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Hagendijk ME, Zipfel N, Melles M, van der Wees PJ, Hulshof CTJ, Çölkesen EB, Hoving JL, van der Burg-Vermeulen SJ. Towards person-centred work-focused healthcare for people with cardiovascular disease: a qualitative exploration of patients' experiences and needs. Disabil Rehabil 2024:1-13. [PMID: 38676465 DOI: 10.1080/09638288.2024.2344653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 04/13/2024] [Indexed: 04/29/2024]
Abstract
PURPOSE To explore the experiences and needs concerning work-focused healthcare of patients experiencing problems with work participation due to cardiovascular disease based on all facets of person-centred care. METHODS Nineteen patients who experienced or continue to experience problems with work participation due to cardiovascular disease participated in semi-structured interviews preceded by preparatory written assignments. The transcripts were analysed by means of directed qualitative content analysis. Adapted principles of the Picker Institute for Person-Centred Care provided a template for the analysis. RESULTS 28 experiences and needs emerged and were grouped into the eight principles for person-centred work-focused healthcare. Randomly presenting one theme for each of the eight principles, the themes included: (1) frequent encounters with occupational healthcare professionals; (2) substantive work-related advice; (3) transparency in communication; (4) support for family; (5) information provision on the work-focused healthcare process; (6) personal control during the process; (7) empathy for the personal situation; and (8) tailored work-focused support. CONCLUSIONS The identified experiences and needs for work-focused healthcare of patients experiencing problems with work participation due to cardiovascular disease clearly indicate the need to improve the delivery of person-centred work-focused healthcare to better meet the individual needs of patients.
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Affiliation(s)
- Marije E Hagendijk
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Nina Zipfel
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Marijke Melles
- Department of Human-Centred Design, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands
| | - Philip J van der Wees
- Scientific Institute for Quality of Healthcare (IQ Healthcare), Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Carel T J Hulshof
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Ersen B Çölkesen
- Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - Jan L Hoving
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Research Centre for Insurance Medicine, Amsterdam, The Netherlands
| | - Sylvia J van der Burg-Vermeulen
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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Salit RB, Schoeppner K, De Biase C, Mohammed J, Gonzales AL, Hashmi SK, Gea-Banacloche J, Savani BN, Carpenter PA, Syrjala KL. American Society for Transplantation and Cellular Therapy Return to Work Guidance Committee Recommendations for Health Care Providers Who Take Care of Hematopoietic Cell Transplantation Patients. Transplant Cell Ther 2022; 28:822-828. [PMID: 36184059 DOI: 10.1016/j.jtct.2022.09.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 12/24/2022]
Abstract
Hematopoietic cell transplantation (HCT) health care providers report a desire to improve long-term outcomes and quality of life for their patients. One of the items frequently cited by patients in terms of transitioning from being a patient back to pre-HCT life is return to work (RTW). However, these patients report little support from their health care providers in facilitating this process, and only 50% to 60% achieve RTW, at a median of 3 years post-HCT. Barriers are physical, psychological, and logistical, as well as poor communication between the patient and their employer. We convened a group of experts in survivorship, rehabilitation, social work, and psychology to draft an evidence-based document to assist health care providers in guiding their patients' RTW journey. Guidance is drawn from the existing literature for HCT and general cancer patients and is divided into pre-HCT, peri-HCT, and post-HCT categories. Collaboration among health care providers, patients, and their employers is key to this transition. Suggested referrals and evaluations also are provided. The goal is for this guidance to be continually updated as we advance the field with more HCT-specific literature.
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Affiliation(s)
- Rachel B Salit
- Fred Hutchinson Cancer Center, Seattle, Washington; University of Washington Medical Center, Seattle, Washington.
| | | | | | - Jaleel Mohammed
- Rehabilitation Association for Hematopoietic Cell Transplantation, Sheffield, United Kingdom; Lincolnshire Community Health Service NHS Trust, Lincoln, United Kingdom
| | | | - Shahrukh K Hashmi
- Mayo Clinic, Rochester, Minnesota; SSMC, Abu Dhabi, United Arab Emirates
| | | | | | - Paul A Carpenter
- Vanderbilt University Medical Center, Nashville, Tennessee; Seattle Children's Medical Center, Seattle, Washington
| | - Karen L Syrjala
- Fred Hutchinson Cancer Center, Seattle, Washington; University of Washington Medical Center, Seattle, Washington
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de Boer AGEM, de Wind A, Coenen P, van Ommen F, Greidanus MA, Zegers AD, Duijts SFA, Tamminga SJ. Cancer survivors and adverse work outcomes: associated factors and supportive interventions. Br Med Bull 2022; 145:60-71. [PMID: 36372773 PMCID: PMC10075241 DOI: 10.1093/bmb/ldac028] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/01/2022] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The number of cancer survivors in a working age is rising. An awareness of factors associated with adverse work outcomes, and of supportive interventions, is needed. SOURCES OF DATA A narrative review of research obtained via several databases, including Medline and PsycINFO, was conducted. AREAS OF AGREEMENT A range of factors is associated with adverse work outcomes such as prolonged sick leave, delayed return to work, disability pension and unemployment in cancer survivors. They include the cancer type and treatment, fatigue, cognitive functioning, work factors and elements of health care systems. Effective supportive interventions encompass physical and multicomponent interventions. AREAS OF CONTROVERSY The role of behaviour determinants and legislative and insurance systems is unclear. It is furthermore uncertain what the optimal timing of delivering supportive interventions is. GROWING POINTS Further focus on vulnerable groups, including specific cancer types and those with lower income, lower educational level and in precarious employment, is needed. AREAS TIMELY FOR DEVELOPING RESEARCH Recent developments are tailored and timely interventions.
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Affiliation(s)
- Angela G E M de Boer
- Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.,Amsterdam Public Health, Societal Participation and Health, Amsterdam, the Netherlands.,Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands
| | - Astrid de Wind
- Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.,Amsterdam Public Health, Societal Participation and Health, Amsterdam, the Netherlands
| | - Pieter Coenen
- Amsterdam Public Health, Societal Participation and Health, Amsterdam, the Netherlands.,Public and Occupational Health, Amsterdam UMC Location Vrije Universiteit, Amsterdam, De Boelelaan 1117 Amsterdam, the Netherlands.,Amsterdam Movement Sciences, Musculoskeletal Health, Amsterdam, the Netherlands
| | - Fenna van Ommen
- Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.,Amsterdam Public Health, Societal Participation and Health, Amsterdam, the Netherlands
| | - Michiel A Greidanus
- Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.,Amsterdam Public Health, Societal Participation and Health, Amsterdam, the Netherlands
| | - Amber D Zegers
- Amsterdam Public Health, Societal Participation and Health, Amsterdam, the Netherlands.,Public and Occupational Health, Amsterdam UMC Location Vrije Universiteit, Amsterdam, De Boelelaan 1117 Amsterdam, the Netherlands
| | - Saskia F A Duijts
- Amsterdam Public Health, Societal Participation and Health, Amsterdam, the Netherlands.,Public and Occupational Health, Amsterdam UMC Location Vrije Universiteit, Amsterdam, De Boelelaan 1117 Amsterdam, the Netherlands.,Research & Development, Netherlands Comprehensive Cancer Organisation, Utrecht, the Netherlands
| | - Sietske J Tamminga
- Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.,Amsterdam Public Health, Societal Participation and Health, Amsterdam, the Netherlands.,Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands
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4
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Kobayashi M, Sezai I, Ishikawa T, Masujima M. Psychological and educational support for cancer patients who return to work: A scoping review. Work 2022; 73:291-300. [DOI: 10.3233/wor-205326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND: Many patients with cancer experience challenges when they return to work (RTW) following cancer diagnosis and treatment. Psycho-educational support is important to facilitate the RTW process. OBJECTIVE: This scoping review examined published reports on psycho-educational support for patients with cancer who RTW. METHODS: We followed the preferred reported items for systematic reviews and meta-analyses statement and the framework of Arksey and O’Malley. We searched the Cochrane Central Register of Controlled Trials database, PubMed, CINAHL (EBSCO), and ICHUSHI and performed manual searches. RESULTS: We retrieved 1,586 articles and retained 48 for analysis (published January 2000 to December 2020). Physicians, occupational physicians, nurses, social workers, and psychologists provide considerable support in hospitals. Delivery modes included individual, face-to-face, and workbook. Psychological support included emotional, stress coping, counseling, and knowledge. Educational support included information or advice provision, communication skills, problem discussion, and work planning. Employment status was typically the primary outcome. We included 50 measurement scales across quality of life, cognitive functioning and illness, self-efficacy, psychological distress, and fatigue. CONCLUSION: This review elucidated psycho-educational support for patients with cancer who RTW, and measurement tools for related effects. Based on the characteristics of the psycho-educational support revealed in this study, future studies should examine the development, intervention, and implementation of support programs for patients’ RTW.
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Affiliation(s)
- Masamitsu Kobayashi
- Faculty of Nursing, National Defense Medical College, Saitama, Japan
- Graduate School of Nursing, Chiba University, Chiba, Japan
| | - Izumi Sezai
- Faculty of Nursing, National Defense Medical College, Saitama, Japan
| | - Takako Ishikawa
- Graduate School Health Care Scienses, Tokyo Medical and Dental University, Tokyo, Japan
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5
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Understanding Cancer Survivors’ Needs and Experiences Returning to Work Post-Treatment: A Longitudinal Qualitative Study. Curr Oncol 2022; 29:3013-3025. [PMID: 35621635 PMCID: PMC9139703 DOI: 10.3390/curroncol29050245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/20/2022] [Accepted: 04/21/2022] [Indexed: 11/16/2022] Open
Abstract
Background: This study aimed to understand Canadian cancer survivors’ experiences during the return-to-work (RTW) process. Methods: A prospective qualitative longitudinal design was employed using the principles of phenomenological inquiry. Cancer survivors took part in three in-depth interviews: at the end of treatment, and 3 and 9 months after the first interview. Transcripts were analyzed using constant comparative analysis, guided by the Cancer and Work model. Results: A total of 38 in-depth interviews were conducted with 13 participants. The resultant themes were: (1) supports received or desired to enable RTW; (2) others’ limited understanding of the long-term impacts of a cancer diagnosis and its treatment; (3) worries and self-doubts about returning to work; and (4) changing perspectives on life and work after cancer. Conclusions: Cancer patients returning to work after treatment often experience challenges throughout the process, including varying levels of support from others and a range of ongoing effects and motivation to RTW. There is a clear gap in terms of the professional supports available to these individuals. Future research should focus on investigating how to improve both quality and accessibility of supports in a way that is personalized to the individual.
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6
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Guo YJ, Tang J, Li JM, Zhu LL, Xu JS. Exploration of interventions to enhance return-to-work for cancer patients: A scoping review. Clin Rehabil 2021; 35:1674-1693. [PMID: 34227435 DOI: 10.1177/02692155211021706] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE With the increasing incidence and earlier onset of cancer, more and more cancer patients are facing the problems of return-to-work. This review is to explore the types, contents, and results of return-to-work interventions for cancer patients. METHODS This scoping review followed Arksey and O'Malley's framework and PRISMA-ScR List. Three Chinese databases and five English databases were searched from the establishment of databases to 31 March, 2021. Article selection and data extraction were conducted by two researchers. RESULTS Thirty-two studies and 1916 cancer patients with mainly breast and gastrointestinal cancer were included. According to the contents, interventions could be divided into four types: (1) physical interventions (n = 6), including high-intensity exercise, low-to-moderate intensity exercise, yoga, and upper limb functional training, (2) psychological interventions (n = 2), including early active individualized psychosocial support and mindfulness-based recovery, (3) vocational interventions (n = 14), including making work plans, educational leaflets, vocational consultations, electronic health intervention, and interventions targeting at employers, (4) multidisciplinary interventions (n = 10), including any combination of above interventions. Physical exercises, making working plans, vocational consultations, educational leaflets, two combinations of vocational and physical interventions were validated to have positive results in enhancing cancer patients' return-to-work. CONCLUSIONS Return-to-work interventions for cancer patients are diversified and can be divided into physical, psychological, vocational, and multidisciplinary interventions. Medical staffs can utilize physical exercises, making working plans, vocational consultation, educational leaflets, combinations of vocational and physical interventions to enhance cancer patients' return-to-work. Other interventions still need to be developed and validated.
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Affiliation(s)
- Yu-Jie Guo
- Medical School (School of Nursing), Nantong University, Nantong, Jiangsu, China
| | - Jue Tang
- Medical School (School of Nursing), Nantong University, Nantong, Jiangsu, China
| | - Jia-Mei Li
- Medical School (School of Nursing), Nantong University, Nantong, Jiangsu, China
| | - Ling-Li Zhu
- Medical School (School of Nursing), Nantong University, Nantong, Jiangsu, China
| | - Jia-Shuo Xu
- Medical School (School of Nursing), Nantong University, Nantong, Jiangsu, China
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7
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Tamminga SJ, Jansen LP, Frings-Dresen MHW, de Boer AGEM. Long-term employment status and quality of life after cancer: A longitudinal prospective cohort study from diagnosis up to and including 5 years post diagnosis. Work 2021; 66:901-907. [PMID: 32925145 PMCID: PMC7683081 DOI: 10.3233/wor-203234] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND: Accumulating evidence suggests that cancer survivors are able to return to work. However, little is known about their work situation 5 years after diagnosis. OBJECTIVE: To explore fluctuations in employment status and its association with quality of life 2, 3, and 5 years after cancer diagnosis of 65 cancer survivors employed at diagnosis. METHODS: In association with a randomised controlled trial (RCT), questionnaires were administrated to eligible cancer survivors at diagnosis, 2, 3, and 5 years thereafter comprising of validated questionnaires related to work (i.e. Work Ability Index (WAI), cancer, and quality of life (QOL) (i.e. SF-36, VAS QOL). The RCT studied a hospital-based work support intervention in female breast and gynaecological cancer survivors who were treated with curative intent and had paid work at diagnosis. Descriptive statistics and longitudinal multi-level analysis were employed. RESULTS: Sixty-five of the 102 eligible cancer survivors participated, who were primarily diagnosed with breast cancer (63%). Two and 5 years after cancer diagnosis respectively 63 (97%) and 48 (81%) participants were employed. Reasons for not being employed after 5 years included receiving unemployment benefits (7%), voluntary unemployment (3%), receiving disability benefits (3%), and early retirement (3%). Longitudinal multi-level analysis showed that employed cancer survivors reported in general statistically significant better quality of life outcomes at 5 years follow-up compared to those not being employed. CONCLUSIONS: We found high employment rates and few fluctuations in employment status. The steepest decline in employment rate occurs after the first two years of diagnosis. Employed participants reported better quality of life outcomes. Survivorship care should therefore focus on the population at risk possibly within the first two years after diagnosis.
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Affiliation(s)
- Sietske J Tamminga
- Academic Medical Center, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Lyanne P Jansen
- Academic Medical Center, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Monique H W Frings-Dresen
- Academic Medical Center, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Angela G E M de Boer
- Academic Medical Center, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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8
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Zaman ACGNM, Tytgat KMAJ, Klinkenbijl JHG, Boer FCD, Brink MA, Brinkhuis JC, Bruinvels DJ, Dol LCM, van Duijvendijk P, Hemmer PHJ, Lamme B, Loosveld OJL, Mok MM, Rejda T, Rutten H, Schoorlemmer A, Sonneveld DJ, Stassen LPS, Veenstra RP, van de Ven A, Velzing ER, Frings-Dresen MHW, de Boer AGEM. Effectiveness of a Tailored Work-Related Support Intervention for Patients Diagnosed with Gastrointestinal Cancer: A Multicenter Randomized Controlled Trial. JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:323-338. [PMID: 32880094 PMCID: PMC8172517 DOI: 10.1007/s10926-020-09920-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Purpose The aim of this research was to study the effectiveness on return to work (RTW) of an early tailored work-related support intervention in patients diagnosed with curative gastrointestinal cancer. Methods A multicenter randomized controlled trial was undertaken, in which patients were assigned randomly to the intervention or the control group (usual care). The intervention encompassed three psychosocial work-related support meetings, starting before treatment. Five self-reported questionnaires were sent over twelve months of follow-up. Primary outcome was days until RTW (fulltime or partial) and secondary outcomes included work status, quality of life, work ability, and work limitations. Descriptive analysis, Kaplan-Meier analysis, relative risk ratio and linear mixed models were applied. Results Participants (N = 88) had a mean age of 55 years; 67% were male and the most common cancer type was colon cancer (66%). Of the participants, 42 were randomized to the intervention group. The median time from sick leave until RTW was 233 days (range 187-279 days) for the control group, versus 190 days (range 139-240 days) for the intervention group (log-rank p = 0.37). The RTW rate at twelve months after baseline was 83.3% for the intervention group and 73.5% for the control group. Work limitations did statistically differ between the groups over time (p = 0.01), but quality of life and work ability did not. Conclusion Patients in the intervention group seem to take fewer days to RTW, albeit not to a statistically significant extent.Trial registration Trial NL4920 (NTR5022) (Dutch Trial Register https://www.trialregister.nl ).
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Affiliation(s)
- A. C. G. N. M. Zaman
- Amsterdam UMC (Location AMC), Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands
| | - K. M. A. J. Tytgat
- Amsterdam UMC (Location AMC), Department of Gastroenterology, University of Amsterdam, Amsterdam, The Netherlands
| | - J. H. G. Klinkenbijl
- Department of Surgery, Gelre Hospitals, Apeldoorn, The Netherlands
- University of Amsterdam, Amsterdam, The Netherlands
| | - F. C. den Boer
- Department of Surgery, Zaans Medical Center, Zaandam, The Netherlands
| | - M. A. Brink
- Department of Gastroenterology, Meander Medical Center, Amersfoort, The Netherlands
| | | | | | - L. C. M. Dol
- Department of Surgery, Northwest Hospital Group, Alkmaar, The Netherlands
| | | | - P. H. J. Hemmer
- Department of Surgical Oncology, University Medical Center Groningen (UMCG), Groningen, The Netherlands
| | - B. Lamme
- Department of Surgery, Albert Schweitzer Hospital, Dordrecht, The Netherlands
| | - O. J. L. Loosveld
- Department of Medical Oncology, Amphia Hospital, Breda, The Netherlands
| | - M. M. Mok
- Department of Surgery, OLVG (Location East), Amsterdam, The Netherlands
| | - T. Rejda
- Tomas Rejda Counselling (Oncological Occupational Physician), Alphen aan den Rijn, The Netherlands
| | - H. Rutten
- Department of Surgery, Catharina Hospital Eindhoven, Eindhoven, The Netherlands
| | - A. Schoorlemmer
- Amsterdam UMC (Location AMC), Department of Surgery, University of Amsterdam, Amsterdam, The Netherlands
| | - D. J. Sonneveld
- Department of Surgery, Dijklander Hospital, Hoorn, The Netherlands
| | - L. P. S. Stassen
- Department of Surgery, Maastricht University Medical Center (MUMC), Maastricht, The Netherlands
| | - R. P. Veenstra
- Department of Gastroenterology, Martini Hospital, Groningen, The Netherlands
| | - A. van de Ven
- Department of General Surgery, Flevo Hospital, Almere, The Netherlands
| | - E. R. Velzing
- Vel.Onc@Work Counselling (Oncological Occupational Physician), Leidschendam, The Netherlands
| | - M. H. W. Frings-Dresen
- Amsterdam UMC (Location AMC), Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands
| | - A. G. E. M. de Boer
- Amsterdam UMC (Location AMC), Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, The Netherlands
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Hatton R, Wallis A, Chew A, Stanley M, Smith A. Return to work and cancer: Perspectives of occupational therapists. Aust Occup Ther J 2021; 68:298-307. [PMID: 33686685 DOI: 10.1111/1440-1630.12727] [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] [Received: 09/29/2020] [Revised: 02/04/2021] [Accepted: 02/15/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Progress in the early detection, diagnosis, and treatment of cancer has translated into more people in Australia living with and beyond cancer. Therefore, there is a larger number of people returning to work following cancer treatment while managing ongoing symptoms of cancer, and side effects of treatment. The purpose of this study was to explore the facilitators and barriers for return to work for someone with cancer, from the perspective of occupational therapists. METHOD This study used a qualitative descriptive design. Participants were recruited via key contacts within the industry and relevant interest groups, and included eight occupational therapists with experience supporting someone with cancer to return to work. Data were collected in semi-structured in-depth Interviews which were audio recorded, transcribed verbatim, and analysed thematically. FINDINGS Two main themes were developed; expectations of the cancer experience versus reality, and vulnerability during return to work. Occupational therapists perceived that the person with cancer, employers, family members, co-workers, and society underestimate the impact of ongoing cancer symptoms on return to work. Return to work was challenging as survivors face unexpected challenges due to ongoing fatigue, cognitive difficulties, or psychological factors. Fear of relapse, concerns regarding disclosure affecting how people with cancer are perceived at work, and worries of leaving the high levels of professional support during treatment, also affected return to work. CONCLUSION Findings from this study may contribute to occupational therapists and people with cancer setting realistic expectations for the return to work experience. Furthermore, it may provide support for occupational therapists to work more effectively with their clients to facilitate a smoother transition back to work as a cancer survivor.
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Affiliation(s)
| | - Amy Wallis
- Edith Cowan University, Joondalup, WA, Australia
| | - Angela Chew
- Edith Cowan University, Joondalup, WA, Australia
| | | | - Andrew Smith
- Leukaemia Foundation, North Melbourne, Vic., Australia
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10
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Salit RB, Lee SJ, Burns LJ, Shaw BE, Majhail NS, Bhatt NS, Wood WA, Syrjala KL. Return-to-Work Guidelines and Programs for Post-Hematopoietic Cell Transplantation Survivors: An Initial Survey. Biol Blood Marrow Transplant 2020; 26:1520-1526. [PMID: 32360563 DOI: 10.1016/j.bbmt.2020.04.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 04/09/2020] [Accepted: 04/18/2020] [Indexed: 11/15/2022]
Abstract
Hematopoietic cell transplantation (HCT) requires absence from work, with potential consequences of unemployment and early retirement. Risk factors for failure to return to work (RTW) following HCT have been reported, but there is little information about how transplant centers facilitate the RTW transition for their post-HCT patients. In the present study, we aimed to determine (1) whether transplant centers have guidelines for RTW post-HCT and the consistency of these guidelines and (2) whether centers have RTW programs for their patients, and the characteristics of these programs. We surveyed representatives from 150 adult transplant centers regarding their RTW guidelines and RTW programs. Centers were selected if they performed at least 50 HCTs (autologous [auto] and/or allogeneic [allo]) annually. The online survey contained 32 open-ended and closed-ended questions and 3 questions each eliciting respondents' demographic and transplant centers information. We received completed surveys from 45 centers (30% response rate). Forty-four percent of centers reported having RTW guidelines. All centers recommend RTW at 6 months or less after HCT for their auto-HCT recipients; recommendations for allo-HCT recipients ranged from 4 months to >1 year after HCT having jobs involving interactions with children, sick people, and animals was considered a reason to delay RTW by most centers. Although 87% of centers endorsed that RTW is a problem for post-HCT recipients, only 36% reported having an RTW program for their patients. The majority validated that RTW programs would be either somewhat helpful (36%) or very helpful (51%) for their patients. The majority of responding HCT centers believe that RTW is a problem for patients after HCT; however, consistent guidelines and RTW programs are lacking. With increasing numbers of HCT survivors, efforts to create standardized guidelines and to develop RTW programs are needed.
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Affiliation(s)
- Rachel B Salit
- Fred Hutchinson Cancer Research Center, Seattle, Washington; University of Washington School of Medicine, Seattle, Washington.
| | - Stephanie J Lee
- Fred Hutchinson Cancer Research Center, Seattle, Washington; University of Washington School of Medicine, Seattle, Washington
| | - Linda J Burns
- Transplant, Cellular Therapy, and Health Services Research, LLC, Stillwater, Minnesota
| | - Bronwen E Shaw
- Center for International Blood and Marrow Transplant Research and Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Navneet S Majhail
- Blood and Marrow Transplant Program, Cleveland Clinic, Cleveland Ohio
| | - Neel S Bhatt
- Fred Hutchinson Cancer Research Center, Seattle, Washington; University of Washington School of Medicine, Seattle, Washington
| | - William A Wood
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Karen L Syrjala
- Fred Hutchinson Cancer Research Center, Seattle, Washington; University of Washington School of Medicine, Seattle, Washington
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11
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Tamminga SJ, Verbeek JHAM, Bos MMEM, Fons G, Kitzen JJEM, Plaisier PW, Frings-Dresen MHW, de Boer AGEM. Two-Year Follow-Up of a Multi-centre Randomized Controlled Trial to Study Effectiveness of a Hospital-Based Work Support Intervention for Cancer Patients. JOURNAL OF OCCUPATIONAL REHABILITATION 2019; 29:701-710. [PMID: 30778742 PMCID: PMC6838305 DOI: 10.1007/s10926-019-09831-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Purpose Purpose is to: (1) study effectiveness of the hospital-based work support intervention for cancer patients at two years of follow-up compared to usual care and (2) identify which early factors predict time to return-to-work (RTW). Methods In this multi-center randomised controlled trial (RCT), 106 (self-)employed cancer patients were randomized to an intervention group or control group and provided 2 years of follow-up data. The intervention group received patient education and work-related support at the hospital. Primary outcome was RTW (rate and time) and quality of life (SF-36), and secondary outcomes were, work ability (WAI), and work functioning (WLQ). Univariate Cox regression analyses were performed to study which early factors predict time to full RTW. Results Participants were diagnosed with breast (61%), gynaecological cancer (35%), or other type of cancer (4%). RTW rates were 84% and 90% for intervention versus control group. They were high compared to national register-based studies. No differences between groups were found on any of the outcomes. Receiving chemotherapy (HR = 2.43, 95% CI 1.59-3.73 p < 0.001), low level of education (HR = 1.65, 95% CI 1.076-2.52 p = 0.02) and low work ability (HR = 1.09 [95% CI 1.04-1.17] p = 0.02) were associated with longer time to full RTW. Conclusions We found high RTW rates compared to national register-based studies and we found no differences between groups. Future studies should therefore focus on reaching the group at risk, which consist of patients who receive chemotherapy, have a low level of education and have a low work ability at diagnosis. TRIAL REGISTRATION: Netherlands Trial Registry (NTR) (http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1658): NTR1658.
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Affiliation(s)
- S J Tamminga
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - J H A M Verbeek
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Finnish Institute of Occupational Health, Kuopio, Finland
| | - M M E M Bos
- Department of Internal Medicine, Reinier de Graaf Groep, Delft, The Netherlands
| | - G Fons
- Department of Gynaecology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - J J E M Kitzen
- Department of Internal Medicine, Albert Schweitzer Hospital, Dordrecht, The Netherlands
| | - P W Plaisier
- Department of Surgery, Albert Schweitzer Hospital, Dordrecht, The Netherlands
| | - M H W Frings-Dresen
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - A G E M de Boer
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
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Söderman M, Friberg E, Alexanderson K, Wennman-Larsen A. Women's experiences of encounters with healthcare professionals' regarding work after breast-cancer surgery and associations with sickness absence: a 2-year follow-up cohort study. Support Care Cancer 2019; 27:1197-1206. [PMID: 30255432 PMCID: PMC6394695 DOI: 10.1007/s00520-018-4453-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 08/30/2018] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Breast cancer (BC) is the most common cancer among women, and half of those diagnosed are of working age. Positive encounters regarding work from healthcare professionals have been shown to promote return to work among sickness absentees in general. However, the knowledge about encounters possible associations with sickness absence (SA) in women with BC is scarce. AIM To explore if women had experienced encounters regarding work from healthcare professionals during the first year after BC surgery and if this was associated with SA during the second year after surgery, controlled for treatment and sociodemographic effects. METHODS A prospective cohort study of 690 Swedish women with primary BC, aged 24-63 years included after surgery. Descriptive statistics and adjusted logistic regression (age, birth country, education, self-rated health, treatment) with 95% confidence intervals (CI) were used. RESULTS Eighty percent of the women had experienced encounters regarding work. Women who got advice and support regarding work (adjusted odds ratio (OR) 0.5; 0.3-0.9) or were encouraged to work (adjusted OR 0.6; 0.3-0.9) had less SA. A larger proportion of those encouraged to work had less advanced cancer, surgery, hormone, or radiotherapy. Consistently, women encouraged to be on SA had more SA, but this was partly explained by disease or treatment factors (crude OR 1.6; 1.1-2.4, adjusted OR 1.2 (0.8-1.9) since a larger proportion of those with more advanced cancer, surgery, or chemotherapy had more SA. CONCLUSION Most women experienced encounters regarding work, and the nature of these encounters were associated with SA 2 years after BC surgery.
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Affiliation(s)
- Mirkka Söderman
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77, Stockholm, Sweden.
| | - E Friberg
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77, Stockholm, Sweden
| | - K Alexanderson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77, Stockholm, Sweden
| | - A Wennman-Larsen
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77, Stockholm, Sweden
- Sophiahemmet University, Stockholm, Sweden
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13
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The International Classification of Functioning, Disability, and Health Model Guides Individualized Care for a Patient With Cancer: A Case Report. REHABILITATION ONCOLOGY 2018. [DOI: 10.1097/01.reo.0000000000000074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Caron M, Durand MJ, Tremblay D. [Interventions to support the return-to-work process after cancer: a literature review]. SANTE PUBLIQUE 2018; 29:655-664. [PMID: 29384299 DOI: 10.3917/spub.175.0655] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Returning to work after cancer can be challenging for cancer survivors and little is known about interventions designed to support survivors returning to work. PURPOSE The objective of this review was to identify interventions designed to support the return-to-work process after a cancer diagnosis. METHODS A literature review was performed mainly done by consulting bibliographical databases. Systematic analysis and interpretation of the results were then performed. RESULTS Twenty-two articles were identified. The first finding is that very few interventions are specifically devoted to return to work after cancer and are usually administered in the clinical setting by healthcare practitioners. The activities proposed to support return to work in these interventions are individual counselling, provision of information and support groups. These activities are provided by various multidisciplinary teams composed of one or more professionals: occupational physicians, social workers and nurses. A second finding is that even with the use of experimental and quasi-experimental approaches, no effect was observed on return to work. CONCLUSION This integrative review highlights two recommendations for the development of future interventions. First, to improve the efficacy of future interventions on return to work of cancer survivors, these interventions must be developed and supported by an intervention theory. Second, future interventions must include and mobilize workplaces.
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15
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Duijts SFA. Management of work through the seasons of cancer survivorship. Curr Opin Support Palliat Care 2017; 12:80-85. [PMID: 29176331 DOI: 10.1097/spc.0000000000000320] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
PURPOSE OF REVIEW Survival from cancer has expanded enormously over the past decades. It is estimated that 40-50% of all cancer survivors are of working age at time of diagnosis and thus potentially part of the labor force. The seasons of survivorship can be used as a steppingstone to describe issues regarding employability survivors are dealing with. RECENT FINDINGS The acute survival stage begins at the point of diagnosis. Disclosure of diagnosis, and flexibility of both employers and (occupational) healthcare professionals are important factors in this stage. Extended survival starts when the survivor has completed the basic course of treatment. Survivors become aware that the old normality at work will be difficult to achieve. Problems like fear of recurrence, cognitive, and physical limitations might intensify during this stage and affect work ability. Permanent survival can be called long-term remission. Prospective studies on work-related outcomes and work-related interventions in this stage are rare. SUMMARY It is important to improve our understanding of the seasons of survival and to explore concepts, such as employability, against the background of these seasons. This perspective may help both survivors and (occupational) healthcare professionals to develop better strategies for dealing with the difficult life event cancer represents in each specific stage.
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Affiliation(s)
- Saskia F A Duijts
- Department of Public and Occupational Health, VU University Medical Center, EMGO+ Institute for Health and Care Research.,Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
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Leensen M, Groeneveld I, Rejda T, Groenenboom P, van Berkel S, Brandon T, de Boer A, Frings-Dresen M. Feasibility of a multidisciplinary intervention to help cancer patients return to work. Eur J Cancer Care (Engl) 2017; 27:e12690. [DOI: 10.1111/ecc.12690] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2017] [Indexed: 11/30/2022]
Affiliation(s)
- M.C.J. Leensen
- Coronel Institute of Occupational Health; Academic Medical Center; University of Amsterdam; Amsterdam The Netherlands
| | | | - T. Rejda
- Leiden University Medical Center; Leiden The Netherlands
| | - P. Groenenboom
- Department of Sports Medicine; Medical Center Haaglanden; The Hague The Netherlands
| | - S. van Berkel
- Department of Sports Medicine; Isala; Zwolle The Netherlands
| | - T. Brandon
- Department of Sports Medicine; Isala; Zwolle The Netherlands
| | - A.G.E.M. de Boer
- Coronel Institute of Occupational Health; Academic Medical Center; University of Amsterdam; Amsterdam The Netherlands
| | - M.H.W. Frings-Dresen
- Coronel Institute of Occupational Health; Academic Medical Center; University of Amsterdam; Amsterdam The Netherlands
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17
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Williams-Whitt K, Bültmann U, Amick B, Munir F, Tveito TH, Anema JR. Workplace Interventions to Prevent Disability from Both the Scientific and Practice Perspectives: A Comparison of Scientific Literature, Grey Literature and Stakeholder Observations. JOURNAL OF OCCUPATIONAL REHABILITATION 2016; 26:417-433. [PMID: 27614465 PMCID: PMC5104758 DOI: 10.1007/s10926-016-9664-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Purpose The significant individual and societal burden of work disability could be reduced if supportive workplace strategies could be added to evidence-based clinical treatment and rehabilitation to improve return-to-work (RTW) and other disability outcomes. The goal of this article is to summarize existing research on workplace interventions to prevent disability, relate these to employer disability management practices, and recommend future research priorities. Methods The authors participated in a year-long collaboration that ultimately led to an invited 3-day conference, Improving Research of Employer Practices to Prevent Disability, held October 14-16, 2015, in Hopkinton, Massachusetts, USA. The collaboration included a topical review of the literature, group conference calls to identify key areas and challenges, drafting of initial documents, review of industry publications, and a conference presentation that included feedback from peer researchers and a question/answer session with an expert panel with direct employer experience. Results Evidence from randomized trials and other research designs has shown general support for job modification, RTW coordination, and organizational support, but evidence is still lacking for interventions at a more granular level. Grey literature reports focused mainly on job re-design and work organization. Panel feedback focused on organizational readiness and the beliefs and values of senior managers as critical factors in facilitating changes to disability management practices. While the scientific literature is focused on facilitating improved coping and reducing discomforts for individual workers, the employer-directed grey literature is focused on making group-level changes to policies and procedures. Conclusions Future research might better target employer practices by tying interventions to positive workplace influences and determinants, by developing more participatory interventions and research designs, and by designing interventions that address factors of organizational change.
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Affiliation(s)
- Kelly Williams-Whitt
- University of Lethbridge, 4401 University Drive, Lethbridge, AB, T1K 3M4, Canada.
| | - Ute Bültmann
- University Medical Center Groningen, Community and Occupational Medicine, University of Groningen, Groningen, The Netherlands
| | - Benjamin Amick
- Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
- Institute for Work and Health, Toronto, Canada
| | - Fehmidah Munir
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK
| | - Torill H Tveito
- Uni Research Health, Bergen, Norway
- Department of Health Promotion, University College of Southeast Norway, Horten, Norway
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18
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Tamminga SJ, Hoving JL, Frings-Dresen MHW, de Boer AGEM. Cancer@Work - a nurse-led, stepped-care, e-health intervention to enhance the return to work of patients with cancer: study protocol for a randomized controlled trial. Trials 2016; 17:453. [PMID: 27634549 PMCID: PMC5025547 DOI: 10.1186/s13063-016-1578-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Accepted: 08/31/2016] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Although the importance of work for patients with cancer is nowadays more acknowledged both in the literature as well as in cancer survivorship care, effective interventions targeting the return to work of these patients are still scarce. Therefore, we developed a nurse-led, stepped-care, e-health intervention aimed at enhancing the return to work of patients with cancer. The objective of this study is to describe the content of the intervention and the study design used to evaluate the feasibility and (cost) effectiveness of the intervention. METHODS We designed a multi-centre randomised controlled trial with a follow-up of 12 months. Patients who have paid employment at the time of diagnosis, are on sick leave and are between 18-62 years old will be eligible to participate. After patients have signed the informed consent form and filled in the baseline questionnaire, they are randomly allocated to either the nurse-led, stepped-care, e-health intervention called Cancer@Work, or care as usual. The primary outcome is sustainable return to work. Secondary outcomes are sick leave days, work ability, work functioning, quality of life, quality of working life and time from initial sick leave to full return to work without extensive need for recovery. The feasibility of the Cancer@Work intervention and direct and indirect costs will be determined. Outcomes will be assessed by questionnaires at 3, 6, 9 and 12 months of follow-up. DISCUSSION The results of this study will provide new insights into the feasibility and (cost) effectiveness of Cancer@Work, a nurse-led, stepped-care, e-health intervention for cancer patients aimed at enhancing their return to work. If proven effective, the intention is to implement the Cancer@Work intervention in usual psycho-oncological care. TRIAL REGISTRATION NTR (Netherlands Trial Registry): NTR5190 . Registered on 18 June 2015.
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Affiliation(s)
- Sietske J Tamminga
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
| | - Jan L Hoving
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Monique H W Frings-Dresen
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Angela G E M de Boer
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Désiron HAM, Crutzen R, Godderis L, Van Hoof E, de Rijk A. Bridging Health Care and the Workplace: Formulation of a Return-to-Work Intervention for Breast Cancer Patients Using an Intervention Mapping Approach. JOURNAL OF OCCUPATIONAL REHABILITATION 2016; 26:350-365. [PMID: 26728492 DOI: 10.1007/s10926-015-9620-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Purpose An increasing number of breast cancer (BC) survivors of working age require return to work (RTW) support. Objective of this paper is to describe the development of a RTW intervention to be embedded in the care process bridging the gap between hospital and workplace. Method The Intervention Mapping (IM) approach was used and combined formative research results regarding RTW in BC patients with published insights on occupational therapy (OT) and RTW. Four development steps were taken, starting from needs assessment to the development of intervention components and materials. Results A five-phased RTW intervention guided by a hospital-based occupational therapist is proposed: (1) assessing the worker, the usual work and contextual factors which impacts on (re-)employment; (2) exploration of match/differences between the worker and the usual work; (3) establishing long term goals, broken down into short term goals; (4) setting up tailored actions by carefully implementing results of preceding phases; (5) step by step, the program as described in phase 4 will be executed. The occupational therapist monitors, measures and reviews goals and program-steps in the intervention to secure the tailor-made approach of each program-step of the intervention. Conclusion The use of IM resulted in a RTW oriented OT intervention. This unique intervention succeeds in matching individual BC patient needs, the input of stakeholders at the hospital and the workplace.
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Affiliation(s)
- Huguette A M Désiron
- Centre Environment and Health, Katholieke Universiteit Leuven, Kapucijnenvoer 35, 3000, Louvain, Belgium.
- Occupational Therapy Education, Department of Health Care, University College of Hasselt PXL, Hasselt, Belgium.
| | - Rik Crutzen
- Department of Health Promotion, CAPHRI School for Public Health and Primary Care, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
| | - Lode Godderis
- Centre Environment and Health, Katholieke Universiteit Leuven, Kapucijnenvoer 35, 3000, Louvain, Belgium
- IDEWE, External Service for Prevention and Protection at Work, Interleuvenlaan 58, 3001, Heverlee, Belgium
| | - Elke Van Hoof
- Department of Experimental and Applied Psychology (EXTO), Faculty of Psychological and Educational Science, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium
| | - Angelique de Rijk
- Department of Social Medicine, Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
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20
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Zaman AGNM, Tytgat KMAJ, Klinkenbijl JHG, Frings-Dresen MHW, de Boer AGEM. Design of a multicentre randomized controlled trial to evaluate the effectiveness of a tailored clinical support intervention to enhance return to work for gastrointestinal cancer patients. BMC Cancer 2016; 16:303. [PMID: 27165185 PMCID: PMC4862045 DOI: 10.1186/s12885-016-2334-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 05/03/2016] [Indexed: 12/24/2022] Open
Abstract
Background Gastrointestinal (GI) cancer is frequently diagnosed in people of working age, and many GI cancer patients experience work-related problems. Although these patients often experience difficulties returning to work, supportive work-related interventions are lacking. We have therefore developed a tailored work-related support intervention for GI cancer patients, and we aim to evaluate its cost-effectiveness compared with the usual care provided. If this intervention proves effective, it can be implemented in practice to support GI cancer patients after diagnosis and to help them return to work. Methods/Design We designed a multicentre randomized controlled trial with a follow-up of twelve months. The study population (N = 310) will include individuals aged 18–63 years diagnosed with a primary GI cancer and employed at the time of diagnosis. The participants will be randomized to the intervention or to usual care. ‘Usual care’ is defined as psychosocial care in which work-related issues are not discussed. The intervention group will receive tailored work-related support consisting of three face-to-face meetings of approximately 30 min each. Based on the severity of their work-related problems, the intervention group will be divided into groups receiving three types of support (A, B or C). A different supportive healthcare professional will be available for each group: an oncological nurse (A), an oncological occupational physician (B) and a multidisciplinary team (C) that includes an oncological nurse, oncological occupational physician and treating oncologist/physician. The primary outcome measure is return to work (RTW), defined as the time to a partial or full RTW. The secondary outcomes are work ability, work limitations, quality of life, and direct and indirect costs. Discussion The hypothesis is that tailored work-related support for GI cancer patients is more effective than usual care in terms of the RTW. The intervention is innovative in that it combines oncological and occupational care in a clinical setting, early in the cancer treatment process. Trial registration METC protocol number NL51444.018.14/Netherlands Trial Register number NTR5022. Registered 6 March 2015.
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Affiliation(s)
- AnneClaire G N M Zaman
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
| | - Kristien M A J Tytgat
- Gastrointestinal Oncological Center Amsterdam, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Jean H G Klinkenbijl
- Department of Surgery, Gelre Hospital, Apeldoorn, The Netherlands.,Faculty of Medicine, University of Amsterdam, Amsterdam, The Netherlands
| | - Monique H W Frings-Dresen
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Angela G E M de Boer
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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van Vilsteren M, van Oostrom SH, de Vet HCW, Franche R, Boot CRL, Anema JR. Workplace interventions to prevent work disability in workers on sick leave. Cochrane Database Syst Rev 2015; 2015:CD006955. [PMID: 26436959 PMCID: PMC9297123 DOI: 10.1002/14651858.cd006955.pub3] [Citation(s) in RCA: 126] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Work disability has serious consequences for individuals as well as society. It is possible to facilitate resumption of work by reducing barriers to return to work (RTW) and promoting collaboration with key stakeholders. This review was first published in 2009 and has now been updated to include studies published up to February 2015. OBJECTIVES To determine the effectiveness of workplace interventions in preventing work disability among sick-listed workers, when compared to usual care or clinical interventions. SEARCH METHODS We searched the Cochrane Work Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and PsycINFO databases on 2 February 2015. SELECTION CRITERIA We included randomised controlled trials (RCTs) of workplace interventions that aimed to improve RTW for disabled workers. We only included studies where RTW or conversely sickness absence was reported as a continuous outcome. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed risk of bias of the studies. We performed meta-analysis where possible, and we assessed the quality of evidence according to GRADE criteria. We used standard methodological procedures expected by Cochrane. MAIN RESULTS We included 14 RCTs with 1897 workers. Eight studies included workers with musculoskeletal disorders, five workers with mental health problems, and one workers with cancer. We judged six studies to have low risk of bias for the outcome sickness absence.Workplace interventions significantly improved time until first RTW compared to usual care, moderate-quality evidence (hazard ratio (HR) 1.55, 95% confidence interval (CI) 1.20 to 2.01). Workplace interventions did not considerably reduce time to lasting RTW compared to usual care, very low-quality evidence (HR 1.07, 95% CI 0.72 to 1.57). The effect on cumulative duration of sickness absence showed a mean difference of -33.33 (95% CI -49.54 to -17.12), favouring the workplace intervention, high-quality evidence. One study assessed recurrences of sick leave, and favoured usual care, moderate-quality evidence (HR 0.42, 95% CI 0.21 to 0.82). Overall, the effectiveness of workplace interventions on work disability showed varying results.In subgroup analyses, we found that workplace interventions reduced time to first and lasting RTW among workers with musculoskeletal disorders more than usual care (HR 1.44, 95% CI 1.15 to 1.82 and HR 1.77, 95% CI 1.37 to 2.29, respectively; both moderate-quality evidence). In studies of workers with musculoskeletal disorders, pain also improved (standardised mean difference (SMD) -0.26, 95% CI -0.47 to -0.06), as well as functional status (SMD -0.33, 95% CI -0.58 to -0.08). In studies of workers with mental health problems, there was a significant improvement in time until first RTW (HR 2.64, 95% CI 1.41 to 4.95), but no considerable reduction in lasting RTW (HR 0.79, 95% CI 0.54 to 1.17). One study of workers with cancer did not find a considerable reduction in lasting RTW (HR 0.88, 95% CI 0.53 to 1.47).In another subgroup analysis, we did not find evidence that offering a workplace intervention in combination with a cognitive behavioural intervention (HR 1.93, 95% CI 1.27 to 2.93) is considerably more effective than offering a workplace intervention alone (HR 1.35, 95% CI 1.01 to 1.82, test for subgroup differences P = 0.17).Workplace interventions did not considerably reduce time until first RTW compared with a clinical intervention in workers with mental health problems in one study (HR 2.65, 95% CI 1.42 to 4.95, very low-quality evidence). AUTHORS' CONCLUSIONS We found moderate-quality evidence that workplace interventions reduce time to first RTW, high-quality evidence that workplace interventions reduce cumulative duration of sickness absence, very low-quality evidence that workplace interventions reduce time to lasting RTW, and moderate-quality evidence that workplace interventions increase recurrences of sick leave. Overall, the effectiveness of workplace interventions on work disability showed varying results. Workplace interventions reduce time to RTW and improve pain and functional status in workers with musculoskeletal disorders. We found no evidence of a considerable effect of workplace interventions on time to RTW in workers with mental health problems or cancer.We found moderate-quality evidence to support workplace interventions for workers with musculoskeletal disorders. The quality of the evidence on the effectiveness of workplace interventions for workers with mental health problems and cancer is low, and results do not show an effect of workplace interventions for these workers. Future research should expand the range of health conditions evaluated with high-quality studies.
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Affiliation(s)
- Myrthe van Vilsteren
- VU University Medical CenterDepartment of Public and Occupational Health, EMGO Institute for Health and Care ResearchPO Box 7057AmsterdamNetherlands1007 MB
| | - Sandra H van Oostrom
- National Institute for Public Health and the EnvironmentCentre for Nutrition, Prevention and Health ServicesBilthovenNetherlands
| | - Henrica CW de Vet
- VU University Medical CenterDepartment of Epidemiology and Biostatistics, EMGO Institute for Health and Care ResearchPO Box 7057AmsterdamNetherlands1007 MB
| | | | - Cécile RL Boot
- EMGO Institute for Health and Care Research, VU University Medical CenterDepartment of Public and Occupational HealthAmsterdamNetherlands
| | - Johannes R Anema
- VU University Medical CenterDepartment of Public and Occupational Health, EMGO Institute for Health and Care ResearchPO Box 7057AmsterdamNetherlands1007 MB
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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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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.
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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.
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Sandberg JC, Strom C, Arcury TA. Strategies used by breast cancer survivors to address work-related limitations during and after treatment. Womens Health Issues 2014; 24:e197-204. [PMID: 24560121 DOI: 10.1016/j.whi.2013.12.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 12/18/2013] [Accepted: 12/19/2013] [Indexed: 11/25/2022]
Abstract
BACKGROUND The primary objective of this exploratory study was to delineate the broad range of adjustments women breast cancer survivors draw upon to minimize cancer-related limitations at the workplace. The study also analyzed whether survivors used strategies to address work-related limitations in isolation or in combination with other strategies, and whether they used formal or informal strategies. METHODS Semi-structured, in-depth interviews were conducted with 14 women who were employed at the time of diagnosis of breast cancer and who continued to work during treatment or returned to work. Interviews were conducted 3 to 24 months after diagnosis. An iterative process was used to systematically analyze the data (the transcripts) using qualitative methods. FINDINGS Participants who worked during or after treatment adjusted their work schedule, performed fewer or other tasks, modified or changed their work environment, reduced non-work activities at the workplace, used cognitive prompts, and acted preemptively to make work tasks manageable after their return to work. Survivors used multiple adjustments and drew upon both formal and informal tactics to minimize or prevent cancer- or treatment-related effects from negatively affecting job performance. CONCLUSIONS Knowledge about the broad range of both formal and informal strategies identified in this study may enable health care and social services providers, as well as cancer survivors and employers, to identify a wide range of specific strategies that may reduce the negative effects of work-related limitations in specific work settings. Insights gained from this analysis should inform future research on work and cancer survivorship.
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Affiliation(s)
- Joanne C Sandberg
- Department of Family and Community Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina.
| | - Carla Strom
- Wake Forest School of Medicine, Comprehensive Cancer Center, Medical Center Boulevard, Winston-Salem, North Carolina
| | - Thomas A Arcury
- Department of Family and Community Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina
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Berg L, Nolbris MJ, Koinberg I, Melin-Johansson C, Möller A, Ohlén J. Characterisation of cancer support and rehabilitation programmes: a Swedish multiple case study. Open Nurs J 2014; 8:1-7. [PMID: 24478809 PMCID: PMC3905349 DOI: 10.2174/1874434601408010001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Revised: 12/20/2013] [Accepted: 12/23/2013] [Indexed: 11/22/2022] Open
Abstract
Cancer support and rehabilitation are suggested to be an integral part of cancer care strategies. This study focuses on comparativeness of cancer support and rehabilitation programmes. The aim of this study was to analyse available cancer support and rehabilitation programmes in Sweden presented as complementary to cancer rehabilitation at cancer clinics. A multiple case study design was chosen in order to inquire the small number of existing supportive and rehabilitative cancer programmes. Based on the structures, processes and outcomes of the nine included programmes, three types of cancer support and rehabilitation programmes were identified: multimodal rehabilitation, comprehensive cancer support and art therapy. Cancer support and rehabilitation programmes offer a variety of activities and therapies which are highly valuable and relevant for people with cancer. The typology of cancer support and rehabilitation programmes and comparability between programmes need further inquiry.
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Affiliation(s)
- Linda Berg
- Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, SE 40530, Sweden
| | - Margaretha Jenholt Nolbris
- Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, SE 40530, Sweden
| | - Ingalill Koinberg
- Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, SE 40530, Sweden
| | - Christina Melin-Johansson
- Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, SE 40530, Sweden
| | - Anders Möller
- Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, SE 40530, Sweden
| | - Joakim Ohlén
- Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, SE 40530, Sweden
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Hubbard G, Gray NM, Ayansina D, Evans JMM, Kyle RG. Case management vocational rehabilitation for women with breast cancer after surgery: a feasibility study incorporating a pilot randomised controlled trial. Trials 2013; 14:175. [PMID: 23768153 PMCID: PMC3698180 DOI: 10.1186/1745-6215-14-175] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2013] [Accepted: 06/04/2013] [Indexed: 11/10/2022] Open
Abstract
Background There is a paucity of methodologically robust vocational rehabilitation (VR) intervention trials. This study assessed the feasibility and acceptability of a VR trial of women with breast cancer to inform the development of a larger interventional study. Methods Women were recruited in Scotland and randomised to either a case management VR service or to usual care. Data were collected on eligibility, recruitment and attrition rates to assess trial feasibility, and interviews conducted to determine trial acceptability. Sick leave days (primary outcome) were self-reported via postal questionnaire every 4 weeks during the first 6 months post-surgery and at 12 months. Secondary outcome measures were change in employment pattern, quality of life and fatigue. Results Of the 1,114 women assessed for eligibility, 163 (15%) were eligible. The main reason for ineligibility was age (>65 years, n = 637, 67%). Of those eligible, 111 (68%) received study information, of which 23 (21%) consented to participate in the study. Data for 18 (78%) women were analysed (intervention: n = 7; control: n = 11). Participants in the intervention group reported, on average, 53 fewer days of sick leave over the first 6 months post-surgery than those in the control group; however, this difference was not statistically significant (p = 0.122; 95% confidence interval −15.8, 122.0). No statistically significant differences were found for secondary outcomes. Interviews with trial participants indicated that trial procedures, including recruitment, randomisation and research instruments, were acceptable. Conclusions Conducting a pragmatic trial of effectiveness of a VR intervention among cancer survivors is both feasible and acceptable, but more research about the exact components of a VR intervention and choice of outcomes to measure effectiveness is required. VR to assist breast cancer patients in the return to work process is an important component of cancer survivorship plans. Trial registration ISRCTN29666484
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Affiliation(s)
- Gill Hubbard
- Cancer Care Research Centre, School of Nursing, Midwifery and Health, University of Stirling, Highland Campus, Centre for Health Science, Old Perth Road, Inverness IV2 3JH, UK.
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Tamminga SJ, Verbeek JHAM, Bos MMEM, Fons G, Kitzen JJEM, Plaisier PW, Frings-Dresen MHW, de Boer AGEM. Effectiveness of a hospital-based work support intervention for female cancer patients - a multi-centre randomised controlled trial. PLoS One 2013; 8:e63271. [PMID: 23717406 PMCID: PMC3661555 DOI: 10.1371/journal.pone.0063271] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Accepted: 04/02/2013] [Indexed: 12/24/2022] Open
Abstract
Objective One key aspect of cancer survivorship is return-to-work. Unfortunately, many cancer survivors face problems upon their return-to-work. For that reason, we developed a hospital-based work support intervention aimed at enhancing return-to-work. We studied effectiveness of the intervention compared to usual care for female cancer patients in a multi-centre randomised controlled trial. Methods Breast and gynaecological cancer patients who were treated with curative intent and had paid work were randomised to the intervention group (n = 65) or control group (n = 68). The intervention involved patient education and support at the hospital and improvement of communication between treating and occupational physicians. In addition, we asked patient's occupational physician to organise a meeting with the patient and the supervisor to make a concrete gradual return-to-work plan. Outcomes at 12 months of follow-up included rate and time until return-to-work (full or partial), quality of life, work ability, work functioning, and lost productivity costs. Time until return-to-work was analyzed with Kaplan-Meier survival analysis. Results Return-to-work rates were 86% and 83% (p = 0.6) for the intervention group and control group when excluding 8 patients who died or with a life expectancy of months at follow-up. Median time from initial sick leave to partial return-to-work was 194 days (range 14–435) versus 192 days (range 82–465) (p = 0.90) with a hazard ratio of 1.03 (95% CI 0.64–1.6). Quality of life and work ability improved statistically over time but did not differ statistically between groups. Work functioning and costs did not differ statistically between groups. Conclusion The intervention was easily implemented into usual psycho-oncological care and showed high return-to-work rates. We failed to show any differences between groups on return-to-work outcomes and quality of life scores. Further research is needed to study which aspects of the intervention are useful and which elements need improvement. Trial Registration Nederlands Trial Register (NTR) 1658
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Affiliation(s)
- Sietske J Tamminga
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
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28
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Mehnert A, de Boer A, Feuerstein M. Employment challenges for cancer survivors. Cancer 2013; 119 Suppl 11:2151-9. [DOI: 10.1002/cncr.28067] [Citation(s) in RCA: 193] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Revised: 11/29/2012] [Accepted: 12/03/2012] [Indexed: 11/10/2022]
Affiliation(s)
- Anja Mehnert
- Section of Psychosocial Oncology, Department of Medical Psychology and Medical Sociology; University Medical Center Leipzig; Leipzig Germany
- Department of Medical Psychology; University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - Angela de Boer
- Coronel Institute of Occupational Health; Academic Medical Center; Amsterdam the Netherlands
| | - Michael Feuerstein
- Department of Medical and Clinical Psychology; Uniformed Services University of the Health Sciences; Bethesda Maryland
- Department of Preventive Medicine and Biometrics; Uniformed Services University of the Health Sciences; Bethesda Maryland
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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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Björneklett HG, Rosenblad A, Lindemalm C, Ojutkangas ML, Letocha H, Strang P, Bergkvist L. A randomized controlled trial of support group intervention after breast cancer treatment: results on sick leave, health care utilization and health economy. Acta Oncol 2013; 52:38-47. [PMID: 23106175 DOI: 10.3109/0284186x.2012.734921] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND More than 50% of breast cancer patients are diagnosed before the age of 65. Returning to work after treatment is, therefore, of interest for both the individual and society. The aim was to study the effect of support group intervention on sick leave and health care utilization in economic terms. MATERIAL AND METHODS Of 382 patients with newly diagnosed breast cancer, 191 + 191 patients were randomized to an intervention group or to a routine control group, respectively. The intervention group received support intervention on a residential basis for one week, followed by four days of follow-up two months later. The support intervention included informative-educational sections, relaxation training, mental visualization and non-verbal communication. Patients answered a questionnaire at baseline, two, six and 12 months about sick leave and health care utilization. RESULTS There was a trend towards longer sick leave and more health care utilization in the intervention group. The difference in total costs was statistically significantly higher in the intervention group after 12 months (p = 0.0036). CONCLUSION Costs to society were not reduced with intervention in its present form.
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31
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Tamminga SJ, de Boer AGEM, Bos MMEM, Fons G, Kitzen JJEM, Plaisier PW, Verbeek JHAM, Frings-Dresen MHW. A hospital-based work support intervention to enhance the return to work of cancer patients: a process evaluation. JOURNAL OF OCCUPATIONAL REHABILITATION 2012; 22:565-78. [PMID: 22699884 PMCID: PMC3484279 DOI: 10.1007/s10926-012-9372-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
PURPOSE To perform a process evaluation of a hospital-based work support intervention for cancer patients aimed at enhancing return to work and quality of life. The intervention involves the delivery of patient education and support at the hospital and involves the improvement of the communication between the treating physician and the occupational physician. In addition, the research team asked patient's occupational physician to organise a meeting with the patient and the supervisor to make a concrete gradual return-to-work plan. METHODS Eligible were cancer patients treated with curative intent and who have paid work. Data were collected from patients assigned to the intervention group (N = 65) and from nurses who delivered the patient education and support at the hospital (N = 4) by means of questionnaires, nurses' reports, and checklists. Data were quantitatively and qualitatively analysed. RESULTS A total of 47 % of all eligible patients participated. Nurses delivered the patient education and support in 85 % of the cases according to the protocol. In 100 % of the cases at least one letter was sent to the occupational physician. In 10 % of the cases the meeting with the patient, the occupational physician and the supervisor took place. Patients found the intervention in general very useful and nurses found the intervention feasible to deliver. CONCLUSIONS We found that a hospital- based work support intervention was easily accepted in usual psycho-oncological care but that it proved difficult to involve the occupational physician. Patients were highly satisfied and nurses found the intervention feasible.
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Affiliation(s)
- S J Tamminga
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, PO Box 22700, 1100 DE, Amsterdam, The Netherlands.
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Charns MP, Foster MK, Alligood EC, Benzer JK, Burgess JF, Li D, McIntosh NM, Burness A, Partin MR, Clauser SB. Multilevel interventions: measurement and measures. J Natl Cancer Inst Monogr 2012; 2012:67-77. [PMID: 22623598 DOI: 10.1093/jncimonographs/lgs011] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Multilevel intervention research holds the promise of more accurately representing real-life situations and, thus, with proper research design and measurement approaches, facilitating effective and efficient resolution of health-care system challenges. However, taking a multilevel approach to cancer care interventions creates both measurement challenges and opportunities. METHODS One-thousand seventy two cancer care articles from 2005 to 2010 were reviewed to examine the state of measurement in the multilevel intervention cancer care literature. Ultimately, 234 multilevel articles, 40 involving cancer care interventions, were identified. Additionally, literature from health services, social psychology, and organizational behavior was reviewed to identify measures that might be useful in multilevel intervention research. RESULTS The vast majority of measures used in multilevel cancer intervention studies were individual level measures. Group-, organization-, and community-level measures were rarely used. Discussion of the independence, validity, and reliability of measures was scant. DISCUSSION Measurement issues may be especially complex when conducting multilevel intervention research. Measurement considerations that are associated with multilevel intervention research include those related to independence, reliability, validity, sample size, and power. Furthermore, multilevel intervention research requires identification of key constructs and measures by level and consideration of interactions within and across levels. Thus, multilevel intervention research benefits from thoughtful theory-driven planning and design, an interdisciplinary approach, and mixed methods measurement and analysis.
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Affiliation(s)
- Martin P Charns
- Center for Organization, Leadership and Management Research, US Department of Veterans Affairs, Boston, MA, USA
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Ladehoff N, Sturm K, Mehnert A. Work-related self-report measures and assessment tools in cancer survivorship: a systematic literature review. Disabil Rehabil 2012; 35:100-12. [PMID: 22697459 DOI: 10.3109/09638288.2012.688921] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To systematically review and appraise studies examining self-report questionnaires measuring work-related aspects in cancer patients. METHOD Literature search methodology: Searches in Embase, PsycINFO, PSYNDEXplus, PSYNDEXplus Tests and PubMed for the period 1990-2011 were completed. Inclusion criteria were as follows: (i) the questionnaire measures work-related aspects; (ii) the questionnaire has been used in at least one study, which involved cancer patient as a relevant target group; and (iii) articles were written in English or German. RESULTS Twenty-two articles out of 350 records were reviewed and 13 questionnaires identified. The majority of measures cover several dimensions of work-related aspects representing a variety of work-related experiences and constructs such as aspects of the work environment, demands at work and work-related interpersonal relations. Nine of the 13 questionnaires showed good internal consistency whereas subscales of four instruments had fair or poor internal consistency. For 12 out of 13 measures, validity and reliability were tested in non-cancer populations. CONCLUSIONS The knowledge about reliability and validity of self-report questionnaires measuring work-related aspects in cancer patients is scarce and more high-quality validation studies are needed. Findings further emphasize the need for the development of valid multidimensional measures that are relevant for both research and rehabilitative occupational interventions.
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Affiliation(s)
- Natalie Ladehoff
- Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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de Boer AGEM, Bruinvels DJ, Tytgat KMAJ, Schoorlemmer A, Klinkenbijl JHG, Frings-Dresen MHW. Employment status and work-related problems of gastrointestinal cancer patients at diagnosis: a cross-sectional study. BMJ Open 2011; 1:e000190. [PMID: 22138895 PMCID: PMC3236817 DOI: 10.1136/bmjopen-2011-000190] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Objective To assess the employment status of patients with gastrointestinal cancer at diagnosis and to examine work-related problems of employed patients. Design New, consecutive patients were included at the Gastrointestinal Oncology Center Amsterdam, a one-stop, rapid access diagnostic assessment centre. Patients were interviewed on their employment status by a nurse. If (self-) employed, patients were asked to self-report on work-related problems, perceived distress (0-10), cancer-related problems, fatigue (MFI-20, range 4-20) and work ability (three WAI questions, range 0-10). Results Of all 333 included new consecutive patients (age range 32-89 years), 95 patients (28%) were (self-) employed at time of diagnosis, 179 (54%) were pensioners, and 59 were not working (18%). For the assessment of work-related problems, 45 (47%) of these 95 employed patients with cancer participated. Their mean age was 56 years, and patients had oesophageal/stomach (49%), colorectal (18%) or hepatic/pancreatic/biliary cancer (33%). Half of the employed patients (49%) were still at work, while 51% were on sick leave. The main reasons for sick leave were stress (35%), (scheduled) operation (26%), fatigue (17%) and pain (13%). Most patients on sick leave (70%) had no contact with their own occupational physician, although the majority (67%) would like to continue to work. Work-related problems were experienced by 73% of working patients. The mean work ability was 5.4, the mean general fatigue score was 11.5, and the mean distress score was 4.7. Employed patients on sick leave reported a lower work ability, more fatigue and higher distress but no more cancer-related problems compared with those still working. Conclusion A quarter of all patients with gastrointestinal cancer seen at an oncological centre are employed at time of diagnosis, and of these employed patients, 73% experience work-related problems. During diagnosis and treatment, information and support on work-related issues should be offered to patients with cancer as an essential part of high-quality oncological care.
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Affiliation(s)
- A G E M de Boer
- Coronel Institute of Occupational Health (Outpatient Clinic People and Work), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - D J Bruinvels
- Coronel Institute of Occupational Health (Outpatient Clinic People and Work), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - K M A J Tytgat
- Department of Gastroenterology and Hepatology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- Gastrointestinal Oncology Center Amsterdam (GIOCA), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - A Schoorlemmer
- Department of Gastroenterology and Hepatology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- Gastrointestinal Oncology Center Amsterdam (GIOCA), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - J H G Klinkenbijl
- Gastrointestinal Oncology Center Amsterdam (GIOCA), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- Department of Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - M H W Frings-Dresen
- Coronel Institute of Occupational Health (Outpatient Clinic People and Work), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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