Department of Psychology, King's College London, London, UK.
Psychooncology. 2013 Mar;22(3):659-67. doi: 10.1002/pon.3049. Epub 2012 Mar 21.
Many factors influence return to work (RTW) following cancer treatment. However specific factors affecting RTW across different cancer types are unclear. This study examined the role of clinical, sociodemographic, work and psychological factors in RTW following treatment for breast, gynaecological, head and neck, and urological cancer.
A 12-month prospective questionnaire study was conducted with 290 patients. Cox regression analyses were conducted to calculate hazard ratios (HR) for time to RTW.
Between 89-94% of cancer survivors returned to work. Breast cancer survivors took the longest to return (median 30 weeks), and urology cancer survivors returned the soonest (median 5 weeks). Earlier return among breast cancer survivors was predicted by a greater sense of control over their cancer at work (HR 1.2; 95% CI: 1.09-1.37) and by full-time work (HR 2.1; CI: 1.24-3.4). Predictive of a longer return among gynaecological cancer survivors was a belief that cancer treatment may impair ability to work (HR 0.75; CI: 0.62-0.91). Among urological cancer survivors constipation was predictive of longer RTW (HR 0.99; CI: 0.97-1.00), whereas undertaking flexible working was predictive of returning sooner (HR 1.70; CI: 1.07-2.7). Head and neck cancer survivors who perceived greater negative consequences of their cancer took longer to return (HR 0.27; CI: 0.11-0.68). Those reporting better physical functioning returned sooner (HR1.04; CI: 1.01-1.08).
A different profile of predictive factors emerged for the four cancer types. In addition to optimal symptom management and workplace adaptations, the findings suggest that eliciting and challenging specific cancer and treatment-related perceptions may facilitate RTW.
许多因素会影响癌症治疗后的工作回归（RTW）。然而，不同癌症类型影响 RTW 的具体因素尚不清楚。本研究检查了临床、社会人口统计学、工作和心理因素在治疗乳腺癌、妇科、头颈部和泌尿系统癌症后的 RTW 中的作用。
对 290 名患者进行了为期 12 个月的前瞻性问卷调查研究。使用 Cox 回归分析计算 RTW 时间的风险比（HR）。
在癌症幸存者中，89-94%的人返回工作岗位。乳腺癌幸存者返回工作的时间最长（中位数 30 周），而泌尿系统癌症幸存者返回工作的时间最短（中位数 5 周）。乳腺癌幸存者更早回归工作，其原因在于他们在工作中对癌症的控制感更强（HR 1.2；95%CI：1.09-1.37）和全职工作（HR 2.1；CI：1.24-3.4）。妇科癌症幸存者中，认为癌症治疗可能会损害工作能力的人（HR 0.75；CI：0.62-0.91）回归工作的时间更长。在泌尿系统癌症幸存者中，便秘预示着 RTW 时间更长（HR 0.99；CI：0.97-1.00），而灵活工作预示着更早回归（HR 1.70；CI：1.07-2.7）。认为癌症对他们有更大负面影响的头颈部癌症幸存者，回归工作的时间更长（HR 0.27；CI：0.11-0.68）。报告身体功能更好的人更早回归（HR1.04；CI：1.01-1.08）。
四种癌症类型的预测因素各不相同。除了最佳的症状管理和工作场所适应外，研究结果表明，了解和挑战特定的癌症和治疗相关的认知可能有助于 RTW。
