Employment status and work-related problems of gastrointestinal cancer patients at diagnosis: a cross-sectional study

Abstract

ObjectiveTo assess the employment status of patients with gastrointestinal cancer at diagnosis and to examine work-related problems of employed patients.DesignNew, 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).ResultsOf 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.ConclusionA 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.

Risk Factors for Depression in Patients Undergoing Hematopoietic Cell Transplantation

“…It is possible that the added stress of these vocational demands contributes to depression after HCT. Indeed, recent study findings in a non-HCT cancer sample indicated that work-related stress is common, even for those on medical leave, during cancer treatment [38]. Patients who are working or in school, in some capacity, during the transplant process may require additional support and strategies on managing vocational demands and stress in the context of diminished medical and psychosocial reserves.…”

Supporting cancer patients with work-related problems through an oncological occupational physician: a feasibility study

“…Patients have consults with several members of this multidisciplinary oncology team, including attention for psychosocial oncological care, support of social problems such as work‐related problems, whereby the physician could refer the patient to an occupational specialist (de Boer et al . ).…”

Development of a tailored work-related support intervention for gastrointestinal cancer patients

“…Besides, support provided "as early as possible" (de Boer et al, 2011;Hoefsmit, Houkes, & Nijhuis, 2012) seems to be most appropriate because this enables patients to keep participating in working life, which in turn increases the chances of work retention (de Boer et al, 2011). The decision diagram is a suitable tool to help recognise if there are work-related problems and the severity of the workrelated problems.…”

“…It is known that patients diagnosed with GI cancer experience work-related problems during diagnosis and treatment (de Boer et al, 2011). Although work ensures the feeling of normalcy, there are patients who continuously experience treatment-related symptoms, but who are, for example highly motivated by their financial responsibilities to RTW.…”

“…Although some general work-related support interventions do exist, no work-related support interventions are available for patients confronted with a GI cancer diagnosis (de Boer et al, 2015) in the curative setting, and there is certainly no tailored support available. In this study, we will focus on patients with GI cancer who are treated with curative intent, because GI cancer is an under-exposed group when addressing work-related support interventions (de Boer et al, 2015) compared to patients with, for example breast cancer (Balak, Roelen, Koopmans, Ten Berge, & Groothoff, 2008;de Boer et al, 2015;Desiron, Crutzen, Godderis, Van Hoof, & de Rijk, 2016), even though GI cancers have a high incidence worldwide (Ferlay et al, 2015). Examples of problems for patients diagnosed with (gastrointestinal) cancer are as follows: complaints with nutritional intake because on passage complaints or nausea (American Cancer Society, 2017), and defecation problems, such as constipation, diarrhoea.…”