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Park SY, Lee MK. Effects of a self-managed return to work intervention for colorectal cancer survivors: A prospective randomized controlled trial. Eur J Oncol Nurs 2024; 70:102593. [PMID: 38795437 DOI: 10.1016/j.ejon.2024.102593] [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: 09/13/2023] [Revised: 03/31/2024] [Accepted: 04/12/2024] [Indexed: 05/28/2024]
Abstract
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.
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Affiliation(s)
- Soo Yeun Park
- College of Nursing, Research Institute of Nursing Science (Dr. Lee); and Colorectal Cancer Center, Kyungpook National University Chilgok Hospital, School of Medicine (Drs Park), Kyungpook National University, Daegu, South Korea.
| | - Myung Kyung Lee
- College of Nursing, Research Institute of Nursing Science (Dr. Lee); and Colorectal Cancer Center, Kyungpook National University Chilgok Hospital, School of Medicine (Drs Park), Kyungpook National University, Daegu, South Korea.
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Owens OL, Dressler EV, Mayfield A, Winkfield KM, Krane LS, Foust M, Sandberg JC. Considerations from employed African-American and white prostate cancer survivors on prostate cancer treatment and survivorship: a qualitative analysis. ETHNICITY & HEALTH 2024; 29:309-327. [PMID: 38317577 PMCID: PMC10987268 DOI: 10.1080/13557858.2024.2312422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 01/25/2024] [Indexed: 02/07/2024]
Abstract
OBJECTIVE To solicit information/suggestions from prostate cancer survivors to improve survivorship experiences specific to work/workability. DESIGN The study employed a qualitative/phenomenological approach. Black/African-American and white prostate cancer survivors who: (1) had prostatectomy or radiation therapy 6-36 months prior, (2) were working for pay within 30 days before having treatment, and (3) expected to be working for pay 6 months later (n = 45) were eligible for this study. Survivors were engaged in 60-to-90-minute structured interviews. Content analysis was used to ascertain prominent themes. RESULTS Participants had the following recommendations for survivors: ask about research on treatment options and side effects; speak with other survivors about cancer diagnosis; and inform family/friends and employers about needed accommodations. Considerations for family/friends emphasized the significance of instrumental (e.g. help finding information) and emotional support (e.g. encouragement). Employer/co-worker considerations most often related to work-related accommodations/support and avoiding stigmatization of the survivor. Considerations for healthcare providers commonly included the provision of unbiased, plain-language communication about treatment options and side effects. No major differences existed by race. CONCLUSIONS Needs of employed PrCA survivors, regardless of their race or treatment type, are commonly related to their desire for informational, instrumental, and/or emotional support from family/friends, employers/co-workers, and healthcare providers. The requested supports are most often related to the side effects of prostate cancer treatment.
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Affiliation(s)
- Otis L Owens
- College of Social Work, University of South Carolina, Columbia, SC, USA
| | - Emily V Dressler
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Andrew Mayfield
- Department of Family and Community Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Karen M Winkfield
- Meharry-Vanderbilt, Alliance, Vanderbilt University Medical Center, Nashville, TN, USA
| | - L Spencer Krane
- Department of Urologic Surgery, Southeastern Louisiana Veterans Health Care Center, New Orleans, LA, USA
| | - Melyssa Foust
- Spartanburg Gibbs Cancer Center and Research Institute, Spartanburg, SC, USA
| | - Joanne C Sandberg
- Department of Family and Community Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
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3
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Chen L, Wang C, Smith GL, Dawkins-Moultin L, Shin LJ, Lu Q. Job Loss and Well-Being Among Chinese American Breast Cancer Survivors: The Mediating Role of Income and Perceived Stress. Int J Behav Med 2024:10.1007/s12529-023-10245-3. [PMID: 38169050 DOI: 10.1007/s12529-023-10245-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND A growing number of studies suggest that job loss has detrimental effects on cancer survivors. However, the underlying mechanisms are not well understood. Furthermore, minorities including Asian American cancer survivors remain understudied, yet they suffer from job loss more often. The present study examined the prevalence of job loss in Chinese American breast cancer survivors (CABCS) and investigated the relationship between job loss and well-being in this group and the underlying mechanisms. METHOD CABCS completed a questionnaire that included demographic, employment, and clinical information, as well as measures of psychosocial well-being. Descriptive analyses were conducted to gauge the prevalence of job loss, linear regressions were used to test associations between job loss and well-being, and path analyses were conducted to test mediations. RESULTS About 45.4% of survivors lost their job after being diagnosed with cancer, and only 35.2% of those who lost their job regained employment up to the assessment time. Job loss was associated with reduced income, which was associated with higher perceived stress, which, in turn, was associated with lower overall quality of life (QoL) and greater depressive symptoms. CONCLUSIONS Findings highlight the high prevalence of job loss and its negative effects on QoL and depression among CABCS. It is important for health care professionals to be sensitive to adverse financial events affecting minority BCS. In addition to offering BCS necessary practical assistance, psychosocial interventions focusing on reducing perceived stress associated with the cancer experience may be effective in mitigating some long-term consequences of job loss.
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Affiliation(s)
- Lingjun Chen
- School of Education, Shanghai Jiao Tong University, Chan Suikau Hall, Room 227, 800 Dongchuan Road, Shanghai, 200240, China.
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Houston, TX, 77030, USA.
| | - Carol Wang
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Houston, TX, 77030, USA
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Grace L Smith
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lenna Dawkins-Moultin
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Houston, TX, 77030, USA
| | - Lilian J Shin
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Houston, TX, 77030, USA
| | - Qian Lu
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Houston, TX, 77030, USA.
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4
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Emerson MA, Reeve BB, Gilkey MB, Elmore SNC, Hayes S, Bradley CJ, Troester MA. Job loss, return to work, and multidimensional well-being after breast cancer treatment in working-age Black and White women. J Cancer Surviv 2023; 17:805-814. [PMID: 36103105 PMCID: PMC10011019 DOI: 10.1007/s11764-022-01252-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 08/31/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE Breast cancer survivorship has improved in recent decades, but few studies have assessed the patterns of employment status following diagnosis and the impact of job loss on long-term well-being in ethnically diverse breast cancer survivors. We hypothesized that post-treatment employment status is an important determinant of survivor well-being and varies by race and age. METHODS In the Carolina Breast Cancer Study, 1646 employed women with primary breast cancer were longitudinally evaluated for post-diagnosis job loss and overall well-being. Work status was classified as "sustained work," "returned to work," "job loss," or "persistent non-employment." Well-being was assessed by the Functional Assessment of Cancer Therapy (FACT-G) instrument. Analysis of covariance was used to evaluate the association between work status and well-being (physical, functional, social, and emotional). RESULTS At 25 months post-diagnosis, 882 (53.6%) reported "sustained work," 330 (20.1%) "returned to work," 162 (9.8%) "job loss," and 272 (16.5%) "persistent non-employment." Nearly half of the study sample (46.4%) experienced interruptions in work during 2 years post-diagnosis. Relative to baseline (5-month FACT-G), women who sustained work or returned to work had higher increases in all well-being domains than women with job loss and persistent non-employment. Job loss was more common among Black than White women (adjusted odds ratio = 3.44; 95% confidence interval 2.37-4.99) and was associated with service/laborer job types, lower education and income, later stage at diagnosis, longer treatment duration, and non-private health insurance. However, independent of clinical factors, job loss was associated with lower well-being in multiple domains. CONCLUSIONS Work status is commonly disrupted in breast cancer survivors, but sustained work is associated with well-being. Interventions to support women's continued employment after diagnosis are an important dimension of breast cancer survivorship. IMPLICATIONS FOR CANCER SURVIVORS Our findings indicate that work continuation and returning to work may be a useful measure for a range of wellbeing concerns, particularly among Black breast cancer survivors who experience greater job loss.
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Affiliation(s)
- Marc A Emerson
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, Chapel Hill, NC, USA.
| | - Bryce B Reeve
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Melissa B Gilkey
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, Chapel Hill, NC, USA
- Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Shekinah N C Elmore
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, Chapel Hill, NC, USA
| | - Sandi Hayes
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Cathy J Bradley
- University of Colorado Comprehensive Cancer Center, Aurora, CO, USA
| | - Melissa A Troester
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, Chapel Hill, NC, USA
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Cherrier MM, Higano CS, Gray HJ. Cognitive skill training improves memory, function, and use of cognitive strategies in cancer survivors. Support Care Cancer 2022; 30:711-720. [PMID: 34368888 PMCID: PMC8639759 DOI: 10.1007/s00520-021-06453-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 07/19/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Cancer survivors commonly report symptoms of impaired cognition. This project examined effectiveness of a behavioral skills training intervention to improve cognition and reduce cognitive dysfunction symptoms in cancer survivors. METHODS Participants were randomly assigned to group-based workshops focused on learning new cognitive skills (skills treatment-TX) or an active control of education workshops (education control-EC) or a passive control of wait list (WL). Participants were evaluated pre- and post intervention with subjective mood and symptom questionnaires and objective neurocognitive tests. RESULTS One hundred twenty-eight participants (mean age 59 years), average 4.6 years (+ / - 5.5 years) post cancer treatment with various cancer types (breast, bladder, prostate, colon, uterine), were enrolled. Analysis of all participants who attended workshop(s) revealed improvement in the TX workshop completers on all objective cognitive measures (attention, concentration, declarative, and working memory) save one test of selective attention, and improvement on a single measure (verbal memory) and decline (selective attention) in the EC group. TX workshop completers also improved on all symptom and mood measures, in contrast to EC group which improved on a single subscale of a symptom measure, but increased on an anxiety measure. TX group alone improved on a quantified measure of each participants' unique, "top three," self-described cognitive symptoms. CONCLUSION Improvement from behavioral skills training was evident from objective cognitive tests, subjective symptom measures, and quantified, individual patient-specific symptoms. Behavioral skill training is an effective treatment for cognitive dysfunction in cancer survivors, and should be considered as a treatment option by health care providers.
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Affiliation(s)
- Monique M. Cherrier
- Department of Psychiatry and Behavioral Sciences, University of Washington, Box 356560, Seattle, WA 98195, USA,Fred Hutchinson Cancer Consortium, Seattle, WA 98195, USA,Corresponding author
| | - Celestia S. Higano
- Department of Medicine, Division of Oncology, University of Washington, Seattle, WA 98195, USA,Fred Hutchinson Cancer Research Center, Seattle, WA 98195, USA
| | - Heidi J. Gray
- Fred Hutchinson Cancer Consortium, Seattle, WA 98195, USA,Department of Medicine, Division of Oncology, University of Washington, Seattle, WA 98195, USA,Department of Obstetrics and Gynecology, University of Washington, Seattle, WA 98195, USA
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6
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Coutu MF, Durand MJ, Coté D, Tremblay D, Sylvain C, Gouin MM, Bilodeau K, Nastasia I, Paquette MA. How does Gender Influence Sustainable Return to Work Following Prolonged Work Disability? An Interpretive Description Study. JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:552-569. [PMID: 33394267 DOI: 10.1007/s10926-020-09953-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/07/2020] [Indexed: 06/12/2023]
Abstract
PURPOSE A sustainable return to work (S-RTW) following prolonged work disability poses different challenges, depending on gender. This article provides a synthesis of gender differences in the issues and factors influencing the S-RTW of workers following such a disability. METHODS Using an interpretive description method, an integrative review was conducted of the literature on gender differences in S-RTW issues and factors associated with four major causes of work disability. The initial review concerned the 2000-2016 literature; it was subsequently updated for November 2016-March 2020. To explore and contextualise the results, four focus groups were held with stakeholders representing the workplace, insurance, and healthcare systems and workers. Qualitative thematic analysis was performed. RESULTS A total of 47 articles were reviewed, and 35 stakeholders participated in the focus groups. The prevailing traditional gender roles were found to have a major gender-specific influence on the attitudes, behaviours, processes and outcomes associated with S-RTW. These differences related to the (1) cumulative workload, (2) work engagement, and (3) expressed and addressed needs. CONCLUSIONS The results highlight the importance of taking into account both professional and personal aspects when integrating gender issues into the assessment of workers' needs and subsequently into interventions.
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Affiliation(s)
- Marie-France Coutu
- Centre d'action en Prévention et réadaptation des Incapacités au Travail (CAPRIT), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada.
- Centre de Recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean Sur Les Innovations en Santé (CR-CSIS), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada.
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada.
| | - Marie-José Durand
- Centre d'action en Prévention et réadaptation des Incapacités au Travail (CAPRIT), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- Centre de Recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean Sur Les Innovations en Santé (CR-CSIS), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
| | - Daniel Coté
- Institut de Recherche Robert-Sauvé en Santé et en Sécurité du Travail (IRSST), 505 Boulevard De Maisonneuve West, Montreal, QC, H3A 3C2, Canada
| | - Dominique Tremblay
- Centre de Recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean Sur Les Innovations en Santé (CR-CSIS), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- School of Nursing, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles-Le Moyne, Longueuil, QC, J4K 0A8, Canada
| | - Chantal Sylvain
- Centre d'action en Prévention et réadaptation des Incapacités au Travail (CAPRIT), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- Centre de Recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean Sur Les Innovations en Santé (CR-CSIS), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
| | - Marie-Michelle Gouin
- Department of Management and Human Resource Management, School of Management, Université de Sherbrooke, 2500 Boulevard de l'Université, Sherbrooke, QC, J1K 2R1, Canada
| | - Karine Bilodeau
- Faculty of Nursing, Université de Montréal, Station Centre-ville, PO Box 6128, Montreal, QC, H3C 3J7, Canada
| | - Iuliana Nastasia
- Institut de Recherche Robert-Sauvé en Santé et en Sécurité du Travail (IRSST), 505 Boulevard De Maisonneuve West, Montreal, QC, H3A 3C2, Canada
| | - Marie-Andrée Paquette
- Centre d'action en Prévention et réadaptation des Incapacités au Travail (CAPRIT), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- Centre de Recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean Sur Les Innovations en Santé (CR-CSIS), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
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Chan RJ, Cooper B, Gordon L, Hart N, Tan CJ, Koczwara B, Kober KM, Chan A, Conley YP, Paul SM, Miaskowski C. Distinct employment interference profiles in patients with breast cancer prior to and for 12 months following surgery. BMC Cancer 2021; 21:883. [PMID: 34340680 PMCID: PMC8327049 DOI: 10.1186/s12885-021-08583-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 06/17/2021] [Indexed: 12/16/2022] Open
Abstract
PURPOSE To identify subgroups of female breast cancer patients with distinct self-reported employment interference (EI) profiles and determine which demographic, clinical, and symptom characteristics, and quality of life outcomes were associated with subgroup membership. METHODS Women with breast cancer (n = 385) were assessed for changes in EI over ten times, from prior to, through 12 months after breast cancer surgery. Latent profile analysis (LPA) was used to identify subgroups of patients with distinct EI profiles. RESULTS Three distinct EI profiles (i.e., None - 26.2% (n = 101), Low - 42.6% (n = 164), High - 31.2% (n = 120)) were identified. Compared to the None and Low groups, patients in the High group were more likely to be younger. Higher proportions in the High group were non-White, pre-menopausal prior to surgery, had more advanced stage disease, had received an axillary lymph node dissection, had received neoadjuvant chemotherapy, had received adjuvant chemotherapy, and had a re-excision or mastectomy on the affected breast within 6 months after surgery. In addition, these patients had lower quality of life scores. Compared to the None group, the High group had higher levels of trait and state anxiety, depressive symptoms, fatigue and sleep disturbance and lower levels of cognitive function. CONCLUSIONS This study provides new knowledge regarding EI profiles among women in the year following breast cancer surgery. The non-modifiable risk factors (e.g., younger age, being non-White, having more advanced stage disease) can inform current screening procedures. The potentially modifiable risk factors can be used to develop interventions to improve employment outcomes of breast cancer patients.
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Affiliation(s)
- Raymond Javan Chan
- School of Nursing, Queensland University of Technology, Kelvin Grove, Australia.,Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Kelvin Grove, QLD, Australia.,Princess Alexandra Hospital, Metro South Hospital and Health Services, Woolloongabba, Queensland, Australia
| | - Bruce Cooper
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, 2 Koret Way - N631Y, San Francisco, CA, 94143-0610, USA
| | - Louisa Gordon
- School of Nursing, Queensland University of Technology, Kelvin Grove, Australia.,QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Nicolas Hart
- School of Nursing, Queensland University of Technology, Kelvin Grove, Australia.,Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - Chia Jie Tan
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore, Singapore.,Department of Pharmacy, National Cancer Centre, Singapore, Singapore, Singapore
| | - Bogda Koczwara
- Flinders Centre for Innovation in Cancer, Flinders Medical Centre and Flinders University, Bedford Park, Australia
| | - Kord M Kober
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, 2 Koret Way - N631Y, San Francisco, CA, 94143-0610, USA
| | - Alexandre Chan
- Department of Clinical Pharmacy Practice, University of California, Irvine, CA, USA
| | - Yvette P Conley
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - Steven M Paul
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, 2 Koret Way - N631Y, San Francisco, CA, 94143-0610, USA
| | - Christine Miaskowski
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, 2 Koret Way - N631Y, San Francisco, CA, 94143-0610, USA.
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8
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Yuan CM, Wang CC, Wu WT, Ho CL, Chen WL. Risk factors for return to work in colorectal cancer survivors. Cancer Med 2021; 10:3938-3951. [PMID: 33991067 PMCID: PMC8209624 DOI: 10.1002/cam4.3952] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 04/05/2021] [Accepted: 04/16/2021] [Indexed: 01/20/2023] Open
Abstract
Background: The increasing incidence of colorectal cancer among individuals in the productive age‐group has adversely affected the labor force and increased healthcare expenses in recent years. Return to work (RTW) is an important issue for these patients. In this study, we explored the factors that influence RTW and investigated the influence of RTW on survival outcomes of patients with colorectal cancer. Methods: Data of individuals (N = 4408) in active employment who were diagnosed with colorectal cancer between 2004 and 2010 were derived from 2 nationwide databases. Subjects were categorized into 2 groups according to their employment status at 5‐year follow‐up. Logistic regression analysis was performed to identify the factors associated with RTW. Survivors were further followed up for another 8 years. Propensity score matching was applied to ensure comparability between the two groups, and survival analysis was performed using the Kaplan–Meier method. Results: In multivariable regression analysis for 5‐year RTW with different characteristics, older age (OR: 0.57 [95% CI, 0.48–0.69]; p < 0.001), treatment with radiotherapy (OR: 0.69 [95% CI, 0.57–0.83]; p < 0.001), higher income (OR: 0.39 [95% CI, 0.32–0.47]; p < 0.001), medium company size (OR: 0.78 [95% CI, 0.63–0.97]; p = 0.022), and advanced pathological staging (stage I, OR: 16.20 [95% CI, 12.48–21.03]; stage II, OR: 13.12 [95% CI, 10.43–16.50]; stage III, OR: 7.68 [95% CI, 6.17–9.56]; p < 0.001 for all) revealed negative correlations with RTW. In Cox proportional hazard regression for RTW and all‐cause mortality, HR was 1.11 (95% CI, 0.80–1.54; p = 0.543) in fully adjusted model. Conclusion: Older age, treatment with radiotherapy, higher income, medium company size, and advanced pathological stage showed negative correlations with RTW. However, we observed no significant association between employment and all‐cause mortality. Further studies should include participants from different countries, ethnic groups, and patients with other cancers.
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Affiliation(s)
- Chung-Mao Yuan
- Department of Internal Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan.,Department of Internal Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Division of Environmental Health and Occupational Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chung-Ching Wang
- Division of Environmental Health and Occupational Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Wei-Te Wu
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Ching-Liang Ho
- Department of Internal Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Wei-Liang Chen
- Division of Environmental Health and Occupational Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Department of Biochemistry, National Defense Medical Center, Taipei, Taiwan
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9
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Seol KH, Bong SH, Kang DH, Kim JW. Factors Associated with the Quality of Life of Patients with Cancer Undergoing Radiotherapy. Psychiatry Investig 2021; 18:80-87. [PMID: 33460533 PMCID: PMC7897871 DOI: 10.30773/pi.2020.0286] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 11/01/2020] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Approximately half of patients with cancer have comorbidities, such as adjustment disorder, major depressive disorder, and delirium. Radiotherapy can cause psychological problems, e.g., the fear of treatment and its side effects, anxiety, depression, and social isolation. Health-related quality of life (QoL) must be determined to evaluate the effectiveness of cancer treatment. We analyzed the clinical, psychological, and sociodemographic factors influencing the QoL of patients with cancer who were undergoing radiotherapy. METHODS Twenty-six patients undergoing radiotherapy (10 male, 16 female) were included. Sociodemographic and clinical data were collected prior to radiotherapy. Psychosocial factors were assessed by self-reported questionnaires before, immediately after, and 3 months after radiotherapy. A multivariate regression analysis identified factors affecting QoL at each time point. RESULTS Patients' diagnoses were breast, cervical, prostate, endometrial, rectal, hypopharyngeal, laryngeal, liver, gallbladder, esophageal, ovarian, lung, and skin cancers. Before radiotherapy, better resilience was significantly associated with a higher QoL score (R2=0.199, p=0.033). Immediately after radiotherapy, financial difficulty was significantly associated with a lower QoL score (R2=0.274, p=0.010). Three months after radiotherapy, the presence of chronic disease (R2=0.398, p=0.002) and the severity of nausea and vomiting were significantly associated with a lower QoL score (R2=0.278, p=0.014). CONCLUSION Resilience, financial difficulty, the presence of chronic diseases, and the severity of nausea and vomiting significantly influenced the QoL of patients with cancer who were undergoing radiotherapy. Factors affecting QoL varied at each time point. Thus, patients with cancer should undergo regular mental health assessments, including assessments of QoL. Multidimensional (physical, psychological, and social) approaches and individualized time-based interventions are needed to improve the QoL of cancer patients undergoing radiotherapy.
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Affiliation(s)
- Ki Ho Seol
- Department of Radiation Oncology, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea
| | - Su Hyun Bong
- Department of Psychiatry, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea
| | - Dae Hun Kang
- Department of Psychiatry, The Armed Forces Daejeon Hospital, Daejeon, Republic of Korea
| | - Jun Won Kim
- Department of Psychiatry, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea
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10
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Hastert TA, Kirchhoff AC, Banegas MP, Morales JF, Nair M, Beebe-Dimmer JL, Pandolfi SS, Baird TE, Schwartz AG. Work changes and individual, cancer-related, and work-related predictors of decreased work participation among African American cancer survivors. Cancer Med 2020; 9:9168-9177. [PMID: 33159501 PMCID: PMC7724298 DOI: 10.1002/cam4.3512] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/28/2020] [Accepted: 09/14/2020] [Indexed: 01/08/2023] Open
Abstract
African American cancer survivors disproportionately experience financial difficulties after cancer. Decreased work participation (going from being employed full time to part time or from employed to not employed) can contribute to financial hardship after cancer but employment outcomes among African American cancer survivors have not been well described. This study estimates the prevalence of work changes and identifies factors associated with decreased work participation among African American cancer survivors. We analyzed data from 916 African American breast, colorectal, lung, and prostate cancer survivors who participated in the Detroit Research on Cancer Survivors (ROCS) cohort and were employed before their cancer diagnosis. Modified Poisson models estimated prevalence ratios of decreased work participation and work changes, including changes to hours, duties, or schedules, between diagnosis and ROCS enrollment controlling for sociodemographic and cancer‐related factors. Nearly half of employed survivors made changes to their schedules, duties, or hours worked due to cancer and 34.6% took at least one month off of work, including 18% who took at least one month of unpaid time off. More survivors employed full time (vs. part time) at diagnosis were on disability at ROCS enrollment (18.7% vs. 12.6%, P < 0.001), while fewer were unemployed (5.9% vs. 15.7%, P < 0.001). Nearly half (47.5%) of employed survivors decreased work participation. Taking paid time off was not associated with decreased work participation; however, taking unpaid time off and making work changes were associated with prevalence ratios of decreased work participation of 1.29 (95% CI: 1.03, 1.62) and 1.37 (95% CI: 1.07, 1.75), respectively. Employment disruptions are common after a cancer diagnosis. Survivors who take unpaid time off and make other work changes may be particularly vulnerable to experiencing decreased work participation.
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Affiliation(s)
- Theresa A Hastert
- Wayne State University School of Medicine, Detroit, MI, USA.,Karmanos Cancer Institute, Detroit, MI, USA
| | - Anne C Kirchhoff
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | | | | | - Mrudula Nair
- Wayne State University School of Medicine, Detroit, MI, USA.,Karmanos Cancer Institute, Detroit, MI, USA
| | - Jennifer L Beebe-Dimmer
- Wayne State University School of Medicine, Detroit, MI, USA.,Karmanos Cancer Institute, Detroit, MI, USA
| | - Stephanie S Pandolfi
- Wayne State University School of Medicine, Detroit, MI, USA.,Karmanos Cancer Institute, Detroit, MI, USA
| | - Tara E Baird
- Wayne State University School of Medicine, Detroit, MI, USA.,Karmanos Cancer Institute, Detroit, MI, USA
| | - Ann G Schwartz
- Wayne State University School of Medicine, Detroit, MI, USA.,Karmanos Cancer Institute, Detroit, MI, USA
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Use of patient-reported controls for secular trends to study disparities in cancer-related job loss. J Cancer Surviv 2020; 15:685-695. [PMID: 33106995 PMCID: PMC8071836 DOI: 10.1007/s11764-020-00960-1] [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: 03/12/2020] [Accepted: 10/18/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Racial/ethnic minorities experience greater job loss than whites during periods of economic downturn and after a cancer diagnosis. Therefore, race/ethnicity-matched controls are needed to distinguish the impact of illness on job loss from secular trends METHODS: Surveys were administered during and 4-month post-completion of breast cancer treatment. Patients were pre-diagnosis employed women aged 18-64, undergoing treatment for stage I-III breast cancers, who spoke English, Chinese, Korean, or Spanish. Each patient was asked to: (1) nominate peers who were surveyed in a corresponding timeframe (active controls), (2) report a friend's work status at baseline and follow-up (passive controls). Both types of controls were healthy, employed at baseline, and shared the nominating patient's race/ethnicity, language, and age. The primary outcome was number of evaluable patient-control pairs by type of control. A patient-control pair was evaluable if work status at follow-up was reported for both individuals. RESULTS Of the 180 patients, 25% had evaluable active controls (45 patient-control pairs); 84% had evaluable passive controls (151 patient-control pairs). Although patients with controls differed from those without controls under each strategy, there was no difference in the percentage of controls who were working at follow-up (96% of active controls; 91% of passive controls). However, only 65% of patients were working at follow-up. CONCLUSIONS The majority of patients had evaluable passive controls. There was no significant difference in outcome between controls ascertained through either method IMPLICATIONS FOR CANCER SURVIVORS: Passive controls are a low-cost, higher-yield option to control for secular trends in racially/ethnically diverse samples.
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12
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Markovic C, Mackenzie L, Lewis J, Singh M. Working with cancer: A pilot study of work participation among cancer survivors in Western Sydney. Aust Occup Ther J 2020; 67:592-604. [PMID: 32657435 DOI: 10.1111/1440-1630.12685] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/19/2020] [Accepted: 06/07/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Around 40% of cancers occur in working-age adults. Improvements in screening and treatment mean that most are expected to live years beyond their diagnosis. However, many experience persistent impairments from treatment such as fatigue, cognitive difficulties, and emotional distress. Work is a key occupation for this population and is an important occupational performance area for occupational therapy intervention. However, little is understood about working with cancer in the Australian context. AIM To pilot a survey to identify factors associated with work participation among cancer survivors, and to determine if the survey collected useful information to build on for further study. METHODS A cross-sectional online survey was developed to measure work participation and factors associated with successful work. Study participants aged 20-65 years, employed at diagnosis, with basic English and computer literacy were recruited from a cancer clinic in Western Sydney over a 3-month period. RESULTS Nineteen survey responses were received and analysed. Participants had returned or remained at work (n = 9, 47.4%), unsuccessfully attempted to return to work (RTW; n = 2, 10.5%), or were on leave from work (n = 8, 42.1%). Of those on leave, most did not plan to RTW (n = 6, 31.6%). Fatigue (n = 15, 78.9%), difficulty concentrating (n = 8, 42.1%), memory issues (n = 8, 42.1%), stomach upset (n = 7, 36.8%), sleep disturbance, (n = 7, 36.8%), and psychological distress (n = 7, 36.8%) impacted perceived work ability. Physically demanding work (n = 8, 42.1%), length of the workday (n = 6, 31.6%), productivity demands (n = 5, 26.3%), and commuting (n = 4, 21.1%) were challenging to manage after cancer. A supportive workplace was a facilitator for work. CONCLUSION Cancer survivors in Western Sydney may face challenges engaging in work after treatment. Work participation may be influenced by side effects of treatment, difficulty performing work demands, and the work environment. Services may be needed for cancer survivors to navigate RTW.
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Affiliation(s)
- Cresta Markovic
- Discipline of Occupational Therapy, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Lidcombe, NSW, Australia
| | - Lynette Mackenzie
- Discipline of Occupational Therapy, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Lidcombe, NSW, Australia
| | - Joanne Lewis
- Discipline of Occupational Therapy, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Lidcombe, NSW, Australia
| | - Michelle Singh
- Occupational Therapy, Blacktown Cancer and Haematology Centre, Blacktown, NSW, Australia
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13
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Tsui J, Sabik LM, Cantor JC. Understanding the Impact of Insurance Coverage Across the Cancer Care Continuum: Moving Beyond Fragmented Systems and Cross-Sectional Data to Inform Policy. J Natl Cancer Inst 2020; 112:657-658. [PMID: 32337553 PMCID: PMC7357315 DOI: 10.1093/jnci/djaa049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 03/27/2020] [Indexed: 11/16/2023] Open
Affiliation(s)
- Jennifer Tsui
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
- Rutgers School of Public Health, Piscataway, NJ, USA
- Rutgers Center for State Health Policy, New Brunswick, NJ, USA
| | - Lindsay M Sabik
- University of Pittsburgh, Graduate School of Public Health, Pittsburgh, PA
- UPMC Hillman Cancer Center, Pittsburgh, PA, USA
| | - Joel C Cantor
- Rutgers Center for State Health Policy, New Brunswick, NJ, USA
- Rutgers Edward J. Bloustein School of Planning and Public Policy, New Brunswick, NJ, USA
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14
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Naughton MJ, Beverly Hery CM, Janse SA, Naftalis EZ, Paskett ED, Van Zee KJ. Prevalence and correlates of job and insurance problems among young breast cancer survivors within 18 months of diagnosis. BMC Cancer 2020; 20:432. [PMID: 32423486 PMCID: PMC7236509 DOI: 10.1186/s12885-020-06846-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 04/07/2020] [Indexed: 11/25/2022] Open
Abstract
Background The prevalence and correlates of job and insurance problems were examined among a cohort of young U.S. breast cancer survivors during the first 18-months following diagnosis. Methods Participants were 708 women diagnosed at ≤45 years with stage I-III breast cancer. 90% were non-Hispanic white, 76% were married/partnered and 67% had ≥4-year college degree. Univariable and multivariable logistic regression examined the associations between demographic, lifestyle and clinical factors with job and insurance problems. Results 18-months after diagnosis, 56% of participants worked full-time, 16% part-time, 18% were homemakers and/or students, 4.5% were unemployed, and 2.4% were disabled. The majority (86%) had private insurance. Job-related problems were reported by 40% of women, and included believing they could not change jobs for fear of losing health insurance (35.0%), being fired (2.3%), and being demoted, denied promotion or denied wage increases (7.8%). Greater job-related problems were associated with being overweight vs. under/normal weight (p = 0.006), income <$50,000/per year (p = 0.01), and working full-time vs. part-time (p = 0.003). Insurance problems were reported by 27% of women, and included being denied health insurance (2.6%), health insurance increases (4.3%), being denied health benefit payments (14.8%) or denied life insurance (11.4%). Insurance problems were associated with being under/normal weight vs. obese (p = 0.01), not being on hormone therapy (p < 0.001), and a tumor size > 5 cm vs. < 2 cm (p = 0.01). Conclusions Young survivors experienced significant job- and insurance-related issues following diagnosis. To the extent possible, work and insurance concerns should be addressed prior to treatment to inform work expectations and avoid unnecessary insurance difficulties.
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Affiliation(s)
- Michelle J Naughton
- Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, 43210, USA.
| | - Chloe M Beverly Hery
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH, 43210, USA
| | - Sarah A Janse
- Center for Biostatistics, Department of Biomedical Informatics, The Ohio State University, Columbus, OH, 43210, USA
| | - Elizabeth Z Naftalis
- Health Texas Community Health Services Corporate Director of Breast Services, Dallas, TX, 75001, USA
| | - Electra D Paskett
- Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, 43210, USA
| | - Kimberly J Van Zee
- Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA
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15
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Mo Y, Zhu X, Lai X, Li L. Sleep in nasopharyngeal carcinoma patients before chemotherapy, after induction chemotherapy, and after concurrent chemoradiotherapy. Med Hypotheses 2020; 144:109840. [PMID: 32505065 DOI: 10.1016/j.mehy.2020.109840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 04/27/2020] [Accepted: 05/12/2020] [Indexed: 11/17/2022]
Abstract
Sleep disturbance is frequently observed in cancer patients before, during and after oncology treatment. We explored the sleep features of patients before treatment, after induction chemotherapy, and after concurrent chemoradiotherapy for nasopharyngeal carcinoma (NPC). Ninety eligible patients diagnosed with NPC (stages III to IVc) and treated with induction chemotherapy plus concurrent chemoradiotherapy were included. The Pittsburgh Sleep Quality Index (PSQI) was applied to assess sleep before treatment, after induction chemotherapy, and after concurrent chemoradiotherapy. The median global PSQI scores in patients with NPC before treatment, after induction chemotherapy, and after concurrent chemoradiotherapy were 5, 6, and 10, respectively. The median scores of daytime dysfunction, sleep disturbance and habitual sleep efficiency were statistically significant at the pretreatment, after induction chemotherapy and after concurrent chemoradiotherapy timepoints (P < 0.049, P < 0.001 and P < 0.001, respectively). However, minimal changes were observed in all subscores after induction chemotherapy. Patients with poor sleep quality after induction chemotherapy were more prone to suffer worse sleep after concurrent chemoradiotherapy (OR = 12.6, 95%; CI = 2.4-67.3). Induction chemotherapy had less effect on the quality of sleep in NPC patients. Patients experienced a significant increase in sleep disturbance after concurrent chemoradiotherapy, particularly those with bad sleep after induction chemotherapy.
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Affiliation(s)
- Yanlin Mo
- Dept of Radiation Oncology, Guangxi Medical University Cancer Hospital, Cancer Institute of Guangxi Zhuang Autonomous Region, 71 Hedi Road, Nanning 530021, China
| | - Xiaodong Zhu
- Dept of Radiation Oncology, Guangxi Medical University Cancer Hospital, Cancer Institute of Guangxi Zhuang Autonomous Region, 71 Hedi Road, Nanning 530021, China
| | - Xiaoying Lai
- Dept of Radiation Oncology, Guangxi Medical University Cancer Hospital, Cancer Institute of Guangxi Zhuang Autonomous Region, 71 Hedi Road, Nanning 530021, China
| | - Ling Li
- Dept of Radiation Oncology, Guangxi Medical University Cancer Hospital, Cancer Institute of Guangxi Zhuang Autonomous Region, 71 Hedi Road, Nanning 530021, China.
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Symptom Care at Home: A Comprehensive and Pragmatic PRO System Approach to Improve Cancer Symptom Care. Med Care 2020; 57 Suppl 5 Suppl 1:S66-S72. [PMID: 30531525 DOI: 10.1097/mlr.0000000000001037] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION There is growing recognition that systematically obtaining the patient's perspective on their health experience, using patient-reported outcomes (PRO), can be used to improve patient care in real time. Few PRO systems are designed to monitor and provide symptom management support between visits. Patients are instructed to contact providers between visits with their concerns, but they rarely do, leaving patients to cope with symptoms alone at home. We developed and tested an automated system, Symptom Care at Home (SCH), to address this gap in tracking and responding to PRO data in-between clinic visits. The purpose of this paper is to describe SCH as an example of a comprehensive PRO system that addresses unmet need for symptom support outside the clinic. METHODS FOR PRO SCORE INTERPRETATION SCH uses pragmatic, single-item measures for assessing symptoms, which are commonly used and readily interpretable for both patients and providers. We established alerting values for PRO symptom data, which was particularly important for conserving oncology providers' time in responding to daily PRO data. METHODS FOR DEVELOPING RECOMMENDATIONS FOR ACTING ON PRO RESULTS The SCH system provides automated, just-in-time self-management coaching tailored to the specific symptom pattern and severity levels reported in the daily call. In addition, the SCH system includes a provider decision support system for follow-up symptom assessment and intervention strategies. DISCUSSION SCH provides PRO monitoring, tailored automated self-management coaching, and alerts the oncology team of poorly controlled symptoms with a provider dashboard that includes evidence-based decision support for follow-up to improve individual patients' symptom care. We particularly emphasize our process for PRO selection, rationale for determining alerting thresholds, and the design of the provider dashboard and decision support. Currently, we are in the process of updating the SCH system, developing both web-based and app versions in addition to interactive voice response phone access and integrating the SCH system in the electronic health record.
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Ekenga CC, Kwon E, Kim B, Park S. Long-Term Employment Outcomes among Female Cancer Survivors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082751. [PMID: 32316224 PMCID: PMC7215616 DOI: 10.3390/ijerph17082751] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 04/10/2020] [Accepted: 04/14/2020] [Indexed: 12/28/2022]
Abstract
Advances in early detection and treatment have led to a growing population of female cancer survivors, many of whom are of working age. We examined the relationship between cancer and long-term (>5 years) employment outcomes in a nationally representative sample of working-age women in the United States. Data from nine waves of the Health and Retirement Study were used to examine employment status and weekly hours worked among cancer survivors (n = 483) and women without cancer (n = 6605). We used random slope regression models to estimate the impact of cancer and occupation type on employment outcomes. There was no difference in employment status between cancer survivors and women without cancer at baseline; however, during follow-up, cancer survivors were more likely to be employed than women without cancer (odds ratio (OR) = 1.33, 95% confidence interval (CI): 1.11–1.58). Among 6–10-year survivors, professional workers were less likely (OR = 0.40, 95% CI: 0.21–0.74) to be employed than manual workers. Among >10-year survivors, professional workers averaged fewer weekly hours worked (−2.4 h, 95% CI: −4.4–−0.47) than manual workers. The impact of cancer on long-term employment outcomes may differ by occupation type. Identifying the occupation-specific mechanisms associated with the return to work will be critical to developing targeted strategies to promote employment in the growing female cancer survivor population.
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Affiliation(s)
- Christine C. Ekenga
- Brown School, Washington University in St. Louis, St. Louis, MO 63130, USA;
- Correspondence: ; Tel.: +1-314-935-8511
| | - Eunsun Kwon
- Department of Social Work, St. Cloud State University, St. Cloud, MN 56301, USA;
| | - BoRin Kim
- Department of Social Work, University of New Hampshire, Durham, NH 03824, USA;
| | - Sojung Park
- Brown School, Washington University in St. Louis, St. Louis, MO 63130, USA;
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18
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Lewis J, Mackenzie L, Black D. Workforce participation of Australian women with breast cancer. Psychooncology 2020; 29:1156-1164. [PMID: 32281238 DOI: 10.1002/pon.5392] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 04/05/2020] [Accepted: 04/06/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVE International research suggests that many women do not return to their previous work after breast cancer. This study aimed to identify workforce participation patterns for Australian women with breast cancer and compare these to healthy aged matched women. METHODS Using the 1946-1951 birth cohort of the Australian Longitudinal Study on Women's Health, the work status of women was compared three years before and three years after their first reported breast cancer diagnosis. Latent class analysis was used to identify workforce participation patterns of women with breast cancer and healthy aged matched women. Multinomial logistic regression examined associations between work patterns and other risk factors. RESULTS Pre and post breast cancer diagnosis work status data were available for 448 women with breast cancer between 1998 and 2010. Three years after diagnosis, 48% of full-time workers returned to full-time work but 52% returned to part time work or were not in paid work. Latent class analysis identified five classes. Women with breast cancer were more likely to be in the 'mostly full-time work' and 'mostly not in paid work' classes compared to healthy women. Odds ratios showed that women in remote areas, partnered, with less education or with chronic health condition were more likely to be 'not in paid work'. CONCLUSION Breast cancer has a negative impact on the workforce participation of Australian women. Women with breast cancer need support to return to work.
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Affiliation(s)
- Joanne Lewis
- Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Lynette Mackenzie
- Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Deborah Black
- Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
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19
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de Boer AG, Torp S, Popa A, Horsboel T, Zadnik V, Rottenberg Y, Bardi E, Bultmann U, Sharp L. Long-term work retention after treatment for cancer: a systematic review and meta-analysis. J Cancer Surviv 2020; 14:135-150. [PMID: 32162193 PMCID: PMC7182621 DOI: 10.1007/s11764-020-00862-2] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 01/29/2020] [Indexed: 12/26/2022]
Abstract
PURPOSE Almost half of people diagnosed with cancer are working age. Survivors have increased risk of unemployment, but little is known about long-term work retention. This systematic review and meta-analysis assessed work retention and associated factors in long-term cancer survivors. METHODS We searched Medline/Pubmed, Embase, PsychINFO, and CINAHL for studies published 01/01/2000-08/01/2019 reporting work retention in adult cancer survivors ≥ 2 years post-diagnosis. Survivors had to be in paid work at diagnosis. Pooled prevalence of long-term work retention was estimated. Factors associated with work retention from multivariate analysis were synthesized. RESULTS Twenty-nine articles, reporting 21 studies/datasets including 14,207 cancer survivors, were eligible. Work retention was assessed 2-14 years post-diagnosis. Fourteen studies were cross-sectional, five were prospective, and two contained both cross-sectional and prospective elements. No studies were scored as high quality. The pooled estimate of prevalence of long-term work retention in cancer survivors working at diagnosis was 0.73 (95%CI 0.69-0.77). The proportion working at 2-2.9 years was 0.72; at 3-3.9 years 0.80; at 4-4.9 years 0.75; at 5-5.9 years 0.74; and 6+ years 0.65. Pooled estimates did not differ by cancer site, geographical area, or study design. Seven studies assessed prognostic factors for work retention: older age, receiving chemotherapy, negative health outcomes, and lack of work adjustments were associated with not working. CONCLUSION Almost three-quarters of long-term cancer survivors working at diagnosis retain work. IMPLICATIONS FOR CANCER SURVIVORS These findings are pertinent for guidelines on cancer survivorship care. Professionals could focus support on survivors most likely to have poor long-term work outcomes.
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Affiliation(s)
- Angela Gem de Boer
- Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Steffen Torp
- Department of Health, Social & Welfare Studies, University College of South-Eastern Norway, Notodden, Norway
| | - Adela Popa
- Lucian Blaga University of Sibiu, Sibiu, Romania
| | - Trine Horsboel
- The Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Vesna Zadnik
- Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Yakir Rottenberg
- Sharett Institute of Oncology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Edit Bardi
- Kepler Universitäts Klinikum, Linz, Austria
| | - Ute Bultmann
- University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle upon Tyne, United Kingdom.
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Predictors of Work-Related Disability During Early Phases of Breast Cancer Treatment. Am J Phys Med Rehabil 2020; 98:627-630. [PMID: 30664010 DOI: 10.1097/phm.0000000000001138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study examined the magnitude of work-related disability in postmenopausal women with breast cancer compared with healthy controls. It also examined demographic and clinical correlates of work-related disability in postmenopausal women with breast cancer. STUDY DESIGN This was an exploratory secondary analysis of longitudinal study. OUTCOME MEASURE The Work Limitations Questionnaire measured the percentage of at-work productivity loss. RESULTS The analysis revealed a significant group-by-time interaction effect (F1,40 = 4.705, P = 0.036, partial η = .105) on work-related disability. Participants with breast cancer (mean = 2.364, SE = 0.374) had significantly higher percentage of at-work productivity loss compared with the healthy control group (mean = 1.263, SE = 0.392). At baseline, cognitive-emotional symptoms were moderately to strongly associated with work-related disability. At 6 months, physical symptoms were moderately associated with work-related disability. CONCLUSIONS Women with newly diagnosed breast cancer are likely to experience higher rates of work-related disability compared with health counterparts. Health care providers should provide intervention to parallel the shift in symptoms that lead to higher work-related disability and job cessation.
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Gao N, Ryan M, Krucien N, Robinson S, Norman R. Paid work, household work, or leisure? Time allocation pathways among women following a cancer diagnosis. Soc Sci Med 2020; 246:112776. [PMID: 31918348 DOI: 10.1016/j.socscimed.2019.112776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 12/12/2019] [Accepted: 12/20/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND There is extensive evidence on the relationship between receiving a cancer diagnosis and labour market outcomes. However, there is limited evidence on the relationship between a cancer diagnosis and non-labour market outcomes such as household work, passive leisure and physical leisure. Furthermore, most current research focuses on time allocation at a given time point, ignoring both the life course perspective and long term effects. METHODS Using data from the Australian Longitudinal Study on Women's Health (ALSWH), we observe time allocation for 91 women diagnosed with breast cancer and 486 women diagnosed with skin cancer, and 2711 women living without cancer. Our analysis is unique in combining sequence analysis and multivariate multinomial logit modelling. Using sequence analysis, we first analyse life-courses post a cancer diagnosis for paid work, household work, passive leisure and physical leisure from 2004 to 2016. Using multivariate multinomial logit modelling, we test whether a cancer diagnosis influences such life-courses. We consider the robustness of results to cancer severity and change in time allocation before and after a cancer diagnosis. RESULTS We identify three clusters for paid work and two clusters for household work, passive leisure and physical leisure. Neither a breast cancer nor skin cancer diagnosis has a significant effect on the pathways of time allocation. Such results are robust to severity of diagnosis with 'cured' and 'non-cured' breast cancer, and skin cancer treated with and without 'chemotherapy or radiotherapy'. Women post a breast cancer diagnosis are less likely to maintain their pre-cancer's time use on paid work, household work and passive leisure; however, such effects are not significant. CONCLUSION Being diagnosed with breast cancer or skin cancer has no significant long-term effect on the pathways of time allocation. Future work should explore the relationship between time allocation and wellbeing and the preference for time allocation.
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Affiliation(s)
- Ni Gao
- Health Economics Research Unit, Institute of Applied Health Sciences, University of Aberdeen, Polwarth Building, Aberdeen, AB25 2ZD, UK.
| | - Mandy Ryan
- Health Economics Research Unit, Institute of Applied Health Sciences, University of Aberdeen, Polwarth Building, Aberdeen, AB25 2ZD, UK
| | - Nicolas Krucien
- Health Economics Research Unit, Institute of Applied Health Sciences, University of Aberdeen, Polwarth Building, Aberdeen, AB25 2ZD, UK
| | - Suzanne Robinson
- Health Systems and Health Economics, School of Public Health, Curtin University, Perth, Australia
| | - Richard Norman
- Health Systems and Health Economics, School of Public Health, Curtin University, Perth, Australia
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Jeon SH, Pohl RV. Medical innovation, education, and labor market outcomes of cancer patients. JOURNAL OF HEALTH ECONOMICS 2019; 68:102228. [PMID: 31521025 DOI: 10.1016/j.jhealeco.2019.102228] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 08/19/2019] [Accepted: 08/19/2019] [Indexed: 06/10/2023]
Abstract
Innovations in cancer treatment have lowered mortality, but little is known about their economic benefits. We assess the effect of two decades of improvement in cancer treatment options on the labor market outcomes of breast and prostate cancer patients. In addition, we compare this effect across cancer patients with different levels of educational attainment. We estimate the effect of medical innovation on cancer patients' labor market outcomes employing tax return and cancer registry data from Canada and measuring medical innovation by using the number of approved drugs and a quality-adjusted patent index. We find that innovations in cancer treatment during the 1990s and 2000s reduced the negative employment effects of cancer by 63% to 70%, corresponding to a reduction in the economic costs of prostate and breast cancer diagnoses by 13,500 and 5800 dollars per year, respectively. The benefits of medical innovation are limited to cancer patients with postsecondary education.
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Affiliation(s)
- Sung-Hee Jeon
- Statistics Canada, Social Analysis and Modelling Division, R.H. Coats Building, Ottawa, ON K1A 0T6, Canada.
| | - R Vincent Pohl
- University of Georgia, Terry College of Business, Department of Economics, 620 S Lumpkin St, Athens, GA 30602, USA.
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23
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de Moor JS, Alfano CM, Kent EE, Norton WE, Coughlan D, Roberts MC, Grimes M, Bradley CJ. Recommendations for Research and Practice to Improve Work Outcomes Among Cancer Survivors. J Natl Cancer Inst 2019; 110:1041-1047. [PMID: 30252079 DOI: 10.1093/jnci/djy154] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 07/11/2018] [Indexed: 11/13/2022] Open
Abstract
Major knowledge gaps limit the development and implementation of interventions to improve employment outcomes among people with cancer. To identify research priorities to improve employment outcomes after cancer, the National Cancer Institute sponsored the meeting "Evidence-Based Approaches for Optimizing Employment Outcomes among Cancer Survivors." This article describes research recommendations stemming from the meeting. At the patient level, longitudinal studies are needed to better understand how patient sociodemographic and clinical characteristics and their experiences at work shape employment outcomes. Interventions that mitigate the impact of cancer and its treatment on employment are critical. At the provider-level, future research is needed to characterize the extent to which physicians and other healthcare providers talk to their patients about employment concerns and how that information is used to inform care. Additionally, there is a need to test models of care delivery that support routine screening of employment concerns, the capture of employment outcomes in electronic health records, and the effective use of this information to improve care. At the employer level, evidence-based training programs are needed to prepare supervisors, managers, human resources staff, and occupational health professionals to address health issues in the workplace; and future interventions are needed to improve patient -employer communication and facilitate workplace accommodations. Importantly, research is needed that reflects the perspectives and priorities of patients and their families, providers and healthcare systems, and employers. Transdisciplinary partnerships and stakeholder engagement are essential to ensure that employment-focused interventions and policies are developed, implemented, and sustained in real-world healthcare delivery and workplace settings.
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Affiliation(s)
- Janet S de Moor
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD
| | | | - Erin E Kent
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD
| | - Wynne E Norton
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD
| | - Diarmuid Coughlan
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD
| | - Megan C Roberts
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD
| | - Melvin Grimes
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD
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McLennan V, Ludvik D, Chambers S, Frydenberg M. Work after prostate cancer: a systematic review. J Cancer Surviv 2019; 13:282-291. [PMID: 30900159 DOI: 10.1007/s11764-019-00750-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Accepted: 03/09/2019] [Indexed: 01/30/2023]
Abstract
PURPOSE Research in the field of vocational rehabilitation, specifically for prostate cancer, remains rare despite increasing recognition of the role of vocational interventions in other cancer groups. The aim of this review was to compile and evaluate current trends, facilitators and barriers associated with returning to work after a prostate cancer diagnosis. METHOD The literature search was conducted in March 2018 using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Forty-seven original research papers published in English in peer-reviewed journals were identified. The included studies comprised a total of 20,083 prostate cancer patients with a mean age of 61 years. RESULTS The studies implied a good overall return to work prognosis in prostate cancer patients; however, these findings are not generalisable to those with physically demanding or low paid jobs, comorbid conditions or poor physical functioning. CONCLUSION The limited research investigating the long-term implications of prostate cancer indicates that there may be problems related to job retention and early unwanted retirement. Facilitators and barriers to employment after prostate cancer are identified and implications for vocational interventions and further research are discussed. IMPLICATIONS FOR CANCER SURVIVORS This review helps to shed light on the barriers and facilitators to employment among prostate cancer survivors, as well as the need for further research and development in vocational rehabilitation interventions for this population.
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Affiliation(s)
- Vanette McLennan
- Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia. .,School of Allied Health Sciences, Griffith University, Southport, QLD, Australia.
| | - Dominika Ludvik
- Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia
| | - Suzanne Chambers
- Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia.,University of Technology Sydney, Sydney, NSW, Australia.,Exercise Medicine Research Institute, Edith Cowan University, Perth, WA, Australia.,Institute for Resilient Regions, University of Southern Queensland, Toowoomba, QLD, Australia
| | - Mark Frydenberg
- Department of Surgery, Monash University, Clayton, Australia
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25
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Whisenant M, Wong B, Mitchell SA, Beck SL, Mooney K. Symptom Trajectories Are Associated With Co-occurring Symptoms During Chemotherapy for Breast Cancer. J Pain Symptom Manage 2019; 57:183-189. [PMID: 30453052 PMCID: PMC6348053 DOI: 10.1016/j.jpainsymman.2018.11.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 10/31/2018] [Accepted: 11/08/2018] [Indexed: 12/20/2022]
Abstract
CONTEXT Symptoms are reported to co-occur during treatment for breast cancer. We previously identified three patterns of fatigue and two patterns of disturbed sleep, depressed mood, and anxiety in women undergoing chemotherapy for breast cancer using a Latent Growth Mixture Model. OBJECTIVES The purpose of this study was to explore whether membership in symptom classes of fatigue, disturbed sleep, depressed mood, and anxiety is associated with other symptoms at moderate-to-severe levels. METHODS Using data from three longitudinal studies, Wilcoxon rank-sum tests and Jonckheere-Terpstra tests for trend were used to distinguish between classes of women on co-occurring symptoms. Summative scores were calculated, including the number of days subjects reported moderate-to-severe levels (4 or higher on a 0-10 scale) of seven symptoms during two cycles of chemotherapy and compared to class membership. RESULTS Participants (n = 166) in the higher fatigue severity class reported more days with moderate-to-severe disturbed sleep, depressed mood, anxiety, nausea, and trouble thinking. Women in the higher severity disturbed sleep class reported more days with moderate-to-severe fatigue, depressed mood, anxiety, and trouble thinking. Women in the higher depressed mood severity class reported more days with moderate-to-severe fatigue, disturbed sleep, anxiety, and nausea. Women in the higher anxiety severity class reported more days with moderate-to-severe fatigue, disturbed sleep, and depressed mood. CONCLUSION Moderate-to-severe symptoms co-occur during cancer treatment for breast cancer. The dynamic process of multiple symptoms may be altered by future identification of a shared etiology.
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Affiliation(s)
- Meagan Whisenant
- The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
| | - Bob Wong
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
| | - Sandra A Mitchell
- Outcomes Research Branch, National Cancer Institute, Rockville, Maryland, USA
| | - Susan L Beck
- College of Nursing, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA
| | - Kathi Mooney
- College of Nursing, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA
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26
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Patient and provider communication about employment following a cancer diagnosis. J Cancer Surviv 2018; 12:813-820. [PMID: 30284114 DOI: 10.1007/s11764-018-0718-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 09/18/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE Cancer treatment can precipitate functional limitations that restrict survivors' ability to work. Yet, it is unclear whether healthcare providers discuss the potential for employment limitations with their patients. We assessed the frequency of patient-provider communication about employment, from the perspectives of survivors, and examined whether receiving a treatment summary was associated with employment communication. METHODS Cancer survivors who were working at diagnosis were identified from the Health Information National Trends Survey-4, conducted in 2014 (n = 290). Separate multivariable regression analyses examined the associations between survivor characteristics and employment communication and receipt of a treatment summary and employment communication. RESULTS Among cancer survivors who were working at diagnosis, 62.69% (95% CI 54.42-70.95) reported discussing employment with any healthcare provider at any time since diagnosis. Younger cancer survivors and those more recently treated were more likely to ever have employment discussions. Survivors who received a treatment summary were also more likely to ever discuss employment with any healthcare provider than survivors who did not receive a treatment summary (OR = 3.47, 95% CI 1.02-11.84). CONCLUSIONS Approximately two thirds of cancer survivors who were working at diagnosis ever discussed employment with a healthcare provider. Thus, for a sizable portion of cancer survivors, the potential impact of cancer on employment is never discussed with any healthcare provider. IMPLICATIONS FOR CANCER SURVIVORS Efforts are needed to proactively screen patients for cancer-related work limitations, empower patients to discuss employment concerns with their healthcare providers, and develop interventions that support survivors' goals for working throughout treatment and recovery.
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27
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Swanberg JE, Nichols HM, Vanderpool RC, Rosenblatt P, Tracy JK. Working poor and working nonpoor cancer survivors: Work-related and employment disparities. Cancer Rep (Hoboken) 2018; 1:e1134. [PMID: 32729229 DOI: 10.1002/cnr2.1134] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 08/06/2018] [Accepted: 08/10/2018] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Many cancer survivors face challenges remaining at work during treatment or returning to work posttreatment. Workplace supports can ease the strain associated with managing the cancer-work interface. Limited research has examined the employment experiences of low-wage earning survivors, who are less likely to have access to workplace supports, overlooking a factor that may influence survivors' employment outcomes. AIMS This study assessed differences in employment experiences between working poor (WP) and working nonpoor (WNP) cancer survivors in the United States. METHODS AND RESULTS Data from the 2011 Medical Expenditure Panel Survey (MEPS) and the 2011 MEPS Experiences with Cancer Survivorship Supplement were analyzed to evaluate differences in workplace supports, cancer-related psychological job distress, productivity, and employment outcomes between WP and WNP cancer survivors. The sample included adults diagnosed with cancer within 5 years prior to survey completion and engaged in paid employment since diagnosis. Working poor respondents had income below 200% of the poverty level. Chi-square tests assessed differences between WP (n = 57) and WNP (n = 164) cancer survivors' demographic, cancer, and employment characteristics; cancer-related psychological job distress; employee productivity; and employment outcome measures. Multiple logistic regression analyses determined the independent association between WP status and these same variables controlling for sociodemographic confounders. Working poor survivors were more likely to take unpaid time off, change from full-time to part-time, to report cancer-related psychological job distress, negative influences on job productivity and employment outcomes, and less likely to have health insurance. In logistic regression analyses, those who took unpaid time off were more likely to be WP; being WP was also associated with poorer employment outcomes, after controlling for sociodemographics differences between WP and WNP. CONCLUSION Working poor survivors had fewer workplace supports and poorer employment outcomes than WNP survivors, highlighting important occupational disparities for cancer survivors. Areas for future research are discussed.
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Affiliation(s)
- Jennifer E Swanberg
- Department of Health Policy and Management, School of Professional Studies, Providence College, Providence, Rhode Island.,University of Maryland School of Social Work, Baltimore, Maryland.,Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland.,University of Maryland Greenebaum Comprehensive Cancer Center
| | - Helen M Nichols
- University of Maryland School of Social Work, Baltimore, Maryland
| | - Robin C Vanderpool
- Department of Health, Behavior & Society, College of Public Health, University of Kentucky, Lexington, Kentucky
| | - Paula Rosenblatt
- Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland.,University of Maryland Greenebaum Comprehensive Cancer Center
| | - J Kathleen Tracy
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland.,Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland.,University of Maryland Greenebaum Comprehensive Cancer Center
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28
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Candon D. The effect of cancer on the labor supply of employed men over the age of 65. ECONOMICS AND HUMAN BIOLOGY 2018; 31:184-199. [PMID: 30292988 DOI: 10.1016/j.ehb.2018.08.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 07/21/2018] [Accepted: 08/24/2018] [Indexed: 06/08/2023]
Abstract
This paper investigates the relationship between cancer diagnosis and the labor supply of employed men over the age of 65. While almost 60% of male cancers are diagnosed in men over the age of 65, no previous research has examined the effect that cancer has on this age group, which is surprising given the relevance of this group to public policy. With data from the Health and Retirement Study, I show that cancer has a significant negative effect on the labor supply of these workers. Using a combination of linear regression models and propensity score matching, I find that respondents who are diagnosed with cancer work 3 fewer hours per week than their non-cancer counterparts. They are also 10 percentage points more likely to stop working. This reduction seems to be driven by a deterioration in physical and mental health.
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Affiliation(s)
- David Candon
- School of Economics, University of Edinburgh, 30 Buccleuch Place, Edinburgh EH8 9JT, UK.
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29
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Ullrich A, Rath HM, Otto U, Kerschgens C, Raida M, Hagen-Aukamp C, Bergelt C. Return to work in prostate cancer survivors - findings from a prospective study on occupational reintegration following a cancer rehabilitation program. BMC Cancer 2018; 18:751. [PMID: 30029637 PMCID: PMC6053748 DOI: 10.1186/s12885-018-4614-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 06/20/2018] [Indexed: 01/21/2023] Open
Abstract
Background This prospective multicentre-study aimed to analyze return to work (RTW) among prostate cancer survivors 12 months after having attended a cancer rehabilitation program and to identify risk factors for no and late RTW. Methods Seven hundred eleven employed prostate cancer survivors treated with radical prostatectomy completed validated self-rating questionnaires at the beginning, the end, and 12 months post rehabilitation. Disease-related data was obtained from physicians and medical records. Work status and time until RTW were assessed at 12-months follow-up. Data were analyzed by univariate analyses (t-tests, chi-square-tests) and multivariate logistic regression models (OR with 95% CI). Results The RTW rate at 12-months follow-up was 87% and the median time until RTW was 56 days. Univariate analyses revealed significant group differences in baseline personal characteristics and health status, psychosocial well-being and work-related factors between survivors who had vs. had not returned to work. Patients’ perceptions of not being able to work (OR 3.671) and feeling incapable to return to the former job (OR 3.162) were the strongest predictors for not having returned to work at 12-months follow-up. Being diagnosed with UICC tumor stage III (OR 2.946) and patients’ perceptions of not being able to work (OR 4.502) were the strongest predictors for late RTW (≥ 8 weeks). Conclusions A high proportion of prostate cancer survivors return to work after a cancer rehabilitation program. However, results indicate the necessity to early identify survivors with low RTW motivation and unfavorable work-related perceptions who may benefit from intensified occupational support during cancer rehabilitation. Electronic supplementary material The online version of this article (10.1186/s12885-018-4614-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anneke Ullrich
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Martinistrasse 52, 20246, Hamburg, Germany.
| | - Hilke Maria Rath
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Martinistrasse 52, 20246, Hamburg, Germany
| | - Ullrich Otto
- Rehabilitation Clinics Hartenstein GmbH, Clinic Quellental, Bad Wildungen, Germany
| | | | - Martin Raida
- HELIOS Rehabilitation Clinic Bergisch-Land, Wuppertal, Germany
| | | | - Corinna Bergelt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Martinistrasse 52, 20246, Hamburg, Germany
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30
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Whisenant M, Wong B, Mitchell SA, Beck SL, Mooney K. Distinct Trajectories of Fatigue and Sleep Disturbance in Women Receiving Chemotherapy for Breast Cancer. Oncol Nurs Forum 2017; 44:739-750. [PMID: 29052653 PMCID: PMC5856248 DOI: 10.1188/17.onf.739-750] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE/OBJECTIVES To examine self-reported severity of fatigue and disturbed sleep experienced daily by women with breast cancer during multiple cycles of chemotherapy, exploring potential classes of women experiencing similar symptom trajectories.
. DESIGN In a secondary analysis, classes of women experiencing similar patterns of fatigue and disturbed sleep were identified.
. SETTING Oncology clinics in the United States.
. SAMPLE 166 women with breast cancer receiving chemotherapy.
. METHODS Severity scores were self-reported daily using an automated system. Classes of fatigue and disturbed sleep severity were identified using latent growth mixture modeling.
. MAIN RESEARCH VARIABLES Fatigue, disturbed sleep, age, stage of disease, education, employment, marital status, chemotherapy regimen, hours lying down, and missed work.
. FINDINGS Three fatigue classes were identified. CONCLUSIONS Patterns of symptom trajectories for fatigue and disturbed sleep were distinguished by baseline symptom severity.
. IMPLICATIONS FOR NURSING Identification of women at risk for fatigue and disturbed sleep may allow clinicians to intensify symptom management.
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31
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Alfano CM, Kent EE, Padgett LS, Grimes M, de Moor JS. Making Cancer Rehabilitation Services Work for Cancer Patients: Recommendations for Research and Practice to Improve Employment Outcomes. PM R 2017; 9:S398-S406. [PMID: 28942911 PMCID: PMC5657535 DOI: 10.1016/j.pmrj.2017.06.019] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 06/21/2017] [Accepted: 06/23/2017] [Indexed: 12/31/2022]
Abstract
Cancer and its treatment can result in impairments that limit physical, psychosocial, and cognitive functioning, interfering with patients' ability to perform work-related functions. Because these work limitations can carry significant personal and societal costs, there is a timely need to identify and refer patients to cancer rehabilitation services to manage adverse consequences of treatment and to preserve employment. Coordinated efforts in 3 key areas will better connect patients to rehabilitation interventions that will help optimize employment. These include the following: planning for the impact of cancer on the ability to work; implementing routine screening for impairments and facilitating referrals to cancer rehabilitation specialists; and focusing rehabilitation interventions on preserving employment. Coordinated strategies are presented to achieve these 3 goals, including the following: implementing changes to clinical practice to routinely screen for impairments; working with oncology providers and patients to better understand the benefits of cancer rehabilitation to facilitate referrals and uptake; training more cancer rehabilitation providers to handle the increased need; better coordination of care across providers and with employers; and filling research gaps needed to proactively anticipate how cancer treatment would affect work for a given patient and deploy personalized interventions to preserve the ability to work.
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Affiliation(s)
- Catherine M Alfano
- American Cancer Society, Inc, 555 11th St NW, Suite 300, Washington, DC 20004(∗).
| | - Erin E Kent
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD(†)
| | | | - Melvin Grimes
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD(§)
| | - Janet S de Moor
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD(‖)
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32
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Stergiou-Kita M, Qie X, Yau HK, Lindsay S. Stigma and work discrimination among cancer survivors: A scoping review and recommendations: Stigmatisation et discrimination au travail des survivants du cancer : Examen de la portée et recommandations. The Canadian Journal of Occupational Therapy 2017; 84:178-188. [PMID: 28608726 DOI: 10.1177/0008417417701229] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Stigma and workplace discrimination can hinder employment opportunities for cancer survivors. PURPOSE This study explored perceptions of stigma and workplace discrimination for cancer survivors to understand the impact on survivors' engagement in paid work and to identify strategies to address stigma and workplace discrimination. METHOD Using Arksey and O'Malley's framework, we searched Medline, Embase, PsycINFO, Scopus, and CINAHL for evidence that intersected three concepts: cancer, stigma, and employment/workplace discrimination. Of the 1,514 articles initially identified, 39 met our inclusion criteria. Findings were charted, collated, and analyzed using content analysis. FINDINGS Myths regarding cancer (i.e., it is contagious, will always result in death) persist and can create misperceptions regarding survivors' employability and lead to self-stigmatization. Workplace discrimination may include hiring discrimination, harassment, job reassignment, job loss, and limited career advancement. Strategies to mitigate stigma and workplace discrimination include education, advocacy, and antidiscrimination policies. IMPLICATIONS Occupational therapists can enhance awareness of workplace concerns and advocate on behalf of cancer survivors.
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33
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Development of a return-to-work planning tool for cancer survivors. The Canadian Journal of Occupational Therapy 2017; 84:223-228. [DOI: 10.1177/0008417417700916] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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34
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Jeon SH. The Long-Term Effects of Cancer on Employment and Earnings. HEALTH ECONOMICS 2017; 26:671-684. [PMID: 27045223 DOI: 10.1002/hec.3342] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2015] [Revised: 02/22/2016] [Accepted: 02/26/2016] [Indexed: 06/05/2023]
Abstract
The study examines long-term effects of cancer on the work status and annual earnings of cancer survivors who had a strong attachment to the labor market prior to their cancer diagnosis. We use linkage data combining Canadian 1991 Census microdata with administrative records from the Canadian Cancer Registry, the Vital Statistics Registry and longitudinal personal income tax records. We estimate changes in the magnitude of cancer effects during the first 3 years following the year of the diagnosis using a large sample of cancer survivors diagnosed at ages 25 to 61. The comparison group consists of similar workers never diagnosed with cancer. The empirical strategy combines coarsened exact matching and regression models to deal with observed and unobserved differences between the cancer and comparison groups. The results show moderate negative cancer effects on work status and annual earnings. Over the 3-year period following the year of the diagnosis, the probability of working is 5 percentage points lower for cancer survivors than for the comparison group, and their earnings are 10% lower. Our findings also suggest that the effects of cancer on labor market outcomes differ for high and low survival rate cancer categories. Copyright © 2016 John Wiley & Sons, Ltd.
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35
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Chen SQ, Liu JE, Zhang ZX, Li Z. Self-acceptance and associated factors among Chinese women with breast cancer. J Clin Nurs 2017; 26:1516-1523. [PMID: 27322368 DOI: 10.1111/jocn.13437] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Shuang-Qin Chen
- School of Nursing; Capital Medical University; Beijing China
| | - Jun-E Liu
- School of Nursing; Capital Medical University; Beijing China
| | - Zhi-Xia Zhang
- Nursing Department; Linfen Fourth People's Hospital; Linfen China
| | - Zhi Li
- School of Nursing; Capital Medical University; Beijing China
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36
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Jeon SH, Pohl RV. Health and work in the family: Evidence from spouses' cancer diagnoses. JOURNAL OF HEALTH ECONOMICS 2017; 52:1-18. [PMID: 28157587 DOI: 10.1016/j.jhealeco.2016.12.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 12/09/2016] [Accepted: 12/30/2016] [Indexed: 06/06/2023]
Abstract
Using Canadian administrative data from multiple sources, we provide the first nationally representative estimates for the effect of spouses' cancer diagnoses on individuals' employment and earnings and on family income. Our identification strategy exploits unexpected health shocks and combines matching with individual fixed effects in a generalized difference-in-differences framework to control for observable and unobservable heterogeneity. While the effect of spousal health shocks on labor supply is theoretically ambiguous, we find strong evidence for a decline in employment and earnings of individuals whose spouses are diagnosed with cancer. We interpret this result as individuals reducing their labor supply to provide care to their sick spouses and to enjoy joint leisure. Family income substantially declines after spouses' cancer diagnoses, suggesting that the financial consequences of such health shocks are considerable.
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Affiliation(s)
- Sung-Hee Jeon
- Statistics Canada, Social Analysis and Modelling Division, R.H. Coats Building, Ottawa, ON K1A 0T6, Canada.
| | - R Vincent Pohl
- University of Georgia, Terry College of Business, Department of Economics, 310 Herty Dr, Athens, GA 30602, USA.
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37
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Banegas MP, Guy GP, de Moor JS, Ekwueme DU, Virgo KS, Kent EE, Nutt S, Zheng Z, Rechis R, Yabroff KR. For Working-Age Cancer Survivors, Medical Debt And Bankruptcy Create Financial Hardships. Health Aff (Millwood) 2017; 35:54-61. [PMID: 26733701 DOI: 10.1377/hlthaff.2015.0830] [Citation(s) in RCA: 188] [Impact Index Per Article: 26.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The rising medical costs associated with cancer have led to considerable financial hardship for patients and their families in the United States. Using data from the LIVESTRONG 2012 survey of 4,719 cancer survivors ages 18-64, we examined the proportions of survivors who reported going into debt or filing for bankruptcy as a result of cancer, as well as the amount of debt incurred. Approximately one-third of the survivors had gone into debt, and 3 percent had filed for bankruptcy. Of those who had gone into debt, 55 percent incurred obligations of $10,000 or more. Cancer survivors who were younger, had lower incomes, and had public health insurance were more likely to go into debt or file for bankruptcy, compared to those who were older, had higher incomes, and had private insurance, respectively. Future longitudinal population-based studies are needed to improve understanding of financial hardship among US working-age cancer survivors throughout the cancer care trajectory and, ultimately, to help stakeholders develop evidence-based interventions and policies to reduce the financial hardship of cancer.
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Affiliation(s)
- Matthew P Banegas
- Matthew P. Banegas is an investigator at the Kaiser Permanente Center for Health Research, in Portland, Oregon
| | - Gery P Guy
- Gery P. Guy Jr. is a health economist at the Centers for Disease Control and Prevention (CDC), in Atlanta, Georgia
| | - Janet S de Moor
- Janet S. de Moor is a program director in the Division of Cancer Control and Population Sciences, at the National Cancer Institute (NCI), in Bethesda, Maryland
| | | | - Katherine S Virgo
- Katherine S. Virgo is an adjunct professor in the Department of Health Policy and Management at Emory University, in Atlanta
| | - Erin E Kent
- Erin E. Kent is an epidemiologist and program director in the Outcomes Research Branch, Applied Research Program, Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, at the NCI
| | - Stephanie Nutt
- Stephanie Nutt is a program manager at the LIVESTRONG Foundation, in Austin, Texas
| | - Zhiyuan Zheng
- Zhiyuan Zheng is a senior epidemiologist at the American Cancer Society in Atlanta, Georgia
| | - Ruth Rechis
- Ruth Rechis is vice president of programs and strategy at the LIVESTRONG Foundation
| | - K Robin Yabroff
- K. Robin Yabroff is an epidemiologist in the Division of Cancer Control and Population Sciences at the NCI
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Ah D, Storey S, Tallman E, Nielsen A, Johns S, Pressler S. Cancer, Cognitive Impairment, and Work-Related Outcomes: An Integrative Review. Oncol Nurs Forum 2016; 43:602-16. [DOI: 10.1188/16.onf.602-616] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Yao N, Wang J, Cai Y, Yuan J, Wang H, Gong J, Anderson R, Sun X. Patterns of cancer screening, incidence and treatment disparities in China: protocol for a population-based study. BMJ Open 2016; 6:e012028. [PMID: 27491672 PMCID: PMC4985820 DOI: 10.1136/bmjopen-2016-012028] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION Cancer has become the leading cause of death in China. Several knowledge gaps exist with respect to the patterns of cancer care and disparities in China. Chinese healthcare researchers do not have access to cancer research data of high quality. Only cancer incidence and mortality rates have been analysed in China while the patterns of cancer screening and treatment and disparities have not been rigorously examined. Potential disparities in cancer care by socioeconomic status have not been analysed in the previous literature. Population-based estimates of cancer care costs remain unexamined in China. This project will depict the pattern of cancer screening, incidence and treatment in Shandong province and enhance our understanding of causes of disparities in cancer control. METHODS AND ANALYSIS We will create the first linked database of cancer registry and health insurance claims in China. We obtained cancer registry data on breast, gastrointestinal and lung cancer incidence from 2011 to 2014 and their health insurance claims information from 6 cities/counties of 10.63 million population and validated it with hospital discharge data. A 1600 participant survey will be administered to collect additional information of patients' socioeconomic status, employment and cancer care costs. Frequency analysis, spatial data exploratory analysis, multivariate logistic regression with instrumental variable, generalised linear regression and subgroup analysis will be used to analyse the following: the receipt of cancer screening, stage at diagnosis, guideline-concordant treatment and cancer care costs. Patient characteristics, tumour features, hospital characteristics, patient comorbidities and county-level descriptors will be used as covariates in the multivariate analysis. ETHICS AND DISSEMINATION The Institutional Review Board of the School of Public Health of Shandong University approved this study (20140201). Data compiled from this project will be made available to all Chinese healthcare researchers. Study results will be disseminated through peer-reviewed publications and presentations at national and international meetings.
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Affiliation(s)
- Nengliang Yao
- Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia, USA
| | - Jialin Wang
- Shandong Provincial Cancer Hospital Affiliated to Shandong University, Shandong Academy of Medical Sciences, Jinan, China
| | - Yuanchu Cai
- Center for Health Management and Policy (Key Laboratory of Health Economics and Policy, National Health and Family Planning Commission), Shandong University, Jinan, China
| | - Jing Yuan
- School of Public Health and Management, Binzhou Medical University, Yantai, China
| | - Haipeng Wang
- Center for Health Management and Policy (Key Laboratory of Health Economics and Policy, National Health and Family Planning Commission), Shandong University, Jinan, China
| | - Jiyong Gong
- Shandong Provincial Cancer Hospital Affiliated to Shandong University, Shandong Academy of Medical Sciences, Jinan, China
| | - Roger Anderson
- Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia, USA
| | - Xiaojie Sun
- Center for Health Management and Policy (Key Laboratory of Health Economics and Policy, National Health and Family Planning Commission), Shandong University, Jinan, China
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Zanville NR, Nudelman KNH, Smith DJ, Von Ah D, McDonald BC, Champion VL, Saykin AJ. Evaluating the impact of chemotherapy-induced peripheral neuropathy symptoms (CIPN-sx) on perceived ability to work in breast cancer survivors during the first year post-treatment. Support Care Cancer 2016; 24:4779-89. [PMID: 27470258 PMCID: PMC5031751 DOI: 10.1007/s00520-016-3329-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 07/03/2016] [Indexed: 12/25/2022]
Abstract
Purpose To describe the impact of chemotherapy-induced peripheral neuropathy symptoms (CIPN-sx) on breast cancer survivors’ (BCS) perceived ability to work post-treatment. Methods The sample included 22 chemotherapy-treated (Ctx+) and 22 chemotherapy-naïve (Ctx−) female BCS. Data was collected at the following three time points: baseline (post-surgery, pre-chemotherapy), 1 month (1 M) post-chemotherapy, and approximately 1 year (1 Y) later. The presence, frequency, number, and severity of CIPN-sx were self-reported using the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group–Neurotoxicity questionnaire (FACT/GOG-Ntx) version 4, a validated 11-item CIPN measure. Perceived ability to work was measured using an item from the Functional Well-Being subscale of the FACT/GOG-Ntx. Results At 1 Y, more than 50 % of Ctx+ reported discomfort, numbness, or tingling in their hands or feet; weakness; or difficulty feeling small objects. The presence, number, and severity of these symptoms were correlated with being less able to work for Ctx+ at 1 M but not 1 Y. Results of a regression analysis using CIPN-sx to predict work ability found that models combining (1) hand numbness and trouble feeling small objects, (2) trouble buttoning buttons and trouble feeling small objects, (3) foot numbness and foot pain, (4) foot numbness and trouble walking, and (5) trouble hearing and hand pain each predicted survivors who were “not at all” able to work at 1 M. Conclusions Unresolved CIPN-sx may play a role in challenges working for BCS post-treatment. These findings highlight the need for research to explore the impact that CIPN-sx have on BCS’ ability to work, as well as the development of interventions to improve work function in BCS with CIPN-sx.
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Affiliation(s)
- Noah R Zanville
- Department of Community & Health Systems, School of Nursing, Indiana University, Indianapolis, IN, USA. .,Training in Research for Behavioral Oncology and Cancer Control Program, Indiana University School of Nursing, Indianapolis, IN, USA.
| | - Kelly N H Nudelman
- Training in Research for Behavioral Oncology and Cancer Control Program, Indiana University School of Nursing, Indianapolis, IN, USA.,Department of Medical and Molecular Genetics, School of Medicine, Indiana University, Indianapolis, IN, USA.,Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Dori J Smith
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Diane Von Ah
- Department of Community & Health Systems, School of Nursing, Indiana University, Indianapolis, IN, USA
| | - Brenna C McDonald
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA.,Indiana University Melvin and Bren Simon Cancer Center, Indiana University, School of Medicine, Indianapolis, IN, USA.,Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Victoria L Champion
- Department of Community & Health Systems, School of Nursing, Indiana University, Indianapolis, IN, USA.,Training in Research for Behavioral Oncology and Cancer Control Program, Indiana University School of Nursing, Indianapolis, IN, USA.,Indiana University Melvin and Bren Simon Cancer Center, Indiana University, School of Medicine, Indianapolis, IN, USA
| | - Andrew J Saykin
- Department of Medical and Molecular Genetics, School of Medicine, Indiana University, Indianapolis, IN, USA.,Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA.,Indiana University Melvin and Bren Simon Cancer Center, Indiana University, School of Medicine, Indianapolis, IN, USA.,Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA
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Bradley CJ. Economic recovery: A measure of the quality of cancer treatment and survivorship? Cancer 2015; 121:4282-5. [DOI: 10.1002/cncr.29511] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 05/20/2015] [Accepted: 05/21/2015] [Indexed: 11/07/2022]
Affiliation(s)
- Cathy J. Bradley
- Department of Healthcare Policy and Research; Virginia Commonwealth University; Richmond Virginia
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Kamau C. Preparing patients with cancer who work and treatment responsiveness. BMJ Support Palliat Care 2015; 7:94-97. [PMID: 26364666 DOI: 10.1136/bmjspcare-2015-000870] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Revised: 05/10/2015] [Accepted: 08/16/2015] [Indexed: 11/03/2022]
Abstract
BACKGROUND Many patients with life-limiting illnesses continue to work because of financial reasons and because work provides good psychosocial support. A lack of appropriate advice/support through patient education could, however, make having a job detrimental to well-being (eg, symptom worsening). AIM This study investigated the frequency with which patients received information that empowers their understanding of their condition, treatment, side effects of treatment and the likely impact on occupational functioning. DESIGN A cross-sectional study. SETTING/PARTICIPANTS An analysis of survey data from 3457 patients with cancer in employment. RESULTS Logistic regression showed that patients who received information about the impact of cancer on work life or education are 1.72 times more likely to have a positive treatment outcome. Patients who receive written information about the type of cancer are 1.99 times more likely to have a positive treatment outcome. Also, patients who receive written information before a cancer-related operation are 1.90 times more likely to have a positive treatment outcome. Information about the side effects of cancer treatment produces worse odds of a positive treatment outcome (0.65-1). A stepwise logistic regression analysing the effects irrespective of current employment status in 6710 patients showed that preparing them produces nearly twice better odds of cancer treatment responsiveness. CONCLUSIONS Palliative care teams should consider ways of actively advising patients who work. Whereas the results showed evidence of good practice in cancer care, there is a need to ensure that all working patients with potentially life-limiting illnesses receive similar support.
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Candon D. The effects of cancer on older workers in the English labour market. ECONOMICS AND HUMAN BIOLOGY 2015; 18:74-84. [PMID: 25965970 DOI: 10.1016/j.ehb.2015.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 03/04/2015] [Accepted: 04/14/2015] [Indexed: 06/04/2023]
Abstract
The continued rise in overall cancer survival rates has ignited a field of research which examines the effect that cancer has on survivors' employment. Previous estimates of the effect of cancer on labour market outcomes, using U.S. data, show significant reductions in employment in the first 6 months after diagnosis. However, this impact has been found to dissipate after 12 and 18 months. I use data from the English Longitudinal Study of Ageing and find that, in England, where there is a more generous welfare support system, not only does cancer have a negative impact in the first 6-month period following diagnosis, but also in the second 6-month period. I estimate that, in the second 6-month period after diagnosis, respondents with cancer are 12.2% points less likely to work and work 4.2 fewer hours a week when compared to matched, healthy controls. This suggests that the negative effects from cancer can persist for longer than the six months identified previously. These results have implications for government policy and employers, because it increases the length of time that survivors may be on government supported sick pay, and the expected time that workers will be absent from work due to illness.
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Affiliation(s)
- David Candon
- School of Economics and Geary Institute, University College Dublin, Ireland.
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Li C, Li C, Forsythe L, Lerro C, Soni A. Mental health services utilization and expenditures associated with cancer survivorship in the United States. J Cancer Surviv 2015; 9:50-8. [PMID: 25108481 PMCID: PMC4492105 DOI: 10.1007/s11764-014-0392-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Accepted: 07/22/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE The aim of this study is to assess mental health services utilization and expenditures associated with cancer history using a nationally representative sample in the US. METHODS We used data from the 2008-2011 Medical Expenditure Panel Survey and multivariate regression models to assess mental health services use and expenditures among cancer survivors compared to individuals without a cancer history, stratified by age (18-64 and ≥65 years) and time since diagnosis (≤1 vs. >1 year). RESULTS Among adults aged 18-64, compared with individuals without a cancer history, cancer survivors were more likely to screen positive for current psychological distress and depression regardless of time since diagnosis; survivors diagnosed >1 year ago were more likely to use mental health prescription drugs; those diagnosed within 1 year reported significantly lower annual per capita mental health drug expenditure and out-of-pocket mental health expenditure, while those diagnosed >1 year presented significantly higher annual per capita mental health expenditure. No significant differences in mental health expenditures were found among adults aged 65 or older. CONCLUSIONS Mental health problems presented higher health and economic burden among younger and longer-term survivors than individuals without a cancer history. This study provides data for monitoring the impact of initiatives to enhance coverage and access for mental health services at the national level. IMPLICATIONS FOR CANCER SURVIVORS Early detection and appropriate treatment of mental health problems may help improve quality of cancer survivorship.
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Affiliation(s)
- Chunyu Li
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS F-76, Atlanta, GA, 30341-3724, USA,
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Miller SM, Hudson SV, Hui SKA, Diefenbach MA, Fleisher L, Raivitch S, Belton T, Roy G, Njoku A, Scarpato J, Viterbo R, Buyyounouski M, Denlinger C, Miyamoto C, Reese A, Baman J. Development and preliminary testing of PROGRESS: a Web-based education program for prostate cancer survivors transitioning from active treatment. J Cancer Surviv 2015; 9:541-53. [PMID: 25697335 DOI: 10.1007/s11764-015-0431-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 01/22/2015] [Indexed: 01/01/2023]
Abstract
PURPOSE This formative research study describes the development and preliminary evaluation of a theory-guided, online multimedia psycho-educational program (PROGRESS) designed to facilitate adaptive coping among prostate cancer patients transitioning from treatment into long-term survivorship. METHODS Guided by the Cognitive-Social Health Information Processing Model (C-SHIP) and using health communications best practices, we conducted a two-phase, qualitative formative research study with early stage prostate cancer patients (n = 29) to inform the Web program development. Phase 1 included individual (n = 5) and group (n = 12) interviews to help determine intervention content and interface. Phase 2 employed iterative user/usability testing (n = 12) to finalize the intervention. Interview data were independently coded and collectively analyzed to achieve consensus. RESULTS Survivors expressed interest in action-oriented content on (1) managing treatment side effects, (2) handling body image and comorbidities related to overweight/obesity, (3) coping with emotional and communication issues, (4) tips to reduce disruptions of daily living activities, and (5) health skills training tools. Patients also desired the use of realistic and diverse survivor images. CONCLUSIONS Incorporation of an established theoretical framework, application of multimedia intervention development best practices, and an evidence-based approach to content and format resulted in a psycho-educational tool that comprehensively addresses survivors' needs in a tailored fashion. IMPLICATIONS FOR CANCER SURVIVORS The results suggest that an interactive Web-based multimedia program is useful for survivors if it covers the key topics of symptom control, emotional well-being, and coping skills training; this tool has the potential to be disseminated and implemented as an adjunct to routine clinical care.
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Affiliation(s)
- Suzanne M Miller
- Department of Psychosocial and Behavioral Medicine, Fox Chase Cancer Center/Temple University Health System, Robert C. Young Pavilion, 333 Cottman Avenue-4th Floor, Philadelphia, PA, 19111, USA,
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Egestad H, Nieder C. Undesirable financial effects of head and neck cancer radiotherapy during the initial treatment period. Int J Circumpolar Health 2015; 74:26686. [PMID: 25623815 PMCID: PMC4306757 DOI: 10.3402/ijch.v74.26686] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 12/15/2014] [Accepted: 12/16/2014] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Healthcare cost and reforms are at the forefront of international debates. One of the current discussion themes in oncology is whether and how patients' life changes due to costs of cancer care. In Norway, the main part of the treatment costs is supported by general taxpayer revenues. OBJECTIVES The objective of this study was to clarify whether head and neck cancer patients (n=67) in northern Norway experienced financial health-related quality of life (HRQOL) deterioration due to costs associated with treatment. DESIGN HRQOL was examined by the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 in the beginning and in the end of radiation treatment in patients treated at the University Hospital in Northern Norway. Changes in financial HRQOL were calculated and compared by paired sample T-tests. Multiple regression analyses were used to examine correlations among gender, marital status, age and treatment with or without additional chemotherapy and changes in the HRQOL domain of financial difficulties. RESULTS The majority of score results at both time points were in the lower range (mean 15-25), indicating limited financial difficulties. We observed no statistically significant differences by gender, marital status and age. Increasing financial difficulties during treatment were reported by male patients and those younger than 65, that is, patients who were younger than retirement age. The largest effect was seen in singles. However, differences were not statistically significant. CONCLUSIONS During the initial phase of the disease trajectory, no significant increase in financial difficulties was found. This is in line with the aims of the Norwegian public healthcare model. However, long-term longitudinal studies should be performed, especially with regard to the trends we observed in single, male and younger patients.
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Affiliation(s)
- Helen Egestad
- Faculty of Health Sciences, Department of Health and Care Sciences, UiT, The Arctic University of Norway, Tromsø, Norway;
| | - Carsten Nieder
- Faculty of Health Sciences, Department of Health and Care Sciences, UiT, The Arctic University of Norway, Tromsø, Norway; Department of Oncology and Palliative Medicine, Nordland Hospital, Bodø, Norway
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Working situation of cancer survivors versus the general population. J Cancer Surviv 2014; 9:349-60. [PMID: 25492237 DOI: 10.1007/s11764-014-0418-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Accepted: 11/21/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE The purposes of this study were to compare the working situation of cancer survivors and the general (cancer-free) population and investigate characteristics associated with the increased likelihood of unemployment between the two groups. METHODS We selected 1927 cancer survivors from the 2008 Korean Community Health Survey data less than 65 years of age and used propensity score matching to randomly select 1924 individuals from the general population who closely resembled the cancer survivors. RESULTS Compared to the general population, cancer survivors were less likely to be engaged in paid work, particularly as permanent workers, and were more likely to work regular hours. Additionally, they tended to do less work that involved lifting or moving heavy objects and uncomfortable postures and were more willing to express their emotions. An increased probability of unemployment among cancer survivors was associated with being over 50 years old, being female, having a lower monthly income, having multiple comorbidities, belonging to a nuclear family, being a National Basic Livelihood Act beneficiary, and having a recent diagnosis. CONCLUSION Cancer survivors may want to pursue flexible occupations and improve their working situation. Further, they perceive their workplace more positively compared to the general population. IMPLICATIONS FOR CANCER SURVIVORS Respecting the cancer survivor's choice to find flexible working conditions that suit their health needs and status, health-care providers involved in managing work-related issues among cancer survivors should be aware of the interaction between work-related concerns and post-cancer disease management.
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48
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Dahl S, Loge JH, Berge V, Dahl AA, Cvancarova M, Fosså SD. Influence of radical prostatectomy for prostate cancer on work status and working life 3 years after surgery. J Cancer Surviv 2014; 9:172-9. [DOI: 10.1007/s11764-014-0399-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 09/01/2014] [Indexed: 11/28/2022]
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Fenn KM, Evans SB, McCorkle R, DiGiovanna MP, Pusztai L, Sanft T, Hofstatter EW, Killelea BK, Knobf MT, Lannin DR, Abu-Khalaf M, Horowitz NR, Chagpar AB. Impact of Financial Burden of Cancer on Survivors' Quality of Life. J Oncol Pract 2014; 10:332-8. [DOI: 10.1200/jop.2013.001322] [Citation(s) in RCA: 271] [Impact Index Per Article: 27.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Increased financial burden as a result of cancer care costs is the strongest independent predictor of poor quality of life among cancer survivors.
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Affiliation(s)
- Kathleen M. Fenn
- Yale School of Medicine; and Yale School of Nursing, New Haven, CT
| | - Suzanne B. Evans
- Yale School of Medicine; and Yale School of Nursing, New Haven, CT
| | - Ruth McCorkle
- Yale School of Medicine; and Yale School of Nursing, New Haven, CT
| | | | - Lajos Pusztai
- Yale School of Medicine; and Yale School of Nursing, New Haven, CT
| | - Tara Sanft
- Yale School of Medicine; and Yale School of Nursing, New Haven, CT
| | | | | | - M. Tish Knobf
- Yale School of Medicine; and Yale School of Nursing, New Haven, CT
| | - Donald R. Lannin
- Yale School of Medicine; and Yale School of Nursing, New Haven, CT
| | - Maysa Abu-Khalaf
- Yale School of Medicine; and Yale School of Nursing, New Haven, CT
| | - Nina R. Horowitz
- Yale School of Medicine; and Yale School of Nursing, New Haven, CT
| | - Anees B. Chagpar
- Yale School of Medicine; and Yale School of Nursing, New Haven, CT
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Clément-Guillotin C, Falzon C, d'Arripe-Longueville F. Can exercise change the stereotypes associated with individuals with cancer? Scand J Med Sci Sports 2014; 25:552-7. [PMID: 24979050 DOI: 10.1111/sms.12272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2014] [Indexed: 10/25/2022]
Abstract
The purpose of this study was to examine whether exercising can positively influence the stereotypes associated with individuals with cancer and, more specifically, have an effect on the impression formation related to warmth and competence. A total of 193 French college students (Mage = 21.08, SD = 1.44 years; 88 females and 105 males) were randomly assigned to one of the conditions of a 2 (participant sex) × 2 (target health status: cancer vs no information) × 3 (target exercise status: exerciser vs non-exerciser vs no information) experimental design. Results indicated that exercising target with cancer was perceived as the most competent compared with targets with cancer and those without information about cancer. These results suggest that exercising could be an effective way to undermine cancer stereotypes and reduce discrimination against people with cancer.
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Affiliation(s)
| | - C Falzon
- LAMHESS, University of Nice Sophia-Antipolis, Nice, France
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