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Dona DJS, Peters MEWJ, Senden TF, Bloem S, Bartstra H, Jacobs MT, Schaafsma FG, Jeurissen P. Including 'Work as a Treatment Goal' in the Care for Patients with Chronic Diseases : The Development of a Generic Care Model-A Descriptive Study. JOURNAL OF OCCUPATIONAL REHABILITATION 2024:10.1007/s10926-024-10215-w. [PMID: 38896400 DOI: 10.1007/s10926-024-10215-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/29/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND The Netherlands faces 60% prevalence of chronic conditions by 2040, impacting societal participation and quality of life. Current clinical care inadequately addresses these consequences, and most hospitals do not integrate occupational health in their care. OBJECTIVES To develop a generic person- and work-oriented medical care model (WMCM) based on real life experiences with work-oriented care and supporting the chronically ill in active societal participation. METHODS A qualitative research project with a participative approach in one hospital (November 2019 until March 2020). In an expert meeting, a schematic representation of a work-oriented care model was developed. Subsequent discussion rounds, with professionals from different patient groups, iteratively refined the model to a WMCM. RESULTS Consensus was reached after seven rounds of discussion, defining the model's core elements (1) a combination of biomedical and biopsychosocial approaches, (2) involvement of a clinical occupational physician in the treatment team, (3) a coordinating role for nursing specialists, and (4) incorporation of a work-oriented intervention plan (WoIP) into the treatment plan. Advocating early attention to societal participation, the model emphasises the WoIP and consensus on monitoring indicators. The final goal is a sustainable return to societal participation, considering both quality of life and work. CONCLUSION It is feasible to develop a generic person- and work-oriented care model for patients with chronic illness within a hospital care setting. Collaboration between healthcare professionals and a specialised occupational physician, with a central role for nurses, is deemed crucial.
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Affiliation(s)
- Desiree J S Dona
- Department of Primary and Community Care, Radboud University Medical Center, Geert Grooteplein 21, 6525, Nijmegen, EZ, The Netherlands.
| | - Marlies E W J Peters
- Department of Primary and Community Care, Radboud University Medical Center, Geert Grooteplein 21, 6525, Nijmegen, EZ, The Netherlands
| | - Theo F Senden
- Department of Primary and Community Care, Radboud University Medical Center, Geert Grooteplein 21, 6525, Nijmegen, EZ, The Netherlands
| | - Sjaak Bloem
- Center for Marketing & Supply Chain Management, Nyenrode Business University, 3621, Breukelen, BG, The Netherlands
| | - Herman Bartstra
- Department of Primary and Community Care, Radboud University Medical Center, Geert Grooteplein 21, 6525, Nijmegen, EZ, The Netherlands
| | - Marieke T Jacobs
- Department of Primary and Community Care, Radboud University Medical Center, Geert Grooteplein 21, 6525, Nijmegen, EZ, The Netherlands
| | - Frederieke G Schaafsma
- Department of Public and Occupational Health, Amsterdam UMC, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Patrick Jeurissen
- Department of IQ Health, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525, Nijmegen, GA, The Netherlands
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Park SY, Lee MK. Effects of a self-managed return to work intervention for colorectal cancer survivors: A prospective randomized controlled trial. Eur J Oncol Nurs 2024; 70:102593. [PMID: 38795437 DOI: 10.1016/j.ejon.2024.102593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 03/31/2024] [Accepted: 04/12/2024] [Indexed: 05/28/2024]
Abstract
PURPOSE The present study aims to assess the efficacy of stage-matched, self-managed Return to Work (RTW) interventions in enhancing RTW outcomes among colorectal cancer (CRC) survivors. METHODS This trial, conducted in South Korea, enrolled 58 unemployed survivors of colorectal cancer. Participants were randomly assigned to either an experimental or a control group. The experimental group received a self-managed return-to-work intervention based on the trans-theoretical model, while the control group received an educational booklet. Assessments were conducted at baseline and at 3, 6, and 12 months to measure changes in various factors including return-to-work status and HRQOL. RESULTS In the experimental group, 28 participants were randomly assigned, while 30 individuals were allocated to the control group. The experimental group exhibited a higher proportion of individuals achieving RTW (64.5% vs 39.3%, p = 0.013) and demonstrated greater improvements in work ability (p = 0.001), RTW self-efficacy (p = 0.035), readiness for RTW in the prepared-for-action (p < 00.0001), uncertain maintenance (p = 0.033), and proactive maintenance (p < 00.0001) stages, quality of working life (p = 0.003), HRQOL (p < 0.05), and illness perception (p < 0.05) compared to the control group at the 12-month follow-up. CONCLUSIONS Stage-matched self-managed RTW interventions incorporating TTM principles may effectively enhance RTW outcomes and work ability among CRC survivors.
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Affiliation(s)
- Soo Yeun Park
- College of Nursing, Research Institute of Nursing Science (Dr. Lee); and Colorectal Cancer Center, Kyungpook National University Chilgok Hospital, School of Medicine (Drs Park), Kyungpook National University, Daegu, South Korea.
| | - Myung Kyung Lee
- College of Nursing, Research Institute of Nursing Science (Dr. Lee); and Colorectal Cancer Center, Kyungpook National University Chilgok Hospital, School of Medicine (Drs Park), Kyungpook National University, Daegu, South Korea.
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Zegers AD, Coenen P, Heeren A, Takke N, Ardon H, Compter A, Dona D, Kouwenhoven M, Schagen SB, de Vos F, Duijts SFA. Work-related experiences and unmet needs of patients with a malignant glioma and relevant professionals: the BrainWork study. J Cancer Surviv 2023:10.1007/s11764-023-01469-z. [PMID: 37782399 DOI: 10.1007/s11764-023-01469-z] [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: 07/12/2023] [Accepted: 09/16/2023] [Indexed: 10/03/2023]
Abstract
PURPOSE Many patients with a malignant (i.e., grade II-IV) glioma are of working age, yet they are rarely included in "cancer and work" studies. Here, we explored (1) the work-related experiences and unmet needs of patients with a malignant glioma and (2) the experiences and needs of relevant healthcare and occupational (health) professionals ("professionals") in providing work-related support to this patient group. METHODS Individual semi-structured interviews were held with patients with a malignant glioma who were of working age and had an employment contract at diagnosis, and relevant professionals. Interviews were transcribed verbatim and analysed thematically. RESULTS Patients (n = 22) were on average 46 ± 13 years of age (64% male) and diagnosed with a grade II (n = 12), III (n = 4), or IV glioma (n = 6). Professionals (n = 16) had on average 15 ± 9 years of relevant work experience with the patient group. Four themes emerged from the data: (1) having a malignant glioma: experienced consequences on work ability, (2) communicating about the consequences of a malignant glioma at work, (3) distilling the right approach: generic or tailored work-related support, and (4) accessibility of work-related support. CONCLUSIONS Glioma-specific consequences on patients' work ability necessitate better communication between, and tailored guidance for, patients, relevant professionals, and the workplace. Suggestions for improvement, e.g., the periodic use of comprehensive neuropsychological assessments, are provided in the article. IMPLICATIONS FOR CANCER SURVIVORS Patients with a malignant glioma would benefit from tailored and proactive outreach about work-related issues bv relevant professionals.
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Affiliation(s)
- Amber Daniëlle Zegers
- Department of Public and Occupational Health, Amsterdam University Medical Centers Location Vrije Universiteit, De Boelelaan 1117, Amsterdam, Netherlands
- Societal Participation and Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Pieter Coenen
- Department of Public and Occupational Health, Amsterdam University Medical Centers Location Vrije Universiteit, De Boelelaan 1117, Amsterdam, Netherlands
- Societal Participation and Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
- Musculoskeletal Health, Amsterdam Movement Sciences Research Institute, Amsterdam, Netherlands
| | - Amy Heeren
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, Netherlands
| | - Nadia Takke
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, Netherlands
| | - Hilko Ardon
- Department of Neurology, TweeSteden Hospital, Tilburg, Netherlands
| | - Annette Compter
- Department of Neurology, Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Desiree Dona
- Department of Human Resources, Radboud University Medical Center, Nijmegen, Netherlands
| | - Mathilde Kouwenhoven
- Department of Neurology, Amsterdam University Medical Centers Location Vrije Universiteit, Amsterdam, Netherlands
- Cancer Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, Netherlands
| | - Sanne B Schagen
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Filip de Vos
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Saskia F A Duijts
- Department of Public and Occupational Health, Amsterdam University Medical Centers Location Vrije Universiteit, De Boelelaan 1117, Amsterdam, Netherlands.
- Societal Participation and Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands.
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, Netherlands.
- Cancer Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, Netherlands.
- Department of Medical Psychology, Amsterdam University Medical Centers location Vrije Universiteit, Amsterdam, Netherlands.
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Beerda DCE, Zegers AD, van Andel ES, Becker-Commissaris A, van der Vorst MJDL, Tange D, Duijts SFA, Brom L. Experiences and perspectives of patients with advanced cancer regarding work resumption and work retention: a qualitative interview study. Support Care Cancer 2022; 30:9713-9721. [DOI: 10.1007/s00520-022-07436-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 10/27/2022] [Indexed: 11/27/2022]
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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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Zegers AD, van Andel ES, Beerda DCE, Dona DJS, Aukema EJ, Brom L, Duijts SFA. Work resumption and retention in patients with advanced cancer: Experiences and perspectives of general and occupational health care professionals. Eur J Cancer Care (Engl) 2022; 31:e13714. [PMID: 36164925 PMCID: PMC9787025 DOI: 10.1111/ecc.13714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 09/05/2022] [Accepted: 09/14/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The objectives of this study were to explore the experiences and perspectives of general and occupational health care professionals regarding work resumption and work retention of patients with advanced cancer, and to identify barriers and facilitators these professionals may encounter. METHODS A qualitative design was applied, and individual semistructured interviews were conducted. General and occupational health care professionals were eligible to participate if they were involved in the work participation guidance of patients with advanced cancer, and were recruited through the network of the research team. Interview data were transcribed verbatim and analysed thematically via ATLAS.ti 9. RESULTS Interviewees (N = 17) had various occupational backgrounds, for example, occupational physician, reintegration consultant, and general practitioner. Four main themes emerged from the data: (1) Assumptions and hesitations, (2) Patient initiates stakeholder communication, (3) Role dispersion: who is in charge of what? and (4) Experience with legislation creates opportunities. CONCLUSION Whereas most interviewees had positive experiences with, and/or optimistic expectations of, the work resumption and work retention of patients with advanced cancer, several barriers to the work participation guidance of these patients were identified. Suggestions for improvement include creating widespread awareness of the possibility of work participation of patients with advanced cancer and developing reintegration guidelines for advanced cancer.
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Affiliation(s)
- Amber D. Zegers
- Department of Public and Occupational HealthAmsterdam UMC location Free UniversityAmsterdamThe Netherlands,Societal Participation and HealthAmsterdam Public Health Research InstituteAmsterdamThe Netherlands
| | - Emma S. van Andel
- Department of Research & DevelopmentNetherlands Comprehensive Cancer Organisation (IKNL)UtrechtThe Netherlands
| | - Donna C. E. Beerda
- Department of Research & DevelopmentNetherlands Comprehensive Cancer Organisation (IKNL)UtrechtThe Netherlands,Department of Public and Occupational HealthAmsterdam UMC location University of AmsterdamAmsterdamThe Netherlands
| | - Desiree J. S. Dona
- Department of Human ResourcesRadboud University Medical CenterNijmegenThe Netherlands
| | - Eline J. Aukema
- Center for Psycho‐OncologyIngeborg Douwes CentrumAmsterdamThe Netherlands
| | - Linda Brom
- Department of Research & DevelopmentNetherlands Comprehensive Cancer Organisation (IKNL)UtrechtThe Netherlands,Netherlands Association for Palliative Care (PZNL)UtrechtThe Netherlands
| | - Saskia F. A. Duijts
- Department of Public and Occupational HealthAmsterdam UMC location Free UniversityAmsterdamThe Netherlands,Societal Participation and HealthAmsterdam Public Health Research InstituteAmsterdamThe Netherlands,Department of Research & DevelopmentNetherlands Comprehensive Cancer Organisation (IKNL)UtrechtThe Netherlands,Department of Medical Psychology, Cancer Center AmsterdamAmsterdam UMC location Free UniversityAmsterdamThe Netherlands
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Porro B, Campone M, Moreau P, Roquelaure Y. Supporting the Return to Work of Breast Cancer Survivors: From a Theoretical to a Clinical Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095124. [PMID: 35564514 PMCID: PMC9105271 DOI: 10.3390/ijerph19095124] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/10/2022] [Accepted: 04/20/2022] [Indexed: 02/04/2023]
Abstract
Promoting the return to work of breast cancer survivors is of major interest to patients, healthcare and occupational health professionals, companies, governments, and researchers worldwide. We previously conducted a French consensus study resulting in a model describing the multifactorial process of the return to work of breast cancer survivors (the REWORK-BC model). Other work has identified the transtheoretical model as a relevant theoretical framework for interventions to promote the return to work of cancer survivors. In this opinion paper, we provide a theoretically-based clinical framework describing how to support breast cancer survivors at each stage of the return-to-work process. This clinical framework considers several essential aspects of supportive care for breast cancer survivors returning to work, such as: (i) helping the patient actively self-manage, by considering her to be the main decision-maker; (ii) respecting and adapting to the patient’s choice of professional project; (iii) respecting the temporality of the patient’s choices; (iv) proposing tailored interventions; (v) implementing simple tools to promote the return to work, shared representation between the patient and a multidisciplinary team, and improvement of working conditions and the knowledge of health and occupational professionals, and managers or employers; and (vi) maintaining certain flexibility aimed at proposing, but never imposing, changes in practices. This clinical framework, specific to breast cancer survivors, could be extrapolated to other tumor types, offering a practical guide for healthcare and occupational health professionals to better understand the return-to-work process of cancer survivors. This clinical framework aims to be a usable tool for any hospital or cancer care center wishing to implement a patient-centered intervention that promotes returning to work, regardless of the country.
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Affiliation(s)
- Bertrand Porro
- Univ. Angers, Univ. Rennes, Inserm, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail)—UMR_S 1085, SFR ICAT, F-49000 Angers, France;
- Correspondence:
| | - Mario Campone
- Oncology Department, Institut de Cancérologie de l’Ouest, F-44805 Saint-Herblain, France;
- Center for Research in Cancerology and Immunology Nantes-Angers, Inserm UMR 1232, Univ. Nantes and Univ. Angers, F-44307 Nantes, France
| | - Philippe Moreau
- University Hospital Hôtel-Dieu, 44000 Nantes, France;
- University of Nantes, 44035 Nantes, France
| | - Yves Roquelaure
- Univ. Angers, Univ. Rennes, Inserm, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail)—UMR_S 1085, SFR ICAT, F-49000 Angers, France;
- Univ. Angers, CHU Angers, Univ. Rennes, Inserm, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail)—UMR_S 1085, SFR ICAT, F-49000 Angers, France
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