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自体干细胞移植大剂量化疗10年后长期淋巴瘤幸存者的就业模式及相关因素

Pattern of employment and associated factors in long-term lymphoma survivors 10 years after high-dose chemotherapy with autologous stem cell transplantation.

作者信息

Kiserud C E, Fagerli U-M, Smeland K B, Fluge Ø, Bersvendsen H, Kvaløy S, Holte H, Dahl A A

机构信息

a National Advisory Unit for Late Effects After Cancer, Department of Oncology , Oslo University Hospital, Radiumhospitalet , Oslo , Norway ;

b Department of Oncology , St. Olav's Hospital , Trondheim , Norway ;

出版信息

Acta Oncol. 2016 May;55(5):547-53. doi: 10.3109/0284186X.2015.1125015.

Abstract

Background This study examined employment patterns and associated factors in lymphoma survivors treated with high-dose chemotherapy with autologous stem cell transplantation (HDT-ASCT) from diagnosis to a follow-up survey at a mean of 10 years after HDT-ASCT. Patients and methods All lymphoma survivors aged ≥18 years at HDT-ASCT in Norway from 1987 to 2008, and alive at the end of 2011 were eligible for this cross-sectional study performed in 2012/2013. Participants completed a mailed questionnaire. Job status was dichotomized as either employed (paid work) or not-employed (disability and retirement pension, on economic support, home-makers, or students). Results The response rate was 78%, and the sample (N = 312) contained 60% men. Mean age at HDT-ASCT was 44.3 and at survey 54.0 years. At diagnosis 85% of survivors were employed, 77% before and 77% after HDT-ASCT, and 58% at follow-up. Forty seven percent of the survivors were employed at all time points. The not-employed group at survey was significantly older and included significantly more females than the employed group. No significant between-group differences were observed for lymphoma-related variables. Fatigue, mental distress and type D personality were significantly higher among those not-employed, while quality of life was significantly lower compared to the employed group. Older age at survey, being female, work ability and presence of type D personality remained significantly related to being not-employed at survey in the multivariable analysis. Conclusions Our findings show that not-employed long-term survivors after HDT-ASCT for lymphoma have more comorbidity, cognitive problems and higher levels of anxiety/depression than employed survivors. These factors should be checked and eventually treated in order to improve work ability.

摘要

背景 本研究调查了接受高剂量化疗联合自体干细胞移植(HDT-ASCT)的淋巴瘤幸存者从诊断到HDT-ASCT后平均10年随访调查期间的就业模式及相关因素。

患者与方法 纳入1987年至2008年在挪威接受HDT-ASCT时年龄≥18岁且在2011年底仍存活的所有淋巴瘤幸存者,于2012/2013年进行这项横断面研究。参与者完成一份邮寄问卷。就业状况分为就业(有薪工作)或未就业(残疾和退休养老金领取者、依靠经济资助者、家庭主妇或学生)。

结果 应答率为78%,样本(N = 312)中60%为男性。HDT-ASCT时的平均年龄为44.3岁,调查时为54.0岁。诊断时85%的幸存者有工作,HDT-ASCT前和后分别为77%,随访时为58%。47%的幸存者在所有时间点均有工作。调查时未就业组的年龄显著更大,女性比例显著高于就业组。淋巴瘤相关变量在两组之间未观察到显著差异。未就业者的疲劳、精神困扰和D型人格显著更高,而生活质量与就业组相比显著更低。在多变量分析中,调查时年龄较大、女性、工作能力和D型人格的存在与调查时未就业仍显著相关。

结论 我们的研究结果表明,接受HDT-ASCT治疗的淋巴瘤长期未就业幸存者比就业幸存者有更多合并症、认知问题和更高水平的焦虑/抑郁。这些因素应进行检查并最终治疗以提高工作能力。

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