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Teja T, Shrivastava S, Choudhary A, Rathod V, Balusani P. Optimizing Acetabular Positioning: A Comprehensive Review of Contemporary Strategies in Total Hip Arthroplasty. Cureus 2024; 16:e59114. [PMID: 38803755 PMCID: PMC11128723 DOI: 10.7759/cureus.59114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 04/26/2024] [Indexed: 05/29/2024] Open
Abstract
Total hip arthroplasty (THA) is a widely practiced surgical intervention to alleviate pain and reinstate functionality in individuals afflicted with hip joint pathology. The positioning of the acetabulum assumes paramount significance in determining the efficacy of THA, exerting profound influences on biomechanical dynamics, stability, and the durability of outcomes over time. This comprehensive review meticulously evaluates contemporary methodologies for optimizing acetabular positioning in THA, encompassing advanced technologies such as computer-assisted navigation systems, patient-specific instrumentation, robotic-assisted surgical approaches, image-based planning techniques, and intraoperative fluoroscopy. Crucially, key discoveries underscore the pivotal role of precise acetabular alignment in mitigating complications such as dislocation, component wear, and impingement. Moreover, the implications for clinical practice accentuate the imperative of continuous education and training to ensure effective deployment of sophisticated methodologies. Recommendations for furthering research and enhancing practice development underscore the necessity of scrutinizing long-term prognoses, assessing cost-effectiveness, and embracing technological innovations perpetually refining THA outcomes. Collaborative endeavors among researchers, practitioners, and industry stakeholders emerge as indispensable drivers of advancement in this domain, fostering an environment conducive to elevating the standard of care for individuals undergoing THA.
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Affiliation(s)
- Tarun Teja
- Orthopaedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Sandeep Shrivastava
- Orthopaedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Abhishek Choudhary
- Orthopaedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Vinit Rathod
- Orthopaedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Prashanth Balusani
- Orthopaedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Le GH, Hermansen Å, Dahl E. Return to work after cancer-the impact of working conditions: A Norwegian Register-based Study. J Cancer Surviv 2023:10.1007/s11764-023-01503-0. [PMID: 38114712 DOI: 10.1007/s11764-023-01503-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 11/15/2023] [Indexed: 12/21/2023]
Abstract
PURPOSE The purpose of this study is to compare a cohort of cancer survivors with a cohort of cancer-free employees (1) with respect to employment prospects over a 15-year period and (2) with respect to the differential impact of working conditions on employment over this time period. METHODS The cancer cohort is retrieved from the Cancer Registry of Norway, while data on the non-cancer cohort are retrieved from register data managed by Statistics Norway. Job exposure matrices were used to remedy the lack of working-conditions information in the register data. We use nearest-neighbor matching to match the non-cancer cohort (the control group) to the cancer-survivor cohort (the treatment group). Cox regression analysis was applied to examine the relationships between working conditions, employment, and cancer. The results are reported separately for mechanical-job exposures and psychosocial exposures, as well as by gender. RESULTS Cancer survivors are more likely to experience reduced employment as compared to individuals without a history of cancer. Male cancer survivors in physically demanding occupations have an increased risk of reduced employment after being diagnosed with cancer. This does not apply to female cancer survivors. Regarding the impact of psychosocial exposures on employment, we find no differences over time between cancer survivors and the non-cancer population. CONCLUSIONS Male cancer survivors in physically demanding occupations have an increased risk of reduced employment after being diagnosed with cancer, whereas this is not the case for female cancer survivors. Psychosocial exposures do not impact the relative risk of reduced employment over time. IMPLICATIONS FOR CANCER SURVIVORS We suggest that return to work after cancer should be considered a process rather than only the re-entry step of resuming work. Thus, it is important to provide long-term support for cancer survivors. We recommend providing more attention to working conditions, particularly in occupations that involve a high level of mechanical-job exposures.
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Affiliation(s)
- Giang Huong Le
- Department of Social Work, Child Welfare and Social Policy, OsloMet - Oslo Metropolitan University, Faculty of Social Sciences, Oslo, Norway.
| | - Åsmund Hermansen
- Department of Social Work, Child Welfare and Social Policy, OsloMet - Oslo Metropolitan University, Faculty of Social Sciences, Oslo, Norway
| | - Espen Dahl
- Department of Social Work, Child Welfare and Social Policy, OsloMet - Oslo Metropolitan University, Faculty of Social Sciences, Oslo, Norway
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Khan I, Sawhney R, McClellan S, Chua K, Alfaraj A, Shevock J, Chun D. Economic Impact of Cancer Diagnosis on Employment, Wages and Intent to Return to Work. Dela J Public Health 2023; 9:54-56. [PMID: 38173956 PMCID: PMC10759979 DOI: 10.32481/djph.2023.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024] Open
Abstract
To assess the work hours and income of patients who have been diagnosed with cancer, treatable with curative intent. The study evaluated the impact of lost wages on patients and their families in the population that is served by Bayhealth Medical Center. METHODS This study was conducted between 2016 and 2020. The curative cancer focus included breast, lung, prostate, colorectal, testicular, uterine, cervical, bladder, esophageal, head and neck, and stomach. Patients were identified on their survivorship visit with Medical Oncology or Radiation Oncology. Two surveys were used to collect information specific to employment status, leave of absence/change in hours, and monthly income. RESULTS Survey one had 142 participants. Survey two had 134 participants. In survey one, 99.3% of participants reported being employed at least half time at the time of diagnosis. On the Survivorship visit, 95% reported being currently employed at least half time. Only 87% were employed in the same job and title. When reporting income, 64% of participants had the same income, and 25.4% reported a reduction in income since being diagnosed and completing cancer treatment. In survey two, completed one-year post-survivorship visit, 83.6% of participants reported being employed at least half time. Of those, 76.9% were working for the same employer as they were at time of diagnosis. To that end, 26.1% of participants reported their income as lower than it was at time of diagnosis. CONCLUSION A cancer diagnosis with treatment can and does have an impact on a person's ability to remain employed at least half time and sustain the same level of income.
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Affiliation(s)
| | | | | | | | | | | | - Dain Chun
- PhD Student, Center for Pharmacometrics and Systems Pharmacology, University of Florida
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Turchi GP, Dalla Riva MS, Orrù L, Pinto E. How to Intervene in the Health Management of the Oncological Patient and of Their Caregiver? A Narrative Review in the Psycho-Oncology Field. Behav Sci (Basel) 2021; 11:99. [PMID: 34356716 PMCID: PMC8301046 DOI: 10.3390/bs11070099] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 07/05/2021] [Accepted: 07/06/2021] [Indexed: 01/22/2023] Open
Abstract
Starting from statistical data derived from the oncological field, some articles have highlighted the importance of communication in the patient-caregiver dyad and have considered the various roles involved in a cancer diagnosis situation. Thus, the question of how to intervene in terms of "quality of life" from the time of diagnosis to the recovery or death of a cancer patient, beyond the sanitary and physical dimensions, has become relevant. Therefore, the present narrative review aims to offer an overview of the state of the art in terms of the psychological treatment modalities of cancer patients, from the diagnosis to the post-surgery period. A total of 67 articles were collected and analyzed, in relation to (1) psychological constructs employed in the oncological field, (2) intervention models and (3) quality of life and well-being measurement and evaluation tools. We described these articles, differentiating between those focusing on the role of (1) the patient, (2) the caregiver, (3) the patient-caregiver dyad and (4) healthcare professional roles. The oncological diagnosis and its repercussions in the lives of the patient and caregiver were explored and critical aspects that emerged from the literature were highlighted. In conclusion, the analysis allowed some considerations about the need to define research protocols and useful management strategies for increasing the overall health of patients with cancer diagnoses and the people who surround them.
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Affiliation(s)
- Gian Piero Turchi
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padua, 35131 Padua, Italy; (G.P.T.); (M.S.D.R.); (L.O.)
| | - Marta Silvia Dalla Riva
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padua, 35131 Padua, Italy; (G.P.T.); (M.S.D.R.); (L.O.)
| | - Luisa Orrù
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padua, 35131 Padua, Italy; (G.P.T.); (M.S.D.R.); (L.O.)
| | - Eleonora Pinto
- Unit of Surgical Oncology of the Esophagus and Digestive Tract, Veneto Institute of Oncology, 35128 Padua, Italy
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de Boer AG, Torp S, Popa A, Horsboel T, Zadnik V, Rottenberg Y, Bardi E, Bultmann U, Sharp L. Long-term work retention after treatment for cancer: a systematic review and meta-analysis. J Cancer Surviv 2020; 14:135-150. [PMID: 32162193 PMCID: PMC7182621 DOI: 10.1007/s11764-020-00862-2] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 01/29/2020] [Indexed: 12/26/2022]
Abstract
PURPOSE Almost half of people diagnosed with cancer are working age. Survivors have increased risk of unemployment, but little is known about long-term work retention. This systematic review and meta-analysis assessed work retention and associated factors in long-term cancer survivors. METHODS We searched Medline/Pubmed, Embase, PsychINFO, and CINAHL for studies published 01/01/2000-08/01/2019 reporting work retention in adult cancer survivors ≥ 2 years post-diagnosis. Survivors had to be in paid work at diagnosis. Pooled prevalence of long-term work retention was estimated. Factors associated with work retention from multivariate analysis were synthesized. RESULTS Twenty-nine articles, reporting 21 studies/datasets including 14,207 cancer survivors, were eligible. Work retention was assessed 2-14 years post-diagnosis. Fourteen studies were cross-sectional, five were prospective, and two contained both cross-sectional and prospective elements. No studies were scored as high quality. The pooled estimate of prevalence of long-term work retention in cancer survivors working at diagnosis was 0.73 (95%CI 0.69-0.77). The proportion working at 2-2.9 years was 0.72; at 3-3.9 years 0.80; at 4-4.9 years 0.75; at 5-5.9 years 0.74; and 6+ years 0.65. Pooled estimates did not differ by cancer site, geographical area, or study design. Seven studies assessed prognostic factors for work retention: older age, receiving chemotherapy, negative health outcomes, and lack of work adjustments were associated with not working. CONCLUSION Almost three-quarters of long-term cancer survivors working at diagnosis retain work. IMPLICATIONS FOR CANCER SURVIVORS These findings are pertinent for guidelines on cancer survivorship care. Professionals could focus support on survivors most likely to have poor long-term work outcomes.
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Affiliation(s)
- Angela Gem de Boer
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Steffen Torp
- Department of Health, Social & Welfare Studies, University College of South-Eastern Norway, Notodden, Norway
| | - Adela Popa
- Lucian Blaga University of Sibiu, Sibiu, Romania
| | - Trine Horsboel
- The Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Vesna Zadnik
- Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Yakir Rottenberg
- Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Edit Bardi
- Kepler Universitäts Klinikum, Linz, Austria
| | - Ute Bultmann
- University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne, United Kingdom.
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Candon D. The joint effect of health shocks and eligibility for social security on labor supply. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2019; 20:969-988. [PMID: 31093845 DOI: 10.1007/s10198-019-01053-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Accepted: 04/11/2019] [Indexed: 06/09/2023]
Abstract
This paper investigates whether or not suffering a health shock, and becoming eligible for social security, have a joint effect on labor supply. Despite millions of people experiencing both of these events each year, no paper has focused exclusively on the joint effect that these events may have on work outcomes. This is surprising given that experiencing a health shock may impact on how a worker responds to becoming eligible for social security. With data from the Health and Retirement Study, I model weekly hours of work as a function of health shocks, social security eligibility, and their interaction. I find that this interaction leads to a 3-4 h reduction in weekly hours of work for men, but has no effect for women. The results are robust to using different work outcomes, age groups, health shock definitions, subgroups, as well as falsification and placebo tests. The results appear to be driven by men who would have had to return to work with impaired health. Policies that promote a more flexible work situation for older men may alleviate these problems in the future.
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Affiliation(s)
- David Candon
- School of Economics, University of Edinburgh, 30 Buccleuch Place, Edinburgh, EH8 9JT, UK.
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Abstract
OBJECTIVE The societal value of unpaid caregiving is estimated to exceed $470 billion annually. In spite of the high value care they provide, caregivers experience significant financial burden. This paper examines the sources and impact of financial burden on cancer caregivers. DATA SOURCES Survey of the published peer-reviewed literature complemented by Web-based sources. CONCLUSION Caregivers for cancer patients may experience financial burden disproportionately relative to other caregivers because of the intensity of care they provide and the cost and complexity of cancer treatment. Financial burden stems from employment loss and cost of care and can continue long after the death of the patient. Few federal policy protections are available for caregivers. IMPLICATIONS FOR NURSING PRACTICE Oncology nurses can play an important role in recognizing the needs of caregivers and act as navigators to connect caregivers to available resources.
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Affiliation(s)
- Cathy J Bradley
- University of Colorado Cancer Center, and Colorado School of Public Health, Aurora, CO.
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A Systematic Review of the Epidemiologic Literature Assessing Health Outcomes in Populations Living near Oil and Natural Gas Operations: Study Quality and Future Recommendations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16122123. [PMID: 31208070 PMCID: PMC6616936 DOI: 10.3390/ijerph16122123] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 06/06/2019] [Accepted: 06/12/2019] [Indexed: 12/19/2022]
Abstract
A systematic method was used to review the existing epidemiologic literature and determine the state of the scientific evidence for potential adverse health outcomes in populations living near oil and natural gas (ONG) operations in the United States. The review utilized adapted systematic review frameworks from the medical and environmental health fields, such as Grading of Recommendations, Assessment, Development and Evaluations (GRADE), the Navigation Guide, and guidance from the National Toxicology Program’s Office of Health Assessment and Translation (OHAT). The review included 20 epidemiologic studies, with 32 different health outcomes. Studies of populations living near ONG operations provide limited evidence (modest scientific findings that support the outcome, but with significant limitations) of harmful health effects including asthma exacerbations and various self-reported symptoms. Study quality has improved over time and the highest rated studies within this assessment have primarily focused on birth outcomes. Additional high-quality studies are needed to confirm or dispute these correlations.
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Kent EE, Davidoff A, de Moor JS, McNeel TS, Virgo KS, Coughlan D, Han X, Ekwueme DU, Guy GP, Banegas MP, Alfano CM, Dowling EC, Yabroff KR. Impact of sociodemographic characteristics on underemployment in a longitudinal, nationally representative study of cancer survivors: Evidence for the importance of gender and marital status. J Psychosoc Oncol 2018; 36:287-303. [PMID: 29634413 DOI: 10.1080/07347332.2018.1440274] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND We examined the longitudinal association between sociodemographic factors and an expanded definition of underemployment among those with and without cancer history in the United States. METHODS Medical Expenditure Panel Survey data (2007-2013) were used in multivariable regression analyses to compare employment status between baseline and two-year follow-up among adults aged 25-62 years at baseline (n = 1,614 with and n = 39,324 without cancer). Underemployment was defined as becoming/staying unemployed, changing from full to part-time, or reducing part-time work significantly. Interaction effects between cancer history/time since diagnosis and predictors known to be associated with employment patterns, including age, gender/marital status, education, and health insurance status at baseline were modeled. RESULTS Approximately 25% of cancer survivors and 21% of individuals without cancer reported underemployment at follow-up (p = 0.002). Multivariable analyses indicated that those with a cancer history report underemployment more frequently (24.7%) than those without cancer (21.4%, p = 0.002) with underemployment rates increasing with time since cancer diagnosis. A significant interaction between gender/marital status and cancer history and underemployment was found (p = 0.0004). There were no other significant interactions. Married female survivors diagnosed >10 years ago reported underemployment most commonly (38.7%), and married men without cancer reported underemployment most infrequently (14.0%). A wider absolute difference in underemployment reports for married versus unmarried women as compared to married versus unmarried men was evident, with the widest difference apparent for unmarried versus married women diagnosed >10 years ago (18.1% vs. 38.7%). CONCLUSION Cancer survivors are more likely to experience underemployment than those without cancer. Longer time since cancer diagnosis and gender/marital status are critical factors in predicting those at greatest risk of underemployment. The impact of cancer on work should be systematically studied across sociodemographic groups and recognized as a component of comprehensive survivorship care.
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Affiliation(s)
- Erin E Kent
- a Division of Cancer Control and Population Sciences, Healthcare Delivery Research Program, National Cancer Institute , Rockville , Maryland , USA.,b ICF International , Fairfax , VA
| | - Amy Davidoff
- c Department of Health Policy & Management , School of Public Health, Yale University , New Haven , Connecticut , USA
| | - Janet S de Moor
- a Division of Cancer Control and Population Sciences, Healthcare Delivery Research Program, National Cancer Institute , Rockville , Maryland , USA
| | - Timothy S McNeel
- d Information Management Services, Inc. , Rockville , Maryland , USA
| | - Katherine S Virgo
- e Department of Health Policy and Management , Rollins School of Public Health, Emory University , Atlanta , Georgia , USA
| | - Diarmuid Coughlan
- f Division of Cancer Control and Population Sciences, Surveillance Research Program, National Cancer Institute , Rockville , Maryland , USA
| | - Xuesong Han
- g American Cancer Society , Atlanta , Georgia , USA
| | - Donatus U Ekwueme
- h Centers for Disease Control and Prevention, Division of Cancer Prevention and Control , Atlanta , Georgia , USA
| | - Gery P Guy
- h Centers for Disease Control and Prevention, Division of Cancer Prevention and Control , Atlanta , Georgia , USA
| | - Matthew P Banegas
- i Kaiser Permanente Center for Health Research , Portland , Oregon , USA
| | | | - Emily C Dowling
- j Massachusetts General Hospital , Boston , Massachusetts , USA
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Hornbrook MC, Grant M, Wendel C, Bulkley JE, Mcmullen CK, Altschuler A, Temple LK, Herrinton LJ, Krouse RS. Rectal Cancer Survivors' Participation in Productive Activities. Perm J 2017; 22:17-022. [PMID: 29236653 DOI: 10.7812/tpp/17-022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
CONTEXT Rectal cancer and its treatment impair survivors' productivity. OBJECTIVE To assess determinants of market and nonmarket employment, job search, volunteering, and homemaking among survivors five years or longer after diagnosis. DESIGN We mailed questionnaires to 1063 survivors who were members of Kaiser Permanente (Northern California, Northwest) during 2010 and 2011. MAIN OUTCOME MEASURES Productive activities, functional health status, and bowel management at the time of the survey. RESULTS Response rate was 60.5% (577/953). Higher comorbidity burdens were associated with lower productivity for men and women rectal cancer survivors. Productive survivors were younger and had lower disease stage and age at diagnosis, higher household income and educational attainment, and fewer comorbidity burdens and workplace adjustments than did nonproductive survivors (p < 0.05 each; 2-sided). Productive rectal cancer survivors were evenly split by sex. CONCLUSION Staying productive is associated with better mental health for rectal cancer survivors. Rectal cancer survivors with multiple chronic conditions, higher disease stage, lower productive activities, and older age need better access to medical care and closer monitoring of the quality of their care, including self-care. To capture the full extent of the involvement of survivors in all types of productive activities, research should routinely include measures of employment, searching for employment, homemaking, and volunteering. Counting market and nonmarket productive activities is innovative and recognizes the continuum of contributions survivors make to families and society. Health care systems should routinely monitor rectal cancer survivors' medical care access, comorbidities, health-related quality of life, and productive activities.
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Affiliation(s)
- Mark C Hornbrook
- Senior Investigator Emeritus at the Center for Health Research in Portland, OR.
| | - Marcia Grant
- Distinguished Professor in the Department of Nursing Research and Education at the City of Hope National Medical Center in Duarte, CA.
| | - Christopher Wendel
- Instructor at the University of Arizona College of Medicine and Arizona Center on Aging in Tucson.
| | - Joanna E Bulkley
- Research Associate at the Center for Health Research in Portland, OR.
| | - Carmit K Mcmullen
- Medical Anthropologist and Investigator in the Science Programs Department at the Center for Health Research in Portland, OR.
| | - Andrea Altschuler
- Research Project Manager for the Division of Research in Oakland, CA.
| | - Larissa Kf Temple
- Chief of the Division of Colorectal Surgery at the University of Rochester Medical Center in NY.
| | | | - Robert S Krouse
- Instructor of Surgery at the University of Pennslvania School of Medicine and Chief of Surgery for the CMC Veterans Affairs Medical Center in Philadelphia.
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Evaluating Disability Insurance Assistance as a Specific Intervention by Physiatrists at a Cancer Center. Am J Phys Med Rehabil 2017. [PMID: 28628540 DOI: 10.1097/phm.0000000000000641] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Because of their expertise, physiatrists provide disability insurance assistance for cancer survivors. In this brief report, we perform a descriptive retrospective analysis of all new (354) outpatient physiatry consultations from January 1, 2009, to December 31, 2013, at a National Cancer Institute Comprehensive Cancer Center. Disability and/or work accommodations were brought up at some point with the physiatrist during the duration of their care for 131 (37%) of 354 patients. More than 90% of the discussions took place during the first visit. Of those patients who had a documented disability/employment discussion, 58 (44.3%) of 131 patients were originally referred for disability assistance specifically, and 58 (44.3%) of 131 also had disability insurance paperwork completed by the physiatrist. Outcomes of initial physiatry disability insurance assistance were 45 (77.6%) of 58 approved/renewed, 5 (8.6%) of 58 denied, and 8 (13.8%) of 58 unknown/died during the disability application process. The median form size was 33 (SD, 25.95) items. This study is the first of its kind and provides an initial look at work-related discussions and support with disability insurance paperwork as a specific intervention provided by physiatrists at a cancer center. The results are compelling and demonstrate that physiatrists frequently provide these interventions. These interventions take considerable time and effort but are generally successful.
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Nekhlyudov L, Ganz PA, Arora NK, Rowland JH. Going Beyond Being Lost in Transition: A Decade of Progress in Cancer Survivorship. J Clin Oncol 2017; 35:1978-1981. [PMID: 28437163 PMCID: PMC5676953 DOI: 10.1200/jco.2016.72.1373] [Citation(s) in RCA: 105] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Affiliation(s)
- Larissa Nekhlyudov
- Larissa Nekhlyudov, Brigham & Women’s Hospital, Boston, MA; Patricia A. Ganz, Fielding School of Public Health, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA; Neeraj K. Arora, Patient-Centered Outcomes Research Institute, Washington, DC; and Julia H. Rowland, National Cancer Institute, Bethesda, MD
| | - Patricia A. Ganz
- Larissa Nekhlyudov, Brigham & Women’s Hospital, Boston, MA; Patricia A. Ganz, Fielding School of Public Health, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA; Neeraj K. Arora, Patient-Centered Outcomes Research Institute, Washington, DC; and Julia H. Rowland, National Cancer Institute, Bethesda, MD
| | - Neeraj K. Arora
- Larissa Nekhlyudov, Brigham & Women’s Hospital, Boston, MA; Patricia A. Ganz, Fielding School of Public Health, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA; Neeraj K. Arora, Patient-Centered Outcomes Research Institute, Washington, DC; and Julia H. Rowland, National Cancer Institute, Bethesda, MD
| | - Julia H. Rowland
- Larissa Nekhlyudov, Brigham & Women’s Hospital, Boston, MA; Patricia A. Ganz, Fielding School of Public Health, Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA; Neeraj K. Arora, Patient-Centered Outcomes Research Institute, Washington, DC; and Julia H. Rowland, National Cancer Institute, Bethesda, MD
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Cabus SJ, Groot W, Maassen van den Brink H. The short-run causal effect of tumor detection and treatment on psychosocial well-being, work, and income. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2016; 17:419-433. [PMID: 25842252 PMCID: PMC4837211 DOI: 10.1007/s10198-015-0688-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 03/18/2015] [Indexed: 06/04/2023]
Abstract
This paper estimates the short-run causal effect of tumor detection and treatment on psychosocial well-being, work and income. Tumor detection can be considered as a random event, so that we can compare individuals' average outcomes in the year of diagnosis with the year before. We argue for using panel data estimation techniques that enable us to control for observed and unobserved information intrinsic to the individual and time constants. We use data of a national representative panel in the Netherlands that includes health survey information and data on work, education, and income between 2007 and 2012. Our findings show differences in the psychosocial dysfunction of men and women in response to tumor detection and treatment. Women, not men, are decreasingly likely to participate in the labor force as a result of malignant tumor detection, while no significant effects are found on her personal or household income. We also demonstrate that fixed effects panel data models are superior to matching techniques.
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Affiliation(s)
- Sofie J. Cabus
- />Top Institute for Evidence Based Education Research, TIER-Maastricht University, Kapoenstraat 2, 6211 KW Maastricht, The Netherlands
| | - Wim Groot
- />Top Institute for Evidence Based Education Research, TIER-Maastricht University, Kapoenstraat 2, 6211 KW Maastricht, The Netherlands
- />Amsterdam School of Economics, University of Amsterdam, Roeterstraat 11, 1017 LW Amsterdam, The Netherlands
| | - Henriëtte Maassen van den Brink
- />Top Institute for Evidence Based Education Research, TIER-Maastricht University, Kapoenstraat 2, 6211 KW Maastricht, The Netherlands
- />Amsterdam School of Economics, University of Amsterdam, Roeterstraat 11, 1017 LW Amsterdam, The Netherlands
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Duguet E, Le Clainche C. Une évaluation de l’impact de l’aménagement des conditions de travail sur la reprise du travail après un cancer. ACTA ACUST UNITED AC 2016. [DOI: 10.3917/reco.pr2.0053] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Candon D. The effects of cancer on older workers in the English labour market. ECONOMICS AND HUMAN BIOLOGY 2015; 18:74-84. [PMID: 25965970 DOI: 10.1016/j.ehb.2015.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 03/04/2015] [Accepted: 04/14/2015] [Indexed: 06/04/2023]
Abstract
The continued rise in overall cancer survival rates has ignited a field of research which examines the effect that cancer has on survivors' employment. Previous estimates of the effect of cancer on labour market outcomes, using U.S. data, show significant reductions in employment in the first 6 months after diagnosis. However, this impact has been found to dissipate after 12 and 18 months. I use data from the English Longitudinal Study of Ageing and find that, in England, where there is a more generous welfare support system, not only does cancer have a negative impact in the first 6-month period following diagnosis, but also in the second 6-month period. I estimate that, in the second 6-month period after diagnosis, respondents with cancer are 12.2% points less likely to work and work 4.2 fewer hours a week when compared to matched, healthy controls. This suggests that the negative effects from cancer can persist for longer than the six months identified previously. These results have implications for government policy and employers, because it increases the length of time that survivors may be on government supported sick pay, and the expected time that workers will be absent from work due to illness.
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Affiliation(s)
- David Candon
- School of Economics and Geary Institute, University College Dublin, Ireland.
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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
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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.
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Moran JR, Short PF. Does cancer reduce labor market entry? Evidence for prime-age females. Med Care Res Rev 2013; 71:224-42. [PMID: 24243912 DOI: 10.1177/1077558713510359] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Existing studies of the labor market status of cancer survivors have focused on the extent to which cancer disrupts the employment of individuals who were working when diagnosed with cancer. We examine how surviving cancer affects labor market entry and usual hours of work among females aged 28 to 54 years who were not working when first diagnosed. We find that prime-age females have employment rates 2 to 6 years after diagnosis that are 12 percentage points lower than otherwise similar women who were initially out of the labor force, full-time employment rates that are 10 percentage points lower, and usual hours of work that are 5 hours per week lower. These estimates are somewhat larger than estimates for prime-age women employed at the time of diagnosis and highlight the importance of considering nonworking females when assessing the economic and psychosocial burden of cancer.
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Affiliation(s)
- John R Moran
- 1Penn State University, University Park, PA, USA
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19
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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.
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Munir F, Kalawsky K, Wallis DJ, Donaldson-Feilder E. Using intervention mapping to develop a work-related guidance tool for those affected by cancer. BMC Public Health 2013; 13:6. [PMID: 23289708 PMCID: PMC3585779 DOI: 10.1186/1471-2458-13-6] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Accepted: 12/22/2012] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Working-aged individuals diagnosed and treated for cancer require support and assistance to make decisions regarding work. However, healthcare professionals do not consider the work-related needs of patients and employers do not understand the full impact cancer can have upon the employee and their work. We therefore developed a work-related guidance tool for those diagnosed with cancer that enables them to take the lead in stimulating discussion with a range of different healthcare professionals, employers, employment agencies and support services. The tool facilitates discussions through a set of questions individuals can utilise to find solutions and minimise the impact cancer diagnosis, prognosis and treatment may have on their employment, sick leave and return to work outcomes. The objective of the present article is to describe the systematic development and content of the tool using Intervention Mapping Protocol (IMP). METHODS The study used the first five steps of the intervention mapping process to guide the development of the tool. A needs assessment identified the 'gaps' in information/advice received from healthcare professionals and other stakeholders. The intended outcomes and performance objectives for the tool were then identified followed by theory-based methods and an implementation plan. A draft of the tool was developed and subjected to a two-stage Delphi process with various stakeholders. The final tool was piloted with 38 individuals at various stages of the cancer journey. RESULTS The tool was designed to be a self-led tool that can be used by any person with a cancer diagnosis and working for most types of employers. The pilot study indicated that the tool was relevant and much needed. CONCLUSIONS Intervention Mapping is a valuable protocol for designing complex guidance tools. The process and design of this particular tool can lend itself to other situations both occupational and more health-care based.
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Affiliation(s)
- Fehmidah Munir
- School of Sport, Exercise & Health Sciences, Loughborough University, Loughborough, Leicestershire LE11 3TU, UK
| | - Katryna Kalawsky
- School of Sport, Exercise & Health Sciences, Loughborough University, Loughborough, Leicestershire LE11 3TU, UK
| | - Deborah J Wallis
- School of Sport, Exercise & Health Sciences, Loughborough University, Loughborough, Leicestershire LE11 3TU, UK
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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]
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Moran JR, Short PF, Hollenbeak CS. Long-term employment effects of surviving cancer. JOURNAL OF HEALTH ECONOMICS 2011; 30:505-14. [PMID: 21429606 PMCID: PMC3110504 DOI: 10.1016/j.jhealeco.2011.02.001] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2010] [Revised: 02/01/2011] [Accepted: 02/10/2011] [Indexed: 05/08/2023]
Abstract
We compare employment and usual hours of work for prime-age cancer survivors from the Penn State Cancer Survivor Survey to a comparison group drawn from the Panel Study of Income Dynamics using cross-sectional and difference-in-differences regression and matching estimators. Because earlier research has emphasized workers diagnosed at older ages, we focus on employment effects for younger workers. We find that as long as two to six years after diagnosis, cancer survivors have lower employment rates and work fewer hours than other similarly aged adults.
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Affiliation(s)
- John R Moran
- Department of Health Policy and Administration, Penn State University, University Park, PA 16802, USA.
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23
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The implications of cancer survivorship for spousal employment. J Cancer Surviv 2011; 5:226-34. [PMID: 21369843 DOI: 10.1007/s11764-011-0175-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2010] [Accepted: 02/16/2011] [Indexed: 10/18/2022]
Abstract
BACKGROUND The purpose of this research was to estimate employment effects for spouses of cancer survivors who were working at the time of the cancer diagnosis. METHODS Spouses of cancer survivors were drawn from the Penn State Cancer Survivor Survey. Comparable spouses of individuals without cancer were drawn from the Panel Survey of Income Dynamics. The final sample included 827 spouses of cancer survivors (542 husbands, 285 wives) and 2,766 spouses of individuals without cancer (1,459 husbands, 1,307 wives). Three employment outcomes were studied 2-6 years after diagnosis: whether working, whether working full time (35+ hours per week), and usual hours per week. We used propensity scores to match cases to controls 3:1. RESULTS Wives of cancer survivors had a lower probability (-7.5 percentage points) of being employed 2-6 years after diagnosis (p = 0.036). They were slightly more likely to be working full time, while averaging 1.1 fewer hours per week overall, but these effects were not statistically significant. Cancer's effect on husbands was not significant for any of the employment outcomes. However, if survivor wives and husbands were working at follow-up, they had more than twice the odds of working full-time (wives OR = 2.18, p = 0.0004; husbands OR = 2.65, p = 0.012) and worked more hours per week than other spouses (wives 1.9, p = 0.041; husbands 1.5, p = 0.04). CONCLUSIONS The implications to cancer survivors and their spouses of these results is that the employment of survivor spouses, especially of wives, is somewhat reshaped by cancer in the medium to long run. However, there is little or no effect on aggregate hours worked by spouses who were employed at diagnosis.
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Fiva JH, Haegeland T, Rønning M. Health status after cancer: does it matter which hospital you belong to? BMC Health Serv Res 2010; 10:204. [PMID: 20626866 PMCID: PMC2914725 DOI: 10.1186/1472-6963-10-204] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2010] [Accepted: 07/13/2010] [Indexed: 11/12/2022] Open
Abstract
Background Survival rates are widely used to compare the quality of cancer care. However, the extent to which cancer survivors regain full physical or cognitive functioning is not captured by this statistic. To address this concern we introduce post-diagnosis employment as a supplemental measure of the quality of cancer care. Methods This study is based on individual level data from the Norwegian Cancer Registry (n = 46,720) linked with data on labor market outcomes and socioeconomic status from Statistics Norway. We study variation across Norwegian hospital catchment areas (n = 55) with respect to survival and employment five years after cancer diagnosis. To handle the selection problem, we exploit the fact that cancer patients in Norway (until 2001) have been allocated to local hospitals based on their place of residence. Results We document substantial differences across catchment areas with respect to patients' post-diagnosis employment rates. Conventional quality indicators based on survival rates indicate smaller differences. The two sets of indicators are only moderately correlated. Conclusions This analysis shows that indicators based on survival and post-diagnosis employment may capture different parts of the health status distribution, and that using only one of them to capture quality of care may be insufficient.
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Affiliation(s)
- Jon H Fiva
- Department of Economics, University of Oslo, PB 1095 Blindern, 0317 Oslo, Norway.
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Norredam M, Meara E, Landrum MB, Huskamp HA, Keating NL. Financial status, employment, and insurance among older cancer survivors. J Gen Intern Med 2009; 24 Suppl 2:S438-45. [PMID: 19838847 PMCID: PMC2763157 DOI: 10.1007/s11606-009-1034-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Few data are available about the socioeconomic impact of cancer for long-term cancer survivors. OBJECTIVES To investigate socioeconomic outcomes among older cancer survivors compared to non-cancer patients. DATA SOURCE 2002 Health and Retirement Study. STUDY DESIGN We studied 964 cancer survivors of > 4 years and 14,333 control patients who had never had cancer from a population-based sample of Americans ages >or= 55 years responding to the 2002 Health and Retirement Study. MEASURES We compared household income, housing assets, net worth, insurance, employment, and future work expectations. ANALYSES Propensity score methods were used to control for baseline differences between cancer survivors and controls. RESULTS Female cancer survivors did not differ from non-cancer patients in terms of income, housing assets, net worth, or likelihood of current employment (all P > 0.20); but more were self-employed (25.0% vs. 17.7%; P = 0.03), and fewer were confident that if they lost their job they would find an equally good job in the next few months (38.4% vs. 45.9%; P = 0.03). Among men, cancer survivors and noncancer patients had similar income and housing assets (both P >or= 0.10) but differed somewhat in net worth (P = 0.04). Male cancer survivors were less likely than other men to be currently employed (25.2% vs. 29.7%) and more likely to be retired (66.9% vs. 62.2%), although the P value did not reach statistical significance (P = 0.06). Men were also less optimistic about finding an equally good job in the next few months if they lost their current job (33.5% vs. 46.9%), although this result was not significant (P = 0.11). CONCLUSIONS Despite generally similar socioeconomic outcomes for cancer survivors and noncancer patients ages >or=55 years, a better understanding of employment experience and pessimism regarding work prospects may help to shape policies to benefit cancer survivors.
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Affiliation(s)
- Marie Norredam
- Department of Health Services Research, Institute of Public Health, University of Copenhagen, Denmark, Copenhagen C, Denmark.
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Grunfeld EA, Rixon L, Eaton E, Cooper AF. The organisational perspective on the return to work of employees following treatment for cancer. JOURNAL OF OCCUPATIONAL REHABILITATION 2008; 18:381-388. [PMID: 19003524 DOI: 10.1007/s10926-008-9152-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2008] [Accepted: 10/07/2008] [Indexed: 05/27/2023]
Abstract
INTRODUCTION Due to improved survival rates across cancer types there is an ever increasing group of cancer survivors of working age with a unique set of needs associated with living with cancer and with returning to work. Little is known about the services provided for cancer survivors or the needs of organisations in the return to work process. This study aimed to provide this information through a survey of the organisational perspective of the return to work of cancer survivors. METHODS Questionnaires were sent to human resource or occupational health departments of 815 medium to large organisations. The questionnaire focussed on the companies' policies and procedures, their return to work services and beliefs about the experiences of cancer survivors returning to the workplace. RESULTS 252 organisations returned completed questionnaires (response rate 31%). 48% of respondents were unable to provide information about the number of employees diagnosed with cancer in the past 12 months. A range of return to work services was provided although only 38% provided employees with written information or guidelines about return to work policies or services. Respondents tended to view employee related factors, such as employee attitude and emotional functioning, as key to a successful return to work. CONCLUSIONS Organisations aim to be supportive of cancer survivors returning to the workplace and potentially offer a range of return to work services. However, employees may not be adequately informed of such services and a lack of information and clear communication may hinder a positive return to work experience.
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Affiliation(s)
- Elizabeth A Grunfeld
- Psychology Department, Institute of Psychiatry, King's College London, Guy's Hospital, London, UK.
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