Colorectal cancer survivors' experiences of return-to-work: A meta-synthesis of qualitative studies

Fear of progression among colorectal cancer patients: a latent profile analysis

PURPOSE

Fear of progression (FoP) leads to poor clinical outcomes in colorectal cancer patients. The study aimed to clarify the profiles and influencing factors of FoP among colorectal cancer patients.

METHODS

A cross-sectional study was conducted with 409 colorectal cancer patients. Convenience sampling method was used to select colorectal cancer patients hospitalized in a tertiary-level hospital in Nanjing as the survey subjects. General information questionnaire, Fear of Progression Questionnaire-Short Form, Distress Disclosure Index, and Social Support Rating Scale were used to collect the data. Latent profile analysis was used to explore the latent profiles of FoP in colorectal cancer patients. Additionally, the influencing factors of profiles were explored by Univariate Analysis and Binomial Logistic Regression Analysis.

RESULTS

Latent profile analysis identified two subgroups of fear of disease progression: the "fear low-risk profile (83%)", and the "severe fear profile (17%)." Patients with low age, low social support utilization, first hospital admission, severe healthcare burden, and preoperative bowel symptoms were prone to severe fear of disease progression.

CONCLUSIONS

There is some heterogeneity in the level of postoperative fear of disease progression in colorectal cancer patients. Doctors and nurses should focus on patients with severe fear and take targeted preventive and psychological care for patients' fear of disease progression as early as possible according to the distribution characteristics of different categories.

The experiences and perceptions of employers on cancer survivors returning to work: a meta-synthesis of qualitative studies

PURPOSE

Employers play an important role in the return-to-work (RTW) of cancer survivors (CSs), and recently a substantial number of qualitative studies from the employers' perspective have emerged. This meta-synthesis aims to systematically review these qualitative studies regarding employers' experiences with CSs' RTW.

METHODS

Five electronic databases were searched from inception to January 2024 to identify the studies. Three researchers conducted quality assessment of included. Subsequent, we performed thematic integration of the included studies with the NVivo 11 software.

RESULTS

Thirteen qualitative studies were included, and 16 topics were finally extracted and summarized into seven categories to form three integrated themes: employers' perspective on facilitators and obstacles for CSs' RTW, employers' response including negative emotion and positive behavior, and employers' need resources from different aspects.

CONCLUSION

CSs' RTW is influenced by many factors; the support employers need is also extensive and complex. Employers need more support beyond healthcare.

Effects of a self-managed return to work intervention for colorectal cancer survivors: A prospective randomized controlled trial

PURPOSE

The present study aims to assess the efficacy of stage-matched, self-managed Return to Work (RTW) interventions in enhancing RTW outcomes among colorectal cancer (CRC) survivors.

METHODS

This trial, conducted in South Korea, enrolled 58 unemployed survivors of colorectal cancer. Participants were randomly assigned to either an experimental or a control group. The experimental group received a self-managed return-to-work intervention based on the trans-theoretical model, while the control group received an educational booklet. Assessments were conducted at baseline and at 3, 6, and 12 months to measure changes in various factors including return-to-work status and HRQOL.

RESULTS

In the experimental group, 28 participants were randomly assigned, while 30 individuals were allocated to the control group. The experimental group exhibited a higher proportion of individuals achieving RTW (64.5% vs 39.3%, p = 0.013) and demonstrated greater improvements in work ability (p = 0.001), RTW self-efficacy (p = 0.035), readiness for RTW in the prepared-for-action (p < 00.0001), uncertain maintenance (p = 0.033), and proactive maintenance (p < 00.0001) stages, quality of working life (p = 0.003), HRQOL (p < 0.05), and illness perception (p < 0.05) compared to the control group at the 12-month follow-up.

CONCLUSIONS

Stage-matched self-managed RTW interventions incorporating TTM principles may effectively enhance RTW outcomes and work ability among CRC survivors.

Experiences of cancer survivors returning to work decision-making: a meta-synthesis of qualitative studies

PURPOSE

Return to work for cancer survivors (CSs) may be challenging, and there is a research gap in integrating the relevant experiences of the return-to-work decision-making process for CSs. Our aim was to synthesize existing qualitative research that integrates the dynamic experiences of CSs in the return-to-work decision-making process and highlights the factors influencing the return-to-work decisions of CSs.

METHODS

We retrieved qualitative studies on a relevant theme published in the PubMed, EBSCO, Scopus, Web of Science, Cochrane Library, and CINAHL databases since construction to December 2023. Literature screening, quality evaluation, and data analysis followed the PRISMA, Joanna Briggs Institute Critical Appraisal Tool (2016), and thematic analysis methods to ensure study reliability. The study was registered on PROSPERO (registration number: CRD42023429623).

RESULTS

Ten articles were included, and six key outcomes were identified based on Social Cognitive Career Theory (SCCT) integration: points of concern for individuals, sense of self-efficacy, outcome expectations, work perception and belonging, medical advice and guidance, and effects of the external reactions.

CONCLUSION

The decision-making process for CSs to return to work is affected by various personal and external factors. Effectively addressing personal appearance, financial, and emotional issues can enhance self-efficacy of CSs. Improving external perceptions of cancer patients and enhancing social support in the workplace and medical settings can help CSs make informed decisions regarding their return to work.

IMPLICATIONS FOR CANCER SURVIVORS

The decision of CSs to return to work is a result of integrating personal, job, and medical care considerations. These findings contribute to the development of future interventions for CSs' return-to-work decisions that target an array of potential factors.