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

Abstract

The aim of the present study was to examine the predictive value of Return to Work Self-efficacy (RTWSE) on Return to Work (RTW) among employees undergoing chemotherapy for cancer and to examine the relative contribution of RTWSE as predictor variable compared to personal, health-related, illness-and treatment-related and work-related factors. Methods A sample of 114 sickness absent employees with various cancers (age 18-62) included in the study on average 33 days after initiating chemotherapy were followed for 15 months. Data sources included patient questionnaires (RTWSE, depression, fatigue, performance status), sociodemographic factors (age, sex, job type, and perceived support from the workplace), patient records (type of cancer, treatment intention, number of treatment modalities, time since diagnosis and time since initiation of chemotherapy), and Danish national registries (RTW and education). Associations between RTWSE at baseline and weeks until full RTW during 15-months follow-up were analyzed using Cox proportional hazards regression. Results In the univariate analysis, high RTWSE was associated with shorter time to RTW (Hazard Ratio (HR) 1.84, 95% confidence interval (CI) 1.12-3.03). In the multivariate model, RTWSE failed to reach statistical significance (HR 1.12, 95% CI 0.62-2.02), whereas female sex (HR 0.30, 95% CI 0.15-0.60) and receiving palliative treatment (HR 0.15, 95% CI 0.05-0.44) were significantly associated with later RTW. Conclusion Compared to other factors of significance, RTWSE was not the strongest predictor of RTW when examined among employees undergoing chemotherapy for cancer. Before using the RTWSE questionnaire to identify employees with cancer at risk of late RTW, it is important to recognize that the predictive value of RTWSE may be different for employees on sick leave due to cancer than for other sickness absence populations.

Self‐efficacy and return to work in cancer survivors: Current knowledge and future prospects

“…The predictive power of RTW-SE on cancer survivors' RTW should be discussed. Rosbjerg et al (2020) suggested that RTW-SE does not appear as the strongest predictor of RTW among cancer patients undergoing chemotherapy. However, the small sample size of this study does not permit any generalisation of this result (Rosbjerg et al, 2020).…”

“…Rosbjerg et al (2020) suggested that RTW-SE does not appear as the strongest predictor of RTW among cancer patients undergoing chemotherapy. However, the small sample size of this study does not permit any generalisation of this result (Rosbjerg et al, 2020). Among workers with psychological or upper-body musculoskeletal injuries, RTW-SE showed the strongest relationship with RTW (Black, Keegel, Sim, Collie, & Smith, 2018).…”

“…In the literature concerning RTW following a cancer diagnosis, SE has been categorised based on three broad domains of functioning: general‐SE (Koch, Wittekindt, Altendorf‐Hofmann, Singer, & Guntinas‐Lichius, 2015), cancer management‐SE (Bains et al., 2012) and job‐SE/ RTW‐SE (Bains et al., 2012; Leensen et al., 2017; Rosbjerg et al., 2020; Wolvers, Leensen, Groeneveld, Frings‐Dresen, & De Boer, 2018). Some authors used a RTW‐SE questionnaire to describe job‐SE (Bains et al., 2012; Wolvers et al., 2018) despite a temporal difference between RTW‐SE and job‐SE.…”

Validation of the Return To Work Self‐Efficacy questionnaire in a population of employees undergoing treatment for cancer

“…In a non‐randomised study, Leensen et al (2017) found that participation in a multidisciplinary cancer rehabilitation programme seemed to improve both actual RTW and RTWSE, and Bains et al (2012) found job SE to be related to work status at baseline in an observational prospective study among patients with colorectal cancer. Furthermore, using the RTWSE‐11, Wolvers et al (2018) found RTWSE to be predictive of full RTW among cancer patients in curative care during 18 months follow‐up, whereas RTWSE was shown to be a less important predictor of actual RTW than other factors such as gender and treatment intention when measured with the RTWSE‐19 DK in a sample of cancer patients with various treatment intentions (Rosbjerg et al, 2020). These contradictory results may be related to differences between study samples and the use of different tools for measuring RTWSE in the two studies (Rosbjerg et al, 2020).…”

“…Furthermore, using the RTWSE‐11, Wolvers et al (2018) found RTWSE to be predictive of full RTW among cancer patients in curative care during 18 months follow‐up, whereas RTWSE was shown to be a less important predictor of actual RTW than other factors such as gender and treatment intention when measured with the RTWSE‐19 DK in a sample of cancer patients with various treatment intentions (Rosbjerg et al, 2020). These contradictory results may be related to differences between study samples and the use of different tools for measuring RTWSE in the two studies (Rosbjerg et al, 2020). Besides being associated with work status and RTW in cancer populations, RTWSE has also been shown to be associated with factors which are correlated with RTW as well.…”