Buckwalter Andrea E, Karnell Lucy Hynds, Smith Russell B, Christensen Alan J, Funk Gerry F
Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The University of Iowa, Iowa City, IA 52242-1093, USA.
Arch Otolaryngol Head Neck Surg. 2007 May;133(5):464-70. doi: 10.1001/archotol.133.5.464.
To evaluate patients' reported reasons for discontinuing employment following treatment for head and neck cancer (HNC). Discontinuing employment is a serious problem for patients with HNC and has an impact on many aspects of their lives.
Prospective, observational outcomes study.
Tertiary care institution.
A total of 666 patients with carcinomas of the head and neck who were treated from January 1, 1998, to October 31, 2004.
Patients provided information about the status of their employment at the time of diagnosis and then at 3, 6, 9, and 12 months after diagnosis. Patients who discontinued employment after treatment rated the importance of 5 factors (eating, speech, appearance, pain or discomfort, and fatigue) in that decision.
The 5 factors were scored on a 5-point Likert scale (5 being most important) as to their importance in the decision to discontinue work. The relationships of patient, disease, and treatment variables to employment status were evaluated.
Of the 666 patients, 239 were employed at the time of their diagnosis. After treatment, 91 (38.1%) of the 239 reported discontinuing work because of their cancer and treatment. Eighty-two (90.1%) of these 91 patients rated each of the 5 factors. Fatigue had the highest percentage (58.5%) of 4 or 5 ratings, followed by speech (51.2%), eating (45.1%), pain or discomfort (37.8%), and appearance (17.1%). Thirty-seven (40.7%) of the 91 patients who discontinued work returned to work within 1 year of treatment.
Identification of the factors associated with the decision to discontinue work is a first step in providing focused solutions to minimize disability.
评估头颈部癌（HNC）患者报告的治疗后停止工作的原因。对于HNC患者而言，停止工作是一个严重问题，且会对其生活的诸多方面产生影响。
前瞻性观察性结局研究。
三级医疗机构。
1998年1月1日至2004年10月31日期间接受治疗的666名头颈部癌患者。
患者提供诊断时以及诊断后3、6、9和12个月时的就业状况信息。治疗后停止工作的患者对5个因素（进食、言语、外貌、疼痛或不适、疲劳）在该决定中的重要性进行评分。
这5个因素按照李克特5级量表（5表示最重要）对其在停止工作决定中的重要性进行评分。评估患者、疾病和治疗变量与就业状况之间的关系。
在666例患者中，239例在诊断时处于就业状态。治疗后，这239例中有91例（38.1%）报告因癌症及治疗而停止工作。这91例患者中有82例（90.1%）对5个因素中的每一个进行了评分。疲劳获得4分或5分的比例最高（58.5%），其次是言语（51.2%）、进食（45.1%）、疼痛或不适（37.8%）以及外貌（17.1%）。91例停止工作的患者中有37例（40.7%）在治疗后1年内重返工作岗位。
确定与停止工作决定相关的因素是提供针对性解决方案以尽量减少残疾的第一步。
