Return to work after breast cancer: Comprehensive longitudinal analyses of its determinants.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 11564-11564 ◽  
Author(s):  
Agnes Dumas ◽  
Ines Maria Vaz Duarte Luis ◽  
Thomas Bovagnet ◽  
Antonio Di Meglio ◽  
Mayssam El-Mouhebb ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Return To Work ◽  
Depression Scale ◽  
Working Hours ◽  
Primary Treatment ◽  
Independent Effect ◽  
Related Factors ◽  
Work Related ◽  
Supportive Environment ◽  
Patient Reported

11564 Background: The interplay between breast cancer (BC) late effects, psychosocial and work-related factors in return to work (RTW) is not well understood. Previous reports were retrospective and did not combine all these features. Methods: We used data of a French prospective cohort study (CANTO, NCT01993498) of stage I-III BC patients (pts) including detailed clinical data of 1,874 pts working at diagnosis (dx) and ≥5 years younger than legal retirement age. The outcome was non-RTW 2 years after dx. Multivariable regressions were conducted to identify correlates of non-RTW. First, we examined the independent effect of treatments, toxicities (Common Toxicity Criteria Adverse Events), and patient reported outcomes (EORTC BR23 and FA12; Hospital Anxiety and Depression Scale) collected shortly after end of primary treatment. Then, in a restricted sample of 1,003 pts with working conditions (WC) information available, we fitted models to account for detailed pre-dx WC including type of contract, working hours, strenuous postures, supportive environment, degree of autonomy and perception of work. All models were adjusted for age, stage, marital status, socioeconomic status and comorbidities. Results: Two years after dx, 21% of pts did not work. Adjusted odds of non-RTW were increased among pts treated with combinations of chemotherapy (CT) and trastuzumab (TR) (e.g. OR of CT-TR = 2.20 [95% CI 1.24-3.88] and OR of CT-TR-hormonotherapy (HT) = 1.72 [1.13-2.63] vs. treated only with CT-HT), who had severe arm morbidity (OR = 1.73 [1.27-2.36] vs. no), severe emotional fatigue (OR = 1.55 [1.03-2.32] vs. no), anxiety (OR = 1.51 [1.02-2.23] vs. no), or depression (OR = 2.23 [1.27-3.94] vs no). In addition, we also found that the odds of non-RTW were increased among pts who had shift working hours (OR = 2.23 [1.32-3.76] vs. no), who did not work in a supportive environment before dx (OR = 2.24 [1.44-3.50] vs. supportive) and who perceived their job as boring (OR = 3.57 [1.71-7.46] vs. not boring). Conclusions: More than 1/5 of pts did not RTW 2 years after dx, with treatment (trastuzumab), clinical, psychological and work-related factors being associated with job reintegration. Multidisciplinary strategies are needed to support BC survivors.

scholarly journals Short-term serial assessment of electronic patient-reported outcome for depression and anxiety in breast Cancer

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jeeyeon Lee ◽  
Jin Hyang Jung ◽  
Wan Wook Kim ◽  
Byeongju Kang ◽  
Jungmin Woo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Treatment Period ◽  
Depression Scale ◽  
Patient Reported Outcome ◽  
Depression And Anxiety ◽  
Short Term ◽  
Web Based ◽  
Patient Reported ◽  
Patient Health

Abstract Purpose The incidence of depression and anxiety is higher in patients with breast cancer than in the general population. We evaluated the degree of depression and anxiety and investigated the changes in patients with breast cancer during the treatment period and short-term follow-up period. Methods Overall, 137 patients with breast cancer were evaluated using the Patient Health Questionnaire 9-item depression scale (PHQ-9) and Generalized Anxiety Disorder scale (GAD-7). The scales were developed as a web-based electronic patient-reported outcome measure, and serial results were assessed before the operation, after the operation, in the post-treatment period, and in the 6-month follow-up period after surgery. Results The degree of depression and anxiety increased during treatment and decreased at 6-month follow-up, even if there were no statistical differences among the four periods (PHQ-9: p = 0.128; GAD-7: p = 0.786). However, daily fatigue (PHQ-9 Q4) and insomnia (PHQ-9 Q3) were the most serious problems encountered during treatment and at 6-month follow-up, respectively. In the GAD-7, worrying too much (Q3) consistently showed the highest scores during the treatment and follow-up periods. Of the patients, 7 (5.11%) and 11 (8.03%) patients had a worsened state of depression and anxiety, respectively, after treatment compared with before treatment. Conclusion Most factors associated with depression and anxiety improved after treatment. However, factors such as insomnia and worrying too much still disturbed patients with breast cancer, even at 6-month follow-up. Therefore, serial assessment of depression and anxiety is necessary for such patients.

scholarly journals Psychosocial Working Conditions Play an Important Role in the Return-to-Work Process After Total Knee and Hip Arthroplasty

2021 ◽  
Author(s):  
Tamara Kamp ◽  
Sandra Brouwer ◽  
Tjerk H. Hylkema ◽  
Jan van Beveren ◽  
Paul C. Rijk ◽  
...  
Keyword(s):  
Return To Work ◽  
Sex Education ◽  
Working Conditions ◽  
Hip Arthroplasty ◽  
Survey Study ◽  
Related Factors ◽  
Psychosocial Working Conditions ◽  
Work Related ◽  
Multicenter Survey ◽  
Total Knee

AbstractPurpose Both personal and work-related factors affect return to work (RTW) after total knee arthroplasty (TKA) and total hip arthroplasty (THA). Little is known about work-related factors associated with the recovery process. This study aimed to determine which work-related factors are associated with time to RTW for both TKA and THA patients. Methods A prospective multicenter survey study was conducted that included patients aged 18–63, had a paid job and were scheduled to undergo primary TKA/THA. Surveys were completed preoperatively, 6 weeks, and 3, 6, and 12 months postoperatively, and included four domains of work-related factors: work characteristics, physical working conditions, psychosocial working conditions and work adjustments. Control variables included age, sex, education, and comorbidity. Time to RTW was defined as days from surgery until RTW. Multivariate linear regression analyses were conducted separately for TKA/THA patients. Results Enrolled were 246 patients (n = 146 TKA, n = 100 THA, median age 56 years, 57% female). Median time to RTW was 79 days (IQR 52.0–146.0). Mainly physical tasks (TKA: B 58.2, 95%CI 9.5–106.8; THA: B 52.1, 95%CI 14.1–90.2) and a combination of physical and mental tasks (TKA: B 50.2, 95%CI 6.4–94.0; THA B 54.0, 95%CI 24.2–83.7) were associated with longer time to RTW after both TKA and THA. More possibilities for personal job development (B − 12.8, 95%CI − 25.3–0.4) and more work recognition (B − 13.2, 95%CI − 25.5 to − 0.9) were significantly associated with shorter time to RTW after TKA. Higher quality of supervisor leadership (B − 14.1, 95%CI − 22.2 to − 6.0) was significantly associated with shorter time to RTW after THA. Conclusion The findings of this study stress the importance of psychosocial working conditions, besides type of job tasks, in RTW after TKA/THA. Further research on work-related factors is needed, as arthroplasty is being performed on an increasingly younger population of knee and hip OA patients for whom participating in work is of critical importance.

scholarly journals New Telework, Time Pressure, and Time Use Control in Everyday Life

2019 ◽  
Vol 11 (11) ◽  
pp. 3067 ◽  
Author(s):  
Eva Thulin ◽  
Bertil Vilhelmson ◽  
Martina Johansson
Keyword(s):  
Everyday Life ◽  
Time Use ◽  
Time Pressure ◽  
Working Hours ◽  
Subjective Time ◽  
Related Factors ◽  
Work Related ◽  
Home Based ◽  
Time Work ◽  
Part Time

This study explores how changing conditions for home-based telework affect the quality of life and social sustainability of workers in terms of time pressure and time use control in everyday life. Changing conditions concern the spread of telework to new types of jobs of a more routine character, involving new practices of unregulated work and anytime smartphone access. Empirically, we draw on survey data from a sample of 456 home-based teleworkers employed by six governmental agencies in Sweden. Results indicate that subjective time pressure is not associated with job type in terms of distinguishing between bounded case work and more independent analytical work. Time pressure is intensified by family-related factors, telework performed outside of working hours, and part-time work, and is moderated by the private use of smartphones. We find no significant associations between subjective time use control, job qualifications, and teleworking practice. Family situation and having small children at home reduce time use control. Also, high levels of smartphone use for work-related purposes are associated with reduced control.

scholarly journals Prevalence of Themes Linked to Delayed Presentation of Breast Cancer in Africa: A Meta-Analysis of Patient-Reported Studies

2020 ◽  
pp. 731-742
Author(s):  
Olayide S. Agodirin ◽  
Isiaka Aremu ◽  
Ganiyu A. Rahman ◽  
Samuel A. Olatoke ◽  
Halimat J. Akande ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Social Influence ◽  
Common Factor ◽  
Delayed Presentation ◽  
Related Factors ◽  
Alternative Care ◽  
Summary Estimate ◽  
Modifiable Factors ◽  
Patient Reported ◽  
Related Theme

PURPOSE The prevalence of themes linked to delay in presentation of breast cancer (BC) and their underlying factors vary considerably throughout Africa. Regional differences and trends are largely unreported. The purpose of this research was to provide summary estimates of the prevalence and distribution of the themes and underlying factors linked to delay in the presentation of BC, regional variation, and trends in an effort to identify targets for intervention. DESIGN We screened articles found through PubMed/Medline, African Journal OnLine, Science Direct, Google/Google Scholar, and ResearchGate. We included patient-reported surveys on the reasons linked to delayed presentation under 6 previously identified themes: symptom misinterpretation, fear, preference for alternative care, social influence, hospital-related factors, and access factors. The meta-analytical procedure in MetaXL used the quality-effect model. RESULTS Twelve of the 236 identified articles were eligible for this review. The overall summary estimate of late presentation (> 90 days) was 54% (95% CI, 23 to 85) and was worst in the eastern and central regions. Symptom misinterpretation was the most common theme (50%; 95% CI, 21 to 56), followed by fear (17%; 95% CI, 3 to 27), hospital-related theme (11%; 95% CI, 1 to 21), preference for alternative care (10%; 95% CI, 0 to 21), social influence (7%; 95% CI, 0 to 14), and access-related theme (6%; 95% CI, 0 to 13). The most common factor underlying symptom misinterpretation was mischaracterizing the breast lesion as benign (60%; 95% CI, 4 to 100) which surpassed lack of awareness in the last decade. Misdiagnosis and failure to refer were the dominant hospital-related factors. CONCLUSION Modifiable factors such as mischaracterizing malignant masses as benign, fear, misdiagnosis, and failure to refer were the prevalent factors contributing to delays throughout Africa. These factors are promising targets for intervention.

Changes in patient-reported outcomes in women with breast cancer in a multicenter double-blind randomized controlled trial assessing the effect of acupuncture in reducing aromatase inhibitor-induced musculoskeletal symptoms (AIMSS).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 9103-9103
Author(s):  
Ting Bao ◽  
Kelly Betts ◽  
Karineh Tarpinian ◽  
Ling Cai ◽  
Jeff Gould ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Controlled Trial ◽  
Depression Scale ◽  
Sham Acupuncture ◽  
Menopausal Symptoms ◽  
Musculoskeletal Symptoms ◽  
Double Blind ◽  
Hot Flash ◽  
Significant Difference ◽  
Patient Reported

9103 Background: Aromatase Inhibitors (AIs) have been associated with worsening of patient related outcomes (PROs) such as AIMSS, menopausal symptoms and depression. Acupuncture has been reported to alleviate such symptoms. We hypothesized that real acupuncture (RA) would improve PROs more than sham acupuncture (SA). Methods: We collected PROs at baseline, 4, 8, and 12 weeks (wks), from women enrolled in a multi-center double blind RCT designed to assess the effect of acupuncture in reducing PROs. Patients were randomized to 8 wkly RA or SA. PROs were measured by the revised National Surgical Adjuvant Breast and Bowel Project (NSABP) menopausal symptoms questionnaire, Center for Epidemiological Studies Depression Scale (CESD), Hospital Anxiety and Depression Scale (HADS), Pittsburgh Sleep Quality Index (PSQI), Hot Flash Daily Diary, Hot Flash Related Daily Interference Scale (HFRDI) and EuroQoL survey. We measured estrogen and cytokines concentrations at baseline and wk 8. We used Wilcoxon rank sum and signed-rank tests to make comparisons between and within group, respectively. Results: We included 23 patients from RA and 24 from SA arms in the intent-to-treat analysis. We have previously reported no significant difference in reduction of AIMSS between two arms. RA caused reduction of CESD scores compared to SA (median: -2 vs 0, p = 0.057). When compared to baseline, there were statistically significant improvements at wk 8 in hot flash severity score (p=0.006), hot flash frequency (p=0.011), HFRDI (p=0.014) and NSABP menopausal symptoms (p=0.022) scores in RA arm; for EuroQoL (p=0.022), HFRDI (p=0.043) and NSABP menopausal symptoms (p=0.005) scores in SA arm. The majority of patients’ estradiol concentrations were undetectable at baseline and wk 8. Changes in other time points, data and analysis of cytokines changes will be presented at the meeting. Conclusions: Real and sham acupuncture were both associated with improvement in PROs in breast cancer patients taking AIs. We detected no significant difference in the change of PROs between real and sham acupuncture, except for CESD.

scholarly journals Impact of Breast Cancer Treatment on Employment: Results of a Multicenter Prospective Cohort Study (CANTO)

2020 ◽  
Vol 38 (7) ◽  
pp. 734-743 ◽  
Author(s):  
Agnes Dumas ◽  
Ines Vaz Luis ◽  
Thomas Bovagnet ◽  
Mayssam El Mouhebb ◽  
Antonio Di Meglio ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Treatment ◽  
Psychological Symptoms ◽  
Depression Scale ◽  
Breast Cancer Diagnosis ◽  
Breast Cancer Treatment ◽  
European Organization ◽  
Logistic Regression Models ◽  
Arm Morbidity ◽  
Patient Reported

PURPOSE Adverse effects of breast cancer treatment can negatively affect survivors’ work ability. Previous reports lacked detailed clinical data or health-related patient-reported outcomes (PROs) and did not prospectively assess the combined impact of treatment and related sequelae on employment. METHODS We used a French prospective clinical cohort of patients with stage I-III breast cancer including 1,874 women who were working and ≥ 5 years younger than legal retirement age (≤ 57 years) at breast cancer diagnosis. Our outcome was nonreturn to work (non-RTW) 2 years after diagnosis. Independent variables included treatment characteristics as well as toxicities (Common Toxicity Criteria Adverse Events [CTCAE] v4) and PROs (European Organization for Research and Treatment of Cancer [EORTC] Quality of life Questionnaires, Breast cancer module [QLQ-BR23] and Fatigue module [QLQ-FA12], Hospital Anxiety and Depression Scale) collected 1 year after diagnosis. Logistic regression models assessed correlates of non-RTW, adjusting for age, stage, comorbidities, and socioeconomic covariates. RESULTS Two years after diagnosis, 21% of patients had not returned to work. Odds of non-RTW were significantly increased among patients treated with combinations of chemotherapy and trastuzumab (odds ratio [OR] v chemotherapy-hormonotherapy: for chemotherapy-trastuzumab, 2.01; 95% CI, 1.18 to 3.44; for chemotherapy-trastuzumab-hormonotherapy, 1.62; 95% CI, 1.10 to 2.41). Other significant associations with non-RTW included grade ≥ 3 CTCAE toxicities (OR v no, 1.59; 95% CI, 1.15 to 2.18), arm morbidity (OR v no, 1.59; 95% CI, 1.19 to 2.13), anxiety (OR v no, 1.47; 95% CI, 1.02 to 2.11), and depression (OR v no, 2.29; 95% CI, 1.34 to 3.91). CONCLUSION Receipt of systemic therapy combinations including trastuzumab was associated with increased odds of non-RTW. Likelihood of unemployment was also higher among patients who reported severe physical and psychological symptoms. This comprehensive study identifies potentially vulnerable patients and warrants supportive interventional strategies to facilitate their RTW.

scholarly journals Analysis of Selected Body Composition Parameters and Ergonomic Safety among Professionally Active Nurses in Poland: A Preliminary Prospective Monocentric and Observational Study

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Anna Kołcz ◽  
Martyna Baran ◽  
Karolina Walewicz ◽  
Małgorzata Paprocka-Borowicz ◽  
Joanna Rosińczuk
Keyword(s):  
Body Composition ◽  
Observational Study ◽  
Musculoskeletal System ◽  
Bioelectrical Impedance ◽  
Working Hours ◽  
Impedance Analysis ◽  
Occupational Group ◽  
The Body ◽  
Related Factors ◽  
Work Related

Nurses consist of an occupational group that is particularly exposed to harmful work-related factors such as prolonged working hours, severe stress, fatigue, and excessive strain on the musculoskeletal system. According to nurses, the limitation of the application of ergonomic principles of work may contribute to the occurrence of numerous dangerous behaviors, improper eating habits, or deficiency of systematic physical activity. The most common consequences are nutritional disorders and musculoskeletal system dysfunctions. This prospective observational study was aimed at evaluating selected parameters of the body composition of professionally active nurses and at determining work-related risks during nursing activities. The study group consisted of 37 active nurses (38.38±11.33 years). The research tool was a device for bioelectrical impedance analysis (BIA). A questionnaire designed by the authors was also implemented, which covered ergonomic principles, musculoskeletal injuries, and nutritional habits. In the present study, it was shown that all average values of the tested nurses’ body composition parameters were within the normal range. The majority of respondents (97.3%) reached a high level of body water. A statistically significant correlation was found between the knowledge of the workplace ergonomic principles and body mass index. In conclusion, musculoskeletal pain and lack of implementation of ergonomic behaviors are a significant problem among nurses, which may be the cause of overweight or obesity in this occupational group.

Return to Work after a Myocardial Infarction: The Influence of Background Factors, Work Characteristics and Illness Severity

1986 ◽  
Vol 14 (4) ◽  
pp. 183-195 ◽  
Author(s):  
John Gunnar Mæland ◽  
Odd Erik Havik
Keyword(s):  
Myocardial Infarction ◽  
Return To Work ◽  
Rural Areas ◽  
Total Sample ◽  
Clinical Severity ◽  
Stepwise Discriminant Analysis ◽  
Related Factors ◽  
Work Related ◽  
Clinical Complications ◽  
Work Resumption

The relationship between return to work (RTW) within 6 months after a myocardial infarction (MI) and selected demographic factors, characteristics of prior work situation, pre-MI health status, and clinical severity of the MI has been studied in 249 patients below 67 years of age living in urban and rural areas of Western Norway. At the follow-up 8 out of 10 urban patients and 6 out of 10 rural patients were back at work. The RTW rate for the total sample was 73%. Age below 51 years, high educational and income level, working in tertiary industries, and in a job characterized by low physical activity and little psychosocial stress were all factors associated with a favourable work resumption. Multivariate analyses showed that socioeconomic or work-related factors could not fully explain the urban-rural differences in RTW. Stepwise discriminant analysis identified the following factors as important and independent predictors for RTW: Place of residence, age, education, perceived job stress, and clinical complications during hospitalization. Failure to return to work after a MI can be explained by a number of individual and social factors and only to a limited degree by the medical status of the patient. More knowledge is needed concerning the socio-cultural differences among both patients and attending physicians in attitudes towards work resumption after a MI.

scholarly journals Women’s psychological health, family function, and social support during their third trimester of pregnancy within the COVID-19 epidemic: A cross-sectional survey

2021 ◽  
pp. 1-13
Author(s):  
Dongning He ◽  
Jianhua Ren ◽  
Biru Luo ◽  
Jie Xiang ◽  
Guoyu Wang ◽  
...  
Keyword(s):  
Social Support ◽  
Fetal Growth ◽  
Psychological Health ◽  
Statistical Significance ◽  
Depression Scale ◽  
Third Trimester ◽  
Related Factors ◽  
Family Function ◽  
Work Related ◽  
Prenatal Examination

Abstract Objective: The study aims to investigate women’s psychological health, family function, and social support during the third trimester within the COVID-19 epidemic. Method: From January 30, 2020 to February 26, 2020, 177 pregnant women during their third trimester (mean gestation time was 37.05±4.06 weeks) in a maternal and children’s hospital were investigated using the Self-Rating Anxiety Scale (SAS), the Edinburgh Postnatal Depression Scale, the Family APGAR Index, and the Perceived Social Support Scale. Non-parametric tests were conducted in the study. The statistical significance was set as p < 0.05. Result: The incidence rate of the participants’ anxiety and depression during the COVID-19 epidemic was 19.21% and 24.29%, respectively. The participants’ greatest concerns in the previous week were the risk of virus transmission (79.66%), and the prenatal examination and fetal growth (70.62%). The SAS ranks were higher in the participants who were concerned about the prenatal examination and fetal growth and work-related affairs. Conclusion: The participants’ psychological health was indirectly affected by the epidemic through the supply of medical resources and work-related factors. The medical staff should employ family support and social resources to guarantee the accessibility of medical services and living materials to decrease the pregnant women’s stress and further improve their psychological health.

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