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Liu J, Ye H, Tian J, Qu L. Construction and validation of a predictive model for the return to work of patients with permanent colorectal stoma: a cross-sectional study. BMC Gastroenterol 2024; 24:352. [PMID: 39375601 PMCID: PMC11459885 DOI: 10.1186/s12876-024-03437-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 09/26/2024] [Indexed: 10/09/2024] Open
Abstract
BACKGROUND The issue of patients returning to work is increasingly garnering attention from countries worldwide. This study aims to investigate the risk factors associated with patients returning to work after undergoing permanent enterostomies. Additionally, it seeks to establish and validate a nomogram prediction model, thereby providing a more effective reference for patients aiming to return to work. METHODS This study was a cross-sectional investigation conducted between September 2022 and September 2023. We conveniently selected 293 postoperative patients with permanent colorectal stomas due to colorectal cancer from three tertiary hospitals in Liaoning Province. Participants were categorized into Returned and Non-Returned groups based on their return to work status. Data were collected using a general information questionnaire, a Stoma Acceptance Questionnaire, and the Ostomy Adjustment Inventory. Binary logistic regression analysis was performed using SPSS 25.0 software to identify independent influencing factors. A predictive model was constructed using R Studio 4.3.0 software. Internal validation was conducted through 1,000 rounds of Bootstrap resampling, and model performance was assessed using Receiver Operating Characteristic (ROC) curves, the Hosmer-Lemeshow (H-L) test, and calibration curves. RESULTS After surgery, the return-to-work rate for patients with permanent colorectal stomas was 29.69%. Age, education level, postoperative time, stoma complication, adjuvant therapy, stoma acceptance score, and ostomy adjustment inventory score were identified as independent factors influencing the return-to-work status of these patients (P < 0.05). These factors were incorporated into a logistic regression model generated by R software, resulting in a ROC curve with an area under the curve (AUC) of 0.916 (95% CI: 0.884-0.947). The Youden index was 0.731, and the cutoff value was 0.228. Sensitivity and specificity were 0.920 and 0.811, respectively. The H-L test demonstrated good model fit (χ2 = 12.858, P = 0.117, P > 0.05). Calibration curves indicated a close alignment between predicted and actual probabilities. CONCLUSIONS The postoperative return-to-work rate is low in patients with permanent enterostomies. The prediction model developed in this study demonstrates strong performance and offers predictive value, providing a scientific foundation for assessing patients' return to work. Caregivers should prioritize the early identification of various patient types for proactive intervention to enhance the rate of postoperative return to work.
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Affiliation(s)
- Jianlei Liu
- Department of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, 121000, P.R. China
| | - Hong Ye
- Second Ward, Department of Hepatobiliary Medicine, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, 121001, P.R. China
| | - Jiayu Tian
- Department of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, 121000, P.R. China
| | - Liangliang Qu
- Department of Orthopaedics, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning, 121001, P.R. China.
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Zhang M, Nie S, Hai Z, Du Y, Jiang M, Cai C. Effects of Illness Perception and Coping Style on Self-Management in Peritoneal Dialysis Patients: A Cross-Sectional Study. Psychol Res Behav Manag 2024; 17:3381-3393. [PMID: 39376735 PMCID: PMC11456736 DOI: 10.2147/prbm.s474427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 09/19/2024] [Indexed: 10/09/2024] Open
Abstract
Aim Chronic disease self-management is critical to disease prognosis and patient quality of life. Several psychological factors influence this process of self-management. In this background, the present study investigated the impact of illness perceptions and coping style on self-management in people with peritoneal dialysis (PD). Methods The study is a cross-sectional study. From May 2022 to January 2023, a convenience sampling method was used to recruit 246 peritoneal dialysis patients. General information questionnaire, brief illness perception questionnaire, medical coping style modes questionnaire and the self-management scale for peritoneal dialysis patients were used in this study. We used SPSS 24.0 to analyze the data, and the statistical methods included descriptive analysis, single factor analysis, Pearson correlation analysis and multiple linear regression analysis. Results A total of 246 patients were included in this study (93.89% response rate). Cognitive representations and emotional representations were 30.40, 14.18, respectively. However, illness comprehensibility was 2.87. Illness perceptions were negative significantly correlated with self-management. With regard to coping style, our patients were more likely to adopt avoidance and resignation coping style. Confrontation and avoidance were positively related to self-management, while acceptance-resignation was negatively related. Conclusion Self-management of peritoneal dialysis patients needs to be improved. Age, female sex, monthly income, illness perceptions and coping style were independently associated with self-management. Impact These findings suggest that interventions that improve illness perceptions and coping style should be explored to ultimately improve their self-management. For example, patients can be provided with psychological counseling so that they can face the disease correctly, and we should pay attention to the positive role of social support.
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Affiliation(s)
- Man Zhang
- Department of Oncology, The First Medical Centre, Chinese PLA General Hospital, Beijing, People’s Republic of China
- Wuhan University School of Nursing, Wuhan, Hubei, People’s Republic of China
| | - Siman Nie
- Beijing Tsinghua Changgung Hospital, Beijing, People’s Republic of China
| | - Ziwei Hai
- Wuhan University School of Nursing, Wuhan, Hubei, People’s Republic of China
| | - Yixin Du
- Wuhan University School of Nursing, Wuhan, Hubei, People’s Republic of China
| | - Menghan Jiang
- Shandong University of Traditional Chinese Medicine College of Health Sciences, Jinan, Shandong, People’s Republic of China
| | - Chunfeng Cai
- Wuhan University School of Nursing, Wuhan, Hubei, People’s Republic of China
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Green L, McDowell L, Ip F, Tapia M, Zhou M, Fahey MT, Dixon B, Magarey M. Early return to work is possible after transoral robotic surgery (TORS) in carefully selected patients with oropharyngeal squamous cell carcinoma. Oral Oncol 2024; 159:107032. [PMID: 39293101 DOI: 10.1016/j.oraloncology.2024.107032] [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: 03/07/2024] [Revised: 08/26/2024] [Accepted: 09/09/2024] [Indexed: 09/20/2024]
Abstract
INTRODUCTION The aims of this study were to investigate the rate and time to return to work (RTW) after transoral robotic surgery (TORS) for oropharyngeal squamous cell carcinoma (OPSCC) and to explore the impact of disease or work-related factors leading to variations in RTW outcomes. METHODS Cross-sectional survey of disease, socioeconomic, work-related and health-related quality of life (HR-QOL). Qualitative analysis of responses for facilitators and barriers to RTW. RESULTS A total of 47 participants employed at diagnosis were included in the study, with an average age 56 years. Median survey time 3.2 years. 22 participants underwent TORS only with 25 undergoing TORS with adjuvant therapy. 93.6 % had stage 1 disease. 95.7 % of participants RTW after TORS with a mean time of 13.6 weeks. Patients returned earlier after TORS alone compared to those requiring adjuvant treatment (10 weeks vs. 17 weeks; p = 0.13) Overall high HR-QOL metrics for all patients, with those undergoing adjuvant having significantly poorer outcomes for the dry mouth/sticky saliva (9.1 vs 41.3, p=<0.001) items. Qualitative analysis of free text responses showed facilitators and barriers to RTW fell under four main categories: physical, phycological/emotional, financial and workplace. CONCLUSION High rate of RTW amongst patients after TORS, which is the highest reported amongst head and neck cancer literature to date. Participants returned earlier after surgery only compared to adjuvant treatment, but both groups reported high HR-QOL metrics. Physical effects of treatment, including fatigue and oral dysfunction were some of the main barriers to RTW; whereas flexible working arrangements and support from employer/colleagues were major facilitators.
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Affiliation(s)
- Lorne Green
- Department of Head and Neck Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Lachlan McDowell
- Division of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Department of Radiation Oncology, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
| | - Fiona Ip
- Pinnacle Surgery, Epworth Richmond Hospital, Melbourne, VIC, Australia
| | - Mario Tapia
- Department of Head and Neck Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Hospital Clinico Regional de Concepcion Dr. Guillermo Grant Benavente, Concepcion, Chile
| | - Meiling Zhou
- Department of Head and Neck Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Michael T Fahey
- Peter MacCallum Cancer Centre, Centre for Biostatistics and Clinical Trials (BaCT), Melbourne, VIC, Australia
| | - Benjamin Dixon
- Pinnacle Surgery, Epworth Richmond Hospital, Melbourne, VIC, Australia; Department of ENT Head & Neck Surgery, St Vincent's Hospital Melbourne, Melbourne, VIC, Australia; Department of Surgery, University of Melbourne, Melbourne, VIC, Australia
| | - Matthew Magarey
- Department of Head and Neck Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Pinnacle Surgery, Epworth Richmond Hospital, Melbourne, VIC, Australia; Department of Medical Education, University of Melbourne, Melbourne, VIC, Australia
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Li L, Duan Y, Cao H, Zhou X, Kang Y, Wan Z, Huang D, Xie J, Cheng ASK. Effect of group online-based peer support intervention on psychological distress of adolescent and young adult cancer patients: a randomized controlled trial. Support Care Cancer 2024; 32:562. [PMID: 39085495 DOI: 10.1007/s00520-024-08765-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 07/25/2024] [Indexed: 08/02/2024]
Abstract
PURPOSE Adolescent and young adult (AYA) cancer patients, aged between 15 to 39 years old, suffer from long-term psychological distress, confronting low self-efficacy and various psychological problems. This study constructs a group online-based peer support intervention combined with offline activities to explore its impact on the psychological distress of AYA cancer patients. METHODS A randomized, two-arm clinical trial was conducted in which 90 AYA cancer patients were recruited. The control group (N = 45) received conventional psychological care and treatment, and the experimental group (N = 45) received 8 weeks of an online peer support intervention. Outcome measures included psychological distress (Distress Thermometer, DT), anxiety and depression (Hospital Anxiety and Depression Scale, HADS), perceived peer support (Cancer Peer Support Scales, CaPSS), and readiness for return to work (Readiness to Return-To-Work Scale, RRTW). RESULTS Eight-week peer support intervention was effective in improving psychological distress, anxiety, and depressive symptoms in the experimental group with statistically significant differences (P < 0.05). Time affected psychological distress, anxiety, and depressive symptoms in AYA cancer patients (P < 0.05), and there was an interaction with intervention factors (P < 0.05). The intervention has a positive effect on relieving the psychological status of AYA cancer patients. For readiness for return to work, the experimental group was in the preparation for the action-behavioral stage immediately, 1 month and 3 months after the end of the intervention (P < 0.01), supporting AYA cancer patients who have not returned to work to maintain optimal return-to-work readiness. CONCLUSIONS The group online-based peer support intervention is popular and has good scientificity, effectiveness, and practical significance for AYA cancer patients. TRIAL REGISTRATION This study was registered at clinicaltrials.gov. (ChiCTR2100053091, registered on 10 November 2021).
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Affiliation(s)
- Lijun Li
- Nursing Department, The Third Xiangya Hospital, Central South University, Changsha, China
- Xiangya Nursing School, Central South University, Changsha, China
| | - Yinglong Duan
- Nursing Department, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Huan Cao
- Xiangya Nursing School, Central South University, Changsha, China
| | - Xing Zhou
- Xiangya Nursing School, Central South University, Changsha, China
| | - Yue Kang
- Xiangya Nursing School, Central South University, Changsha, China
| | - Ziyu Wan
- Xiangya Nursing School, Central South University, Changsha, China
| | - Dawei Huang
- Department of Information, Third Xiangya Hospital, Central South University, Changsha, China
| | - Jianfei Xie
- Nursing Department, The Third Xiangya Hospital, Central South University, Changsha, China.
| | - Andy S K Cheng
- School of Health Sciences, Western Sydney University, Sydney, Australia
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Lee LH, Yang CI, Chen MK, Hsieh MY, Chen YJ. Exploring return to work for patients with head and neck cancer. Work 2024; 77:231-241. [PMID: 37638463 DOI: 10.3233/wor-220707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023] Open
Abstract
BACKGROUND The number of survivors of head and neck cancer (HNC) has steadily increased due to major advances in cancer care. However, cancer survivors who experience job loss face different challenges regarding return to work (RTW). Relatively few studies have integrated the experience encountered by patients. OBJECTIVE This mixed-methods study aimed to explore the experience and challenges of RTW in patients with HNC. METHODS Data were collected with structured questionnaires (n = 120) and semi-structured face-to-face interviews (n = 12). RESULTS Relationships were found between patient's physical status, perceived stress, and social support. Patients who continued work, or not, had significant differences in reported physical function and stress. Four themes emerged from the qualitative data, including the perceived meaning of work, challenges for RTW, preparing for RTW, and social support. After diagnosis and treatment, patients perceived the meaning of work, such as personal value, responsibility, and financial need. They faced many challenges to RTW, including declining physical strength, workload, schedule rearrangement, speech difficulty, and changed appearance. In order to RTW, they prepared extensively and needed support from family and friends. CONCLUSION This study revealed the experiences and challenges of RTW patients with HNC. The results allowed us to identify patients' concerns and ways that healthcare providers could improve the RTW process. Future studies may develop tailored approaches for RTW in healthcare and government policies.
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Affiliation(s)
- Li-Hung Lee
- Department of Nursing, Hung Kuang University, Taichung, Taiwan
| | - Cheng-I Yang
- Department of Nursing, Hung Kuang University, Taichung, Taiwan
| | - Mu-Kuan Chen
- Department of Otorhinolaryngology - Head and Neck Surgery, Changhua Christian Hospital, Changhua, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Ming-Yu Hsieh
- Department of Otorhinolaryngology - Head and Neck Surgery, Changhua Christian Hospital, Changhua, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Yen-Ju Chen
- Department of Nursing, Da-Yeh University, Changhua, Taiwan
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Tsai PL, Wang CP, Fang YY, Chen YJ, Chen SC, Chen MR, Ko JY, Lin JJ, Lou PJ, Lai YH. Return to work in head and neck cancer survivors: its relationship with functional, psychological, and disease-treatment factors. J Cancer Surviv 2023; 17:1715-1724. [PMID: 35900687 DOI: 10.1007/s11764-022-01224-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 06/11/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE Return to work (RTW) is important for survivors of head and neck cancer (HNC). The purposes of the study were to investigate the RTW ratio among HNC survivors and identify factors significantly affecting RTW in this population. METHODS A cross-sectional study with consecutive sampling was conducted in a medical center in Taiwan, with 111 patients with HNC who had completed major treatments within 5 years and were employed before their cancer diagnosis enrolled as participants. Cervical range of motion (CROM) functionality, handgrip and hip flexor strength, maximal mouth opening (MMO), selected symptoms, depression, and disease/treatment-related factors were assessed. All of the factors were analyzed using t-test, chi-square test, and multiple logistic regression. RESULTS Less than half (44.1%, n = 49) of the participants had returned to work. The t-test/chi-square test results showed the RTW group to be younger in age and better educated; have better handgrip/hip flexor strength, MMO, and CROM; have less speech difficulty and pain; and have less-advanced cancer than the non-RTW group. Further analysis of the above significant variables by logistic regression revealed early cancer stage, dominant handgrip strength, and less speech difficulty were the robust factors related to RTW. CONCLUSIONS The RTW ratio is low in HNC survivors. RTW in HNC survivors is a multifactorial and complicated issue and needs to be further examined. IMPLICATIONS FOR CANCER SURVIVORS Assessing the factors related to RTW systematically and developing comprehensive interventions and rehabilitation programs to reduce related dysfunctions are necessary to enhance RTW ability in HNC survivors.
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Affiliation(s)
- Pi-Ling Tsai
- School of Nursing, College of Medicine, National Taiwan University, 1, Jen-Ai Rd., Section 1, Taipei, 100, Taiwan
- College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chen-Ping Wang
- College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Otolaryngology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, 100, Taiwan
| | - Yuan-Yuan Fang
- School of Nursing, College of Medicine, National Taiwan University, 1, Jen-Ai Rd., Section 1, Taipei, 100, Taiwan
- College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yen-Ju Chen
- Department of Nursing, College of Nursing and Health Sciences, Dayeh University, Changhua, Taiwan
| | - Shu-Ching Chen
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Min-Ru Chen
- School of Nursing, College of Medicine, National Taiwan University, 1, Jen-Ai Rd., Section 1, Taipei, 100, Taiwan
- College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Jenq-Yuh Ko
- College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Otolaryngology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, 100, Taiwan
| | - Jiu-Jenq Lin
- College of Medicine, National Taiwan University, Taipei, Taiwan
- School of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Pei-Jen Lou
- College of Medicine, National Taiwan University, Taipei, Taiwan.
- Department of Otolaryngology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, 100, Taiwan.
| | - Yeur-Hur Lai
- School of Nursing, College of Medicine, National Taiwan University, 1, Jen-Ai Rd., Section 1, Taipei, 100, Taiwan.
- College of Medicine, National Taiwan University, Taipei, Taiwan.
- National Taiwan University Cancer Center, Taipei, Taiwan.
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Campisi G, Bazzano M, Mauceri R, Panzarella V, La Mantia G, Di Fede O. Improving the cancer adult patient support network (iCAN): a pilot study on a communication model and modified focus group. Front Psychol 2023; 14:1223168. [PMID: 37936570 PMCID: PMC10627017 DOI: 10.3389/fpsyg.2023.1223168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 10/02/2023] [Indexed: 11/09/2023] Open
Abstract
Background Many consider that cancer has the greatest impact of any disease in the world, and it can drastically limit patients' quality of life. Combating such a life-threatening disease can pose many challenges to daily life, highlighted by demonstrating the need to discuss one's health status within a focus group and encourage treatment compliance. Aim the purposes of this study were to share the authors' experience of a modified focus group in an Oral Medicine Unit, termed "Improving Cancer Adult Patients Support Network" (iCAN), and to evaluate how effective communication could improve patients' quality of life and empower them by virtue of enhanced knowledge and an awareness of cancer management. Methods the paper adhered to the COREQ checklist regarding its reporting procedures. The iCAN format was precisely reproduced four times with four groups, consisting of 12 adult male and female patients with solid cancers. They discussed several main topics relating to cancer treatment, as chosen by a majority of the participants. Four specialists were involved in the discussion of the selected topics The iCAN format was faithfully reproduced during each meeting, with the participants in the roles of moderator and health specialists. Finally, a satisfaction questionnaire was administered. Results the most reliable results demonstrated a marked change in lifestyle and eating habits in more than 50% of participants. More than 80% were unaware of the side effects of cancer treatments in general and the oral mucosa in particular. Each meeting reported a maximum degree of satisfaction experienced by the participants. Conclusion iCAN focus group meetings appear to have facilitated a process of narrative interviewing, thereby improving the doctor-patient relationship underlying the humanization of the care process.
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Affiliation(s)
- Giuseppina Campisi
- Unit of Oral Medicine and Dentistry for Fragile Patients, Department of Rehabilitation, Fragility, and Continuity of Care, University Hospital Palermo, Palermo, Italy
- Department Di.Chir.On.S., University of Palermo, Palermo, Italy
| | - Monica Bazzano
- Department Di.Chir.On.S., University of Palermo, Palermo, Italy
| | - Rodolfo Mauceri
- Unit of Oral Medicine and Dentistry for Fragile Patients, Department of Rehabilitation, Fragility, and Continuity of Care, University Hospital Palermo, Palermo, Italy
- Department Di.Chir.On.S., University of Palermo, Palermo, Italy
| | - Vera Panzarella
- Department Di.Chir.On.S., University of Palermo, Palermo, Italy
| | - Gaetano La Mantia
- Unit of Oral Medicine and Dentistry for Fragile Patients, Department of Rehabilitation, Fragility, and Continuity of Care, University Hospital Palermo, Palermo, Italy
- Department Di.Chir.On.S., University of Palermo, Palermo, Italy
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, The University of Messina, Messina, Italy
| | - Olga Di Fede
- Department Di.Chir.On.S., University of Palermo, Palermo, Italy
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Granström B, Isaksson J, Westöö N, Holmlund T, Tano K, Laurell G, Tiblom Ehrsson Y. Perceptions of life and experiences of health care support among individuals one year after head and neck cancer treatment - An interview study. Eur J Oncol Nurs 2023; 66:102383. [PMID: 37506610 DOI: 10.1016/j.ejon.2023.102383] [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: 03/02/2023] [Revised: 06/09/2023] [Accepted: 07/01/2023] [Indexed: 07/30/2023]
Abstract
PURPOSE To examine how individuals treated for head and neck cancer perceive life one year after the end of treatment and how they experience supportive efforts from health care. METHODS A semi-structured interview study of 21 patients was performed one year after the end of treatment. The patients gave their views concerning physical, psychological, and return-to-work issues, and their experiences concerning rehabilitative efforts from health care and particularly the contact nurse were captured. A thematic analysis was conducted. RESULTS One year after treatment the patients were still suffering from side effects and from fear of recurrence, but they strived to live as they did before the cancer diagnosis, such as having returned to work and resuming leisure activities. Moreover, the rehabilitative efforts from health care had ended. Having access to a contact nurse, also known as a clinical nurse specialist, was positive, however, the participants lacked regular long-term follow-ups with the contact nurse regarding rehabilitation needs. Improvement possibilities were seen in clarifying the role of the contact nurse and that the contact nurse should show engagement and make the initial contact with the patients. CONCLUSION Despite the sequelae from treatment, the patients strived to live as before their diagnosis. By regular, engaged, and long-term follow-ups by the contact nurse, remaining needs may be uncovered, and appropriate individualized support and rehabilitation can be offered.
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Affiliation(s)
- Brith Granström
- Department of Clinical Science, Otorhinolaryngology, Umeå University, Umeå, Sweden.
| | - Joakim Isaksson
- Department of Social Work, Stockholm University, Stockholm, Sweden
| | - Nilla Westöö
- Ear, Nose, and Throat Clinic, Uppsala University Hospital, Uppsala, Sweden
| | - Thorbjörn Holmlund
- Department of Clinical Science, Otorhinolaryngology, Umeå University, Umeå, Sweden
| | - Krister Tano
- Department of Clinical Science/ENT/Sunderby Research Unit, Umeå University, Umeå, Sweden
| | - Göran Laurell
- Department of Surgical Sciences, Section of Otorhinolaryngology and Head & Neck Surgery, Uppsala University, Uppsala, Sweden
| | - Ylva Tiblom Ehrsson
- Department of Surgical Sciences, Section of Otorhinolaryngology and Head & Neck Surgery, Uppsala University, Uppsala, Sweden
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Zhang Y, Wang Y, Wu A, Tao X, Li M, Yan D, Wen F, Hou L. The Prevalence and Determinants of Return to Work in Head and Neck Cancer Survivors: A Scoping Review. JOURNAL OF OCCUPATIONAL REHABILITATION 2023; 33:418-431. [PMID: 36689058 DOI: 10.1007/s10926-022-10090-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/06/2022] [Indexed: 06/17/2023]
Affiliation(s)
- Yuanyuan Zhang
- Shanghai JiaoTong University School of Nursing, No.227 South Chongqing Road, Shanghai, China
| | - Yueping Wang
- Shanghai JiaoTong University School of Medicine Affiliated Ninth People's Hospital, No.639 Zhizaoju Road, Shanghai, China
| | - Anqi Wu
- Shanghai JiaoTong University School of Nursing, No.227 South Chongqing Road, Shanghai, China
- Shanghai JiaoTong University School of Medicine Affiliated Shanghai Children ' s Medical Center, No.1678 Dongfang Road, Shanghai, China
| | - Xingjuan Tao
- Shanghai JiaoTong University School of Nursing, No.227 South Chongqing Road, Shanghai, China
| | - Mengyao Li
- Shanghai JiaoTong University School of Nursing, No.227 South Chongqing Road, Shanghai, China
| | - Dexiu Yan
- Shanghai JiaoTong University School of Nursing, No.227 South Chongqing Road, Shanghai, China
| | - Fule Wen
- Shanghai JiaoTong University School of Nursing, No.227 South Chongqing Road, Shanghai, China
| | - Lili Hou
- Shanghai JiaoTong University School of Nursing, No.227 South Chongqing Road, Shanghai, China.
- Shanghai JiaoTong University School of Medicine Affiliated Ninth People's Hospital, No.639 Zhizaoju Road, Shanghai, China.
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Wang C, Liao Z, Li Z, Wang Y, Wu Y, Hu R. Identifying barriers to resilience from the perspective of young and middle-aged patients with lymphoma: A qualitative exploration. Eur J Oncol Nurs 2023; 64:102348. [PMID: 37290165 DOI: 10.1016/j.ejon.2023.102348] [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: 12/24/2022] [Revised: 05/01/2023] [Accepted: 05/02/2023] [Indexed: 06/10/2023]
Abstract
PURPOSE This study aimed to understand and identify barriers to resilience in young and middle-aged patients with lymphoma in the context of Chinese culture. METHODS A qualitative descriptive study was employed. Face-to-face, semi-structured, and in-depth individual interviews were conducted between May and July 2022. Purposive and differential sampling was used to select eligible participants. Conventional content analysis was used to analyze qualitative data and identify categories and subcategories. This study followed the COREQ checklist. RESULTS Twenty patients aged 28-59 years completed the interviews. Three categories involving thirteen subcategories were identified from the interview data: (1) internal barriers-derived from individual cognitive, emotional, behavioral, spiritual, and physical distress, resulting in internal negative constructs, and reducing the motivation to overcome adversity; (2) unbalanced family functioning-families threatened by disease are incapable of maintaining normal functioning and fail to act effectively when facing crises; and (3) absent social support-insufficient or unavailable shielding protection from social support further inhibits resilience among patients with lymphoma. CONCLUSIONS This study identified various barriers to the resilience of young and middle-aged patients with lymphoma in the context of Chinese culture. In addition to the patient's internal barriers of resilience, specific family and socio-cultural barriers should also be emphasized by healthcare professionals. Multidisciplinary and family-centered resilience intervention should be developed to help such patients cope with, adapt to the disease, and achieve good psychosocial returns.
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Affiliation(s)
- Chunfeng Wang
- The School of Nursing, Fujian Medical University, Fujian Province, China
| | - Zhenling Liao
- The School of Nursing, Fujian Medical University, Fujian Province, China
| | - Zhangjie Li
- The School of Nursing, Fujian Medical University, Fujian Province, China
| | - Ying Wang
- The School of Nursing, Fujian Medical University, Fujian Province, China
| | - Yong Wu
- Department of Hematology, Fujian Medical University Union Hospital, Fujian Province, China.
| | - Rong Hu
- The School of Nursing, Fujian Medical University, Fujian Province, China.
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Zecena Morales C, Lisy K, McDowell L, Piper A, Jefford M. Return to work in head and neck cancer survivors: a systematic review. J Cancer Surviv 2023; 17:468-483. [PMID: 36396907 DOI: 10.1007/s11764-022-01298-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 11/08/2022] [Indexed: 11/18/2022]
Abstract
PURPOSE Cancer survivors face higher rates of unemployment compared with individuals without a history of cancer. Compared to other cancer types, head and neck cancer (HNC) survivors face unique disease and treatment-specific issues that may limit return to work (RTW). This review aimed to determine employment outcomes of HNC survivors post-treatment and identify factors associated with RTW. METHODS A systematic search was conducted in MEDLINE, CINAHL and PsycINFO in December 2021. Inclusion criteria included adults (≥ 18 years); completed treatment for HNC; data available on RTW post-treatment. Both quantitative and qualitative studies were considered. Studies were critically appraised and data synthesised narratively. RESULTS Twenty-nine publications were included: 22 quantitative, four qualitative and three mixed methods. The proportion of HNC survivors who RTW ranged from 32 to 90%, with participants taking 3.6-11 months to RTW. Working in a professional role and having a supportive work environment were positively associated with RTW. CONCLUSIONS The proportion of HNC survivors who RTW varies significantly which may be due to the heterogeneity between the studies including difference in clinical characteristics of the participants and/or sample size. Future studies that are longitudinal, adequately powered and measure a range of clinical and demographic variables are needed to better understand the RTW experience and assist development of effective RTW strategies. IMPLICATIONS FOR CANCER SURVIVORS This review suggests potential areas for intervention, including enhanced symptom management and engaging with employers to foster supportive work environments to support RTW of HNC survivors.
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Affiliation(s)
- Claudia Zecena Morales
- Department of Health Services Research, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia
| | - Karolina Lisy
- Department of Health Services Research, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia
- Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, VIC, Australia
| | - Lachlan McDowell
- Division of Radiation Oncology, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia
| | - Amanda Piper
- Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia
| | - Michael Jefford
- Department of Health Services Research, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia.
- Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia.
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, VIC, Australia.
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12
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Qi L, Bao W, Wang S, Ding X, Li W. Mendelian randomization eradicates the causal relationship between educational attainment, household income, and oropharyngeal cancer. Front Oncol 2023; 13:930940. [PMID: 36937420 PMCID: PMC10017480 DOI: 10.3389/fonc.2023.930940] [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: 04/29/2022] [Accepted: 01/31/2023] [Indexed: 03/06/2023] Open
Abstract
Background It was reported that educational attainment and household income are associated with oropharyngeal cancer. However, whether such an association is causal is still unknown. Methods The Mendelian randomization (MR) design was performed to disentangle their causal relationship. Initially, genetic variants proxied for educational attainment and household income were extracted from the largest genome-wide association studies (GWAS), and two oropharyngeal GWAS datasets were used in the discovery and validation stages separately. A reverse MR analysis was carried out to judge whether oropharyngeal cancer affects educational attainment and household income. The results from the two stages were combined using meta-analysis. The heterogeneity and horizontal pleiotropy were appraised using several methods. Results All selected genetic variants were valid. In the discovery stage, genetically elevated years of education might decrease the risk of oropharyngeal cancer (IVW OR = 0.148 [0.025, 0.872], p-value = 0.035), while such a result became insignificant in the validation stage (IVW p-value >0.05). Household income cannot change the risk of oropharyngeal cancer at both stages. The reverse MR suggested that oropharyngeal cancer should slightly alter household income (IVW OR = 1.001 [1.000, 1.003], p-value = 0.036) in the discovery set, but the result cannot be replicated in the validation stage. The meta-analysis did not find any significant results either. The results were also assessed by sensitivity analyses, and there was no heterogeneity or horizontal pleiotropy in the analyses. The statistical powers were all above 80% at the discovery stage. Conclusions There should be no causal association between educational attainment, household income, and oropharyngeal cancer.
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Affiliation(s)
- Li Qi
- Department of Otorhinolaryngology, The Affiliated Hospital of Inner Mongolia University for the Nationalities, Tongliao, China
- Department of Otorhinolaryngology, The First Hospital of China Medical University, Shenyang, China
| | - Wenzhao Bao
- Department of Anesthesiology, The Affiliated Hospital of Inner Mongolia University for the Nationalities, Tongliao, China
| | - Sai Wang
- Department of Otorhinolaryngology, The First Hospital of China Medical University, Shenyang, China
| | - Xiaoxu Ding
- Department of Otorhinolaryngology, The First Hospital of China Medical University, Shenyang, China
| | - Wei Li
- Department of Otorhinolaryngology, The First Hospital of China Medical University, Shenyang, China
- *Correspondence: Wei Li, ;
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13
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Chiu SE, Cho KA, Huang BS, Lin CY, Chung CF, Chang YL, Chen SC. Factors Facilitating or Creating Barriers to Returning to Work in Head and Neck Cancer Patients Within the First 6 Months After Treatment. Clin Nurs Res 2023; 32:197-208. [PMID: 35833270 DOI: 10.1177/10547738221106292] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Head and neck cancer (HNC) patients who are unable to return to work after completing treatment might face financial loss and reduced self-esteem. The aim of this study was to identify factors influencing a return to work in HNC cancer patients in the first 6 months after treatment. This cross-sectional study examined HNC patients who completed treatment from the outpatient radiation department of a single cancer center in northern Taiwan. Patients were assessed according to psychological distress, patient-perceived health status, barriers to returning to work, and facilitators of returning to work. Of the 106 HNC patients surveyed, 54.7% successfully returned to work. Barriers to returning to work included poor self-perception of health, greater psychological distress, and age ≥50 years. Patients who had higher psychological distress, returned to work after start of the pandemic, or received reconstruction surgery were less likely to experience a positive environment facilitating a return to work.
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Affiliation(s)
- Su-Erh Chiu
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Kuei-An Cho
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Bing-Shen Huang
- Department of Radiation Oncology and Proton and Radiation Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chien-Yu Lin
- Department of Radiation Oncology and Proton and Radiation Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ching-Fang Chung
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ya-Lan Chang
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Shu-Ching Chen
- Department of Radiation Oncology and Proton and Radiation Therapy Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,School of Nursing and Geriatric and Long-Term Care Research Center, College of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan.,School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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14
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So SCY, Ng DWL, Liao Q, Fielding R, Soong I, Chan KKL, Lee C, Ng AWY, Sze WK, Chan WL, Lee VHF, Lam WWT. Return to Work and Work Productivity During the First Year After Cancer Treatment. Front Psychol 2022; 13:866346. [PMID: 35496253 PMCID: PMC9039203 DOI: 10.3389/fpsyg.2022.866346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 03/24/2022] [Indexed: 01/01/2023] Open
Abstract
Objectives Working-age cancer patients face barriers to resuming work after treatment completion. Those resuming work contend with reduced productivity arising from persisting residual symptoms. Existing studies of return to work (RTW) after cancer diagnosis were done predominantly in Western countries. Given that employment and RTW in cancer survivors likely vary regionally due to healthcare provision and social security differences, we documented rates and correlates of RTW, work productivity, and activity impairment among Chinese cancer survivors in Hong Kong at one-year post-treatment. Methods Of 1,106 cancer patients assessed at six-months post-cancer treatment (baseline), 593 previously worked; detailed work status, psychological distress (HADS), physical symptom distress (MSAS-SF), supportive care needs (SCNS-SF34-C), health-related quality of life (SF12), and illness perception (B-IPQ) were assessed. Six months later (follow-up), work productivity and activity impairment were assessed (WPAI; n = 402). Descriptive analyses examined RTW rate. Fully adjusted regressions determined RTW, work productivity, and activity impairment predictors. Results At baseline, 39% (232/593) were working, 26% (153/593) on sick leave, and 35% (208/593) were unemployed. Compared to patients returning to work, unemployed participants were older, likely manual/service-oriented workers, and had lower family income, chemotherapy, fewer unmet health system and information needs, poorer physical functioning, and negative illness perceptions. Sick leave participants were likely service-oriented workers, who had head and neck cancer, chemotherapy, and poor physical functioning. At FU, baseline depressive symptoms, physical symptom distress, and negative illness perceptions predicted presenteeism and work productivity loss; gynecological cancer, fewer unmet health system and information needs, and greater unmet sexuality needs predicted absenteeism; physical symptom distress, negative illness perception, and poor physical functioning predicted activity impairment. Conclusion Cancer survivors who had more physically demanding jobs and poorer physical functioning delayed RTW. Unmanaged physical symptom and psychological distress hindered work productivity.
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Affiliation(s)
- Serana Chun Yee So
- LKS Faculty of Medicine, Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, Hong Kong SAR, China.,School of Public Health, Centre for Psycho-Oncology Research and Training, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Danielle Wing Lam Ng
- LKS Faculty of Medicine, Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, Hong Kong SAR, China.,School of Public Health, Centre for Psycho-Oncology Research and Training, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Qiuyan Liao
- School of Public Health, Centre for Psycho-Oncology Research and Training, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Richard Fielding
- LKS Faculty of Medicine, Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, Hong Kong SAR, China.,School of Public Health, Centre for Psycho-Oncology Research and Training, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Inda Soong
- Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, Hong Kong SAR, China
| | - Karen Kar Loen Chan
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Conrad Lee
- Department of Clinical Oncology, Princess Margaret Hospital, Hong Kong, Hong Kong SAR, China
| | - Alice Wan Ying Ng
- Department of Clinical Oncology, Tuen Mun Hospital, Tuen Mun, Hong Kong SAR, China
| | - Wing Kin Sze
- Department of Clinical Oncology, Tuen Mun Hospital, Tuen Mun, Hong Kong SAR, China
| | - Wing Lok Chan
- Department of Clinical Oncology, The University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Victor Ho Fun Lee
- Department of Clinical Oncology, The University of Hong Kong, Kowloon, Hong Kong SAR, China
| | - Wendy Wing Tak Lam
- LKS Faculty of Medicine, Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, Hong Kong SAR, China.,School of Public Health, Centre for Psycho-Oncology Research and Training, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
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