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Beerda DCE, Greidanus MA, de Rijk AE, de Wind A, Tamminga SJ, Schaafsma FG. The SME tool supporting employers of small- and medium-sized enterprises during the return to work of employees on long-term sick leave: study protocol for a randomized controlled trial and for a process evaluation. Trials 2024; 25:541. [PMID: 39152487 PMCID: PMC11328497 DOI: 10.1186/s13063-024-08383-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 08/06/2024] [Indexed: 08/19/2024] Open
Abstract
BACKGROUND Returning to work after long-term sick leave can be challenging, particularly in small- and medium-sized enterprises (SMEs) where support may be limited. Recognizing the responsibilities and challenges of SME employers, a web-based intervention (hereafter the SME tool) has been developed. The SME tool aims to enhance the employer's intention and ability to support the sick-listed employee. Based on the Self-Determination Theory, it is hypothesized that this intention is enhanced by intervening in the employer's autonomy, competences, and relatedness targeted at, e.g., communication with sick-listed employee, involvement of other stakeholders, and practical support. This is achieved by means of providing templates, communication videos, and information on legislation. This article describes the design of an effect and process evaluation of the SME tool. METHODS A randomized controlled trial (RCT) with a 6-month follow-up will be conducted with a parallel-group design with two arms: an intervention group and a control group. Sick-listed employees (≤ 8 weeks) of SMEs (≤ 250 employees) at risk of long-term sick leave and their employers will be recruited and randomly allocated as a dyad (1:1). Employers randomized to the intervention group receive unlimited access to the SME tool, while those in the control group will receive care as usual. The primary outcome is the satisfaction of the employee with the return to work (RTW) support provided by their employer. Secondary outcomes include social support, work performance, and quality of work life at the employee level and self-efficacy in providing RTW support at the employer level. Outcomes will be assessed using questionnaires at baseline and 1, 3, and 6 months of follow-up. Process evaluation measures include, e.g., recruitment and use of and perceived usefulness of the SME tool. Additionally, semi-structured interviews with employers, employees, and occupational physicians will explore the interpretation of the RCT results and strategies for the national implementation of the SME tool. DISCUSSION The SME tool is hypothesized to be valuable in addition to usual care helping employers to effectively support the RTW of their long-term sick-listed employees, by improving the employers' intention and ability to support. TRIAL REGISTRATION ClinicalTrials.gov, NCT06330415. Registered on February 14, 2024.
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Affiliation(s)
- Donna C E Beerda
- Department of Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.
- Amsterdam Public Health Research Institute, Societal Participation & Health, Amsterdam, the Netherlands.
| | - Michiel A Greidanus
- Department of Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Societal Participation & Health, Amsterdam, the Netherlands
| | - Angelique E de Rijk
- Department of Social Medicine, Faculty of Health, Medicine and Life Sciences, Research Institute Primary Care and Public Health (CAPHRI), Maastricht University, Duboisdomein 30, Maastricht, the Netherlands
| | - Astrid de Wind
- Department of Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Societal Participation & Health, Amsterdam, the Netherlands
| | - Sietske J Tamminga
- Department of Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Societal Participation & Health, Amsterdam, the Netherlands
| | - Frederieke G Schaafsma
- Department of Public and Occupational Health, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands
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Zegers AD, Coenen P, Heeren A, Takke N, Ardon H, Compter A, Dona D, Kouwenhoven M, Schagen SB, de Vos F, Duijts SFA. Work-related experiences and unmet needs of patients with a malignant glioma and relevant professionals: the BrainWork study. J Cancer Surviv 2023:10.1007/s11764-023-01469-z. [PMID: 37782399 DOI: 10.1007/s11764-023-01469-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 09/16/2023] [Indexed: 10/03/2023]
Abstract
PURPOSE Many patients with a malignant (i.e., grade II-IV) glioma are of working age, yet they are rarely included in "cancer and work" studies. Here, we explored (1) the work-related experiences and unmet needs of patients with a malignant glioma and (2) the experiences and needs of relevant healthcare and occupational (health) professionals ("professionals") in providing work-related support to this patient group. METHODS Individual semi-structured interviews were held with patients with a malignant glioma who were of working age and had an employment contract at diagnosis, and relevant professionals. Interviews were transcribed verbatim and analysed thematically. RESULTS Patients (n = 22) were on average 46 ± 13 years of age (64% male) and diagnosed with a grade II (n = 12), III (n = 4), or IV glioma (n = 6). Professionals (n = 16) had on average 15 ± 9 years of relevant work experience with the patient group. Four themes emerged from the data: (1) having a malignant glioma: experienced consequences on work ability, (2) communicating about the consequences of a malignant glioma at work, (3) distilling the right approach: generic or tailored work-related support, and (4) accessibility of work-related support. CONCLUSIONS Glioma-specific consequences on patients' work ability necessitate better communication between, and tailored guidance for, patients, relevant professionals, and the workplace. Suggestions for improvement, e.g., the periodic use of comprehensive neuropsychological assessments, are provided in the article. IMPLICATIONS FOR CANCER SURVIVORS Patients with a malignant glioma would benefit from tailored and proactive outreach about work-related issues bv relevant professionals.
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Affiliation(s)
- Amber Daniëlle Zegers
- Department of Public and Occupational Health, Amsterdam University Medical Centers Location Vrije Universiteit, De Boelelaan 1117, Amsterdam, Netherlands
- Societal Participation and Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Pieter Coenen
- Department of Public and Occupational Health, Amsterdam University Medical Centers Location Vrije Universiteit, De Boelelaan 1117, Amsterdam, Netherlands
- Societal Participation and Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
- Musculoskeletal Health, Amsterdam Movement Sciences Research Institute, Amsterdam, Netherlands
| | - Amy Heeren
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, Netherlands
| | - Nadia Takke
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, Netherlands
| | - Hilko Ardon
- Department of Neurology, TweeSteden Hospital, Tilburg, Netherlands
| | - Annette Compter
- Department of Neurology, Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Desiree Dona
- Department of Human Resources, Radboud University Medical Center, Nijmegen, Netherlands
| | - Mathilde Kouwenhoven
- Department of Neurology, Amsterdam University Medical Centers Location Vrije Universiteit, Amsterdam, Netherlands
- Cancer Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, Netherlands
| | - Sanne B Schagen
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Filip de Vos
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Saskia F A Duijts
- Department of Public and Occupational Health, Amsterdam University Medical Centers Location Vrije Universiteit, De Boelelaan 1117, Amsterdam, Netherlands.
- Societal Participation and Health, Amsterdam Public Health Research Institute, Amsterdam, Netherlands.
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, Netherlands.
- Cancer Treatment and Quality of Life, Cancer Center Amsterdam, Amsterdam, Netherlands.
- Department of Medical Psychology, Amsterdam University Medical Centers location Vrije Universiteit, Amsterdam, Netherlands.
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Zegers AD, van Andel ES, Beerda DCE, Dona DJS, Aukema EJ, Brom L, Duijts SFA. Work resumption and retention in patients with advanced cancer: Experiences and perspectives of general and occupational health care professionals. Eur J Cancer Care (Engl) 2022; 31:e13714. [PMID: 36164925 PMCID: PMC9787025 DOI: 10.1111/ecc.13714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 09/05/2022] [Accepted: 09/14/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The objectives of this study were to explore the experiences and perspectives of general and occupational health care professionals regarding work resumption and work retention of patients with advanced cancer, and to identify barriers and facilitators these professionals may encounter. METHODS A qualitative design was applied, and individual semistructured interviews were conducted. General and occupational health care professionals were eligible to participate if they were involved in the work participation guidance of patients with advanced cancer, and were recruited through the network of the research team. Interview data were transcribed verbatim and analysed thematically via ATLAS.ti 9. RESULTS Interviewees (N = 17) had various occupational backgrounds, for example, occupational physician, reintegration consultant, and general practitioner. Four main themes emerged from the data: (1) Assumptions and hesitations, (2) Patient initiates stakeholder communication, (3) Role dispersion: who is in charge of what? and (4) Experience with legislation creates opportunities. CONCLUSION Whereas most interviewees had positive experiences with, and/or optimistic expectations of, the work resumption and work retention of patients with advanced cancer, several barriers to the work participation guidance of these patients were identified. Suggestions for improvement include creating widespread awareness of the possibility of work participation of patients with advanced cancer and developing reintegration guidelines for advanced cancer.
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Affiliation(s)
- Amber D. Zegers
- Department of Public and Occupational HealthAmsterdam UMC location Free UniversityAmsterdamThe Netherlands,Societal Participation and HealthAmsterdam Public Health Research InstituteAmsterdamThe Netherlands
| | - Emma S. van Andel
- Department of Research & DevelopmentNetherlands Comprehensive Cancer Organisation (IKNL)UtrechtThe Netherlands
| | - Donna C. E. Beerda
- Department of Research & DevelopmentNetherlands Comprehensive Cancer Organisation (IKNL)UtrechtThe Netherlands,Department of Public and Occupational HealthAmsterdam UMC location University of AmsterdamAmsterdamThe Netherlands
| | - Desiree J. S. Dona
- Department of Human ResourcesRadboud University Medical CenterNijmegenThe Netherlands
| | - Eline J. Aukema
- Center for Psycho‐OncologyIngeborg Douwes CentrumAmsterdamThe Netherlands
| | - Linda Brom
- Department of Research & DevelopmentNetherlands Comprehensive Cancer Organisation (IKNL)UtrechtThe Netherlands,Netherlands Association for Palliative Care (PZNL)UtrechtThe Netherlands
| | - Saskia F. A. Duijts
- Department of Public and Occupational HealthAmsterdam UMC location Free UniversityAmsterdamThe Netherlands,Societal Participation and HealthAmsterdam Public Health Research InstituteAmsterdamThe Netherlands,Department of Research & DevelopmentNetherlands Comprehensive Cancer Organisation (IKNL)UtrechtThe Netherlands,Department of Medical Psychology, Cancer Center AmsterdamAmsterdam UMC location Free UniversityAmsterdamThe Netherlands
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Tailoring work participation support for cancer survivors using the stages of change: perspectives of (health care) professionals and survivors. J Cancer Surviv 2022; 17:706-719. [PMID: 35275360 DOI: 10.1007/s11764-022-01196-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 02/21/2022] [Indexed: 01/03/2023]
Abstract
PURPOSE Interventions to support work participation in cancer survivors (CSs) have shown limited effectiveness. Applying a behavioral change framework (e.g., stages of change) could make work participation interventions for CSs more timely and tailored. We aimed to explore the application of the stages of change framework to work participation support for CSs and to generate stage-specific intervention content. METHODS Eighteen experts (e.g., occupational physicians, reintegration consultants) were individually interviewed, and three focus groups with CSs (n = 6, n = 5, n = 4) were conducted. Data were analyzed along the six work-related behavioral change stages purported by the readiness for return to work framework, which is based on the stages of change. RESULTS The following themes were identified: (1) pre-contemplation: emotional support and staying connected-encourage contact with the employer/colleagues; (2) contemplation: considering return to work is stressful-facilitate the deliberation process; (3) preparation self-evaluative: assess current capabilities-seek guidance from, e.g., occupational physicians; (4) preparation behavioral: planning return to work-allow for personalized solutions and encourage supervised return to work; (5) uncertain maintenance: guard against overload-train self-efficacy strategies and communication tactics; and (6) proactive maintenance: accept and prepare for the long term. CONCLUSIONS Our results support the potential utility of tailoring CSs' work participation support along the stages of change. IMPLICATIONS FOR CANCER SURVIVORS We provided recommendations for intervention content and developed a stage-specific work participation intervention for CSs, the effectiveness of which will be evaluated in an upcoming randomized controlled trial.
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Greidanus MA, de Boer AGEM, de Rijk AE, Brouwers S, de Reijke TM, Kersten MJ, Klinkenbijl JHG, Lalisang RI, Lindeboom R, Zondervan PJ, Frings-Dresen MHW, Tamminga SJ. The Successful Return-To-Work Questionnaire for Cancer Survivors (I-RTW_CS): Development, Validity and Reproducibility. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2021; 13:567-582. [PMID: 32508005 PMCID: PMC7478947 DOI: 10.1007/s40271-020-00427-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background Cancer survivors’ perspectives on a successful return to work (RTW) may not be captured in the common measure of RTW, namely time until RTW. Objective The purpose of this study was therefore to develop an RTW outcome measure that reflects employed cancer survivors’ perspectives, with items that could be influenced by an employer, i.e. the Successful Return-To-Work questionnaire for Cancer Survivors (I-RTW_CS), and to assess its construct validity and reproducibility. Methods First, three focus groups with cancer survivors (n = 14) were organized to generate issues that may constitute successful RTW. Second, a two-round Delphi study among 108 cancer survivors was conducted to select the most important issues. Construct validity of the I-RTW_CS was assessed using correlations with a single-item measure of successful RTW and the Quality of Working Life Questionnaire for Cancer Survivors (QWLQ-CS; n = 57). Reproducibility (test–retest reliability) was assessed using the intraclass correlation coefficient (ICC; n = 50). Results Forty-eight issues were generated, of which seven were included: ‘enjoyment in work’; ‘work without affecting health’; ‘confidence of employer without assumptions about work ability’; ‘open communication with employer’; ‘feeling welcome at work’; ‘good work–life balance’; and ‘joint satisfaction with the situation (employer and cancer survivor)’. Correlations with single-item successful RTW and QWLQ-CS were 0.58 and 0.85, respectively. The reproducibility showed an ICC of 0.72. Conclusions The I-RTW_CS provides an RTW outcome measure that includes cancer survivors’ perspectives and weights its items on an individual basis, allowing a more meaningful evaluation of cancer survivors’ RTW. This study provides preliminary evidence for its construct validity and reproducibility.
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Affiliation(s)
- Michiel A Greidanus
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
| | - Angela 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
| | - Angelique E de Rijk
- Department of Social Medicine, Faculty of Health, Medicine and Life Sciences, Research Institute Primary Care and Public Health (CAPHRI), Maastricht University, Duboisdomein 30, Maastricht, The Netherlands
| | - Sonja Brouwers
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Theo M de Reijke
- Department of Urology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Marie José Kersten
- Department of Hematology, Cancer Center Amsterdam, Lymphoma and Myeloma Center Amsterdam (LYMMCARE), Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Jean H G Klinkenbijl
- Department of Surgery, Gelre Hospital, Apeldoorn, The Netherlands
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Roy I Lalisang
- Division of Medical Oncology, Department of Internal Medicine, GROW School of Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Robert Lindeboom
- Department of Clinical Methods and Public Health, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Patricia J Zondervan
- Department of Urology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Monique H W Frings-Dresen
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Sietske J Tamminga
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
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Greidanus MA, de Rijk AE, de Boer AGEM, Bos MEMM, Plaisier PW, Smeenk RM, Frings-Dresen MHW, Tamminga SJ. A randomised feasibility trial of an employer-based intervention for enhancing successful return to work of cancer survivors (MiLES intervention). BMC Public Health 2021; 21:1433. [PMID: 34289828 PMCID: PMC8293550 DOI: 10.1186/s12889-021-11357-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 06/16/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Employers express a need for support during sickness absence and return to work (RTW) of cancer survivors. Therefore, a web-based intervention (MiLES) targeted at employers with the objective of enhancing cancer survivors' successful RTW has been developed. This study aimed to assess feasibility of a future definitive randomised controlled trial (RCT) on the effectiveness of the MiLES intervention. Also preliminary results on the effectiveness of the MiLES intervention were obtained. METHODS A randomised feasibility trial of 6 months was undertaken with cancer survivors aged 18-63 years, diagnosed with cancer < 2 years earlier, currently in paid employment, and sick-listed < 1 year. Participants were randomised to an intervention group, with their employer receiving the MiLES intervention, or to a waiting-list control group (2:1). Feasibility of a future definitive RCT was determined on the basis of predefined criteria related to method and protocol-related uncertainties (e.g. reach, retention, appropriateness). The primary effect measure (i.e. successful RTW) and secondary effect measures (e.g. quality of working life) were assessed at baseline and 3 and 6 months thereafter. RESULTS Thirty-five cancer survivors were included via medical specialists (4% of the initially invited group) and open invitations, and thereafter randomised to the intervention (n = 24) or control group (n = 11). Most participants were female (97%) with breast cancer (80%) and a permanent employment contract (94%). All predefined criteria for feasibility of a future definitive RCT were achieved, except that concerning the study's reach (90 participants). After 6 months, 92% of the intervention group and 100% of the control group returned to work (RR: 0.92, 95% CI: 0.81-1.03); no difference were found with regard to secondary effect measures. CONCLUSIONS With the current design a future definitive RCT on the effectiveness of the MiLES intervention on successful RTW of cancer survivors is not feasible, since recruitment of survivors fell short of the predefined minimum for feasibility. There was selection bias towards survivors at low risk of adverse work outcomes, which reduced generalisability of the outcomes. An alternative study design is needed to study effectiveness of the MiLES intervention. TRIAL REGISTRATION The study has been registered in the Dutch Trial Register ( NL6758/NTR7627 ).
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Affiliation(s)
- M A Greidanus
- Department Public and Occupational Health/ Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
| | - A E de Rijk
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Duboisdomein 30, Maastricht, The Netherlands
| | - A G E M de Boer
- Department Public and Occupational Health/ Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - M E M M Bos
- Department of Medical Oncology, Erasmus Medical Center, Doctor Molewaterplein 40, Rotterdam, The Netherlands
| | - P W Plaisier
- Department of Surgery, Albert Schweitzer Hospital, Albert Schweitzerplaats 25, Dordrecht, The Netherlands
| | - R M Smeenk
- Department of Surgery, Albert Schweitzer Hospital, Albert Schweitzerplaats 25, Dordrecht, The Netherlands
| | - M H W Frings-Dresen
- Department Public and Occupational Health/ Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - S J Tamminga
- Department Public and Occupational Health/ Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
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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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Stapelfeldt CM, Momsen AMH, Jensen AB, Andersen NT, Nielsen CV. Municipal return to work management in cancer survivors: a controlled intervention study. Acta Oncol 2021; 60:370-378. [PMID: 33287597 DOI: 10.1080/0284186x.2020.1853227] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Resuming work during or after cancer treatment has become an important target in cancer rehabilitation. PURPOSE The aim was in a controlled trial to study the return to work (RTW) effect of an early, individually tailored vocational rehabilitation intervention targeted to improve readiness for RTW in cancer survivors. MATERIAL AND METHODS Participants diagnosed with breast, cervix, ovary, testicular, colon-rectal, and head-and-neck cancers as well as being employed were allocated to a vocational rehabilitation intervention provided by municipal social workers (n = 83) or to usual municipal RTW management (n = 264). The intervention contained three elements: motivational communication inspired by Acceptance and Commitment Therapy by which RTW barriers were addressed, municipal cancer rehabilitation and finally employer and workplace contact. RTW effect was assessed as relative cumulative incidence proportions (RCIP) in the control and intervention group within 52 weeks of follow-up, estimated from the week where treatment ended at the hospital. RCIP was interpreted and reported as relative risk (RR) with 95% confidence intervals (CI) adjusted for gender, age cancer diagnosis, education, comorbidity, and sick leave weeks. RESULTS Across cancer diagnoses 69 (83.1%) and 215 (81.4%) returned to work in the intervention and control group, respectively. No statistical effect was seen (RR 1.08 (95% CI 0.98-1.19)). Repeating the analyses solely for participants with breast cancer (n = 290) showed a significant effect of the intervention (RR 1.12 (95% CI 1.01-1.23)). CONCLUSION More than 80% returned to work in both groups. However, no statistical difference in RTW effect was seen across cancer diagnoses within one year from being exposed to an early, individually tailored vocational rehabilitation intervention compared with usual municipal RTW management. TRIAL REGISTRATION NUMBER ISRCTN50753764.
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Affiliation(s)
- Christina M. Stapelfeldt
- Department of Public Health, Aarhus University, Aarhus, Denmark
- DEFACTUM - Social and Health Services & Labour Market, Central Denmark Region, Aarhus, Denmark
| | - Anne-Mette H. Momsen
- DEFACTUM - Social and Health Services & Labour Market, Central Denmark Region, Aarhus, Denmark
| | | | | | - Claus Vinther Nielsen
- Department of Public Health, Aarhus University, Aarhus, Denmark
- DEFACTUM - Social and Health Services & Labour Market, Central Denmark Region, Aarhus, Denmark
- Goedstrup Hospital, Herning, Denmark
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9
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A multidisciplinary working model for promoting return to work of cancer survivors. Support Care Cancer 2021; 29:5151-5160. [PMID: 33611646 DOI: 10.1007/s00520-021-06074-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 02/11/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Despite wide recognition of the necessity of an integrative maintenance and return to work (RTW) program for cancer survivors, no such program has been described in the literature. AIMS To examine a working model of an integrative multidisciplinary health care approach for promoting RTW, using the Delphi method. METHODS A working model for promoting cancer survivors' RTW by oncology health professionals was subjected to two rounds of evaluation by an expert panel in accordance with the Delphi research method. Twenty-six international experts in oncology (social workers, nurses, psychologists, physicians, and cancer patients) participated in the first round and 16 participated in the second round. RESULTS The mean score of the working model's applicability was 6.07 (SD = 1.07, range = 1-7). The model outlines in detail an integrative approach for promotion of RTW according to two axes: the oncology health professionals' role and the timeline axis featuring four stages of oncology treatment and follow-up. CONCLUSIONS Our proposed model addresses the need for an integrated program that may increase the rate of RTW and improve the quality of life of cancer survivors. The model should be subjected to further evaluation, especially its adaptability to different health systems in different countries.
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