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Greidanus MA, van Ommen F, de Boer AGEM, Coenen P, Duijts SFA. Experiences of unemployed and/or work-disabled cancer survivors who have pursued to return to paid employment: a focus group study. J Cancer Surviv 2024:10.1007/s11764-024-01657-5. [PMID: 39138713 DOI: 10.1007/s11764-024-01657-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2024] [Accepted: 07/30/2024] [Indexed: 08/15/2024]
Abstract
PURPOSE To explore experiences of unemployed and/or work-disabled cancer survivors who have pursued to return to paid employment. METHODS Four digital focus group interviews were conducted with 16 cancer survivors (< 10 years post-diagnosis) who have pursued to return to work within the last 2 years. Interview topics included motivations, facilitators of and barriers to job seeking, and returning to and maintaining paid employment. Interview audio recordings were transcribed verbatim and analyzed using conventional content analyses. RESULTS Participants were mostly female (94%), and the majority had successfully returned to paid employment (56%). Both intrinsic factors (e.g., sense of purpose, social interactions) and extrinsic factors (e.g., financial necessity) motivated their return to paid employment. During job seeking, participants experienced facilitators including support, personal qualities (e.g., life experience), and trial workplaces. Barriers included inadequate support, perceived employer discrimination, and work ability uncertainty. Returning to and maintaining employment was facilitated by flexible work, supportive colleagues, and intrinsic drive, while barriers included side effects (e.g., fatigue) and overly demanding work. CONCLUSIONS Unemployed and/or work-disabled cancer survivors are generally motivated to return to paid employment by both intrinsic and extrinsic factors, but uncertainty about their ability and inadequate support may hinder this. These findings highlight the need for trial workplaces, support during every phase of return to paid employment, and a flexible, supportive workplace. IMPLICATIONS FOR CANCER SURVIVORS Tailored interventions addressing the needs identified in this study are urgently needed. The recommendations provided offer strategies for various stakeholders to enhance support for unemployed and work-disabled cancer survivors.
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Affiliation(s)
- M A Greidanus
- Department of Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
- Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, The Netherlands.
| | - F van Ommen
- Department of Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, The Netherlands
| | - A G E M de Boer
- Department of Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, The Netherlands
| | - P Coenen
- Amsterdam Public Health Research Institute, Societal Participation and Health, Amsterdam, The Netherlands
- Department of Public and Occupational Health, Amsterdam UMC Location Vrije Universiteit, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Movement Sciences Research Institute, Musculoskeletal Health, Amsterdam, The Netherlands
| | - S F A Duijts
- Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, The Netherlands
- Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Rijnkade 5, Utrecht, The Netherlands
- Department of Medical Psychology, Amsterdam UMC Location Vrije Universiteit, De Boelelaan 1117, Amsterdam, The Netherlands
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Schellack S, Breidenbach C, Rick O, Kowalski C. Predictive factors for return to work among cancer survivors in Europe: A systematic review. Crit Rev Oncol Hematol 2024; 200:104422. [PMID: 38897312 DOI: 10.1016/j.critrevonc.2024.104422] [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: 02/06/2024] [Revised: 06/13/2024] [Accepted: 06/14/2024] [Indexed: 06/21/2024] Open
Abstract
Of the 4.4 million people diagnosed with cancer in Europe each year, around 36 % are of working age. Return-to-work rates vary across Europe. Work is important for the individual, as well as for society, and this review aims to provide an overview of the predictors for the return to work (RTW) process in European cancer survivors of working age. A systematic literature search was conducted. The present review included quantitative and qualitative study designs published since 2013. In total, the review included 85 papers examining cancer survivors with various cancer diagnoses in 18 European countries. Identified predictive factors for RTW related to the social system, treatment, disease, health behavior, the individuals' psychosocial, work, and sociodemographic situations. There is a need for a standardized definition and operationalization of RTW. Providers can use these results to identify survivors at risk and support cancer survivors in their RTW process.
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Affiliation(s)
- Sophie Schellack
- German Cancer Society, Kuno-Fischer-Straße 8, Berlin 14057, Germany.
| | | | - Oliver Rick
- Center for Oncology Rehabilitation, Clinic Reinhardshoehe, Quellenstraße 8-12, Bad Wildungen 34537, Germany
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de Wit M, van Asselt KM, Mak-van der Vossen M, de Boer AGEM. Let's talk about work: pilot study of an education program on discussing work participation with cancer patients for general practitioners in training. BMC MEDICAL EDUCATION 2024; 24:739. [PMID: 38982451 PMCID: PMC11232123 DOI: 10.1186/s12909-024-05705-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 06/25/2024] [Indexed: 07/11/2024]
Abstract
BACKGROUND Cancer patients report that they lack support from healthcare providers when it comes to returning to or maintaining employment. In the education of general practitioners (GPs) in the Netherlands, there is little attention given to discussing work participation with patients. The aim of this pilot study was to evaluate a newly developed education program for GPs in training that focuses on discussing work participation with cancer patients. METHODS Two groups of in total twenty-one GPs in training participated in the education program. GPs were educated about the importance of discussing work participation with patients, work-related problems cancer patients can experience, and advice they can give to support cancer patients regarding work issues. In this pilot study using a mixed-method design, participants evaluated the program in two self-developed questionnaires and in a focus group discussion. RESULTS Seventeen participating GPs (81%) indicated that the education program was suitable for implementation in the education curriculum. Eleven participants (52%) reported that they had never discussed work participation with cancer patients before. Directly after the education program, eighteen participants (86%) reported that they planned to discuss work participation more often with their patients. Four months after the program, 67% indicated they had applied their new knowledge and skills in practice by discussing work participation and by referring cancer patients to occupational health professionals or online resources. According to the GPs in training, integrating the topic of work participation into other education for GPs in training and focusing on a broader group of patients could improve the impact of the education program. CONCLUSIONS According to the results of this pilot study, the newly developed education program increased the awareness of GPs in training on the importance of discussing work participation with cancer patients. Future studies should focus on whether cancer patients experience more support from their GPs for maintaining and returning to employment after their GP has participated in the training program.
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Affiliation(s)
- Mariska de Wit
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Coronel Institute of Occupational Health, Meibergdreef 9, PO Box 22700, Amsterdam, 1100 DE, The Netherlands.
- Amsterdam Public Health research institute, Amsterdam, The Netherlands.
| | - Kristel M van Asselt
- Department of General Practice and Nursing science, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marianne Mak-van der Vossen
- Amsterdam Public Health research institute, Amsterdam, The Netherlands
- Department of General Practice, Amsterdam UMC, Amsterdam, The Netherlands
| | - Angela G E M de Boer
- Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Coronel Institute of Occupational Health, Meibergdreef 9, PO Box 22700, Amsterdam, 1100 DE, The Netherlands
- Amsterdam Public Health research institute, Amsterdam, The Netherlands
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4
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Kuai B, Huang Y, Su X, Shi Y, Feng G, Hu L, Guo Y. The experiences and perceptions of employers on cancer survivors returning to work: a meta-synthesis of qualitative studies. Support Care Cancer 2024; 32:454. [PMID: 38913103 DOI: 10.1007/s00520-024-08637-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 06/07/2024] [Indexed: 06/25/2024]
Abstract
PURPOSE Employers play an important role in the return-to-work (RTW) of cancer survivors (CSs), and recently a substantial number of qualitative studies from the employers' perspective have emerged. This meta-synthesis aims to systematically review these qualitative studies regarding employers' experiences with CSs' RTW. METHODS Five electronic databases were searched from inception to January 2024 to identify the studies. Three researchers conducted quality assessment of included. Subsequent, we performed thematic integration of the included studies with the NVivo 11 software. RESULTS Thirteen qualitative studies were included, and 16 topics were finally extracted and summarized into seven categories to form three integrated themes: employers' perspective on facilitators and obstacles for CSs' RTW, employers' response including negative emotion and positive behavior, and employers' need resources from different aspects. CONCLUSION CSs' RTW is influenced by many factors; the support employers need is also extensive and complex. Employers need more support beyond healthcare.
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Affiliation(s)
- BenXin Kuai
- Medical School of Nantong University (School of Nursing), Nantong, 226001, Jiangsu, China
| | - YanJun Huang
- Medical School of Nantong University (School of Nursing), Nantong, 226001, Jiangsu, China
| | - Xiaoqin Su
- Medical School of Nantong University (School of Nursing), Nantong, 226001, Jiangsu, China
| | - Yue Shi
- Medical School of Nantong University (School of Nursing), Nantong, 226001, Jiangsu, China
| | - Guojia Feng
- Medical School of Nantong University (School of Nursing), Nantong, 226001, Jiangsu, China
| | - Lanyue Hu
- Medical School of Nantong University (School of Nursing), Nantong, 226001, Jiangsu, China
| | - YuJie Guo
- Medical School of Nantong University (School of Nursing), Nantong, 226001, Jiangsu, China.
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Wen L, Gao Z, Zhong X, Wen L, Zang S, Bai X. Readiness for return to work and its influencing factors among head and neck cancer patients: a cross-sectional study. Support Care Cancer 2024; 32:420. [PMID: 38850487 DOI: 10.1007/s00520-024-08622-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 06/01/2024] [Indexed: 06/10/2024]
Abstract
PURPOSE This study aims to investigate the Readiness for Return-to-Work (RRTW) of patients with head and neck tumours and to analyse the relationships among self-efficacy, disease uncertainty, psychosocial adaptation, and RRTW in head and neck cancer (HNC) patients. METHODS A cross-sectional study was conducted with 259 HNC patients with a discharge length of ≥1 month at a tertiary hospital in Liaoning Province. The research tools included a self-designed general information questionnaire, the Readiness for Return-to-Work (RRTW) Scale, the General Self-Efficacy Scale (GSES), the Mishel Uncertainty in Illness Scale (MUIS), and the Self-Reporting Psychosocial Adjustment to Illness Scale (PAIS-SR). Descriptive statistical analysis, the rank sum test, Spearman correlation analysis, and ordered multiple and dichotomous logistic regression analyses were used. RESULTS The overall RRTW among HNC patients was low (41.9%). HNC patients who did not return to work were mainly in the precontemplation stage (38.1%) and contemplation stage (29.9%). HNC patients who returned to work were mainly in the active maintenance stage (64.2%). Children's status (OR = 0.218, 95% CI 0.068-0.703), self-efficacy (OR = 1.213, 95% CI 1.012-1.454), unpredictability (OR = 0.845, 95% CI 0.720-0.990), occupational environment (OR = 0.787, 95% CI 0.625-0.990), and family environment (OR = 0.798, 95% CI 0.643-0.990) influence the RRTW of HNC patients who have not returned to work. Educational level (OR = 62.196, 95% CI 63.307-68.567), children's status (OR = 0.058, 95% CI 1.004-2.547), self-efficacy (OR = 1.544, 95% CI 3.010-8.715), unpredictability (OR = 0.445, 95% CI 1.271-2.280), and psychological status (OR = 0.340, 95% CI 1.141-2.401) influence the RRTW of HNC patients who have returned to work. CONCLUSION Children's status, education level, self-efficacy, illness uncertainty, and psychosocial adjustment are crucial to RRTW. This study provides a theoretical basis for formulating intervention measures aimed at improving the RRTW of patients.
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Affiliation(s)
- Liying Wen
- Department of Operating Room, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zhuoran Gao
- Department of Radiation Oncology, The First Hospital of China Medical University, 10/F, Oncology Building, No. 210, Baita I Street, Hunnan District, Shenyang, Liaoning Province, China
| | - Xia Zhong
- Department of Radiation Oncology, The First Hospital of China Medical University, 10/F, Oncology Building, No. 210, Baita I Street, Hunnan District, Shenyang, Liaoning Province, China
| | - Lijie Wen
- Oncology Day Clinic, The First Hospital of Dandong, Dandong, China
| | - Shuang Zang
- Department of Community Nursing, School of Nursing, China Medical University, Shenyang, China
| | - Xinghua Bai
- Department of Radiation Oncology, The First Hospital of China Medical University, 10/F, Oncology Building, No. 210, Baita I Street, Hunnan District, Shenyang, Liaoning Province, China.
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Andersen JL, Johansen JS, Urbanska EM, Meldgaard P, Hjorth-Hansen P, Kristiansen C, Stelmach M, Santoni-Rugiu E, Ulhøi MP, Højgaard B, Jensen MS, Dydensborg AB, Dünweber C, Hansen KH. Lung cancer patients with anaplastic lymphoma kinase rearrangement lose affiliation with labor market at diagnosis. Lung Cancer Manag 2024; 13:LMT68. [PMID: 38818369 PMCID: PMC11137781 DOI: 10.2217/lmt-2023-0013] [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: 10/13/2024] [Accepted: 02/21/2024] [Indexed: 06/01/2024] Open
Abstract
Aim: The main purpose of the present study was to investigate the labor market affiliation of ALK+ NSCLC patients in long-term treatment as well as overall survival and incidence/prevalence. Materials & methods: Nationwide retrospective study of all patients with ALK+ NSCLC in Denmark diagnosed between 2012 and 2018. Results: During the study period ALK+ NSCLC patients had a median overall survival of 44.0 months and a 7.8-fold increase in disease prevalence. Six months prior to diagnosis, 81% of ALK+ NSCLC patients ≤60 years of age were employed. At the end of the 18-month follow-up period, 36% were employed. Conclusion: ALK+ NSCLC patients have prolonged survival following diagnosis, but a large fraction of patients lose affiliation with the labor market.
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Affiliation(s)
| | - Jakob Sidenius Johansen
- Department of Oncology, Herlev & Gentofte University Hospital, DK-2730, Herlev, Denmark
- Present address: Employment with Dept. of Oncology, Herlev & Gentofte University hospital, DK-2730, Herlev, Denmark, Denmark ended during the writing of the article
| | - Edyta Maria Urbanska
- Department of Oncology, Rigshospitalet, Copenhagen University Hospital, DK-2100, Copenhagen, Denmark
| | - Peter Meldgaard
- Department of Oncology, Aarhus University Hospital, DK-8000, Aarhus, Denmark
| | - Peter Hjorth-Hansen
- Department of Oncology, Aalborg University Hospital, DK-9000, Aalborg, Denmark
| | - Charlotte Kristiansen
- Department of Oncology, Vejle Hospital, University Hospital of Southern Denmark, DK-7100, Vejle, Denmark
| | | | - Eric Santoni-Rugiu
- Department of Pathology, Rigshospitalet, Copenhagen University Hospital, DK-2100, Copenhagen, Denmark
| | - Maiken Parm Ulhøi
- Department of Oncology, Aarhus University Hospital, DK-8000, Aarhus, Denmark
| | - Betina Højgaard
- VIVE, Copenhagen, Denmark (The Danish Center for Social Science Research), DK-1052, Copenhagen, Denmark
- Present address: Steno Diabetes Center, DK-2730, Herlev, Denmark
| | - Morten Sall Jensen
- VIVE, Aarhus, Denmark (The Danish Center for Social Science Research), DK-8230, Åbyhøj, Denmark
- Present address: Novo Nordisk, Søborg, DK-2860, Denmark
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Levkovich I, Rosman L, Signorelli C. "Hearing the pupils' voices through my own struggles": A qualitative study of return to work among school counselors who are breast cancer survivors. PLoS One 2024; 19:e0300396. [PMID: 38728325 PMCID: PMC11086897 DOI: 10.1371/journal.pone.0300396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 02/27/2024] [Indexed: 05/12/2024] Open
Abstract
For breast cancer survivors, returning to work is an important step for their personal, financial, and psycho-social recovery. Returning to work as a school counselor can be particularly challenging because of the demands of their job and stress at work. This qualitative study examines return to work among school counselors who are breast cancer survivors. In-depth, semi-structured interviews were conducted with 28 survivors of breast cancer stages I-III between the ages of 32 and 55, and up to ten years after the completion of chemotherapy. Interviews focused on the discovery of the illness, treatment period, ramifications of the diagnosis on various aspects of life, and implications for work. Using thematic analysis of the data collected, analysis of the findings revealed three key themes: 1) "Everyone is replaceable": The significance of disruptions in work continuity for school counselors who are breast cancer survivors. 2) "From Zero to a Hundred": Challenges Faced by Counselors in Returning to Work after Breast Cancer Recovery.3) "It's hard to listen to counselees' problems when I am immersed in my own crisis": How surviving breast cancer affects return to work among school counselors. Findings highlight the unique needs of these counselors and the challenges they face upon returning to work. The study discusses recommendations for school principals including training, advocacy, and awareness to support survivors and improve their return to work.
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Affiliation(s)
- Inbar Levkovich
- Faculty of Graduate Studies, Oranim Academic College, Kiryat Tiv’on, Israel
| | - Lahav Rosman
- Faculty of Graduate Studies, Oranim Academic College, Kiryat Tiv’on, Israel
| | - Christina Signorelli
- School of Clinical Medicine, UNSW Medicine & Health, Discipline of Paediatrics, UNSW Sydney, Kensington, NSW, Australia
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW, Australia
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Forbes D, Lisy K, Wood C, White V, Evans S, Afshar N, Ristevski E, Sharma A, Changrani K, Jefford M. Factors beyond diagnosis and treatment that are associated with return to work in Australian cancer survivors-A systematic review. Asia Pac J Clin Oncol 2024; 20:198-209. [PMID: 37357383 DOI: 10.1111/ajco.13973] [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: 07/12/2022] [Revised: 05/12/2023] [Accepted: 06/06/2023] [Indexed: 06/27/2023]
Abstract
Return to work (RTW) is a marker of functional recovery for working-age cancer survivors. Identifying factors that impact on RTW in cancer survivors is an essential step to guide further research and interventions to support RTW. This systematic review aimed to identify nontreatment, non-cancer-related variables impacting RTW in Australian cancer survivors. A systematic search was conducted in EMBASE, PsycINFO, CINAHL, PubMed, and Google Scholar. Studies were eligible if they included: (1) adults living post diagnosis of malignancy; (2) quantitative data for nontreatment, non-cancer-related variables impacting RTW; (3) only Australian participants. Included studies were critically appraised, and relevant data extracted and synthesized narratively. Six studies were included in the review, published between 2008 and 2020. Studies were of variable quality and mixed methodologies. One study included malignancies of any type with the remainder focusing on survivors of colorectal cancer (n = 3), oropharyngeal cancer (n = 1), and glioblastoma multiforme (n = 1). Multiple factors were related to RTW in individual studies, including older age, presence of three or more comorbidities, fewer work hours pre-morbidly, lower body mass index, longer than recommended sleep duration, and not having private health insurance; however, there was limited consistency in findings between studies. Other variables examined included: occupation type, household income, healthy lifestyle behaviors, flexibility, and duration of employment with workplace; however, no significant associations with RTW were reported. Further research is required to gather compelling evidence on factors that influence RTW in Australian cancer survivors.
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Affiliation(s)
- Danielle Forbes
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Karolina Lisy
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Colin Wood
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Victoria White
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
- School of Psychology, Deakin University, Melbourne, Victoria, Australia
| | - Sue Evans
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Victorian Cancer Registry, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Nina Afshar
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Cancer Health Services Research Unit, Centre for Health Policy, School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Eli Ristevski
- Monash Rural Health, Monash University, Warragul, Victoria, Australia
| | - Arun Sharma
- Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Krisha Changrani
- Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Michael Jefford
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
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Yagil D, Cohen M. Self-employed workers with chronic health conditions: A qualitative study. J Health Psychol 2024:13591053241239462. [PMID: 38520040 DOI: 10.1177/13591053241239462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2024] Open
Abstract
Chronic health conditions affect many individuals of working age, who cope with physical, psychological, and social difficulties that often involve limited work ability. This qualitative study explored experiences of self-employed individuals with chronic health conditions to advance our understanding of the effect of chronic illness on work. In-depth semi-structured interviews were conducted with 23 self-employed individuals coping with cancer, heart disease, inflammatory bowel disease, lung disease, or asthma. Data were analyzed with thematic analysis. Analysis of the interviews revealed four themes: uncertainty in planning work and committing to customers, acceptance versus denial of reduced work abilities, disclosure of health status to workers and customers, and temporal substitutes as a source of both support and concern. The results indicate that self-employed workers with a chronic health condition cope with unique challenges due to the need to sustain their business in the face of illness and a sense of sole responsibility.
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10
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Xu W, Hu D, Chen H, Li N, Feng X, Hu M, Cao F, Jin B, Zhang C. Quality of working life and adaptability of returning to work in nurse cancer survivors: a cross-sectional study. Support Care Cancer 2024; 32:226. [PMID: 38478116 DOI: 10.1007/s00520-024-08409-2] [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: 08/15/2023] [Accepted: 02/26/2024] [Indexed: 04/18/2024]
Abstract
OBJECTIVE To explore the relationship between quality of working life (QWL) and adaptability of returning to work (RTW) among nurse cancer survivors (NCSs). METHOD We conducted a cross-sectional study on nurses previously diagnosed with cancer. QWL was quantified using the Quality of Working Life Scale (QWL7-32), and the level of RTW adaptability was assessed using the Adaptability of Returning to Work for Cancer Survivors (ARTW-CS) scale. Multiple linear regression analysis was used to control for confounding factors, and a simple effect analysis was performed on the interaction term. RESULTS After controlling for sociodemographic, work-related, and health-related factors, the findings indicated a significant correlation between "adaptation and planning" and QWL score (p < 0.05). Further analysis revealed that "RTW gradualness" and "support seeking" had an interaction effect (p = 0.021). The simple effect analysis demonstrated that when the "RTW gradualness" score was ≥ 16 points, nurses with a high "support seeking" score (≥ 7 points) exhibited a significantly better QWL than those with a low "support seeking" score (< 7 points) (p < 0.001). CONCLUSION The interaction between "RTW gradualness" and "support seeking" in the ARTW-CS scale significantly impacted the QWL of the NCSs, underscoring the importance of implementing a gradual career plan and seeking support to enhance QWL.
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Affiliation(s)
- Wenjing Xu
- The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Danhong Hu
- The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Hao Chen
- The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Na Li
- The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xiao Feng
- The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Miaoye Hu
- The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Fuxiao Cao
- The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Bixia Jin
- The Fifth Affiliated Hospital, Wenzhou Medical University, Lishui, Zhejiang, China
| | - Chunmei Zhang
- The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
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11
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de Boer AG, Tamminga SJ, Boschman JS, Hoving JL. Non-medical interventions to enhance return to work for people with cancer. Cochrane Database Syst Rev 2024; 3:CD007569. [PMID: 38441440 PMCID: PMC10913845 DOI: 10.1002/14651858.cd007569.pub4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
BACKGROUND People with cancer are 1.4 times more likely to be unemployed than people without a cancer diagnosis. Therefore, it is important to investigate whether programmes to enhance the return-to-work (RTW) process for people who have been diagnosed with cancer are effective. This is an update of a Cochrane review first published in 2011 and updated in 2015. OBJECTIVES To evaluate the effectiveness of non-medical interventions aimed at enhancing return to work (RTW) in people with cancer compared to alternative programmes including usual care or no intervention. SEARCH METHODS We searched CENTRAL (the Cochrane Library), MEDLINE, Embase, CINAHL, PsycINFO and three trial registers up to 18 August 2021. We also examined the reference lists of included studies and selected reviews, and contacted authors of relevant studies. SELECTION CRITERIA We included randomised controlled trials (RCTs) and cluster-RCTs on the effectiveness of psycho-educational, vocational, physical or multidisciplinary interventions enhancing RTW in people with cancer. The primary outcome was RTW measured as either RTW rate or sick leave duration measured at 12 months' follow-up. The secondary outcome was quality of life (QoL). DATA COLLECTION AND ANALYSIS Two review authors independently assessed RCTs for inclusion, extracted data and rated certainty of the evidence using GRADE. We pooled study results judged to be clinically homogeneous in different comparisons reporting risk ratios (RRs) with 95% confidence intervals (CIs) for RTW and mean differences (MD) or standardised mean differences (SMD) with 95% CIs for QoL. MAIN RESULTS We included 15 RCTs involving 1477 people with cancer with 19 evaluations because of multiple treatment groups. In this update, we added eight new RCTs and excluded seven RCTs from the previous versions of this review that were aimed at medical interventions. All included RCTs were conducted in high-income countries, and most were aimed at people with breast cancer (nine RCTs) or prostate cancer (two RCTs). Risk of bias We judged nine RCTs at low risk of bias and six at high risk of bias. The most common type of bias was a lack of blinding (9/15 RCTs). Psycho-educational interventions We found four RCTs comparing psycho-educational interventions including patient education and patient counselling versus care as usual. Psycho-educational interventions probably result in little to no difference in RTW compared to care as usual (RR 1.09, 95% CI 0.96 to 1.24; 4 RCTs, 512 participants; moderate-certainty evidence). This means that in the intervention and control groups, approximately 625 per 1000 participants may have returned to work. The psycho-educational interventions may result in little to no difference in QoL compared to care as usual (MD 1.47, 95% CI -2.38 to 5.32; 1 RCT, 124 participants; low-certainty evidence). Vocational interventions We found one RCT comparing vocational intervention versus care as usual. The evidence was very uncertain about the effect of a vocational intervention on RTW compared to care as usual (RR 0.94, 95% CI 0.78 to 1.13; 1 RCT, 34 participants; very low-certainty evidence). The study did not report QoL. Physical interventions Four RCTs compared a physical intervention programme versus care as usual. These physical intervention programmes included walking, yoga or physical exercise. Physical interventions likely increase RTW compared to care as usual (RR 1.23, 95% CI 1.08 to 1.39; 4 RCTs, 434 participants; moderate-certainty evidence). This means that in the intervention group probably 677 to 871 per 1000 participants RTW compared to 627 per 1000 in the control group (thus, 50 to 244 participants more RTW). Physical interventions may result in little to no difference in QoL compared to care as usual (SMD -0.01, 95% CI -0.33 to 0.32; 1 RCT, 173 participants; low-certainty evidence). The SMD translates back to a 1.8-point difference (95% CI -7.54 to 3.97) on the European Organisation for Research and Treatment of Cancer Quality of life Questionnaire Core 30 (EORTC QLQ-C30). Multidisciplinary interventions Six RCTs compared multidisciplinary interventions (vocational counselling, patient education, patient counselling, physical exercises) to care as usual. Multidisciplinary interventions likely increase RTW compared to care as usual (RR 1.23, 95% CI 1.09 to 1.33; 6 RCTs, 497 participants; moderate-certainty evidence). This means that in the intervention group probably 694 to 844 per 1000 participants RTW compared to 625 per 1000 in the control group (thus, 69 to 217 participants more RTW). Multidisciplinary interventions may result in little to no difference in QoL compared to care as usual (SMD 0.07, 95% CI -0.14 to 0.28; 3 RCTs, 378 participants; low-certainty evidence). The SMD translates back to a 1.4-point difference (95% CI -2.58 to 5.36) on the EORTC QLQ-C30. AUTHORS' CONCLUSIONS Physical interventions (four RCTs) and multidisciplinary interventions (six RCTs) likely increase RTW of people with cancer. Psycho-educational interventions (four RCTs) probably result in little to no difference in RTW, while the evidence from vocational interventions (one RCT) is very uncertain. Psycho-educational, physical or multidisciplinary interventions may result in little to no difference in QoL. Future research on enhancing RTW in people with cancer involving multidisciplinary interventions encompassing a physical, psycho-educational and vocational component is needed, and be preferably tailored to the needs of the patient.
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Affiliation(s)
- Angela Gem de Boer
- Department of Public and Occupational Health, University of Amsterdam, Amsterdam Public Health Research Institute, Coronel Institute of Occupational Health, Amsterdam UMC, Location AMC, Amsterdam, Netherlands
| | - Sietske J Tamminga
- Department of Public and Occupational Health, University of Amsterdam, Amsterdam Public Health Research Institute, Coronel Institute of Occupational Health, Amsterdam UMC, Location AMC, Amsterdam, Netherlands
| | - Julitta S Boschman
- Cochrane Work, Department of Public and Occupational Health, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam UMC, Location AMC, Amsterdam, Netherlands
| | - Jan L Hoving
- Cochrane Work, Department of Public and Occupational Health, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam UMC, Location AMC, Amsterdam, Netherlands
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Ng DWL, So SCY, Fielding R, Mehnert-Theuerkauf A, Kwong A, Suen D, Wong L, Fung SWW, Chun OK, Fong DYT, Chan S, Molasiotis A, So WKW, Lam WWT. Return to work, work productivity loss and activity impairment in Chinese breast cancer survivors 12-month post-surgery: a longitudinal study. Front Public Health 2024; 12:1340920. [PMID: 38463159 PMCID: PMC10920332 DOI: 10.3389/fpubh.2024.1340920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 02/05/2024] [Indexed: 03/12/2024] Open
Abstract
Introduction Existing evidence of returning-to-work (RTW) after cancer comes predominately from Western settings, with none prospectively examined since the initial diagnostic phase. This study prospectively documents RTW-rate, time-to-RTW, work productivity loss, and activity impairment, within the first-year post-surgery among Chinese women with breast cancer (BCW) and identify potential causal co-variants. Methods This observational longitudinal study followed 371 Chinese BCW who were employed/self-employed at the time of diagnosis at 4-week post-surgery (baseline). RTW-status and time-to-RTW were assessed at baseline (T1), 4-month (T2), 6-month (T3), and 12-month (T4) post-baseline. WPAI work productivity loss and activity impairment were assessed at T4. Baseline covariates included demographics, medical-related factors, work satisfaction, perceived work demand, work condition, RTW self-efficacy, B-IPQ illness perception, COST financial well-being, EORTC QLQ-C30 and QLQ-BR23 physical and psychosocial functioning, and HADS psychological distress. Results A 68.2% RTW-rate (at 12-month post-surgery), prolonged delay in RTW (median = 183 days), and significant proportions of T4 work productivity loss (20%), and activity impairment (26%), were seen. BCW who were blue-collar workers with lower household income, poorer financial well-being, lower RTW self-efficacy, poorer job satisfaction, poorer illness perception, greater physical symptom distress, impaired physical functioning, and unfavorable work conditions were more likely to experience undesired work-related outcomes. Discussion Using a multifactorial approach, effective RTW interventions should focus on not only symptom management, but also to address psychosocial and work-environmental concerns. An organizational or policy level intervention involving a multidisciplinary team comprising nurses, psychologists, occupational health professionals, and relevant stakeholders in the workplace might be helpful in developing a tailored organizational policy promoting work-related outcomes in BCW.
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Affiliation(s)
- Danielle Wing Lam Ng
- LKS Faculty of Medicine, School of Public Health, Centre for Psycho-Oncology Research and Training, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- LKS Faculty of Medicine, Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Serana Chun Yee So
- LKS Faculty of Medicine, School of Public Health, Centre for Psycho-Oncology Research and Training, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- LKS Faculty of Medicine, Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Richard Fielding
- LKS Faculty of Medicine, School of Public Health, Centre for Psycho-Oncology Research and Training, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- LKS Faculty of Medicine, Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Anja Mehnert-Theuerkauf
- University Medical Center Leipzig, Department of Medical Psychology and Medical Sociology, The University of Leipzig, Leipzig, Germany
| | - Ava Kwong
- LKS Faculty of Medicine, School of Clinical Medicine, Department of Surgery, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Dacita Suen
- LKS Faculty of Medicine, School of Clinical Medicine, Department of Surgery, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Ling Wong
- Department of Surgery, Tung Wah Hospital, Hospital Authority, Hong Kong, Hong Kong SAR, China
| | - Sara Wai Wun Fung
- Department of Surgery, Kwong Wah Hospital, Hospital Authority, Hong Kong, Hong Kong SAR, China
| | - Oi Kwan Chun
- Department of Surgery, Kwong Wah Hospital, Hospital Authority, Hong Kong, Hong Kong SAR, China
| | - Daniel Y. T. Fong
- LKS Faculty of Medicine, School of Nursing, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Sharon Chan
- Department of Surgery, United Christian Hospital, Hospital Authority, Hong Kong, Hong Kong SAR, China
| | - Alex Molasiotis
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
- College of Arts, Humanities and Education, University of Derby, Derby, United Kingdom
| | - Winnie K. W. So
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Wendy Wing Tak Lam
- LKS Faculty of Medicine, School of Public Health, Centre for Psycho-Oncology Research and Training, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- LKS Faculty of Medicine, Jockey Club Institute of Cancer Care, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
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13
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Corbière M, Rabouin D, Negrini A, Mazaniello-Chézol M, Sideris L, Prady C, Lachance JP. Validation of the Return-to-Work Obstacles and Self-Efficacy Scale for Women on Sick Leave Due to Breast Cancer (ROSES-BC). JOURNAL OF OCCUPATIONAL REHABILITATION 2024:10.1007/s10926-023-10169-5. [PMID: 38311709 DOI: 10.1007/s10926-023-10169-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/19/2023] [Indexed: 02/06/2024]
Abstract
PURPOSE Breast cancer (BC) is the most frequently diagnosed cancer among women. Approximately 40% of BC survivors are diagnosed during the peak years of their professional career. Women face numerous obstacles when returning to work (RTW) after BC. Their decision-making process and self-efficacy to overcome these barriers may undergo alterations. The objective of this study was to validate the Return-to-work Obstacles and Self-Efficacy Scale (ROSES) for BC survivors, with a focus on three psychometric properties: construct validity, test-retest reliability, and predictive validity. METHODS This prospective study consists of three phases: Phase 1 (baseline, during sick leave) was conducted to evaluate construct validity, Phase 2 (2 weeks later) assessed test-retest reliability, and Phase 3 (6-month follow-up, RTW or not) aimed to evaluate predictive validity. A total of 153 BC survivors participated in Phase 1 of the study, where they completed the 10 dimensions of the ROSES (e.g., fear of relapse, cognitive difficulties). Confirmatory factor analyses (CFA), Pearson correlations, and Cox regressions were performed, with respect to each phase. RESULTS The mean duration for RTW with the same employer was 62.7 weeks. CFAs confirmed the ROSES structure, which had previously been established for other health conditions, showing satisfactory coefficients. Significant Pearson correlation coefficients were observed between the ROSES dimensions from Phase 1 to Phase 2, ranging from 0.66 to 0.88. When considering various confounding variables, chemotherapy treatment and cognitive difficulties (ROSES dimension) emerged as the only significant predictors of RTW. CONCLUSION These findings support the utilization of the ROSES in clinical and research settings for BC survivors to improve their successful RTW. After an initial screening using the ROSES, occupational health professionals can further conduct a focused and thorough evaluation of specific dimensions, such as cognitive difficulties. Additional research and information are required to assist BC survivors in dealing with cognitive impairments induced by chemotherapy when they return to work.
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Affiliation(s)
- Marc Corbière
- Department of Education and Pedagogy - Career counselling, University of Quebec in Montreal, Montreal, Canada.
- Research Centre of the Institut universitaire en santé mentale de Montréal, Montreal, Canada.
| | - Daniel Rabouin
- Research Centre of the Institut universitaire en santé mentale de Montréal, Montreal, Canada
| | - Alessia Negrini
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), Montreal, Canada
| | | | - Lucas Sideris
- Department of Surgery, Maisonneuve-Rosemont Hospital, Montreal, Canada
- University of Montreal, Montreal, Canada
| | - Catherine Prady
- CISSS Montérégie Centre, Greenfield Park, Québec, Canada
- Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Jean-Philippe Lachance
- Research Centre of the Institut universitaire en santé mentale de Montréal, Montreal, Canada
- Health and Society institute, University of Quebec in Montreal, Montreal, Canada
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14
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Forbat L. Multiple myeloma in people of working age in Czechia, Germany, and Poland: findings from a qualitative interview study. J Cancer Surviv 2023:10.1007/s11764-023-01510-1. [PMID: 38114713 DOI: 10.1007/s11764-023-01510-1] [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: 10/03/2023] [Accepted: 12/04/2023] [Indexed: 12/21/2023]
Abstract
PURPOSE The study sought to understand the experiences of working age adults with myeloma and their partner/family members, living in Czechia, Germany, and Poland. METHODS Qualitative interviews were conducted with 36 working age adults living with myeloma, and three family members. Data were collected from May to October 2022. Thematic analysis was applied to the data. RESULTS Healthcare and state support within each country are described. The degree of work engagement was informed by patients' symptom burden, treatment needs, state financial aid, and family/financial obligations. Many did not conceptualise their status as involving 'return to work' as they had continued to be engaged with their jobs throughout. For some, remote working enabled them to manage treatments/side-effects and their job, while avoiding infection. In some cases, patients did not tell their employer or colleagues about their illness, for fear of discrimination. CONCLUSION While experiences varied between countries, common across accounts was a struggle to balance ongoing treatments with employment, at a time when participants were expected to finance their own households and maintain their income and roles. Implications for Cancer Survivors To improve quality of life, clinical discussions around treatment decision-making should take into account patients' attitudes/approach to work, type of work engaged in, and other activities considered important to them. European Union and national cancer plans should set out optimum standards for employers, to ensure an equitable benchmark for how employees are supported. Such approaches would improve legal protections and better enforcement of employer policies to accommodate patients' limitations in the workplace.
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15
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Nicklin E, Phang I, Short SC, Hoogendoorn P, Boele FW. Patient and caregiver return to work after a primary brain tumor. Neurooncol Pract 2023; 10:565-575. [PMID: 38026585 PMCID: PMC10666801 DOI: 10.1093/nop/npad039] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023] Open
Abstract
Background Studies focusing on the return to work (RTW) experiences of patients with a brain tumor (BT) are scarce. We aimed to explore, in-depth, the occupational expectations, experiences, and satisfaction of patients who RTW after a BT diagnosis and treatment, those not able to, and their family caregivers. Methods This multicenter, cross-sectional study utilized semi-structured interviews and reflexive thematic analysis. Interviews were conducted with adults diagnosed with primary BT, in employment/self-employed before diagnosis, currently in follow-up care, and also with their caregivers. Results In total, 23 interviews (17 patients/6 caregivers) took place. Five themes were developed: (1) Early (adjustments and) expectations: "Thought I would be back at work the following Monday"; pre-treatment patients wanted to be better informed about potential recovery time and side-effects. (2) Drivers to RTW: "Getting my life back on track"; RTW was seen as a symbol of normality and also dictated by financial pressures. (3) Experiences returning to work: "It's had its ups and downs": patients who had successfully returned were supported by employers financially, emotionally, and practically. (4) Required support: "He had surgery and that was it": suggested support included a back-to-work scheme and comprehensive financial support. (5) Caring and paid work: The "juggling act": carer's work was significantly impacted; often reducing/increasing their working hours while managing increasing caring demands. Conclusions Future research focusing on RTW in neuro-oncology populations is needed. Interventions should be developed to improve employer/employee communication, and increase knowledge about BT care and possibilities for RTW, to support patients and caregivers towards sustained employment.
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Affiliation(s)
- Emma Nicklin
- Leeds Institute of Medical Research, St James’s Hospital, University of Leeds, Leeds, UK
| | - Isaac Phang
- Lancashire Teaching Hospitals NHS Foundation Trust, Lancashire, UK
| | - Susan C Short
- Leeds Institute of Medical Research, St James’s Hospital, University of Leeds, Leeds, UK
| | | | - Florien W Boele
- Leeds Institute of Medical Research, St James’s Hospital, University of Leeds, Leeds, UK
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
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16
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Viseux M, Johnson S, Roquelaure Y, Bourdon M. Breast Cancer Survivors' Experiences of Managers' Actions During the Return to Work Process: A Scoping Review of Qualitative Studies. JOURNAL OF OCCUPATIONAL REHABILITATION 2023; 33:687-701. [PMID: 37010716 DOI: 10.1007/s10926-023-10101-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/03/2023] [Indexed: 06/19/2023]
Abstract
PURPOSE Managers' actions can facilitate the return to work (RTW) process for breast cancer survivors (BCS). However, data on BCS' experiences of managers' actions regarding RTW are dispersed across multiple qualitative studies and do not offer useful insights for managers to support employees returning to work. This study aimed to summarize and map managers' actions experienced by BCS over three RTW phases (before, during, after) and categorize them as facilitating or hindering RTW. METHODS A scoping review of qualitative studies was conducted. Four databases (MEDLINE, PsycINFO, Cochrane Library, EMBASE) were systematically searched for articles published between 2000 and 2022. Studies and participant characteristics were extracted using an excel spreadsheet. A thematic analysis with a predominantly deductive and semantic approach was conducted. RESULTS Twenty-nine studies were included after screening 1042 records. Five themes were generated from the data. Two themes addressed the phase 'before RTW': 'managers' interpersonal skills' and 'preparing for RTW'; three in the 'during RTW' phase: 'managers' interpersonal skills', 'offering work flexibility', and 'offering work accommodations', and only one, 'paying attention to follow-up', was addressed in the 'after RTW' phase. CONCLUSION This review mapped managers' actions experienced by BCS in three phases of the RTW process. Results suggested that, according to BCS, managers need to mobilize specific skills to provide appropriate support during the RTW process. Further research is needed to better understand the skills underlying managers' actions facilitating the RTW process.
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Affiliation(s)
- Marie Viseux
- UMR INSERM 1246 SPHERE "methodS in Patient-Centered Outcomes and HEalth ResEarch", Nantes University, University of Tours, 22 Boulevard Benoni Goullin, Nantes, France.
| | - Stacey Johnson
- Integrated Center for Oncology, Boulevard Jacques Monod, 44805, Nantes, Saint-Herblain, France
- Université Côte d'Azur, LAMHESS, 261 Boulevard du Mercantour, 06200, Nice, France
| | - Yves Roquelaure
- University of Angers, University of Rennes, Inserm, EHESP, IRSET (Institut de Recherche en Santé, Environnement Et Travail) - UMR_S 1085, SFR ICAT, F-49000, Angers, France
- UMR Inserm S 1085, EHESP, IRSET (Institut de Recherche en Santé, Environnement Et Travail) - University of Angers, CHU Angers, University of Rennes, SFR ICAT, F-49000, Angers, France
| | - Marianne Bourdon
- UMR INSERM 1246 SPHERE "methodS in Patient-Centered Outcomes and HEalth ResEarch", Nantes University, University of Tours, 22 Boulevard Benoni Goullin, Nantes, France
- Integrated Center for Oncology, Boulevard Jacques Monod, 44805, Nantes, Saint-Herblain, France
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Fardell JE, Tan SY(C, Kerin-Ayres K, Dhillon HM, Vardy JL. Symptom Clusters in Survivorship and Their Impact on Ability to Work among Cancer Survivors. Cancers (Basel) 2023; 15:5119. [PMID: 37958295 PMCID: PMC10647426 DOI: 10.3390/cancers15215119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 10/18/2023] [Accepted: 10/20/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Cancer survivors often experience a range of symptoms after treatment which can impact their quality of life. Symptoms may cluster or co-occur. We aimed to investigate how symptoms and symptom clusters impact the ability to work among cancer survivors. METHODS We used symptom severity data and ability to work data routinely collected from cancer survivors attending a survivorship clinic after primary treatment with curative intent. We defined symptom clusters using single linkage and a threshold on the rescaled distances of <10. We then conducted a logistic regression to examine how symptoms and symptom clusters were related to the ability to work. RESULTS We analysed data from 561 cancer survivors, mean age 58 years and 1.5 years post diagnosis, with mixed diagnoses including breast (40.5%), colorectal (32.3%), and haematological cancers (15.3%). Limitations to work ability were reported by 34.9% of participants. Survivors experiencing pain, emotional, and cognitive symptom clusters were 14-17% more likely to report limitations in their ability to work. Older survivors and those with a higher stage disease were more likely to report limitations in their ability to work. CONCLUSION A better understanding and management of symptom severity and symptom clusters may help the sizable proportion of cancer survivors experiencing symptoms to participate in work after treatment.
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Affiliation(s)
- Joanna E. Fardell
- UNSW Medicine & Health, School of Clinical Medicine, UNSW Sydney, Sydney 1466, Australia;
- Western Sydney Youth Cancer Service, Westmead Hospital, Sydney 2145, Australia
| | - Sim Yee (Cindy) Tan
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney 2006, Australia;
- Concord Cancer Centre, Concord Repatriation General Hospital, Sydney 2139, Australia;
| | - Kim Kerin-Ayres
- Concord Cancer Centre, Concord Repatriation General Hospital, Sydney 2139, Australia;
| | - Haryana M. Dhillon
- Psycho-Oncology Cooperative Research Group, School of Psychology, Faculty of Science, University of Sydney, Sydney 2006, Australia;
| | - Janette L. Vardy
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney 2006, Australia;
- Concord Cancer Centre, Concord Repatriation General Hospital, Sydney 2139, Australia;
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Hallgren E, Ayers BL, Moore R, Purvis RS, McElfish PA, Maraboyina S, Bryant-Smith G. Facilitators and barriers to employment for rural women cancer survivors. J Cancer Surviv 2023; 17:1338-1346. [PMID: 35142993 DOI: 10.1007/s11764-022-01179-y] [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: 12/10/2021] [Accepted: 02/01/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Limited research exists on the employment experiences of rural women cancer survivors, yet this population may face unique barriers to employment following a cancer diagnosis. This study aims to identify facilitators and barriers to employment for rural women cancer survivors. METHODS We used a qualitative descriptive design to examine facilitators and barriers to employment for rural women cancer survivors. We conducted interviews with 33 rural women with cancer histories. RESULTS Facilitators of employment included paid time off, flexible work arrangements, and supportive workplace social networks, while barriers to employment included compromised immunity, long-term treatment effects, stigma and discrimination, and limited rural job markets. Rural women with secure employment histories generally experienced facilitators of employment, while rural women with insecure (e.g., temporary, informal, non-standard) employment histories generally faced barriers to retaining jobs and finding employment. CONCLUSIONS Formal and informal workplace support helped rural women retain their jobs during and following cancer treatment, especially those with secure employment. However, women with insecure employment histories generally faced multiple barriers to retaining and finding employment. More inclusive policies to support workers facing disabling illnesses, such as paid medical leave, are needed to ensure cancer survivors can maintain employment and/or financial security during and following their cancer treatment. IMPLICATIONS FOR CANCER SURVIVORS Cancer survivors with secure employment may benefit from formal and informal workplace support in retaining their employment. Those with insecure employment histories may benefit from access to job placement services and inclusive policies protecting employment for all workers experiencing disabling illness.
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Affiliation(s)
- Emily Hallgren
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave, Fayetteville, AR, 72703, USA.
| | - Britni L Ayers
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave, Fayetteville, AR, 72703, USA
| | - Ramey Moore
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave, Fayetteville, AR, 72703, USA
| | - Rachel S Purvis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave, Fayetteville, AR, 72703, USA
| | - Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave, Fayetteville, AR, 72703, USA
| | - Sanjay Maraboyina
- Department of Radiation Oncology, University of Arkansas for Medical Sciences, 4301 W. Markham St., #771, Little Rock, AR, 72205, USA
| | - Gwendolyn Bryant-Smith
- Department of Radiology, University of Arkansas for Medical Sciences, 4301 W. Markham St. - Slot 556, Little Rock, AR, 72205, USA
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Özer Güçlüel Y, Can G. Evaluation of job stress and quality of life in individuals returning to work after cancer treatment. Eur J Oncol Nurs 2023; 66:102381. [PMID: 37611501 DOI: 10.1016/j.ejon.2023.102381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 06/19/2023] [Accepted: 07/01/2023] [Indexed: 08/25/2023]
Abstract
PURPOSE The aim of this study was to investigate the impact of work life on work stress and quality of life in cancer patients returning to work after treatment. METHODS This descriptive cross-sectional study was conducted between January 2021 and June 2021 with 302 cancer patients who ad registered at the oncology outpatient clinic of a university hospital and had started or continued work after treatment. Data were collected using a personal information questionnaire, the Perceived Work Stress Scale, and the EORTC QLQ-C30. Results with p < 0.05 were considered statistically significant. RESULTS The mean age of the patients was 44.97 ± 10.08 years. They were predominantly women, had a diagnosis of breast cancer, and had received chemotherapy. The patients' perceived work stress score was 2.10 ± 0.68 (level D) and the EORTC QLQ-C30 score was 65.95 ± 20.11. Women, participants who were worried about their jobs, those who worked >36 months after cancer treatment, public and private sector workers, those who considered leaving their jobs after cancer treatment, and those who considered changing jobs had higher work stress scores. CONCLUSIONS The results of this study suggest that perceived work stress negatively affects the quality of life in individuals returning to work after cancer treatment. Therefore, individuals should be supported in returning to work and subsequent phases, and future should focus on the concepts of rehabilitation and return to work.
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Affiliation(s)
- Yasemin Özer Güçlüel
- Haliç University School of Nursing, Internal Medicine Nursing, Alibeyköy, İstanbul, Turkey.
| | - Gülbeyaz Can
- İstanbul University -Cerrahpaşa Florence Nightingale Faculty of Nursing, Internal Medicine Nursing, Abide-i Hürriyet Cad., Çağlayan, İstanbul, Turkey.
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Walker H, Rimmer B, Dutton L, Finch T, Gallagher P, Lewis J, Burns R, Araújo-Soares V, Williams S, Sharp L. Experiences of work for people living with a grade 2/3 oligodendroglioma: a qualitative analysis within the Ways Ahead study. BMJ Open 2023; 13:e074151. [PMID: 37770270 PMCID: PMC10546132 DOI: 10.1136/bmjopen-2023-074151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 09/07/2023] [Indexed: 09/30/2023] Open
Abstract
OBJECTIVES This study aimed to explore the work experiences of people living with an oligodendroglioma. DESIGN This was a descriptive qualitative study. One-time semi-structured interviews exploring supportive care needs were conducted; work was discussed at various points throughout each interview. An inductive thematic analysis was undertaken. SETTING Participants were recruited across the UK through four National Health Service hospitals and the Brain Tumour Charity research involvement networks. PARTICIPANTS 19 people with grade 2 or 3 oligodendroglioma (mean age 52 years; male n=11). At diagnosis, 16 participants were working, 2 studying and 1 retired. At the interview (mean time since diagnosis 9.6 years; range 1-18 years), seven participants were working, eight retired (four on medical grounds) and four unable to work due to illness. RESULTS Seven themes were constructed: (1) physical and cognitive limitations; (2) work ability and productivity; (3) work accommodations; (4) changing roles; (5) attitudes of clients and coworkers; (6) feelings and ambitions; and (7) financial implications. Fatigue, seizures and cognitive deficits influenced work ability. A stressful work environment could exacerbate symptoms. Changes in job roles and work environment were often required. Employer and coworker support were integral to positive experiences. Work changes could result in financial stress and strain. CONCLUSIONS This study has highlighted, for the first time, influences on work experiences in this understudied population. These findings have implications for clinicians and employers, when considering the importance of work in rehabilitation for people with oligodendrogliomas, and the individually assessed adjustments required to accommodate them, should employment be desired.
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Affiliation(s)
- Hayley Walker
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Ben Rimmer
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Lizzie Dutton
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Tracy Finch
- Department of Nursing, Midwifery, and Health, Northumbria University, Newcastle upon Tyne, UK
| | | | - Joanne Lewis
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Richéal Burns
- Faculty of Science, Atlantic Technological University, Sligo, Ireland
- Health and Biomedical Strategic Research Centre, Atlantic Technological University, Sligo, Ireland
| | - Vera Araújo-Soares
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
- Centre for Preventive Medicine and Digital Health, Department for Prevention of Cardiovascular and Metabolic Disease, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Sophie Williams
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
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Liu WH, Fox J, Yates P. Work-related experiences of prostate cancer survivors in Australia: a qualitative study. BMC Public Health 2023; 23:1806. [PMID: 37716940 PMCID: PMC10505317 DOI: 10.1186/s12889-023-16706-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 09/05/2023] [Indexed: 09/18/2023] Open
Abstract
BACKGROUND Prostate cancer (PCa) is the most diagnosed cancer in Australian men, and the number of survivors is growing with advances in diagnosis and treatment. Work participation following PCa diagnosis and treatment becomes a significant aspect of quality of life and survivorship. Using a qualitative phenomenological approach, we explored the work-related experiences of PCa survivors in Australia. METHODS Semi-structured telephone interviews were conducted with 16 men (6 salaried employees, 10 self-employed; 8 diagnosed ≥ 5 years) purposively sampled from a community setting. Interviews were inductively analysed. RESULTS Five main themes emerged: motivations to work; treatment decisions and work; the effects of PCa and its treatment on ability to participate in work; being an employee versus being self-employed; and personal agency. PCa and its treatment side-effects were detrimental to men's work capacity and ability, and could persist over an extended period. Most men expressed a strong desire to retain work or return to work. Discussions with healthcare professionals about work-related consequences were largely missing when treatment decisions were made. Self-employed men faced greater challenges than their salaried counterparts due to high financial burden and limited social and business support. Family, workplace and wider community support, and self-care, enhanced men's work participation experiences. CONCLUSIONS PCa and its treatment substantially and persistently impacted men's working lives, and their experiences were diverse and multifaceted. Self-employed and long-term PCa survivors face greater challenges and are at high risk of poor work outcomes. A systematic approach and involvement of stakeholders at all levels is required to support ongoing work participation.
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Affiliation(s)
- Wei-Hong Liu
- Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia.
- Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology, Kelvin Grove, QLD, 4059, Australia.
| | - Jennifer Fox
- Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Patsy Yates
- Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
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22
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Changrani K, Chima S, Sharma A, Han GG, Sharma A, McNamara M, Jefford M, Emery J, Druce P. A systematic review of smartphone applications for cancer survivors. J Cancer Surviv 2023:10.1007/s11764-023-01435-9. [PMID: 37700151 DOI: 10.1007/s11764-023-01435-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 07/21/2023] [Indexed: 09/14/2023]
Abstract
PURPOSE Mobile phone applications are positioned to support, educate, and empower cancer survivors during post-treatment care. We undertook a review to assess the utility of such smartphone applications; determine whether their use correlates with improved quality of life and other self-reported outcomes; and understand the feasibility of integrating mobile apps into routine follow-up care. METHODS MEDLINE, EMBASE, Emcare, and PsycINFO databases were searched for studies evaluating apps that addressed at least one of the five Cancer Survivorship Care Quality Framework (CSCQF) domains published up until December 2021. Studies were narratively synthesized. Implementation barriers and facilitators were mapped against the Technology Acceptance Model. RESULTS Twenty-three primary studies were included in this review. Only three randomized controlled trials (RCTs) were identified. Studies generally found mobile apps to be feasible, acceptable, and well-placed to support survivorship care. Health promotion was the most predominant CSCQF domain with apps primarily aiming to support exercise and dietary changes. The domains of monitoring for cancer recurrence (n=5) and management of co-morbidities (n=1) were underrepresented. Barriers to app use included greater time since active treatment, lack of familiarity with technology, and content not tailored to the user. CONCLUSIONS Mobile apps are both feasible and acceptable in supporting the transition between active treatment and follow-up care. However, understanding the utility of such apps is limited by the low number of RCTs. IMPLICATIONS FOR CANCER SURVIVORS Mobile apps have the potential to be useful support tools for patients post-treatment. However, given the number of apps developed, targeted, and available to cancer survivors, practical guidance to help cancer survivors choose appropriate apps is needed.
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Affiliation(s)
| | - Sophie Chima
- Centre for Cancer Research and Department of General Practice, Victorian Comprehensive Cancer Centre, University of Melbourne, Melbourne, Australia
| | - Arun Sharma
- The Royal Melbourne Hospital, Parkville, Melbourne, Australia
| | - Gil-Gyu Han
- The Royal Melbourne Hospital, Parkville, Melbourne, Australia
| | - Anushka Sharma
- The Royal Melbourne Hospital, Parkville, Melbourne, Australia
| | - Mairead McNamara
- Centre for Cancer Research and Department of General Practice, Victorian Comprehensive Cancer Centre, University of Melbourne, Melbourne, Australia
| | - Michael Jefford
- Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia
| | - Jon Emery
- Centre for Cancer Research and Department of General Practice, Victorian Comprehensive Cancer Centre, University of Melbourne, Melbourne, Australia
| | - Paige Druce
- Centre for Cancer Research and Department of General Practice, Victorian Comprehensive Cancer Centre, University of Melbourne, Melbourne, Australia
- Central Clinical School, Monash University, Melbourne, Australia
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23
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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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24
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Corbière M, Charette-Dussault É, Larivière N. Recognition During the Return-to-Work Process in Workers with Common Mental Disorders. JOURNAL OF OCCUPATIONAL REHABILITATION 2023; 33:486-505. [PMID: 36462069 DOI: 10.1007/s10926-022-10087-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/18/2022] [Indexed: 06/17/2023]
Abstract
Purpose Considering worker's perspective, the purpose of this study was twofold: (1) to document the meaning of the experience of recognition in the return to work (RTW) process of work after a sick leave due to a common mental disorder (CMD) and (2) to investigate the phenomenon of recognition for workers in the process of RTW after a sick leave due to a CMD, by evaluating the presence or absence of marks of recognition from salient RTW stakeholders stemming from different systems. Methods The Relational Caring Inquiry phenomenological method was used to explore the meaning of recognition during the return-to-work process and marks of recognition in a group of 20 workers who returned to their employment after a sick leave due to a CMD. In depth individual interviews were conducted with each participant. Results The definition of recognition that emerged from workers experiencing the RTW process is related to the behaviours and attitudes of various stakeholders, stemming from the work, health, insurance and social systems that allow them to feel appreciated, valued and respected, throughout the RTW process. Recognition was most often described as showing support, trust, respect for recovery and pace, and providing positive feedback. Conclusion The findings from this study could serve as guidelines in organizations regarding the RTW process, and in particular clarifying the roles and actions that different stakeholders could take in the workplace to stimulate expressions of meaningful recognition.
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Affiliation(s)
- Marc Corbière
- Department of Education and Pedagogy - Career Counseling, Université du Québec à Montréal, Montreal, QC, Canada.
- Research Center of the Institut, Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.
| | - Élyse Charette-Dussault
- Research Center of the Institut, Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada
| | - Nadine Larivière
- Research Center of the Institut, Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
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25
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Magnavita N, Di Prinzio RR, Meraglia I, Vacca ME, Arnesano G, Merella M, Mauro I, Iuliano A, Terribile DA. Supporting Return to Work after Breast Cancer: A Mixed Method Study. Healthcare (Basel) 2023; 11:2343. [PMID: 37628540 PMCID: PMC10454012 DOI: 10.3390/healthcare11162343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/14/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023] Open
Abstract
Breast cancer (BC) is the most common invasive cancer in the world. Most BC survivors (BCSs) continue working while dealing with cancer-related disabilities. BCSs' return-to-work (RTW) after cancer treatment is an important stage of their recovery and is associated with a higher survival rate. In this study, we addressed the RTW of BCSs with the intention of facilitating this process through direct action in the workplace. Thirty-two women who requested assistance from January to December 2022 were enrolled in the study. Semi-structured interviews and medical examinations were conducted by a team of three physicians. Interviews were analyzed using Thematic Analysis. Moreover, a quantitative cross-sectional study was conducted to compare the health status of BCSs with that of a control group of 160 working women, using standardized questionnaires on work ability, fatigue, sleep problems, anxiety, depression, and happiness. BCSs were also asked to rate the level of organizational justice they perceived at work prior to their illness. From the qualitative analysis emerged three facilitating/hindering themes: (1) person-related factors, (2) company-related factors, and (3) society-related factors. In the quantitative analysis, BCSs had significantly higher scores for anxiety, depression, sleep problems and fatigue, and lower levels of happiness than controls. The RTW of BCSs entails adapting working conditions and providing adequate support. The work-related analysis of each case made it possible to highlight the measures that need to be taken in the workplace to promote RTW. The treatment of cancer should be paired with advice on the best way to regain the ability to work.
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Affiliation(s)
- Nicola Magnavita
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Reparata Rosa Di Prinzio
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
- Alta Scuola di Economia e Management dei Sistemi Sanitari (ALTEMS), Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Igor Meraglia
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
| | - Maria Eugenia Vacca
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
| | - Gabriele Arnesano
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
| | - Marco Merella
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
| | - Igor Mauro
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
| | - Angela Iuliano
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
| | - Daniela Andreina Terribile
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
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26
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van Ommen F, Coenen P, Malekzadeh A, de Boer AGEM, Greidanus MA, Duijts SFA. Interventions for work participation of unemployed or work-disabled cancer survivors: a systematic review. Acta Oncol 2023; 62:753-764. [PMID: 37010899 DOI: 10.1080/0284186x.2023.2187261] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 02/28/2023] [Indexed: 04/04/2023]
Abstract
Background: Supporting unemployed or work-disabled cancer survivors in their work participation can have extensive individual and societal benefits. We aimed to identify and summarise interventions for work participation of unemployed or work-disabled cancer survivors.Methods: Five databases (Medline, Embase, PsycINFO, CINAHL and Cochrane Library) were systematically searched for quantitative studies on interventions aimed at enhancing work participation of unemployed or work-disabled cancer survivors. Work participation refers to participation in the workforce, fulfilling one's work role. Manual and automatic screening (with ASReview software) were performed on titles and abstracts, followed by manual full-text screening. Data were extracted regarding study, patient and intervention characteristics, and work participation outcomes. Risk of bias (RoB) was assessed using the Cochrane RoB2 and QUIPS tools.Results: We identified 10,771 articles, of which we included two randomised controlled trials (RCTs), of which one feasibility RCT, and three cohort studies. In total, 1862 cancer survivors were included, with predominantly breast cancer. Work participation was mainly measured as time to return to work (RTW) and RTW rate. Interventions included components of coaching (e.g., psychological or rehabilitation), training (e.g., building confidence and managing fatigue) and self-management. Two RCTs with unclear RoB did not show an effect of multicomponent interventions compared to care as usual. One cohort study found a significant effect of a psycho-educational intervention on RTW rates, with moderate RoB. The other two cohort studies, with moderate RoB, reported significant associations between components including job search and placement assistance, and work participation.Discussion: Only few interventions aimed at enhancing work participation of unemployed or work-disabled cancer survivors, have been evaluated. In two cohort studies, promising components for future multicomponent interventions were identified. However, findings suggest that more evidence is necessary on such multicomponent interventions, in which elements explicitly directed at work and including the workplace should be included.
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Affiliation(s)
- F van Ommen
- Department of Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Societal Participation and Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - P Coenen
- Societal Participation and Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
- Department of Public and Occupational Health, Amsterdam UMC location Vrije Universiteit, Amsterdam, the Netherlands
- Musculoskeletal Health, Amsterdam Movement Sciences Research Institute, Amsterdam, the Netherlands
| | - A Malekzadeh
- Medical Library, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
| | - A G E M de Boer
- Department of Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Societal Participation and Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
- Cancer Centre Amsterdam, Cancer Treatment and Quality of life, Amsterdam, the Netherlands
| | - M A Greidanus
- Department of Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Societal Participation and Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - S F A Duijts
- Cancer Centre Amsterdam, Cancer Treatment and Quality of life, Amsterdam, the Netherlands
- Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands
- Department of Medical Psychology, Amsterdam UMC location Vrije Universiteit, Amsterdam, the Netherlands
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27
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Georgescu I, Minvielle E, Scotté F. Motivation of patients with chronic cancer during COVID-19: a qualitative analysis. Support Care Cancer 2023; 31:296. [PMID: 37093535 PMCID: PMC10123469 DOI: 10.1007/s00520-023-07735-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 04/04/2023] [Indexed: 04/25/2023]
Abstract
PURPOSE Motivation to treat cancer and prevent its negative impact has been largely explored in a non-pandemic context. However, little is known about the motivation to comply with the treatment, especially during a pandemic. To fill this gap, we have explored the individual and contextual factors impacting patients' motivation during the COVID-19 period using the integrated model. METHODS We have conducted two qualitative studies before (study 1) and during the COVID-19 (study 2) period in a cancer centre. We respectively interviewed 30 and 22 patients with various chronic cancers in study 1 and also with COVID-19 in study 2. Data analysis was based on content analysis and grounded theory approach identifying the factors affecting patient motivations during both periods, and then comparing them. RESULTS Our results show the mechanisms that allow patients to maintain their motivation despite the threats related to COVID-19. They underline the importance of respecting the rules and laws for patients' motivation. CONCLUSION Compliance with legislation fuels the psychological need of protection in patients, which is a key determinant of motivation in the context of the pandemic. Considering patients' self-regulatory activities to assess motivational factors, going beyond clinical aspects, to include organisational and quality-of-life-related aspects throughout their care pathway is crucial.
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Affiliation(s)
- Irène Georgescu
- MRM, University of Montpellier, Rue Vendémiaire, 34000, Montpellier, France.
| | - Etienne Minvielle
- I3-Centre de Recherche en Gestion, Ecole polytechnique, CNRS, Institut polytechnique de Paris, Gustave Roussy, Villejuif, France
- Gustave Roussy, 114 Rue Edouard Vaillant, Villejuif, 94800, France
| | - Florian Scotté
- Gustave Roussy, 114 Rue Edouard Vaillant, Villejuif, 94800, France
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28
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Guseva Canu I, Bovio N, Arveux P, Bulliard JL, Fournier E, Germann S, Konzelmann I, Maspoli M, Rapiti E, Grzebyk M. Breast cancer and occupation: Non-parametric and parametric net survival analyses among Swiss women (1990–2014). Front Public Health 2023; 11:1129708. [PMID: 37089493 PMCID: PMC10115164 DOI: 10.3389/fpubh.2023.1129708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 03/14/2023] [Indexed: 04/08/2023] Open
Abstract
IntroductionOccupation can contribute to differences in risk and stage at diagnosis of breast cancer. This study aimed at determining whether occupation, along with skill level and the socio-professional category, affect the breast cancer survival (BCS) up to 10 years after diagnosis.Materials and methodsWe used cancer registry records to identify women diagnosed with primary invasive breast cancer in western Switzerland over the period 1990–2014 and matched them with the Swiss National Cohort. The effect of work-related variables on BCS was assessed using non-parametric and parametric net survival methods.ResultsStudy sample included 8,678 women. In the non-parametric analysis, we observed a statistically significant effect of all work-related variables on BCS. Women in elementary occupations, with low skill level, and in paid employment not classified elsewhere, had the lowest BCS, while professionals, those with the highest skill level and belonging to top management and independent profession category had the highest BCS. The parametric analysis confirmed this pattern. Considering elementary occupations as reference, all occupations but Craft and related trades had a hazard ratio (HR) below 1. Among professionals, technicians and associate professionals, and clerks, the protective effect of occupation was statistically significant and remained unchanged after adjustment for age, calendar period, registry, nationality, and histological type. After adjusting for tumor stage, the HRs increased only slightly, though turned non-significant. The same effect was observed in top management and independent professions and supervisors, low level management and skilled laborers, compared to unskilled employees.ConclusionThese results suggest that work-related factors may affect BCS. Yet, this study was conducted using a limited set of covariates and a relatively small study sample. Therefore, further larger studies are needed for more detailed analyses of at risk occupations and working conditions and assessing the potential interaction between work-related variables and tumor stage.
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Affiliation(s)
- Irina Guseva Canu
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
- *Correspondence: Irina Guseva Canu,
| | - Nicolas Bovio
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Patrick Arveux
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Jean-Luc Bulliard
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
- Neuchâtel and Jura Cancer Registry, Neuchâtel, Switzerland
| | - Evelyne Fournier
- Geneva Cancer Registry, University of Geneva, Geneva, Switzerland
| | - Simon Germann
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | | | | | | | - Michel Grzebyk
- Department of Occupational Epidemiology, National Research and Safety Institute (INRS), Vandoeuvre lès Nancy, France
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Zhong J, Shao L, Xin Z, Zhang JE. The mediating role of self-efficacy in the relationship between social support and work withdrawal behavior: A cross-sectional study among young lung cancer survivors. Asia Pac J Oncol Nurs 2023; 10:100207. [PMID: 36938530 PMCID: PMC10014270 DOI: 10.1016/j.apjon.2023.100207] [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: 10/25/2022] [Revised: 02/08/2023] [Accepted: 02/09/2023] [Indexed: 02/17/2023] Open
Abstract
Objective The study aimed to explore the predictors of work withdrawal behavior among young lung cancer survivors and examine the mediating role of self-efficacy in the relationship between social support and work withdrawal behavior. Methods This cross-sectional study was conducted in a cancer center in southern China. A total of 215 young lung cancer survivors were recruited from January 2021 to July 2021 and investigated by a demographic and disease-related questionnaire, the Work Withdrawal Behavior Scale, Social Support Rating Scale, and General Self-efficacy Scale. Data analysis was performed using IBM SPSS 25.0 (IBM Corp., Armonk, NY, USA) and PROCESS macro version 3.3 for SPSS developed by Preacher and Hayes. Results The mean score of work withdrawal behavior was 3.02 (±0.70). Existing symptoms, income, residence, the duration of postoperative rest time, social support, and self-efficacy were the predictors and explained 70.2% of the variance of work withdrawal behavior. The mediating effect of self-efficacy was identified between social support and work withdrawal behavior (indirect effect = 0.36, bias-corrected 95% confidence interval [-0.542 to -0.197]). Conclusions Work withdrawal behavior was prevalent among young lung cancer survivors. Social support and self-efficacy were significantly associated with work withdrawal behavior, and self-efficacy was identified as a mediator between social support and work withdrawal behavior among this group. Health professionals could help them return and adapt to work by relieving their symptoms, providing social support, and enhancing their self-efficacy.
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Affiliation(s)
- Jiudi Zhong
- Department of Thoracic Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, China
| | - Lu Shao
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Ziya Xin
- Department of Thoracic Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, China
| | - Jun-e Zhang
- School of Nursing, Sun Yat-sen University, Guangzhou, China
- Corresponding author. School of Nursing, Sun Yat-sen University, No 74, Zhongshan Er Road, Guangzhou, 510080 , China.
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Cheng ASK, Lee S, Li N, Tsang S, Zeng Y. Chinese Translation and Cross-Cultural Adaptation of the Return-to-Work Self-Efficacy Scale among Chinese Female Breast Cancer Survivors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4225. [PMID: 36901236 PMCID: PMC10001523 DOI: 10.3390/ijerph20054225] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/14/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
Breast cancer is the leading cancer type among women globally. Since breast cancer has a high survival rate, most survivors are likely to return to work (RTW). In recent years, breast cancer cases have risen significantly in younger age groups. As self-efficacy is an important factor in the success of RTW, this study performed a translation and cross-cultural adaptation of the Chinese version of the Return-To-Work Self-Efficacy Scale (CRTWSE-19) and examined its psychometric properties in patients with breast cancer. This validation study followed standard guidelines, including forward translation, back translation, cross-cultural adaptation, and psychometric testing. The results of this study show that the CRTWSE-19 met reliability standards, including high internal reliability for the total scores and subscales. An exploratory factor analysis of 19 items extracted 3 factors showing consistency with the original version of the RTWSE-19. Criterion validity was demonstrated by comparing subdomains with the Fear of Cancer Recurrence Inventory. Furthermore, the known-group validity was studied by comparing mean scores among the unemployed group and the employed group. We conclude that the CRTWSE-19 has very good screening accuracy and is able to discriminate between working and unemployed populations. It can facilitate health care professionals in triaging, planning, and evaluating interventions in clinical practice.
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Affiliation(s)
- Andy S. K. Cheng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Suki Lee
- Yang Memorial Methodist Social Service, Hong Kong, China
| | - Nadia Li
- Hong Kong Lutheran Social Service, Hong Kong, China
| | | | - Yingchun Zeng
- School of Medicine, Zhejiang University City College, Hangzhou 242332, China
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31
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Zapata Bonilla SA, Fried M, Singer S, Hentschel L, Richter S, Hohenberger P, Kasper B, Andreou D, Pink D, Arndt K, Bornhäuser M, Schmitt J, Schuler MK, Eichler M. Working situation and burden of work limitations in sarcoma patients: results from the multi-center prospective PROSa study. J Cancer Res Clin Oncol 2023:10.1007/s00432-022-04556-3. [PMID: 36624191 PMCID: PMC10356622 DOI: 10.1007/s00432-022-04556-3] [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: 10/13/2022] [Accepted: 12/22/2022] [Indexed: 01/11/2023]
Abstract
PURPOSE We investigated predictors of limitations in work performance, odds of drop out of work, and odds of receiving disability pension in sarcoma patients. METHODS We measured clinical and sociodemographic data in adult sarcoma patients and recorded if the patients received a (1) disability pension at baseline or (2) had dropped out of work 1 year after initial assessment. (3) Work limitations were assessed using the Work-limitations questionnaire (WLQ©). We analyzed exploratively. RESULTS (1) Amongst 364 analyzed patients, odds to receive a disability pension were higher in patients with abdominal tumors, older patients, high grade patients and with increasing time since diagnosis. (2) Of 356 patients employed at baseline, 21% (n = 76) had dropped out of work after 1 year. The odds of dropping out of work were higher in bone sarcoma patients and in patients who received additive radiotherapy ± systemic therapy compared with patients who received surgery alone. Odds of dropping out of work were less amongst self-employed patients and dropped with increasing time since diagnosis. (3) Work limitations were higher in woman and increased with age. Patients with bone and fibrous sarcomas were more affected than liposarcoma patients. Patients with abdominal tumors reported highest restrictions. Sarcoma treatment in the last 6 months increased work limitations. CONCLUSION Work limitations, drop out of work and dependence on a disability pension occurs frequently in patients with sarcoma adding to the burden of this condition. We were able to identify vulnerable groups in both the socioeconomic and disease categories.
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Affiliation(s)
- Sergio Armando Zapata Bonilla
- Clinic and Polyclinic for Internal Medicine III, Haematology and Medical Oncology/University Centre for Tumor Diseases (UCT), University Hospital Johannes Gutenberg, University Hospital Mainz, Mainz, Germany.
| | - Marius Fried
- Clinic and Polyclinic for Internal Medicine III, Haematology and Medical Oncology/University Centre for Tumor Diseases (UCT), University Hospital Johannes Gutenberg, University Hospital Mainz, Mainz, Germany
| | - Susanne Singer
- Institute for Medical Biostatistics, Epidemiology and Informatics, University Hospital Mainz, Mainz, Germany
| | - Leopold Hentschel
- National Center for Tumor Diseases Dresden (NCT/UCC), Dresden, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany.,Faculty of Medicine and University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany.,Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden, Germany
| | - Stephan Richter
- Clinic and Polyclinic for Internal Medicine I, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Peter Hohenberger
- Division of Surgical Oncology & Thoracic Surgery, Mannheim University Medical Center, University of Heidelberg, Heidelberg, Germany
| | - Bernd Kasper
- Sarcoma Unit, Mannheim Cancer Center (MCC), Mannheim University Medical Center, University of Heidelberg, Mannheim, Germany
| | - Dimosthenis Andreou
- Department of General Orthopedics and Tumor Orthopedics, University Hospital Munster, Munster, Germany.,Department of Orthopedics and Trauma, Medical University of Graz, Graz, Austria
| | - Daniel Pink
- Sarcoma Center Berlin-Brandenburg, Helios Hospital Bad Saarow, Brandenburg, Germany.,Department of Internal Medicine C, University Hospital Greifswald, Greifswald, Germany
| | - Karin Arndt
- German Sarcoma Foundation, Woelfersheim, Germany
| | - Martin Bornhäuser
- National Center for Tumor Diseases Dresden (NCT/UCC), Dresden, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany.,Faculty of Medicine and University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany.,Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden, Germany.,Clinic and Polyclinic for Internal Medicine I, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Jochen Schmitt
- National Center for Tumor Diseases Dresden (NCT/UCC), Dresden, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany.,Faculty of Medicine and University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany.,Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden, Germany.,Center for Evidence-Based Healthcare, Medizinische Fakultät Carl Gustav Carus, TU, Dresden, Germany
| | - Markus K Schuler
- Clinic and Polyclinic for Internal Medicine I, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Martin Eichler
- National Center for Tumor Diseases Dresden (NCT/UCC), Dresden, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany.,Faculty of Medicine and University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany.,Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden, Germany.,Clinic and Polyclinic for Internal Medicine I, University Hospital Carl Gustav Carus, Dresden, Germany
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Tiedtke CM, Blonk RW, Van Rhenen W, Van Egmond MP, Joosen MC. Tailored support for preparing employees with cancer to return to work: Recognition and gaining new insights in an open atmosphere. Work 2023; 76:1519-1533. [PMID: 37355925 PMCID: PMC10741312 DOI: 10.3233/wor-220566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 04/27/2023] [Indexed: 06/26/2023] Open
Abstract
BACKGROUND A considerable number of cancer survivors face difficulties in returning to work (RTW). More insight is needed on how to support employees shortly after cancer treatment and help them make the transition back to work. OBJECTIVE To gain an in-depth understanding of how and under what circumstances a Cancer & Work Support (CWS) program, which assists sick-listed employees with cancer in preparing their RTW, works. METHODS A qualitative design was used, inspired by Grounded Theory and Realist Evaluation components. Semi-structured interviews were conducted with RTW professionals (N = 8) and employees with cancer (N = 14). Interview themes covered experiences with CWS, active elements, and impeding and facilitating factors. Interviews were transcribed and analyzed by multiple researchers for contextual factors, active mechanisms, and the outcomes experienced. RESULTS Respondents experienced the support as human centered, identifying two characteristics: 'Involvement' ('how' the support was offered), and 'Approach' ('what' was offered). Four themes were perceived as important active elements: 1) open connection and communication, 2) recognition and attention, 3) guiding awareness and reflection, and 4) providing strategies for coping with the situation. Variation in the experiences and RTW outcomes, appeared to be related to the personal, medical and environmental context. CONCLUSION Both professionals and employees really appreciated the CWS because it contributed to RTW after cancer. This research shows that not only 'what' RTW professionals do, but also 'how' they do it, is important for meaningful RTW support. A good relationship in an open and understanding atmosphere can contribute to the receptiveness (of employees) for cancer support.
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Affiliation(s)
- Corine M. Tiedtke
- Tranzo-Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Roland W.B. Blonk
- Tranzo-Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
- Department of Human Resource Studies, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
- TNO Innovation for Life, Leiden, The Netherlands
- Optentia Research Unit, North-West University, Vanderbijlpark, South Africa
| | - Willem Van Rhenen
- Arbo Unie, Nieuwegein, The Netherlands
- Center for Human Resource Organization and Management Effectiveness, Nyenrode Business University, Breukelen, The Netherlands
| | | | - Margot C.W. Joosen
- Tranzo-Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
- Department of Human Resource Studies, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
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Paltrinieri S, Costi S, Pellegrini M, Díaz Crescitelli ME, Vicentini M, Mancuso P, Giorgi Rossi P, Fugazzaro S, Mazzini E, Escorpizo R, Ghirotto L. Adaptation of the Core Set for Vocational Rehabilitation for Cancer Survivors: A Qualitative Consensus-Based Study. JOURNAL OF OCCUPATIONAL REHABILITATION 2022; 32:718-730. [PMID: 35334038 PMCID: PMC8949826 DOI: 10.1007/s10926-022-10033-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/27/2022] [Indexed: 06/14/2023]
Abstract
PURPOSE The Core Set for Vocational Rehabilitation (CS-VR) of the International Classification of Functioning, Disability and Health (ICF) describes the work functioning of individuals in need of VR. We aimed to adapt the CS-VR from the perspective of cancer survivors (CSs) and stakeholders, developing a CS-VR-Onco. METHODS We held five focus groups with 17 CSs who were employed at the time of diagnosis, to discuss their work reintegration experiences. After analyzing the focus group conversations, the CS-VR-Onco was developed. During a group interview, eleven stakeholders explored barriers/facilitations in assessing the work functioning of CSs by using the CS-VR-Onco. We applied the framework method and thematic analysis. RESULTS For the focus groups, the CS-VR-Onco of 85 categories emerged, and the ICF chapters of Mental functions, Exercise and tolerance functions, Interpersonal interactions and relationships, Major life areas, General tasks and demands, Mobility, Support and relationships, and Attitudes were prioritized. For the group interview, stakeholders' perspectives can be synthetized into two themes: close to the lived experience and usability criteria. Stakeholders confirmed the categories of the CS-VR-Onco, a checklist that should be used through an integrated approach across multiple disciplines. CONCLUSIONS The adapted CS-VR-Onco reflects the CSs' lived experiences of work reintegration and the factors that have influenced this process. The CS-VR-Onco was described as complete and usable through an integrated approach.
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Affiliation(s)
- Sara Paltrinieri
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Risorgimento 80, 42123, Reggio Emilia, Italy
| | - Stefania Costi
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Risorgimento 80, 42123, Reggio Emilia, Italy.
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, Università di Modena e Reggio Emilia, 41100, Modena, Italy.
| | - Martina Pellegrini
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Risorgimento 80, 42123, Reggio Emilia, Italy
| | - Matías Eduardo Díaz Crescitelli
- Qualitative Research Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Viale Umberto I 50, 42123, Reggio Emilia, Italy
| | - Massimo Vicentini
- Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, Italy
| | - Pamela Mancuso
- Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, Italy
| | - Paolo Giorgi Rossi
- Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, Italy
| | - Stefania Fugazzaro
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Risorgimento 80, 42123, Reggio Emilia, Italy
| | - Elisa Mazzini
- Medical Directorate, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Via Amendola 2, 42122, Reggio Emilia, Italy
| | - Reuben Escorpizo
- Department of Rehabilitation and Movement Science, College of Nursing and Health Sciences, University of Vermont, Burlington, VT, 05401, USA
- Swiss Paraplegic Research, Nottwil, Switzerland
| | - Luca Ghirotto
- Qualitative Research Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Viale Umberto I 50, 42123, Reggio Emilia, Italy
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Ranes M, Wiestad TH, Thormodsen I, Arving C. Determinants of exercise adherence and maintenance for cancer survivors: Implementation of a community-based group exercise program. A qualitative feasibility study. PEC INNOVATION 2022; 1:100088. [PMID: 37213720 PMCID: PMC10194213 DOI: 10.1016/j.pecinn.2022.100088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 09/08/2022] [Accepted: 09/28/2022] [Indexed: 05/23/2023]
Abstract
Objective Despite verified knowledge that physical exercise plays an important part in recovery after cancer treatment, multiple studies have shown that maintaining a physically active lifestyle after cancer is challenging. There is a need for qualitative studies to increase understanding into patient experiences and perspectives, and facilitate the design of more sustainable exercise program. This qualitative descriptive feasibility study explores experiences from the implementation of a novel four-month community-based group exercise program for cancer survivors within municipality health service after completion of rehabilitation in the specialist health care service. Methods Fourteen cancer survivors participated in focus group interviews after completing Rehabilitation: Physical activity and Coping - feasibility study. Data were analyzed using the systematic text condensation method. Results We identified a main category, Determinants for exercise adherence and maintenance and four subcategories: peer-support, environment, structure and knowledge. Conclusion A social and supportive exercise environment promotes exercise adherence and maintenance among cancer survivors. This knowledge can be useful for further efforts to implement high quality community-based group exercise programs for cancer survivors. Innovation This study adds knowledge of survivors' experience of a novel community-based group exercise program in clinical practice and can promote the implementation of sustainable community-based exercise programs for cancer survivors.
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Affiliation(s)
- Maria Ranes
- Department of Oncology and Medical Physics, Haukeland University Hospital, Bergen, Norway
- Corresponding author at: Department of Oncology and Medical Physics, Haukeland University Hospital, Box 1400, 5021 Bergen, PO, Norway
| | - Tor Helge Wiestad
- Department of Oncology and Medical Physics, Haukeland University Hospital, Bergen, Norway
| | - Inger Thormodsen
- Department of Oncology and Medical Physics, Haukeland University Hospital, Bergen, Norway
| | - Cecilia Arving
- Department of Oncology and Medical Physics, Haukeland University Hospital, Bergen, Norway
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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35
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de Boer AGEM, de Wind A, Coenen P, van Ommen F, Greidanus MA, Zegers AD, Duijts SFA, Tamminga SJ. Cancer survivors and adverse work outcomes: associated factors and supportive interventions. Br Med Bull 2022; 145:60-71. [PMID: 36372773 PMCID: PMC10075241 DOI: 10.1093/bmb/ldac028] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/01/2022] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The number of cancer survivors in a working age is rising. An awareness of factors associated with adverse work outcomes, and of supportive interventions, is needed. SOURCES OF DATA A narrative review of research obtained via several databases, including Medline and PsycINFO, was conducted. AREAS OF AGREEMENT A range of factors is associated with adverse work outcomes such as prolonged sick leave, delayed return to work, disability pension and unemployment in cancer survivors. They include the cancer type and treatment, fatigue, cognitive functioning, work factors and elements of health care systems. Effective supportive interventions encompass physical and multicomponent interventions. AREAS OF CONTROVERSY The role of behaviour determinants and legislative and insurance systems is unclear. It is furthermore uncertain what the optimal timing of delivering supportive interventions is. GROWING POINTS Further focus on vulnerable groups, including specific cancer types and those with lower income, lower educational level and in precarious employment, is needed. AREAS TIMELY FOR DEVELOPING RESEARCH Recent developments are tailored and timely interventions.
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Affiliation(s)
- Angela G E M de Boer
- Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.,Amsterdam Public Health, Societal Participation and Health, Amsterdam, the Netherlands.,Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands
| | - Astrid de Wind
- Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.,Amsterdam Public Health, Societal Participation and Health, Amsterdam, the Netherlands
| | - Pieter Coenen
- Amsterdam Public Health, Societal Participation and Health, Amsterdam, the Netherlands.,Public and Occupational Health, Amsterdam UMC Location Vrije Universiteit, Amsterdam, De Boelelaan 1117 Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Musculoskeletal Health, Amsterdam, the Netherlands
| | - Fenna van Ommen
- Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.,Amsterdam Public Health, Societal Participation and Health, Amsterdam, the Netherlands
| | - Michiel A Greidanus
- Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.,Amsterdam Public Health, Societal Participation and Health, Amsterdam, the Netherlands
| | - Amber D Zegers
- Amsterdam Public Health, Societal Participation and Health, Amsterdam, the Netherlands.,Public and Occupational Health, Amsterdam UMC Location Vrije Universiteit, Amsterdam, De Boelelaan 1117 Amsterdam, the Netherlands
| | - Saskia F A Duijts
- Amsterdam Public Health, Societal Participation and Health, Amsterdam, the Netherlands.,Public and Occupational Health, Amsterdam UMC Location Vrije Universiteit, Amsterdam, De Boelelaan 1117 Amsterdam, the Netherlands.,Research & Development, Netherlands Comprehensive Cancer Organisation, Utrecht, the Netherlands
| | - Sietske J Tamminga
- Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.,Amsterdam Public Health, Societal Participation and Health, Amsterdam, the Netherlands.,Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands
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36
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Yang ZY, Chen WL, Wu WT, Lai CH, Ho CL, Wang CC. Return to Work and Mortality in Breast Cancer Survivors: A 11-Year Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14418. [PMID: 36361291 PMCID: PMC9655987 DOI: 10.3390/ijerph192114418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/23/2022] [Accepted: 10/29/2022] [Indexed: 06/16/2023]
Abstract
Breast cancer is the most commonly occurring cancer in women, and it is a major cause of cancer death around the world. With the development of diagnostic methods and improvements in treatment methods, the incidence rate of breast cancer and the number of breast cancer survivors continue to simultaneously increase. We used national registry database to analyze the features that affect employment and return to work among breast cancer survivors. A total of 23,220 employees, who were newly diagnosed with breast cancer were recruited based on the Labor Insurance Database (LID), the Taiwan Cancer Registry (TCR), and National Health Insurance Research Database (NHIRD) during the period 2004-2015. The correlations between return to work (RTW) and independent confounding factors were examined using Cox proportional hazards model. Survival probability was analyzed using the Kaplan-Meir method. After adjusting for confounding variables, cancer stage, chemotherapy and higher income were significantly negatively correlated with RTW. Among breast cancer survivors, RTW was found to be related to a lower risk of all-cause mortality in both the unadjusted and fully adjusted model. Patients who had RTW exhibited better survival in all stages. Work-, disease- and treatment-related factors influenced RTW among employees with breast cancer. RTW was associated with better breast cancer survival. Our study demonstrates the impact of RTW and the associated factors on breast cancer survivorship.
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Affiliation(s)
- Zhe-Yu Yang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
| | - Wei-Liang Chen
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
- Division of Occupational Medicine, Department of Family & Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
| | - Wei-Te Wu
- National Institute of Environmental Health Science, National Health Research Institutes, Miaoli 350, Taiwan
| | - Ching-Huang Lai
- School of Public Health, National Defense Medical Center, Taipei 114, Taiwan
| | - Ching-Liang Ho
- Division of Hematology/Oncology, Department of Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei 114, Taiwan
| | - Chung-Ching Wang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
- Division of Occupational Medicine, Department of Family & Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
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37
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Patterns of Concerns Among Hematological Cancer Survivors. Cancer Nurs 2022; 45:447-456. [PMID: 35120022 DOI: 10.1097/ncc.0000000000001060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Advances in treatment for hematological cancers warrant greater attention on survivorship concerns. OBJECTIVE The aims of this study were to describe survivorship concerns among hematological cancer survivors, identify subgroups of survivors with distinct classes of concerns, and examine sociodemographic and clinical differences across subgroups. METHODS We conducted a cross-sectional analysis of data from 1160 hematological cancer survivors, who rated their degree of concern regarding 20 physical, emotional, and practical changes. Clusters of concerns were identified using latent class analysis. Associations between respondent characteristics and cluster membership were calculated using multinomial logistic regression. RESULTS Survivors had a mean of 7.5 concerns (SD, 4.6; range, 0-19), the most frequent being fatigue/tiredness (85.4%); anxiety, stress, and worry about cancer returning (70.2%); and changes to concentration/memory (55.4%). Three distinct classes of concerns were identified: class 1 (low, 47.0%), characterized by low endorsement of most concerns, apart from fatigue; class 2 (moderate, 32.3%), characterized by high endorsement of a combination of concerns across domains; and class 3 (high, 20.7%), characterized by the highest number of concerns out of the 3 identified classes, including greater endorsement of concerns relating to sexual well-being. Class membership was differentiated by survivor age, sex, marital status, and diagnosis. CONCLUSIONS Three distinct patterns of concerns were detected in a large sample of hematological cancer survivors. Patterns of concerns could be differentiated by survivor characteristics. IMPLICATIONS FOR PRACTICE Our study highlights the concerns experienced by hematological cancer survivors and provides support for a tailored biopsychosocial approach to survivorship care in this context.
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Consolazio G. The Assessment of Disability in Italy: The Laborious Procedure and Sharing of Objectives. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13777. [PMID: 36360657 PMCID: PMC9655108 DOI: 10.3390/ijerph192113777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 10/11/2022] [Accepted: 10/21/2022] [Indexed: 06/16/2023]
Abstract
The assessment of disability in Italy requires the support of a system entirely dedicated to forensic evaluative medicine, which, for years, has been associated with the National Social Security Institute (INPS). Its medical offices are daily engaged in evaluating applications submitted by citizens. Their examination takes place in two different ways in the various Italian regions: assessments carried out by the Local Health Authority (ASL) and controlled by the INPS; evaluations carried out entirely by the INPS only. The main problem observed, and not yet resolved, is the excess time taken to respond to a citizen's request, especially in areas where the procedure retains the biphasic ASL-INPS modality. This phenomenon is exemplified by the presentation of cases of the INPS medical office of Iglesias (South Sardinia, Italy), which include a series of disability applications examined in the year 2021 from January to September. The most favourable feedback is a tested and shared path in the determination of judgments.
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Affiliation(s)
- Giuseppe Consolazio
- Medical Office, National Social Security Institute (INPS), 09016 Iglesias, Italy
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39
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Inoue S, Tateishi S, Harada A, Oginosawa Y, Abe H, Saeki S, Tsukada J, Mori K. Qualitative study of barriers and facilitators encountered by individuals with physical diseases in returning and continuing to work. BMC Health Serv Res 2022; 22:1229. [PMID: 36192749 PMCID: PMC9531482 DOI: 10.1186/s12913-022-08604-z] [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: 04/24/2022] [Accepted: 09/26/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The number of employees with physical diseases is increasing, and there is a need for support to help them return and continue to work. To provide effective support, it is important to identify barriers and facilitators for individuals in returning and continuing to work. Previous studies have reported barriers and facilitators for specific diseases. However, few reports have dealt with these issues across various diseases. To identify a range of barriers and facilitators that may apply to different physical diseases, we conducted a qualitative analysis by interviewing patients with diverse characteristics being treated for diseases. METHODS We conducted semi-structured interviews based on the criteria for qualitative research. We investigated three disease groups to obtain details of barriers and facilitators: impairments that were visible to other people (mainly stroke); impairments invisible to others (mainly heart disease); and impairments that changed over time (mainly cancer). Interview transcripts were analyzed and the results reported using systematic text condensation. RESULTS We extracted 769 meaning units from 28 patient interviews. We categorized barriers and facilitators that were generalizable to various diseases into three themes (personal factors, workplace factors, and inter-sectoral collaboration and social resources) and 10 sub-themes (work ability, psychological impacts, health literacy, social status, family background, workplace structure, workplace system, workplace support, inter-sectoral collaboration, and social resources). CONCLUSIONS This study identified 10 sub-themes that can be applied for workers with physical diseases; those sub-themes may be used as a basis for communicating with those individuals about returning and continuing to work. Our results suggest that various barriers and facilitators for workers with physical diseases should be understood and addressed at medical institutions, workplaces, and support sites.
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Affiliation(s)
- Shunsuke Inoue
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Seiichiro Tateishi
- Disaster Occupational Health Center, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.
| | - Arisa Harada
- Department of Occupational Medicine School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Yasushi Oginosawa
- The Second Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Haruhiko Abe
- Department of Heart Rhythm Management, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Satoru Saeki
- Department of Rehabilitation Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Junichi Tsukada
- Hematology, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Koji Mori
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
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The need to consider return to work as a main outcome in patients undergoing surgery for diffuse low-grade glioma: a systematic review. Acta Neurochir (Wien) 2022; 164:2789-2809. [PMID: 35945356 DOI: 10.1007/s00701-022-05339-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 08/02/2022] [Indexed: 01/26/2023]
Abstract
OBJECTIVE For a long time, return to work (RTW) has been neglected in patients harboring a diffuse low-grade glioma (LGG). However, a majority of LGG patients worked at time of diagnosis. Moreover, these patients now live longer given current treatment paradigms, especially thanks to early maximal surgery. METHODS We systematically searched available medical databases for studies that reported data on RTW in patients who underwent resection for LGG. RESULTS A total of 30 studies were selected: 19 considered RTW (especially rate and timing) as an outcome and 11 used scales of health-related quality of life (HRQoL) which included work-related aspects. Series that considered RTW as a main endpoint were composed of 1014 patients, with postoperative RTW rates ranging from 31 to 97.1% (mean 73.1%). Timing to RTW ranged from 15 days to 22 months (mean 6.3 months). Factors related to an increased proportion of RTW were: younger age, better neurologic status, having a white-collar occupation, working pre-operatively, being the sole breadwinner, the use of awake surgery, and greater extent of resection. Female sex, older age, poor neurologic status, pre-operative history of work absences, slow lexical access speed, and postoperative seizures were negatively related to RTW. No studies that used HRQoL scales directly investigated RTW rate or timing. CONCLUSIONS RTW was scarcely analyzed in LGG patients who underwent resection. However, because they are usually young, with no or only mild functional deficits and have a longer life expectancy, postoperative RTW should be assessed more systematically and accurately as a main outcome. As majority (61.5-100%) of LGG patients were working at time of surgery, the responsibility of neurosurgeons is to bring these patients back to their previous activities according to his/her wishes. RTW might also be included as a critical endpoint for future prospective studies and randomized control trials on LGGs.
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Olischläger DLT, den Boer LXY, de Heus E, Brom L, Dona DJS, Klümpen HJ, Stapelfeldt CM, Duijts SFA. Rare cancer and return to work: experiences and needs of patients and (health care) professionals. Disabil Rehabil 2022:1-12. [PMID: 35850601 DOI: 10.1080/09638288.2022.2099589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE Patients with a rare cancer often face delays in their diagnostic and treatment trajectory, which may affect their work. In this study, we explored experiences and needs of: 1) patients with a rare cancer regarding return to work (RTW) and work retention, and 2) (health care) professionals (HCPs) regarding work-related support of patients with a rare cancer, throughout their disease trajectory. METHODS Semi-structured, in-depth interviews with working-age patients with a rare cancer (n = 16), and HCPs (n = 9) were conducted. During the interviews, a predefined topic list was used. Interviews were transcribed verbatim and analysed by means of thematic analysis. RESULTS In total, three themes emerged from the interviews: 1) Awareness in patients and HCPs as a first step towards work, 2) Being/becoming an expert is a tough job, and 3) Enhancing employability through early personalized guidance. CONCLUSIONS Patients with a rare cancer are confronted with uncertainties regarding work, due to an overall lack of knowledge and experience with these types of cancer. Raising awareness among patients, HCPs and employers about rare cancer and its implications, and providing timely individualized, supportive occupational care are required to improve rare cancer patients' ability to work.Implications for rehabilitationRecognizing and paying attention to the work-related consequences of a rare cancer diagnosis and its treatment is essential to facilitate rare cancer patients' occupational rehabilitation process.Multidisciplinary collaboration and involvement of HCPs specialized in rare cancer are required to provide suitable work-related support.A personalized approach is necessary to adequately address rare cancer patients' RTW and work retention needs.
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Affiliation(s)
- Daphne L T Olischläger
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Li Xiang Y den Boer
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Eline de Heus
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Linda Brom
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,Netherlands Association for Palliative Care (PZNL), Utrecht, The Netherlands
| | - Desiree J S Dona
- Department of Human Resources, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Heinz-Josef Klümpen
- Department of Medical Oncology, Amsterdam University Medical Centers (location VUmc), Amsterdam, The Netherlands
| | | | - Saskia F A Duijts
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,Department of Medical Psychology, Amsterdam UMC location Vrije Universiteit, Amsterdam, The Netherlands.,Cancer Center Amsterdam, Cancer treatment and Quality of life, Amsterdam, The Netherlands
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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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Understanding Cancer Survivors’ Needs and Experiences Returning to Work Post-Treatment: A Longitudinal Qualitative Study. Curr Oncol 2022; 29:3013-3025. [PMID: 35621635 PMCID: PMC9139703 DOI: 10.3390/curroncol29050245] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/20/2022] [Accepted: 04/21/2022] [Indexed: 11/16/2022] Open
Abstract
Background: This study aimed to understand Canadian cancer survivors’ experiences during the return-to-work (RTW) process. Methods: A prospective qualitative longitudinal design was employed using the principles of phenomenological inquiry. Cancer survivors took part in three in-depth interviews: at the end of treatment, and 3 and 9 months after the first interview. Transcripts were analyzed using constant comparative analysis, guided by the Cancer and Work model. Results: A total of 38 in-depth interviews were conducted with 13 participants. The resultant themes were: (1) supports received or desired to enable RTW; (2) others’ limited understanding of the long-term impacts of a cancer diagnosis and its treatment; (3) worries and self-doubts about returning to work; and (4) changing perspectives on life and work after cancer. Conclusions: Cancer patients returning to work after treatment often experience challenges throughout the process, including varying levels of support from others and a range of ongoing effects and motivation to RTW. There is a clear gap in terms of the professional supports available to these individuals. Future research should focus on investigating how to improve both quality and accessibility of supports in a way that is personalized to the individual.
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Emery J, Butow P, Lai-Kwon J, Nekhlyudov L, Rynderman M, Jefford M. Management of common clinical problems experienced by survivors of cancer. Lancet 2022; 399:1537-1550. [PMID: 35430021 DOI: 10.1016/s0140-6736(22)00242-2] [Citation(s) in RCA: 74] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 01/23/2022] [Accepted: 02/03/2022] [Indexed: 12/16/2022]
Abstract
Improvements in early detection and treatment have led to a growing prevalence of survivors of cancer worldwide. Models of care fail to address adequately the breadth of physical, psychosocial, and supportive care needs of those who survive cancer. In this Series paper, we summarise the evidence around the management of common clinical problems experienced by survivors of adult cancers and how to cover these issues in a consultation. Reviewing the patient's history of cancer and treatments highlights potential long-term or late effects to consider, and recommended surveillance for recurrence. Physical consequences of specific treatments to identify include cardiac dysfunction, metabolic syndrome, lymphoedema, peripheral neuropathy, and osteoporosis. Immunotherapies can cause specific immune-related effects most commonly in the gastrointestinal tract, endocrine system, skin, and liver. Pain should be screened for and requires assessment of potential causes and non-pharmacological and pharmacological approaches to management. Common psychosocial issues, for which there are effective psychological therapies, include fear of recurrence, fatigue, altered sleep and cognition, and effects on sex and intimacy, finances, and employment. Review of lifestyle factors including smoking, obesity, and alcohol is necessary to reduce the risk of recurrence and second cancers. Exercise can improve quality of life and might improve cancer survival; it can also contribute to the management of fatigue, pain, metabolic syndrome, osteoporosis, and cognitive impairment. Using a supportive care screening tool, such as the Distress Thermometer, can identify specific areas of concern and help prioritise areas to cover in a consultation.
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Affiliation(s)
- Jon Emery
- Centre for Cancer Research and Department of General Practice, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia.
| | - Phyllis Butow
- PoCoG and CeMPED, School of Psychology SoURCe, Institute of Surgery, University of Sydney, Sydney, NSW, Australia
| | | | - Larissa Nekhlyudov
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Meg Rynderman
- Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Michael Jefford
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia; Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
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Efficacy of an Algorithm-Based Nursing Intervention to Promote a Balance Between Cancer Patients’ Social Roles and Outpatient Treatment. Cancer Nurs 2022:00002820-990000000-00015. [DOI: 10.1097/ncc.0000000000001108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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46
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Change in the value of work after breast cancer: evidence from a prospective cohort. J Cancer Surviv 2022; 17:694-705. [PMID: 35267143 DOI: 10.1007/s11764-022-01197-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 02/20/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Return to work (RTW) after cancer can be modulated by psychosocial factors, including a reordering of one's life values, with more emphasis on private life than work-life. This change in patients' outlook on work-life is however poorly understood. METHODS We used data from a French cohort (CANTO, NCT01993498) of women diagnosed with stage I-III primary breast cancer (BC) prospectively assessing life priorities between work and private life at diagnosis and 2 years after diagnosis. We identified women who reported a shift in life values toward private life, and we investigated the clinical, demographic, work-related, and psychosocial determinants of this change using logistic regressions. RESULTS Overall, 46% (N = 1097) of the women had reordered their life priorities toward private life 2 years after diagnosis. The factors positively associated with this shift included being diagnosed with stage III BC, perceiving one's job as not very interesting, being an employee/clerk (vs. executive occupation), perceiving no support from the supervisor at baseline, perceiving negative interferences of cancer in daily life, and perceiving a positive impact from experiencing cancer. Depressive symptoms were negatively associated with this shift. CONCLUSION After BC, there seems to be an important reordering of life values, with more emphasis on private life. This change is influenced by clinical determinants, but also by work-related and psychosocial factors. IMPLICATIONS FOR CANCER SURVIVORS Stakeholders should consider this change in a patient's outlook on work-life as much as the classical physical late effects when designing post-BC programs to support RTW.
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Lieb M, Wünsch A, Schieber K, Bergelt C, Faller H, Geiser F, Goerling U, Hönig K, Hornemann B, Maatouk I, Niecke A, Stein B, Teufel M, Wickert M, Büttner-Teleagă A, Erim Y, Weis J. Return to work after cancer: Improved mental health in working cancer survivors. Psychooncology 2022; 31:893-901. [PMID: 34989051 DOI: 10.1002/pon.5877] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 12/23/2021] [Accepted: 12/26/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Aim of the study was to compare working and non-working patients over a period of 12 months regarding socio-demographic, cancer-specific and mental health parameters. METHODS This study was conducted as part of a Germany-wide longitudinal survey among 1398 patients in 13 national Comprehensive Cancer Centers. The sample used for analysis consisted of n = 430 cancer patients younger than 65 years (age M = 52.4 years, SD = 8.1; 67.0% females). Socio-demographic, cancer-specific and mental health parameters (Depression: Patient Health Questionnaire, Anxiety: Generalized Anxiety Disorder Scale, Distress: Distress Thermometer) were assessed at baseline during hospitalization and at 12 months follow-up. RESULTS 73.7% of all patients (n = 317) have returned to work after one year. While working and non-working patients did not differ in socio-demographic parameters, there were significant differences in the presence of metastases, tumor and treatment status. Mixed analysis of variances revealed significant interactions between working status and time for depression (p = 0.009), anxiety (p = 0.003) and distress (p = 0.007). Non-working patients reported higher levels of depression, anxiety and distress than working patients over time. A logistic regression showed significant associations between lower depression (p = 0.019), lower distress (p = 0.033) and the absence of a tumor (p = 0.015) with working status. CONCLUSIONS The majority of cancer survivors returned to work. Non-working patients had higher levels of depression, anxiety and distress than working patients. After controlling for cancer-specific factors, mental health parameters were still independently associated with working status. Return to work can thus be associated with an improved mental health in cancer survivors. In order to establish causality, further research is necessary.
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Affiliation(s)
- Marietta Lieb
- Department of Psychosomatic Medicine and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg, University Hospital of Erlangen, Erlangen, Germany
| | - Alexander Wünsch
- Clinic for Psychosomatic Medicine and Psychotherapy, Medical Center Freiburg, Faculty of Medicine, University Freiburg in Cooperation with Outpatient Support for Cancer Patients, Comprehensive Cancer Center Freiburg, Freiburg, Germany
| | - Katharina Schieber
- Department of Psychosomatic Medicine and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg, University Hospital of Erlangen, Erlangen, Germany
| | - Corinna Bergelt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Hamburg, Germany
| | - Hermann Faller
- Department of Medical Psychology and Psychotherapy, Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany
| | - Franziska Geiser
- University of Bonn, Clinic for Psychosomatic Medicine and Psychotherapy, Bonn, Germany
| | - Ute Goerling
- Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität and Berlin Institute of Health, Berlin, Germany
| | - Klaus Hönig
- Ulm University Clinic Department of Psychosomatic Medicine and Psychotherapy, Comprehensive Cancer Center Ulm (CCCU), Ulm, Germany
| | - Beate Hornemann
- Comprehensive Cancer Center, University Clinic Center Dresden, Dresden, Germany
| | - Imad Maatouk
- Department of General Internal Medicine and Psychosomatics, Medical University Hospital Heidelberg, Heidelberg, Germany
| | - Alexander Niecke
- Department of Psychosomatics and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Barbara Stein
- Department of Psychosomatic Medicine and Psychotherapy, Paracelsus Medical University, Nuremberg General Hospital, Nuremberg, Germany
| | - Martin Teufel
- Department of Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, Comprehensive Cancer Center Essen (WTZ) and LVR Hospital, Essen, Germany
| | - Martin Wickert
- Medical University Hospital Tuebingen, Universitätsklinikum Tübingen, Comprehensive Cancer Center Tübingen-Stuttgart, Tübingen, Germany
| | | | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg, University Hospital of Erlangen, Erlangen, Germany
| | - Joachim Weis
- Comprehensive Cancer Center, Department Self-help Research, Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Long-term outcomes among localized prostate cancer survivors: prospective predictors for return-to-work three years after cancer rehabilitation. Support Care Cancer 2022; 30:843-854. [PMID: 34392427 PMCID: PMC8636403 DOI: 10.1007/s00520-021-06376-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 06/19/2021] [Indexed: 12/02/2022]
Abstract
PURPOSE This study aimed at (1) investigating the work status of men treated by radical prostatectomy due to diagnosis of localized prostate cancer (LPCa) three years after having attended a cancer rehabilitation program and (2) identifying prospective risk factors for not working at this time point. METHODS In a longitudinal, questionnaire-based multicenter study, 519 working-age LPCa survivors reported on their work status 12 and 36 months following rehabilitation. Chi-square tests/t tests and multivariable logistic regression analysis were used to identify prospective factors associated with not working at 36 months follow-up. RESULTS Nearly three quarter of LPCa survivors (N = 377, 73%) worked 3 years after post-acute rehabilitation. Most participants (N = 365, 71%) showed continuous return-to-work (RTW) patterns as they worked both 1 and 3 years following rehabilitation. Multivariable regression analysis revealed older age, low or middle socio-economic status as well as resigned and unambitious work behavior and fatigue at the time of attending the rehabilitation program to be prospective factors for not working at 36 months follow-up. Low socio-economic status [Odds ratio (OR) 4.81, 95% confidence interval (CI) 2.07-11.16] and unambitious work behavior [OR 4.48, 95% CI 2.16-9.31] were the strongest predictors. CONCLUSION Long-term work retention is a realistic goal among LPCa survivors. The results contribute to the identification of at-risk LPCa survivors early in the RTW process. Special attention should be paid to social inequality. Further, interventions related to the management of fatigue and work-related coping styles could improve long-term RTW, as these were relevant, but potentially modifiable factors impeding work retention.
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Lim CYS, Laidsaar-Powell RC, Young JM, Steffens D, Koczwara B, Zhang Y, Butow P. Work: saviour or struggle? A qualitative study examining employment and finances in colorectal cancer survivors living with advanced cancer. Support Care Cancer 2022; 30:9057-9069. [PMID: 35972645 PMCID: PMC9378257 DOI: 10.1007/s00520-022-07307-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 07/26/2022] [Indexed: 01/05/2023]
Abstract
PURPOSE Continuing employment or returning to work (RTW) as a cancer survivor can be meaningful and financially necessary, yet challenging. However, there is a lack of qualitative research on RTW experiences and financial wellbeing of people with advanced colorectal cancer (CRC-A). This study aimed to fill this gap. METHODS Adults treated for CRC-A were recruited 0.5-2 years post-surgery (or post-diagnosis of CRC-A for palliative chemotherapy participants). Semi-structured telephone interviews, exploring RTW and finances, were subjected to framework analysis. Demographic, clinical, and quality of life data (FACT-C, Distress Thermometer, COST measure) were collected to characterise the sample and inform the framework analysis. RESULTS Analysis of 38 interviews revealed five overarching themes: work as a struggle, work as my identity, work as my saviour, work as a financial necessity, and employer and colleague response. Many survivors with CRC-A desired to, and had the capacity to, continue work or RTW, yet faced unique challenges from compounded stigma of both cancer and toileting issues. Inability to RTW negatively impacted financial and psychosocial wellbeing. Workplace support was an important facilitator of RTW. CONCLUSION For survivors with CRC-A, continuing or RTW is fraught with challenges, including physical functioning challenges, financial anxiety, and unsupportive workplace environments. Survivors require psychosocial, financial, and employer support to manage these difficulties. This paper recommends a multiprong approach, including education programmes (facilitated through workers' union groups, human resource institutions, and/or large consumer CRC groups) and policies, to support workers and for employers to understand the unique challenges of employees with CRC-A.
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Affiliation(s)
- Chloe Yi Shing Lim
- Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia.
| | - Rebekah C Laidsaar-Powell
- Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Jane M Young
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
| | - Daniel Steffens
- Surgical Outcomes Research Centre (SOuRCe), Sydney Local Health District, Sydney, NSW, Australia
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, NSW, Australia
| | - Bogda Koczwara
- Department of Medical Oncology, Flinders Medical Center, Bedford Park, South Australia, Australia
- National Breast Cancer Foundation, Sydney, NSW, Australia
| | - Yuehan Zhang
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Phyllis Butow
- Centre for Medical Psychology and Evidence-Based Decision-Making (CeMPED), School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
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Teramatsu H, Yamato H, Jiang Y, Kako H, Kuhara S, Ohya R, Itoh H, Kuroda K, Matsushima Y, Saeki S. Pre-operative Physical Performance Is Associated With Early Return to Work in Peri-operative Lung Cancer Patients. J UOEH 2022; 44:341-351. [PMID: 36464308 DOI: 10.7888/juoeh.44.341] [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: 06/17/2023]
Abstract
Little is known about the factors related to return to work (RTW) in patients with peri-operative lung cancer (LC). This study aimed to investigate whether pre-operative physical performance is associated with early RTW in patients with peri-operative LC. A total of 59 patients who wished to resume work after lung resection surgery were included and were divided into three groups: early RTW (within 14 days after discharge), delayed RTW (within 15-90 days), and non-RTW (failure of RTW within 90 days). The early RTW group had significantly lower scores on the modified Medical Research Council dyspnea scale (mMRC) and significantly higher scores on the Euro Quality of Life 5-Dimension 3-Level (EQ-5D-3L) than the non-RTW group. Multivariate logistic regression analysis showed that EQ-5D-3L scores were significantly associated with early RTW, and mMRC scores and knee extensor strength tended to be associated with early RTW. Better pre-operative quality of life, mild dyspnea, and greater lower limb muscle strength tended to be associated with early RTW in patients with peri-operative LC.
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Affiliation(s)
- Hiroaki Teramatsu
- Department of Rehabilitation, University Hospital of Occupational and Environmental Health, Japan. 1-1, Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8556, Japan
| | - Hiroshi Yamato
- Department of Health Development, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan. 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan
| | - Ying Jiang
- Department of Health Development, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan. 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan
| | - Hiroaki Kako
- Department of Rehabilitation, University Hospital of Occupational and Environmental Health, Japan. 1-1, Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8556, Japan
| | - Satoshi Kuhara
- Department of Rehabilitation, University Hospital of Occupational and Environmental Health, Japan. 1-1, Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8556, Japan
| | - Ryosuke Ohya
- Department of Rehabilitation, University Hospital of Occupational and Environmental Health, Japan. 1-1, Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8556, Japan
| | - Hideaki Itoh
- Department of Rehabilitation Medicine, University of Occupational and Environmental Health, Japan. 1-1, Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan
| | - Koji Kuroda
- Second Department of Surgery, University of Occupational and Environmental Health, Japan. 1-1, Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan
| | - Yasuyuki Matsushima
- Department of Rehabilitation Medicine, University of Occupational and Environmental Health, Japan. 1-1, Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan
| | - Satoru Saeki
- Department of Rehabilitation Medicine, University of Occupational and Environmental Health, Japan. 1-1, Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan
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