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Buresti G, Rondinone BM, Valenti A, Boccuni F, Fortuna G, Iavicoli S, Cristina Dentici M, Persechino B. Measures of Work-life Balance and Interventions of Reasonable Accommodations for the Return to Work of Cancer Survivors: A Scoping Review. Saf Health Work 2024; 15:255-262. [PMID: 39309276 PMCID: PMC11410488 DOI: 10.1016/j.shaw.2024.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 07/15/2024] [Accepted: 07/23/2024] [Indexed: 09/25/2024] Open
Abstract
Background Nearly half of patients diagnosed with cancer are in the middle of their traditional working age. The return to work after cancer entails challenges because of the cancer or treatments and associated with the workplace. The study aimed at providing more insight into the occupational outcomes encountered by workers with cancer and to provide interventions, programs, and practices to support their return to work. Methods A scoping review was conducted using the Arksey and O'Malley framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for scoping review guidelines. Relevant studies were systematically searched in PubMed/MEDLINE, SCOPUS and Grey literature from 01 January 2000 to 22 February 2024. Results The literature search generated 3,017 articles; 53 studies were considered eligible for this review. Most of the studies were longitudinal and conducted in Europe. Three macroarea were identified: studies on the impact of cancer on workers in terms of sick leave, employment, return to work, etc.; studies reporting wider issues that may affect workers, such as the compatibility of treatment and work and employment; studies reporting interventions or policies aiming to promote the return to work. Conclusion There is a lack in the literature in defining multidisciplinary interventions combining physical, psycho-behavioural, educational, and vocational components that could increase the return-to-work rates. Future studies should focus on interdisciplinary return to work efforts with multiple stakeholders with the involvement of an interdisciplinary teamwork (healthcare workers and employers) to combine these multidisciplinary interventions at the beginning of sick leave period.
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Affiliation(s)
- Giuliana Buresti
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority (INAIL), Monte Porzio Catone, Rome, Italy
| | - Bruna Maria Rondinone
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority (INAIL), Monte Porzio Catone, Rome, Italy
| | - Antonio Valenti
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority (INAIL), Monte Porzio Catone, Rome, Italy
| | - Fabio Boccuni
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority (INAIL), Monte Porzio Catone, Rome, Italy
| | - Grazia Fortuna
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority (INAIL), Monte Porzio Catone, Rome, Italy
| | | | - Maria Cristina Dentici
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority (INAIL), Monte Porzio Catone, Rome, Italy
| | - Benedetta Persechino
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority (INAIL), Monte Porzio Catone, Rome, Italy
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Ayala-Garcia A, Benavides FG, Serra L. Labour market participation after sickness absence due to cancer: a dynamic cohort study in Catalonia (Spain). BMC Public Health 2023; 23:2477. [PMID: 38082284 PMCID: PMC10714569 DOI: 10.1186/s12889-023-17321-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The consequences of cancer on working until retirement age remain unclear. This study aimed to analyse working life considering all possible labour market states in a sample of workers after sickness absence (SA) due to cancer and to compare their working life paths to those of a sample of workers without SA and with an SA due to other diseases. METHODS This was a retrospective dynamic cohort study among social security affiliates in Catalonia from 2012-2018. Cases consisted of workers with an SA due to cancer between 2012-2015 (N = 516) and were individually age- and sex-matched with those of affiliates with an SA due to other diagnoses and workers without an SA. All workers (N = 1,548, 56% women) were followed up from entry into the cohort until the end of 2018 to characterise nine possible weekly labour states. Sequence analysis, optimal matching, and multinomial logistic regression were used to identify and assess the probability of future labour market participation patterns (LMPPs). All analyses were stratified by sex. RESULTS Compared with workers with an SA due to cancer, male workers with no SA and SA due to other causes showed a lower probability of being in the LMPP of death (aRRR 0.02, 95% CI: 0.00‒0.16; aRRR 0.17, 95% CI: 0.06‒0.46, respectively) and, among women, a lower probability of permanent disability and death (aRRR 0.24, 95% CI: 0.10‒0.57; aRRR 0.39, 95% CI: 0.19‒0.83, respectively). Compared to workers with SA due to cancer, the risk of early retirement was lower among workers with no SA (women, aRRR 0.60, 95% CI: 0.22‒1.65; men, aRRR 0.64, 95% CI: 0.27‒1.52), although these results were not statistically significant. CONCLUSIONS Workplaces, many of which have policies common to all diagnoses, should be modified to the needs of cancer survivors to prevent an increasing frequency of early retirement and permanent disability when possible. Future studies should assess the impact of cancer on premature exit from the labour market among survivors, depending on cancer localisation and type of treatment.
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Affiliation(s)
- Amaya Ayala-Garcia
- Center for Research in Occupational Health (CiSAL), Universitat Pompeu Fabra, PRBB Building, Dr. Aiguader, 88, 08003, Barcelona, Spain.
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
- IMIM - Parc Salut Mar, Barcelona, Spain.
| | - Fernando G Benavides
- Center for Research in Occupational Health (CiSAL), Universitat Pompeu Fabra, PRBB Building, Dr. Aiguader, 88, 08003, Barcelona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- IMIM - Parc Salut Mar, Barcelona, Spain
| | - Laura Serra
- Center for Research in Occupational Health (CiSAL), Universitat Pompeu Fabra, PRBB Building, Dr. Aiguader, 88, 08003, Barcelona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- IMIM - Parc Salut Mar, Barcelona, Spain
- Research Group On Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain
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Etuknwa A, Daniels K, Nayani R, Eib C. Sustainable Return to Work for Workers with Mental Health and Musculoskeletal Conditions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1057. [PMID: 36673814 PMCID: PMC9859362 DOI: 10.3390/ijerph20021057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/16/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
Common mental health and musculoskeletal disorders (CMDs and MSDs) are two of the most significant causes of non-participation in employment amongst working age adults. BACKGROUND This case study fills an important gap in the scientific literature on reintegration back to work after sickness absence due to CMDs and MSDs. It particularly examines the return to work (RTW) experiences of sick-listed employees to understand the facilitators and barriers of sustainable RTW. METHODS Using a realist evaluation approach within a qualitative inquiry, perceptions of employees were explored to provide in-depth understanding of what, how and under what circumstances sustainable RTW can be enabled for employees absent on a short- or long-term basis. Repeat face-to-face semi-structured interviews were conducted with 22 participants (15 women and 7 men, aged 30-50 years and sick-listed with MSDs and CMDs) who were recruited using purposive sampling. Data was thematically analysed. RESULTS A total of 2 main codes and 5 subcodes were developed and grouped into three theoretical abstractions. As a result of validating the context, mechanism, and outcome configurations with accounts of participants, all three initial theories explaining the most prominent mechanisms that either facilitates or impedes a sustainable RTW for people with CMDs and MSDs were justified. CONCLUSIONS Our findings reveal the active role of line managers on the RTW outcomes of returning employees. However, line-manager's competence and ability to effectively support and implement appropriate RTW strategies suited to employees' hinges on working in alignment with key stakeholders and returning employees.
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Affiliation(s)
| | - Kevin Daniels
- Norwich Research Park, Norwich Business School, University of East Anglia, Norwich NR4 7TJ, UK
| | - Rachel Nayani
- Norwich Research Park, Norwich Business School, University of East Anglia, Norwich NR4 7TJ, UK
| | - Constanze Eib
- Department of Psychology, Uppsala University, 752 36 Uppsala, Sweden
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4
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The role of physical arm function and demographic disparities in breast cancer survivors’ ability to return to work. Support Care Cancer 2022; 30:10301-10310. [PMID: 36355217 PMCID: PMC9648455 DOI: 10.1007/s00520-022-07449-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 10/31/2022] [Indexed: 11/12/2022]
Abstract
Purpose Ability to return to work (RTW) is an important aspect of breast cancer that is limited for many survivors. With 90% survivorship in the USA, it is imperative that focus shifts toward the improvement of physical arm function to improve survivors’ ability to RTW. This narrative review discusses the role of physical arm function and demographic disparities in breast cancer survivor RTW. Methods Literature on physical function, arm function, and demographic disparities following breast cancer treatment and their implications for RTW is discussed. Results The ability to RTW is a key component of recovery for breast cancer survivors, but challenges and inequalities persist. Treatment effects can induce and prolong functional disability, affecting survivors’ ability to RTW. These effects may be compounded for survivors whose occupation requires physical arm function. The RTW landscape, including the occupations survivors have, the physical function required for job tasks, and availability of workplace accommodations, is also unclear. Additional demographic disparities (e.g., income, live in rural area) exist, but the extent to which these factors influence RTW is not well understood. More work is needed to understand the compounded impact of treatment effects, demographic disparities, and occupational factors on RTW. Multidisciplinary rehabilitation that includes occupational counseling and exercise is a promising approach, but widespread adoption in the US healthcare model presents an ongoing challenge. Areas for further research are highlighted. Conclusion There is an incomplete understanding of the effects of treatment on physical arm function and the role of demographic disparities on breast cancer survivor RTW.
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Residual work capacity and (in)ability to work fulltime among a year cohort of cancer survivors who claim a disability benefit. J Cancer Surviv 2021; 17:860-870. [PMID: 34859358 DOI: 10.1007/s11764-021-01147-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 11/18/2021] [Indexed: 11/12/2022]
Abstract
PURPOSE Residual work capacity (RWC) and inability to work fulltime (IWF) are important outcomes in disability benefit assessments for workers diagnosed with cancer. The aim of this study is to gain insight into the prevalence of both outcomes, the associations of disease-related and socio-demographic factors and if these differ across cancer diagnosis groups. METHODS A year cohort of anonymized register data of cancer survivors who claim a disability benefit after 2 years of sick leave (n = 3690, age 53.3 ± 8.8, 60.4% female) was used. Having no RWC was defined as having no possibilities to perform any work at all, whereas IWF was defined as being able to work less than 8 h per day. RESULTS The prevalence of being assessed with no RWC was 42.6%. Of the applicants with RWC (57.4%), 69.8% were assessed with IWF. Cancers of the respiratory organs showed the highest odds for having no RWC, whereas lymphoid and haematopoietic cancers showed the highest odds for IWF. Within specific cancer diagnosis groups, different associations were identified for both outcomes. CONCLUSION The prevalence of no RWC and IWF in applicants of work disability benefits diagnosed with cancer is high compared to the prevalence in other diagnoses. The odds for no RWC, IWF, and associated factors differ per cancer diagnosis group. IMPLICATIONS FOR CANCER SURVIVORS Being diagnosed with cancer has an enormous impact on work (dis)ability. Our results show that 2 years after being diagnosed with cancer, the majority of the disability benefit applicants are assessed with RWC; however, only 15% of all applicants with cancer had a normal ability to work fulltime, and therefore, it is of great importance to accompany them in their return to work.
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Tamminga SJ, Jansen LP, Frings-Dresen MHW, de Boer AGEM. Long-term employment status and quality of life after cancer: A longitudinal prospective cohort study from diagnosis up to and including 5 years post diagnosis. Work 2021; 66:901-907. [PMID: 32925145 PMCID: PMC7683081 DOI: 10.3233/wor-203234] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND: Accumulating evidence suggests that cancer survivors are able to return to work. However, little is known about their work situation 5 years after diagnosis. OBJECTIVE: To explore fluctuations in employment status and its association with quality of life 2, 3, and 5 years after cancer diagnosis of 65 cancer survivors employed at diagnosis. METHODS: In association with a randomised controlled trial (RCT), questionnaires were administrated to eligible cancer survivors at diagnosis, 2, 3, and 5 years thereafter comprising of validated questionnaires related to work (i.e. Work Ability Index (WAI), cancer, and quality of life (QOL) (i.e. SF-36, VAS QOL). The RCT studied a hospital-based work support intervention in female breast and gynaecological cancer survivors who were treated with curative intent and had paid work at diagnosis. Descriptive statistics and longitudinal multi-level analysis were employed. RESULTS: Sixty-five of the 102 eligible cancer survivors participated, who were primarily diagnosed with breast cancer (63%). Two and 5 years after cancer diagnosis respectively 63 (97%) and 48 (81%) participants were employed. Reasons for not being employed after 5 years included receiving unemployment benefits (7%), voluntary unemployment (3%), receiving disability benefits (3%), and early retirement (3%). Longitudinal multi-level analysis showed that employed cancer survivors reported in general statistically significant better quality of life outcomes at 5 years follow-up compared to those not being employed. CONCLUSIONS: We found high employment rates and few fluctuations in employment status. The steepest decline in employment rate occurs after the first two years of diagnosis. Employed participants reported better quality of life outcomes. Survivorship care should therefore focus on the population at risk possibly within the first two years after diagnosis.
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Affiliation(s)
- Sietske J Tamminga
- Academic Medical Center, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Lyanne P Jansen
- Academic Medical Center, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Monique H W Frings-Dresen
- Academic Medical Center, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Angela G E M de Boer
- Academic Medical Center, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Zaman ACGNM, Tytgat KMAJ, Klinkenbijl JHG, Boer FCD, Brink MA, Brinkhuis JC, Bruinvels DJ, Dol LCM, van Duijvendijk P, Hemmer PHJ, Lamme B, Loosveld OJL, Mok MM, Rejda T, Rutten H, Schoorlemmer A, Sonneveld DJ, Stassen LPS, Veenstra RP, van de Ven A, Velzing ER, Frings-Dresen MHW, de Boer AGEM. Effectiveness of a Tailored Work-Related Support Intervention for Patients Diagnosed with Gastrointestinal Cancer: A Multicenter Randomized Controlled Trial. JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:323-338. [PMID: 32880094 PMCID: PMC8172517 DOI: 10.1007/s10926-020-09920-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Purpose The aim of this research was to study the effectiveness on return to work (RTW) of an early tailored work-related support intervention in patients diagnosed with curative gastrointestinal cancer. Methods A multicenter randomized controlled trial was undertaken, in which patients were assigned randomly to the intervention or the control group (usual care). The intervention encompassed three psychosocial work-related support meetings, starting before treatment. Five self-reported questionnaires were sent over twelve months of follow-up. Primary outcome was days until RTW (fulltime or partial) and secondary outcomes included work status, quality of life, work ability, and work limitations. Descriptive analysis, Kaplan-Meier analysis, relative risk ratio and linear mixed models were applied. Results Participants (N = 88) had a mean age of 55 years; 67% were male and the most common cancer type was colon cancer (66%). Of the participants, 42 were randomized to the intervention group. The median time from sick leave until RTW was 233 days (range 187-279 days) for the control group, versus 190 days (range 139-240 days) for the intervention group (log-rank p = 0.37). The RTW rate at twelve months after baseline was 83.3% for the intervention group and 73.5% for the control group. Work limitations did statistically differ between the groups over time (p = 0.01), but quality of life and work ability did not. Conclusion Patients in the intervention group seem to take fewer days to RTW, albeit not to a statistically significant extent.Trial registration Trial NL4920 (NTR5022) (Dutch Trial Register https://www.trialregister.nl ).
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Affiliation(s)
- A. C. G. N. M. Zaman
- Amsterdam UMC (Location AMC), Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands
| | - K. M. A. J. Tytgat
- Amsterdam UMC (Location AMC), Department of Gastroenterology, University of Amsterdam, Amsterdam, The Netherlands
| | - J. H. G. Klinkenbijl
- Department of Surgery, Gelre Hospitals, Apeldoorn, The Netherlands
- University of Amsterdam, Amsterdam, The Netherlands
| | - F. C. den Boer
- Department of Surgery, Zaans Medical Center, Zaandam, The Netherlands
| | - M. A. Brink
- Department of Gastroenterology, Meander Medical Center, Amersfoort, The Netherlands
| | | | | | - L. C. M. Dol
- Department of Surgery, Northwest Hospital Group, Alkmaar, The Netherlands
| | | | - P. H. J. Hemmer
- Department of Surgical Oncology, University Medical Center Groningen (UMCG), Groningen, The Netherlands
| | - B. Lamme
- Department of Surgery, Albert Schweitzer Hospital, Dordrecht, The Netherlands
| | - O. J. L. Loosveld
- Department of Medical Oncology, Amphia Hospital, Breda, The Netherlands
| | - M. M. Mok
- Department of Surgery, OLVG (Location East), Amsterdam, The Netherlands
| | - T. Rejda
- Tomas Rejda Counselling (Oncological Occupational Physician), Alphen aan den Rijn, The Netherlands
| | - H. Rutten
- Department of Surgery, Catharina Hospital Eindhoven, Eindhoven, The Netherlands
| | - A. Schoorlemmer
- Amsterdam UMC (Location AMC), Department of Surgery, University of Amsterdam, Amsterdam, The Netherlands
| | - D. J. Sonneveld
- Department of Surgery, Dijklander Hospital, Hoorn, The Netherlands
| | - L. P. S. Stassen
- Department of Surgery, Maastricht University Medical Center (MUMC), Maastricht, The Netherlands
| | - R. P. Veenstra
- Department of Gastroenterology, Martini Hospital, Groningen, The Netherlands
| | - A. van de Ven
- Department of General Surgery, Flevo Hospital, Almere, The Netherlands
| | - E. R. Velzing
- Vel.Onc@Work Counselling (Oncological Occupational Physician), Leidschendam, The Netherlands
| | - M. H. W. Frings-Dresen
- Amsterdam UMC (Location AMC), Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands
| | - A. G. E. M. de Boer
- Amsterdam UMC (Location AMC), Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands
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8
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Dorland HF, Abma FI, Roelen CAM, Bültmann U, Amick BC. Validation of the Work Role Functioning Questionnaire 2.0 in cancer patients. Eur J Cancer Care (Engl) 2021; 30:e13420. [PMID: 33538368 PMCID: PMC8365733 DOI: 10.1111/ecc.13420] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 11/06/2020] [Accepted: 01/13/2021] [Indexed: 12/17/2022]
Abstract
Objective The Work Role Functioning Questionnaire 2.0 (WRFQ), measuring the percentage of time a worker has difficulties in meeting the work demands for a given health state, has shown strong reliability and validity in various populations with different chronic conditions. The present study aims to validate the WRFQ in working cancer patients. Methods A validation study of the WRFQ 2.0 was conducted, using baseline data from the longitudinal Work Life after Cancer study. Structural validity (Confirmatory Factor Analysis, CFA), internal consistency (Cronbach's alpha) and discriminant validity (hypothesis testing) were evaluated. Results 352 working cancer patients, most of them diagnosed with breast cancer (48%) and 58% in a job with mainly non‐manual tasks, showed a mean WRFQ score of 78.6 (SD = 17.1), which means that they had on average difficulties for 78.6% of the time they spent working. Good internal consistency (α = 0.96) and acceptable to good fit for both the four and five‐factor model (CFA) was found. The WRFQ distinguished between cancer patients reporting good vs. poor health (80.3 vs. 73.0, p = 0.001), low vs. high fatigue (82.0 vs. 72.2, p < 0.001), no vs. clinical depression (80.4 vs. 58.8, p < 0.001) and low vs. high cognitive symptoms (86.1 vs. 64.7, p < 0.001). Conclusions The WRFQ 2.0 is a reliable and valid instrument to measure work functioning in working cancer patients. Further psychometric research on responsiveness is needed to support its use in health practice.
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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
| | - Ute Bültmann
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Benjamin C Amick
- Fay W Boozman College of Public Health, University of Arkansas Medical Sciences, Little Rock, Arkansas, USA
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Returning to work in lung cancer survivors-a multi-center cross-sectional study in Germany. Support Care Cancer 2020; 29:3753-3765. [PMID: 33211206 PMCID: PMC8163665 DOI: 10.1007/s00520-020-05886-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 11/06/2020] [Indexed: 11/18/2022]
Abstract
Purpose To investigate the work situation of lung cancer survivors and to identify the factors associated with their returning to work. Methods Descriptive analysis and logistic regression were used to evaluate study population characteristics and independent factors of subsequently returning to work. To analyze time to return to work, Cox regression was used. Results The study sample included 232 lung cancer survivors of working age from 717 enrolled participants in the multi-center cross-sectional LARIS (Quality of Life and Psychosocial Rehabilitation in Lung Cancer Survivors) study. About 67% of the survivors were not employed during the survey. More than 51% of the survivors who were employed before their illness did not return to their work. The survivors who had returned to their careers were younger, associated with higher household income, lower fatigue score, and stable relationship and vocational training. Patients who received social service counseling showed a higher chance of regaining their career. Conclusions Lung cancer survivors were found to be associated with a high risk of unemployment and very low professional reintegration after interruption due to illness. More comprehensive studies are needed to support lung cancer survivors and targeting of patients in need of special attention in rehabilitation that would benefit from the findings in the present study. Supplementary Information The online version contains supplementary material available at 10.1007/s00520-020-05886-z.
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10
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Return to Work of Breast Cancer Survivors: Perspectives and Challenges for Occupational Physicians. Cancers (Basel) 2020; 12:cancers12020355. [PMID: 32033165 PMCID: PMC7072532 DOI: 10.3390/cancers12020355] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 01/31/2020] [Accepted: 02/03/2020] [Indexed: 11/17/2022] Open
Abstract
Breast cancer is one of the most common diseases worldwide, mainly affecting the female gender. Considering the increase of breast cancer incidence and the decrease of mortality due to news diagnostic and therapeutic tools, the return to work issue after treatment is going to be very common in the next years. Occupational physicians therefore need to face the return to work and the fitness for work of workers previously diagnosed with breast cancer with a sufficient cultural and technical background. In addition to individual characteristics preceding the diagnosis, clinical outcome, lifestyles and occupational variables are the most impactful factors on return to work that need to be taken into account. The aim of this work is to analyze these factors and discuss the central role of occupational physicians in the decision-making process of returning to work in breast cancer survivors.
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11
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Chen YY, Wang CC, Wu WT, Lai CH, Ho CL, Hsu YY, Chen WL. Trajectories of returning to work and its impact on survival in survivors with oral cancer: A 5-year follow-up study. Cancer 2019; 126:1225-1234. [PMID: 31809559 DOI: 10.1002/cncr.32643] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 10/26/2019] [Accepted: 11/01/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND A return to work (RTW) is a challenge for survivors of oral cancer. Further light could be shed on the RTW of patients with oral cancer, which remains largely uninvestigated. The objective of this study was to investigate the trajectories of RTW and their impact on survival in workers with oral cancer. METHODS In total, 12,222 workers who were newly diagnosed with oral cancer were identified during the period from 2004 to 2015 and were included in this cohort study. The associations between independent variables and RTW were analyzed using Cox proportional hazard models. RESULTS Overall, 8793 workers returned to work in the first years after a diagnosis of oral cancer. Chemotherapy (hazard ratio [HR], 0.88; 95% CI, 0.78-0.99) and radiation therapy (HR, 0.83; 95% CI, 0.75-0.92) were inversely associated with RTW. Patients who had received surgical treatment (HR, 1.24; 95% CI, 1.01-1.53) were more likely to RTW. Employees with stage I (HR, 1.66; 95% CI, 1.47-1.87), stage II (HR, 1.52; 95% CI, 1.35-1.72), and stage III (HR, 1.32; 95% CI, 1.16-1.51) disease were associated with an increased likelihood of RTW in the fifth year after diagnosis. Kaplan-Meier survival analysis demonstrated better survival for the RTW group versus the non-RTW group in patients with stage III and IV oral cancer (P < .001). The fully adjusted HR indicated that the RTW group had significantly better outcomes than the non-RTW group in all-cause mortality (P < .001; HR, 0.36; 95% CI, 0.33-0.39). CONCLUSIONS Sociodemographic and medical factors affect the RTW of cancer survivors. RTW may have a beneficial effect on survival of patients with oral cancer.
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Affiliation(s)
- Yuan-Yuei Chen
- Department of Internal Medicine, Tri-Service General Hospital Songshan Branch and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.,Division of Environmental Health and Occupational Medicine, Department of Family Medicine and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.,Department of General Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Chung-Ching Wang
- Division of Environmental Health and Occupational Medicine, Department of Family Medicine and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.,Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital Songshan Branch and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Wei-Te Wu
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan, Republic of China
| | - Ching-Huang Lai
- School of Public Health, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Ching-Liang Ho
- Division of Hematology/Oncology, Department of Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Ya-Yuan Hsu
- Division of Labor Market, Institute of Labor, Occupational Safety, and Health, Ministry of Labor, Taipei, Taiwan, Republic of China
| | - Wei-Liang Chen
- Division of Environmental Health and Occupational Medicine, Department of Family Medicine and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.,Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital Songshan Branch and School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
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12
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Lear-Claveras A, Ubalde-Lopez M, Serra Saurina L. Labor market situation after an episode of sickness absence due to malignant neoplasia. Evidence from a Spanish cohort. BMC Public Health 2019; 19:506. [PMID: 31053064 PMCID: PMC6499967 DOI: 10.1186/s12889-019-6792-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 04/09/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Due to the progress in screening and cancer treatments, survivor's prognosis has improved enabling a more likely return to work. However, return to work after a cancer diagnosis may be complex because of an unbalanced health status and work demands relationship that may push them out of the labor market. The aim of this study is to assess the risk of dropping out of the labor market due to unemployment, partial retirement, and permanent disability during the year following an episode due to a malignant neoplasm compared to other non-malignant pathologies. METHODS Cohort study of 9699 workers affiliated with the Social Security System in Catalonia, who had a sickness absence episode between 2012 and 2013 due to malignant neoplasm, mental, musculoskeletal disorders, cardiovascular diseases and injuries. Competing risk regression models were applied to assess the risk of dropping out of the labor market, by calculating subhazard ratios (SHR) in both sexes. Models were adjusted for age, occupational category, type of contract, economic activity, annual median salary and duration of the SA episode as potential confounders. RESULTS Sickness absence due to malignant neoplasia represented 1.7% out of the 9699 episodes included between 2012 and 2013. Although, 80% of individuals continued working in the year following an episode due to malignant neoplasm, women showed a trend towards exiting the labor market because of partial retirement [SHR = 8.4(1.5-45.5)] and permanent disability [SHR = 5.8(1.5-22.9)] compared to non-malignant pathologies. There were no significant differences for unemployment either in women [SHR = 0.4(0.2-0.9)] and in men [SHR = 0.2(0.1-0.6)]. CONCLUSIONS Although return to work is a common pathway among cancer survivors, partial retirement and permanent disability seem to be potential pathways to exit the labor market among women.
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Affiliation(s)
- Ana Lear-Claveras
- Center for Research in Occupational Health (CiSAL), Pompeu Fabra University, Barcelona, Spain
| | - Monica Ubalde-Lopez
- Center for Research in Occupational Health (CiSAL), Pompeu Fabra University, Barcelona, Spain. .,IMIM - Parc Salut Mar, Barcelona, Spain. .,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
| | - Laura Serra Saurina
- Center for Research in Occupational Health (CiSAL), Pompeu Fabra University, Barcelona, Spain.,IMIM - Parc Salut Mar, Barcelona, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
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13
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Arndt V, Koch-Gallenkamp L, Bertram H, Eberle A, Holleczek B, Pritzkuleit R, Waldeyer-Sauerland M, Waldmann A, Zeissig SR, Doege D, Thong MSY, Brenner H. Return to work after cancer. A multi-regional population-based study from Germany. Acta Oncol 2019; 58:811-818. [PMID: 30777496 DOI: 10.1080/0284186x.2018.1557341] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: With improving prognosis, the ability to return to work after cancer has become a realistic goal but only little is known regarding details such as sustainability, financial consequences, and potential determinants of return to work in long-term survivors in Germany. Methods: We studied return to work in a population-based sample of 1558 long-term cancer survivors, diagnosed in 1994-2004 with breast, colorectal or prostate cancer before age 60 (mean 50.1). Information regarding employment status and financial difficulties was obtained via mailed questionnaires from patients who were identified by six population-based cancer registries in Germany. Cumulative incidence of return to work was determined by time-to-event analysis with consideration of competing events. Chi2 tests and multiple logistic regression modeling were employed to identify potential sociodemographic and clinical determinants of return to work. Results: Within a mean period since diagnosis of 8.3 years, 63% of all working-age cancer survivors initially returned to their old job and another 7% took up a new job. Seventeen percent were granted a disability pension, 6% were early retired (not cancer-related), 4% became unemployed, and 1% left the job market for other reasons. Resumption of work occurred within the first 2 years after diagnosis in 90% of all returnees. Cancer-related reduction of working hours was reported by 17% among all returnees and 6% quit their job due to cancer within 5 years past return to work. The probability of return to work was strongly related with age at diagnosis, tumor stage, education, and occupational class but did not differ with respect to the tumor site, gender nor marital status. Conclusions: Most long-term survivors after breast, colorectal, or prostate cancer of working-age are able to return to work. However, financial problems might arise due to a reduction in working hours. An additional provision of targeted interventions for high-risk groups should be discussed.
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Affiliation(s)
- Volker Arndt
- Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Lena Koch-Gallenkamp
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Heike Bertram
- Cancer Registry of North Rhine-Westphalia, Münster, Germany
| | - Andrea Eberle
- Bremen Cancer Registry, Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
| | | | | | | | - Annika Waldmann
- Ministry of Health and Consumer Protection, Hamburg Cancer Registry, Hamburg, Germany
- Institute of Social Medicine and Epidemiology, University Lübeck, Lübeck, Germany
| | | | - Daniela Doege
- Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Melissa S. Y. Thong
- Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
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14
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Vayr F, Savall F, Bigay-Game L, Soulat JM, Chouaid C, Herin F. Lung cancer survivors and employment: A systematic review. Lung Cancer 2019; 131:31-39. [PMID: 31027695 DOI: 10.1016/j.lungcan.2019.03.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 03/07/2019] [Accepted: 03/09/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND The aim of this systematic review is to identify, in a comprehensive manner, the impact of lung cancer on the employment status of survivors. METHODS The Preferred Reported Items for Systematic Reviews and Meta-analyses (PRISMA) statement was used as a formal guideline. The systematic review includes scientific papers published between January 2000 and October 2018. The search strategy queried the database MEDLINE. Inclusion criteria comprised: (1) inclusion of patients diagnosed with lung cancer (LC) (2); assessment of employment status or employment outcomes or work adjustments or return to work (3); inclusion of scientific papers published in peer-reviewed journals (4); inclusion of articles written either in English or in French. Literature reviews were not included. RESULTS A total of 642 scientific papers were retrieved. Twenty-three articles were included in the systematic review: 5 longitudinal studies and 18 cross-sectional studies. LC survivors are 2-3 times more likely to be unemployed as compared with control groups. Previous studies highlight a median duration of sickness absence increased for LC survivors compared to control groups. The strongest decline in earnings was observed among LC survivors as compared to other cancer types. CONCLUSIONS LC is associated with a significant impact on employment of patients. The promising results of recent therapeutic strategies could lead to a better social and professional prognosis. A reduction of indirect costs is to be expected.
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Affiliation(s)
- Flora Vayr
- Occupational Diseases Department, Toulouse-Purpan, University Hospital Toulouse, F-31000, France
| | - Frédéric Savall
- INSERM UMR 1027, Université de Toulouse III, Toulouse, F-31000, France; Laboratory of Molecular Anthropology AMIS, UMR 5288 CNRS, France
| | - Laurence Bigay-Game
- Pneumology Department, Toulouse-Purpan, University Hospital Toulouse, F-31000, France
| | - Jean-Marc Soulat
- Occupational Diseases Department, Toulouse-Purpan, University Hospital Toulouse, F-31000, France; INSERM UMR 1027, Université de Toulouse III, Toulouse, F-31000, France
| | - Christos Chouaid
- Pneumology Department, Centre Hospitalier Intercommunal Creteil, Ile de France, France
| | - Fabrice Herin
- Occupational Diseases Department, Toulouse-Purpan, University Hospital Toulouse, F-31000, France; INSERM UMR 1027, Université de Toulouse III, Toulouse, F-31000, France.
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15
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Hartung TJ, Sautier LP, Scherwath A, Sturm K, Kröger N, Koch U, Mehnert A. Return to Work in Patients with Hematological Cancers 1 Year after Treatment: A Prospective Longitudinal Study. Oncol Res Treat 2018; 41:697-701. [DOI: 10.1159/000491589] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 06/28/2018] [Indexed: 11/19/2022]
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16
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Tamminga SJ, de Jong M, Frings-Dresen MHW, de Boer AGEM. The Quality of Working Life Questionnaire for Cancer Survivors: Sufficient responsiveness for use as a patient-reported outcome measurement. Eur J Cancer Care (Engl) 2018; 27:e12910. [DOI: 10.1111/ecc.12910] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 07/20/2018] [Accepted: 07/24/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Sietske J. Tamminga
- Department: Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Academic Medical Center; University of Amsterdam; Amsterdam The Netherlands
| | - Merel de Jong
- Department: Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Academic Medical Center; University of Amsterdam; Amsterdam The Netherlands
| | - Monique H. W. Frings-Dresen
- Department: Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Academic Medical Center; University of Amsterdam; Amsterdam The Netherlands
| | - Angela G. E. M. de Boer
- Department: Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Academic Medical Center; University of Amsterdam; Amsterdam The Netherlands
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17
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Return to work in European Cancer survivors: a systematic review. Support Care Cancer 2018; 26:2983-2994. [PMID: 29845421 DOI: 10.1007/s00520-018-4270-6] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 05/14/2018] [Indexed: 10/16/2022]
Abstract
PURPOSE Return to work (RTW) of cancer survivors (CSs) fluctuates in different contexts. This systematic review searched for recent data on the RTW rate of CSs in Europe, investigating associated factors. METHODS Bibliographic search covered the period from January 2010 to February 2018, with no language restrictions. European population-based studies assessing RTW rate after cancer diagnosis were included. We excluded studies focusing on a specific cancer diagnosis. RESULTS Twelve observational studies were selected. The cohorts investigated included 280 to 46,720 individuals from Northwestern and Central Europe diagnosed with cancer from 1987 to 2010. The median interval between diagnosis and documented RTW was 2 years (0.2-23.4 years). RTW rates of CSs ranged from 39 to 77%. RTW of individuals employed at the time of diagnosis ranged from 60 to 92%, the latter registered in a sample with good prognosis. Personal factors, work-related factors, and cancer-related factors were all associated with RTW. Healthcare team interventions facilitated reintegration to work. CONCLUSIONS Data from Mediterranean and Central European countries are urgently needed to understand whether RTW is an issue for CSs there as well and whether socio-rehabilitative interventions are required to mitigate the potential negative impact of cancer on individuals and society.
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18
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Leensen MCJ, Groeneveld IF, van der Heide I, Rejda T, van Veldhoven PLJ, van Berkel S, Snoek A, van Harten W, Frings-Dresen MHW, de Boer AGEM. Return to work of cancer patients after a multidisciplinary intervention including occupational counselling and physical exercise in cancer patients: a prospective study in the Netherlands. BMJ Open 2017; 7:e014746. [PMID: 28619770 PMCID: PMC5623345 DOI: 10.1136/bmjopen-2016-014746] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To support return to work (RTW) among cancer patients, a multidisciplinary rehabilitation programme was developed which combined occupational counselling with a supervised physical exercise programme during chemotherapy. The aim was to investigate RTW rates of cancer patients and to evaluate changes in work-related quality of life and physical outcomes. DESIGN Longitudinal prospective intervention study using a one-group design. SETTING Two hospitals in the Netherlands. PARTICIPANTS Of the eligible patients, 56% participated; 93 patients with a primary diagnosis of cancer receiving chemotherapy and on sick leave were included. Patients completed questionnaires on RTW, the importance of work, work ability (WAI), RTW self-efficacy, fatigue (MFI), and quality of life (EORTC QLQ C-30) at baseline and 6, 12 and 18 months follow-up. Before and after the exercise programme 1-repetition maximum (1RM) muscle strength and cardiorespiratory fitness (VO2 peak) were assessed. RESULTS Six months after the start of a multidisciplinary rehabilitation programme that combined occupational counselling with a supervised physical exercise programme, 59% of the cancer patients returned to work, 86% at 12 months and 83% at 18 months. In addition, significant improvements (p<0.05) in the importance of work, work ability, RTW self-efficacy, and quality of life were observed, whereas fatigue levels were significantly reduced. After completing the exercise programme, 1RM muscle strength was significantly increased but there was no improvement in VO2 peak level. CONCLUSIONS RTW rates of cancer patients were high after completion of the multidisciplinary rehabilitation programme. A multidisciplinary rehabilitation programme which combines occupational counselling with a supervised physical exercise programme is likely to result in RTW, reduced fatigue and increased importance of work, work ability, and quality of life.
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Affiliation(s)
- Monique C J Leensen
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | | | - Iris van der Heide
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Tomas Rejda
- Leiden University Medical Center, Leiden, The Netherlands
| | | | - Sietske van Berkel
- Department of Sports Medicine, Isala Medical Center, Zwolle, The Netherlands
| | - Aernout Snoek
- Department of Sports Medicine, Isala Medical Center, Zwolle, The Netherlands
| | - Wim van Harten
- University Twente, Enschede, The Netherlands
- Rijnstate Hospital, Arnhem, The Netherlands
- The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Monique H W Frings-Dresen
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Angela G E M de Boer
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands
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19
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Leensen M, Groeneveld I, Rejda T, Groenenboom P, van Berkel S, Brandon T, de Boer A, Frings-Dresen M. Feasibility of a multidisciplinary intervention to help cancer patients return to work. Eur J Cancer Care (Engl) 2017; 27:e12690. [DOI: 10.1111/ecc.12690] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2017] [Indexed: 11/30/2022]
Affiliation(s)
- M.C.J. Leensen
- Coronel Institute of Occupational Health; Academic Medical Center; University of Amsterdam; Amsterdam The Netherlands
| | | | - T. Rejda
- Leiden University Medical Center; Leiden The Netherlands
| | - P. Groenenboom
- Department of Sports Medicine; Medical Center Haaglanden; The Hague The Netherlands
| | - S. van Berkel
- Department of Sports Medicine; Isala; Zwolle The Netherlands
| | - T. Brandon
- Department of Sports Medicine; Isala; Zwolle The Netherlands
| | - A.G.E.M. de Boer
- Coronel Institute of Occupational Health; Academic Medical Center; University of Amsterdam; Amsterdam The Netherlands
| | - M.H.W. Frings-Dresen
- Coronel Institute of Occupational Health; Academic Medical Center; University of Amsterdam; Amsterdam The Netherlands
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20
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Tamminga SJ, van Hezel S, de Boer AG, Frings-Dresen MH. Enhancing the Return to Work of Cancer Survivors: Development and Feasibility of the Nurse-Led eHealth Intervention Cancer@Work. JMIR Res Protoc 2016; 5:e118. [PMID: 27286819 PMCID: PMC4920959 DOI: 10.2196/resprot.5565] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 04/28/2016] [Accepted: 05/19/2016] [Indexed: 11/20/2022] Open
Abstract
Background It is important to enhance the return to work of cancer survivors with an appropriate intervention, as cancer survivors experience problems upon their return to work but consider it an essential part of their recovery. Objective The objective of our study was to develop an eHealth intervention to enhance the return to work of cancer survivors and to test the feasibility of the eHealth intervention with end users. Methods To develop the intervention we 1) searched the literature, 2) interviewed 7 eHealth experts, 3) interviewed 7 cancer survivors, 2 employers, and 7 occupational physicians, and 4) consulted experts. To test feasibility, we enrolled 39 cancer survivors, 9 supervisors, 7 occupational physicians, 9 general physicians and 2 social workers and gave them access to the eHealth intervention. We also interviewed participants, asked them to fill in a questionnaire, or both, to test which functionalities of the eHealth intervention were appropriate and which aspects needed improvement. Results Cancer survivors particularly want information and support regarding the possibility of returning to work, and on financial and legal aspects of their situation. Furthermore, the use of blended care and the personalization of the eHealth intervention were preferred features for increasing compliance. The first version of the eHealth intervention consisted of access to a personal and secure website containing various functionalities for cancer survivors blended with support from their specialized nurse, and a public website for employers, occupational physicians, and general physicians. The eHealth intervention appeared feasible. We adapted it slightly by adding more information on different cancer types and their possible effects on return to work. Conclusions A multistakeholder and mixed-method design appeared useful in the development of the eHealth intervention. It was challenging to meet all end user requirements due to legal and privacy constraints. The eHealth intervention appeared feasible, although implementation in daily practice needs to be subject of further research. ClinicalTrial Dutch Trial Register number (NTR): 5190; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5190 (Archived by WebCite at http://www.webcitation.org/6hm4WQJqC)
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Affiliation(s)
- Sietske J Tamminga
- Coronel Institute of Occupational Health, Academic Medical Center, Amsterdam, Netherlands.
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21
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Zaman AGNM, Tytgat KMAJ, Klinkenbijl JHG, Frings-Dresen MHW, de Boer AGEM. Design of a multicentre randomized controlled trial to evaluate the effectiveness of a tailored clinical support intervention to enhance return to work for gastrointestinal cancer patients. BMC Cancer 2016; 16:303. [PMID: 27165185 PMCID: PMC4862045 DOI: 10.1186/s12885-016-2334-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 05/03/2016] [Indexed: 12/24/2022] Open
Abstract
Background Gastrointestinal (GI) cancer is frequently diagnosed in people of working age, and many GI cancer patients experience work-related problems. Although these patients often experience difficulties returning to work, supportive work-related interventions are lacking. We have therefore developed a tailored work-related support intervention for GI cancer patients, and we aim to evaluate its cost-effectiveness compared with the usual care provided. If this intervention proves effective, it can be implemented in practice to support GI cancer patients after diagnosis and to help them return to work. Methods/Design We designed a multicentre randomized controlled trial with a follow-up of twelve months. The study population (N = 310) will include individuals aged 18–63 years diagnosed with a primary GI cancer and employed at the time of diagnosis. The participants will be randomized to the intervention or to usual care. ‘Usual care’ is defined as psychosocial care in which work-related issues are not discussed. The intervention group will receive tailored work-related support consisting of three face-to-face meetings of approximately 30 min each. Based on the severity of their work-related problems, the intervention group will be divided into groups receiving three types of support (A, B or C). A different supportive healthcare professional will be available for each group: an oncological nurse (A), an oncological occupational physician (B) and a multidisciplinary team (C) that includes an oncological nurse, oncological occupational physician and treating oncologist/physician. The primary outcome measure is return to work (RTW), defined as the time to a partial or full RTW. The secondary outcomes are work ability, work limitations, quality of life, and direct and indirect costs. Discussion The hypothesis is that tailored work-related support for GI cancer patients is more effective than usual care in terms of the RTW. The intervention is innovative in that it combines oncological and occupational care in a clinical setting, early in the cancer treatment process. Trial registration METC protocol number NL51444.018.14/Netherlands Trial Register number NTR5022. Registered 6 March 2015.
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Affiliation(s)
- AnneClaire G N M Zaman
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
| | - Kristien M A J Tytgat
- Gastrointestinal Oncological Center Amsterdam, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Jean H G Klinkenbijl
- Department of Surgery, Gelre Hospital, Apeldoorn, The Netherlands.,Faculty of Medicine, University of Amsterdam, Amsterdam, The Netherlands
| | - Monique H W Frings-Dresen
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Angela G E M de Boer
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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22
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Stergiou-Kita M, Pritlove C, van Eerd D, Holness LD, Kirsh B, Duncan A, Jones J. The provision of workplace accommodations following cancer: survivor, provider, and employer perspectives. J Cancer Surviv 2015; 10:489-504. [DOI: 10.1007/s11764-015-0492-5] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 10/19/2015] [Indexed: 12/01/2022]
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23
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Murray K, Lam KBH, McLoughlin DC, Sadhra SS. Predictors of return to work in cancer survivors in the Royal Air Force. JOURNAL OF OCCUPATIONAL REHABILITATION 2015; 25:153-159. [PMID: 25038986 DOI: 10.1007/s10926-014-9516-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE Return to work (RTW) is beneficial for cancer survivors, employers and society. However, little is known about predictors of RTW in the military environment. METHODS A cohort of 194 Royal Air Force (RAF) personnel aged 18-58 who survived primary cancer treatment between 2001 and 2011 were followed up for 18 months. Information was obtained from occupational health and primary care records. Personal, occupational and clinical predictors of RTW were identified by Cox proportional hazards regression. RESULTS The median sickness absence before RTW was 107 days. Six months after diagnosis 54 % of participants had RTW, and reached 80 % by 12 months. Time taken to RTW was predicted by age at diagnosis, rank, trade group, pre-diagnosis sickness absence, site of cancer, treatment modality, and prognosis. RTW at 18 months were predicted by higher rank (HR = 2.31; 95 % CI 1.46-3.65), and having melanoma (9.75; 4.97-19.13). Those receiving chemotherapy were significantly less likely to have RTW compared to other treatment modalities (0.18; 0.10-0.32). CONCLUSIONS Rank, cancer diagnostic group, and treatment modality are the most important predictors of RTW in cancer survivors in the RAF. These predictors can be used to inform rehabilitation programmes and decisions on RTW.
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Affiliation(s)
- Kenneth Murray
- Royal Air Force Centre of Aviation Medicine, Henlow, SG16 6DN, UK
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24
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de Boer AGEM. The European Cancer and Work Network: CANWON. JOURNAL OF OCCUPATIONAL REHABILITATION 2014; 24:393-8. [PMID: 24002638 DOI: 10.1007/s10926-013-9474-5] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
PURPOSE The number of cancer survivors is rapidly growing due to improved treatment and ageing population. Almost half of cancer patients will experience a cancer diagnosis during working age when career and work-related issues play an important role. Many cancer survivors are at risk for unemployment which greatly affects their quality of life and financial situation. Research on cancer and work is therefore of great importance but scattered over Europe and lacking appropriate dissemination. Moreover, interventions supporting employment of cancer survivors are urgently required but scarcely developed. METHODS The European Cancer and Work Network (CANWON) aims to combine knowledge on: (1) prognostic factors of unemployment in cancer survivors including gender- and country-specific differences; (2) work-related costs of survivorship for both patients and society; (3) the role of employers; and (4) development and evaluation of innovative, interdisciplinary interventions which effectively support employment. Furthermore, it aims at disseminating research knowledge and best practice worldwide. RESULTS CANWON currently unites 23 teams from 15 countries across different stakeholders and research areas. The expected benefits are rapid exchange of research knowledge, standardised methods and techniques, innovative interventions, future guidelines on cancer and work and the improvement of quality of life of cancer patients. CONCLUSIONS Understanding prognostic factors, work-related costs, role of the employer and innovative interventions in relation to work in cancer survivors might progress the understanding of other patients with long-term conditions therefore the knowledge resulting from CANWON will benefit a wide range of patient groups.
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Affiliation(s)
- Angela G E M de Boer
- Academic Medical Center, Coronel Institute of Occupational Health, PO Box 22700, 1100 DE, Amsterdam, The Netherlands,
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25
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Bränström R, Arrelöv B, Gustavsson C, Kjeldgård L, Ljungquist T, Nilsson G, Alexanderson K. Sickness certification at oncology clinics: perceived problems, support, need for education and reasons for certifying unnecessarily long sickness absences. Eur J Cancer Care (Engl) 2013; 23:89-97. [DOI: 10.1111/ecc.12104] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2013] [Indexed: 11/28/2022]
Affiliation(s)
- R. Bränström
- Department of Clinical Neuroscience; Division of Insurance Medicine; Karolinska Institutet; Stockholm Sweden
- Department of Public Health Sciences; Karolinska Institutet; Stockholm Sweden
| | - B. Arrelöv
- Stockholm County Council; Stockholm Sweden
| | - C. Gustavsson
- Department of Clinical Neuroscience; Division of Insurance Medicine; Karolinska Institutet; Stockholm Sweden
| | - L. Kjeldgård
- Department of Clinical Neuroscience; Division of Insurance Medicine; Karolinska Institutet; Stockholm Sweden
| | - T. Ljungquist
- Department of Clinical Neuroscience; Division of Insurance Medicine; Karolinska Institutet; Stockholm Sweden
| | - G.H. Nilsson
- Department of Neurobiology, Care Sciences and Society; Division of Family Medicine; Karolinska Institutet; Stockholm Sweden
| | - K. Alexanderson
- Department of Clinical Neuroscience; Division of Insurance Medicine; Karolinska Institutet; Stockholm Sweden
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26
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Mehnert A, de Boer A, Feuerstein M. Employment challenges for cancer survivors. Cancer 2013; 119 Suppl 11:2151-9. [DOI: 10.1002/cncr.28067] [Citation(s) in RCA: 193] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Revised: 11/29/2012] [Accepted: 12/03/2012] [Indexed: 11/10/2022]
Affiliation(s)
- Anja Mehnert
- Section of Psychosocial Oncology, Department of Medical Psychology and Medical Sociology; University Medical Center Leipzig; Leipzig Germany
- Department of Medical Psychology; University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - Angela de Boer
- Coronel Institute of Occupational Health; Academic Medical Center; Amsterdam the Netherlands
| | - Michael Feuerstein
- Department of Medical and Clinical Psychology; Uniformed Services University of the Health Sciences; Bethesda Maryland
- Department of Preventive Medicine and Biometrics; Uniformed Services University of the Health Sciences; Bethesda Maryland
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Baili P, Hoekstra-Weebers J, Van Hoof E, Bartsch HH, Travado L, Garami M, Di Salvo F, Micheli A, Veerus P. Cancer rehabilitation indicators for Europe. Eur J Cancer 2013; 49:1356-64. [DOI: 10.1016/j.ejca.2012.10.028] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2012] [Revised: 10/30/2012] [Accepted: 10/30/2012] [Indexed: 11/28/2022]
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Rick O, Kalusche EM, Dauelsberg T, König V, Korsukéwitz C, Seifart U. Reintegrating cancer patients into the workplace. DEUTSCHES ARZTEBLATT INTERNATIONAL 2012; 109:702-8. [PMID: 23264814 DOI: 10.3238/arztebl.2012.0702] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2012] [Accepted: 07/30/2012] [Indexed: 01/06/2023]
Abstract
BACKGROUND In Germany at present, 64% of women and 59% of men who receive a diagnosis of cancer are still alive five years later. 45% of men and 57% of women with cancer are still of working age. Cancer can markedly harm their ability to work. METHODS We analyzed data from selected publications to calculate the percentage of cancer patients in Germany who are now returning to work. RESULTS The efficacy of oncological rehabilitation has not been demonstrated by a randomized controlled trial, nor is it clear whether the existing studies have accounted for potentially confounding variables. A combined assessment of reports from various countries reveals that 63% of cancer patients who are of working age go back to work after being unable to work for an average of five months. The situation varies markedly across countries: In Germany, the percentage of women with breast cancer who return to work is only 59%, compared to 80% in the USA and 82% in the United Kingdom. Younger and better educated patients are more likely to return to work, as are those who have received less invasive treatment with fewer complications. CONCLUSION Most cancer patients of working age go back to work, but the percentages vary widely from one country to another, perhaps reflecting differences in social systems.
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