Predictors for earlier return to work of cancer patients

Abstract

PurposeThis study aims to investigate how perceived work ability, job self-efficacy, value of work, and fatigue predict return to work (RTW) in cancer patients who received chemotherapy.MethodsData of a before-after study on a multidisciplinary intervention that aimed to enhance RTW was used, consisting of four assessments up to 18 months. Time to partial and full RTW of 76 and 81 participants, respectively, was analyzed in Cox proportional hazard analysis with time-dependent variables. Univariate analyses of work ability, job self-efficacy, value of work, or fatigue as covariates were succeeded by multivariate analyses of work ability and either job self-efficacy, value of work, or fatigue as covariates.ResultsParticipants were mostly female (93%), and diagnosed with breast cancer (87%). Most participants were permanently employed (84%) and 48% was sole breadwinner. When adjusted for timing variables and prognostic factors, all hypothesized factors were predictive for earlier RTW (p < .05). In models that also included work ability, only job self-efficacy significantly predicted earlier full RTW: hazard ratio = 1.681; p = .025.ConclusionsLower fatigue and higher value of work, work ability, and job self-efficacy of cancer survivors are associated with earlier RTW. Work ability and job self-efficacy seem to be key predictors.Implications for cancer survivorsLimiting fatigue, increasing value of work, job self-efficacy, and perceived work ability are promising goals for enhancing earlier RTW. Occupational rehabilitation should empower patients to organize appropriate conditions for work and to educate them on rights and obligations during sick leave.Electronic supplementary materialThe online version of this article (10.1007/s11764-017-0655-7) contains supplementary material, which is available to authorized users.

Return to work after breast cancer: The role of treatment‐related side effects and potential impact on quality of life

“…It was the most frequently self‐reported reason for impaired RTW, and fatigue persisting 1.5 years after end of therapy was a significant determinant for impaired RTW in the long run. Our results strengthen findings from previous trials that also found an influence of fatigue on RTW (Kiasuwa Mbengi et al, ; Mehnert, ; Porro et al, ; Wolvers, Leensen, Groeneveld, Frings‐Dresen, & Boer, ). Thus, health professionals' and the public's awareness needs to be raised that fatigue is a serious syndrome (and not just listlessness or moaning) that severely hampers general functioning and daily routine.…”

The Predictive Value of Return to Work Self-efficacy for Return to Work Among Employees with Cancer Undergoing Chemotherapy

“…In contrast to the present study, Wolvers et al [29] found RTWSE to be predictive of RTW in employees with cancer. Keeping in mind that the participants in Wolver et al's study [29] were all in curative treatment, in physically good shape, and motivated for RTW, one might speculate that RTWSE is more likely to be predictive of RTW in populations of cancer patients in curative care who are motivated for RTW than in populations of cancer patients with a wider range of treatment intentions (i.e., curative, adjuvant, neo-adjuvant and palliative) who are therefore potentially less motivated for RTW. It is well-known that after being diagnosed with a life-threatening illness, life priorities may change [12][13][14], and it is possible that a subsample in the present study could have had an expectation of being able to RTW but chose not to RTW due to other life priorities.…”

“…Likewise, the employees undergoing palliative treatment may also have had other life priorities beside RTW [13,14,49,50]. Differences in sample characteristics with regard to treatment intention and motivation for RTW are therefore possible explanations as to why RTWSE failed to predict RTW in the present sample of employees with cancer but was predictive in the study by Wolvers et al [29]. The majority of the population in Wolvers et al's study was women with breast cancer, too.…”

“…As cancer is a potential life threatening disease and studies have shown that a cancer diagnosis may change life priorities and the meaning of work [1], the predictive value of RTWSE may be different compared to other sickness absence populations. To our knowledge, the predictive value of RTWSE in a cancer population has been examined only once, using the RTWSE -11, and as part of an intervention study in which RTWSE showed to be predictive of full RTW during 18 months of follow-up [29]. This finding was based on a sample of 81 patients with cancer (mainly breast cancer, 87%), undergoing chemotherapy with a curative intention, participating in an intervention program aiming at increasing RTW among cancer patients [29].…”

“…To our knowledge, the predictive value of RTWSE in a cancer population has been examined only once, using the RTWSE -11, and as part of an intervention study in which RTWSE showed to be predictive of full RTW during 18 months of follow-up [29]. This finding was based on a sample of 81 patients with cancer (mainly breast cancer, 87%), undergoing chemotherapy with a curative intention, participating in an intervention program aiming at increasing RTW among cancer patients [29]. In order to generalize the results from that study, one should notice that the participants were all (I) in curative treatment, (II) physically well-functioning, and (III) had chosen to participate in an intervention program aiming at enhancing RTW.…”