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Fiabane E, Dordoni P, Perrone C, Bernardo A, Corsi F, Gabanelli P. What really matters for returning to work after breast cancer? A 6-month exploratory study. Women Health 2024; 64:298-307. [PMID: 38499393 DOI: 10.1080/03630242.2024.2324312] [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: 02/02/2023] [Accepted: 02/23/2024] [Indexed: 03/20/2024]
Abstract
Return to work (RTW) after breast cancer (BC) may significantly impact on women recovery and quality of life. Literature hightlighed several factors associated to RTW after BC but there is still some concern about prognostic factors influencing work resumption after BC treatments. The present study aims to explore which baseline factors are associated with RTW at 6-month after BC surgery. The participants in this 6-month prospective study were 149 patients who underwent breast cancer-related surgery and accessed an Oncology Clinic for cancer therapy from March 2017 to December 2019 in Northern Italy. Participants filled in a battery of questionnaires at baseline, and they were asked whether they had returned to work at 6-month follow-up. Psychological measurements included job stress (Job Content Questionnaire), work engagement (Utrecht Work Engagement Scale), quality of life (World Health Organization Quality of Life- BREF), anxiety and depression (Hospital Anxiety and Depression Scale), resilience (Connor - Davidson Resilience Scale - 10 item) and personal expectations about RTW (ad-hoc single item). Moreover, sociodemographic, clinical, and work-related data were collected. Independent t-test and Chi-square test were used for comparisons among variables; logistic regression model was used to explore predictors of RTW. A total of 73.9 percent returned to work at6-month after surgery. In the multivariate model, chemiotherapy (B = -1.428; SE = 0.520) and baseline women's expectations about their RTW (B = -0.340; DS = 0.156) were significant predictors of RTW. These results suggest that careful individual clinical and psychological screening of risk factors at baseline can prevent from occupational disability and long sickness absence.
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Affiliation(s)
- Elena Fiabane
- Psychology Unit of Pavia Institute, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Paola Dordoni
- Psychology Unit of Pavia Institute, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Cecilia Perrone
- Psychology Unit of Pavia Institute, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Antonio Bernardo
- Operative Unit of Medical Oncology of Pavia Institute, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Fabio Corsi
- Breast Unit of Pavia Institute, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Paola Gabanelli
- Psychology Unit of Pavia Institute, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
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Silvaggi F, Mariniello A, Leonardi M, Silvani A, Lamperti E, Di Cosimo S, Folli S, Trapani A, Schiavolin S. Psychosocial factors associated with workability after surgery in cancer survivors: An explorative study. J Health Psychol 2023; 28:999-1010. [PMID: 36800903 PMCID: PMC10492438 DOI: 10.1177/13591053231151286] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
Abstract
This study aimed to evaluate the work ability and its associated factors in patients with glioma (II, III) and breast cancer after 6 (T0) and 12 (T1) months from surgery. A total of 99 patients were evaluated with self-reported questionnaires at T0 and T1. Correlation and Mann-Whitney tests were used to investigate the association between work ability and sociodemographic, clinical, and psychosocial factors. The Wilcoxon test was used to investigate the longitudinal change in work ability. Our sample showed a decrease in work ability level between T0 and T1. Work ability was associated with emotional distress, disability, resilience, and social support in glioma III patients at T0, and with fatigue, disability, and clinical treatments in patients with breast cancer at T0 and T1. Work ability levels decreased in patients with glioma and breast cancer and were associated with different psychosocial factors after surgery. Their investigation is suggested to facilitate the return to work.
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Affiliation(s)
- Fabiola Silvaggi
- Department of Neurology, Public Health, Disability Unit, Fondazione IRCSS Istituto Neurologico Carlo Besta, Italy
| | - Arianna Mariniello
- Department of Neurology, Public Health, Disability Unit, Fondazione IRCSS Istituto Neurologico Carlo Besta, Italy
| | - Matilde Leonardi
- Department of Neurology, Public Health, Disability Unit, Fondazione IRCSS Istituto Neurologico Carlo Besta, Italy
| | - Antonio Silvani
- UOC Neuro-Oncology Unit , Fondazione IRCCS Istituto Neurologico Carlo Besta, Italy
| | - Elena Lamperti
- UOC Neuro-Oncology Unit , Fondazione IRCCS Istituto Neurologico Carlo Besta, Italy
| | - Serena Di Cosimo
- Biomarkers Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Italy
| | - Secondo Folli
- Breast Cancer Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Italy
| | - Anna Trapani
- Breast Cancer Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Italy
| | - Silvia Schiavolin
- Department of Neurology, Public Health, Disability Unit, Fondazione IRCSS Istituto Neurologico Carlo Besta, Italy
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Magnavita N, Di Prinzio RR, Meraglia I, Vacca ME, Arnesano G, Merella M, Mauro I, Iuliano A, Terribile DA. Supporting Return to Work after Breast Cancer: A Mixed Method Study. Healthcare (Basel) 2023; 11:2343. [PMID: 37628540 PMCID: PMC10454012 DOI: 10.3390/healthcare11162343] [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: 07/21/2023] [Revised: 08/14/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023] Open
Abstract
Breast cancer (BC) is the most common invasive cancer in the world. Most BC survivors (BCSs) continue working while dealing with cancer-related disabilities. BCSs' return-to-work (RTW) after cancer treatment is an important stage of their recovery and is associated with a higher survival rate. In this study, we addressed the RTW of BCSs with the intention of facilitating this process through direct action in the workplace. Thirty-two women who requested assistance from January to December 2022 were enrolled in the study. Semi-structured interviews and medical examinations were conducted by a team of three physicians. Interviews were analyzed using Thematic Analysis. Moreover, a quantitative cross-sectional study was conducted to compare the health status of BCSs with that of a control group of 160 working women, using standardized questionnaires on work ability, fatigue, sleep problems, anxiety, depression, and happiness. BCSs were also asked to rate the level of organizational justice they perceived at work prior to their illness. From the qualitative analysis emerged three facilitating/hindering themes: (1) person-related factors, (2) company-related factors, and (3) society-related factors. In the quantitative analysis, BCSs had significantly higher scores for anxiety, depression, sleep problems and fatigue, and lower levels of happiness than controls. The RTW of BCSs entails adapting working conditions and providing adequate support. The work-related analysis of each case made it possible to highlight the measures that need to be taken in the workplace to promote RTW. The treatment of cancer should be paired with advice on the best way to regain the ability to work.
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Affiliation(s)
- Nicola Magnavita
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
| | - Reparata Rosa Di Prinzio
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
- Alta Scuola di Economia e Management dei Sistemi Sanitari (ALTEMS), Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Igor Meraglia
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
| | - Maria Eugenia Vacca
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
| | - Gabriele Arnesano
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
| | - Marco Merella
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
| | - Igor Mauro
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
| | - Angela Iuliano
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
| | - Daniela Andreina Terribile
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (N.M.); (I.M.); (M.E.V.); (G.A.); (M.M.); (I.M.); (A.I.); (D.A.T.)
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
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Rolland AL, Porro B, Kab S, Ribet C, Roquelaure Y, Bertin M. Impact of breast cancer care pathways and related symptoms on the return-to-work process: results from a population-based French cohort study (CONSTANCES). Breast Cancer Res 2023; 25:30. [PMID: 36949546 PMCID: PMC10031867 DOI: 10.1186/s13058-023-01623-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 02/24/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND Breast cancer (BC) treatments and related symptoms may affect return to work (RTW). The objective of this study was to investigate the impact of BC care pathways (timing and sequence of treatments) and related symptoms on RTW. METHODS The study population included working-age women with BC who were enrolled in the French CONSTANCES cohort from 2012 to 2018. BC treatments, antidepressant/anxiolytic and antalgic drug deliveries (used as proxies of depression and pain, respectively) and statutory sick pay (used to estimate RTW and time to RTW) were assessed monthly using data from the French national healthcare system database. BC care pathways were identified with the sequence analysis method. Cox models with time-dependent covariates were used to investigate the impact of BC care pathways and related symptoms on RTW and time to RTW, after adjusting for age and socioeconomic characteristics. RESULTS 73.2% (231/303) of women returned to work within 2 years after BC diagnosis. Five BC care pathway patterns were identified: (i) BC surgery only, (ii) BC surgery and radiotherapy, (iii) BC surgery and chemotherapy, (iv) BC surgery and chemotherapy and radiotherapy, and (v) BC surgery and long-term alternative chemotherapy/radiotherapy. The hazards ratios of non-RTW were significantly higher for women who received BC surgery and long-term alternative chemotherapy/radiotherapy and for > 55-year-old women. Time to RTW was significantly longer in women who received chemotherapy (patterns iii to v) and in women with antidepressant/anxiolytic and antalgic drug deliveries. CONCLUSION This study highlights the value of considering the dynamic, cumulative and temporal features of BC care pathways and related symptoms to facilitate the RTW of women with BC.
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Affiliation(s)
- Anne-Lise Rolland
- Univ. Angers, CHU Angers, Univ. Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, SFR ICAT, SIRIC ILIAD, F-49000, Angers, France
- Département d'Information Médicale, Centre Hospitalo-Universitaire d'Angers, 49100, Angers, France
| | - Bertrand Porro
- Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, SFR ICAT, SIRIC ILIAD, University Angers, University Rennes, 49000, Angers, France
- Department of Human and Social Sciences, Institut de Cancérologie de L'Ouest (ICO), 49055, Angers, France
| | - Sofiane Kab
- Unité Cohortes en Population, Inserm, UVSQ, UMS 011, Université Paris Saclay, Université de Paris, Paris, France
| | - Céline Ribet
- Unité Cohortes en Population, Inserm, UVSQ, UMS 011, Université Paris Saclay, Université de Paris, Paris, France
| | - Yves Roquelaure
- Univ. Angers, CHU Angers, Univ. Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, SFR ICAT, SIRIC ILIAD, F-49000, Angers, France
| | - Mélanie Bertin
- Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, SFR ICAT, SIRIC ILIAD, University Angers, University Rennes, 49000, Angers, France.
- Univ Rennes, EHESP, CNRS, Inserm, Arènes - UMR 6051, RSMS - U 1309, F-35000, Rennes, France.
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Cheng ASK, Lee S, Li N, Tsang S, Zeng Y. Chinese Translation and Cross-Cultural Adaptation of the Return-to-Work Self-Efficacy Scale among Chinese Female Breast Cancer Survivors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4225. [PMID: 36901236 PMCID: PMC10001523 DOI: 10.3390/ijerph20054225] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/14/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
Breast cancer is the leading cancer type among women globally. Since breast cancer has a high survival rate, most survivors are likely to return to work (RTW). In recent years, breast cancer cases have risen significantly in younger age groups. As self-efficacy is an important factor in the success of RTW, this study performed a translation and cross-cultural adaptation of the Chinese version of the Return-To-Work Self-Efficacy Scale (CRTWSE-19) and examined its psychometric properties in patients with breast cancer. This validation study followed standard guidelines, including forward translation, back translation, cross-cultural adaptation, and psychometric testing. The results of this study show that the CRTWSE-19 met reliability standards, including high internal reliability for the total scores and subscales. An exploratory factor analysis of 19 items extracted 3 factors showing consistency with the original version of the RTWSE-19. Criterion validity was demonstrated by comparing subdomains with the Fear of Cancer Recurrence Inventory. Furthermore, the known-group validity was studied by comparing mean scores among the unemployed group and the employed group. We conclude that the CRTWSE-19 has very good screening accuracy and is able to discriminate between working and unemployed populations. It can facilitate health care professionals in triaging, planning, and evaluating interventions in clinical practice.
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Affiliation(s)
- Andy S. K. Cheng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Suki Lee
- Yang Memorial Methodist Social Service, Hong Kong, China
| | - Nadia Li
- Hong Kong Lutheran Social Service, Hong Kong, China
| | | | - Yingchun Zeng
- School of Medicine, Zhejiang University City College, Hangzhou 242332, China
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6
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The role of physical arm function and demographic disparities in breast cancer survivors’ ability to return to work. Support Care Cancer 2022; 30:10301-10310. [PMID: 36355217 PMCID: PMC9648455 DOI: 10.1007/s00520-022-07449-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 10/31/2022] [Indexed: 11/12/2022]
Abstract
Purpose Ability to return to work (RTW) is an important aspect of breast cancer that is limited for many survivors. With 90% survivorship in the USA, it is imperative that focus shifts toward the improvement of physical arm function to improve survivors’ ability to RTW. This narrative review discusses the role of physical arm function and demographic disparities in breast cancer survivor RTW. Methods Literature on physical function, arm function, and demographic disparities following breast cancer treatment and their implications for RTW is discussed. Results The ability to RTW is a key component of recovery for breast cancer survivors, but challenges and inequalities persist. Treatment effects can induce and prolong functional disability, affecting survivors’ ability to RTW. These effects may be compounded for survivors whose occupation requires physical arm function. The RTW landscape, including the occupations survivors have, the physical function required for job tasks, and availability of workplace accommodations, is also unclear. Additional demographic disparities (e.g., income, live in rural area) exist, but the extent to which these factors influence RTW is not well understood. More work is needed to understand the compounded impact of treatment effects, demographic disparities, and occupational factors on RTW. Multidisciplinary rehabilitation that includes occupational counseling and exercise is a promising approach, but widespread adoption in the US healthcare model presents an ongoing challenge. Areas for further research are highlighted. Conclusion There is an incomplete understanding of the effects of treatment on physical arm function and the role of demographic disparities on breast cancer survivor RTW.
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Yang ZY, Chen WL, Wu WT, Lai CH, Ho CL, Wang CC. Return to Work and Mortality in Breast Cancer Survivors: A 11-Year Longitudinal Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14418. [PMID: 36361291 PMCID: PMC9655987 DOI: 10.3390/ijerph192114418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/23/2022] [Accepted: 10/29/2022] [Indexed: 06/16/2023]
Abstract
Breast cancer is the most commonly occurring cancer in women, and it is a major cause of cancer death around the world. With the development of diagnostic methods and improvements in treatment methods, the incidence rate of breast cancer and the number of breast cancer survivors continue to simultaneously increase. We used national registry database to analyze the features that affect employment and return to work among breast cancer survivors. A total of 23,220 employees, who were newly diagnosed with breast cancer were recruited based on the Labor Insurance Database (LID), the Taiwan Cancer Registry (TCR), and National Health Insurance Research Database (NHIRD) during the period 2004-2015. The correlations between return to work (RTW) and independent confounding factors were examined using Cox proportional hazards model. Survival probability was analyzed using the Kaplan-Meir method. After adjusting for confounding variables, cancer stage, chemotherapy and higher income were significantly negatively correlated with RTW. Among breast cancer survivors, RTW was found to be related to a lower risk of all-cause mortality in both the unadjusted and fully adjusted model. Patients who had RTW exhibited better survival in all stages. Work-, disease- and treatment-related factors influenced RTW among employees with breast cancer. RTW was associated with better breast cancer survival. Our study demonstrates the impact of RTW and the associated factors on breast cancer survivorship.
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Affiliation(s)
- Zhe-Yu Yang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
| | - Wei-Liang Chen
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
- Division of Occupational Medicine, Department of Family & Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
| | - Wei-Te Wu
- National Institute of Environmental Health Science, National Health Research Institutes, Miaoli 350, Taiwan
| | - Ching-Huang Lai
- School of Public Health, National Defense Medical Center, Taipei 114, Taiwan
| | - Ching-Liang Ho
- Division of Hematology/Oncology, Department of Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei 114, Taiwan
| | - Chung-Ching Wang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
- Division of Occupational Medicine, Department of Family & Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
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Symptom Management and Quality of Life of Breast Cancer Patients Using Acupuncture-Related Therapies and Herbal Medicine: A Scoping Review. Cancers (Basel) 2022; 14:cancers14194683. [PMID: 36230606 PMCID: PMC9564317 DOI: 10.3390/cancers14194683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 09/14/2022] [Accepted: 09/21/2022] [Indexed: 12/03/2022] Open
Abstract
Simple Summary This is a scoping review of published literature on the usefulness of acupuncture-related therapies and herbal medicine in alleviating the side effects associated with breast cancer treatments. It is an important study given that the various treatment interventions for breast cancer, such as surgery, chemotherapy, radiotherapy, and hormone therapy, have unpleasant side effects that compromise the patient’s quality of life. The study revealed positive impact of some acupuncture-related therapies and herbal medicines in improving the symptoms and quality of life of patients with breast cancer. These findings will inform further studies on the economic impact of acupuncture and herbal medicines in the management of adverse events in patients on breast cancer treatment. Abstract The side effects associated with breast cancer treatments often reduce the patients’ quality of life. The effectiveness of acupuncture-related therapies and herbal medicine in managing the side effect is not fully understood. The study included clinical studies published in the 10 years since 2011 and analyzed the effectiveness of the therapies for managing side effects of anticancer treatment. The databases of MEDLINE via PubMed, CENTRAL, EMBASE, OASIS, and NSDL were searched. Thirty studies, including 13 (43.3%) randomized controlled trials (RCTs), 12 (40.0%) before-and-after studies, three (10.0%) case series, one (3.3%) case report, and one (3.3%) non-RCT, were included in this review. The main symptoms identified were aromatase inhibitors-induced arthralgia (AIA), lymphedema, and chemotherapy-induced peripheral neuropathy (CIPN). The types of acupuncture-related therapies applied included manual acupuncture, electro-acupuncture, moxibustion, and electro-moxibustion. In ten studies, eight herbal medications were administered. The Brief Pain Inventory-Short Form (BPI-SF) and Functional Assessment of Cancer Therapy-General (FACT-G) and -Breast (FACT-B) were frequently used to evaluate pain and QoL, respectively. Most studies suggested beneficial effects of acupuncture and herbal medicine on managing pain, daily function, and quality of life in patients going through AIA, CIPN, and/or lymphedema, with mild side effects. The scoping review implies the potential of CAM therapies as promising interventions for managing symptoms which otherwise lack alternative management options, and for improving the quality of life of breast cancer patients.
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Vella F, Filetti V, Cirrincione L, Rapisarda V, Matera S, Skerjanc A, Cannizzaro E, Vitale E. Work Ability after Breast Cancer: Study of Healthcare Personnel Operating in a Hospital of South Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10835. [PMID: 36078550 PMCID: PMC9518308 DOI: 10.3390/ijerph191710835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 08/23/2022] [Accepted: 08/27/2022] [Indexed: 06/15/2023]
Abstract
Breast cancer (BrC) treatment can produce disabilities that often impact the quality of daily life and impact the social and working relationships of the patient. This paper looked into the remaining work ability in a group of female healthcare personnel (HCPs) with BrC in Southern Italy. Each HCP was subjected to a medical check, routine blood tests, and a questionnaire on the work ability index (WAI). Of 980 (100%) HCWs undergoing health control, 6% (n = 54) had experienced BRC, and only 66.6% (n = 36) agreed to take part in the study. A total of 28 (78%) were on night shifts. The WAI score was quite low in 5 (13.8%) cases, moderate in 10 (27.7%) cases, good in 14 (38.8%) cases, and excellent in 7 (19.5%) HCWs. Among all health figures, in nurses as well as technical staff, lower WAI scores were observed. HCWs reported various comorbidities, which affected WAI score, such as limited mobility in the upper limbs, arm/shoulder pain, numbness, and lymphoedema. The main complication that negatively affects any work activity is the morbidity in the upper limbs. This seems to affect the ability to perform tasks, and the re-entry to work is highlighted on sick leave days.
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Affiliation(s)
- Francesca Vella
- Occupational Medicine Section, Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy
| | - Veronica Filetti
- Occupational Medicine Section, Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy
| | - Luigi Cirrincione
- Department of Sciences for Health Promotion and Mother and Child Care “Giuseppe D’Alessandro”, University of Palermo, 90127 Palermo, Italy
| | - Venerando Rapisarda
- Occupational Medicine Section, Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy
| | - Serena Matera
- Occupational Medicine Section, Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy
| | - Alenka Skerjanc
- Clinical Institute for Occupational, Traffic and Sports Medicine, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
| | - Emanuele Cannizzaro
- Department of Sciences for Health Promotion and Mother and Child Care “Giuseppe D’Alessandro”, University of Palermo, 90127 Palermo, Italy
| | - Ermanno Vitale
- Occupational Medicine Section, Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy
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10
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Martin E, Di Meglio A, Menvielle G, Arvis J, Bourmaud A, Michiels S, Pistilli B, Vaz-Luis I, Dumas A. Informing the development of multidisciplinary interventions to help breast cancer patients return to work: a qualitative study. Support Care Cancer 2022; 30:8287-8299. [PMID: 35819520 DOI: 10.1007/s00520-022-07262-5] [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: 02/23/2022] [Accepted: 06/27/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Return to work (RTW) after breast cancer (BC) can be a major challenge for patients. Multidisciplinary interventions seem to be effective but the role of digital solutions is under-developed and therefore not evaluated. We explored the preferences, needs, and barriers regarding RTW interventions, including opinions about the use of digital approaches to deliver such interventions. METHODS We conducted a qualitative study based on interviews with 30 patients with BC and 18 healthcare providers in four French regions. Emergent themes were identified using thematic content analysis. RESULTS Most providers declared that they did not proactively address RTW with patients, mainly due to having other priorities and a lack of knowledge. The following themes emerged: several development and deployment barriers regarding RTW interventions exist, multidisciplinary interventions are preferred, and there is a need to maintain contact between the patient and workplace during sick leave, including pathways and interlocutors that can facilitate RTW. Participants had mostly positive representations of using digital tools to facilitate RTW; however, fear of loss of human contact and the exacerbation of inequalities were identified as possible risks associated with the development of digital-only interventions. CONCLUSIONS Interventions blending the needs and preferences of patients with BC and the healthcare system are warranted. A personalized multimodal approach with mixed digital and in-person features has surfaced as a possible solution to address the weaknesses of existing interventions. IMPLICATIONS FOR CANCER SURVIVORS Since most women work at the time of diagnosis, it is of particular relevance to build interventions promoting RTW.
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Affiliation(s)
- Elise Martin
- Université Paris-Saclay, Gustave Roussy, Inserm, Biomarqueurs Prédictifs Et Nouvelles Stratégies Thérapeutiques en Oncologie, 94800, Villejuif, France.
| | - Antonio Di Meglio
- Université Paris-Saclay, Gustave Roussy, Inserm, Biomarqueurs Prédictifs Et Nouvelles Stratégies Thérapeutiques en Oncologie, 94800, Villejuif, France.,Medical Oncology Department, Gustave Roussy, 94800, Villejuif, France
| | - Gwenn Menvielle
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie Et de Sante Publique, Paris, France
| | | | | | - Stefan Michiels
- Office of Biostatistics and Epidemiology, Gustave Roussy, Villejuif, France.,Oncostat U1018, Inserm, University Paris-Saclay, Labeled Ligue Contre Le Cancer, Villejuif, France
| | - Barbara Pistilli
- Medical Oncology Department, Gustave Roussy, 94800, Villejuif, France
| | - Ines Vaz-Luis
- Université Paris-Saclay, Gustave Roussy, Inserm, Biomarqueurs Prédictifs Et Nouvelles Stratégies Thérapeutiques en Oncologie, 94800, Villejuif, France.,Medical Oncology Department, Gustave Roussy, 94800, Villejuif, France
| | - Agnès Dumas
- Université Paris Cité, ECEVE, UMR 1123, INSERM, Paris, France
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Bilodeau K, Gouin MM, Lecours A, Lederer V, Durand MJ, Kilpatrick K, Lepage D, Ladouceur-Deslauriers L, Dorta T. Co-design of a return-to-work intervention after breast cancer treatments: feasibility study protocol (Preprint). JMIR Res Protoc 2022; 11:e37009. [PMID: 35451972 PMCID: PMC9077508 DOI: 10.2196/37009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/24/2022] [Accepted: 03/29/2022] [Indexed: 12/04/2022] Open
Abstract
Background The mortality rate from breast cancer has been declining for many years, and the population size of working-age survivors is steadily increasing. However, the recurrent side effects of cancer and its treatment can result in multiple disabilities and disruptions to day-to-day life, including work disruptions. Despite the existing knowledge of best practices regarding return to work (RTW) for breast cancer survivors, only a few interdisciplinary interventions have been developed to address the individualized needs and multiple challenges of breast cancer survivors, health care professionals, and employer and insurer representatives. Thus, it seems appropriate to develop RTW interventions collaboratively by using a co-design approach with these specific stakeholders. Objective This paper presents a protocol for developing and testing an innovative, interdisciplinary pilot intervention based on a co-design approach to better support RTW and job retention after breast cancer treatment. Methods First, a participatory research approach will be used to develop the intervention in a co-design workshop with 12 to 20 participants, including people affected by cancer, employer and insurer representatives, and health care professionals. Next, a pilot intervention will be tested in a primary care setting with 6 to 8 women affected by breast cancer. The acceptability and feasibility of the pilot intervention will be pretested through semistructured interviews with participants, health care professionals, and involved patient partners. The transcribed data will undergo an iterative content analysis. Results The first phase of the project—the co-design workshop—was completed in June 2021. The pilot test of the intervention will begin in spring 2022. The results from the test will be available in late 2022. Conclusions The project will offer novel data regarding the use of the co-design approach for the development of innovative, co-designed interventions. In addition, it will be possible to document the acceptability and feasibility of the pilot intervention with a primary care team. Depending on the results obtained, the intervention could be implemented on a larger scale. International Registered Report Identifier (IRRID) DERR1-10.2196/37009
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Affiliation(s)
- Karine Bilodeau
- Faculty of Nursing, University of Montreal, Montreal, QC, Canada
- Centre de recherche Hopital Maisonneuve Rosemont, Montreal, QC, Canada
| | - Marie-Michelle Gouin
- Faculté de médecine et des sciences de la santé, University of Sherbrooke, Longueuil, QC, Canada
| | - Alexandra Lecours
- Département de relations industrielles, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Valérie Lederer
- Département de relations industrielles, Université du Québec en Outaouais, Gatineau, QC, Canada
| | - Marie-José Durand
- Faculté de médecine et des sciences de la santé, University of Sherbrooke, Longueuil, QC, Canada
| | - Kelley Kilpatrick
- Centre de recherche Hopital Maisonneuve Rosemont, Montreal, QC, Canada
- Ingram School of Nursing, Mcgill University, Montreal, QC, Canada
| | - David Lepage
- Centre intégré universitaire de santé et de services sociaux de l'Est de l'île de Montréal, Montréal, QC, Canada
| | | | - Tomas Dorta
- Faculté de l'aménagement, École de Design, Université de Montréal, Montreal, QC, Canada
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Rosenberg J, Butow PN, Shaw JM. The untold story of late effects: a qualitative analysis of breast cancer survivors' emotional responses to late effects. Support Care Cancer 2022; 30:177-185. [PMID: 34245359 DOI: 10.1007/s00520-021-06402-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 06/26/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE Breast cancer survivors are at increased risk of adverse outcomes, called late effects, years after the completion of active treatment. Late effects can significantly impair physical functioning. The current study aimed to explore breast cancer survivors' experiences of late effects, their emotional responses to existing or potential late effects and their perceived impact. METHODS A total of 36 women treated for breast cancer in the last 10 years participated in semi-structured telephone interviews. Participant views were sought with respect to knowledge, experience, and perceived longer-term risk. A thematic analysis was conducted. RESULTS Four themes emerged from the data: (1) late effects awareness, (2) framing and coping, (3) uncertainty and (4) management. There was a range of emotional responses to late effects; however, many participants reported being unaware of their risk of late effects. Participants conceptualised late effects as any long-term effect of treatment regardless of the time of onset. Women reported living with constant uncertainty and feared cancer recurrence. Many were focused on managing long-term treatment side effects, rather than late effects. CONCLUSION Many women undergo treatment and remain unaware of associated late effect risks. National guidelines recommend patients be informed about late effects; however, the results of this study suggest a gap between policy and practice. Evidence-based interventions are needed to equip women with strategies to physically and emotionally manage late effects.
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Affiliation(s)
- Jodie Rosenberg
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia. .,Psycho-Oncology Co-Operative Research Group, School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia.
| | - Phyllis N Butow
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia.,Psycho-Oncology Co-Operative Research Group, School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Joanne M Shaw
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia.,Psycho-Oncology Co-Operative Research Group, School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
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13
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Hou W, Li Q, Liu X, Zeng Y, Cheng AS. Exploring the employment readiness and return to work status of breast cancer patients and related factors. Int J Nurs Sci 2021; 8:426-431. [PMID: 34631993 PMCID: PMC8488802 DOI: 10.1016/j.ijnss.2021.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 09/01/2021] [Accepted: 09/02/2021] [Indexed: 11/30/2022] Open
Abstract
Objective To investigate the employment status, employment readiness, and other factors affecting the ease or difficulty with which breast cancer patients effect their return to work (RTW). Methods This study adopted a mixed-method design, recruiting participants from among breast cancer patients in a cancer hospital in Hunan from December 2018 to June 2019. We approached 300 individuals, 192 of whom ultimately participated in this study. The quantitative part of the study involved several scales: the Patient Health Questionnaire-9 (PHQ-9), the Brief Fatigue Inventory (BFI), the Work Ability Index (WAI), and the Lam Assessment of Employment Readiness (LASER). The qualitative part involved a set of open-ended questions and written responses collected from 41 participants who had already returned to work at the time of data collection. Their written responses mainly concerned factors influencing RTW. Results Forty-one breast cancer patients had returned to work. The results reported a median total Cognitive Symptom Checklist score of 9.00 (6.00, 15.25), a median WAI score of 5.00 (3.50, 9.75), a median BFI score of 26.00 (14.75, 42.00), a median total PHQ-9 score of 8.00 (5.25, 17.00), and a LASER score of 50.35 ± 11.90. Multiple regression analysis showed that the participants’ cancer stage, cognitive limitations, depression, fatigue, and work ability were significant predictors of employment readiness (P < 0.05). Exploring the qualitative data, we found that higher skill levels, better social support, and a flexible work schedule facilitated RTW; stress, lack of confidence in one’s work skills, depression, and fatigue are all possible barriers to RTW. Conclusion The findings indicate that breast cancer patients have a low level of employment readiness. Nurses and other healthcare providers can develop relevant interventions to promote employment readiness and ultimately achieve RTW in this study population.
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Affiliation(s)
- Wenmin Hou
- Intensive Care Unit, The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Qiaoping Li
- Nursing Department, The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiangyu Liu
- Department of Health Service Center, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, China
| | - Yingchun Zeng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Andy Sk Cheng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
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3 rd Etnean Occupational Medicine Workshop-Breast Cancer and Work. Cancers (Basel) 2020; 12:cancers12071925. [PMID: 32708784 PMCID: PMC7409062 DOI: 10.3390/cancers12071925] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 07/13/2020] [Indexed: 12/03/2022] Open
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