treatment and Are Returning to the Community: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:74. [PMID: 36612405 PMCID: PMC9819972 DOI: 10.3390/ijerph20010074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/01/2022] [Accepted: 11/29/2022] [Indexed: 06/17/2023]
Abstract
This study aimed to examine the effectiveness of a discharge plan model for South Korean patients with cancer who had completed treatment and were returning to the community. Overall, 23 patients with cancer were recruited at the National Cancer Center in Goyang-si. The effectiveness of the discharge plan was examined using four methods: Social Needs Screening Toolkit (2018), early screening for discharge plan, current life situation v.2.0, and a questionnaire regarding problems after discharge from the hospital. Subsequently, the results were analyzed using descriptive statistical analysis methods with the Stata 14.0 program. The largest age group of study participants was between 45 and 64 years. No participants responded to urgent needs, whereas nine (39.13%) participants needed support for their social needs. According to the in-depth evaluation of participants, more than 80% of the respondents answered that patients with cancer needed no help in self-management, daily living activities, or mental health. The satisfaction survey results showed that the degree to which the "discharge plan" was helpful for health management at home after discharge was 4.41 of 5, and the degree to which it helped return to daily life was 3.86 of 5.
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Affiliation(s)
- Young Ae Kim
- National Cancer Control Institute, National Cancer Center, Goyang-si 10408, Republic of Korea
| | - Hye Ri Choi
- School of Nursing, University of Hong Kong, Hong Kong
| | - Mingee Choi
- Graduate School of Social Welfare, Yonsei University, Seoul 03722, Republic of Korea
| | - Ah Kyung Park
- Department of Social Work, National Cancer Center, Goyang-si 10408, Republic of Korea
| | - Hye Ryun Kim
- Department of Social Welfare, Seoul Welfare Foundation, Seoul 04147, Republic of Korea
| | - Chaemin Lee
- Department of Social Work, National Cancer Center, Goyang-si 10408, Republic of Korea
| | - Elim Lee
- Department of Social Work, National Cancer Center, Goyang-si 10408, Republic of Korea
| | - Kyung Ok Kim
- College of Nursing, Kyungbok University, Namyangju-si 12051, Republic of Korea
| | - Mi Young Kwak
- Public Healthcare Quality Improvement Team, National Medical Center, Seoul 04564, Republic of Korea
| | - Yoon Jung Chang
- National Cancer Control Institute, National Cancer Center, Goyang-si 10408, Republic of Korea
| | - So-Youn Jung
- Center for Breast Cancer, National Cancer Center, Goyang-si 10408, Republic of Korea
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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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A general framework for selecting work participation outcomes in intervention studies among persons with health problems: a concept paper. BMC Public Health 2022; 22:2189. [DOI: 10.1186/s12889-022-14564-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 11/07/2022] [Indexed: 11/27/2022] Open
Abstract
Abstract
Background
Work participation is important for health and can be considered as engagement in a major area of life which is of significance for most people, but it can also be thought of as fulfilling or discharging a role. Currently, academic research lacks a comprehensive classification of work participation outcomes. The International Classification of Functioning is the foremost model in defining work functioning and its counterpart work disability, but it does not provide a critical (core) set of outcomes. Standardizing the definitions and nomenclature used in the research of work participation would ensure that the outcomes of studies are comparable, and practitioners and guideline developers can better decide what works best. As work participation is a broad umbrella term including outcome categories which need unambiguous differentiation, a framework needs to be developed first.
Aim
To propose a framework which can be used to develop a generic core outcome set for work participation.
Methods
First, we performed a systematic literature search on the concept of (work) participation, views on how to measure it, and on existing classifications for outcome measurements. Next, we derived criteria for the framework and proposed a framework based on the criteria. Last, we applied the framework to six case studies as a proof of concept.
Results
Our literature search provided 2106 hits and we selected 59 studies for full-text analysis. Based on the literature and the developed criteria we propose four overarching outcome categories: (1) initiating employment, (2) having employment, (3) increasing or maintaining productivity at work, and (4) return to employment. These categories appeared feasible in our proof-of-concept assessment with six different case studies.
Conclusion
We propose to use the framework for work participation outcomes to develop a core outcome set for intervention studies to improve work participation.
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The role of physical arm function and demographic disparities in breast cancer survivors’ ability to return to work. Support Care Cancer 2022; 30:10301-10310. [PMID: 36355217 PMCID: PMC9648455 DOI: 10.1007/s00520-022-07449-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 10/31/2022] [Indexed: 11/12/2022]
Abstract
Purpose Ability to return to work (RTW) is an important aspect of breast cancer that is limited for many survivors. With 90% survivorship in the USA, it is imperative that focus shifts toward the improvement of physical arm function to improve survivors’ ability to RTW. This narrative review discusses the role of physical arm function and demographic disparities in breast cancer survivor RTW. Methods Literature on physical function, arm function, and demographic disparities following breast cancer treatment and their implications for RTW is discussed. Results The ability to RTW is a key component of recovery for breast cancer survivors, but challenges and inequalities persist. Treatment effects can induce and prolong functional disability, affecting survivors’ ability to RTW. These effects may be compounded for survivors whose occupation requires physical arm function. The RTW landscape, including the occupations survivors have, the physical function required for job tasks, and availability of workplace accommodations, is also unclear. Additional demographic disparities (e.g., income, live in rural area) exist, but the extent to which these factors influence RTW is not well understood. More work is needed to understand the compounded impact of treatment effects, demographic disparities, and occupational factors on RTW. Multidisciplinary rehabilitation that includes occupational counseling and exercise is a promising approach, but widespread adoption in the US healthcare model presents an ongoing challenge. Areas for further research are highlighted. Conclusion There is an incomplete understanding of the effects of treatment on physical arm function and the role of demographic disparities on breast cancer survivor RTW.
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FNU N, Kuan WC, Kong YC, Bustamam RS, Wong LP, Subramaniam S, Ho GF, Zaharah H, Yip CH, Bhoo-Pathy N. Cancer-related costs, the resulting financial impact and coping strategies among cancer survivors living in a setting with a pluralistic health system: a qualitative study. Ecancermedicalscience 2022; 16:1449. [PMID: 36405936 PMCID: PMC9666287 DOI: 10.3332/ecancer.2022.1449] [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: 05/27/2022] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND Evidence on the financial experiences of cancer survivors living in settings with pluralistic health systems remains limited. We explored the out-of-pocket costs, the resulting financial impact and the coping strategies adopted by cancer survivors in Malaysia, a middle-income country with a government-led tax-funded public health sector, and a predominantly for-profit private health sector. METHODS Data were derived from 20 focus group discussions that were conducted in five public and private Malaysian hospitals, which included 102 adults with breast, cervical, colorectal or prostate cancers. The discussions were segregated by type of healthcare setting and gender. Thematic analysis was performed. RESULTS Five major themes related to cancer costs emerged: 1) cancer therapies and imaging services, 2) supportive care, 3) complementary therapies, 4) non-medical costs and 5) loss of household income. Narratives on out-of-pocket medical costs varied not only by type of healthcare setting, clinical factors and socioeconomic backgrounds, but also by private health insurance ownership. Non-health costs (e.g. transportation, food) and loss of income were nonetheless recurring themes. Coping mechanisms that were raised included changing of cancer treatment decisions, continuing work despite ill health and seeking financial assistance from third parties. Unmet needs in coping with financial distress were especially glaring among the women. CONCLUSION The long-term costs of cancer (medications, cancer surveillance, supportive care, complementary medicine) should not be overlooked even in settings where there is access to highly subsidised cancer care. In such settings, patients may also have unmet needs related to non-health costs of cancer and loss of income.
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Affiliation(s)
- Noorulain FNU
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - Wai-Chee Kuan
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - Yek-Ching Kong
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - Ros Suzanna Bustamam
- Department of Radiotherapy and Oncology, Kuala Lumpur Hospital, 50586 Kuala Lumpur, Malaysia
| | - Li-Ping Wong
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - ShriDevi Subramaniam
- Institute of Clinical Research, National Institutes of Health, 40170 Shah Alam, Malaysia
| | - Gwo-Fuang Ho
- Department of Clinical Oncology, Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - Hafizah Zaharah
- Department of Radiotherapy and Oncology, National Cancer Institute, 62250 Putrajaya, Malaysia
| | - Cheng-Har Yip
- Subang Jaya Medical Centre, 47500 Subang Jaya, Malaysia
| | - Nirmala Bhoo-Pathy
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
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Andreu Y, Martínez P, Soto-Rubio A, Pérez-Marín M, Cervantes A, Arribas L. Quality of life in cancer survivorship: Sociodemographic and disease-related moderators. Eur J Cancer Care (Engl) 2022; 31:e13692. [PMID: 36069249 DOI: 10.1111/ecc.13692] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 06/23/2022] [Accepted: 08/02/2022] [Indexed: 01/06/2023]
Abstract
RATIONALE To identify high-risk survivors in order to provide appropriate care. PURPOSE To analyse the quality of life (QOL) of cancer survivors using an instrument designed specifically for this population and considering different sociodemographic and disease-related characteristics as possible modulating variables. METHODS The Quality of Life in Adult Cancer Survivors (QLACS) was filled out by a large and heterogeneous sample of disease-free post-treatment Spanish cancer survivors (N = 1862). RESULTS QLACS scores were comparable to those obtained in other studies and indicative of worse QOL as a function of shorter elapsed time since the end of primary treatment. The best QOL was shown by prostate, and the worst by hematologic cancer survivors. Both systemic treatments (chemotherapy and hormone therapy) and the combination of radiotherapy and chemotherapy were associated with worse QOL. Likewise, younger age, female sex, unemployment status and not having a stable partner were associated with worse QOL. CONCLUSION Greater understanding of the QOL experienced by the already large and continuously growing population of cancer survivors is relevant for guiding both clinical practice and health policy. In addition, knowing the risk factors associated with worse QOL facilitates the development of targeted prevention programmes for those survivors who need it the most.
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Affiliation(s)
- Yolanda Andreu
- Department of Personality, Assessment and Psychological Treatments, Universitat de València, Valencia, Spain
| | - Paula Martínez
- Faculty of Health Sciences, Valencian International University, Valencia, Spain
| | - Ana Soto-Rubio
- Department of Personality, Assessment and Psychological Treatments, Universitat de València, Valencia, Spain
| | - Marián Pérez-Marín
- Department of Personality, Assessment and Psychological Treatments, Universitat de València, Valencia, Spain
| | - Andrés Cervantes
- Medical Oncology Department, Instituto de Investigación Sanitaria INCLIVA, Valencia, Spain
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Kurosawa S, Yamaguchi T, Mori A, Matsuura T, Masuko M, Murata M, Tashiro H, Kako S, Satake A, Hagihara M, Ota S, Saito T, Kagawa K, Matsuo Y, Itonaga H, Uoshima N, Yamaguchi H, Naito K, Takahashi M, Fukuda T. Incidence and predictors of recurrent sick leave in survivors who returned to work after allogeneic hematopoietic cell transplantation. J Cancer Surviv 2022; 17:781-794. [PMID: 36048313 DOI: 10.1007/s11764-022-01250-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 08/12/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Although rather favorable probabilities of return to work have been reported after allogeneic hematopoietic cell transplantation (allo-HCT), survivors often have difficulty continuing to work because of their immunocompromised status and diverse late effects after allo-HCT. We evaluated the incidence of and risk factors for recurrent sick leave in allo-HCT survivors after they initially returned to work. METHODS We targeted allo-HCT survivors who were employed at diagnosis, aged 20-64 at survey, and survived for ≥ 2 years without relapse. Of the 1904 survivors who were informed of the study, 1148 returned the questionnaire (60%), and 1048 eligible participants were included in the overall analysis. In the present study that considered recurrent sick leave after return to work, we targeted 896 participants who returned to work at least once after allo-HCT. Participants stated if they had recurrent sick leave after returning to work and its reasons, as well as associated patient-, HCT/HCT center-, and work-related factors and clinical events after allo-HCT. A logistic regression analysis was conducted to explore correlated factors for recurrent sick leave. RESULTS In survivors who returned to work, 30% required recurrent sick leave. The most frequent causes of recurrent leave were physical issues (72%), and analysis of free descriptions demonstrated that these were mainly associated with graft-versus-host disease, infection, or readmission. Other reasons included work-related issues such as gap between physical and working conditions. Multivariate analysis showed that cord blood transplantation, longer employment duration, and counseling from healthcare professionals were associated with a lower risk of recurrent leave. Readmission, immunosuppressant use, and symptoms involving the respiratory system, gut, and joints and muscles were associated with a higher risk. CONCLUSIONS Our results drawn from a large cohort study should help healthcare professionals identify and assist at-risk patients. Multi-professional teams that provide continuous support and effective communication with the workplace are necessary to improve long-term outcomes after allo-HCT. IMPLICATIONS FOR CANCER SURVIVORS In order to continue working after the initial return to work, it is important to receive counseling from healthcare professionals and obtain reasonable accommodation from workplace.
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Affiliation(s)
- Saiko Kurosawa
- Department of Oncology, Ina Central Hospital, 1313-1 Koshiro-kubo, Ina, Nagano, 396-8555, Japan. .,Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan.
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Ayako Mori
- Nursing Division, National Cancer Center Hospital, Tokyo, Japan
| | - Tomoko Matsuura
- Nursing Division, National Cancer Center Hospital, Tokyo, Japan.,Nursing Division, Fukuoka National Hospital, Fukuoka, Japan
| | - Masayoshi Masuko
- Department of Hematopoietic Cell Therapy, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Makoto Murata
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Haruko Tashiro
- Department of Hematology/Oncology, Teikyo University School of Medicine, Tokyo, Japan
| | - Shinichi Kako
- Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Atsushi Satake
- First Department of Internal Medicine, Kansai Medical University, Osaka, Japan
| | - Maki Hagihara
- Department of Hematology and Clinical Immunology, Yokohama City University School of Medicine, Yokohama, Japan
| | - Shuichi Ota
- Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan
| | - Takeshi Saito
- Division of Clinical Oncology and Hematology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Kumiko Kagawa
- Department of Hematology, Endocrinology and Metabolism, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Yayoi Matsuo
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan
| | - Hidehiro Itonaga
- Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
| | - Nobuhiko Uoshima
- Department of Hematology, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan
| | | | - Kensuke Naito
- Department of Hematology, Hamamatsu Medical Center, Hamamatsu, Japan
| | - Miyako Takahashi
- Japan Cancer Survivorship Network, Tokyo, Japan.,Iwate Medical University, Morioka, Japan.,The Jikei University School of Medicine, Tokyo, Japan
| | - Takahiro Fukuda
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
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Von Ah D, McDonald BC, Crouch AD, Ofner S, Perkins S, Storey S, Considine R, Unverzagt F. Randomized double-masked controlled trial of cognitive training in breast cancer survivors: a preliminary study. Support Care Cancer 2022; 30:7457-7467. [PMID: 35648204 PMCID: PMC9156616 DOI: 10.1007/s00520-022-07182-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 05/26/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the acceptability, satisfaction, and preliminary efficacy of cognitive training for improving cognitive function and health outcomes in breast cancer survivors (BCS). PATIENTS AND METHODS BCS enrolled in this 2-group randomized, double-masked controlled trial of cognitive training. Primary outcomes included the acceptability and satisfaction of the interventions. Secondary outcomes included examining the effect size and reliable improvement of perceived cognitive function and health outcomes, including work ability, health perception (status and change), and quality of life. Exploratory outcomes were performance on neuropsychological tests and plasma levels of brain-derived neurotropic factor (BDNF). Data were collected at baseline and immediately post-intervention. Using ANCOVA models, the intervention was compared to attention control while adjusting for covariates and baseline values. The effect sizes for differences in means and the reliable improvement percentage were reported. RESULTS Thirty-six BCS completed the study and were on average 57.6 (SD = 8.0) years old, 59.4% Caucasian, and had some college education (74.5%). Both programs were reported to be satisfactory and acceptable. Non-significant small effect sizes were noted for the intervention on cognitive abilities (d = 0.26) and cognitive concerns (d = - 0.32), with reliable improvement noted in 32% and 28% of BCS, respectively. Small to medium effect sizes were noted in improvement in work ability (d = 0.37) and health perception status (d = 0.30) and change (d = 0.60, p < 0.05). CONCLUSIONS Cognitive training was acceptable to BCS and resulted in improvement in perceived cognitive function and perceptions of "real-world" health benefits. A larger randomized controlled trial is warranted to determine its effectiveness for objective cognitive performance.
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Affiliation(s)
- Diane Von Ah
- Ohio State University College of Nursing, 394 Newton Hall, 1585 Neil Avenue, Columbus, OH 43210 USA
| | | | - Adele D. Crouch
- NewCourtland Center for Transitions and Health, University of Pennsylvania School of Nursing, Philadelphia, PA USA
| | - Susan Ofner
- Indiana University School of Medicine, Indianapolis, IN USA
| | - Susan Perkins
- Indiana University School of Medicine, Indianapolis, IN USA
| | - Susan Storey
- School of Nursing, Indiana University, Indianapolis, IN 46202 USA
| | | | - Fred Unverzagt
- Department of Psychiatry, School of Medicine, Indiana University, Indianapolis, IN USA
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41
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Kang D, Bae KR, Kim HY, Ahn Y, Kim N, Shim Y, Sohn TS, Lee WY, Baek JH, Kweon SS, Cho J. Changes in working status after cancer diagnosis and socio-demographic, clinical, work-related, and psychological factors associated with it. BMC Cancer 2022; 22:917. [PMID: 36008854 PMCID: PMC9404600 DOI: 10.1186/s12885-022-10013-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 08/11/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND While many studies investigated changes in working status in cancer survivors, most studies have been performed in survivors of breast cancer and few studies evaluated factors associated with changes in the working status of cancer survivors comprehensively. We aimed to evaluate the changes in the working status of cancer survivors after diagnosis and socio-demographic, clinical, work-related and psychological factors associated with it. METHODS We conducted a cross-sectional survey of adult patients with cancer who were working at the time of diagnosis. A trained interviewer inquired about participants' current working status, including leave of absence, discontinuing, continuing, and changing work. Sociodemographic, clinical, work-related and psychological factors were measured. Multinomial logistic regression was used to identify factors associated with changes in the working status. RESULTS Among the 730 patients, 29%, 18% and 6% were currently on a discontinued working, leave of absence and had changed jobs, respectively. Patients who discontinued working after cancer diagnosis were more likely to be female, have ≥ $3,000 of monthly family income, not be the principal wage earners for their families and be blue-collar workers. In clinical characteristics, advanced-stage cancer and experienced cancer recurrence was associated with leave of absence and discontinued working. In work-related and psychological factors, stress due to insufficient job control (relative risk ratio [RRR] = 2.26), interpersonal conflict (RRR = 1.86), job insecurity (RRR = 2.63), organizational system (RRR = 3.49), and lack of reward (RRR = 11.76), and less meaning to work were more likely to discontinue working after a cancer diagnosis. CONCLUSION Occupational health care professionals and other stakeholders need to openly communicate with patients with cancer about potential barriers during the return-to-work trajectory.
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Affiliation(s)
- Danbee Kang
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, South Korea.,Center for Clinical Epidemiology, Samsung Medical Center, Seoul, South Korea
| | - Ka Ryeong Bae
- National Cancer Survivorship Center, National Cancer Control Institute, National Cancer Center, Goyang, South Korea
| | - Ho Young Kim
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, South Korea.,Cancer Education Center, Samsung Medical Center, Seoul, South Korea
| | - Yeojin Ahn
- Cancer Education Center, Samsung Medical Center, Seoul, South Korea
| | - Nayeon Kim
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, South Korea.,Cancer Education Center, Samsung Medical Center, Seoul, South Korea
| | - Youngmog Shim
- Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Tae Sung Sohn
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Woo Yong Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Ji Hyun Baek
- Gwangju-Jeonnam Regional Cancer Center, Chonnam National University Hwasun Hospital, Hwasun, South Korea
| | - Sun-Seog Kweon
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Juhee Cho
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, South Korea. .,Center for Clinical Epidemiology, Samsung Medical Center, Seoul, South Korea. .,Cancer Education Center, Samsung Medical Center, Seoul, South Korea.
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42
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Oliveira AF, Fernandes S, Reis JD, Torres A, Santos IM, Von Ah D. Cognitive functioning and work-related outcomes of non-central nervous system cancer survivors: protocol for a systematic review with meta-analysis. BMJ Open 2022; 12:e060300. [PMID: 35820744 PMCID: PMC9277407 DOI: 10.1136/bmjopen-2021-060300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION In recent years, growing attention has been given to the study of the impact of cancer-related cognitive impairment (CRCI) in working non-central nervous system (CNS) cancer survivors. Available literature has shown that working cancer survivors identify cognitive problems at work as very problematic and worrisome. Some reviews have discussed the association between CRCI and work-related outcomes; however, none to date have investigated this association through comprehensive systematic review with meta-analysis. Hence, this work will comprehensively summarise existing evidence from quantitative studies assessing the relationship between CRCI and work-related outcomes of adult non-CNS cancer survivors at working age. METHODS AND ANALYSIS The systematic review procedures and its report will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Electronic searches in the databases Web of Science, Scopus, PubMed, ProQuest, PsycINFO and CINAHL, complemented by a manual search of other relevant articles, will be performed from 2000 onwards to identify relevant publications. Two independent reviewers will assess studies for inclusion and extract data from each article using a standardised form. Studies eligible for inclusion must be quantitative, contain adult non-CNS cancer survivors with CRCI, and a measure of cognitive functioning and work-related outcomes. To assess risk of bias, the Joanna Briggs Institute Critical Appraisal Tool Studies checklists will be independently used by the two researchers. Synthesis of the included articles will be conducted using a narrative method and through meta-analysis. Meta-analysis will be reported via correlation for the association between CRCI and work-related outcomes. The cumulative evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation system. ETHICS AND DISSEMINATION Ethics approval is not required since individual patient data will not be collected. The findings will be published in a peer-review indexed journal, presented at scientific meetings and included in a chapter of a Doctoral thesis. PROSPERO REGISTRATION NUMBER CRD42020165458.
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Affiliation(s)
- Ana F Oliveira
- Center for Health Technology and Services Research (CINTESIS@RISE), Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Sofia Fernandes
- Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Juliana D Reis
- Department of Mathematics, University of Aveiro, Aveiro, Portugal
| | - Ana Torres
- Center for Health Technology and Services Research (CINTESIS@RISE), Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
- Department of Psychology and Education, Faculty of Human and Social Sciences, University of Beira Interior, Covilhã, Portugal
| | - Isabel M Santos
- William James Center for Research (WJCR), Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Diane Von Ah
- The Ohio State University, College of Nursing, Columbus, Ohio, USA
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43
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Viseux M, Tamminga SJ, Greidanus MA, Porro B, Roquelaure Y, Bourdon M. Enhancing Emotional Skills of Managers to Support the Return to Work of Cancer Survivors: A Research Opinion Focusing on Value, Feasibility and Challenges. Front Psychol 2022; 13:910779. [PMID: 35903738 PMCID: PMC9319043 DOI: 10.3389/fpsyg.2022.910779] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 06/13/2022] [Indexed: 11/14/2022] Open
Affiliation(s)
- Marie Viseux
- UMR INSERM 1246 SPHERE “Methods in Patient-Centered Outcomes and HEalth ResEarch”, Nantes University, University of Tours, Nantes, France
- *Correspondence: Marie Viseux
| | - Sietske J. Tamminga
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Amsterdam, Netherlands
- Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, Netherlands
| | - Michiel A. Greidanus
- Amsterdam UMC Location University of Amsterdam, Public and Occupational Health, Amsterdam, Netherlands
- Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, Netherlands
| | - Bertrand Porro
- University of Angers, University of Rennes, Inserm, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, SFR ICAT, Angers, France
| | - Yves Roquelaure
- UMR Inserm S 1085, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail) – University of Angers, CHU Angers, University of Rennes, SFR ICAT, Angers, France
| | - Marianne Bourdon
- UMR INSERM 1246 SPHERE “Methods in Patient-Centered Outcomes and HEalth ResEarch”, Nantes University, University of Tours, Nantes, France
- Integrated Center for Oncology, Nantes, France
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44
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Nicholas LH, Davidoff AJ, Howard DH, Keating NL, Ritzwoller DP, Robin Yabroff K, Bradley CJ. Cancer Survivorship and Supportive Care Economics Research: Current Challenges and Next Steps. J Natl Cancer Inst Monogr 2022; 2022:57-63. [PMID: 35788375 DOI: 10.1093/jncimonographs/lgac004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 01/28/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Rapid growth in the number of cancer survivors raises numerous questions about health and economic outcomes among survivors along with their families, caregivers, and employers. Health economics theory and methods can contribute to many open questions to improve survivorship. METHODS In this paper, we review key areas where more research is needed and describe strategies for improving data infrastructure, research funding, and capacity building to strengthen survivorship health economics research. CONCLUSIONS Health economics has broadened an understanding of key supply- and demand-side factors that promote cancer survivorship. To ensure necessary research in survivorship health economics moving forward, we recommend dedicated funding, inclusion of health economics outcomes in primary data collection, and investments in secondary data sets.
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Affiliation(s)
- Lauren Hersch Nicholas
- Department of Health Systems, Management & Policy, Colorado School of Public Health & University of Colorado Cancer Center, Aurora, CO, USA
| | | | - David H Howard
- Department of Health Policy & Management, Emory University, Atlanta, Georgia
| | - Nancy L Keating
- Departments of Health Care Policy and Medicine, Harvard Medical School, Cambridge, MA, USA
| | | | | | - Cathy J Bradley
- Department of Health Systems, Management & Policy, Colorado School of Public Health & University of Colorado Cancer Center, Aurora, CO, USA
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45
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Boland V, Drury A, Sheaf G, Brady AM. Living with or beyond lymphoma: A rapid review of the unmet needs of lymphoma survivors. Psychooncology 2022; 31:1076-1101. [PMID: 35670252 PMCID: PMC9545574 DOI: 10.1002/pon.5973] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 05/04/2022] [Accepted: 05/29/2022] [Indexed: 11/08/2022]
Abstract
Objective To establish an understanding of the unmet needs of people living with or beyond a lymphoma diagnosis. Survivors of lymphoma are at increased risk of unmet needs due to cancer, treatment‐related toxicities and extended survivorship. Despite the rapidly growing numbers of lymphoma survivors, their needs and research priorities are underserved and undervalued, therefore left largely unaddressed. Methods A rapid review method and reflexive thematic analysis approach assimilated current knowledge. Eligibility criteria included quantitative, qualitative, or mixed approaches employing cross‐sectional, longitudinal, cohort or review designs focused on the needs of adult lymphoma survivors (any subtype or stage of disease). Five databases: CINAHL, EMBASE, Medline, PsycInfo and Scopus, were systematically searched. Results Forty‐seven studies met the inclusion criteria via a stringent screening process facilitated by NVivo. Almost 60 per cent of articles were published within the last five years and investigated a homogenous lymphoma sample. Most studies employed quantitative approaches (77%) and cross‐sectional designs (67%). Studies were of high methodological quality. Five major themes were identified: disparity in health service delivery, the psychological impact of cancer, impactful and debilitating concerns, the monetary cost of survival and insufficient provision of survivorship information. A meta‐analytical approach was not feasible due to the breadth of methodologies of included studies. Conclusions This review shows that lymphoma survivors experience a myriad of unmet needs across multiple domains, reinforcing the need for lymphoma‐specific research. However, more research is needed to advance and achieve informed decision‐making relating to survivorship care, placing due attention to the needs and research priorities of lymphoma survivors.
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Affiliation(s)
- Vanessa Boland
- School of Nursing & Midwifery, Faculty of Health Sciences, Trinity College Dublin, Dublin, Ireland, D02 T283
| | - Amanda Drury
- School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland, D04 V1W8
| | - Greg Sheaf
- The Library of Trinity College Dublin, Dublin, 2, Ireland
| | - Anne-Marie Brady
- School of Nursing & Midwifery, Faculty of Health Sciences, Trinity College Dublin, Dublin, Ireland, D02 T283
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46
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So SCY, Ng DWL, Liao Q, Fielding R, Soong I, Chan KKL, Lee C, Ng AWY, Sze WK, Chan WL, Lee VHF, Lam WWT. Return to Work and Work Productivity During the First Year After Cancer Treatment. Front Psychol 2022; 13:866346. [PMID: 35496253 PMCID: PMC9039203 DOI: 10.3389/fpsyg.2022.866346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 03/24/2022] [Indexed: 01/01/2023] Open
Abstract
Objectives Working-age cancer patients face barriers to resuming work after treatment completion. Those resuming work contend with reduced productivity arising from persisting residual symptoms. Existing studies of return to work (RTW) after cancer diagnosis were done predominantly in Western countries. Given that employment and RTW in cancer survivors likely vary regionally due to healthcare provision and social security differences, we documented rates and correlates of RTW, work productivity, and activity impairment among Chinese cancer survivors in Hong Kong at one-year post-treatment. Methods Of 1,106 cancer patients assessed at six-months post-cancer treatment (baseline), 593 previously worked; detailed work status, psychological distress (HADS), physical symptom distress (MSAS-SF), supportive care needs (SCNS-SF34-C), health-related quality of life (SF12), and illness perception (B-IPQ) were assessed. Six months later (follow-up), work productivity and activity impairment were assessed (WPAI; n = 402). Descriptive analyses examined RTW rate. Fully adjusted regressions determined RTW, work productivity, and activity impairment predictors. Results At baseline, 39% (232/593) were working, 26% (153/593) on sick leave, and 35% (208/593) were unemployed. Compared to patients returning to work, unemployed participants were older, likely manual/service-oriented workers, and had lower family income, chemotherapy, fewer unmet health system and information needs, poorer physical functioning, and negative illness perceptions. Sick leave participants were likely service-oriented workers, who had head and neck cancer, chemotherapy, and poor physical functioning. At FU, baseline depressive symptoms, physical symptom distress, and negative illness perceptions predicted presenteeism and work productivity loss; gynecological cancer, fewer unmet health system and information needs, and greater unmet sexuality needs predicted absenteeism; physical symptom distress, negative illness perception, and poor physical functioning predicted activity impairment. Conclusion Cancer survivors who had more physically demanding jobs and poorer physical functioning delayed RTW. Unmanaged physical symptom and psychological distress hindered work productivity.
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Affiliation(s)
- Serana Chun Yee So
- LKS Faculty of Medicine, Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, Hong Kong SAR, China.,School of Public Health, Centre for Psycho-Oncology Research and Training, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Danielle Wing Lam Ng
- LKS Faculty of Medicine, Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, Hong Kong SAR, China.,School of Public Health, Centre for Psycho-Oncology Research and Training, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Qiuyan Liao
- School of Public Health, Centre for Psycho-Oncology Research and Training, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Richard Fielding
- LKS Faculty of Medicine, Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, Hong Kong SAR, China.,School of Public Health, Centre for Psycho-Oncology Research and Training, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Inda Soong
- Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, Hong Kong SAR, China
| | - Karen Kar Loen Chan
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Conrad Lee
- Department of Clinical Oncology, Princess Margaret Hospital, Hong Kong, Hong Kong SAR, China
| | - Alice Wan Ying Ng
- Department of Clinical Oncology, Tuen Mun Hospital, Tuen Mun, Hong Kong SAR, China
| | - Wing Kin Sze
- Department of Clinical Oncology, Tuen Mun Hospital, Tuen Mun, Hong Kong SAR, China
| | - Wing Lok Chan
- Department of Clinical Oncology, The University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Victor Ho Fun Lee
- Department of Clinical Oncology, The University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Wendy Wing Tak Lam
- LKS Faculty of Medicine, Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, Hong Kong SAR, China.,School of Public Health, Centre for Psycho-Oncology Research and Training, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Hussain T. Patient Benefit and Quality of Life after Robot-Assisted Head and Neck Surgery. Laryngorhinootologie 2022; 101:S160-S185. [PMID: 35605618 DOI: 10.1055/a-1647-8650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Robotic systems for head and neck surgery are at different stages of technical development and clinical application. Currently, robotic systems are predominantly used for transoral surgery of the pharynx and larynx. Robotic surgery of the neck, the thyroid, and the middle and inner ear is much less common; however, some oncological and functional outcomes have been reported. This article provides an overview of the current state of robot-assisted head and neck surgery with a special emphasis on patient benefit and postoperative quality of life (QoL). The focus is placed on the role of transoral robotic surgery (TORS) for the resection of oropharyngeal carcinomas. For this application, reported long-term outcomes show functional post-operative advantages for selected oropharyngeal cancer patients after TORS compared to open surgery and primary radiotherapy. Since TORS also plays a significant role in the context of potential therapy de-escalation for HPV-positive oropharyngeal cancer patients, ongoing trials are presented. Regarding the evaluation of the therapeutic benefit and the QoL of cancer patients, special attention has to be paid to the large degree of variability of individual patients' preferences. Influencing factors and tools for a detailed assessment of QoL parameters are therefore detailed at the beginning of this article. Notably, while some robotic systems for ear and skull base surgery are being developed in Europe, TORS systems are mainly used in North America and Asia. In Europe and Germany in particular, transoral laser microsurgery (TLM) is a well-established technology for transoral tumor resection. Future trials comparing TORS and TLM with detailed investigation of QoL parameters are therefore warranted and might contribute to identifying suitable fields for the application of the different techniques.
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Affiliation(s)
- Timon Hussain
- Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Essen, Universität Duisburg-Essen
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Critical Competences for the Management of Post-Operative Course in Patients with Digestive Tract Cancer: The Contribution of MADIT Methodology for a Nine-Month Longitudinal Study. Behav Sci (Basel) 2022; 12:bs12040101. [PMID: 35447673 PMCID: PMC9029589 DOI: 10.3390/bs12040101] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/25/2022] [Accepted: 04/06/2022] [Indexed: 02/01/2023] Open
Abstract
There is a high postoperative morbidity rate after cancer surgery, that impairs patients’ self-management, job condition and economic strength. This paper describes the results of a peculiar psychological intervention on patients undergoing surgery for esophageal, gastric and colorectal cancer. The intervention aimed to enhance patients’ competences in the management of postoperative daily life. A narrative approach (M.A.D.I.T.—Methodology for the Analysis of Computerised Text Data) was used to create a questionnaire, Health and Employment after Gastro-Intestinal Surgery—Dialogical Questionnaire, HEAGIS-DQ, that assesses four competences. It was administered to 48 participants. Results were used as guidance for specific intervention, structured on patients’ competence profiles. The intervention lasted nine months after surgery and was structured in weekly to monthly therapeutic sessions. Quality of Life questionnaires were administered too. At the end of the intervention, 94% of patients maintained their job and only 10% of patients asked for financial support. The mean self-perception of health-related quality of life was 71.2. The distribution of three of four competences increased after nine months (p < 0.05). Despite economic difficulties due to lasting symptoms after surgery, and to the current pandemic scenario, a structured intervention with patients let them to resume their jobs and continue activities after surgery.
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Managing the Consequences of Oncological Major Surgery: A Short- and Medium-Term Skills Assessment Proposal for Patient and Caregiver through M.A.D.I.T. Methodology. Behav Sci (Basel) 2022; 12:bs12030077. [PMID: 35323396 PMCID: PMC8945744 DOI: 10.3390/bs12030077] [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: 01/26/2022] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 02/06/2023] Open
Abstract
The effects of cancer surgery and treatment harm patients’ life and working ability: major causes of this can be intensified by the postoperative symptoms. This study, the first part of the HEAGIS project (Health and Employment after Gastrointestinal Surgery), proposes a method to assess patients and caregivers’ competences in dealing with postoperative course and the related needs to improve the adequate competences. In this observational study, an ad hoc structured interview was conducted with 47 patients and 15 caregivers between the third and fifteenth postoperative day. Oesophageal (38%), esophagogastric junction (13%), gastric (30%), colon (8%) and rectum (11%) cancer patients were considered. Computerized textual data analysis methodology was used to identify levels of competences. Text analysis highlighted three different levels (low, medium and high) of four specific types of patients and caregivers’ competences. In particular, the overall trend of the preview of future scenarios and use of resource competences was low. Less critical were situation evaluation and preview repercussion of own actions’ competences. Caregivers’ trends were similar. The Kruskal–Wallis test did not distinguish any differences in the level of competences related to the characteristics of the participants. Patients and caregivers are not accurate in planning the future after surgery, using personal beliefs rather than referring to physicians, and not recognizing adequate resources. The medium-low competences’ trend leads to unexpected critical situations, and patients could not deal with them in a maximally effective way. Both patients and caregivers should be taken over by healthcare professionals to improve patients’ competences and make the curative surgery effective in daily life.
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50
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Change in the value of work after breast cancer: evidence from a prospective cohort. J Cancer Surviv 2022; 17:694-705. [PMID: 35267143 DOI: 10.1007/s11764-022-01197-w] [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: 01/20/2022] [Accepted: 02/20/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Return to work (RTW) after cancer can be modulated by psychosocial factors, including a reordering of one's life values, with more emphasis on private life than work-life. This change in patients' outlook on work-life is however poorly understood. METHODS We used data from a French cohort (CANTO, NCT01993498) of women diagnosed with stage I-III primary breast cancer (BC) prospectively assessing life priorities between work and private life at diagnosis and 2 years after diagnosis. We identified women who reported a shift in life values toward private life, and we investigated the clinical, demographic, work-related, and psychosocial determinants of this change using logistic regressions. RESULTS Overall, 46% (N = 1097) of the women had reordered their life priorities toward private life 2 years after diagnosis. The factors positively associated with this shift included being diagnosed with stage III BC, perceiving one's job as not very interesting, being an employee/clerk (vs. executive occupation), perceiving no support from the supervisor at baseline, perceiving negative interferences of cancer in daily life, and perceiving a positive impact from experiencing cancer. Depressive symptoms were negatively associated with this shift. CONCLUSION After BC, there seems to be an important reordering of life values, with more emphasis on private life. This change is influenced by clinical determinants, but also by work-related and psychosocial factors. IMPLICATIONS FOR CANCER SURVIVORS Stakeholders should consider this change in a patient's outlook on work-life as much as the classical physical late effects when designing post-BC programs to support RTW.
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