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Altherr A, Bolliger C, Kaufmann M, Dyntar D, Scheinemann K, Michel G, Mader L, Roser K. Education, Employment, and Financial Outcomes in Adolescent and Young Adult Cancer Survivors-A Systematic Review. Curr Oncol 2023; 30:8720-8762. [PMID: 37887531 PMCID: PMC10604989 DOI: 10.3390/curroncol30100631] [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: 07/07/2023] [Revised: 08/11/2023] [Accepted: 09/02/2023] [Indexed: 10/28/2023] Open
Abstract
Adolescents and young adults (AYAs) with cancer face unique challenges. We aimed to describe (i) education, employment, and financial outcomes and (ii) determinants for adverse outcomes in AYA cancer survivors. We performed a systematic literature search. We included original research articles on AYA (15-39 years of age) cancer survivors (≥2 years after diagnosis) and our outcomes of interest. We narratively synthesized the results of the included articles. We included 35 articles (24 quantitative and 11 qualitative studies). Patients in education had to interrupt their education during cancer treatment, and re-entry after treatment was challenging. After treatment, most survivors were employed but started their employment at an older age than the general population. Overall, no disadvantages in income were found. Survivors reported more absent workdays than comparisons. We identified chemotherapy, radiotherapy, late effects or health problems, female sex, migration background, and lower education associated with adverse outcomes. Although most AYA cancer survivors were able to re-enter education and employment, they reported difficulties with re-entry and delays in their employment pathway. To facilitate successful re-entry, age-tailored support services should be developed and implemented.
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Affiliation(s)
- Aurelia Altherr
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Lucerne, Switzerland; (A.A.); (C.B.); (D.D.); (K.S.); (G.M.)
| | - Céline Bolliger
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Lucerne, Switzerland; (A.A.); (C.B.); (D.D.); (K.S.); (G.M.)
| | - Michaela Kaufmann
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Lucerne, Switzerland; (A.A.); (C.B.); (D.D.); (K.S.); (G.M.)
| | - Daniela Dyntar
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Lucerne, Switzerland; (A.A.); (C.B.); (D.D.); (K.S.); (G.M.)
- Cancer Registry of Central Switzerland, 6000 Lucerne, Switzerland
| | - Katrin Scheinemann
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Lucerne, Switzerland; (A.A.); (C.B.); (D.D.); (K.S.); (G.M.)
- Division of Hematology & Oncology, Children’s Hospital of Eastern Switzerland, 9006 St. Gallen, Switzerland
- Department of Pediatrics, McMaster Children’s Hospital and McMaster University, Hamilton, ON L8N 3Z5, Canada
| | - Gisela Michel
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Lucerne, Switzerland; (A.A.); (C.B.); (D.D.); (K.S.); (G.M.)
| | - Luzius Mader
- Institute of Social and Preventive Medicine, University of Bern, 3012 Bern, Switzerland;
- Cancer Registry Bern-Solothurn, University of Bern, 3008 Bern, Switzerland
| | - Katharina Roser
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Lucerne, Switzerland; (A.A.); (C.B.); (D.D.); (K.S.); (G.M.)
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van Ommen F, Coenen P, Malekzadeh A, de Boer AGEM, Greidanus MA, Duijts SFA. Interventions for work participation of unemployed or work-disabled cancer survivors: a systematic review. Acta Oncol 2023; 62:753-764. [PMID: 37010899 DOI: 10.1080/0284186x.2023.2187261] [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: 10/26/2022] [Accepted: 02/28/2023] [Indexed: 04/04/2023]
Abstract
Background: Supporting unemployed or work-disabled cancer survivors in their work participation can have extensive individual and societal benefits. We aimed to identify and summarise interventions for work participation of unemployed or work-disabled cancer survivors.Methods: Five databases (Medline, Embase, PsycINFO, CINAHL and Cochrane Library) were systematically searched for quantitative studies on interventions aimed at enhancing work participation of unemployed or work-disabled cancer survivors. Work participation refers to participation in the workforce, fulfilling one's work role. Manual and automatic screening (with ASReview software) were performed on titles and abstracts, followed by manual full-text screening. Data were extracted regarding study, patient and intervention characteristics, and work participation outcomes. Risk of bias (RoB) was assessed using the Cochrane RoB2 and QUIPS tools.Results: We identified 10,771 articles, of which we included two randomised controlled trials (RCTs), of which one feasibility RCT, and three cohort studies. In total, 1862 cancer survivors were included, with predominantly breast cancer. Work participation was mainly measured as time to return to work (RTW) and RTW rate. Interventions included components of coaching (e.g., psychological or rehabilitation), training (e.g., building confidence and managing fatigue) and self-management. Two RCTs with unclear RoB did not show an effect of multicomponent interventions compared to care as usual. One cohort study found a significant effect of a psycho-educational intervention on RTW rates, with moderate RoB. The other two cohort studies, with moderate RoB, reported significant associations between components including job search and placement assistance, and work participation.Discussion: Only few interventions aimed at enhancing work participation of unemployed or work-disabled cancer survivors, have been evaluated. In two cohort studies, promising components for future multicomponent interventions were identified. However, findings suggest that more evidence is necessary on such multicomponent interventions, in which elements explicitly directed at work and including the workplace should be included.
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Affiliation(s)
- F van Ommen
- Department of Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Societal Participation and Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - P Coenen
- Societal Participation and Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
- Department of Public and Occupational Health, Amsterdam UMC location Vrije Universiteit, Amsterdam, the Netherlands
- Musculoskeletal Health, Amsterdam Movement Sciences Research Institute, Amsterdam, the Netherlands
| | - A Malekzadeh
- Medical Library, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
| | - A G E M de Boer
- Department of Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Societal Participation and Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
- Cancer Centre Amsterdam, Cancer Treatment and Quality of life, Amsterdam, the Netherlands
| | - M A Greidanus
- Department of Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Societal Participation and Health, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - S F A Duijts
- Cancer Centre Amsterdam, Cancer Treatment and Quality of life, Amsterdam, the Netherlands
- Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands
- Department of Medical Psychology, Amsterdam UMC location Vrije Universiteit, Amsterdam, the Netherlands
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Rosi-Schumacher M, Patel S, Phan C, Goyal N. Understanding Financial Toxicity in Patients with Head and Neck Cancer: A Systematic Review. Clin Med Insights Oncol 2023; 17:11795549221147730. [PMID: 36710886 PMCID: PMC9880590 DOI: 10.1177/11795549221147730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 12/06/2022] [Indexed: 01/24/2023] Open
Abstract
Background Cancer treatment often results in financial burdens for patients including healthcare costs as well as treatment-induced disability leading to "financial toxicity" (FT) and decreased quality of life. The purpose of this review is to describe FT related to head and neck cancer (HNC) treatment, including quantifications of direct and indirect costs and descriptions of measurement tools. Methods PubMed, Embase, Cochrane Library, and Web of Science databases were searched to identify articles published before April 2022. Full-text published studies were included if they assessed direct or indirect costs of HNC treatment; studies were excluded if they did not focus on HNC or financial burden. The risk of bias was assessed, and the results of the studies were synthesized. Results Database searches yielded 530 unique studies, and 33 studies met the criteria for inclusion. Medical expenses for patients with HNC were higher than for patients with other cancers or controls in several studies. Major surgical procedures, neck dissection, free-flap reconstruction, and intensive care unit admission increased hospital costs. Trimodal therapy with surgery plus chemoradiation represented the most expensive treatment, and chemoradiation increased complication-related health care costs. In several studies, >50% of patients treated for HNC were disabled and did not return to work. One of the greatest contributors to the indirect cost of HNC treatment is the loss of lifetime wages. Patients with HNC are at risk for depression, anxiety, and social isolation, which are linked to a decreased quality of life and treatment non-adherence. The only tools used to assess FT in patients with HNC are the Comprehensive Score for financial Toxicity (COST) and the Financial Index of Toxicity (FIT). Conclusion Financial toxicity is highly prevalent among patients with HNC. Further research is needed to validate the assessment tools for quantifying FT in HNC patients.
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Affiliation(s)
- Mattie Rosi-Schumacher
- Department of Otolaryngology—Head and
Neck Surgery, Jacobs School of Medicine and Biomedical Sciences, The State
University of New York at Buffalo, Buffalo, NY, USA
| | - Shivam Patel
- Pennsylvania State University College
of Medicine, Hershey, PA, USA
| | - Chandat Phan
- Pennsylvania State University College
of Medicine, Hershey, PA, USA
| | - Neerav Goyal
- Pennsylvania State University College
of Medicine, Hershey, PA, USA,Department of Otolaryngology—Head and
Neck Surgery, Penn State Milton S Hershey Medical Center, Pennsylvania State
University, Hershey, PA, USA,Neerav Goyal, Department of
Otolaryngology—Head and Neck Surgery, Penn State Milton S Hershey Medical
Center, Pennsylvania State University, Hershey, PA 17033, USA.
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Aagesen M, Pilegaard MS, Hauken MA, Wæhrens EEE, la Cour K. Users' perspective on rehabilitation interventions for young adult cancer survivors: A group concept mapping study. Eur J Cancer Care (Engl) 2022; 31:e13734. [PMID: 36218020 PMCID: PMC9786878 DOI: 10.1111/ecc.13734] [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: 07/11/2022] [Revised: 09/09/2022] [Accepted: 09/22/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE We aim to identify and prioritise rehabilitation interventions to strengthen participation in everyday life for young adult cancer survivors (YACS) between 18 and 39 years, involving the perspectives of YACS and relevant stakeholders. METHODS A group concept mapping study was conducted in Denmark from 2019 to 2020. Online, participants generated and sorted ideas followed by rating their importance. Multidimensional scaling followed by hierarchical cluster analyses were applied to generate a cluster rating map of the prioritised interventions, which participants validated at a face-to-face meeting. Finally, a concluding conceptual model of prioritised rehabilitation intervention for YACS was developed. RESULTS The study involved 25 YACS, three family members and 31 professionals working with YACS. The conceptual model included 149 ideas classified into eight intervention components created by the participants: (1) Treatment and possibilities within the social and healthcare system, (2) Rights and Finance, (3) Education and Work, (4) Psychological problems, (5) Body and Everyday Life, (6) Peer-to-peer, (7) Sexuality and Relationships and (8) Family and Friends. All components were rated equally important, whereby 17 ideas across the eight components were rated very important. CONCLUSION This study indicates that rehabilitation of YACS should be composed of eight equally important intervention components requiring an interdisciplinary approach.
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Affiliation(s)
- Maria Aagesen
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Department of Clinical ResearchUniversity of Southern DenmarkOdenseDenmark
| | - Marc Sampedro Pilegaard
- The Research Unit for User Perspectives and Community‐based Interventions, the Research Group for Occupational Science, Department of Public HealthUniversity of Southern DenmarkOdenseDenmark,OPEN, Open Patient data Explorative NetworkOdense University HospitalOdenseDenmark
| | - May Aasebø Hauken
- Centre for Crisis Psychology, Faculty of PsychologyUniversity of BergenBergenNorway
| | - Eva Elisabet Ejlersen Wæhrens
- The Research Unit for User Perspectives and Community‐based Interventions, the Research Group for Occupational Science, Department of Public HealthUniversity of Southern DenmarkOdenseDenmark,The Parker Institute, Copenhagen University Hospitals Bispebjerg–FrederiksbergFrederiksbergDenmark
| | - Karen la Cour
- The Research Unit for User Perspectives and Community‐based Interventions, the Research Group for Occupational Science, Department of Public HealthUniversity of Southern DenmarkOdenseDenmark
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Devine KA, Christen S, Mulder RL, Brown MC, Ingerski LM, Mader L, Potter EJ, Sleurs C, Viola AS, Waern S, Constine LS, Hudson MM, Kremer LCM, Skinner R, Michel G, Gilleland Marchak J, Schulte FSM. Recommendations for the surveillance of education and employment outcomes in survivors of childhood, adolescent, and young adult cancer: A report from the International Late Effects of Childhood Cancer Guideline Harmonization Group. Cancer 2022; 128:2405-2419. [PMID: 35435238 PMCID: PMC9321726 DOI: 10.1002/cncr.34215] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 07/30/2021] [Accepted: 08/24/2021] [Indexed: 12/12/2022]
Abstract
Educational achievement and employment outcomes are critical indicators of quality of life in survivors of childhood, adolescent, and young adult (CAYA) cancer. This review is aimed at providing an evidence-based clinical practice guideline (CPG) with internationally harmonized recommendations for the surveillance of education and employment outcomes in survivors of CAYA cancer diagnosed before the age of 30 years. The CPG was developed by a multidisciplinary panel under the umbrella of the International Late Effects of Childhood Cancer Guideline Harmonization Group. After evaluating concordances and discordances of 4 existing CPGs, the authors performed a systematic literature search through February 2021. They screened articles for eligibility, assessed quality, and extracted and summarized the data from included articles. The authors formulated recommendations based on the evidence and clinical judgment. There were 3930 articles identified, and 83 of them, originating from 17 countries, were included. On a group level, survivors were more likely to have lower educational achievement and more likely to be unemployed than comparisons. Key risk factors for poor outcomes included receiving a primary diagnosis of a central nervous system tumor and experiencing late effects. The authors recommend that health care providers be aware of the risk of educational and employment problems, implement regular surveillance, and refer survivors to specialists if problems are identified. In conclusion, this review presents a harmonized CPG that aims to facilitate evidence-based care, positively influence education and employment outcomes, and ultimately minimize the burden of disease and treatment-related late adverse effects for survivors of CAYA cancers. LAY SUMMARY: A multidisciplinary panel has developed guidelines for the surveillance of education and employment outcomes among survivors of childhood, adolescent, and young adult cancer. On the basis of evidence showing that survivors are at risk for lower educational achievement and unemployment, it is recommended that all survivors receive regular screening for educational and employment outcomes.
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Affiliation(s)
- Katie A Devine
- Department of Pediatrics, Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, New Jersey
| | - Salome Christen
- Health Science and Health Policy, Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Renée L Mulder
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Morven C Brown
- Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom.,Newcastle University Centre for Cancer, Newcastle Upon Tyne, United Kingdom
| | - Lisa M Ingerski
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.,Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Luzius Mader
- Danish Cancer Society Research Center, Copenhagen, Denmark.,Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | | | | | - Adrienne S Viola
- Department of Pediatrics, Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, New Jersey
| | | | - Louis S Constine
- Department of Radiation Oncology, University of Rochester Medical Center, Rochester, New York.,Department of Pediatrics, University of Rochester Medical Center, Rochester, New York
| | - Melissa M Hudson
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | | | - Roderick Skinner
- Newcastle University Centre for Cancer, Newcastle Upon Tyne, United Kingdom.,Department of Paediatric and Adolescent Haematology/Oncology, Great North Children's Hospital, Newcastle Upon Tyne, United Kingdom
| | - Gisela Michel
- Health Science and Health Policy, Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Jordan Gilleland Marchak
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.,Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Fiona S M Schulte
- Division of Psychosocial Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Armin JS, Marshall CA, Kroeger S. Exploring the Experiences of University Students with a History of Cancer: A Pilot Study. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:294-298. [PMID: 31776893 DOI: 10.1007/s13187-019-01627-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
This exploratory pilot study aims to provide preliminary data describing the experiences of university student cancer survivors, quantify their connection to the campus Disability Resource Center, and assess the feasibility of conducting research with this population. In this descriptive study of cancer survivor students at one large university in the southwestern U.S., online survey respondents with a history of cancer (N = 19) reported cognitive, emotional, and physical limitations that affected their educational experience. The majority (78.9%) of our participants were children, adolescents, or young adults (up to age 39) when diagnosed with cancer; all others were diagnosed between 40 and 60 years old. We found that students living with cancer have short- and long-term impairments, including memory issues that made academic performance difficult. These effects led some students to cope individually while others sought support from institutional entities or instructors. Here we document survivor experiences and propose next steps in research, which includes an intervention that builds on our preliminary findings and uses the positive deviance model.
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Affiliation(s)
- Julie S Armin
- Department of Family & Community Medicine and Sonoran University Center for Excellence in Disabilities, College of Medicine, University of Arizona, 655 N. Alvernon Way, Ste. 228, Tucson, AZ, 85711, USA.
| | - Catherine A Marshall
- Department of Disability and Psychoeducational Studies, College of Education, University of Arizona, Tucson, AZ, USA
| | - Sue Kroeger
- Department of Disability and Psychoeducational Studies, College of Education, University of Arizona, Tucson, AZ, USA
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7
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Strauser DR, Shen S, Greco C, Fine E, Liptak C. Work Personality, Core Self-evaluation and Perceived Career Barriers in Young Adult Central Nervous System Cancer Survivors. JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:119-128. [PMID: 32399851 DOI: 10.1007/s10926-020-09897-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE The purpose of this study is to examine the relationship between work personality, core self-evaluation (CSE), and perceived internal and external barriers to employment in a group of young adult CNS survivors. METHODS The participants consisted of 110 young adult survivors of pediatric central nervous system (CNS) tumors aged between 18 and 30 years old (M = 23.05, SD = 3.36). Mediation analysis with structural equational modeling (SEM) technique was used to correlate a number of different measures (Work Personality [WP], Perceived Employment Barriers [PEB], and Core-Self Evaluation [CSE]). RESULTS Results revealed an exceptionally well-fitting model to our data with work personality predicting CSE positively: β = 0.34, SE = 0.07, 95% CI (0.18, 0.47) while CSE inversely predicts Perceived Barriers to Employment, β = - 0.60, SE = 0.06, 95% CI (- 0.70, - 0.49). There is a direct pathway from WP to PEB once CSE was accounted for β = - 0.20, SE = 0.07, 95% CI (- 0.33, - 0.06). The presence of both significant direct and indirect effects of WP on PEB implied that there was a partial mediating effect of CSE on the association between WP and PEB. CONCLUSIONS Work personality is a robust construct that can be applied to young adult CNS survivors in effort to gain more insight into the personality and psychological factors that impact career development and employment in this group. The major finding of this study was that work personality and CSE had a significant direct effect on perceived career barriers and that there was a significant indirect effect with CSE acting as a mediator between developmental work personality and perceived career barriers.
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Affiliation(s)
- David R Strauser
- University of Illinois at Urbana-Champaign, Champaign, USA.
- National Changhua University of Education, Changhua, Taiwan, ROC.
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 213A Huff Hall, 1206 South Fourth Street, Champaign, IL, 61820, USA.
| | - Sa Shen
- University of Illinois at Urbana-Champaign, Champaign, USA
| | - Chelsea Greco
- University of Illinois at Urbana-Champaign, Champaign, USA
| | - Elizabeth Fine
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, USA
| | - Cori Liptak
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, USA
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8
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Soejima T, Sato I, Takita J, Koh K, Kaneko T, Inada H, Ozono S, Kamibeppu K. Impacts of physical late effects on presenteeism in childhood cancer survivors. Pediatr Int 2020; 62:1241-1249. [PMID: 32402092 DOI: 10.1111/ped.14293] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 02/28/2020] [Accepted: 05/07/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Many childhood cancer survivors (CCSs) experience physical late effects related to their cancer types and treatment modalities. Physical late effects are an important factor in various occupational outcomes among CCSs. However, the relationship between physical late effects and presenteeism has remained unclear. This study aimed to estimate the impacts of physical late effects on presenteeism among employed CCSs. METHODS Childhood cancer survivors replied to a questionnaire regarding presenteeism, and their attending physicians assessed their physical late effects between September 2014 and December 2015. The Work Limitations Questionnaire was used to measure presenteeism. Propensity score analysis and a generalized linear model were used to adjust covariates related to physical late effects and / or presenteeism. RESULTS Of the 125 questionnaires distributed, 114 were returned. The data from 61 employed CCSs were analyzed. After controlling for covariates by propensity score analysis and generalized linear model, there were no significant differences in presenteeism between employed CCSs with either no or single physical late effects. However, employed CCSs with multiple physical late effects reported higher scores in Output (Estimate = 9.3, P = 0.041), Physical Demands (Estimate = 12.2, P = 0.020), and Productivity Loss scores (Estimate = 2.4, P = 0.045) on the Work Limitations Questionnaire than employed CCSs with no physical late effects. CONCLUSIONS Employed CCSs with multiple physical late effects were at an increased risk for presenteeism. Healthcare and social welfare systems should be established to provide vocational assistance for CCSs after being employed to alleviate presenteeism.
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Affiliation(s)
- Takafumi Soejima
- Department of Family Nursing, School of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Health Quality and Outcome Research, Division of Nursing Systems, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Iori Sato
- Department of Family Nursing, School of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Health Quality and Outcome Research, Division of Nursing Systems, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Junko Takita
- Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto-shi, Kyoto, Japan
| | - Katsuyoshi Koh
- Department of Hematology/Oncology, Saitama Children's Medical Center, Saitama-shi, Saitama, Japan
| | - Takashi Kaneko
- Department of Hematology/Oncology, Tokyo Metropolitan Children's Medical Center, Fuchu-shi, Tokyo, Japan
| | - Hiroko Inada
- Department of Pediatrics, Kurume University School of Medicine, Kurume-shi, Fukuoka, Japan
| | - Shuichi Ozono
- Department of Pediatrics, Kurume University School of Medicine, Kurume-shi, Fukuoka, Japan
| | - Kiyoko Kamibeppu
- Department of Family Nursing, School of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Health Quality and Outcome Research, Division of Nursing Systems, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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9
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Tanner L, Keppner K, Lesmeister D, Lyons K, Rock K, Sparrow J. Cancer Rehabilitation in the Pediatric and Adolescent/Young Adult Population. Semin Oncol Nurs 2020; 36:150984. [DOI: 10.1016/j.soncn.2019.150984] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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10
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Young adults diagnosed with high grade gliomas: Patterns of care, outcomes, and impact on employment. J Clin Neurosci 2019; 68:45-50. [PMID: 31371189 DOI: 10.1016/j.jocn.2019.07.063] [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: 03/04/2019] [Revised: 07/07/2019] [Accepted: 07/18/2019] [Indexed: 11/21/2022]
Abstract
There is limited information on the patterns of care and outcomes of high grade gliomas (HGGs) in young adults, in particular, the impact it has on a person's employment. We retrospectively identified young adult patients (age ≤ 40 years old) with newly diagnosed high grade gliomas treated between January 2013 and June 2018 across four major neuro-oncology centres in Australia. Patient demographics, tumour characteristics and treatment parameters were collected and outcomes determined. A total of 113 patients were identified with a median follow up of 27.0 months (range 1.0-70.2 months). The median age was 31 years, majority were male (65%) and employed (71.6%). IDH mutations were detected in 66 (62%) cases. The median progression-free survival (PFS) was 38.0 months (95% CI 23.3-52.7 months) and median overall survival (OS) was not reached. Patients with IDH wild type anaplastic astrocytoma and glioblastoma had a significantly shorter median PFS (19.3 months vs. NR, p = 0.001) and median OS (43.5 months vs NR, p = 0.007) than those with IDH mutated grade III anaplastic astrocytoma and oligodendroglioma. There was no significant difference in median OS or PFS between patients who underwent gross or subtotal tumour resection. Significantly, after diagnosis only 36 (32%) patients reported being employed. Young patients with IDH wild type astrocytomas and glioblastoma had better outcomes than reported historical controls. Most patients did not continue in employment post diagnosis.
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11
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Scardaville MC, Murphy KM, Liu F, Boydston S, Robert R, Shin K, Nguyen V, Frieden L. Knowledge of Legal Protections and Employment-Related Resources Among Young Adults with Cancer. J Adolesc Young Adult Oncol 2019; 8:312-319. [PMID: 31021285 DOI: 10.1089/jayao.2018.0097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: Young adults (aged 18-39 years) who have received a cancer diagnosis can encounter significant barriers in their transition to employment. American young adults' familiarity with federal legislation and resources related to employment is unclear. The study questions included: (1) To what extent do young adults who have had a cancer diagnosis know about legal and programmatic supports that may help to address their employment-related needs and (2) What modes of receiving information about resources to address their employment-related concerns do young adults who have had a cancer diagnosis prefer? Methods: A cross-sectional online survey was conducted with a convenience sample composed of 203 young adults living in the United States, had a cancer diagnosis other than nonmelanoma skin cancer, and were between 18 and 39 years of age. Over half (57.6%) of respondents received a cancer diagnosis at age 24 years or older. The mean age at participation was 30.4. Results: More than half of the sample (57.0%) was familiar with the Americans with Disabilities Act yet many did not know that cancer was a covered condition. Almost 80% of the respondents were not familiar with other federal initiatives with employment protections for people with cancer. Participants preferred in-person trainings and resource fact sheets as the presentation channels, although sociodemographic factors such as employment status were related to preferred delivery methods. Conclusion: These young adults would benefit from additional outreach around federal guidelines concerning employment-related rights and services and programs applicable to young adult cancer survivors.
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Affiliation(s)
- Melissa C Scardaville
- 1 Human Services and Public Health, American Institutes for Research, Washington, District of Columbia
| | - Kathleen M Murphy
- 2 Human Services and Public Health, American Institutes for Research, Austin, Texas
| | - Feng Liu
- 2 Human Services and Public Health, American Institutes for Research, Austin, Texas
| | - Steven Boydston
- 2 Human Services and Public Health, American Institutes for Research, Austin, Texas
| | - Rhonda Robert
- 3 Department of Clinical Psychology and Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson, Houston, Texas
| | - Ki Shin
- 4 Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson, Houston, Texas
| | - Vinh Nguyen
- 5 Independent Living Research Utilization, TIRR Memorial Hermann, Houston, Texas
| | - Lex Frieden
- 6 School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, Texas
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12
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Langi FLFG, Balcazar FE, Suarez-Balcazar Y. Analysis of Time in Rehabilitation and Incidence of Successful Rehabilitation Within Individuals with Disabilities Receiving Occupational/Vocational Training. JOURNAL OF OCCUPATIONAL REHABILITATION 2018; 28:701-710. [PMID: 29302873 DOI: 10.1007/s10926-017-9753-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Objective To investigate the incidence of successful rehabilitation, defined as 90 successive days in employment, within individuals with disabilities receiving occupational/vocational training (OVT) service. Method The follow-up records between January 1, 2004 and December 31, 2012 of 5313 individuals aged 15-55 who obtained OVT in the vocational rehabilitation (VR) program of the State of Illinois were examined. Cox regression models were used to analyze the effect of study factors on VR outcomes. Results After controlling for the other factors, males (incidence ratio [IR] 1.11, 95% CI 1.03-1.20), individuals with learning disability (IR 1.14, 95% CI 1.03-1.26), had existing employment (IR 1.40, 95% CI 1.26-1.56), and persons who were referred from educational institutions (IR 1.17, 95% CI 1.01-1.36) or community agencies (IR 1.30, 95% CI 1.14-1.48) appeared to have a relatively high incidence of successful rehabilitation. In contrast, those who lived in densely populated areas (IR ranged from 0.56 to 0.89), had physical disability (IR 0.77, 95% CI 0.68-0.88), had disability of most significant degree (IR 0.85, 95% CI 0.79-0.93), and persons with Supplemental Security Income/Social Security Disability Insurance supports (IR 0.84, 95% CI 0.76-0.94), tended to have a lower incidence of rehabilitation than their counterparts. Conclusion The incidence of successful rehabilitation seems to be related to the demographic, disability, and pre-service characteristics, but not necessarily the provider factors.
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Affiliation(s)
- F L Fredrik G Langi
- Department of Epidemiology and Biostatistics, School of Public Health and College of Medicine, Sam Ratulangi University, Manado, North Sulawesi, Indonesia.
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, USA.
| | - Fabricio E Balcazar
- Department of Disability and Human Development, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Yolanda Suarez-Balcazar
- Department of Disability and Human Development, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
- Department of Occupational Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
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13
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Anestin AS, Lippé S, Robaey P, Bertout L, Drouin S, Krajinovic M, Michon B, Rondeau É, Samoilenko M, Laverdière C, Sinnett D, Sultan S. Psychological risk in long-term survivors of childhood acute lymphoblastic leukemia and its association with functional health status: A PETALE cohort study. Pediatr Blood Cancer 2018; 65:e27356. [PMID: 30084222 DOI: 10.1002/pbc.27356] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 06/18/2018] [Accepted: 06/19/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND Recent research has suggested that long-term pediatric cancer survivors were at risk of important physical and psychological morbidities. To date, we do not know to what extent functional health status contributes to psychological risk and which domains are most important. The aim of this study was to systematically explore which functional domain could explain anxiety, depression, and distress symptoms. PROCEDURE We used data available for 105 adolescents and 182 adults successfully treated for childhood acute lymphoblastic leukemia at two Canadian sites part of the PETALE cohort. Participants were ≥5 years postdiagnosis, aged 22 ± 6 years, 52% female, and 49% acute lymphoblastic leukemia high-risk status. The contribution of health functional status (15D/16D questionnaires) to self-reported anxiety, depression, and distress (Beck scales and distress thermometer) was evaluated using adjusted logistic regression models. RESULTS Prevalence rates found for mild-severe anxiety, depression, and distress were 14%, 21%, and 30% among adolescents and 27%, 20%, and 19% among adults. Frequent health domains associated with psychological risk were sleeping and breathing in adolescents, and vitality/fatigue, discomfort/symptoms, mental function, and sleeping in adults. Mental function was systematically associated with psychological risk across age groups (median OR = 10.00, 95% CI 3.01-33.71). Exploratory mediation bootstrapping analyses suggested that the effect on psychological risk of overall health status and mental function problems was partly explained by social/work/school functioning. CONCLUSION The results identified important functional health domains that could be targeted for interventions preventing psychological risk: vitality/fatigue, discomfort/symptoms, sleeping, and mental function issues. Health domains probably affect mood partly by limiting social/work/school functioning.
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Affiliation(s)
- Annélie S Anestin
- Sainte-Justine University Health Center (SJUHC), Montréal, Québec, Canada.,Department of Psychology, Université de Montréal, Montréal, Québec, Canada
| | - Sarah Lippé
- Sainte-Justine University Health Center (SJUHC), Montréal, Québec, Canada.,Department of Psychology, Université de Montréal, Montréal, Québec, Canada
| | - Philippe Robaey
- Sainte-Justine University Health Center (SJUHC), Montréal, Québec, Canada.,Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.,University of Ottawa, Ottawa, Ontario, Canada
| | - Laurence Bertout
- Sainte-Justine University Health Center (SJUHC), Montréal, Québec, Canada
| | - Simon Drouin
- Sainte-Justine University Health Center (SJUHC), Montréal, Québec, Canada
| | - Maja Krajinovic
- Sainte-Justine University Health Center (SJUHC), Montréal, Québec, Canada.,Department of Pediatrics, Université de Montréal, Montréal, Québec, Canada
| | - Bruno Michon
- Quebec University Health Center (QUHC), Montréal, Québec, Canada
| | - Émélie Rondeau
- Sainte-Justine University Health Center (SJUHC), Montréal, Québec, Canada
| | - Mariia Samoilenko
- Sainte-Justine University Health Center (SJUHC), Montréal, Québec, Canada.,Université du Québec à Montréal (UQAM), Montréal, Québec, Canada
| | - Caroline Laverdière
- Sainte-Justine University Health Center (SJUHC), Montréal, Québec, Canada.,Department of Pediatrics, Université de Montréal, Montréal, Québec, Canada
| | - Daniel Sinnett
- Sainte-Justine University Health Center (SJUHC), Montréal, Québec, Canada.,Department of Pediatrics, Université de Montréal, Montréal, Québec, Canada
| | - Serge Sultan
- Sainte-Justine University Health Center (SJUHC), Montréal, Québec, Canada.,Department of Psychology, Université de Montréal, Montréal, Québec, Canada.,Department of Pediatrics, Université de Montréal, Montréal, Québec, Canada
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14
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Brinkman TM, Ness KK, Li Z, Huang IC, Krull KR, Gajjar A, Merchant TE, Klosky JL, Partin RE, Olsson IT, Boop F, Klimo P, Chemaitilly W, Khan RB, Srivastava D, Robison LL, Hudson MM, Armstrong GT. Attainment of Functional and Social Independence in Adult Survivors of Pediatric CNS Tumors: A Report From the St Jude Lifetime Cohort Study. J Clin Oncol 2018; 36:2762-2769. [PMID: 30091946 PMCID: PMC6145833 DOI: 10.1200/jco.2018.77.9454] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Purpose Beyond survival, achieving independence is a primary goal for adult survivors of pediatric CNS tumors. However, the prevalence of and risk factors for failure to achieve independence, assessed with multiple concurrent indicators, have not been examined. Patients and Methods Functional and social independence was assessed in 306 survivors (astrocytoma [n = 130], medulloblastoma [n = 77], ependymoma [n = 36], and other [n = 63]; median current age, 25.3 years [range, 18.9 to 53.1 years]; time since diagnosis, 16.8 years [range, 10.6 to 41.8 years]). Six observed indicators were used to identify latent classes of independence, which included employment, living independently, assistance with personal care, assistance with routine needs, obtaining a driver's license, and marital status. Physical performance impairments were defined as scores < 10th percentile on measures of aerobic capacity, strength, flexibility, balance, mobility, and adaptive function. Multinomial logistic regression estimated odds ratios (ORs) and 95% CIs were calculated for associations of disease/treatment exposures and impairments in physical performance with nonindependence. Results Three classes of independence were identified as independent (40%), moderately independent (34%), and nonindependent (26%). In multivariable models, craniospinal irradiation (OR, 4.20; 95% CI, 1.69 to 10.44) and younger age at diagnosis (OR, 1.24; 95% CI, 1.14 to 1.35) were associated with risk of nonindependence versus independence. Beyond impaired IQ, limitations in aerobic capacity (OR, 5.47; 95% CI, 1.78 to 16.76), flexibility (OR, 3.66; 95% CI, 1.11 to 12.03), and adaptive physical function (OR, 11.54; 95% CI, 3.57 to 37.27) were associated with nonindependence versus independence. Nonindependent survivors reported reduced physical but not mental health-related quality of life compared with independent survivors. Conclusion Sixty percent of survivors of pediatric CNS tumors do not achieve complete independence as adults. Reduction in intensity of primary therapies and interventions that target physical performance and adaptive deficits may help survivors to achieve greater independence.
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Affiliation(s)
- Tara M. Brinkman
- Tara M. Brinkman, Kirsten K. Ness, Zhenghong Li, I-Chan Huang, Kevin R. Krull, Amar Gajjar, Thomas E. Merchant, James L. Klosky, Robyn E. Partin, Ingrid Tonning Olsson, Frederick Boop, Paul Klimo Jr, Wassim Chemaitilly, Raja Khan, Deokumar Srivastava, Leslie L. Robison, Melissa M. Hudson, and Gregory T. Armstrong, St Jude Children’s Research Hospital; and Frederick Boop and Paul Klimo Jr, University of Tennessee Health Science Center, Memphis, TN
| | - Kirsten K. Ness
- Tara M. Brinkman, Kirsten K. Ness, Zhenghong Li, I-Chan Huang, Kevin R. Krull, Amar Gajjar, Thomas E. Merchant, James L. Klosky, Robyn E. Partin, Ingrid Tonning Olsson, Frederick Boop, Paul Klimo Jr, Wassim Chemaitilly, Raja Khan, Deokumar Srivastava, Leslie L. Robison, Melissa M. Hudson, and Gregory T. Armstrong, St Jude Children’s Research Hospital; and Frederick Boop and Paul Klimo Jr, University of Tennessee Health Science Center, Memphis, TN
| | - Zhenghong Li
- Tara M. Brinkman, Kirsten K. Ness, Zhenghong Li, I-Chan Huang, Kevin R. Krull, Amar Gajjar, Thomas E. Merchant, James L. Klosky, Robyn E. Partin, Ingrid Tonning Olsson, Frederick Boop, Paul Klimo Jr, Wassim Chemaitilly, Raja Khan, Deokumar Srivastava, Leslie L. Robison, Melissa M. Hudson, and Gregory T. Armstrong, St Jude Children’s Research Hospital; and Frederick Boop and Paul Klimo Jr, University of Tennessee Health Science Center, Memphis, TN
| | - I-Chan Huang
- Tara M. Brinkman, Kirsten K. Ness, Zhenghong Li, I-Chan Huang, Kevin R. Krull, Amar Gajjar, Thomas E. Merchant, James L. Klosky, Robyn E. Partin, Ingrid Tonning Olsson, Frederick Boop, Paul Klimo Jr, Wassim Chemaitilly, Raja Khan, Deokumar Srivastava, Leslie L. Robison, Melissa M. Hudson, and Gregory T. Armstrong, St Jude Children’s Research Hospital; and Frederick Boop and Paul Klimo Jr, University of Tennessee Health Science Center, Memphis, TN
| | - Kevin R. Krull
- Tara M. Brinkman, Kirsten K. Ness, Zhenghong Li, I-Chan Huang, Kevin R. Krull, Amar Gajjar, Thomas E. Merchant, James L. Klosky, Robyn E. Partin, Ingrid Tonning Olsson, Frederick Boop, Paul Klimo Jr, Wassim Chemaitilly, Raja Khan, Deokumar Srivastava, Leslie L. Robison, Melissa M. Hudson, and Gregory T. Armstrong, St Jude Children’s Research Hospital; and Frederick Boop and Paul Klimo Jr, University of Tennessee Health Science Center, Memphis, TN
| | - Amar Gajjar
- Tara M. Brinkman, Kirsten K. Ness, Zhenghong Li, I-Chan Huang, Kevin R. Krull, Amar Gajjar, Thomas E. Merchant, James L. Klosky, Robyn E. Partin, Ingrid Tonning Olsson, Frederick Boop, Paul Klimo Jr, Wassim Chemaitilly, Raja Khan, Deokumar Srivastava, Leslie L. Robison, Melissa M. Hudson, and Gregory T. Armstrong, St Jude Children’s Research Hospital; and Frederick Boop and Paul Klimo Jr, University of Tennessee Health Science Center, Memphis, TN
| | - Thomas E. Merchant
- Tara M. Brinkman, Kirsten K. Ness, Zhenghong Li, I-Chan Huang, Kevin R. Krull, Amar Gajjar, Thomas E. Merchant, James L. Klosky, Robyn E. Partin, Ingrid Tonning Olsson, Frederick Boop, Paul Klimo Jr, Wassim Chemaitilly, Raja Khan, Deokumar Srivastava, Leslie L. Robison, Melissa M. Hudson, and Gregory T. Armstrong, St Jude Children’s Research Hospital; and Frederick Boop and Paul Klimo Jr, University of Tennessee Health Science Center, Memphis, TN
| | - James L. Klosky
- Tara M. Brinkman, Kirsten K. Ness, Zhenghong Li, I-Chan Huang, Kevin R. Krull, Amar Gajjar, Thomas E. Merchant, James L. Klosky, Robyn E. Partin, Ingrid Tonning Olsson, Frederick Boop, Paul Klimo Jr, Wassim Chemaitilly, Raja Khan, Deokumar Srivastava, Leslie L. Robison, Melissa M. Hudson, and Gregory T. Armstrong, St Jude Children’s Research Hospital; and Frederick Boop and Paul Klimo Jr, University of Tennessee Health Science Center, Memphis, TN
| | - Robyn E. Partin
- Tara M. Brinkman, Kirsten K. Ness, Zhenghong Li, I-Chan Huang, Kevin R. Krull, Amar Gajjar, Thomas E. Merchant, James L. Klosky, Robyn E. Partin, Ingrid Tonning Olsson, Frederick Boop, Paul Klimo Jr, Wassim Chemaitilly, Raja Khan, Deokumar Srivastava, Leslie L. Robison, Melissa M. Hudson, and Gregory T. Armstrong, St Jude Children’s Research Hospital; and Frederick Boop and Paul Klimo Jr, University of Tennessee Health Science Center, Memphis, TN
| | - Ingrid Tonning Olsson
- Tara M. Brinkman, Kirsten K. Ness, Zhenghong Li, I-Chan Huang, Kevin R. Krull, Amar Gajjar, Thomas E. Merchant, James L. Klosky, Robyn E. Partin, Ingrid Tonning Olsson, Frederick Boop, Paul Klimo Jr, Wassim Chemaitilly, Raja Khan, Deokumar Srivastava, Leslie L. Robison, Melissa M. Hudson, and Gregory T. Armstrong, St Jude Children’s Research Hospital; and Frederick Boop and Paul Klimo Jr, University of Tennessee Health Science Center, Memphis, TN
| | - Frederick Boop
- Tara M. Brinkman, Kirsten K. Ness, Zhenghong Li, I-Chan Huang, Kevin R. Krull, Amar Gajjar, Thomas E. Merchant, James L. Klosky, Robyn E. Partin, Ingrid Tonning Olsson, Frederick Boop, Paul Klimo Jr, Wassim Chemaitilly, Raja Khan, Deokumar Srivastava, Leslie L. Robison, Melissa M. Hudson, and Gregory T. Armstrong, St Jude Children’s Research Hospital; and Frederick Boop and Paul Klimo Jr, University of Tennessee Health Science Center, Memphis, TN
| | - Paul Klimo
- Tara M. Brinkman, Kirsten K. Ness, Zhenghong Li, I-Chan Huang, Kevin R. Krull, Amar Gajjar, Thomas E. Merchant, James L. Klosky, Robyn E. Partin, Ingrid Tonning Olsson, Frederick Boop, Paul Klimo Jr, Wassim Chemaitilly, Raja Khan, Deokumar Srivastava, Leslie L. Robison, Melissa M. Hudson, and Gregory T. Armstrong, St Jude Children’s Research Hospital; and Frederick Boop and Paul Klimo Jr, University of Tennessee Health Science Center, Memphis, TN
| | - Wassim Chemaitilly
- Tara M. Brinkman, Kirsten K. Ness, Zhenghong Li, I-Chan Huang, Kevin R. Krull, Amar Gajjar, Thomas E. Merchant, James L. Klosky, Robyn E. Partin, Ingrid Tonning Olsson, Frederick Boop, Paul Klimo Jr, Wassim Chemaitilly, Raja Khan, Deokumar Srivastava, Leslie L. Robison, Melissa M. Hudson, and Gregory T. Armstrong, St Jude Children’s Research Hospital; and Frederick Boop and Paul Klimo Jr, University of Tennessee Health Science Center, Memphis, TN
| | - Raja B. Khan
- Tara M. Brinkman, Kirsten K. Ness, Zhenghong Li, I-Chan Huang, Kevin R. Krull, Amar Gajjar, Thomas E. Merchant, James L. Klosky, Robyn E. Partin, Ingrid Tonning Olsson, Frederick Boop, Paul Klimo Jr, Wassim Chemaitilly, Raja Khan, Deokumar Srivastava, Leslie L. Robison, Melissa M. Hudson, and Gregory T. Armstrong, St Jude Children’s Research Hospital; and Frederick Boop and Paul Klimo Jr, University of Tennessee Health Science Center, Memphis, TN
| | - Deokumar Srivastava
- Tara M. Brinkman, Kirsten K. Ness, Zhenghong Li, I-Chan Huang, Kevin R. Krull, Amar Gajjar, Thomas E. Merchant, James L. Klosky, Robyn E. Partin, Ingrid Tonning Olsson, Frederick Boop, Paul Klimo Jr, Wassim Chemaitilly, Raja Khan, Deokumar Srivastava, Leslie L. Robison, Melissa M. Hudson, and Gregory T. Armstrong, St Jude Children’s Research Hospital; and Frederick Boop and Paul Klimo Jr, University of Tennessee Health Science Center, Memphis, TN
| | - Leslie L. Robison
- Tara M. Brinkman, Kirsten K. Ness, Zhenghong Li, I-Chan Huang, Kevin R. Krull, Amar Gajjar, Thomas E. Merchant, James L. Klosky, Robyn E. Partin, Ingrid Tonning Olsson, Frederick Boop, Paul Klimo Jr, Wassim Chemaitilly, Raja Khan, Deokumar Srivastava, Leslie L. Robison, Melissa M. Hudson, and Gregory T. Armstrong, St Jude Children’s Research Hospital; and Frederick Boop and Paul Klimo Jr, University of Tennessee Health Science Center, Memphis, TN
| | - Melissa M. Hudson
- Tara M. Brinkman, Kirsten K. Ness, Zhenghong Li, I-Chan Huang, Kevin R. Krull, Amar Gajjar, Thomas E. Merchant, James L. Klosky, Robyn E. Partin, Ingrid Tonning Olsson, Frederick Boop, Paul Klimo Jr, Wassim Chemaitilly, Raja Khan, Deokumar Srivastava, Leslie L. Robison, Melissa M. Hudson, and Gregory T. Armstrong, St Jude Children’s Research Hospital; and Frederick Boop and Paul Klimo Jr, University of Tennessee Health Science Center, Memphis, TN
| | - Gregory T. Armstrong
- Tara M. Brinkman, Kirsten K. Ness, Zhenghong Li, I-Chan Huang, Kevin R. Krull, Amar Gajjar, Thomas E. Merchant, James L. Klosky, Robyn E. Partin, Ingrid Tonning Olsson, Frederick Boop, Paul Klimo Jr, Wassim Chemaitilly, Raja Khan, Deokumar Srivastava, Leslie L. Robison, Melissa M. Hudson, and Gregory T. Armstrong, St Jude Children’s Research Hospital; and Frederick Boop and Paul Klimo Jr, University of Tennessee Health Science Center, Memphis, TN
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15
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Tu WM, Pfaller J, Iwanaga K, Chan F, Strauser D, Wang MH, Ditchman N. A Psychometric Validation of the Employers' Stigmatizing Attitudes Toward Cancer Survivors Scale. JOURNAL OF OCCUPATIONAL REHABILITATION 2018; 28:541-547. [PMID: 29209930 DOI: 10.1007/s10926-017-9746-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Purpose The aim of this study was to evaluate the measurement structure of the Employers' Stigmatizing Attitudes Toward Cancer Survivors Scale (ESATPD-Cancer Scale). Methods A quantitative descriptive design using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). One hundred and seventy-seven Taiwanese human resources (HR) professionals participated in this study. Results EFA revealed a one-factor measurement structure accounting for 50% of the total variance. We conducted a CFA to confirm the one-factor structure; after two pairs of error terms were correlated, the re-specified model was found to fit the data adequately: χ2/df = 1.69, GFI = 0.97, CFI = 0.98, and RMSEA = 0.06. Internal consistency reliability coefficient (Cronbach's alpha) for the ESATPD-Cancer Scale was computed to be 0.80. In addition, stigmatizing attitudes were found to be negatively associated with HR professionals' willingness to hire cancer survivors. Conclusions The results of this study support a one-factor measurement structure for the ESATPD-Cancer Scale in a sample of HR professionals in Taiwan. Findings also support a relationship between ESATPD-Cancer Scale scores and HR professionals' willingness to hire cancer survivors, demonstrating support for the construct validity of the scale.
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Affiliation(s)
- Wei-Mo Tu
- Department of Rehabilitation and Health Services, University of North Texas, 1155 Union Circle #311456, Denton, TX, 76203, USA.
| | - Joseph Pfaller
- Rehabilitation Psychology & Special Education, University of Wisconsin-Madison, 1000 Bascom Mall, Madison, WI, 53706, USA
| | - Kanako Iwanaga
- Rehabilitation Psychology & Special Education, University of Wisconsin-Madison, 1000 Bascom Mall, Madison, WI, 53706, USA
| | - Fong Chan
- Rehabilitation Psychology & Special Education, University of Wisconsin-Madison, 1000 Bascom Mall, Madison, WI, 53706, USA
| | - David Strauser
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Huff Hall, MC-588, 1206 S Fourth St, Champaign, IL, 61820, USA
| | - Ming-Hung Wang
- Graduate Institute of Rehabilitation Counseling, National Changhua University of Education, No.1, Jinde Rd., Changhua City, Changhua County, 500, Taiwan
| | - Nicole Ditchman
- Department of Psychology, Counseling and Rehabilitation Science Division, Illinois Institute of Technology, 3105 South Dearborn, Chicago, IL, 60616, USA
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16
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Crom DB, Ness KK, Martinez LR, Hebl MR, Robison LL, Hudson MM, Brinkman TM. Workplace experiences and turnover intention among adult survivors of childhood cancer. J Cancer Surviv 2018; 12:469-478. [PMID: 29550965 PMCID: PMC6054557 DOI: 10.1007/s11764-018-0686-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 03/01/2018] [Indexed: 11/30/2022]
Abstract
PURPOSE The purpose of this study was to investigate workplace experiences and turnover intention (consideration of leaving or changing a job) and to examine factors associated with turnover intention among survivors. METHODS Adult survivors of childhood cancer with a history of employment (n = 289) completed measures of workplace experiences (n = 50, 18-29 years; n = 183, 30-44 years; n = 56; > 45 years of age at follow-up). Turnover intention was assessed using three items from the Job Satisfaction Scale. Responses were dichotomized as reflecting high vs. low turnover intention. Path analysis was used to estimate the influence of demographic characteristics, treatment exposures (cranial radiation therapy [CRT]), and workplace experiences on turnover intention. RESULTS Thirty percent of survivors reported high turnover intention (95% CL, 25 to 36%). Exposure to CRT (P = 0.003), older attained age (P < 0.001), experiencing formal workplace discrimination (P = 0.008), and having lower continuance (P < 0.001) or affective commitment (P < 0.001) were associated with high turnover intention among survivors. Informal discrimination, mediated through job satisfaction, also influenced survivors' reported intent to leave their jobs. CONCLUSIONS One third of adult survivors of childhood cancer report turnover intention, which is related to their cancer treatment, but more temporally proximal, workplace discrimination. Additional research is needed to understand the consequences of turnover intention among survivors. IMPLICATIONS FOR CANCER SURVIVORS Survivors and their health care providers should be aware of legislative policies related to workplace discrimination (e.g., American with Disabilities Act) and related implications for job turnover.
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Affiliation(s)
- Deborah B Crom
- Department of Oncology, Division of Cancer Survivorship, St. Jude Children's Research Hospital, Memphis, TN, USA.
| | - Kirsten K Ness
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Larry R Martinez
- Department of Psychology, Portland State University, Portland, OR, USA
| | | | - Leslie L Robison
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Melissa M Hudson
- Department of Oncology, Division of Cancer Survivorship, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Tara M Brinkman
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
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17
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Brinkman TM, Recklitis CJ, Michel G, Grootenhuis MA, Klosky JL. Psychological Symptoms, Social Outcomes, Socioeconomic Attainment, and Health Behaviors Among Survivors of Childhood Cancer: Current State of the Literature. J Clin Oncol 2018; 36:2190-2197. [PMID: 29874134 PMCID: PMC6053297 DOI: 10.1200/jco.2017.76.5552] [Citation(s) in RCA: 137] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The diagnosis, treatment, and medical late effects of childhood cancer may alter the psychosocial trajectory of survivors across their life course. This review of the literature focuses on mental health symptoms, achievement of social milestones, socioeconomic attainment, and risky health behaviors in survivors of childhood cancer. Results suggest that although most survivors are psychologically well adjusted, survivors are at risk for anxiety and depression compared with siblings. Although the absolute risk of suicide ideation and post-traumatic stress symptoms is low, adult survivors are at increased risk compared with controls. Moreover, young adult survivors are at risk for delayed psychosexual development, lower rates of marriage or cohabitation, and nonindependent living. Survivors' socioeconomic attainment also is reduced, with fewer survivors graduating college and gaining full-time employment. Despite risk for late health-related complications, survivors of childhood cancer generally engage in risky health behaviors at rates similar to or only slightly lower than siblings and peers. CNS tumors and CNS-directed therapies are salient risk factors for poor psychosocial outcomes. In addition, physical health morbidities resulting from cancer-directed therapies are associated with worse psychosocial functioning. Several studies support the effectiveness of cognitive and behavioral interventions to treat psychological symptoms as well as to modify health behaviors. Additional randomized controlled trials are needed to evaluate the efficacy and long-term outcomes of intervention efforts. Future research should focus on the identification of potential genetic predispositions related to psychosocial outcomes to provide opportunities for preventive interventions among survivors of childhood cancer.
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Affiliation(s)
- Tara M Brinkman
- Tara M. Brinkman and James L. Klosky, St Jude Children's Research Hospital, Memphis, TN; Christopher J. Recklitis, Dana-Farber Cancer Institute, Boston, MA; Gisela Michel, University of Lucerne, Lucerne, Switzerland; and Martha A. Grootenhuis, Princess Maxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Christopher J Recklitis
- Tara M. Brinkman and James L. Klosky, St Jude Children's Research Hospital, Memphis, TN; Christopher J. Recklitis, Dana-Farber Cancer Institute, Boston, MA; Gisela Michel, University of Lucerne, Lucerne, Switzerland; and Martha A. Grootenhuis, Princess Maxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Gisela Michel
- Tara M. Brinkman and James L. Klosky, St Jude Children's Research Hospital, Memphis, TN; Christopher J. Recklitis, Dana-Farber Cancer Institute, Boston, MA; Gisela Michel, University of Lucerne, Lucerne, Switzerland; and Martha A. Grootenhuis, Princess Maxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Martha A Grootenhuis
- Tara M. Brinkman and James L. Klosky, St Jude Children's Research Hospital, Memphis, TN; Christopher J. Recklitis, Dana-Farber Cancer Institute, Boston, MA; Gisela Michel, University of Lucerne, Lucerne, Switzerland; and Martha A. Grootenhuis, Princess Maxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - James L Klosky
- Tara M. Brinkman and James L. Klosky, St Jude Children's Research Hospital, Memphis, TN; Christopher J. Recklitis, Dana-Farber Cancer Institute, Boston, MA; Gisela Michel, University of Lucerne, Lucerne, Switzerland; and Martha A. Grootenhuis, Princess Maxima Center for Pediatric Oncology, Utrecht, the Netherlands
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Lindsay S, Cagliostro E, Albarico M, Srikanthan D, Mortaji N. A Systematic Review of the Role of Gender in Securing and Maintaining Employment Among Youth and Young Adults with Disabilities. JOURNAL OF OCCUPATIONAL REHABILITATION 2018; 28:232-251. [PMID: 28836051 DOI: 10.1007/s10926-017-9726-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Purpose There is a critical need for gender-specific vocational supports for young adults with disabilities as they transition to employment. We conducted a systematic review to explore the role of gender in securing and maintaining employment. Methods Systematic searches of seven databases identified 48 studies meeting our inclusion criteria. Using a narrative synthesis approach, these studies were analyzed in terms of the characteristics of the participants, methodology, results, and quality of the evidence. Results Among the 48 studies, 112,473 participants (56% male), mean age (of the total sample) was 21, represented across ten countries. Twenty-one studies reported that young men with disabilities had better employment outcomes than women with disabilities. Eight studies showed that females with disabilities had better employment outcomes than males. Five studies reported that there were no gender differences in employment outcomes for youth with various disabilities. With regards to maintaining employment, men with disabilities often work more hours and have better wages compared to women with disabilities. There are several gender-related barriers and facilitators to maintaining employment including social supports and gender role expectations. Conclusions Our findings highlight that there is a critical need for gender-specific vocational supports for young adults with disabilities.
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Affiliation(s)
- Sally Lindsay
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON, M4G 1R8, Canada.
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada.
| | - Elaine Cagliostro
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON, M4G 1R8, Canada
| | - Mikhaela Albarico
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON, M4G 1R8, Canada
| | - Dilakshan Srikanthan
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON, M4G 1R8, Canada
| | - Neda Mortaji
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, ON, M4G 1R8, Canada
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19
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How do social security schemes and labor market policies support the return-to-work of cancer survivors? A review article. J Cancer Policy 2018. [DOI: 10.1016/j.jcpo.2018.02.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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20
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Kosola S, McCarthy MC, McNeil R, Orme LM, Drew S, Sawyer SM. Early Education and Employment Outcomes After Cancer in Adolescents and Young Adults. J Adolesc Young Adult Oncol 2018; 7:238-244. [DOI: 10.1089/jayao.2017.0045] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Silja Kosola
- Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Murdoch Children's Research Institute, Melbourne, Australia
- Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia
| | - Maria C. McCarthy
- Murdoch Children's Research Institute, Melbourne, Australia
- Children's Cancer Centre, Royal Children's Hospital, Melbourne, Australia
| | - Robyn McNeil
- Murdoch Children's Research Institute, Melbourne, Australia
- Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia
| | - Lisa M. Orme
- Children's Cancer Centre, Royal Children's Hospital, Melbourne, Australia
- ONTrac at Peter Mac Victorian Adolescent & Young Adult Cancer Service, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Sarah Drew
- Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Susan M. Sawyer
- Murdoch Children's Research Institute, Melbourne, Australia
- Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
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Mader L, Michel G, Roser K. Unemployment Following Childhood Cancer. DEUTSCHES ARZTEBLATT INTERNATIONAL 2017; 114:805-812. [PMID: 29229046 PMCID: PMC5736865 DOI: 10.3238/arztebl.2017.0805] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 03/24/2017] [Accepted: 08/08/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND Childhood cancer survivors are at risk of physical and mental long-term sequelae that may interfere with their employment situation in adulthood. We updated a systematic review from 2006 and assessed unemployment in adult childhood cancer survivors compared to the general population, and its predictors. METHODS Systematic literature searches for articles published between February 2006 and August 2016 were performed in CINAHL, EMBASE, PubMed, PsycINFO, and SocINDEX. We extracted unemployment rates in studies with and without population controls (controlled /uncontrolled studies). Unemployment in controlled studies was evaluated using a meta-analytic approach. RESULTS We included 56 studies, of which 27 were controlled studies. Approximately one in six survivors was unemployed. The overall meta-analysis of controlled studies showed that survivors were more likely to be unemployed than controls (Odds Ratio [OR] = 1.48, 95% confidence interval [CI]: [1.14; 1.93]). Elevated odds were found in survivors in the US and Canada (OR = 1.86, 95% CI: [1.26; 2.75]), as well as in Europe (OR = 1.39, 95% CI: [0.97; 1.97]). Survivors of brain tumors in particular were more likely to be unemployed (OR = 4.62, 95% CI: [2.56; 8.31]). Narrative synthesis across all included studies revealed younger age at study and diagnosis, female sex, radiotherapy, and physical late effects as further predictors of unemployment. CONCLUSION Childhood cancer survivors are at considerable risk of unemployment in adulthood. They may benefit from psycho-social care services along the cancer trajectory to support labor market integration.
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Affiliation(s)
- Luzius Mader
- Department of Health Sciences & Health Policy, University of Luzern, Switzerland
| | - Gisela Michel
- Department of Health Sciences & Health Policy, University of Luzern, Switzerland
| | - Katharina Roser
- Department of Health Sciences & Health Policy, University of Luzern, Switzerland
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22
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Rumrill PD, Merchant D, Kaya C, Chan F, Hartman E, Tansey T. Demographic and service-related correlates of competitive employment outcomes among state-federal vocational rehabilitation clients with learning disabilities: A purposeful selection logistic regression analysis. JOURNAL OF VOCATIONAL REHABILITATION 2017. [DOI: 10.3233/jvr-170889] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | | | - Cahit Kaya
- Southern University, Baton Rouge, LA, USA
| | - Fong Chan
- University of Wisconsin, Madison, WI, USA
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Murphy KM, Nguyen V, Shin K, Sebastian-Deutsch A, Frieden L. Health Care Professionals and the Employment-Related Needs of Cancer Survivors. JOURNAL OF OCCUPATIONAL REHABILITATION 2017; 27:296-305. [PMID: 26857027 DOI: 10.1007/s10926-016-9629-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Introduction Individuals diagnosed with cancer look to health care professionals as primary sources of information. This positions staff in oncology settings in an ideal role to inform patients, who continue workforce participation in increasing numbers, about resources that might help them to handle work-related issues related to their oncological symptoms. This article reports on findings from a survey of staff that provide nonmedical services to cancer patients in two Houston area hospital systems. The impetus for this survey was two-fold: the trend in recent years for increasing numbers of cancer survivors to stay in the workforce after or even during treatment, and low levels of awareness that these employees are eligible for protection under the Americans with Disabilities Act of 1990 and its 2008 amendments (ADA Amendments Act of 2008, Pub. L. 110-325, 122 Stat. 3553, 2008; Americans with Disabilities Act, 42 U.S.C. § 12111-17, 2006). The survey assesses perceptions of the effects of cancer on patients' employment status, levels of knowledge about supports to address these employment-related needs, and respondents' preferred modes for information receipt. The latter topic serves the purpose of tailoring training activities to the respondents' informational needs and learning preferences. Methods Data were collected via an online survey administered in two Houston-area hospital systems. This article reports on the findings from 86 respondents. Results Tenure as measured by years in oncology is related positively to level of knowledge about disability-related benefits, legislation and programs (r = .32, P < .01). Respondents with more years in their profession worked with patients whom they reported had a higher number of cancer side effects that "created work difficulties for patients" (r = .24, P < .05). The number of side effects was in turn positively associated with negative effects of the diagnosis at work (r = .27, P < .05). A higher score of negative effects of the cancer diagnosis at work in turn correlated with unwanted consequences of disclosing the cancer at work (r = .36, P < .01). No statistically significant correlations were observed among the variables measuring respondents' reported knowledge of disability-related benefits, laws and programs, their perception of patients' level of understanding of these topics, and reports of patients' receipt of reasonable accommodation. Conclusions Health care professionals who treat cancer patients could benefit from training resources about how survivors might address their employment-related needs, including how to convey that knowledge to their patients. Mentoring programs might also have positive outcomes, since respondents with greater tenure in oncology-related settings reported higher levels of knowledge about disability-related topics.
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Affiliation(s)
- Kathleen M Murphy
- SEDL an Affiliate of the American Institutes for Research (AIR), 4700 Mueller Blvd, Austin, TX, 78723, USA.
| | - Vinh Nguyen
- Southwest Americans with Disabilities Act (ADA) Center, Independent Living Research Utilization (ILRU) Program, TIRR Memorial Hermann, Houston, TX, USA
| | - Ki Shin
- University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | | | - Lex Frieden
- School of Biomedical Informatics, The University of Texas Health Science Center, Houston, TX, USA
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Berg CJ, Stratton E, Esiashvili N, Mertens A. Young Adult Cancer Survivors' Experience with Cancer Treatment and Follow-Up Care and Perceptions of Barriers to Engaging in Recommended Care. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2016; 31:430-42. [PMID: 25948413 PMCID: PMC4712118 DOI: 10.1007/s13187-015-0853-9] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
We examined correlates of low engagement in the healthcare system, experiences with survivorship care, barriers to follow-up care, and potential resources for promoting follow-up care among young adult survivors of childhood cancers. We conducted a mixed-method study involving surveys of 106 survivors of childhood cancer aged 18-34 recruited from a university-affiliated children's hospital and an NCI-designated cancer center in the Southeastern USA. Phone-based semistructured interviews were then conducted in a subset of 26. Assessments included health factors, psychosocial factors, healthcare system interaction, and interest in resources to promote engagement in healthcare. Survey participants were on average 22.14 (SD = 3.16) years old, 50.0 % female, and 77.4 % White. Overall, 46.0 % had attended survivorship clinic, 47.2 % reported receiving a treatment summary, 68.9 % had a primary care provider, and 17.0 % reported no interaction with healthcare in the past 2 years. Correlates of less than annual healthcare provider visits included being older (p = 0.003), being male (p < 0.001), lack of insurance (p = 0.002), and having had chemotherapy (p = 0.05). Participants reported varied experiences in terms of how health and treatment information was presented, from none or too little to overwhelming or anxiety-provoking amounts. Barriers to engaging in survivorship care included no/limited insurance, time, or transportation; major life changes; anxiety; and difficulty transitioning from pediatrics to adult care. Participants highlighted the need for educational and psychosocial resources, particularly technology-based resources. Multilevel interventions are needed to increase engagement in survivorship care among young adult cancer survivors. Technology-based resources addressing social support and mental well-being are intervention possibilities.
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Affiliation(s)
- Carla J Berg
- Department of Behavioral Sciences and Health Education, Emory University School of Public Health, Room 524, 1518 Clifton Road NE, Atlanta, GA, 30322, USA.
| | - Erin Stratton
- Department of Behavioral Sciences and Health Education, Emory University School of Public Health, Room 524, 1518 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Natia Esiashvili
- Department of Radiology, School of Medicine, Woodruff Health Sciences Center, Emory University, 1440 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Ann Mertens
- Aflac Cancer Center/Department of Pediatrics, Department of Oncology, School of Medicine, Woodruff Health Sciences Center, Emory University, 1440 Clifton Road NE, Atlanta, GA, 30322, USA
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Gunnes MW, Lie RT, Bjørge T, Syse A, Ruud E, Wesenberg F, Moster D. Economic independence in survivors of cancer diagnosed at a young age: A Norwegian national cohort study. Cancer 2016; 122:3873-3882. [PMID: 27518040 PMCID: PMC5157778 DOI: 10.1002/cncr.30253] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 06/18/2016] [Accepted: 07/19/2016] [Indexed: 11/06/2022]
Abstract
BACKGROUND The impact of cancer on socioeconomic outcomes is attracting attention as the number of survivors of cancer in young age continues to rise. This study examines economic independence in a national cohort of survivors of cancer at a young age in Norway. METHODS Through the linkage of several national registries, the study cohort comprised 1,212,013 individuals born in Norway during 1965 through 1985, of which 5440 had received a cancer diagnosis before age 25 years. Follow-up was through 2007, and the main outcomes were receipt of governmental financial assistance, employment, income, and occupation. Analytic methods included Cox proportional hazard regression, log-binomial regression, and quantile regression models. RESULTS Individuals in the cancer survivor group had an increased probability of receiving governmental financial assistance (men: hazard ratio [HR], 1.4; 95% confidence interval [CI], 1.3-1.5; women: HR, 1.5; 95% CI, 1.3-1.6) and of not being employed (men: HR, 1.4; 95% CI, 1.2-1.7; women: HR, 1.4; 95% CI, 1.2-1.6) compared with those in the noncancer group. Income discrepancies were particularly pronounced for survivors of central nervous system tumors. There was no difference in representation in higher skilled occupations. CONCLUSIONS Survivors of cancer at a young age in Norway had an increased risk of being economically dependent and unemployed. This was evident in several tumor groups and was most pronounced in female survivors. There were only small differences in income or representation in higher skilled occupations for most employed survivors compared with the noncancer group. The current results are important for understanding the impact of a cancer diagnosis at a young age on subsequent job market outcomes. Cancer 2016;122:3873-3882. © 2016 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.
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Affiliation(s)
- Maria W Gunnes
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Department of Pediatrics, Haukeland University Hospital, Bergen, Norway
| | - Rolv Terje Lie
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Norwegian Institute of Public Health, Bergen, Norway
| | - Tone Bjørge
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Cancer Registry of Norway, Oslo, Norway
| | - Astri Syse
- Department of Research, Statistics Norway, Oslo, Norway
| | - Ellen Ruud
- Department of Pediatric Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Finn Wesenberg
- Cancer Registry of Norway, Oslo, Norway.,Department of Pediatric Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Dag Moster
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Department of Pediatrics, Haukeland University Hospital, Bergen, Norway.,Norwegian Institute of Public Health, Bergen, Norway
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Chan F, Wang CC, Fitzgerald S, Muller V, Ditchman N, Menz F. Personal, environmental, and service-delivery determinants of employment quality for state vocational rehabilitation consumers: A multilevel analysis. JOURNAL OF VOCATIONAL REHABILITATION 2016. [DOI: 10.3233/jvr-160806] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Fong Chan
- University of Wisconsin-Madison, Madison, WI, USA
| | - Chia-Chiang Wang
- University at Buffalo, State University of New York, Buffalo, NY, USA
| | | | - Veronica Muller
- Hunter College, City University of New York, Buffalo, NY, USA
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27
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Kaya C, Chan F, Rumrill P, Hartman E, Wehman P, Iwanaga K, Pai CH, Avellone L. Vocational rehabilitation services and competitive employment for transition-age youth with autism spectrum disorders. JOURNAL OF VOCATIONAL REHABILITATION 2016. [DOI: 10.3233/jvr-160812] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Cahit Kaya
- Pennsylvania State University, State College, PA, USA
- Department of Rehabilitation and Disability Studies, Southern University, Baton Rouge, LA, USA
| | - Fong Chan
- University of Wisconsin-Madison, Madison, WI, USA
| | | | | | - Paul Wehman
- Virginia Commonwealth University, Richmond, VA, USA
| | | | - Chia-Hui Pai
- Association for Positive Behavior Support, Changhua County, Taiwan
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Donker-Cools BHPM, Daams JG, Wind H, Frings-Dresen MHW. Effective return-to-work interventions after acquired brain injury: A systematic review. Brain Inj 2015; 30:113-31. [PMID: 26645137 DOI: 10.3109/02699052.2015.1090014] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To gather knowledge about effective return-to-work (RTW) interventions for patients with acquired brain injury (ABI). METHODS A database search was performed in PubMed, EMBASE, PsycINFO, CINAHL and the Cochrane Library using keywords and Medical Subject Headings. Studies were included if they met inclusion criteria: adult patients with non-progressive ABI, working pre-injury and an intervention principally designed to improve RTW as an outcome. The methodological quality of included studies was determined and evidence was assessed qualitatively. RESULTS Twelve studies were included, of which five were randomized controlled trials and seven were cohort studies. Nine studies had sufficient methodological quality. There is strong evidence that work-directed interventions in combination with education/coaching are effective regarding RTW and there are indicative findings for the effectiveness of work-directed interventions in combination with skills training and education/coaching. Reported components of the most effective interventions were tailored approach, early intervention, involvement of patient and employer, work or workplace accommodations, work practice and training of social and work-related skills, including coping and emotional support. CONCLUSION AND IMPLICATIONS Effective RTW interventions for patients with ABI are a combination of work-directed interventions, coaching/education and/or skills training. These interventions have the potential to facilitate sustained RTW for patients with ABI.
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Affiliation(s)
- Birgit H P M Donker-Cools
- a Academic Medical Center, University of Amsterdam , Coronel Institute of Occupational Health , Amsterdam , the Netherlands.,b Research Center for Insurance Medicine , Amsterdam , the Netherlands
| | - Joost G Daams
- a Academic Medical Center, University of Amsterdam , Coronel Institute of Occupational Health , Amsterdam , the Netherlands
| | - Haije Wind
- a Academic Medical Center, University of Amsterdam , Coronel Institute of Occupational Health , Amsterdam , the Netherlands.,b Research Center for Insurance Medicine , Amsterdam , the Netherlands
| | - Monique H W Frings-Dresen
- a Academic Medical Center, University of Amsterdam , Coronel Institute of Occupational Health , Amsterdam , the Netherlands.,b Research Center for Insurance Medicine , Amsterdam , the Netherlands
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de Boer AGEM, Taskila TK, Tamminga SJ, Feuerstein M, Frings‐Dresen MHW, Verbeek JH. Interventions to enhance return-to-work for cancer patients. Cochrane Database Syst Rev 2015; 2015:CD007569. [PMID: 26405010 PMCID: PMC6483290 DOI: 10.1002/14651858.cd007569.pub3] [Citation(s) in RCA: 139] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Cancer patients are 1.4 times more likely to be unemployed than healthy people. Therefore it is important to provide cancer patients with programmes to support the return-to-work (RTW) process. This is an update of a Cochrane review first published in 2011. OBJECTIVES To evaluate the effectiveness of interventions aimed at enhancing RTW in cancer patients compared to alternative programmes including usual care or no intervention. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL, in the Cochrane Library Issue 3, 2014), MEDLINE (January 1966 to March 2014), EMBASE (January 1947 to March 2014), CINAHL (January 1983 to March, 2014), OSH-ROM and OSH Update (January 1960 to March, 2014), PsycINFO (January 1806 to 25 March 2014), DARE (January 1995 to March, 2014), ClinicalTrials.gov, Trialregister.nl and Controlled-trials.com up to 25 March 2014. We also examined the reference lists of included studies and selected reviews, and contacted authors of relevant studies. SELECTION CRITERIA We included randomised controlled trials (RCTs) of the effectiveness of psycho-educational, vocational, physical, medical or multidisciplinary interventions enhancing RTW in cancer patients. The primary outcome was RTW measured as either RTW rate or sick leave duration measured at 12 months' follow-up. The secondary outcome was quality of life. DATA COLLECTION AND ANALYSIS Two review authors independently assessed trials for inclusion, assessed the risk of bias and extracted data. We pooled study results we judged to be clinically homogeneous in different comparisons reporting risk ratios (RRs) with 95% confidence intervals (CIs). We assessed the overall quality of the evidence for each comparison using the GRADE approach. MAIN RESULTS Fifteen RCTs including 1835 cancer patients met the inclusion criteria and because of multiple arms studies we included 19 evaluations. We judged six studies to have a high risk of bias and nine to have a low risk of bias. All included studies were conducted in high income countries and most studies were aimed at breast cancer patients (seven trials) or prostate cancer patients (two trials).Two studies involved psycho-educational interventions including patient education and teaching self-care behaviours. Results indicated low quality evidence of similar RTW rates for psycho-educational interventions compared to care as usual (RR 1.09, 95% CI 0.88 to 1.35, n = 260 patients) and low quality evidence that there is no difference in the effect of psycho-educational interventions compared to care as usual on quality of life (standardised mean difference (SMD) 0.05, 95% CI -0.2 to 0.3, n = 260 patients). We did not find any studies on vocational interventions. In one study breast cancer patients were offered a physical training programme. Low quality evidence suggested that physical training was not more effective than care as usual in improving RTW (RR 1.20, 95% CI 0.32 to 4.54, n = 28 patients) or quality of life (SMD -0.37, 95% CI -0.99 to 0.25, n = 41 patients).Seven RCTs assessed the effects of a medical intervention on RTW. In all studies a less radical or functioning conserving medical intervention was compared with a more radical treatment. We found low quality evidence that less radical, functioning conserving approaches had similar RTW rates as more radical treatments (RR 1.04, 95% CI 0.96 to 1.09, n = 1097 patients) and moderate quality evidence of no differences in quality of life outcomes (SMD 0.10, 95% CI -0.04 to 0.23, n = 1028 patients).Five RCTs involved multidisciplinary interventions in which vocational counselling was combined with patient education, patient counselling, and biofeedback-assisted behavioral training or physical exercises. Moderate quality evidence showed that multidisciplinary interventions involving physical, psycho-educational and vocational components led to higher RTW rates than care as usual (RR 1.11, 95% CI 1.03 to 1.16, n = 450 patients). We found no differences in the effect of multidisciplinary interventions compared to care as usual on quality of life outcomes (SMD 0.03, 95% CI -0.20 to 0.25, n = 316 patients). AUTHORS' CONCLUSIONS We found moderate quality evidence that multidisciplinary interventions enhance the RTW of patients with cancer.
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Affiliation(s)
- Angela GEM de Boer
- Academic Medical CentreCoronel Institute of Occupational HealthMeibergdreef 9AmsterdamNetherlands1105 AZ
| | - Tyna K Taskila
- The Work FoundationCentre for Workforce Effectiveness21 Palmer StreetLondonUKSW1V 3PF
| | - Sietske J Tamminga
- Academic Medical CentreCoronel Institute of Occupational HealthMeibergdreef 9AmsterdamNetherlands1105 AZ
| | - Michael Feuerstein
- Uniformed Services University of the Health SciencesDepartments of Medical and Clinical Psychology and Preventive Medicine and Biometrics4301 Jones Bridge RoadBethesdaUSAMD 20814‐4799
| | - Monique HW Frings‐Dresen
- Academic Medical Center, University of AmsterdamCoronel Institute of Occupational Health and Research Center for Insurance MedicineMeibergdreef 9PO Box 22700AmsterdamNetherlands1100 DE
| | - Jos H Verbeek
- Finnish Institute of Occupational HealthCochrane Work Review GroupPO Box 310KuopioFinland70101
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30
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Chiu CY, Chan F, Strauser D, Feuerstein M, Ditchman N, Cardoso E, O'Neill J, Muller V. State rehabilitation services tailored to employment status among cancer survivors. JOURNAL OF OCCUPATIONAL REHABILITATION 2014; 24:89-99. [PMID: 23504487 DOI: 10.1007/s10926-013-9434-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
PURPOSE Previous analyses of vocational rehabilitation services for unemployed cancer survivors indicated that counseling and guidance, job search assistance, and job placement services are significantly associated with increased odds for employment. However, many cancer survivors with jobs to return to may require vocational interventions that are different from unemployed cancer survivors. It is unclear whether the public rehabilitation system provides vocational services that are based on the work status of cancer survivors rather than providing the same set of services for all cancer survivors. This study examined whether differences in the types of services were indeed based on the employment status of those with a history of cancer at the time of application. METHODS Administrative data on 1,460 cancer survivors were obtained through the US Rehabilitation Services Administration Case Service Report (RSA-911) dataset for fiscal year 2007. Data on demographic characteristics and vocational service patterns were extracted and analyzed. Multiple discriminant analysis was used to identify differential services received by cancer survivors based on employment status at time of application for vocational rehabilitation services. RESULTS Results of the multiple discriminant analysis indicated one significant canonical discriminant function, with Wilks's λ = .92, χ (2)(19, N = 1,456) = 114.87, p < .001. The correlations between the discriminating variables and the significant canonical discriminant function were highest for diagnoses and treatment (-.526), job placement (.487), transportation (.419), job search (.403), vocational training (.384), job readiness (.344), university training (.307), and rehabilitation technology (-.287). The group centroids along the significant discriminant function (the distance of each group from the center of the canonical function) indicated that the employed applicant group (-.542) and the unemployed applicant group (.153) can be differentiated based on vocational rehabilitation services received, with the employed applicant group receiving primarily diagnostic and treatment services and rehabilitation technology/job accommodation services, while the unemployed applicant group received more vocational training, job seeking skills training, and job placement services. CONCLUSIONS Employed cancer survivors who are at risk of losing their job and unemployed cancer survivors who are looking for a job receive different vocational services tailored to needs, suggesting that state vocational rehabilitation services for cancer survivors is responsive to individual client needs.
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Affiliation(s)
- Chung-Yi Chiu
- Department of Rehabilitation Counseling, University of Texas Southwestern Medical Center, Dallas, 6011 Harry Hines Blvd, Dallas, TX, 75390-9088, USA,
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Strauser DR, Wagner S, Chan F, Wong AWK. Perceptions of Young Adult Central Nervous System Cancer Survivors and Their Parents Regarding Career Development and Employment. REHABILITATION RESEARCH, POLICY, AND EDUCATION 2014. [DOI: 10.1891/2168-6653.28.3.158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Purpose: Identify barriers to career development and employment from both the survivor and parent perspective.Method: Young adult survivors (N = 43) and their parents participated in focus groups to elicit information regarding perceptions regarding career development and employment.Results: Perceptions of both the young adults and parents indicate that there is a significant need for comprehensive career and employment services targeted for young adult central nervous system cancer survivors.Conclusions: Findings provide initial evidence and support for the need to incorporate career and vocational services into psychosocial treatment programs. More research is needed in this area to gain an understanding of the specific career and vocational needs and to further explore how the interaction between the young adults and their parents impact vocational outcomes.
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Exploring Factors that Influence Childhood Cancer Survivorsʼ Choice of Occupation and Choice to Attend College. REHABILITATION ONCOLOGY 2014. [DOI: 10.1097/01893697-201432040-00005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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Developmental Work Personality Among Young Adult CNS Cancer Survivors: An Exploratory Study. AUSTRALIAN JOURNAL OF REHABILITATION COUNSELLING 2013. [DOI: 10.1017/jrc.2013.3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The primary aim of this brief exploratory study is to examine differences in developmental work personality in a sample of young adult CNS cancer survivors and a group of young adult college students without disabilities. Participants were 43 young adults with central nervous systems cancer (females = 58.1%, Mean age = 21.64, SD = 3.64) and a comparison sample of 45 typically developing others who were college students (females = 77.3%, mean age = 20.91, SD = 1.04). They completed the Developmental Work Personality Scale (DWPS). Group differences in developmental work personality were examined using multivariate analysis of variance procedures. Results indicated that overall developmental work personality, and subscale scores of work tasks, and social skills were significantly lower among CNS cancer survivors compared to typically developing other young adults. Findings suggest influences of developmental atypicality in work personality with CNS cancer survivorship.
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Mehnert A, de Boer A, Feuerstein M. Employment challenges for cancer survivors. Cancer 2013; 119 Suppl 11:2151-9. [DOI: 10.1002/cncr.28067] [Citation(s) in RCA: 193] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Revised: 11/29/2012] [Accepted: 12/03/2012] [Indexed: 11/10/2022]
Affiliation(s)
- Anja Mehnert
- Section of Psychosocial Oncology, Department of Medical Psychology and Medical Sociology; University Medical Center Leipzig; Leipzig Germany
- Department of Medical Psychology; University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - Angela de Boer
- Coronel Institute of Occupational Health; Academic Medical Center; Amsterdam the Netherlands
| | - Michael Feuerstein
- Department of Medical and Clinical Psychology; Uniformed Services University of the Health Sciences; Bethesda Maryland
- Department of Preventive Medicine and Biometrics; Uniformed Services University of the Health Sciences; Bethesda Maryland
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Employment outcomes among survivors of common cancers: the Symptom Outcomes and Practice Patterns (SOAPP) study. J Cancer Surviv 2013; 7:191-202. [PMID: 23378060 DOI: 10.1007/s11764-012-0258-2] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Accepted: 11/28/2012] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Risk factors for employment difficulties after cancer diagnosis are incompletely understood, and interventions to improve post-cancer employment remain few. New targets for intervention are needed. METHODS We assessed a cohort of 530 nonmetastatic cancer patients (aged ≤ 65 years, >6 months from diagnosis, off chemo- or radiotherapy) from the observational multi-site Symptom Outcomes and Practice Patterns study. Participants reported employment change, current employment, and symptoms. Groups were based on employment at survey (working full- or part-time versus not working) and whether there had been a change due to illness (yes versus no). The predictive power of symptom interference with work was evaluated for employment group (working stably versus no longer working). Race/ethnicity, gender, cancer type, therapy, and time since diagnosis were also assessed. Association between employment group and specific symptoms was examined. RESULTS The cohort was largely non-Hispanic white (76 %), female (85 %), and diagnosed with breast cancer (75 %); 24 % reported a change in employment. On multivariable analysis, participants with at least moderate symptom interference were more likely to report no longer working than their less effected counterparts (odds ratio (OR) = 8.0, 95 % CI, 4.2-15.4), as were minority participants compared with their non-Hispanic white counterparts (OR = 3.2, 95 % CI, 1.8-5.6). Results from the multiple regression model indicated the combination of fatigue (OR = 2.3, 95 % CI, 1.1-4.7), distress (OR = 3.9, 95 % CI, 1.7-9.0), and dry mouth (OR = 2.6, 95 % CI, 1.1-6.2) together with race/ethnicity and time since diagnosis adequately accounted for employment group. CONCLUSIONS Our findings support the hypothesis that residual symptom burden is related to post-cancer employment: Residual symptoms may be targets for intervention to improve work outcomes among cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS This analysis examines whether increased symptom burden is associated with a change to not working following a cancer diagnosis. We also examined individual symptoms to assess which symptoms were most strongly associated with not working after a cancer diagnosis. Our hope is that we will be able to use this information to both screen survivors post-active treatment as well as target high-risk symptoms for further and more aggressive intervention, in an attempt to improve post-cancer work outcomes.
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Strauser D, Wagner S, Wong AWK, O’Sullivan D. Career readiness, developmental work personality and age of onset in young adult central nervous system survivors. Disabil Rehabil 2012; 35:543-50. [DOI: 10.3109/09638288.2012.703754] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Berg C, Hayashi RJ. Participation and Self-Management Strategies of Young Adult Childhood Cancer Survivors. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2012. [DOI: 10.3928/15394492-20120607-01] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
This study describes a connection between late effects, engagement in major life activities, and self-management strategies in young adult childhood cancer survivors. A mailed survey focused on late effects of pain, fatigue, depression, cognition, memory, and body image distortion and their impact on work, education, independent living, and community and social engagement. Additionally, survivors identified self-management strategies that minimize their late effects. Eighty-eight percent of the 42 responders struggled with at least one of the six late effects. Work and educational pursuits were affected, with memory and fatigue the most intrusive to daily activities. Self-management strategies of sleep/rest, fitness, quiet leisure, and support of family/friends were the most common. Reaching out to long-term follow-up cancer clinics, health professionals, survivors, or community resources were the least employed management strategies. Occupational therapists can look to community models for educating survivors about self-management, and take this opportunity to define new collaborative partnerships with long-term follow-up cancer clinics and community agencies to assist young adult survivors transitioning to adult roles.
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Factors Affecting Childhood Cancer Survivorsʼ Choice to Attend a Specific College: A Pilot Study. REHABILITATION ONCOLOGY 2012. [DOI: 10.1097/01893697-201230010-00001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Tonorezos ES, Oeffinger KC. Research challenges in adolescent and young adult cancer survivor research. Cancer 2011; 117:2295-300. [DOI: 10.1002/cncr.26058] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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de Boer AG, Taskila T, Tamminga SJ, Frings-Dresen MH, Feuerstein M, Verbeek JH. Interventions to enhance return-to-work for cancer patients. Cochrane Database Syst Rev 2011:CD007569. [PMID: 21328297 DOI: 10.1002/14651858.cd007569.pub2] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Cancer survivors are 1.4 times more likely to be unemployed than healthy people. It is therefore important to provide cancer patients with programmes to support the return-to-work process. OBJECTIVES To evaluate the effectiveness of interventions aimed at enhancing return-to-work in cancer patients. SEARCH STRATEGY We searched the Cochrane Central Register of Controlled Trials (CENTRAL, in The Cochrane Library Issue 2, 2010), MEDLINE, EMBASE, CINAHL, OSH-ROM, PsycINFO, DARE, ClinicalTrials.gov, Trialregister.nl and Controlled-trials.com to February 2010, reference lists of included articles and selected reviews, and contacted authors of relevant articles. SELECTION CRITERIA Randomised controlled trials (RCTs) and controlled before-after studies (CBAs) of the effectiveness of psychological, vocational, physical, medical or multidisciplinary interventions enhancing return-to-work in cancer patients. The primary outcome was return-to-work measured as either return-to-work rate or sick leave duration. Secondary outcome was quality of life. DATA COLLECTION AND ANALYSIS Two authors independently selected trials, assessed the risk of bias and extracted data. We pooled studies with sufficient data, judged to be clinically homogeneous in different comparisons. We assessed the overall quality of the evidence for each comparison using the GRADE approach. MAIN RESULTS Fourteen articles reporting 14 RCTs and 4 CBAs were included. These studies involved a total of 1652 participants. Results indicated low quality evidence of similar return-to-work rates for psychological interventions compared to care as usual (odds ratio (OR) = 2.32, 95% confidence interval (CI) 0.94 to 5.71). No vocational interventions were retrieved. Very low evidence suggested that physical training was not more effective than care as usual on improving return-to-work (OR = 1.20, 95% CI 0.32 to 4.54). Eight RCTs on medical interventions showed low quality evidence that functioning conserving approaches had similar return-to-work rates as more radical treatments (OR = 1.53, 95% CI 0.95 to 2.45). Moderate quality evidence showed multidisciplinary interventions involving physical, psychological and vocational components led to higher return-to-work rates than care as usual (OR = 1.87, 95% CI 1.07 to 3.27). No differences in the effect of psychological, physical, medical or multidisciplinary interventions compared to care as usual were found on quality of life outcomes. AUTHORS' CONCLUSIONS Moderate quality evidence showed that employed patients with cancer experience return-to-work benefits from multidisciplinary interventions compared to care as usual. More high quality RCTs aimed at enhancing return-to-work in cancer patients are needed.
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Affiliation(s)
- Angela Gem de Boer
- Coronel Institute of Occupational Health, Academic Medical Centre, Meibergdreef 9, Amsterdam, Netherlands, 1105 AZ
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