Hansen Jennifer A, Feuerstein Michael, Calvio Lisseth C, Olsen Cara H
Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA.
J Occup Environ Med. 2008 Jul;50(7):777-84. doi: 10.1097/JOM.0b013e318165159e.
Residual symptoms such as fatigue, cognitive limitations, and emotional distress can be experienced by cancer survivors. These symptoms may impact their abilities at work. It is unclear to what degree these symptoms are associated with work in occupationally active breast cancer survivors, the most prevalent cancer survivor group.
A sample of 100 women working part- or full-time with a history of breast cancer and a noncancer comparison group (n = 103) completed questionnaires related to physical fatigue, depression, anxiety, and cognitive limitations. Demographic variables, job stress, type of job, stage at diagnosis, treatment exposure, and health behaviors were also measured as potential confounders.
Four years postdiagnosis breast cancer survivors reported higher levels of age-adjusted work limitations (F = 32.708, P < 0.001). Significant group by fatigue (beta = -0.311, 95% CI = -0.545 to -0.076) and group by depression (beta = 0.331, 95% CI = 0.024 to 0.638) interactions were observed. Fatigue was more strongly related to work limitations in the cancer survivor group whereas depressive symptoms were more strongly related to limitations at work in the noncancer group. Although fatigue accounted for 22% of the variance in the model, it explained 71% of the contribution of symptom burden to the overall model.
Fatigue was more strongly related to work in the breast cancer survivor group after accounting for many potential confounders. There is a pressing need to better understand and effectively manage fatigue in the workplace in occupationally active breast cancer survivors.
癌症幸存者可能会出现疲劳、认知受限和情绪困扰等残留症状。这些症状可能会影响他们的工作能力。目前尚不清楚这些症状在职业活跃的乳腺癌幸存者(最常见的癌症幸存者群体)中与工作的关联程度。
100名有乳腺癌病史且从事兼职或全职工作的女性样本以及一个非癌症对照组(n = 103)完成了与身体疲劳、抑郁、焦虑和认知受限相关的问卷调查。还测量了人口统计学变量、工作压力、工作类型、诊断阶段、治疗暴露情况和健康行为等潜在混杂因素。
乳腺癌幸存者在诊断后四年报告的年龄调整后的工作受限水平更高(F = 32.708,P < 0.001)。观察到疲劳组间(β = -0.311,95% CI = -0.545至-0.076)和抑郁组间(β = 0.331,95% CI = 0.024至0.638)存在显著交互作用。在癌症幸存者组中,疲劳与工作受限的相关性更强,而在非癌症组中,抑郁症状与工作受限的相关性更强。尽管疲劳在模型中占方差的22%,但它解释了症状负担对整体模型贡献的71%。
在考虑了许多潜在混杂因素后,疲劳在乳腺癌幸存者组中与工作的相关性更强。迫切需要更好地理解并有效管理职业活跃的乳腺癌幸存者工作场所中的疲劳。