1
|
Fauser D, Banaschak H, Zollmann P, Streibelt M, Bethge M. Auswirkungen der SARS-CoV-2-Pandemie auf die Inanspruchnahme der
onkologischen Rehabilitation: eine
Difference-in-Differences-Analyse. DIE REHABILITATION 2022; 62:104-112. [PMID: 36279877 DOI: 10.1055/a-1936-4083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Zusammenfassung
Ziel der Studie Der durch die SARS-CoV-2-Pandemie eingeschränkte
Zugang zur rehabilitativen Versorgung kann die Teilhabe von Menschen mit
Krebserkrankungen beeinträchtigen und birgt die Gefahr einer Progression
der zugrundeliegenden Erkrankung. Ziel unserer Analysen war es zu beschreiben,
in welchem Umfang die Inanspruchnahme onkologischer Rehabilitation
pandemiebedingt zurückgegangen ist.
Methodik Wir nutzten monatliche Querschnittsdaten von der Deutschen
Rentenversicherung zur Inanspruchnahme onkologischer Rehabilitation
(Ca-Reha-Leistung nach § 15 für Versicherte im
erwerbsfähigen Alter oder § 31 Abs. 1 Nr. 2 SGB VI für
Rentner) in den Jahren 2019 und 2020. Mit einem Difference-in-Differences-Modell
schätzten wir die auf die Pandemie zurückzuführende
Reduktion der Inanspruchnahme onkologischer Rehabilitation. Als
Difference-in-Differences-Schätzer wurde das Incidence Rate Ratio (IRR)
berechnet.
Ergebnisse Wir berücksichtigten 146.924 onkologische
Rehabilitationen im Jahr 2019 und 113.117 Leistungen im Jahr 2020. Die
Inanspruchnahme onkologischer Rehabilitation reduzierte sich pandemiebedingt um
11,5% bei Leistungen nach § 15 SGB VI (IRR=0,885;
95% KI: 0,864 bis 0,906) und um 26,5% bei Leistungen nach
§ 31 (IRR=0,735; 95% KI: 0,717 bis 0,754). Bei
Ca-Reha-Leistungen nach § 31 war der Rückgang in den alten
Bundesländern höher als in den neuen Bundesländern und
für allgemeine Antragsverfahren deutlich stärker als für
Anschlussrehabilitationen.
Schlussfolgerung Die Analysen zeigen einen pandemiebedingten
Rückgang onkologischer Rehabilitation vor allem bei onkologischen
Rehabilitationsleistungen für Rentner nach § 31. Der Verzicht
auf die durch medizinische Rehabilitation erreichbare körperliche und
psychische Erholung und Linderung von Krankheits- und Behandlungsnebenwirkungen
wird für viele an Krebs erkrankte Personen mit einer
Verschärfung von Teilhabeeinschränkungen einhergehen. Ein
wiederholtes Monitoring von Arbeitsfähigkeit und Gesundheit chronisch
kranker Menschen könnte erforderliche Daten generieren, um zu
klären, warum rehabilitationsbedürftige Menschen von der
Inanspruchnahme onkologischer Rehabilitation Abstand genommen haben und wie sie
unterstützt werden können.
Collapse
Affiliation(s)
- David Fauser
- Institut für Sozialmedizin und Epidemiologie,
Universität zu Lübeck, Lübeck, Germany
| | - Hannes Banaschak
- Institut für Sozialmedizin und Epidemiologie,
Universität zu Lübeck, Lübeck, Germany
| | - Pia Zollmann
- Dezernat Reha-Wissenschaften, Deutsche Rentenversicherung Bund, Berlin,
Germany
| | - Marco Streibelt
- Dezernat Reha-Wissenschaften, Deutsche Rentenversicherung Bund, Berlin,
Germany
| | - Matthias Bethge
- Institut für Sozialmedizin und Epidemiologie,
Universität zu Lübeck, Lübeck, Germany
| |
Collapse
|
2
|
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.
Collapse
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
| |
Collapse
|
3
|
Faaij M, Schoormans D, Pearce A. Work, daily activities and leisure after cancer. Eur J Cancer Care (Engl) 2022; 31:e13596. [PMID: 35451156 PMCID: PMC9542011 DOI: 10.1111/ecc.13596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 03/29/2022] [Accepted: 04/05/2022] [Indexed: 11/27/2022]
Abstract
Objective Determine if cancer survivors have lower participation in paid work, more limitations in daily activities or more limitations in leisure compared with those without cancer, stratified by age (working age ≤65 years; retirement age >65 years). Secondary objectives are identifying sociodemographic or clinical factors associated with work, daily activities or leisure and analysis of the relationship between work, daily activities and leisure. Methods Secondary analyses, using logistic regression, were performed on three cohorts (lymphoma, prostate and thyroid cancer) from the Dutch Patient Reported Outcomes Following Initial treatment and Long‐term Evaluation of Survivorship (PROFILES) registry and a nationally representative non‐cancer sample. Results Working‐age cancer survivors (n = 926) were significantly (p < 0.001) less likely to participate in paid work and more likely to report limitations in daily activities and leisure compared to the non‐cancer cohort (n = 1279). Among retirement aged cancer survivors (n = 1046), paid work was significantly more likely (p < 0.001), as were limitations in leisure (p < 0.05), compared with the non‐cancer controls (n = 334). Conclusions Cancer impacts daily activities and leisure, as well as paid work. These roles are important for cancer survivors' quality of life, suggesting support to return to these activities may be an important component of survivorship care.
Collapse
Affiliation(s)
- Marjon Faaij
- University Utrecht, Utrecht, The Netherlands.,Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Dounya Schoormans
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Alison Pearce
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, New South Wales, Australia.,Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
4
|
Carlson MA, Fradgley EA, Bridge P, Taylor J, Morris S, Coutts E, Paul C. The dynamic relationship between cancer and employment-related financial toxicity: an in-depth qualitative study of 21 Australian cancer survivor experiences and preferences for support. Support Care Cancer 2021; 30:3093-3103. [PMID: 34850273 DOI: 10.1007/s00520-021-06707-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 11/16/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND People with a cancer diagnosis experience physical and emotional impacts that may affect employment. Alongside cancer care costs, reduced ability to generate an income is a key contributor to financial toxicity which is associated with poor emotional wellbeing, quality of life, treatment adherence and survival. This study aimed to explore people's experiences of changes to employment and their suggestions for how cancer survivors can be better supported. METHODS Semi-structured telephone interviews were conducted with a purposive sample of 21 cancer survivors identified as part of a larger study of emotional distress. Purposive sampling was used to include a diverse group of people across age, gender, tumour type, self-reported financial difficulties and employment status. Interviews were inductively and iteratively coded by two independent coders and analysed using thematic analysis. RESULTS There is a dynamic relationship between a person's cancer treatment and their employment. For some, employment was disrupted due to physical or emotional impacts of cancer, or workplace stigma and discrimination. Others continued to work at the detriment of their health. Participants wished they had been made aware earlier how cancer might impact their capacity to work, their finances and their health. There was a lack of knowledge on the financial supports that may be available to them. CONCLUSIONS Healthcare professionals may have a role in minimising the financial impact of a cancer diagnosis through early assessment, communication of patients' potential work capacity and appropriate referrals to occupational therapy to aid return to work or financial planning. A robust government social support system specifically for households experiencing cancer is urgently required.
Collapse
Affiliation(s)
- Melissa A Carlson
- School of Medicine and Public Health, University of Newcastle, level 4 West, HMRI Building, University Drive, Callaghan, NSW, 2308, Australia.,Hunter Cancer Research Alliance, HMRI Building, New Lambton Heights, Australia
| | - Elizabeth A Fradgley
- School of Medicine and Public Health, University of Newcastle, level 4 West, HMRI Building, University Drive, Callaghan, NSW, 2308, Australia.,Priority Research Centre for Cancer Research Innovation and Translation, University of Newcastle, Callaghan, Australia.,Hunter Cancer Research Alliance, HMRI Building, New Lambton Heights, Australia.,Priority Research Centre for Health Behavior, University of Newcastle, Callaghan, Australia
| | - Paula Bridge
- School of Medicine and Public Health, University of Newcastle, level 4 West, HMRI Building, University Drive, Callaghan, NSW, 2308, Australia.,Hunter Cancer Research Alliance, HMRI Building, New Lambton Heights, Australia.,Priority Research Centre for Health Behavior, University of Newcastle, Callaghan, Australia
| | - Jo Taylor
- School of Medicine and Public Health, University of Newcastle, level 4 West, HMRI Building, University Drive, Callaghan, NSW, 2308, Australia.,Hunter Cancer Research Alliance, HMRI Building, New Lambton Heights, Australia.,Priority Research Centre for Health Behavior, University of Newcastle, Callaghan, Australia
| | - Sarah Morris
- School of Medicine and Public Health, University of Newcastle, level 4 West, HMRI Building, University Drive, Callaghan, NSW, 2308, Australia
| | - Emily Coutts
- School of Medicine and Public Health, University of Newcastle, level 4 West, HMRI Building, University Drive, Callaghan, NSW, 2308, Australia
| | - Christine Paul
- School of Medicine and Public Health, University of Newcastle, level 4 West, HMRI Building, University Drive, Callaghan, NSW, 2308, Australia. .,Priority Research Centre for Cancer Research Innovation and Translation, University of Newcastle, Callaghan, Australia. .,Hunter Cancer Research Alliance, HMRI Building, New Lambton Heights, Australia. .,Priority Research Centre for Health Behavior, University of Newcastle, Callaghan, Australia.
| |
Collapse
|
5
|
Shim S, Kang D, Bae KR, Lee WY, Nam SJ, Sohn TS, Jeong BC, Sinn DH, Kweon SS, Shim YM, Cho J. Association between cancer stigma and job loss among cancer survivors. Psychooncology 2021; 30:1347-1355. [PMID: 33817907 DOI: 10.1002/pon.5690] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 03/03/2021] [Accepted: 03/09/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Previous qualitative studies found cancer stigma was associated with work discrimination and job loss among cancer patients. This study aims to quantify the association between cancer stigma and job loss among cancer survivors. METHODS For this study, we used the data from a face-to-face cross sectional survey conducted at two cancer hospitals in Seoul and Hwasun in South Korea from October 2017 to March 2018. Cancer stigma was assessed using a validated questionnaire which consists of 12 items in three domains: (a) impossibility of recovery; (b) stereotypes; and (c) discrimination. Multivariable logistic regression was performed to evaluate the association between cancer stigma and job loss adjusting age, sex, marital status, education, job type, residence area, cancer site, stage, comorbidity, time since diagnosis, and self-efficacy. RESULTS Among 433 cancer survivors, 24.0% lost their jobs after cancer, and 20.7% experienced discrimination at work. Of total, 21.7% of the survivors agreed that it was difficult to treat cancer regardless of highly developed medical science. Survivors with stigma on impossibility of recovery and stereotypes were 3.10 (95% confidence interval [CI]: [1.76, 5.44]) and 2.10 (95% CI: [1.20, 3.67]) times more likely to lose a job than survivors without cancer stigma. Survivors with discrimination experience at work had 1.98 (95% CI: [1.05, 3.74]) times higher risk of losing a job than survivors without it. CONCLUSIONS Survivors with cancer stigma were more likely to lose their jobs than survivors without cancer stigma. Considering its social and economic impact on job loss, comprehensive interventions for working cancer survivors as well as public campaigns against cancer stigma would be necessary.
Collapse
Affiliation(s)
- Sungkeun Shim
- Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, South Korea.,Cancer Education Center, Samsung Comprehensive Cancer Center, Seoul, South Korea
| | - Danbee Kang
- Cancer Education Center, Samsung Comprehensive Cancer Center, Seoul, South Korea.,Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea
| | - Ka Ryeong Bae
- Cancer Education Center, Samsung Comprehensive Cancer Center, Seoul, South Korea.,Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea
| | - Woo Yong Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Seok Jin Nam
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Tae Sung Sohn
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Byong Chang Jeong
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Dong Hyun Sinn
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sun Seog Kweon
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Young Mog Shim
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Juhee Cho
- Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, South Korea.,Cancer Education Center, Samsung Comprehensive Cancer Center, Seoul, South Korea.,Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea
| |
Collapse
|
6
|
Stapelfeldt CM, Momsen AMH, Jensen AB, Andersen NT, Nielsen CV. Municipal return to work management in cancer survivors: a controlled intervention study. Acta Oncol 2021; 60:370-378. [PMID: 33287597 DOI: 10.1080/0284186x.2020.1853227] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Resuming work during or after cancer treatment has become an important target in cancer rehabilitation. PURPOSE The aim was in a controlled trial to study the return to work (RTW) effect of an early, individually tailored vocational rehabilitation intervention targeted to improve readiness for RTW in cancer survivors. MATERIAL AND METHODS Participants diagnosed with breast, cervix, ovary, testicular, colon-rectal, and head-and-neck cancers as well as being employed were allocated to a vocational rehabilitation intervention provided by municipal social workers (n = 83) or to usual municipal RTW management (n = 264). The intervention contained three elements: motivational communication inspired by Acceptance and Commitment Therapy by which RTW barriers were addressed, municipal cancer rehabilitation and finally employer and workplace contact. RTW effect was assessed as relative cumulative incidence proportions (RCIP) in the control and intervention group within 52 weeks of follow-up, estimated from the week where treatment ended at the hospital. RCIP was interpreted and reported as relative risk (RR) with 95% confidence intervals (CI) adjusted for gender, age cancer diagnosis, education, comorbidity, and sick leave weeks. RESULTS Across cancer diagnoses 69 (83.1%) and 215 (81.4%) returned to work in the intervention and control group, respectively. No statistical effect was seen (RR 1.08 (95% CI 0.98-1.19)). Repeating the analyses solely for participants with breast cancer (n = 290) showed a significant effect of the intervention (RR 1.12 (95% CI 1.01-1.23)). CONCLUSION More than 80% returned to work in both groups. However, no statistical difference in RTW effect was seen across cancer diagnoses within one year from being exposed to an early, individually tailored vocational rehabilitation intervention compared with usual municipal RTW management. TRIAL REGISTRATION NUMBER ISRCTN50753764.
Collapse
Affiliation(s)
- Christina M. Stapelfeldt
- Department of Public Health, Aarhus University, Aarhus, Denmark
- DEFACTUM - Social and Health Services & Labour Market, Central Denmark Region, Aarhus, Denmark
| | - Anne-Mette H. Momsen
- DEFACTUM - Social and Health Services & Labour Market, Central Denmark Region, Aarhus, Denmark
| | | | | | - Claus Vinther Nielsen
- Department of Public Health, Aarhus University, Aarhus, Denmark
- DEFACTUM - Social and Health Services & Labour Market, Central Denmark Region, Aarhus, Denmark
- Goedstrup Hospital, Herning, Denmark
| |
Collapse
|
7
|
Skaczkowski G, Asahina A, Wilson C. Returning to Work After Cancer in Australia: What Facilitates a Positive Return to Work Experience? JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:41-49. [PMID: 33125606 DOI: 10.1007/s10926-020-09881-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose This study examined the impact of task-based and relationship-based social support received in the workplace on cancer survivors' retrospective satisfaction with their return to work experience. Methods Cancer survivors (N = 159), completed an online questionnaire assessing their satisfaction with the return to work experience, overall job satisfaction, contact with employers and co-workers while absent, perceived task-based and relationship-based social support received at the time of returning to work, and the perceived emotional quality of workplace relationships. Results Survivors reported that contact with employers, but not co-workers, while absent from work was associated with a more positive return to work experience. Additionally, greater perceived task-based and relationship-based social support at the time of returning to work were significantly correlated with greater satisfaction with returning to work. Importantly, the impact of task-based and relationship-based social support was fully mediated by the perceived emotional quality of workplace relationships. Job satisfaction independently predicted variance in return to work satisfaction. Conclusions Supporting effective return to work after cancer involves consideration of the workplace social context. Greater resources are needed to help workplaces foster and maintain social connections with employees who are absent from work for cancer treatment.
Collapse
Affiliation(s)
- Gemma Skaczkowski
- School of Psychology & Public Health, La Trobe University, Melbourne, Australia
- Olivia Newton-John Cancer Wellness & Research Centre, Austin Health, Melbourne, Australia
| | - Akira Asahina
- School of Psychology & Public Health, La Trobe University, Melbourne, Australia
| | - Carlene Wilson
- School of Psychology & Public Health, La Trobe University, Melbourne, Australia.
- Olivia Newton-John Cancer Wellness & Research Centre, Austin Health, Melbourne, Australia.
| |
Collapse
|
8
|
Mitsui K, Endo M, Imai Y, Ueda Y, Ogawa H, Muto G, Yan Y, Deshpande GA, Terao Y, Takeda S, Tanigawa T, Nishimura K, Hayashi K, Saito M, Kokaze A. Predictors of resignation and sick leave after cancer diagnosis among Japanese breast cancer survivors: a cross-sectional study. BMC Public Health 2021; 21:138. [PMID: 33446165 PMCID: PMC7809813 DOI: 10.1186/s12889-021-10168-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 01/05/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In Japan, 55.5% of breast cancer survivors (BCSs) are of working age, so various perspectives regarding return to work (RTW) after cancer diagnosis need to be considered. Therefore, this study aimed to clarify the risk factors for resignation and taking sick leave (SL) among BCSs in continued employment at the time of diagnosis. METHODS A web-based retrospective cross-sectional survey was conducted on BCSs using data from a 2018 Japanese national research project (Endo-Han) commissioned by the Ministry of Health, Labour and Welfare of Japan. The subjects were women aged 18-69 years who had been diagnosed with breast cancer for the first time at least 1 year previously. The risk factors for resignation and taking SL after breast cancer diagnosis, including age at diagnosis, education level, cancer stage, surgery, chemotherapy, radiotherapy, employment status, and occupational type, were then analyzed using a logistic regression model. RESULTS In total, 40 (14.9%) of 269 BCSs quit their jobs at least 1 year after being diagnosed with breast cancer. The results of the multivariable analysis indicated that lower education level (odds ratio [OR]: 3.802; 95% confidence interval [CI]: 1.233-11.729), taking SL (OR: 2.514; 95%CI: 1.202-5.261), and younger age at diagnosis (OR: 0.470; 95%CI: 0.221-0.998) were predictors of resignation. Of 229 patients who continued working, SL was taken by 72 (31.4%). In addition, undergoing surgery was found to be a predictor of taking SL (OR: 8.311; 95%CI: 1.007-68.621). CONCLUSIONS In total, 40 (14.9%) of 269 BCSs quit their jobs at least 1 year after being diagnosed with breast cancer. The results of this study indicated that younger age, lower education level, and taking SL were predictors of resignation after breast cancer diagnosis.
Collapse
Affiliation(s)
- Kiyomi Mitsui
- Department of Hygiene, Public Health, and Preventive Medicine, Showa University, Tokyo, Japan
| | - Motoki Endo
- Department of Public Health, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Yuya Imai
- Department of Public Health, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Yuito Ueda
- Department of Public Health, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Hiroko Ogawa
- Department of Public Health, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Go Muto
- Department of Hygiene, Kitasato University School of Medicine, Sagamihara, Kanagawa Japan
| | - Yan Yan
- Department of Palliative Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | | | - Yasuhisa Terao
- Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Satoru Takeda
- Department of Obstetrics and Gynecology, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Takeshi Tanigawa
- Department of Public Health, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Katsuji Nishimura
- Department of Psychiatry, Tokyo Women’s Medical University School of Medicine, Tokyo, Japan
| | - Kazuhiko Hayashi
- Department of Chemotherapy and Palliative Care, Tokyo Women’s Medical University Hospital, Tokyo, Japan
| | - Mitsue Saito
- Department of Breast Oncology, Juntendo University School of Medicine, Tokyo, Japan
| | - Akatsuki Kokaze
- Department of Hygiene, Public Health, and Preventive Medicine, Showa University, Tokyo, Japan
| |
Collapse
|
9
|
Salaheddine I, Bellagamba G, Cypowyj C, Eisinger F, Lehucher-Michel MP. Délai de retour au travail selon les caractéristiques médico-sociales de salariés affectés par un cancer : étude transversale dans le Sud-Est de la France. ARCH MAL PROF ENVIRO 2020. [DOI: 10.1016/j.admp.2019.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
10
|
Bellagamba G, Descamps A, Cypowyj C, Eisinger F, Villa A, Lehucher-Michel MP. Cancer survivors' efforts to facilitate return to work. PSYCHOL HEALTH MED 2020; 26:845-852. [PMID: 32693633 DOI: 10.1080/13548506.2020.1795212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study assesses individual factors that influence return to work (RTW) and in particular on the cancer survivors' ability to prepare his/her job resumption. A self-administered questionnaire was completed by 105 cancer survivors after at least 4 weeks after the time of their RTW. Various methods of returning to work were compared between occupational and medical characteristics with multivariate statistical tests. Regular contact by a cancer survivor with the company during sick leave is associated with RTW within 1 year of diagnosis (ORaj = 5.78). Optional pre-reinstatement visit with the occupational physician is associated with the absence of employee activity's change (ORaj = 2.30). The cancer survivors who during treatment period ask for an adaption of treatment are more likely to have a change in working conditions (ORaj = 14.5). The adaptation to recovery conditions appears to be associated with survivors' effort to RTW. It should be confirmed with new studies.
Collapse
Affiliation(s)
- Gauthier Bellagamba
- Aix-Marseille Univ, CEReSS 3279, Marseille, France.,FACE Prévention, Fréjus, France
| | | | | | - François Eisinger
- AP-HM, Groupe hospitalier Timone, Service de médecine et santé au travail, Marseille, France
| | - Antoine Villa
- APHM, Groupe Hospitalier Timone, Service de médecine et santé au travail, Marseille, France
| | - Marie-Pascale Lehucher-Michel
- Aix-Marseille Univ, CEReSS 3279, Marseille, France.,APHM, Groupe Hospitalier Timone, Service de médecine et santé au travail, Marseille, France
| |
Collapse
|
11
|
Clin B, Heutte N, Boulanger M, Troussard X, Cornet E, Damaj GL, Bouvier V, Guizard AV, Launoy G, Licaj I. Analysis of medico-social factors for return to work among patients presenting with haematological malignancy (adamantine): results of a 'pilot study'. BMC Res Notes 2020; 13:313. [PMID: 32616070 PMCID: PMC7331231 DOI: 10.1186/s13104-020-05149-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 06/19/2020] [Indexed: 12/02/2022] Open
Abstract
Objective The aim of this study was to describe return to work determinants in patients with haematological malignancy. Results This medico-social pilot study included patients with haematological malignancy in the département of Calvados, aged 18 to 55 years, diagnosed between 1st January and 31st December 2010 and alive at 1st January 2015. Patients were identified via consultation of the Lower Normandy haematological malignancy Registry. They completed a specially developed self-questionnaire, in addition to validated questionnaires for anxiety-depression, quality of life and fatigue. Of the patients contacted, 50% accepted to participate. The mean age at diagnosis was 49.8 years, and the majority of patients (79.2%) was professionally active at the time of diagnosis. Only 64.9% of subjects had stopped work due to illness. The psychological impact (demonstrated anxiety) was significantly greater in men (p = 0.01). The majority of subjects returned to work after treatment (80.7%) and among them, the mean duration of absence from work was 16.1 months. Only 52.6% of subjects had informed their occupational physician and 56.7% had benefited from a pre-return visit. The satisfactory response rate obtained is promising for the extension of the present project as a prospective multicentric study.
Collapse
Affiliation(s)
- Bénédicte Clin
- INSERM U1086 « ANTICIPE », 14033, Caen Cedex, France. .,Université de Caen Normandie, Caen, France. .,Occupational Health Department, Service de Santé au Travail et Pathologie Professionnelle, C.H.U. (University Hospital) Côte de Nacre, CHU Caen, Caen, France.
| | - Natacha Heutte
- CETAPS EA3832, Université de Rouen, Mont-Saint-Aignan, France.,Clinical Research Department, Centre François Baclesse, Caen, France
| | | | - Xavier Troussard
- Service d'Hématologie Clinique, CHU de Caen, Caen, France.,Registre des Hémopathies Malignes de Basse-Normandie, Caen, France
| | - Edouard Cornet
- Registre des Hémopathies Malignes de Basse-Normandie, Caen, France
| | | | | | | | - Guy Launoy
- INSERM U1086 « ANTICIPE », 14033, Caen Cedex, France.,Université de Caen Normandie, Caen, France
| | - Idlir Licaj
- INSERM U1086 « ANTICIPE », 14033, Caen Cedex, France.,Clinical Research Department, Centre François Baclesse, Caen, France.,Department of Community Medicine, Faculty of Health Sciences, The UiT Arctic University of Norway, Tromsø, Norway
| |
Collapse
|
12
|
Petersen KS, Momsen AH, Stapelfeldt CM, Nielsen CV. Reintegrating Employees Undergoing Cancer Treatment into the Workplace: A Qualitative Study of Employer and Co-worker Perspectives. JOURNAL OF OCCUPATIONAL REHABILITATION 2019; 29:764-772. [PMID: 31056724 DOI: 10.1007/s10926-019-09838-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Purpose The purpose of this study was to explore how employers and co-workers experience the return to work (RTW) process of employees undergoing cancer treatment. Methods Sixteen semi-structured individual interviews and participant observations at seven workplaces took place, involving seven employers and nine co-workers with different professions. A phenomenological-hermeneutic analytic approach was applied involving coding, identification of themes, and interpretation. Results We identified three employer themes: call for knowledge, Making decisions, and Feeling helpless. Also, three co-worker themes were identified: understanding and sympathy, extra work and burden, and Insecurity about future work tasks. Early initiated RTW, e.g. less work hours and work accommodations, did neither constitute challenges for employers nor co-workers in the beginning of the RTW process. However, when the RTW process was prolonged employers encountered difficulties in finding suitable work tasks, whereas co-workers were burdened by extra work. Conclusions Overall, cancer survivors' RTW process was welcomed and encouraged at the workplace level. However, employer and co-worker experiences suggested that RTW initiation parallel with cancer treatment raised challenges at the workplace level, when the RTW process was extended beyond the initial RTW plan; increased workload and difficulties in balancing the needs of the cancer survivor and co-workers. Mechanisms that support cancer survivors' RTW without introducing strain on co-workers should be investigated in future research. Furthermore, support for employers in their RTW management responsibilities needs to be addressed in general and in particular in future RTW interventions.
Collapse
Affiliation(s)
| | - A H Momsen
- Section of Social Medicine and Rehabilitation, Aarhus University and DEFACTUM, Central Region Denmark, P.P. Oerums Gade 9-11, Building 1B, 8000, Aarhus C, Denmark
| | - C M Stapelfeldt
- Section of Social Medicine and Rehabilitation, Aarhus University and DEFACTUM, Central Region Denmark, P.P. Oerums Gade 9-11, Building 1B, 8000, Aarhus C, Denmark
| | - C V Nielsen
- Section of Social Medicine and Rehabilitation, Aarhus University and DEFACTUM, Central Region Denmark, P.P. Oerums Gade 9-11, Building 1B, 8000, Aarhus C, Denmark
| |
Collapse
|
13
|
Aubel D. Patient-reported outcomes from a workplace intervention program for cancer survivors highlight ongoing needs to support continuation of work. Support Care Cancer 2019; 27:4377-4384. [PMID: 31281940 PMCID: PMC6803589 DOI: 10.1007/s00520-019-04964-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 06/26/2019] [Indexed: 11/11/2022]
Abstract
Purpose The aim of this study was to investigate the perceptions of cancer survivors who continue to work and provide information to evaluate and develop a supportive workplace program (Ensemble) based on the principles of navigation. Methods A mixed-methods design using surveys and open-ended questions was used to study the perceptions of two groups of cancer survivors in the same workplace: those who chose to use a workplace navigational program (Ensemble program users) and those who declined (non-users). Key outcomes were communication and attitudinal self-efficacy, measured by the Communication and Attitudinal Self-Efficacy scale for cancer (CASE-cancer); emotional and informational social support, measured by the Patient-Reported Outcomes Measurement Information System Social Support domain (PROMIS-Social Support); and satisfaction with the navigator relationship, measured using the Patient Satisfaction with Interpersonal Relationship with Navigator (PSN-I). Results The study included 7 program users and 17 non-users. There were no significant differences in attitudinal self-efficacy, emotional support, or informational support between the groups. The relationship with the Nurse Navigator was rated highly by program users. The most frequent themes to the open-ended responses included work demands, privacy, integration of life and work, and program improvement. Conclusions Successful reintegration into/continuation of work remains a key need for cancer survivors. The navigation program design for cancer survivors should be further improved and applied across work settings. Electronic supplementary material The online version of this article (10.1007/s00520-019-04964-1) contains supplementary material, which is available to authorized users.
Collapse
|
14
|
de Moor JS, Alfano CM, Kent EE, Norton WE, Coughlan D, Roberts MC, Grimes M, Bradley CJ. Recommendations for Research and Practice to Improve Work Outcomes Among Cancer Survivors. J Natl Cancer Inst 2019; 110:1041-1047. [PMID: 30252079 DOI: 10.1093/jnci/djy154] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 07/11/2018] [Indexed: 11/13/2022] Open
Abstract
Major knowledge gaps limit the development and implementation of interventions to improve employment outcomes among people with cancer. To identify research priorities to improve employment outcomes after cancer, the National Cancer Institute sponsored the meeting "Evidence-Based Approaches for Optimizing Employment Outcomes among Cancer Survivors." This article describes research recommendations stemming from the meeting. At the patient level, longitudinal studies are needed to better understand how patient sociodemographic and clinical characteristics and their experiences at work shape employment outcomes. Interventions that mitigate the impact of cancer and its treatment on employment are critical. At the provider-level, future research is needed to characterize the extent to which physicians and other healthcare providers talk to their patients about employment concerns and how that information is used to inform care. Additionally, there is a need to test models of care delivery that support routine screening of employment concerns, the capture of employment outcomes in electronic health records, and the effective use of this information to improve care. At the employer level, evidence-based training programs are needed to prepare supervisors, managers, human resources staff, and occupational health professionals to address health issues in the workplace; and future interventions are needed to improve patient -employer communication and facilitate workplace accommodations. Importantly, research is needed that reflects the perspectives and priorities of patients and their families, providers and healthcare systems, and employers. Transdisciplinary partnerships and stakeholder engagement are essential to ensure that employment-focused interventions and policies are developed, implemented, and sustained in real-world healthcare delivery and workplace settings.
Collapse
Affiliation(s)
- Janet S de Moor
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD
| | | | - Erin E Kent
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD
| | - Wynne E Norton
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD
| | - Diarmuid Coughlan
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD
| | - Megan C Roberts
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD
| | - Melvin Grimes
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD
| | | |
Collapse
|
15
|
Fauser D, Wienert J, Zomorodbakhsch B, Schmielau J, Biester I, Krüger HU, Presl A, Bethge M. Work-Related Medical Rehabilitation in Cancer: A Cluster-Randomized Multicenter Study. DEUTSCHES ARZTEBLATT INTERNATIONAL 2019; 116:592-599. [PMID: 31587707 DOI: 10.3238/arztebl.2019.0592] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 03/01/2019] [Accepted: 06/03/2019] [Indexed: 01/22/2023]
Abstract
BACKGROUND Current guidelines recommend rehabilitative measures to alleviate dis- turbances resulting from cancer and its treatment. To give cancer survivors further assistance in getting back to work, work-related medical rehabilitation is currently being tested in Germany. In this cluster-randomized, multicenter trial, we studied the efficacy of work-related medical rehabilitation compared with conventional medical rehabilitation (trial no. DRKS00007770 in the German Clinical Trials Registry). METHODS A total of 484 cancer survivors of working age who were candidates for rehabilitation were recruited and assigned at random to either the intervention group (IG; work-related medical rehabilitation) or the control group (CG). The primary end- point was self-assessed function in a role one year after the end of rehabilitation, as evaluated with the health-related quality of life questionnaire of the European Organisation for Research and Treatment of Cancer (EORTC QLQ-C30). Further endpoints included symptom and function scales, subjective ability to work, coping with illness, and return to work. Neither the medical personnel nor the subjects were blinded. RESULTS One year after the end of rehabilitation, data from 379 subjects who par- ticipated in the last follow-up survey were evaluated. The intervention and control groups did not differ significantly either in the primary endpoint of role function (IG = 60.8 vs. CG = 57.6 out of a maximum of 100 points; p = 0.204) or in any of the secondary endpoints. A last observation carried forward analysis yielded com- parable results. At 12 months, 28.5% of the subjects in the IG and 25.3% of those in the CG were still unable to work. CONCLUSION This study did not reveal any significant clinically relevant advantage of work-related medical rehabilitation at one year. Future studies should determine whether a second period of rehabilitation might be helpful and whether selected subjects might benefit from the assistance of case managers beyond the period of rehabilitation.
Collapse
Affiliation(s)
- David Fauser
- Institute for Social Medicine and Epidemiology, University of Lübeck; Department of Psychology & Methods, University of Bremen; Paracelsus-Klinik am See, Bad Gandersheim; AMEOS Reha Klinikum, Ratzeburg; MediClin Rose Klinik, Horn-Bad Meinberg; Klinik Bavaria, Freyung
| | | | | | | | | | | | | | | |
Collapse
|
16
|
Fauser D, Wienert J, Beinert T, Schmielau J, Biester I, Krüger HU, Presl A, Bethge M. Work-related medical rehabilitation in patients with cancer-Postrehabilitation results from a cluster-randomized multicenter trial. Cancer 2019; 125:2666-2674. [PMID: 30985930 DOI: 10.1002/cncr.32131] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 02/04/2019] [Accepted: 03/11/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND Effective multidisciplinary rehabilitation programs supporting the return to work have become increasingly relevant for cancer survivors. In Germany, inpatient work-related medical rehabilitation programs consider treatment modules of work-related diagnostics, work-related functional capacity training, psychosocial groups, and intensified social counseling. The authors tested the effectiveness of a work-related medical rehabilitation program compared with conventional medical rehabilitation using a cluster-randomized multicenter trial (German Clinical Trial Register: DRKS00007770). METHODS In total, 484 patients with cancer were recruited at 4 rehabilitation centers. Patients at a center who started their rehabilitation in the same week represented a cluster. These clusters were randomly assigned using computer-generated randomization schedules either to an intervention group (IG) or to a control group (CG). The primary outcome was role functioning. Secondary outcomes were other quality-of-life domains and the return to work. RESULTS In total, 425 patients (210 in the IG) were included in the analysis at the 3-month follow-up. There was no significant difference between the IG and CG in role functioning (b = 3.55; 95% CI, -1.18 to 8.29; P = .142). Participants in the IG reported better physical functioning (b = 5.99; 95% CI, 3.33-8.65; P < .001), less physical fatigue (b = -5.09; 95% CI, -9.62 to -0.56; P = .028), and less pain (b = -6.24; 95% CI, -11.24 to -1.23; P = .015). CONCLUSIONS Work-related medical rehabilitation had no effect on the primary outcome compared with conventional medical rehabilitation but may enhance physical functioning and reduce physical fatigue and pain.
Collapse
Affiliation(s)
- David Fauser
- Institute for Social Medicine and Epidemiology, University of Lubeck, Lubeck, Germany
| | - Julian Wienert
- Department of Psychology and Methods, Jacobs University Bremen, Bremen, Germany
| | - Thomas Beinert
- Department of Oncology, Paracelsus-Klinik am See, Bad Gandersheim, Germany
| | - Jan Schmielau
- Department of Oncology, AMEOS Reha Klinikum, Ratzeburg, Germany
| | - Irene Biester
- Department of Oncology, MediClin Rose Klinik, Horn-Bad Meinberg, Germany
| | | | - Angelika Presl
- Department of Oncology, Klinik Bavaria, Freyung, Germany
| | - Matthias Bethge
- Institute for Social Medicine and Epidemiology, University of Lubeck, Lubeck, Germany
| |
Collapse
|
17
|
Monteiro I, Morais S, Costa AR, Lopes-Conceição L, Araújo N, Fontes F, Dias T, Pereira S, Lunet N. Changes in employment status up to 5 years after breast cancer diagnosis: A prospective cohort study. Breast 2019; 48:38-44. [PMID: 31493581 DOI: 10.1016/j.breast.2019.07.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 07/10/2019] [Accepted: 07/30/2019] [Indexed: 10/26/2022] Open
Abstract
AIM To assess how sociodemographic, clinical and treatment characteristics impact employment status five-years following a breast cancer diagnosis, and to compare the incidence rate of changes with the general population. METHODS A total of 462 women with incident breast cancer were evaluated before treatment and three- and five-years later. Adjusted odds ratios (ORs) with 95% confidence intervals (95%CIs) were computed through multinomial logistic regression. Data for comparisons were retrieved from the SHARE Project. Incidence rate ratios (IRRs) with 95%CIs were calculated using Poisson regression. RESULTS Among the 242 employed women prior to diagnosis, 162 remained employed, 26 became unemployed, 27 entered early retirement, 14 entered normal retirement and 13 were on sick leave at five-years. Unemployment increased with age (≥55 vs < 55 years: OR = 4.49, 95%CI:1.56-12.92; OR = 3.40, 95%CI:1.05-10.97 at three- and five-years, respectively) and decreased with education (>4 vs ≤ 4 years: OR = 0.36, 95%CI:0.13-0.97; OR = 0.27, 95%CI:0.10-0.71 at three- and five-years, respectively). Axillary surgery (unemployment at five-years: OR = 5.13, 95%CI:1.30-20.27), hormonal therapy (unemployment at three-years: OR = 0.28, 95%CI:0.10-0.83) and targeted therapy (sick leave at three-years: OR = 3.79, 95%CI:1.14-12.63) also influenced employment status. Five-years post diagnosis, women with breast cancer had a lower incidence of unemployment (IRR = 0.51, 95%CI:0.30-0.89) than the general population, while, among older women, there was a higher tendency to enter early retirement (IRR = 1.72, 95%CI:0.82-3.61). CONCLUSIONS Although not all women may want to pursue or continue a professional life following their breast cancer experience; those who do may benefit from social and employer support when returning to work.
Collapse
Affiliation(s)
| | - Samantha Morais
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Portugal
| | - Ana Rute Costa
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Portugal
| | | | - Natália Araújo
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Portugal
| | - Filipa Fontes
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Portugal; Instituto Português de Oncologia do Porto (IPO-Porto), Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Portugal
| | - Teresa Dias
- Instituto Português de Oncologia do Porto (IPO-Porto), Portugal
| | - Susana Pereira
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Portugal; Instituto Português de Oncologia do Porto (IPO-Porto), Portugal
| | - Nuno Lunet
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Portugal.
| |
Collapse
|
18
|
Rosenberg SM, Vaz-Luis I, Gong J, Rajagopal PS, Ruddy KJ, Tamimi RM, Schapira L, Come S, Borges V, de Moor JS, Partridge AH. Employment trends in young women following a breast cancer diagnosis. Breast Cancer Res Treat 2019; 177:207-214. [PMID: 31147983 DOI: 10.1007/s10549-019-05293-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 05/21/2019] [Indexed: 12/28/2022]
Abstract
PURPOSE Little is known about how a breast cancer diagnosis and treatment affects job-related outcomes in young women with breast cancer, who are an integral part of the workforce. We sought to describe employment trends among young breast cancer survivors. METHODS 911 women with non-metastatic breast cancer were surveyed about employment-related outcomes 1 year post-diagnosis. Participants were enrolled in the Young Women's Breast Cancer Study an ongoing, multi-center cohort of women diagnosed with breast cancer at age ≤ 40. RESULTS Among 911 women, median age at diagnosis was 36 years (range 17-40). Most women (80%, n = 729) were employed 1 year post-diagnosis. Among the 7% (n = 62) employed before diagnosis but who reported unemployment at 1 year, approximately half reported they were unemployed for health reasons. Among employed women, 7% said treatment affected their ability to perform their job. Women with stage-three disease (vs. stage 1 disease, odds ratio (OR): 3.73, 95% CI 1.39-9.97) and those who reported having money to pay bills after cutting back or difficulty paying bills at baseline (vs. having enough money for special things, OR 2.70, 95% CI 1.32-5.52) at baseline were more likely to have transitioned out of the workforce. CONCLUSIONS Our results suggest an impact of disease burden and socioeconomic status on employment in young breast cancer survivors. There is a need to ensure young survivors who leave the workforce following diagnosis are sufficiently supported given the potential adverse psychosocial and financial impacts of unemployment on survivors, their families, communities, and society.
Collapse
Affiliation(s)
- Shoshana M Rosenberg
- Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA, 02215, USA. .,Harvard Medical School, Boston, MA, USA.
| | | | | | | | | | - Rulla M Tamimi
- Harvard Medical School, Boston, MA, USA.,Brigham and Women's Hospital, Boston, MA, USA
| | | | - Steven Come
- Harvard Medical School, Boston, MA, USA.,Beth Israel Deaconess Medical Center, Boston, MA, USA
| | | | - Janet S de Moor
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Ann H Partridge
- Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA, 02215, USA.,Harvard Medical School, Boston, MA, USA
| |
Collapse
|
19
|
Kiasuwa-Mbengi RL, Nyaga V, Otter R, de Brouwer C, Bouland C. The EMPCAN study: protocol of a population-based cohort study on the evolution of the socio-economic position of workers with cancer. Arch Public Health 2019; 77:15. [PMID: 30937166 PMCID: PMC6427850 DOI: 10.1186/s13690-019-0337-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 02/12/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The improvements in cancer control led to an increase in the number of cancer survivors, notably, in the working age population (16-64 years). There is a strong need to assess and understand their reintegration on the labour market, which underlines and ensures their social integration and quality of life. The objectives of the EMPCAN study is therefore to measure the scale of return-to-work after cancer and to identify the determining factors, allowing for the implementation of an adequate socio-professional support. METHODS We requested data from the Belgian Cancer Registry and the Crossroad Bank for Social Security. We included all socially insured Belgian workers diagnosed between 2004 and 2011 with colorectal, breast, head & neck, prostate, testis, lung and corpus uteri cancer. The end of (administrative) follow-up was 31st December 2012. We include demographic, health-related and work-related factors in the analysis and observed how these factors interplay to determine the working status. After having solved legal, ethical and technical issues for the coupling, we will perform survival analysis with competing risks using the Fine and Gray model; we will also perform a multistate model using transitions probabilities; and finally, a group-based modeling for longitudinal data using the 'proc traj' package in SAS. DISCUSSION The results of the EMPCAN study will allow the provision of an evidence-based support to professional reintegration policies. It will also bring some key features for the prediction of the cancer-related social security needs. Besides the raise of awareness among health professionals and policy makers, this study could lead to a better planning and organization of vocational rehabilitation programs.
Collapse
Affiliation(s)
- Régine L. Kiasuwa-Mbengi
- Belgian Cancer Centre, Department of Public Health and Epidemiology, Sciensano, Brussels, Belgium
- Research Centre for Environmental and Occupational Health, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium
| | - Victoria Nyaga
- Belgian Cancer Centre, Department of Public Health and Epidemiology, Sciensano, Brussels, Belgium
| | - Renée Otter
- Belgian Cancer Centre, Department of Public Health and Epidemiology, Sciensano, Brussels, Belgium
| | - Christophe de Brouwer
- Research Centre for Environmental and Occupational Health, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium
| | - Catherine Bouland
- Research Centre for Environmental and Occupational Health, School of Public Health, Université Libre de Bruxelles, Brussels, Belgium
| |
Collapse
|
20
|
Tamura S, Sakaguchi K, Yamanaka R. Concerns and Returns to Work in Patients with Breast Cancer Receiving Outpatient Chemotherapy: a Pilot Study. Asia Pac J Oncol Nurs 2019; 6:187-192. [PMID: 30931364 PMCID: PMC6371663 DOI: 10.4103/apjon.apjon_58_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Objective Breast cancer survivors are increasing in number among survivors of all types of cancer, and survivors returning to work are extremely important. The development of outpatient chemotherapy has increased the working population of patients undergoing cancer therapy. Consequently, a significant number of breast cancer survivors experience physical, psychological, and social problems. This study aimed to clarify differences in concerns among patients with breast cancer receiving outpatient chemotherapy according to their employment status. Methods Twenty-eight patients with breast cancer undergoing outpatient chemotherapy were recruited. A questionnaire was used to survey the attributes, employment status, and levels of concern in these patients based on the Cancer-chemotherapy Concerns Rating Scale (CCRS). Data from three groups (employed full time, employed part-time, and unemployed) were analyzed using multiple comparison tests. Results The patients' mean age was (55.1 ± 9.9) years. According to the CCRS findings, the following three parameters differed between the three groups: scores for the items "I always think about my disease" (employed vs. unemployed, P = 0.005) and "I can't work (housework/schoolwork)" (employed full time vs. part time, P = 0.045), and scores for the "self-existence" subscale (employed vs. unemployed, P = 0.024). Conclusions This study revealed the characteristics of concerns in patients with breast cancer according to their employment status. Being able to continue working is considered to enhance the social health of these patients. Predicting concerns in employed patients will help gain perspective in early nursing interventions.
Collapse
Affiliation(s)
- Saori Tamura
- Department of Nursing, Doshisha Women's College of Liberal Arts, Kyoto, Japan
| | - Koichi Sakaguchi
- Department of Endocrine and Breast Surgery, Graduate School for Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Ryuya Yamanaka
- Department of Molecular Target Therapy for Cancer, Graduate School for Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| |
Collapse
|
21
|
Pearce A, Tomalin B, Kaambwa B, Horevoorts N, Duijts S, Mols F, van de Poll-Franse L, Koczwara B. Financial toxicity is more than costs of care: the relationship between employment and financial toxicity in long-term cancer survivors. J Cancer Surviv 2018; 13:10-20. [PMID: 30357537 DOI: 10.1007/s11764-018-0723-7] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 10/11/2018] [Indexed: 11/12/2022]
Abstract
PURPOSE The aim of this study was to examine the relationship between employment and financial toxicity by examining the prevalence of, and factors associated with, financial toxicity among cancer survivors. METHODS We conducted a secondary analysis of a sub-sample from the Dutch Patient Reported Outcomes Following Initial Treatment and Long-term Evaluation of Survivorship (PROFILES) registry. Descriptive statistics, bivariate analysis and logistic regression were used. RESULTS A total of 2931 participants with diverse cancer types were included in the analysis with a mean age of 55 years (range 18 to 65). Nearly half (49%) of participants were employed at the time of the survey, and 22% reported financial toxicity. Those who were not employed were at greater risk of financial toxicity (27% vs 16%, p < 0.001), and this did not vary according to time since diagnosis. The odds of reporting financial toxicity were greater for participants who were male, younger, unmarried, with low education, low socioeconomic status, or without paid employment. Those with basal cell carcinoma had lower risk of financial toxicity, while those with haematological or colorectal cancer had highest risk of financial toxicity. CONCLUSIONS This research confirms that unemployment is significantly associated with financial toxicity and that those with limited financial resources are most at risk. IMPLICATIONS FOR CANCER SURVIVORS Increased awareness of financial toxicity and its associated factors among clinicians may result in improved screening and appropriate referrals for support services. The implementation of effective multidisciplinary return to work interventions, as part of standard cancer survivorship care, may reduce financial toxicity among cancer survivors.
Collapse
Affiliation(s)
- Alison Pearce
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, PO Box 123, Broadway, NSW, 2007, Australia.
| | - Bianca Tomalin
- Flinders Centre for Innovation in Cancer, Flinders University, Adelaide, Australia
| | | | - Nicole Horevoorts
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.,Department of Research, The Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
| | - Saskia Duijts
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of General Practice, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.,Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Floortje Mols
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.,Department of Research, The Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
| | - Lonneke van de Poll-Franse
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.,Department of Research, The Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands.,Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Bogda Koczwara
- Flinders Centre for Innovation in Cancer, Flinders University, Adelaide, Australia
| |
Collapse
|
22
|
Armaou M, Schumacher L, Grunfeld EA. Cancer Survivors' Social Context in the Return to Work Process: Narrative Accounts of Social Support and Social Comparison Information. JOURNAL OF OCCUPATIONAL REHABILITATION 2018; 28:504-512. [PMID: 28980114 DOI: 10.1007/s10926-017-9735-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Purpose Returning to work is a process that is intertwined with the social aspects of one's life, which can influence the way in which that person manages their return to work and also determines the support available to them. This study aimed to explore cancer patients' perceptions of the role of their social context in relation to returning to work following treatment. Methods Twenty-three patients who had received a diagnosis of either urological, breast, gynaecological, or bowel cancer participated in semi-structured interviews examining general perceptions of cancer, work values and perceptions of the potential impact of their cancer diagnosis and treatment on work. Interviews were analysed using the iterative process of Framework Analysis. Results Two superordinate themes emerged as influential in the return to work process: Social support as a facilitator of return to work (e.g. co-workers' support and support outside of the workplace) and Social comparison as an appraisal of readiness to return to work (e.g. comparisons with other cancer patients, colleagues, and employees in other organisations or professions). Conclusions Two functions of the social context of returning to work after cancer were apparent in the participants' narrative: the importance of social support as a facilitator of returning to work and the utilisation of social comparison information in order to appraise one's readiness to return to work. The role of social context in returning to work has largely been absent from the research literature to date. The findings of this study suggest that social support and social comparison mechanisms may have a significant impact on an individual's successful return to the workplace.
Collapse
Affiliation(s)
- M Armaou
- Faculty of Health and Life Sciences, Coventry University, Coventry, UK.
| | - L Schumacher
- Faculty of Health and Life Sciences, Coventry University, Coventry, UK
| | - E A Grunfeld
- Department of Psychological Sciences, Birkbeck, University of London, Malet Street, London, WC1E 7HX, UK
| |
Collapse
|
23
|
den Bakker CM, Anema JR, Zaman AGNM, de Vet HCW, Sharp L, Angenete E, Allaix ME, Otten RHJ, Huirne JAF, Bonjer HJ, de Boer AGEM, Schaafsma FG. Prognostic factors for return to work and work disability among colorectal cancer survivors; A systematic review. PLoS One 2018; 13:e0200720. [PMID: 30110333 PMCID: PMC6093640 DOI: 10.1371/journal.pone.0200720] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 07/02/2018] [Indexed: 12/22/2022] Open
Abstract
Background Colorectal cancer is diagnosed progressively in employed patients due to screening programs and increasing retirement age. The objective of this study was to identify prognostic factors for return to work and work disability in patients with colorectal cancer. Methods The research protocol was published at PROSPERO with registration number CRD42017049757. A systematic review of cohort and case-control studies in colorectal cancer patients above 18 years, who were employed when diagnosed, and who had a surgical resection with curative intent were included. The primary outcome was return to work or work disability. Potentially prognostic factors were included in the analysis if they were measured in at least three studies. Risk of bias was assessed according to the QUality In Prognosis Studies tool. A qualitative synthesis analysis was performed due to heterogeneity between studies. Quality of evidence was evaluated according to Grading of Recommendation Assessment, Development and Evaluation. Results Eight studies were included with a follow-up period of 26 up to 520 weeks. (Neo)adjuvant therapy, higher age, and more comorbidities had a significant negative influence on return to work. A previous period of unemployment, extensive surgical resection and postoperative complications significantly increased the risk of work disability. The quality of evidence for these prognostic factors was considered very low to moderate. Conclusion Health care professionals need to be aware of these prognostic factors to select patients eligible for timely intensified rehabilitation in order to optimize the return to work process and prevent work disability.
Collapse
Affiliation(s)
- Chantal M. den Bakker
- Department of Occupational and Public Health, VU University medical center, Amsterdam Public Health research institute, Amsterdam, The Netherlands
- Department of Surgery, VU University medical center, Amsterdam, The Netherlands
- * E-mail:
| | - Johannes R. Anema
- Department of Occupational and Public Health, VU University medical center, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - AnneClaire G. N. M. Zaman
- Academic Medical Center, Amsterdam Public Health research institute, Coronel Institute of Occupational Health, University of Amsterdam, Amsterdam, The Netherlands
| | - Henrika C. W. de Vet
- Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, VU University medical center, Amsterdam, The Netherlands
| | - Linda Sharp
- Institute of Health & Society, Newcastle University, Newcastle, United Kingdom
| | - Eva Angenete
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Göteburg, Sweden
| | - Marco E. Allaix
- Department of Surgical Sciences, University of Torino, Torino, Italy
| | | | - Judith A. F. Huirne
- Department of Gynaecology, VU University medical center, Amsterdam, The Netherlands
| | - Hendrik J. Bonjer
- Department of Surgery, VU University medical center, Amsterdam, The Netherlands
| | - Angela G. E. M. de Boer
- Academic Medical Center, Amsterdam Public Health research institute, Coronel Institute of Occupational Health, University of Amsterdam, Amsterdam, The Netherlands
| | - Frederieke G. Schaafsma
- Department of Occupational and Public Health, VU University medical center, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| |
Collapse
|
24
|
Kiasuwa Mbengi RL, Nicolaie AM, Goetghebeur E, Otter R, Mortelmans K, Missinnne S, Arbyn M, Bouland C, de Brouwer C. Assessing factors associated with long-term work disability after cancer in Belgium: a population-based cohort study using competing risks analysis with a 7-year follow-up. BMJ Open 2018; 8:e014094. [PMID: 29455161 PMCID: PMC5855469 DOI: 10.1136/bmjopen-2016-014094] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 10/17/2017] [Accepted: 10/26/2017] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES The number of workers with cancer has dramatically increasing worldwide. One of the main priorities is to preserve their quality of life and the sustainability of social security systems. We have carried out this study to assess factors associated with the ability to work after cancer. Such insight should help with the planning of rehabilitation needs and tailored programmes. PARTICIPANTS We conducted this register-based cohort study using individual data from the Belgian Disability Insurance. Data on 15 543 socially insured Belgian people who entered into the long-term work disability between 2007 and 2011 due to cancer were used. PRIMARY AND SECONDARY OUTCOME MEASURES We estimated the duration of work disability using Kaplan-Meier and the cause-specific cumulative incidence of ability to work stratified by age, gender, occupational class and year of entering the work disability system for 11 cancer sites using the Fine and Gray model allowing for competing risks. RESULTS The overall median time of work disability was 1.59 years (95% CI 1.52 to 1.66), ranging from 0.75 to 4.98 years. By the end of follow-up, more than one-third of the disabled cancer survivors were able to work (35%). While a large proportion of the women were able to work at the end of follow-up, the men who were able to work could do so sooner. Being women, white collar, young and having haematological, male genital or breast cancers were factors with the bestlikelihood to be able to return to work. CONCLUSION Good prognostic factors for the ability to work were youth, woman, white collar and having breast, male genital or haematological cancers. Reviewing our results together with the cancer incidence predictions up to 2025 offers a high value for social security and rehabilitation planning and for ascertaining patients' perspectives.
Collapse
Affiliation(s)
- Régine Levo Kiasuwa Mbengi
- Belgian Cancer Centre, Scientific Insitute of Public Health, Brussels, Belgium
- Research Centre for Environmental and Occupational Health, Brussels School of Public Health, Université Libre de Bruxelles (ESP-ULB), Brussels, Belgium
| | | | | | - Renee Otter
- Belgian Cancer Centre, Scientific Insitute of Public Health, Brussels, Belgium
| | | | - Sarah Missinnne
- Belgian Cancer Centre, Scientific Insitute of Public Health, Brussels, Belgium
| | - Marc Arbyn
- Unit of Cancer Epidemiology, Scientific Institute of Public Health, Brussels, Belgium
| | - Catherine Bouland
- Research Centre for Environmental and Occupational Health, Brussels School of Public Health, Université Libre de Bruxelles (ESP-ULB), Brussels, Belgium
| | - Christophe de Brouwer
- Research Centre for Environmental and Occupational Health, Brussels School of Public Health, Université Libre de Bruxelles (ESP-ULB), Brussels, Belgium
| |
Collapse
|
25
|
Petersen KS, Momsen AH, Stapelfeldt CM, Olsen PR, Nielsen CV. Return-to-work intervention during cancer treatment - The providers' experiences. Eur J Cancer Care (Engl) 2017; 27:e12793. [PMID: 29205611 DOI: 10.1111/ecc.12793] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2017] [Indexed: 11/26/2022]
Abstract
To explore in-depth understanding of providers' experiences when involved in a return-to-work (RTW) intervention offered during cancer treatment. Semi-structured individual interviews and participant observations at a hospital department and two municipal job centers were carried out, including ten providers (physicians, nurses and social workers). A phenomenological-hermeneutic approach was applied, involving coding, identification of themes and interpretation of findings. Three major themes were identified: Treatment first, Work as an integrated component in cancer rehabilitation, and Challenges in bringing up work issues. Differences in providers' experiences of the RTW intervention offered to cancer patients were found: in the hospital setting RTW was a second priority, whereas in the municipality job centers it was an integrated component. Further studies are needed to investigate how and when occupational rehabilitation services can be implemented across sectors to support cancer patients' RTW. In the future, work issues ought to be systematically presented by providers across sectors as early as possible to support cancer patients' RTW. Cancer patients' individual needs and thoughts about RTW are to be identified by both health care providers during treatment and social workers at the municipality level and shared across sectors.
Collapse
Affiliation(s)
- K S Petersen
- Department of Medicine and Health Technology, Faculty of Health Sciences, Aalborg University, Aalborg East, Denmark
| | - A H Momsen
- Department of Public Health, Section of Social Medicine and Rehabilitation, Central Region Denmark, Aarhus University and DEFACTUM, Aarhus, Denmark
| | - C M Stapelfeldt
- Department of Public Health, Section of Social Medicine and Rehabilitation, Central Region Denmark, Aarhus University and DEFACTUM, Aarhus, Denmark
| | - P R Olsen
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - C V Nielsen
- Department of Public Health, Section of Social Medicine and Rehabilitation, Central Region Denmark, Aarhus University and DEFACTUM, Aarhus, Denmark
| |
Collapse
|
26
|
Lee MK, Kang HS, Lee KS, Lee ES. Three-Year Prospective Cohort Study of Factors Associated with Return to Work After Breast Cancer Diagnosis. JOURNAL OF OCCUPATIONAL REHABILITATION 2017; 27:547-558. [PMID: 27858198 DOI: 10.1007/s10926-016-9685-7] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Purpose The purpose of this prospective cohort study of breast cancer survivors was to identify factors before diagnosis, during treatment, and after treatment that are associated with return to work (RTW). Methods A total of 288 women with breast cancer (stage I-III) and whose age were 18-65 years-old answered questionnaires at 4-6, 12, 24, and 36 months after diagnosis. The surveys asked about performance of regular exercise and health-related quality of life issues. "RTW at 36 months" was assigned to patients who reported any of the following: working at least twice; no job at baseline but working more than once; job at baseline, stopped working, and then started working again; and working during all 3 years. Results We classified 107 of 288 of the women (37.1%) as having returned to work. Analysis of pre-diagnostic factors indicated that more education and practice of regular endurance exercise were positively associated with RTW. Analysis of factors during treatment indicated that appetite loss and fatigue were negatively associated with RTW. Analysis of factors at post-treatment indicated that better body image, better physical function, better existential well-being, and participation in regular endurance and resistance exercise were positively associated with RTW. Childbirth at 12-24 months was negatively associated with RTW. Conclusion Women who participate in exercise before, during, and after treatment for breast cancer are more likely to RTW. A woman's need to care for children, perceived body image, and existential well-being may also affect her RTW.
Collapse
Affiliation(s)
- Myung Kyung Lee
- College of Nursing, Research Institute of Nursing Science, Kyungpook National University, Daegu, Republic of Korea
| | - Han Sung Kang
- Center for Breast Cancer, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Republic of Korea
| | - Keun Seok Lee
- Center for Breast Cancer, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Republic of Korea
| | - Eun Sook Lee
- Center for Breast Cancer, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 10408, Republic of Korea.
| |
Collapse
|
27
|
Clur L, Barnard A, Joubert YT. Work adjustment of cancer survivors: An organisational support framework. SA JOURNAL OF INDUSTRIAL PSYCHOLOGY 2017. [DOI: 10.4102/sajip.v43i0.1468] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
|
28
|
Endo M, Haruyama Y, Muto G, Kiyohara K, Mizoue T, Kojimahara N, Yamaguchi N. Work Sustainability Among Male Cancer Survivors After Returning to Work. J Epidemiol 2017; 28:88-93. [PMID: 29093353 PMCID: PMC5800885 DOI: 10.2188/jea.je20160152] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background Few studies have investigated the work continuance rate among cancer survivors after return to work (RTW). The objective of this study was to clarify work sustainability after RTW among Japanese male cancer survivors. Methods We collected data on male cancer survivors from an occupational health register. Inclusion criteria were as follows: employees who returned to work after an episode of sick leave due to clinically certified cancer diagnosed between January 1, 2000 and December 31, 2011. Results Of 1,033 male employees who were diagnosed with cancer, 786 employees (76.1%) returned to work after their first episode of sick leave due to cancer. Work continuance rates among all subjects were 80.1% 1 year after RTW and 48.5% 5 years after RTW. The mean duration of work after RTW was 4.5 years. The work continuance rates varied significantly by cancer type. The “Lung” and “Hepatic, Pancreatic” cancer groups had the shortest duration of work (0.9 year after RTW). Conclusions Of workers who returned to work after their first episode of leave after cancer, 50% continued to work after 5 years in large-scale companies. There was a steep decrease in work continuance rates during the first year after RTW, with considerable differences according to cancer site.
Collapse
Affiliation(s)
- Motoki Endo
- Department of Public Health, Tokyo Women's Medical University
| | - Yasuo Haruyama
- Department of Public Health, Dokkyo Medical University, School of Medicine
| | - Go Muto
- Department of Epidemiology and Environmental Health, Juntendo University Faculty of Medicine
| | - Kosuke Kiyohara
- Department of Public Health, Tokyo Women's Medical University
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine
| | | | | |
Collapse
|
29
|
van Egmond MP, Duijts SFA, Jonker MA, van der Beek AJ, Anema JR. Effectiveness of a tailored return to work program for cancer survivors with job loss: results of a randomized controlled trial. Acta Oncol 2016; 55:1210-1219. [PMID: 27549145 DOI: 10.1080/0284186x.2016.1213417] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Up to 53% of cancer survivors (CSs) experiences job loss during or after treatment. To support CSs with job loss in the Netherlands, a tailored return to work (RTW) program was developed. The objective of this study was to assess the effectiveness of the program on duration until sustainable RTW in CSs with job loss. MATERIAL AND METHODS This study employed a two-armed (intervention/control) randomized controlled design with one-year follow-up. The primary outcome measure was duration until sustainable RTW. The secondary outcome measures were: rate of RTW, fatigue, quality of life, and participation in society. Descriptive analyses, Kaplan-Meier estimators and Cox regression analyses were conducted. RESULTS Participants (N = 171) had a mean age of 48.4 years (SD = 8.6). The majority was female (69%) and breast cancer survivor (40%). The crude hazard ratio (HR) for duration until sustainable RTW was 0.86 (95% CI 0.46-1.62; p = 0.642). In the adjusted model, the intervention group had a slight, but statistically non-significant, improvement in duration until sustainable RTW compared to the control group (HR 1.16; 95% CI 0.59-2.31; p = 0.663). The program did not have any significant effects on secondary outcome measures. CONCLUSION As the tailored RTW program did not demonstrate a statistically significant effect on duration until sustainable RTW in CSs with job loss, implementation of the program in its current form is not recommended.
Collapse
Affiliation(s)
- M. P. van Egmond
- Department of Public and Occupational Health, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
- Research Center for Insurance Medicine, AMC-UMCG-UWV-VUmc, The Netherlands
| | - S. F. A. Duijts
- Department of Public and Occupational Health, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - M. A. Jonker
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - A. J. van der Beek
- Department of Public and Occupational Health, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
- Research Center for Insurance Medicine, AMC-UMCG-UWV-VUmc, The Netherlands
| | - J. R. Anema
- Department of Public and Occupational Health, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
- Research Center for Insurance Medicine, AMC-UMCG-UWV-VUmc, The Netherlands
| |
Collapse
|
30
|
Wienert J, Schwarz B, Bethge M. Effectiveness of work-related medical rehabilitation in cancer patients: study protocol of a cluster-randomized multicenter trial. BMC Cancer 2016; 16:544. [PMID: 27465148 PMCID: PMC4964285 DOI: 10.1186/s12885-016-2563-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 07/14/2016] [Indexed: 11/21/2022] Open
Abstract
Background Work is a central resource for cancer survivors as it not only provides income but also impacts health and quality of life. Additionally, work helps survivors to cope with the perceived critical life event. The German Pension Insurance provides medical rehabilitation for working-age patients with chronic diseases to improve and restore their work ability, and support returning to or staying at work, and thus tries to sustainably avoid health-related early retirement. Past research showed that conventional medical rehabilitation programs do not support returning to work sufficiently and that work-related medical rehabilitation programs report higher return-to-work rates across several health conditions, when compared to medical rehabilitation. Therefore, the current study protocol outlines an effectiveness study of such a program for cancer survivors. Methods To evaluate the effectiveness of work-related medical rehabilitation in cancer patients we conduct a cluster-randomized multicenter trial. In total, 504 rehabilitation patients between 18 and 60 years with a Karnofsky Performance Status of ≥70 %, a preliminary positive social-medical prognosis of employability for at least 3 h/day within the next 6 months and an elevated risk of not returning to work will be recruited in four inpatient rehabilitation centers. Patients are randomized to the work-related medical rehabilitation program or the conventional medical rehabilitation program based on their week of arrival at each rehabilitation center. The work-related medical rehabilitation program comprises additional work-related diagnostics, multi-professional team meetings, an introductory session as well as work-related functional capacity training, work-related psychological groups, and social counseling. All additional components are aimed at the adjustment of the patients’ capacity in relation to their individual job demands. Role functioning defines the main study outcome and will be assessed with the EORTC-QLQ30. Secondary outcome measures are the remaining scales of the EORTC-QLQ30, fatigue, self-rated work ability, disease coping, participation in working life, realization of work-related goals and therapies during rehabilitation, and treatment satisfaction. Discussion A positive evaluation of work-related medical rehabilitation in cancer patients is expected due to the promising findings on the effectiveness of such programs for patients with other health conditions. Results may support the dissemination of work-related medical rehabilitation programs in German cancer rehabilitation. Trial registration German Clinical Trials Register DRKS00007770. Registered 13 May 2015. Electronic supplementary material The online version of this article (doi:10.1186/s12885-016-2563-z) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Julian Wienert
- Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany.
| | - Betje Schwarz
- Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Matthias Bethge
- Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| |
Collapse
|
31
|
Ganem G, Antoine EC, Touboul C, Naman H, Dohollou N, Facchini T, Coscas Y, Lortholary A, Catala S, Jacquot S, Lhomel C, Eisinger F. Maintaining professional activity during breast cancer treatment. Eur J Cancer Care (Engl) 2016; 25:458-65. [DOI: 10.1111/ecc.12460] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2016] [Indexed: 11/29/2022]
Affiliation(s)
- G. Ganem
- Clinique Victor Hugo; Le Mans France
| | | | | | - H. Naman
- Centre Azuréen de Cancérologie; Mougins France
| | - N. Dohollou
- Polyclinique Bordeaux Nord Aquitaine; Bordeaux France
| | | | - Y. Coscas
- Clinique de la Porte de Saint Cloud; Boulogne-Billancourt France
| | | | - S. Catala
- Clinique Saint Pierre; Perpignan France
| | - S. Jacquot
- Clinique Clémentville; Montpellier France
| | - C. Lhomel
- Institutional Department; Roche; Boulogne-Billancourt France
| | | |
Collapse
|
32
|
Working with cancer: health and employment among cancer survivors. Ann Epidemiol 2015; 25:832-8. [PMID: 26320705 PMCID: PMC9884513 DOI: 10.1016/j.annepidem.2015.07.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Revised: 07/11/2015] [Accepted: 07/13/2015] [Indexed: 01/31/2023]
Abstract
PURPOSE Cancer affects a growing proportion of US workers. Factors contributing to whether they continue or return to work after cancer diagnosis include: age, physical and mental health, health insurance, education, and cancer site. The purpose of this study was to assess the complex relationships between health indicators and employment status for adult cancer survivors. METHODS We analyzed pooled data from the 1997-2012 US National Health Interview Survey (NHIS). Our sample included adults with a self-reported physician diagnosis of cancer (n = 24,810) and adults with no cancer history (n = 382,837). Using structural equation modeling (SEM), we evaluated the relationship between sociodemographic factors, cancer site, and physical and mental health indicators on the overall health and employment status among adults with a cancer history. RESULTS The overall model for cancer survivors fit the data well (χ(2) (374) = 3654.7, P < .001; comparative fit index = 0.98; root mean square error of approximation = 0.04). Although black cancer survivors were less likely to report good-to-excellent health, along with Hispanic survivors, they were more likely to continue to work after diagnosis compared with their white counterparts. Health insurance status and educational level were strongly and positively associated with health status and current employment. Age and time since diagnosis were not significantly associated with health status or employment, but there were significant differences by cancer site. CONCLUSIONS A proportion of cancer survivors may continue to work because of employment-based health insurance despite reporting poor health and significant physical and mental health limitations. Acute and long-term health and social support are essential for the continued productive employment and quality of life of all cancer survivors.
Collapse
|
33
|
Keim-Malpass J, Levine B, Danhauer SC, Avis NE. Work-related perceptions and quality of life among breast cancer survivors. Psychooncology 2015; 25:873-6. [PMID: 26315583 DOI: 10.1002/pon.3951] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Revised: 06/11/2015] [Accepted: 08/05/2015] [Indexed: 11/07/2022]
Affiliation(s)
| | - Beverly Levine
- Wake Forest School of Medicine, Department of Social Sciences and Health Policy, Winston-Salem, NC, USA
| | - Suzanne C Danhauer
- Wake Forest School of Medicine, Department of Social Sciences and Health Policy, Winston-Salem, NC, USA
| | - Nancy E Avis
- Wake Forest School of Medicine, Department of Social Sciences and Health Policy, Winston-Salem, NC, USA
| |
Collapse
|
34
|
Stapelfeldt CM, Labriola M, Jensen AB, Andersen NT, Momsen AMH, Nielsen CV. Municipal return to work management in cancer survivors undergoing cancer treatment: a protocol on a controlled intervention study. BMC Public Health 2015. [PMID: 26215644 PMCID: PMC4517365 DOI: 10.1186/s12889-015-2062-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background Cancer survivors are often left on their own to deal with the challenges of resuming work during or after cancer treatment, mainly due to unclear agreements between stakeholders responsible for occupational rehabilitation. Social inequality exists in cancer risk, survival probability and continues with regard to the chance of being able to return to work. The aim is to apply an early, individually tailored occupational rehabilitation intervention to cancer survivors in two municipalities parallel with cancer treatment focusing on enhancing readiness for return to work. Methods/Design In a controlled trial municipal job consultants use acceptance and commitment therapy dialogue and individual-placement-and-support-inspired tools with cancer survivors to engage them in behaviour changes toward readiness for return to work. The workplace is involved in the return to work process. Patients referred to surgery, radiotherapy or chemotherapy at the Oncology Department, Aarhus University Hospital, Denmark for the diagnoses; breast, colon-rectal, head and neck, thyroid gland, testicular, ovarian or cervix cancer are eligible for the study. Patients must be residents in the municipalities of Silkeborg or Randers, 18–60 years of age and have a permanent or temporary employment (with at least 6 months left of their contract) at inclusion. Patients, for whom the treating physician considers occupational rehabilitation to be unethical, or who are not reading or talking Danish are excluded. The control group has identical inclusion and exclusion criteria except for municipality of residence. Return to work is the primary outcome and is indentified in a social transfer payment register. Effect is assessed as relative cumulative incidences within 52 weeks and will be analysed in generalised linear regression models using the pseudo values method. As a secondary outcome; co-morbidity and socio-economic status is analysed as effect modifiers of the intervention effect on return to work. Discussion The innovative element of this intervention is the timing of the occupational rehabilitation which is much earlier initiated than usual and the active involvement of the workplace. We anticipate that vulnerable cancer survivors will benefit from this approach and reduce the effects of social inequality on workability. Trial registration Current Controlled Trials ISRCTN50753764. Registered August 21st, 2014.
Collapse
Affiliation(s)
- Christina M Stapelfeldt
- Public Health and Quality Improvement - CFK, Central Denmark Region, MarselisborgCentret, P.P. Oerums Gade 11, Building 1B, 8000, Aarhus C, Denmark.
| | - Merete Labriola
- Public Health and Quality Improvement - CFK, Central Denmark Region, MarselisborgCentret, P.P. Oerums Gade 11, Building 1B, 8000, Aarhus C, Denmark
| | | | - Niels Trolle Andersen
- Section of Biostatistics, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Anne-Mette H Momsen
- Public Health and Quality Improvement - CFK, Central Denmark Region, MarselisborgCentret, P.P. Oerums Gade 11, Building 1B, 8000, Aarhus C, Denmark
| | - Claus Vinther Nielsen
- Public Health and Quality Improvement - CFK, Central Denmark Region, MarselisborgCentret, P.P. Oerums Gade 11, Building 1B, 8000, Aarhus C, Denmark.,Section of Clinical Social Medicine and Rehabilitation, Department of Public Health, Aarhus University, Aarhus, Denmark
| |
Collapse
|
35
|
Mitchell T. Both sides of the couch: a qualitative exploration of the experiences of female healthcare professionals returning to work after treatment for cancer. Eur J Cancer Care (Engl) 2015; 24:840-53. [DOI: 10.1111/ecc.12308] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2015] [Indexed: 12/01/2022]
Affiliation(s)
- T. Mitchell
- Faculty of Health and Applied Sciences; University of the West of England; Bristol UK
| |
Collapse
|
36
|
Abstract
Employment issues for cancer survivors (CS) were investigated from the perspective of Northern Ireland government general employment advisors. An e-survey was designed and developed based on the results of a scoping search of journal articles, previously validated questionnaires and relevant related surveys; discussions of draft versions of the e-survey and method with lead representatives of stakeholder organizations; and a pilot study with seven prospective respondents. The e-survey and subsequent reminder to employment advisors were distributed internally by the government employment advisory agency. The e-survey was completed by 78/156 (50%) advisors, the majority of whom (74%) received a request for advice in the last year from at least one CS. Most CS used the employment service less than 1 year (52%) or 1 year or more after treatment (32%). Fatigue was the most commonly reported barrier to returning to work (10%) and staying in work (14%), and a supportive employer was the top facilitating factor in returning to (21%) and continuing in (27%), employment. Although most advisors had a positive attitude about a CS's capacity to return to work, half were uncertain about how best to advise cancer survivors.
Collapse
Affiliation(s)
- Emma R Lawlor
- a UKCRC Centre of Excellence for Public Health (Northern Ireland), School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast , Belfast , Northern Ireland
| | | |
Collapse
|
37
|
Mackenzie CR. ‘It is hard for mums to put themselves first’: How mothers diagnosed with breast cancer manage the sociological boundaries between paid work, family and caring for the self. Soc Sci Med 2014; 117:96-106. [DOI: 10.1016/j.socscimed.2014.07.043] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Revised: 07/08/2014] [Accepted: 07/17/2014] [Indexed: 11/30/2022]
|
38
|
Goss C, Leverment IMG, de Bono AM. Breast cancer and work outcomes in health care workers. Occup Med (Lond) 2014; 64:635-7. [DOI: 10.1093/occmed/kqu122] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
39
|
Returning to work following curative chemotherapy: a qualitative study of return to work barriers and preferences for intervention. Support Care Cancer 2014; 22:3263-73. [PMID: 25066834 DOI: 10.1007/s00520-014-2324-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 06/16/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE This study aimed to explore barriers to return to work (RTW) and preferences for intervention and support for cancer patients treated with curative intent from the perspectives of cancer survivors and oncology health professionals. METHODS Participants attended a focus group (N = 24) or an individual interview (N = 14). A topic guide and a semi-structured recorded interview format were used to gather data, which were later transcribed and analysed for global themes and subthemes. RESULTS With regard to barriers, the global theme 'work capacity' captured an array of barriers encompassing financial pressure, preparedness for work, lack of confidence as well as other key physical, practical and psychosocial barriers. Participants expressed a preference for RTW models that focus on objective and structured assessment whilst allowing for flexibility to address individual needs. CONCLUSIONS Cancer survivors perceive multiple barriers when attempting to RTW. These barriers were perceived to impact upon work capacity, where 'capacity' was defined broadly to include practical, physical and psychosocial concerns. RTW is an important concern for cancer survivors and structured RTW interventions should be incorporated into the care of cancer survivors.
Collapse
|
40
|
Long-term workforce participation patterns following head and neck cancer. J Cancer Surviv 2014; 9:30-9. [PMID: 25060809 DOI: 10.1007/s11764-014-0382-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Accepted: 06/30/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE This analysis describes the long-term workforce participation patterns of individuals diagnosed with head and neck cancer (HNC). METHODS Survivors of HNC (ICD10 C00-C14, C32) diagnosed at least 8 months previously were identified from the National Cancer Registry Ireland and sent a survey including questions about working arrangements before and since diagnosis. Descriptive statistics and multivariate logistic regression were used to examine the factors that influence workforce participation at 0, 1 and 5 years after diagnosis. RESULTS Two hundred sixty-four individuals employed at the time of diagnosis responded to the survey, an average 6 years post-diagnosis. Seventy-seven percent took time off work after diagnosis, with a mean work absence of 9 months (range 0-65 months). Fifty-two percent of participants reduced their working hours (mean reduction 15 h/week). The odds of workforce participation following HNC were increased by not being eligible for free medical care (OR 2.61, 95% CI 1.15-5.94), having lip, mouth or salivary gland cancer (compared to cancer of the pharynx or cancer of the larynx, OR 2.79, 1.20-6.46), being self-employed (OR 2.01, 1.07-3.80), having private health insurance (OR 2.06, 1.11-3.85) and not receiving chemotherapy (OR 2.82, 1.31-6.06). After 5 years, only the effect of medical card remained (i.e., medical insurance) (OR 4.03, 1.69-9.62). CONCLUSIONS Workforce participation patterns after HNC are complex and are influenced by cancer, treatment and employment factors. IMPLICATIONS FOR CANCER SURVIVORS Patients should be informed of the potential impacts of HNC on workforce participation, and clinicians, policy makers and employers should be aware of these potential longer-term effects and related variables.
Collapse
|
41
|
Braybrooke JP, Mimoun S, Zarca D, Elia D, Pinder B, Lloyd AJ, Breheny K, Lomazzi M, Borisch B. Patients' experiences following breast cancer treatment: an exploratory survey of personal and work experiences of breast cancer patients from three European countries. Eur J Cancer Care (Engl) 2014; 24:650-61. [PMID: 25053521 DOI: 10.1111/ecc.12222] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2014] [Indexed: 11/28/2022]
Abstract
Improved treatments for early breast cancer have led to a significant increase in overall survival. While evidence regarding potential long-term sequelae of adjuvant treatments exists, relatively little research reports patients' own perceptions of change before and after adjuvant chemotherapy (AC). This study aimed to identify key ongoing issues associated with AC in daily life. An online survey developed for this study was completed by 198 women (mean age 49.7 years) in the UK, France and Germany who had AC 1-5 years previously for oestrogen receptor positive, HER2 negative early breast cancer. Women without AC and endocrine therapy, those treated with Trastuzumab or who had recurrent disease were excluded. A third of women who responded were currently unable to perform their former family role. The majority had needed support, particularly with child care, during treatment. While 54% were in full-time employment before diagnosis this had reduced to 32% following AC. Of those women still working, over half reported difficulties with tiredness or concentration. Most (85.8%) were satisfied with healthcare professionals' treatment information, but only 29.7% received information about returning to work. This exploratory survey highlights areas of women's lives affected 1-5 years following AC for early breast cancer. The impact on returning to work and issues surrounding childcare particularly, require further study.
Collapse
Affiliation(s)
| | | | | | | | - B Pinder
- ICON Patient Reported Outcomes, Oxford, UK
| | - A J Lloyd
- ICON Patient Reported Outcomes, Oxford, UK
| | - K Breheny
- Health Economics, School of Health and Population Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - M Lomazzi
- Institute of Global Health, University of Geneva, Genève, Switzerland
| | - B Borisch
- Institute of Global Health, University of Geneva, Genève, Switzerland
| |
Collapse
|
42
|
Désiron HAM, Donceel P, Godderis L, Van Hoof E, de Rijk A. What is the value of occupational therapy in return to work for breast cancer patients? A qualitative inquiry among experts. Eur J Cancer Care (Engl) 2014; 24:267-80. [PMID: 24961966 DOI: 10.1111/ecc.12209] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2014] [Indexed: 11/30/2022]
Abstract
An increasing number of patients are confronted with breast cancer (BC) and functional limitations after treatment. Occupational therapy (OT) is successful in return to work (RTW), but not yet available for BC patients. This paper explores experts' opinions on OT interventions for RTW in BC patients in the Belgian context. Primary data were topic-interviews with all heads of OT departments in Flemish University Hospitals (n = 5). Secondary data were four focus group interviews with care professionals in oncological rehabilitation (n = 41). All data were transcribed and thematic analysis was used. Integrated in multidisciplinary teamwork, OT interventions should have a holistic and client-centred approach, start early in the rehabilitation process, include workplace visits and contacts with relevant stakeholders, and use goal setting to start up tailor made rehabilitation, linking assessment of abilities and work. Occupational therapists are regarded as professionals who can effectively answer BC patients unmet needs regarding RTW due to their skill to bridge between care and workplace. According to the experts, OT interventions supporting RTW in BC patients are useful when integrated in regular healthcare. They agree on the components but organisational barriers should be removed, for example not providing reimbursement for including this type of support trough healthcare insurance.
Collapse
Affiliation(s)
- H A M Désiron
- Centre Environment & Health, Katholieke Universiteit Leuven, Leuven, Belgium
| | | | | | | | | |
Collapse
|
43
|
Vanderpool RC, Swanberg JE, Chambers MD. A Narrative Review of the Confluence of Breast Cancer and Low-wage Employment and Its Impact on Receipt of Guideline-recommended Treatment. Glob Adv Health Med 2014; 2:75-85. [PMID: 24416698 PMCID: PMC3833560 DOI: 10.7453/gahmj.2013.046] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Breast cancer is the leading cause of cancer among women in the United States, costing the healthcare system, employers, and society billions of dollars each year. Despite improvements in screening and treatment, significant breast cancer treatment and survivorship disparities exist among various groups of women. One variable that has not been explored extensively as a possible contributor to breast cancer treatment disparities is employment. This is concerning, given the changing economic and employment trends in the United States favoring low-wage employment. Currently, one-quarter to one-third of all US workers are considered to be working poor, and women are disproportionally represented in this group. Characteristics of low-wage work-limited paid time off, minimal health benefits, schedule inflexibility, and economic insecurity-may become even more significant in the event of a breast cancer diagnosis. To date, there has been limited research into how job conditions inherent to low-wage work may influence working poor survivors' receipt of guideline-recommended breast cancer treatment. Therefore, the purpose of this narrative review was to critically examine the current literature to further our understanding of how employment context may impact treatment decisions and adherence-and therefore receipt of guideline-recommended care-among newly diagnosed, working poor breast cancer survivors. After undertaking a comprehensive review, we failed to identify any published literature that explicitly addressed low-wage employment and receipt of guideline-recommended breast cancer treatment. Four articles reported circumstances where women delayed, missed, or quit treatments due to work interference, or alternatively, developed strategies that allowed them to continue to work and obtain their breast cancer treatment concurrent with medical and economic challenges. An additional five articles, while focused on other cancer and employment outcomes, described the need for increased patient-provider communication about the influence of work on treatment decisions and the development of alternative treatment plans. Due to the paucity of research in this area, future policy, practice, and research efforts should focus on the employment context of working poor breast cancer survivors as a potential contributor to cancer disparities. Engagement of women, employers, oncology providers, healthcare systems, and interdisciplinary researchers is warranted to improve cancer outcomes among this disparate population of working women.
Collapse
Affiliation(s)
- Robin C Vanderpool
- University of Kentucky College of Public Health, Department of Health Behavior, Lexington, United States
| | | | - Mara D Chambers
- University of Kentucky College of Medicine, Markey Cancer Center, Comprehensive Breast Care Center, Lexington, United States
| |
Collapse
|
44
|
Abstract
BACKGROUND Improvements in some treatment programs for multiple myeloma (MM) are increasing survival. As patients live longer with MM as a chronic disease, the personal financial effects of MM treatment become a serious concern. OBJECTIVE The objective of this study was to identify the personal financial effects of MM and its treatment in 5 areas: employment, disability, health/medical and life insurance, retirement, and out-of-pocket expenses. METHODS We mailed a questionnaire about financial issues to 1015 patients who had received intensive treatment for MM at the study site. Data analysis included descriptive statistics and comparisons using independent t tests. RESULTS Our sample (n = 762; mean age, 61 [SD, 9.26] years) experienced issues with employment (66% employed at diagnosis and treatment; 33% employed at questionnaire time), disability (35% applied), health/medical and life insurance (29% lost coverage and 8% changed coverage), retirement (13% retired during treatment), and out-of-pocket expenses (36% of income in first treatment year and 28% of income during most recent 12 months). CONCLUSIONS Issues of employment, disability, health insurance, retirement, and out-of-pocket costs for treatment are major challenges for patients. IMPLICATIONS FOR PRACTICE In the midst of assessing physical needs during clinical trials for chemotherapy and stem cell transplants, healthcare providers must keep sight of patients' personal financial needs so that we can intervene promptly with referrals to social work, rehabilitation therapy, and other healthcare professions to help patients decrease the personal financial effects of MM and its treatment.
Collapse
|
45
|
Vidor C, Leroyer A, Christophe V, Seillier M, Foncel J, Van de Maële J, Bonneterre J, Fantoni S. Decrease social inequalities return-to-work: development and design of a randomised controlled trial among women with breast cancer. BMC Cancer 2014; 14:267. [PMID: 24742314 PMCID: PMC4004459 DOI: 10.1186/1471-2407-14-267] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Accepted: 03/25/2014] [Indexed: 12/01/2022] Open
Abstract
Background Despite the improvement in the care management, women cancer patients who are still in employment find themselves for the most part obliged to stop working while they are having treatment. Their return-to-work probability is impacted by numerous psychosocial factors. The objective is to describe the development and the content of an intervention aimed to facilitate the return to work of female breast cancer patients and in particular the women in the most precarious situations through early active individualised psychosocial support (APAPI). Methods The intervention proposed is made up of 4 interviews with a psychologist at the hospital, distributed over the year according to the diagnosis and conducted on the same day as a conventional follow-up consultation, then a consultation with a specialist job retention physician. We expect, in the first instance, that this intervention will reduce the social inequalities of the return-to-work rate at 12 months. The EPICES score will enable the population to be broken down according to the level of social precariousness. The other expected results are the reduction of the social inequalities in the quality of the return to work at 18 and 24 months and the disparities between the individual and collective resources of the patients. This intervention is assessed in the context of a controlled and randomised multi-centre study. The patients eligible are women aged between 18 and 55 years with a unilateral breast cancer with local extension exclusively, having received surgery followed by adjuvant chemotherapy, in employment at the time of the diagnosis and dealt with by one of the 2 investigating centres. Discussion It is essential to assess this type of intervention before envisaging its generalisation. The study set in place will enable us to measure the impact of this intervention aiming to facilitate the return to work of breast cancer patients, in particular for those who suffer from social fragility, compared with the standard care.
Collapse
Affiliation(s)
- Clémence Vidor
- University Lille Nord de France-Université de Lille III, Unité de Recherche en sciences Cognitives et Affectives (URECA) EA 1059, BP 60149, F-59653 Villeneuve-d'Ascq Cedex, France.
| | | | | | | | | | | | | | | |
Collapse
|
46
|
Prognostic factors of work disability in sick-listed cancer survivors. J Cancer Surviv 2013; 7:582-91. [PMID: 23800959 DOI: 10.1007/s11764-013-0297-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Accepted: 06/10/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE Sick-listed cancer survivors may face lasting side-effects, even after a successful completion of treatment. As a consequence, they are at risk of work disability, which may lead to job loss. Knowledge of prognostic factors of work disability may support cancer survivors in their trajectory of vocational rehabilitation. The purpose of this study was to identify prognostic factors of work disability in sick-listed cancer survivors. METHODS From the first day of sick leave, a cohort of 131 cancer survivors was followed for 24 months. Included participants were aged between 20 and 63 years. Data were collected, using questionnaires, at 10 months after reporting sick. The level of work disability, i.e., entitlement for disability compensation, was assessed by an insurance physician and a labour expert at 24 months. Univariate and multiple logistic regression analyses were performed. RESULTS In the univariate analysis, 14 variables were found to be associated with the level of work disability at 24 months. These factors were related to socio-demographics, health characteristics, work-related characteristics, and return to work (RTW) expectations. Multiple logistic regression showed that at 10-month sick leave, perception of health care providers on cancer survivors' work ability and experienced influence on RTW, both reported by workers, were significantly associated with the level of work disability at 24 months. CONCLUSION It seems in the interest of cancer survivors to take an active role in planning their RTW trajectory and to discuss RTW with their health care providers. IMPLICATIONS FOR CANCER SURVIVORS The potential role healthcare providers may play in counselling cancer survivors on RTW must not be underestimated. Cancer survivors may benefit in having control on their RTW trajectory.
Collapse
|
47
|
Brooks J, McCluskey S, King N, Burton K. Illness perceptions in the context of differing work participation outcomes: exploring the influence of significant others in persistent back pain. BMC Musculoskelet Disord 2013; 14:48. [PMID: 23363454 PMCID: PMC3562516 DOI: 10.1186/1471-2474-14-48] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Accepted: 01/29/2013] [Indexed: 11/10/2022] Open
Abstract
Background Previous research has demonstrated that the significant others of individuals with persistent back pain may have important influences on work participation outcomes. The aim of this study was to extend previous research by including individuals who have remained in work despite persistent back pain in addition to those who had become incapacitated for work, along with their significant others. The purpose of this research was to explore whether the illness beliefs of significant others differed depending on their relative’s working status, and to make some preliminary identification of how significant others may facilitate or hinder work participation for those with persistent back pain. Methods Interviews structured around the Illness Perception Questionnaire (chronic pain version) were conducted with back pain patients recruited from a hospital pain management clinic along with their significant others. Some patients had remained in work despite their back pain; others had ceased employment. Data were analysed using template analysis. Results There were clear differences between beliefs about, and reported responses to, back pain symptoms amongst the significant others of individuals who had remained in employment compared with the significant others of those who had ceased work. Three overarching themes emerged: perceived consequences of back pain, specific nature of employment and the impact of back pain on patient identity. Conclusions Significant others of employed individuals with back pain focused on the extent to which activity could still be undertaken despite back pain symptoms. Individuals out of work due to persistent back pain apparently self-limited their activity and were supported in their beliefs and behaviours by their significant others. To justify incapacity due to back pain, this group had seemingly become entrenched in a position whereby it was crucial that the individual with back pain was perceived as completely disabled. We suggest that significant others are clearly important, and potentially detrimental, sources of support to individuals with back pain. The inclusion of significant others in vocational rehabilitation programmes could potentially be a valuable way of mobilising readily accessible resources in a way that supports optimal functioning.
Collapse
Affiliation(s)
- Joanna Brooks
- Centre for Applied Psychological Research, Institute for Research in Citizenship and Applied Human Sciences, University of Huddersfield, Queensgate, Huddersfield, HD1 3DH, UK.
| | | | | | | |
Collapse
|
48
|
van Muijen P, Weevers N, Snels I, Duijts S, Bruinvels D, Schellart A, van der Beek A. Predictors of return to work and employment in cancer survivors: a systematic review. Eur J Cancer Care (Engl) 2012; 22:144-60. [DOI: 10.1111/ecc.12033] [Citation(s) in RCA: 167] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2012] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - I.A.K. Snels
- Dutch Workers Insurance Authority; Amsterdam; the Netherlands
| | | | | | | | | |
Collapse
|
49
|
Böttcher HM, Steimann M, Rotsch M, Zurborn KH, Koch U, Bergelt C. Occupational stress and its association with early retirement and subjective need for occupational rehabilitation in cancer patients. Psychooncology 2012; 22:1807-14. [PMID: 23175474 DOI: 10.1002/pon.3224] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Revised: 10/12/2012] [Accepted: 10/13/2012] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Returning to work often plays an important role for cancer survivors. Occupational stress may hamper a successful return to work, so cancer survivors should be given the opportunity to address occupational stress issues before returning to work. We investigated the amount of occupational stress among cancer patients and whether it is associated with their well-being, their subjective need for occupational rehabilitation and elevations in their risk of early retirement. METHODS At the beginning of rehabilitation, we asked cancer patients to respond to occupation-related and health-related questionnaires. We used t-tests, chi-square tests, and logistic regression analyses to address our research questions. RESULTS A total of 477 patients participated in the study. Of these, 19% were occupationally stressed, and 26% reported subjective need for occupational rehabilitation. Patients who reported work-related stress had a diminished quality of life, were more likely to report subjective need for occupational rehabilitation (OR = 2.16), and had a higher risk of early retirement (OR = 5.44). Furthermore, cancer patients reported deficits in both active coping abilities and mental stability at work. CONCLUSIONS Because occupational stress is associated with a higher risk of early retirement, both patients and physicians should take work-related problems seriously. Screening patients for occupational stress may help physicians identify patients who are at risk of experiencing problematic work re-entries. Furthermore, the results of the study suggest that cancer patients might have problems maintaining confidence in their abilities to solve work-related problems. Therefore, facilitating the development of a perception of self-efficacy might be an important treatment goal.
Collapse
Affiliation(s)
- Hilke M Böttcher
- Center of Psychosocial Medicine, Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Germany.
| | | | | | | | | | | |
Collapse
|
50
|
Ullrich A, Böttcher HM, Bergelt C. Geschlechtsspezifische Aspekte der Rückkehr zur Arbeit bei Patientinnen und Patienten mit einer Krebserkrankung. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2012; 55:516-32. [DOI: 10.1007/s00103-012-1454-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
|