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Rolland AL, Porro B, Kab S, Ribet C, Roquelaure Y, Bertin M. Impact of breast cancer care pathways and related symptoms on the return-to-work process: results from a population-based French cohort study (CONSTANCES). Breast Cancer Res 2023; 25:30. [PMID: 36949546 PMCID: PMC10031867 DOI: 10.1186/s13058-023-01623-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 02/24/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND Breast cancer (BC) treatments and related symptoms may affect return to work (RTW). The objective of this study was to investigate the impact of BC care pathways (timing and sequence of treatments) and related symptoms on RTW. METHODS The study population included working-age women with BC who were enrolled in the French CONSTANCES cohort from 2012 to 2018. BC treatments, antidepressant/anxiolytic and antalgic drug deliveries (used as proxies of depression and pain, respectively) and statutory sick pay (used to estimate RTW and time to RTW) were assessed monthly using data from the French national healthcare system database. BC care pathways were identified with the sequence analysis method. Cox models with time-dependent covariates were used to investigate the impact of BC care pathways and related symptoms on RTW and time to RTW, after adjusting for age and socioeconomic characteristics. RESULTS 73.2% (231/303) of women returned to work within 2 years after BC diagnosis. Five BC care pathway patterns were identified: (i) BC surgery only, (ii) BC surgery and radiotherapy, (iii) BC surgery and chemotherapy, (iv) BC surgery and chemotherapy and radiotherapy, and (v) BC surgery and long-term alternative chemotherapy/radiotherapy. The hazards ratios of non-RTW were significantly higher for women who received BC surgery and long-term alternative chemotherapy/radiotherapy and for > 55-year-old women. Time to RTW was significantly longer in women who received chemotherapy (patterns iii to v) and in women with antidepressant/anxiolytic and antalgic drug deliveries. CONCLUSION This study highlights the value of considering the dynamic, cumulative and temporal features of BC care pathways and related symptoms to facilitate the RTW of women with BC.
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Affiliation(s)
- Anne-Lise Rolland
- Univ. Angers, CHU Angers, Univ. Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, SFR ICAT, SIRIC ILIAD, F-49000, Angers, France
- Département d'Information Médicale, Centre Hospitalo-Universitaire d'Angers, 49100, Angers, France
| | - Bertrand Porro
- Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, SFR ICAT, SIRIC ILIAD, University Angers, University Rennes, 49000, Angers, France
- Department of Human and Social Sciences, Institut de Cancérologie de L'Ouest (ICO), 49055, Angers, France
| | - Sofiane Kab
- Unité Cohortes en Population, Inserm, UVSQ, UMS 011, Université Paris Saclay, Université de Paris, Paris, France
| | - Céline Ribet
- Unité Cohortes en Population, Inserm, UVSQ, UMS 011, Université Paris Saclay, Université de Paris, Paris, France
| | - Yves Roquelaure
- Univ. Angers, CHU Angers, Univ. Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, SFR ICAT, SIRIC ILIAD, F-49000, Angers, France
| | - Mélanie Bertin
- Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, SFR ICAT, SIRIC ILIAD, University Angers, University Rennes, 49000, Angers, France.
- Univ Rennes, EHESP, CNRS, Inserm, Arènes - UMR 6051, RSMS - U 1309, F-35000, Rennes, France.
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Porro B, Tamminga SJ, de Boer AGEM, Petit A, Roquelaure Y, Greidanus MA. Identification of actions to be taken by managers to facilitate the return to work of cancer survivors: Consensus between managers and cancer survivors. BMC Public Health 2022; 22:1905. [PMID: 36224592 PMCID: PMC9555691 DOI: 10.1186/s12889-022-14271-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 09/28/2022] [Indexed: 11/10/2022] Open
Abstract
Background Managers are considered to be main stakeholders in the return to work (RTW) of cancer survivors. However, the perspectives of cancer survivors and managers differ on what managerial actions should be taken during the RTW of cancer survivors. This difference might put effective collaboration and successful RTW at risk. Therefore, this study aims to reach consensus among managers and cancer survivors on the managerial actions to be taken during the four different RTW phases of cancer survivors (i.e., Disclosure, Treatment, RTW plan, Actual RTW). Methods The Technique for Research of Information by Animation of a Group of Experts (TRIAGE) was implemented with managers and cancer survivors (hereafter referred to as “experts”). An initial list of 24 actions was derived from a previous study. Firstly, for each action, fifteen experts were asked to indicate individually how important this action is per RTW phase (Likert scale from 1 – “Not important at all” to 6 – “Very important”). Consensus was reached when ≥ 80% (i.e., ≥ twelve experts) of the experts rated that action ≥5. Secondly, for each phase of the RTW process, the 15 actions with the highest percentage were discussed with eight experts during the collective consultation, except for the actions that already reached consensus. After discussion, the experts voted whether each action was important (“yes” / “no”) and consensus required ≥ 87.5% (i.e., ≥ seven experts) of the experts to consider an action as important. Results Twenty-five managerial actions were finally retained for at least one of the RTW phases, e.g., Disclosure: “respect privacy” and “radiate a positive attitude”, Treatment: “show appreciation” and “allow sufficient sick leave”, RTW Plan: “tailor” and “communicate”, and Actual RTW: “support practically” and “balance interest”. Conclusion Cancer survivors and managers reached consensus on the importance of 25 managerial actions, distributed into each phase of the RTW process. These actions should be considered an interplay of managerial actions by different stakeholders on the part of the employer (e.g., direct supervisor, HR-manager), and should be a responsibility that is shared by these stakeholders. The collective implementation of these actions within the company will help cancer survivors feel fully supported. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14271-w.
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Affiliation(s)
- B Porro
- Univ. Angers, CHU Angers, Univ. Rennes, Inserm, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, SFR ICAT, F-49000, Angers, France.
| | - S J Tamminga
- Department of Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.,Amsterdam Public Health research institute, Societal Participation & Health, Amsterdam, The Netherlands
| | - A G E M de Boer
- Department of Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.,Amsterdam Public Health research institute, Societal Participation & Health, Amsterdam, The Netherlands
| | - A Petit
- Univ. Angers, CHU Angers, Univ. Rennes, Inserm, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, SFR ICAT, F-49000, Angers, France
| | - Y Roquelaure
- Univ. Angers, CHU Angers, Univ. Rennes, Inserm, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, SFR ICAT, F-49000, Angers, France
| | - M A Greidanus
- Department of Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.,Amsterdam Public Health research institute, Societal Participation & Health, Amsterdam, The Netherlands
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Martin E, Di Meglio A, Menvielle G, Arvis J, Bourmaud A, Michiels S, Pistilli B, Vaz-Luis I, Dumas A. Informing the development of multidisciplinary interventions to help breast cancer patients return to work: a qualitative study. Support Care Cancer 2022; 30:8287-8299. [PMID: 35819520 DOI: 10.1007/s00520-022-07262-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 06/27/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Return to work (RTW) after breast cancer (BC) can be a major challenge for patients. Multidisciplinary interventions seem to be effective but the role of digital solutions is under-developed and therefore not evaluated. We explored the preferences, needs, and barriers regarding RTW interventions, including opinions about the use of digital approaches to deliver such interventions. METHODS We conducted a qualitative study based on interviews with 30 patients with BC and 18 healthcare providers in four French regions. Emergent themes were identified using thematic content analysis. RESULTS Most providers declared that they did not proactively address RTW with patients, mainly due to having other priorities and a lack of knowledge. The following themes emerged: several development and deployment barriers regarding RTW interventions exist, multidisciplinary interventions are preferred, and there is a need to maintain contact between the patient and workplace during sick leave, including pathways and interlocutors that can facilitate RTW. Participants had mostly positive representations of using digital tools to facilitate RTW; however, fear of loss of human contact and the exacerbation of inequalities were identified as possible risks associated with the development of digital-only interventions. CONCLUSIONS Interventions blending the needs and preferences of patients with BC and the healthcare system are warranted. A personalized multimodal approach with mixed digital and in-person features has surfaced as a possible solution to address the weaknesses of existing interventions. IMPLICATIONS FOR CANCER SURVIVORS Since most women work at the time of diagnosis, it is of particular relevance to build interventions promoting RTW.
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Affiliation(s)
- Elise Martin
- Université Paris-Saclay, Gustave Roussy, Inserm, Biomarqueurs Prédictifs Et Nouvelles Stratégies Thérapeutiques en Oncologie, 94800, Villejuif, France.
| | - Antonio Di Meglio
- Université Paris-Saclay, Gustave Roussy, Inserm, Biomarqueurs Prédictifs Et Nouvelles Stratégies Thérapeutiques en Oncologie, 94800, Villejuif, France.,Medical Oncology Department, Gustave Roussy, 94800, Villejuif, France
| | - Gwenn Menvielle
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie Et de Sante Publique, Paris, France
| | | | | | - Stefan Michiels
- Office of Biostatistics and Epidemiology, Gustave Roussy, Villejuif, France.,Oncostat U1018, Inserm, University Paris-Saclay, Labeled Ligue Contre Le Cancer, Villejuif, France
| | - Barbara Pistilli
- Medical Oncology Department, Gustave Roussy, 94800, Villejuif, France
| | - Ines Vaz-Luis
- Université Paris-Saclay, Gustave Roussy, Inserm, Biomarqueurs Prédictifs Et Nouvelles Stratégies Thérapeutiques en Oncologie, 94800, Villejuif, France.,Medical Oncology Department, Gustave Roussy, 94800, Villejuif, France
| | - Agnès Dumas
- Université Paris Cité, ECEVE, UMR 1123, INSERM, Paris, France
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M. S, A. WL, J. L. H, K. A, E. F. Interventions regarding physicians' sickness certification practice - a systematic literature review with meta-analyses. Scand J Prim Health Care 2022; 40:104-114. [PMID: 35254203 PMCID: PMC9090374 DOI: 10.1080/02813432.2022.2036420] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE A variety of interventions aiming to influence physicians' sickness certification practice have been conducted, most are, however, not evaluated scientifically. The aim of this systematic literature review was to obtain updated knowledge about interventions regarding physicians' sickness certification practice and to summarize their possible effects, in terms of sickness absence (SA) or return to work (RTW) among patients. METHODS We searched PubMed and Web of Science up through 15 June 2020 and selected peer-reviewed studies that reported effects of controlled interventions that aimed to improve physicians' sickness certification practice and used SA or RTW among patients as outcome measures. Meta-analyses were conducted using random-effect models. RESULTS Of the 1399 identified publications, 12 studies covering 9 interventions were assessed as relevant and included in the review. Most (70%) were from the Netherlands, two had a controlled, and seven a randomized controlled study design. All interventions included some type of training of physicians, and two interventions also included IT-support. Regarding the outcomes of SA/RTW, 30 different effect measures were used. In the meta-analyses, no statistically significant effect in favor of the interventions was observed for having any RTW (i.e. first, partial, or full) nor full RTW. CONCLUSIONS The individual studies showed that physicians' sickness certification practice might be influenced by interventions in both the intended and non-intended direction, however, no statistically significant effect was indicated by the meta-analysis. The included studies varied considerably concerning intervention content and effect measures.KEY POINTSThe knowledge is very limited regarding the content of interventions directed to physician's sickness certification practiceThe identified interventions included some type of training of physicians, and some of them also included IT-support for physiciansThere was a great heterogeneity among the interventions concerning effect measures used regarding return to work among patientsThe individual studies showed that physicians' sickness certification practice might be influenced by interventions in both intended and non-intended directions, however, the overall meta-analysis did not indicate an effect.
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Affiliation(s)
| | - Wennman-Larsen A.
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Sophiahemmet University, Stockholm, Sweden
| | - Hoving J. L.
- Amsterdam UMC, location Academic Medical Center, University of Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, and Research center for Insurance Medicine, Amsterdam, The Netherlands
| | - Alexanderson K.
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Friberg E.
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- CONTACT Friberg E Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, StockholmSE-171 77, Sweden
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5
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Gragnano A, Miglioretti M, Magon G, Pravettoni G. Work with cancer or stop working after diagnosis? Variables affecting the decision. Work 2021; 70:177-185. [PMID: 34511522 DOI: 10.3233/wor-213563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Studies about work and cancer predominantly considered the return to work of cancer survivors. However, some studies highlighted that many patients work with cancer even immediately after the diagnosis. Little is known about the frequency, causes, and consequences of this behavior. OBJECTIVE This study aimed to estimate how many cancer patients continue working in the month after the diagnosis in an Italian context and to determine which factors affect the decision to stop working in the same period. METHODS One hundred seventy-six patients with breast, gastrointestinal, prostate, or female reproductive system cancer completed a survey with demographic, occupational, and psychosocial information. Clinical information was collected from medical records. We measured how many workers continued working in the month after cancer diagnosis without substantial interruptions and selected the best logistic regression model of this behavior's predictors. RESULTS Sixty-eight percent of the patients continued working in the month after the diagnosis. Patients were more likely to stop working with a higher level of perceived work-health incompatibility (OR = 2.64; 95%CI: 1.48-4.69), an open-ended contract (OR = 3.20; CI: 1.13-9.09), and a complex treatment (surgery+chemo-/radio-therapy, OR = 4.25; CI: 1.55-11.65) and less likely with breast cancer (OR = 0.20; CI: 0.07-0.56), and more children (OR = 0.59; CI: 0.37-0.96). CONCLUSIONS To continue working with cancer is a common practice among the newly diagnosed. The decision to suspend work activity relates to evaluating how much work activities hamper one's health care needs and the practical difficulties expected in handling cancer care and work.
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Affiliation(s)
- Andrea Gragnano
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | | | | | - Gabriella Pravettoni
- European Institute of Oncology (IEO), Milan, Italy.,Department of Oncology and Hematooncology, University of Milan, Milan, Italy
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6
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Wennman-Larsen A, Svärd V, Alexanderson K, Friberg E. Factors of decisive importance for being in work or not during two years after breast cancer surgery: content analysis of 462 women's open answers. BMC WOMENS HEALTH 2021; 21:332. [PMID: 34521383 PMCID: PMC8438964 DOI: 10.1186/s12905-021-01468-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 09/01/2021] [Indexed: 11/10/2022]
Abstract
Background Paid work is one of the most important aspects in life among working-aged women diagnosed with breast cancer. Despite several attempts, no previous study provides a comprehensive overview from the women’s perspective about factors of importance for being able to work or not. Therefore, the aim of this study was to gain knowledge about factors that women themselves state are of decisive importance for being able to work or not during the first two years after breast cancer surgery. Methods Data was collected in a two-year follow-up questionnaire within the frame of a prospective cohort study of working-aged women who had undergone breast cancer surgery. 749 were included in the questionnaire study and of the 616 (82%) responding women, 462 (75%) wrote statements on an open-ended question about factors of decisive importance for being able to work or not work during the past two years. The statements were analyzed with content analysis. Results Five categories of factors of importance for being able to work or not were identified, each covering several sub-categories: Health and wellbeing, Contacts and encounters, Flexibility and adjustment possibilities, Socioeconomic consequences from working/not working, and Own motivation and characteristics. A wide variety of factors were mentioned by the women and the findings give a multifaceted picture of many single but interrelated factors of decisive importance for being able to work/not work. The importance of flexibility in the return-to-work process was stressed, as well as the importance of supportive encounters from, e.g., colleagues, managers, as well as relatives. Conclusions The results give a comprehensive overview over a variety of different types of factors for being able to return to/remain in work or to not work after breast cancer surgery, adding new knowledge about e.g. the importance of colleagues, and the women’s own preferences or characteristics. These are factors that different stakeholders, both from healthcare but also from the work place and the insurance office, need to be aware of and collaborate around to support women with breast cancer during the period of treatment, rehabilitation and return to work.
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Affiliation(s)
- Agneta Wennman-Larsen
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 17177, Stockholm, Sweden. .,Department of Nursing Science, Sophiahemmet University, Box 5605, 11486, Stockholm, Sweden.
| | - Veronica Svärd
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 17177, Stockholm, Sweden.,Department of Social Work, Södertörn University, 14189, Huddinge, Sweden
| | - Kristina Alexanderson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 17177, Stockholm, Sweden
| | - Emilie Friberg
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 17177, Stockholm, Sweden
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Greidanus MA, de Rijk AE, Frings-Dresen MHW, Tiedtke CM, Brouwers S, de Boer AGEM, Tamminga SJ. The Use and Perceived Usefulness of an Online Toolbox Targeted at Employers (MiLES Intervention) for Enhancing Successful Return to Work of Cancer Survivors. JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:393-404. [PMID: 33090355 PMCID: PMC8172399 DOI: 10.1007/s10926-020-09929-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE The MiLES intervention is a web-based intervention targeted at employers with the objective of enhancing successful return to work (RTW) of cancer survivors. The aim of this study is to gain insight into the employers' use and perceived usefulness of the MiLES intervention. METHODS Employer representatives (e.g. Human Resource managers and supervisors) were given access to the MiLES intervention, which contains, among others, interactive videos, conversation checklists and tailored tips. After six weeks, an online questionnaire gathered data on employers' use and the perceived usefulness of the intervention. In-depth qualitative data on these topics were gathered during semi-structured interviews, which were analyzed using a content analysis. RESULTS Thirty-one eligible employers were included. Twenty-two of them filled out the questionnaire and twenty were interviewed. Typically, employers used the intervention 2-3 times, for 26 min per visit. The usefulness of the intervention scored 7.6 out of 10 points, and all employers would recommend it to colleagues. Employers' use decreased when support needs were low and when the intervention did not correspond with their specific situation (e.g. complex reintegration trajectories). Employers perceived the intervention to be supporting and practically oriented. They appreciated the fact that the intervention was web-based and combined visual and textual content. The possibility of consulting specialized services for complex situations would further enhance its usefulness. CONCLUSION The MiLES intervention provides employers with a useful tool in their daily practice. Its effectiveness for enhancing employers' managerial skills and cancer survivors' successful RTW is subject for further research.
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Affiliation(s)
- M A Greidanus
- Department Public and Occupational Health/Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
| | - A E de Rijk
- Department of Social Medicine, Faculty of Health, Medicine and Life Sciences, Research Institute Primary Care and Public Health (CAPHRI), Maastricht University, Duboisdomein 30, Maastricht, The Netherlands
| | - M H W Frings-Dresen
- Department Public and Occupational Health/Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - C M Tiedtke
- Department of Public Health and Primary Care, Centre for Environment & Health, KU Leuven, Kapucijnenvoer 35, Leuven, Belgium
| | - S Brouwers
- Department Public and Occupational Health/Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - A G E M de Boer
- Department Public and Occupational Health/Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - S J Tamminga
- Department Public and Occupational Health/Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
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Kim K, Yoon H. Health-Related Quality of Life among Cancer Survivors Depending on the Occupational Status. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073803. [PMID: 33917318 PMCID: PMC8038705 DOI: 10.3390/ijerph18073803] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/01/2021] [Accepted: 04/03/2021] [Indexed: 11/16/2022]
Abstract
The study aimed to identify and compare the factors affecting health-related quality of life (HRQoL) depending on the occupational status of cancer survivors. This study was a secondary data analysis from the Korea National Health and Nutrition Examination Survey (KNHANES) from 2014 to 2018. Hierarchical multivariate linear regression was used to investigate the factors affecting the HRQoL of each group. Non-working cancer survivors had significantly lower HRQoL than working cancer survivors (p < 0.001). A hierarchical multiple regression model showed that demographic, health-related, and psychological characteristics explained 62.0% of non-working cancer survivors' HRQoL (F = 4.29, p < 0.001). Among the input variables, health-related characteristics were the most influential factors (ΔR2 = 0.274, F = 9.84, p < 0.001). For working cancer survivors, health-related characteristics were the only variable that was statistically associated with HRQoL (F = 5.556, p < 0.001). It is important to enhance physical activities and manage the chronic disease to improve the HRQoL of working cancer survivors. Further, managing health-related characteristics, including depressive symptoms and suicidal ideation, is necessary for non-working cancer survivors. Regarding working survivors, psychological factors such as depressive symptoms and suicidal tendencies did not affect HRQoL. Therefore, an early and effective return to work program should be developed for the improvement of their HRQoL.
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9
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Coping Strategies and Their Impact on Emotional Distress and Fatigue Among Breast Cancer Survivors: A Cross-sectional Survey. Cancer J 2021; 27:83-89. [PMID: 33750065 DOI: 10.1097/ppo.0000000000000505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES This study examined the relations between subjective stress and strategies for coping with stress (emotion control strategies and self-compassion), as well as the relations between emotional distress and fatigue. METHODS The study used a cross-sectional survey design. Participants were 170 women aged 24 to 82 years with diagnoses of breast cancer stages I to III who were 1 to 12 months postchemotherapy, with no current evidence of disease and no previous cancer diagnosis. Participants were recruited by consecutive sampling, and the overall response rate was 85%. RESULTS Higher subjective stress was associated with higher emotional control (r = 0.23, P < 0.01), and both were associated with higher emotional distress (r = 0.63, P < 0.001; r = 0.20, P < 0.05). Lower self-compassion was associated with higher emotional distress (r = -0.20, P < 0.05). Fatigue exhibited a high association with emotional distress (r = 0.67, P < 0.001), which increased as subjective stress increased. Older age was associated with emotional control (r = 0.16, P < 0.05), whereas younger age was associated with emotional distress. Time elapsed since chemotherapy was negatively associated with both emotional distress (r = -0.19, P < 0.05) and fatigue (r = -0.18, P < 0.05). A strong positive association emerged between fatigue and emotional distress (r = 0.67, P < 0.001). CONCLUSIONS The results of this study underline the importance of self-compassion as a coping strategy to decrease emotional distress among breast cancer survivors.
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Stapelfeldt CM, Momsen AMH, Jensen AB, Andersen NT, Nielsen CV. Municipal return to work management in cancer survivors: a controlled intervention study. Acta Oncol 2021; 60:370-378. [PMID: 33287597 DOI: 10.1080/0284186x.2020.1853227] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Resuming work during or after cancer treatment has become an important target in cancer rehabilitation. PURPOSE The aim was in a controlled trial to study the return to work (RTW) effect of an early, individually tailored vocational rehabilitation intervention targeted to improve readiness for RTW in cancer survivors. MATERIAL AND METHODS Participants diagnosed with breast, cervix, ovary, testicular, colon-rectal, and head-and-neck cancers as well as being employed were allocated to a vocational rehabilitation intervention provided by municipal social workers (n = 83) or to usual municipal RTW management (n = 264). The intervention contained three elements: motivational communication inspired by Acceptance and Commitment Therapy by which RTW barriers were addressed, municipal cancer rehabilitation and finally employer and workplace contact. RTW effect was assessed as relative cumulative incidence proportions (RCIP) in the control and intervention group within 52 weeks of follow-up, estimated from the week where treatment ended at the hospital. RCIP was interpreted and reported as relative risk (RR) with 95% confidence intervals (CI) adjusted for gender, age cancer diagnosis, education, comorbidity, and sick leave weeks. RESULTS Across cancer diagnoses 69 (83.1%) and 215 (81.4%) returned to work in the intervention and control group, respectively. No statistical effect was seen (RR 1.08 (95% CI 0.98-1.19)). Repeating the analyses solely for participants with breast cancer (n = 290) showed a significant effect of the intervention (RR 1.12 (95% CI 1.01-1.23)). CONCLUSION More than 80% returned to work in both groups. However, no statistical difference in RTW effect was seen across cancer diagnoses within one year from being exposed to an early, individually tailored vocational rehabilitation intervention compared with usual municipal RTW management. TRIAL REGISTRATION NUMBER ISRCTN50753764.
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Affiliation(s)
- Christina M. Stapelfeldt
- Department of Public Health, Aarhus University, Aarhus, Denmark
- DEFACTUM - Social and Health Services & Labour Market, Central Denmark Region, Aarhus, Denmark
| | - Anne-Mette H. Momsen
- DEFACTUM - Social and Health Services & Labour Market, Central Denmark Region, Aarhus, Denmark
| | | | | | - Claus Vinther Nielsen
- Department of Public Health, Aarhus University, Aarhus, Denmark
- DEFACTUM - Social and Health Services & Labour Market, Central Denmark Region, Aarhus, Denmark
- Goedstrup Hospital, Herning, Denmark
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Kaur MN, Klassen AF, Xie F, Bordeleau L, Zhong T, Cano SJ, Tsangaris E, Breitkopf T, Kuspinar A, Pusic AL. An international mixed methods study to develop a new preference-based measure for women with breast cancer: the BREAST-Q Utility module. BMC Womens Health 2021; 21:8. [PMID: 33407389 PMCID: PMC7789506 DOI: 10.1186/s12905-020-01125-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 11/10/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Generic preference-based measures (PBM), though commonly used, may not be optimal for use in economic evaluations of breast cancer interventions. No breast cancer-specific PBM currently exists, and the generic PBMs fail to capture the unique concerns of women with breast cancer (e.g., body image, appearance, treatment-specific adverse effects). Hence, the objective of this study was to develop a breast cancer-specific PBM, the BREAST-Q Utility module. METHODS Women diagnosed with breast cancer (stage 0-4, any treatment) were recruited from two tertiary hospitals in Canada and one in the US. The study followed an exploratory sequential mixed methods approach, whereby semi-structured interviews were conducted and at the end of the interview, participants were asked to list their top five health-related quality of life (HRQOL) concerns and to rate the importance of each item on the BREAST-Q. Interviews were audio-recorded, transcribed verbatim, and coded. Constant comparison was used to refine the codes and develop a conceptual framework. Qualitative and quantitative data were triangulated to develop the content of the Utility module that was refined through 2 rounds of cognitive debriefing interviews with women diagnosed with breast cancer and feedback from experts. RESULTS Interviews were conducted with 57 women aged 55 ± 10 years. A conceptual framework was developed from 3948 unique codes specific to breasts, arms, abdomen, and cancer experience. Five top-level domains were HRQOL (i.e., physical, psychological, social, and sexual well-being) and appearance. Data from the interviews, top 5 HRQOL concerns, and BREAST-Q item ratings were used to inform dimensions for inclusion in the Utility module. Feedback from women with breast cancer (N = 9) and a multidisciplinary group of experts (N = 27) was used to refine the module. The field-test version of the HSCS consists of 10 unique dimensions. Each dimension is measured with 1 or 2 candidate items that have 4-5 response levels each. CONCLUSION The field-test version of the BREAST-Q Utility module was derived from extensive patient and expert input. This comprehensive approach ensured that the content of the Utility module is relevant, comprehensive, and includes concerns that matter the most to women with breast cancer.
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Affiliation(s)
- Manraj N Kaur
- McMaster University, 3N27, 1280 Main Street W, Hamilton, ON, L8N 3Z5, Canada.
| | - Anne F Klassen
- McMaster University, 3N27, 1280 Main Street W, Hamilton, ON, L8N 3Z5, Canada
| | - Feng Xie
- McMaster University, CRL-223, 1280 Main Street W, Hamilton, ON, L8N 3Z5, Canada
| | - Louise Bordeleau
- Juravinski Cancer Center, Room 3-17, 699 Concession Street, Hamilton, ON, L8V 5C2, Canada
| | - Toni Zhong
- Toronto General Hospital, Norman Urquhart Wing, Toronto, ON, 8N-871M5G 2C4, Canada
| | - Stefan J Cano
- Modus Outcomes, Suite 210b, Spirella Building, Letchworth Garden City, SG6 4ET, UK
| | - Elena Tsangaris
- Brigham and Women's Hospital, 75 Francis S, Boston, MA, 02116, USA
| | - Trisia Breitkopf
- McMaster University, 3N27, 1280 Main Street W, Hamilton, ON, L8N 3Z5, Canada
| | - Ayse Kuspinar
- McMaster University, Room 435, 1400 Main Street West, Hamilton, ON, L8S 1C7, Canada
| | - Andrea L Pusic
- Brigham and Women's Hospital, 75 Francis S, Boston, MA, 02116, USA
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12
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Factors Influencing Received Social Support Among Emerging Adults With Inflammatory Bowel Disease: A Cross-Sectional Study. Gastroenterol Nurs 2020; 43:429-439. [PMID: 33055542 DOI: 10.1097/sga.0000000000000483] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The majority of research among individuals with inflammatory bowel disease (IBD) focuses on perceived social support. A gap exists regarding the role of received social support in self-management enhancement. The purpose of this study was to examine specific contextual factors (individual, condition-specific, and emerging adulthood factors) that influence received social support (total, informational, emotional, and tangible) among emerging adults (ages 18-29 years) with IBD. A convenience sample of 61 emerging adults with a diagnosis of IBD was obtained. An association was found between high total received social support and several individual factors such as being closer to the younger end of the age range (ages 18-29 years), married, and fully employed. When controlling for time since diagnosis and symptom interference, high tangible received social support was associated with the use of immunomodulator and biological medications. Emerging adulthood factors were not associated with total or any types of received social support. Future research could examine differences between types of social support and self-management behaviors. These findings contribute a new direction for intervention development with a focus on individual and condition-specific factors to enhance received social support and ultimately health outcomes for individuals with IBD.
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13
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Greidanus MA, de Boer AGEM, de Rijk AE, Frings-Dresen MHW, Tamminga SJ. The MiLES intervention targeting employers to promote successful return to work of employees with cancer: design of a pilot randomised controlled trial. Trials 2020; 21:363. [PMID: 32345344 PMCID: PMC7189583 DOI: 10.1186/s13063-020-04288-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 03/28/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Employers express a need for support to facilitate the return to work (RTW) process of employees with cancer. We have developed the MiLES intervention, an online toolbox targeting employers during the RTW of employees with cancer. To evaluate the MiLES intervention, we propose the design of a pilot randomised controlled trial (RCT). The aim of this pilot is to determine whether a future RCT to study the effectiveness of this intervention on successful RTW of employees with cancer is feasible. Secondary aims are to obtain preliminary results on the effectiveness of the intervention and to determine the sample size needed in a future definitive RCT. METHODS A pilot RCT with a 6-month follow-up will be conducted. Using medical specialists at Dutch hospitals, we aim to enrol 90 participants diagnosed with cancer (<2 years earlier) aged 18-63 years who are in paid employment with an employer and who are currently sick-listed or partly sick-listed for <1 year. Participants randomised to the intervention group will be asked to inform their employer about the online toolbox supporting employers during the RTW process of employees with cancer. Participants in the control group will receive 'care as usual' from their employer. All measures will be assessed at the level of the employee using questionnaires at baseline and after 3 and 6 months of follow-up. The feasibility of a future RCT will be determined using criteria concerning method-related uncertainties and acceptability of the study protocol. The primary effect measure will be successful RTW (that is, RTW perceived as being successful by the cancer survivor themselves). This effect measure will be used to perform the sample size calculation for a future definitive RCT. DISCUSSION The design is proposed to determine the feasibility to study the effectiveness of the MiLES intervention targeting employers on the successful RTW of employees diagnosed with cancer. This pilot RCT can increase the probability of a successful future definitive RCT on the effectiveness of the intervention and potentially obviate the need to carry out an unfeasible and resource-intensive study. TRIAL REGISTRATION Dutch Trial Register (NTR): NL6758, NTR7627. Registered on 30 October 2018.
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Affiliation(s)
- Michiel A Greidanus
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Meibergdreef 9, Amsterdam, The Netherlands.
| | - Angela G E M de Boer
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Meibergdreef 9, Amsterdam, The Netherlands
| | - Angelique E de Rijk
- Department of Social Medicine, Faculty of Health, Medicine and Life Sciences, Research Institute Primary Care and Public Health (CAPHRI), Maastricht University, Duboisdomein 30, Maastricht, The Netherlands
| | - Monique H W Frings-Dresen
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Meibergdreef 9, Amsterdam, The Netherlands
| | - Sietske J Tamminga
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Meibergdreef 9, Amsterdam, The Netherlands
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14
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Greidanus MA, de Boer AGEM, Tiedtke CM, Frings-Dresen MHW, de Rijk AE, Tamminga SJ. Supporting employers to enhance the return to work of cancer survivors: development of a web-based intervention (MiLES intervention). J Cancer Surviv 2020; 14:200-210. [PMID: 31938966 PMCID: PMC7182637 DOI: 10.1007/s11764-019-00844-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 12/01/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE The purpose of this study was to develop an intervention targeting employers, with the aim of enhancing cancer survivors' return to work (RTW). METHODS Intervention Mapping was used to combine information gathered from several procedures involving numerous stakeholders, for example, employers, cancer survivors, oncological occupational physicians, and e-health experts. RESULTS Employers indicated that they require tailored support during four RTW phases: (1) disclosure, (2) treatment, (3) RTW planning, and (4) actual RTW. The most important employer actions were identified for each RTW phase, for instance, "communicate," "support practically," and "assess work ability," and thereafter formulated as the performance objectives of the intervention. The trans-theoretical model of change was used as a theoretical framework, and several methodologies were employed to induce the desired behavior change, for example modeling, tailoring, and active learning. Subsequently, a web-based intervention with interactive videos, conversation checklists, links to reliable external sources, and succinct, tailored tips and information was developed and adjusted on the basis of pre-tests with different stakeholders. CONCLUSIONS The intervention was developed with input from employers and all relevant stakeholders in the RTW of cancer survivors. The systematic, step-wise development resulted in a succinct and easily accessible intervention targeting the most important employer actions during all RTW phases. As such, the intervention corresponds with employers' needs and preferences in practice. IMPLICATIONS FOR CANCER SURVIVORS By providing employers with support, the intervention could well be the missing link in efforts to optimize the work participation of cancer survivors.
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Affiliation(s)
- M A Greidanus
- Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
| | - A G E M de Boer
- Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - C M Tiedtke
- Department of Public Health and Primary Care, Centre for Environment & Health, Katholieke Universiteit Leuven, Kapucijnenvoer 35, Leuven, Belgium
| | - M H W Frings-Dresen
- Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - A E de Rijk
- Department of Social Medicine, Faculty of Health, Medicine and Life Sciences, Research Institute Primary Care and Public Health (CAPHRI), Maastricht University, Duboisdomein 30, Maastricht, Netherlands
| | - S J Tamminga
- Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
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15
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Dumas A, Vaz Luis I, Bovagnet T, El Mouhebb M, Di Meglio A, Pinto S, Charles C, Dauchy S, Delaloge S, Arveux P, Coutant C, Cottu P, Lesur A, Lerebours F, Tredan O, Vanlemmens L, Levy C, Lemonnier J, Mesleard C, Andre F, Menvielle G. Impact of Breast Cancer Treatment on Employment: Results of a Multicenter Prospective Cohort Study (CANTO). J Clin Oncol 2019; 38:734-743. [PMID: 31834818 PMCID: PMC7048162 DOI: 10.1200/jco.19.01726] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Adverse effects of breast cancer treatment can negatively affect survivors’ work ability. Previous reports lacked detailed clinical data or health-related patient-reported outcomes (PROs) and did not prospectively assess the combined impact of treatment and related sequelae on employment. METHODS We used a French prospective clinical cohort of patients with stage I-III breast cancer including 1,874 women who were working and ≥ 5 years younger than legal retirement age (≤ 57 years) at breast cancer diagnosis. Our outcome was nonreturn to work (non-RTW) 2 years after diagnosis. Independent variables included treatment characteristics as well as toxicities (Common Toxicity Criteria Adverse Events [CTCAE] v4) and PROs (European Organization for Research and Treatment of Cancer [EORTC] Quality of life Questionnaires, Breast cancer module [QLQ-BR23] and Fatigue module [QLQ-FA12], Hospital Anxiety and Depression Scale) collected 1 year after diagnosis. Logistic regression models assessed correlates of non-RTW, adjusting for age, stage, comorbidities, and socioeconomic covariates. RESULTS Two years after diagnosis, 21% of patients had not returned to work. Odds of non-RTW were significantly increased among patients treated with combinations of chemotherapy and trastuzumab (odds ratio [OR] v chemotherapy-hormonotherapy: for chemotherapy-trastuzumab, 2.01; 95% CI, 1.18 to 3.44; for chemotherapy-trastuzumab-hormonotherapy, 1.62; 95% CI, 1.10 to 2.41). Other significant associations with non-RTW included grade ≥ 3 CTCAE toxicities (OR v no, 1.59; 95% CI, 1.15 to 2.18), arm morbidity (OR v no, 1.59; 95% CI, 1.19 to 2.13), anxiety (OR v no, 1.47; 95% CI, 1.02 to 2.11), and depression (OR v no, 2.29; 95% CI, 1.34 to 3.91). CONCLUSION Receipt of systemic therapy combinations including trastuzumab was associated with increased odds of non-RTW. Likelihood of unemployment was also higher among patients who reported severe physical and psychological symptoms. This comprehensive study identifies potentially vulnerable patients and warrants supportive interventional strategies to facilitate their RTW.
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Affiliation(s)
- Agnes Dumas
- Université de Paris, ECEVE UMR 1123, INSERM (National Institute for Health and Medical Research), Paris, France.,Clinical Research Department, Gustave Roussy, Villejuif, France
| | - Ines Vaz Luis
- Breast Cancer Unit, Department of Medical Oncology, Gustave Roussy, Villejuif, France.,INSERM Unit U 981, Villejuif, France
| | - Thomas Bovagnet
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Mayssam El Mouhebb
- Clinical Research Department, Gustave Roussy, Villejuif, France.,INSERM Unit U 981, Villejuif, France
| | | | - Sandrine Pinto
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Cecile Charles
- Department of Supportive Care, Gustave Roussy, Université Paris-Saclay, Villejuif, France.,Laboratoire de Psychopathologie et Processus de Santé (EA 4057), Université de Paris, Paris, France
| | - Sarah Dauchy
- Department of Supportive Care, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Suzette Delaloge
- Breast Cancer Unit, Department of Medical Oncology, Gustave Roussy, Villejuif, France
| | - Patrick Arveux
- Clinical Research Department, Centre Georges-François Leclerc, Dijon, France.,INSERM U1018, Center for Research in Epidemiology and Population Health, Villejuif, France
| | - Charles Coutant
- Clinical Research Department, Centre Georges-François Leclerc, Dijon, France
| | - Paul Cottu
- Department of Medical Oncology, Institut Curie, Paris, France
| | - Anne Lesur
- Institut de Cancérologie de Lorraine Alexis Vautrin, Vandoeuvre les Nancy, France
| | | | | | | | | | | | | | - Fabrice Andre
- Breast Cancer Unit, Department of Medical Oncology, Gustave Roussy, Villejuif, France.,INSERM Unit U 981, Villejuif, France
| | - Gwenn Menvielle
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
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16
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Chen SC, Huang BS, Hung TM, Lin CY, Chang YL. Impact of physical and psychosocial dysfunction on return to work in survivors of oral cavity cancer. Psychooncology 2019; 28:1910-1917. [PMID: 31291694 DOI: 10.1002/pon.5173] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 07/03/2019] [Accepted: 07/08/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To compare the levels of social support, physical function, and social-emotional function between oral cavity cancer survivors who did or did not resume work 6 months or longer after treatment completion. METHODS This cross-sectional study examined survivors of oral cavity cancer who were treated at the outpatient radiation department of a medical center in Northern Taiwan. Questionnaires were used to collect data regarding perceived social support, physical function, social-emotional function, and return to work status after treatment. Logistic regression was conducted to determine factors related to returning to work. RESULTS We examined 174 survivors of oral cavity cancer, 55.2% of whom returned to work after treatment. Relative to survivors who returned to work, those who did not return to work reported needing greater tangible social support, having fewer positive social interactions, having poorer physical function, and having poorer social-emotional function. Multivariable analysis indicated that younger age (OR = 0.864, P < .05), higher family income (OR = 10.835, P < .05), sufficient tangible social support (OR = 0.943, P < .05), positive social interaction (OR = 1.025, P < .05), and better physical function (OR = 1.062, P < .05) were significantly associated with the return to work. CONCLUSIONS Survivors of oral cavity cancer who did not return to work had worse physical and social-emotional function and required more tangible social support and positive social interactions. Providing occupational rehabilitation and counseling for oral cavity cancer survivors may help them return to work.
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Affiliation(s)
- Shu-Ching Chen
- School of Nursing, College of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan.,Department of Radiation Oncology, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Proton and Radiation Therapy Center, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Bing-Shen Huang
- Department of Radiation Oncology, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Proton and Radiation Therapy Center, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Tsung-Min Hung
- Department of Radiation Oncology, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Proton and Radiation Therapy Center, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chien-Yu Lin
- Department of Radiation Oncology, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Proton and Radiation Therapy Center, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ya-Lan Chang
- Department of Nursing, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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17
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Yagil D, Eshed-Lavi N, Carel R, Cohen M. Return to Work of Cancer Survivors: Predicting Healthcare Professionals' Assumed Role Responsibility. JOURNAL OF OCCUPATIONAL REHABILITATION 2019; 29:443-450. [PMID: 30120666 DOI: 10.1007/s10926-018-9807-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Purpose Returning to work is highly beneficial for many cancer survivors. While research has documented the significance of healthcare professionals in the process of return to work (RTW), very little is known about those professionals' views regarding their responsibility for RTW. The purpose of the present study was to identify factors that predict the extent to which healthcare professionals view involvement in the RTW of cancer survivors as part of their role. Methods In a cross-sectional design, questionnaires measuring attitudes regarding personal role responsibility for RTW, team role responsibility for RTW and benefits of RTW were administered to 157 healthcare professionals who care for working-age cancer survivors: oncologists, occupational physicians, family physicians, oncology nurses, oncology social workers, and psychologists. Results Both belief in the benefits of RTW, and the view that RTW is the team responsibility of healthcare professionals working with cancer survivors, are positively related to viewing RTW as part of the responsibilities of one's personal professional role. Moderation analysis indicated that perception of team responsibility for RTW moderates the effect of the perceived benefits of RTW, such that the perception of benefits is significantly associated with personal role responsibility only when there is a low level of perceived team responsibility. Conclusions Issues related to RTW should be routinely included in basic and advanced training of healthcare professionals involved in the treatment of working-age cancer survivors, to increase awareness of this aspect of cancer survivors' well-being and position RTW as part of healthcare professionals' role responsibilities.
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Affiliation(s)
- Dana Yagil
- Faculty Social Welfare and Health Sciences, University of Haifa, Mount Carmel, 31905, Haifa, Israel.
| | - Nofar Eshed-Lavi
- Faculty Social Welfare and Health Sciences, University of Haifa, Mount Carmel, 31905, Haifa, Israel
| | - Rafi Carel
- Faculty Social Welfare and Health Sciences, University of Haifa, Mount Carmel, 31905, Haifa, Israel
| | - Miri Cohen
- Faculty Social Welfare and Health Sciences, University of Haifa, Mount Carmel, 31905, Haifa, Israel
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18
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Return to Work Interventions for Cancer Survivors: A Systematic Review and a Methodological Critique. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16081343. [PMID: 31014004 PMCID: PMC6518012 DOI: 10.3390/ijerph16081343] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 04/11/2019] [Accepted: 04/12/2019] [Indexed: 12/24/2022]
Abstract
Cancer patients are more at risk of being unemployed or having difficulties to return to work (RTW) compared to individuals without health concerns, and is thus a major public health issue. The aim of this systematic review is to identify and describe the interventions developed specifically to help cancer patients to RTW after treatment. Two researchers independently screened the articles for inclusion and Critical Appraisal Skills Program (CASP) checklists were used to assess the methodology of the included studies. Ten manuscripts met the inclusion criteria. The type of studies were three quasi-experimental studies, three longitudinal studies, three randomized controlled trials (RCTs) and a qualitative study. RTW interventions were conducted in or outside the hospital (n = 6 and 3 respectively), or both (n = 1). Improvements in RTW were only observed in quasi-experimental studies. No improvement in RTW was noted in RCTs, nor in other measures (e.g., quality of life, fatigue). Lack of statistically significant improvement does not necessarily reflect reality, but may be attributed to non-adapted research methods. This systematic review underscores the need for researches in the RTW field to reach a consensus on RTW criteria and their assessment. Recommendations to this effect are suggested.
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Söderman M, Wennman-Larsen A, Alexanderson K, Friberg E. Experiences of positive encounters with healthcare professionals among women on long-term sickness absence due to breast cancer or due to other diagnoses: a nationwide survey. BMC Public Health 2019; 19:349. [PMID: 30922280 PMCID: PMC6440120 DOI: 10.1186/s12889-019-6666-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 03/18/2019] [Indexed: 11/18/2022] Open
Abstract
Background Experiences of encounters with professionals have been shown to influence return to work (RTW) among sickness absentees in general. The aim was to gain knowledge on experiences of encounters with healthcare professionals and the ability to RTW among women on long-term sickness absence (SA) due to breast cancer (BC) compared to among women on long-term SA due to other diagnoses. Methods Analyses of questionnaire data about experiences of encounters with healthcare professionals among 6197 women aged 19–65 years and on a SA spell lasting 4–8 months. Of those, 187 were on SA due to BC. Descriptive statistics and adjusted (for age, birth country, educational level, depressive symptoms) logistic regression analyses with 95% confidence intervals (CI) were conducted. Results About 95% in both groups of women stated that they had experienced positive encounters with healthcare, and a minority, about 20%, had experienced negative encounters. Four specific types of positive encounters had been experienced to a lesser extent by women with BC: “allowed me to take own responsibility” (odds ratio (OR) 0.6; 95% CI 0.4–0.8), “encouraged me to carry through my own solutions” (OR 0.5; 95% CI 0.4–0.7), “made reasonably high demands” (OR 0.6; 95% CI 0.4–0.9), and “sided with me/stood on my side” (OR 0.6; 95% CI 0.4–0.8). Among the women with BC, 46% stated that positive encounters promoted their ability to RTW compared to 56% among the others. Conclusion: Most of the women had experienced positive encounters and about half stated that positive encounters promoted their ability to RTW, although a slightly smaller proportion of the women with BC stated that. This study emphasizes that not only medical treatment but also encounters may influence the ability to RTW, something that is of clinical importance.
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Affiliation(s)
- M Söderman
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77, Stockholm, Sweden.
| | - A Wennman-Larsen
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77, Stockholm, Sweden.,Sophiahemmet University, Stockholm, Sweden
| | - K Alexanderson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77, Stockholm, Sweden
| | - E Friberg
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77, Stockholm, Sweden
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20
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Palant A, Himmel W. Are there also negative effects of social support? A qualitative study of patients with inflammatory bowel disease. BMJ Open 2019; 9:e022642. [PMID: 30670504 PMCID: PMC6347904 DOI: 10.1136/bmjopen-2018-022642] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 10/03/2018] [Accepted: 10/19/2018] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE Social support is considered an important resource in coping with chronic conditions. By conducting a series of interviews with people who suffer from inflammatory bowel disease (IBD), we received the impression that social support in face-to-face or online communication could also be a source of stress and strain. The aim of our study was to better understand and describe possible negative effects of social support. DESIGN This is a secondary analysis of narrative interviews. The interviewees were selected using a maximum-variation sampling approach. Grounded theory and the 'OSOP' (one sheet of paper) method were applied to categorise those parts of the interviews that touched on the negative effects of social support. SETTING The open-end interview collection took place throughout Germany from September 2011 to June 2012. Most of the participants were interviewed in their homes, some in the Department of General Practice in Göttingen. PARTICIPANTS 42 patients with IBD. RESULTS Two interrelated categories emerged: (1) unwanted confrontation and (2) undesirable reactions. The interviewees perceived social support as negative, especially if they felt overwhelmed and/or if they had not asked for it. Consequently, some of our interview partners developed strategies to prevent coming into social contact with others or stopped talking entirely about their disease. CONCLUSION While social support is usually conceptualised and perceived as a positive resource in chronic disease, it sometimes turns into a negative experience and may end in social isolation and deteriorate health. This process also happens in online support groups and increases anxiety when exchanging with other people on the internet. Before motivating ill people to seek contact with others, they should know about the negative effects of social support.
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Affiliation(s)
- Alexander Palant
- Department of General Practice, University Medical Center, Göttingen, Germany
| | - Wolfgang Himmel
- Department of General Practice, University Medical Center, Göttingen, Germany
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Porro B, Michel A, Zinzindohoué C, Bertrand P, Monrigal E, Trentini F, Baussard L, Cousson-Gélie F. Quality of life, fatigue and changes therein as predictors of return to work during breast cancer treatment. Scand J Caring Sci 2019; 33:467-477. [PMID: 30664270 DOI: 10.1111/scs.12646] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 12/04/2018] [Indexed: 12/19/2022]
Abstract
PURPOSE To our knowledge, only one study has assessed Quality of Life (QOL) as a predictor of return to work (RTW) during breast cancer treatment and one has evaluated multidimensional cancer-related fatigue (CRF) as a determinant of RTW. However, no study has assessed the impact of changes in these variables on RTW. The objective of this study was to evaluate QOL, multidimensional CRF and changes in these variables as determinants of RTW during breast cancer treatment. METHODS We performed a longitudinal study of 68 patients with a mean age of 46.97 years (SD = 6.92), who were employed at the time of diagnosis. Women were assessed at the beginning of adjuvant treatments (T0) and followed up with by telephone at three (T1) and 6 months later (T2), using questionnaires (QLQ-C30; MFI-20). RESULTS Global QOL, OR = 1.12 [1.01-1.25], sleep disturbance, OR = 1.04 [1.002-1.08], fatigue (QLQ-C30), OR = 0.93 [0.88-0.99], nausea-vomiting, OR = 0.84 [0.73-0.97], reduced motivation, OR = 1.49 [1.05-2.11] and general fatigue, OR = 0.79 [0.63-0.99] at T0 were associated with RTW at T1. At T2 global QOL, OR = 1.09 [1.01-1.17], cognitive functioning, OR = 1.10 [1.03-1.17], general fatigue, OR = 1.82 [1.04-3.17] and mental fatigue, OR = 0.29 [0.11-0.81] were associated with RTW. Furthermore, changes in mental fatigue were associated with RTW at T2, OR = 0.02 [0.001-0.29]. CONCLUSIONS Quality of life, fatigue and their changes in them, especially cognitive functioning and mental fatigue, can play an important role in predicting the RTW of women with breast cancer. This confirms the importance of multidisciplinary care for cancer and the emergence of a theoretical psychological model of RTW.
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Affiliation(s)
- Bertrand Porro
- University Paul Valéry Montpellier 3, University Montpellier, EPSYLON EA 4556, Montpellier, France
| | - Aude Michel
- University Paul Valéry Montpellier 3, University Montpellier, EPSYLON EA 4556, Montpellier, France.,Montpellier Breast Institute (MIS), Montpellier, France
| | | | | | | | | | - Louise Baussard
- University Paul Valéry Montpellier 3, University Montpellier, EPSYLON EA 4556, Montpellier, France.,Epidaure Prevention Department of the Regional Institute of Cancer of Montpellier (ICM)-Val d'Aurelle, Montpellier, France
| | - Florence Cousson-Gélie
- University Paul Valéry Montpellier 3, University Montpellier, EPSYLON EA 4556, Montpellier, France.,Epidaure Prevention Department of the Regional Institute of Cancer of Montpellier (ICM)-Val d'Aurelle, Montpellier, France
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22
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Heuser C, Halbach S, Kowalski C, Enders A, Pfaff H, Ernstmann N. Sociodemographic and disease-related determinants of return to work among women with breast cancer: a German longitudinal cohort study. BMC Health Serv Res 2018; 18:1000. [PMID: 30594181 PMCID: PMC6311058 DOI: 10.1186/s12913-018-3768-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 11/26/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Return to work (RTW) is a key parameter of outcome quality that ensures social participation. Therefore, this study analyses the sociodemographic and disease-related determinants of RTW among newly diagnosed breast cancer patients. METHODS In a prospective, multicentre cohort study, breast cancer patients were surveyed three times: directly after surgery, after 10 weeks, and after 40 weeks. Logistic regression analysis was applied to estimate the association of RTW at 40 weeks following discharge with sociodemographic and disease-related characteristics (n = 577). RESULTS The sociodemographic variables "entrance certificate at a university of applied science" compared to "university entrance certificate" (OR = 3.1, 95%-CI = 1.2-8.1), age group "55-59 years" compared to "18-44 years" (OR = 3.2, 95%-CI = 1.2-8.4) and "having children" (OR = 2.8, 95%-CI = 1.2-6.2) as well as the disease-related variables "rehabilitation" (OR = 0.5, 95%-CI = 0.3-0.9), self-rated health "good" and "excellent" compared to "bad" (OR = 2.7, 95%-CI = 1.4-5.5; OR = 11.6, 95%-CI = 4.2-31.8) and the UICC-classification "stage II" and "stage III/IV" in comparison to "stage 0/I" (OR = 0.5, 95%-CI = 0.3-0.8; OR = 0.2, 95%-CI = 0.1-0.5) significantly affect RTW among breast cancer patients (Nagelkerke's Pseudo-R2 = 0.275). CONCLUSIONS The findings show that significant differences in RTW exist between patient groups and suggest that RTW issues must be addressed more effectively before, during and after treatment. For future research on RTW in Germany, longitudinal studies with a follow-up of several years are necessary. Information and support deficits should be tackled by social services or breast care nurses. TRIAL REGISTRATION Database Health Services Research, VfD_PIAT_12_001630 , registered 01.03.2012.
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Affiliation(s)
- Christian Heuser
- Center for Health Communication and Health Services Research (CHSR), Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
- Center for Integrated Oncology (CIO Bonn), University Hospital Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
| | - Sarah Halbach
- Center for Health Communication and Health Services Research (CHSR), Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
- Center for Integrated Oncology (CIO Bonn), University Hospital Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
| | - Christoph Kowalski
- German Cancer Society e.V. (DKG), Department for Certification, Kuno-Fischer-Straße 8, 14057 Berlin, Germany
| | - Anna Enders
- The Federal Centre for Health Education (BZgA), Department for Research and Quality Management, Maarweg 149-161, 50825 Cologne, Germany
| | - Holger Pfaff
- Institute of Medical Sociology,Health Services Research, and Rehabilitation Science (IMVR), Faculty of Human Sciences and Faculty of Medicine, University of Cologne, Eupener Str. 129, 50933 Cologne, Germany
| | - Nicole Ernstmann
- Center for Health Communication and Health Services Research (CHSR), Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
- Center for Integrated Oncology (CIO Bonn), University Hospital Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
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23
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Gragnano A, Negrini A, Miglioretti M, Corbière M. Common Psychosocial Factors Predicting Return to Work After Common Mental Disorders, Cardiovascular Diseases, and Cancers: A Review of Reviews Supporting a Cross-Disease Approach. JOURNAL OF OCCUPATIONAL REHABILITATION 2018; 28:215-231. [PMID: 28589524 DOI: 10.1007/s10926-017-9714-1] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Purpose This systematic review aimed at identifying the common psychosocial factors that facilitate or hinder the return to work (RTW) after a sick leave due to common mental disorders (CMDs), cardiovascular diseases (CVDs), or cancers (CAs). Methods We conducted a review of reviews searching 13 databases from 1994 to 2016 for peer-reviewed, quantitative, cohort studies investigating factors influencing RTW after a CMD, CVD, or CA. Then, for each disease we identified additional cohort studies published after the date of the latest review included. Data were extracted following a three steps best-evidence synthesis method: the extraction of results about each predictor from studies within each single review and in the additional papers; the synthesis of results across the reviews and additional papers investigating the same disease; and the synthesis of results across the diseases. Results The search strategy identified 1029 unique records from which 27 reviews and 75 additional studies underwent comprehensive review. 14 reviews and 32 additional cohort studies met eligibility criteria. Specific predictors of RTW with different levels of evidence are provided for each disease. We found four common facilitators of RTW (job control, work ability, perceived good health and high socioeconomic status), and six barriers of RTW (job strain, anxiety, depression, comorbidity, older age and low education). Conclusion This is the first review to systematically analyze commonalities in RTW after CMDs, CVDs, or CAs. The common factors identified indicate that the RTW process presents many similarities across various diseases, thus supporting the validity of a cross-disease approach.
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Affiliation(s)
- Andrea Gragnano
- Institut de recherche Robert-Sauvé en santé et en Sécurité du travail, 505 boul. de Maisonneuve Ouest, Montreal, QC, H3A 3C2, Canada.
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montreal, QC, Canada.
- Department of Education, Career Counselling, Université du Québec à Montréal (UQAM), Montreal, QC, Canada.
| | - Alessia Negrini
- Institut de recherche Robert-Sauvé en santé et en Sécurité du travail, 505 boul. de Maisonneuve Ouest, Montreal, QC, H3A 3C2, Canada
| | | | - Marc Corbière
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montreal, QC, Canada
- Department of Education, Career Counselling, Université du Québec à Montréal (UQAM), Montreal, QC, Canada
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24
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Caron M, Durand MJ, Tremblay D. Perceptions of Breast Cancer Survivors on the Supporting Practices of Their Supervisors in the Return-to-Work Process: A Qualitative Descriptive Study. JOURNAL OF OCCUPATIONAL REHABILITATION 2018; 28:89-96. [PMID: 28271399 DOI: 10.1007/s10926-017-9698-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Purpose Supervisors are known to be key actors in ensuring the success of absent employees in their return-to-work process. However, to date, little is known about the perceptions of breast cancer survivors on the practices put in place by their supervisors to support them during this process. The objective of this study was to describe the perceptions of breast cancer survivors on the practices put in place by their supervisors to support them during their return-to-work process. Method A qualitative descriptive study was conducted. Semi-structured interviews were carried out with breast cancer survivors (n = 10) who had returned to work after treatment and were still at work more than 18 months later. Each interview was audio recorded and then transcribed verbatim for qualitative thematic content analysis using a semi-open codification framework. Results Participants identified three main practices put in place by their supervisors to support them and which they perceived as particularly helpful during the return-to-work process: (1) maintaining communication during their period of absence; (2) working with them to structure their return-to-work process before their actual return; and (3) allowing them flexibility in their schedule for a certain period, particularly at the beginning of the return-to-work process. Breast cancer survivors also identified an omission in the practice of employers: lack of follow-up over time. Conclusion Knowledge about the practices perceived as helpful by breast cancer survivors during their return-to-work process lays the groundwork for the eventual development of services to help breast cancer survivors in their return to work.
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Affiliation(s)
- Maryse Caron
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada.
| | - Marie-José Durand
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
- School of Rehabilitation, Université de Sherbrooke, Longueuil, QC, Canada
| | - Dominique Tremblay
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
- School of Nursing Sciences, Université de Sherbrooke, Longueuil, QC, Canada
- Research Center - Hôpital Charles-Le Moyne, Université de Sherbrooke, 150 Place Charles LeMoyne, Longueuil, QC, J4K 0A8, Canada
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25
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Kagee A, Roomaney R, Knoll N. Psychosocial predictors of distress and depression among South African breast cancer patients. Psychooncology 2017; 27:908-914. [DOI: 10.1002/pon.4589] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 09/25/2017] [Accepted: 11/14/2017] [Indexed: 11/10/2022]
Affiliation(s)
- Ashraf Kagee
- Department of Psychology; Stellenbosch University; Matieland South Africa
| | - Rizwana Roomaney
- Department of Psychology; Stellenbosch University; Matieland South Africa
| | - Nina Knoll
- Free University of Berlin; Berlin Germany
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26
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Nordgren L, Söderlund A. Social support, self-rated health and low mood in people on sick leave due to heart failure: a cross-sectional study. Scand J Public Health 2017; 46:606-612. [PMID: 29160157 DOI: 10.1177/1403494817718070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
AIMS The aim of this study was to investigate social support in relation to self-rated health and the prevalence of low mood in people on sick leave due to heart failure. METHODS A cross-sectional design was used, and 590 individuals on sick leave due to heart failure in Sweden responded to the postal questionnaire. The questions therein concerned received and needed functional and structural support from managers, work colleagues, families and friends. Multivariate analyses were conducted. RESULTS The variables of income and needed support from family contributed significantly and negatively to self-rated health. Those who perceived that they needed more support from their manager reported experiencing low mood more frequently. CONCLUSIONS The results showed a negative relation between manager support and low mood. Thus, support from managers and perceptions of low mood during sick leave are negatively associated, however, we do not know anything about the causality of this association. The results also indicated that needed support from family was negatively associated with self-rated health. The results also highlighted a multidimensional frailty in people with heart failure that needs to be recognized in future research as well as in clinical practice.
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Affiliation(s)
- Lena Nordgren
- 1 Centre for Clinical Research Sörmland, Uppsala University, Sweden.,2 Department of Public Health and Caring Sciences, Uppsala University, Sweden
| | - Anne Söderlund
- 3 School of Health, Care and Social Welfare, Mälardalen University, Sweden
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27
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Greidanus M, de Boer A, de Rijk A, Tiedtke C, Dierckx de Casterlé B, Frings-Dresen M, Tamminga S. Perceived employer-related barriers and facilitators for work participation of cancer survivors: A systematic review of employers' and survivors' perspectives. Psychooncology 2017; 27:725-733. [DOI: 10.1002/pon.4514] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 07/21/2017] [Accepted: 07/25/2017] [Indexed: 11/11/2022]
Affiliation(s)
- M.A. Greidanus
- Academic Medical Center; University of Amsterdam, Department: Coronel Institute of Occupational Health, Amsterdam Public Health research institute; Amsterdam The Netherlands
| | - A.G.E.M. de Boer
- Academic Medical Center; University of Amsterdam, Department: Coronel Institute of Occupational Health, Amsterdam Public Health research institute; Amsterdam The Netherlands
| | - A.E. de Rijk
- Department of Social Medicine, Research Institute Primary Care and Public Health (CAPHRI), Faculty of Health, Medicine, and Life Sciences; Maastricht University; Maastricht The Netherlands
| | - C.M. Tiedtke
- Department of Social Medicine, Research Institute Primary Care and Public Health (CAPHRI), Faculty of Health, Medicine, and Life Sciences; Maastricht University; Maastricht The Netherlands
| | - B. Dierckx de Casterlé
- Department of Public Health and Primary Care, Academic Center for Nursing and Midwifery; Katholieke Universiteit Leuven; Leuven Belgium
| | - M.H.W. Frings-Dresen
- Academic Medical Center; University of Amsterdam, Department: Coronel Institute of Occupational Health, Amsterdam Public Health research institute; Amsterdam The Netherlands
| | - S.J. Tamminga
- Academic Medical Center; University of Amsterdam, Department: Coronel Institute of Occupational Health, Amsterdam Public Health research institute; Amsterdam The Netherlands
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28
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Dorland HF, Abma FI, Roelen CAM, Stewart RE, Amick BC, Ranchor AV, Bültmann U. Work functioning trajectories in cancer patients: Results from the longitudinal Work Life after Cancer (WOLICA) study. Int J Cancer 2017; 141:1751-1762. [PMID: 28681478 DOI: 10.1002/ijc.30876] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 05/19/2017] [Accepted: 06/16/2017] [Indexed: 11/12/2022]
Abstract
More than 60% of cancer patients are able to work after cancer diagnosis. However, little is known about their functioning at work. Therefore, the aims of this study were to (1) identify work functioning trajectories in the year following return to work (RTW) in cancer patients and (2) examine baseline sociodemographic, health-related and work-related variables associated with work functioning trajectories. This longitudinal cohort study included 384 cancer patients who have returned to work after cancer diagnosis. Work functioning was measured at baseline, 3, 6, 9 and 12 months follow-up. Latent class growth modeling (LCGM) was used to identify work functioning trajectories. Associations of baseline variables with work functioning trajectories were examined using univariate and multivariate analyses. LCGM analyses with cancer patients who completed on at least three time points the Work Role Functioning Questionnaire (n = 324) identified three work functioning trajectories: "persistently high" (16% of the sample), "moderate to high" (54%) and "persistently low" work functioning (32%). Cancer patients with persistently high work functioning had less time between diagnosis and RTW and had less often a changed meaning of work, while cancer patients with persistently low work functioning reported more baseline cognitive symptoms compared to cancer patients in the other trajectories. This knowledge has implications for cancer care and guidance of cancer patients at work.
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Affiliation(s)
- Heleen F Dorland
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Femke I Abma
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Corné A M Roelen
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.,HumanCapitalCare, Enschede, the Netherlands
| | - Roy E Stewart
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Benjamin C Amick
- Department of Health Policy and Management, Florida International University, Robert Stempel College of Public Health & Social Work, Miami, Florida.,Institute for Work & Health, Toronto, Canada
| | - Adelita V Ranchor
- Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Ute Bültmann
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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29
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Olsson M, Nilsson M, Fugl-Meyer K, Petersson LM, Wennman-Larsen A, Kjeldgård L, Alexanderson K. Life satisfaction of women of working age shortly after breast cancer surgery. Qual Life Res 2017; 26:673-684. [PMID: 28070803 PMCID: PMC5309315 DOI: 10.1007/s11136-016-1479-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2016] [Indexed: 12/21/2022]
Abstract
Purpose To explore, among women of working age, satisfaction with life as a whole and with different life domains, and its associations with social and health variables, shortly after breast cancer surgery. Methods This cross-sectional study included 605 women, aged 20–63 years, who had had breast cancer surgery with no distant metastasis, pre-surgical chemotherapy, or previous breast cancer. Associations between LiSat-11 and demographic and social factors as well as health- and treatment-related variables were analysed by multivariable logistic regression. Results Compared with Swedish reference levels, the women were, after breast cancer surgery, less satisfied with life, particularly sexual life. Women working shortly after breast cancer surgery were more often satisfied with life in provision domains compared with the reference population. Although most included variables showed associations with satisfaction, after adjustment for all significantly associated variables, only six variables—having children, being in work, having emotional and informational social support, and having good physical and emotional functioning—were positively associated with satisfaction with life as a whole. The odds ratios for satisfaction were higher in most life domains if the woman had social support and good emotional and cognitive functioning. Conclusions One month after breast cancer surgery, satisfaction with different life domains was associated primarily with social support and health-related functioning. However, this soon after surgery, treatment-related variables showed no significant associations with life satisfaction. These results are useful for planning interventions to enhance e.g. social support and emotional as well as cognitive functioning.
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Affiliation(s)
- Mariann Olsson
- Division of Social Work, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
| | - Marie Nilsson
- Division of Social Work, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Department of Social Work, Karolinska University Hospital, Stockholm, Sweden.,Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Kerstin Fugl-Meyer
- Division of Social Work, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Department of Social Work, Karolinska University Hospital, Stockholm, Sweden
| | - Lena-Marie Petersson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Agneta Wennman-Larsen
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Sophiahemmet University, Stockholm, Sweden
| | - Linnea Kjeldgård
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Kristina Alexanderson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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30
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Duijts SFA, van Egmond MP, Gits M, van der Beek AJ, Bleiker EM. Cancer survivors' perspectives and experiences regarding behavioral determinants of return to work and continuation of work. Disabil Rehabil 2016; 39:2164-2172. [PMID: 27596990 DOI: 10.1080/09638288.2016.1219924] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
PURPOSE Supportive interventions to enhance return to work (RTW) in cancer survivors hardly showed positive effects so far. Behavioral determinants might have to be considered in the development of interventions to achieve sustained employability. This study aimed to explore cancer survivors' perspectives and experiences regarding behavioral determinants of RTW and continuation of work. MATERIALS AND METHODS In this qualitative study, semi-structured telephone interviews were held with 28 cancer survivors. All participants were at working age, 1-2 years after diagnosis and employed at time of diagnosis. Thematic content analysis was performed. RESULTS Work turned out to be a meaningful aspect of cancer survivors' life, and most participants reported a positive attitude towards their job. Social support to RTW or to continue working was mainly received from family and friends, but pressure to RTW from the occupational physician was also experienced. Changes in expectations regarding work ability from negative to positive during the treatment process were observed. Those who applied active coping mechanisms felt equipped to deal with difficulties regarding work. CONCLUSIONS Behavioral determinants should be taken into account in the development of future interventions to support cancer survivors' RTW. However, the causal relationship still has to be determined. Implications for rehabilitation Factors influencing occupational motivation among cancer survivors need to be understood in more detail. Previous studies in non-cancer populations have demonstrated that behavioral determinants, such as a positive attitude towards work, high social support and self-efficacy may increase return to work rates or shorten the time to return to work. Addressing behavioral determinants in future development of work-related interventions for cancer survivors is essential in achieving sustained employability.
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Affiliation(s)
- Saskia F A Duijts
- a Department of Public and Occupational Health , EMGO+ Institute for Health and Care Research, VU University Medical Center , Amsterdam , The Netherlands.,b Division of Psychosocial Research and Epidemiology , The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Martine P van Egmond
- a Department of Public and Occupational Health , EMGO+ Institute for Health and Care Research, VU University Medical Center , Amsterdam , The Netherlands.,c Research Center for Insurance Medicine AMC-UMCG-UWV-VUmc , Amsterdam , The Netherlands
| | - Maxime Gits
- a Department of Public and Occupational Health , EMGO+ Institute for Health and Care Research, VU University Medical Center , Amsterdam , The Netherlands
| | - Allard J van der Beek
- a Department of Public and Occupational Health , EMGO+ Institute for Health and Care Research, VU University Medical Center , Amsterdam , The Netherlands.,c Research Center for Insurance Medicine AMC-UMCG-UWV-VUmc , Amsterdam , The Netherlands
| | - Eveline M Bleiker
- b Division of Psychosocial Research and Epidemiology , The Netherlands Cancer Institute , Amsterdam , The Netherlands
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31
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Bondesson T, Petersson LM, Wennman-Larsen A, Alexanderson K, Kjeldgård L, Nilsson MI. A study to examine the influence of health professionals' advice and support on work capacity and sick leave after breast cancer surgery. Support Care Cancer 2016; 24:4141-8. [PMID: 27146389 DOI: 10.1007/s00520-016-3239-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 04/24/2016] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to investigate how women, shortly after breast cancer surgery, experienced encounters with, and information from, healthcare professionals regarding work and sick leave and if these experiences were associated with self-reported work capacity and sick leave. METHODS This is a cross-sectional study based on questionnaire data from 605 women who had had breast cancer surgery, aged 20-63 years. Exclusion criteria were known distant metastases, pre surgical therapy, and/or previous breast cancer. Data on age, type of surgery, global health, and work environment were included as covariates in multivariable logistic regression analysis. RESULTS Five percent of the women had not received any advice concerning work or sick leave. Women reporting receiving useful advice or support related to paid work had lower risk of reporting reduced physical or psychological/social work capacity due to the cancer or treatment (OR 0.46 (95 % CI 0.26-0.81) respective OR 0.45 (95 % CI 0.26-0.77)). There were no associations between having received useful advice or support concerning work and being on sick leave. Women encouraged to take sick leave had an OR of 2.17 (95 % CI 1.39-3.37) of being sickness absent. They also to a higher extent had reduced physical and psychological/social work capacity. Women who reported to have been encouraged to work were sickness absent to a lower extent (OR 0.64; 95 % CI 0.41-0.98) and reported higher physical work capacity. CONCLUSIONS Work and sick leave is being discussed during consultations with women with breast cancer and the advice given seems to be in line with the women's subjective work capacity.
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Affiliation(s)
- Tina Bondesson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Berzelius väg 3, plan 6, SE-171 77, Stockholm, Sweden
- Department of Oncology, Karolinska University Hospital, Södersjukhuset, Stockholm, Sweden
| | - Lena-Marie Petersson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Berzelius väg 3, plan 6, SE-171 77, Stockholm, Sweden
- Division of Nursing, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Stockholm, Sweden
| | - Agneta Wennman-Larsen
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Berzelius väg 3, plan 6, SE-171 77, Stockholm, Sweden
- Sophiahemmet University, Stockholm, Sweden
| | - Kristina Alexanderson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Berzelius väg 3, plan 6, SE-171 77, Stockholm, Sweden
| | - Linnea Kjeldgård
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Berzelius väg 3, plan 6, SE-171 77, Stockholm, Sweden
| | - Marie I Nilsson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Berzelius väg 3, plan 6, SE-171 77, Stockholm, Sweden.
- Division of Social Work, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Stockholm, Sweden.
- Division of Social Work, Karolinska University Hospital, Stockholm, Sweden.
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Drageset S, Lindstrøm TC, Giske T, Underlid K. Women's experiences of social support during the first year following primary breast cancer surgery. Scand J Caring Sci 2015; 30:340-8. [DOI: 10.1111/scs.12250] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 04/22/2015] [Indexed: 01/17/2023]
Affiliation(s)
- Sigrunn Drageset
- Faculty of Health and Social Sciences; Bergen University College; Bergen Norway
| | | | - Tove Giske
- Haraldsplass Deaconess University College; Bergen Norway
| | - Kjell Underlid
- Faculty of Health and Social Sciences; Bergen University College; Bergen Norway
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Vidor C, Leroyer A, Christophe V, Seillier M, Foncel J, Van de Maële J, Bonneterre J, Fantoni S. Decrease social inequalities return-to-work: development and design of a randomised controlled trial among women with breast cancer. BMC Cancer 2014; 14:267. [PMID: 24742314 PMCID: PMC4004459 DOI: 10.1186/1471-2407-14-267] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Accepted: 03/25/2014] [Indexed: 12/01/2022] Open
Abstract
Background Despite the improvement in the care management, women cancer patients who are still in employment find themselves for the most part obliged to stop working while they are having treatment. Their return-to-work probability is impacted by numerous psychosocial factors. The objective is to describe the development and the content of an intervention aimed to facilitate the return to work of female breast cancer patients and in particular the women in the most precarious situations through early active individualised psychosocial support (APAPI). Methods The intervention proposed is made up of 4 interviews with a psychologist at the hospital, distributed over the year according to the diagnosis and conducted on the same day as a conventional follow-up consultation, then a consultation with a specialist job retention physician. We expect, in the first instance, that this intervention will reduce the social inequalities of the return-to-work rate at 12 months. The EPICES score will enable the population to be broken down according to the level of social precariousness. The other expected results are the reduction of the social inequalities in the quality of the return to work at 18 and 24 months and the disparities between the individual and collective resources of the patients. This intervention is assessed in the context of a controlled and randomised multi-centre study. The patients eligible are women aged between 18 and 55 years with a unilateral breast cancer with local extension exclusively, having received surgery followed by adjuvant chemotherapy, in employment at the time of the diagnosis and dealt with by one of the 2 investigating centres. Discussion It is essential to assess this type of intervention before envisaging its generalisation. The study set in place will enable us to measure the impact of this intervention aiming to facilitate the return to work of breast cancer patients, in particular for those who suffer from social fragility, compared with the standard care.
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Affiliation(s)
- Clémence Vidor
- University Lille Nord de France-Université de Lille III, Unité de Recherche en sciences Cognitives et Affectives (URECA) EA 1059, BP 60149, F-59653 Villeneuve-d'Ascq Cedex, France.
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