Mehnert A, Barth J, Gaspar M, Leibbrand B, Kegel C-D, Bootsveld W, Friedrich M, Hartung T J, Berger D, Koch U
Department of Medical Psychology and Medical Sociology & Division of Psychosocial Oncology, University Medical Center Leipzig, Hamburg, Germany.
Klinik Nordfriesland, St. Peter-Ording, Germany.
Eur J Cancer Care (Engl). 2017 Sep;26(5). doi: 10.1111/ecc.12528. Epub 2016 Jun 23.
This longitudinal study was designed to assess patients' desire for early retirement and investigate which cancer-related and psychosocial characteristics are associated with early retirement. We assessed 750 cancer patients at the beginning (t ) and end (t ) of, and 12 months after (t ) inpatient cancer rehabilitation. At t , 22% had a desire to retire early. These patients reported significantly longer sick leave periods, less favourable workplace environments, lower work ability, higher psychological distress and lower quality of life than other patients. At t , 12.5% of patients received temporary or permanent early retirement pensions. Of all patients with a desire for early retirement at t , 43% had returned to work at t . This subgroup had a significantly lower physical quality of life than other patients returning to work. The most influential predictors of early retirement were being on sick leave (OR = 6.50, 95% CI = 1.97-21.47) and a desire for early retirement (OR = 5.61, 95% CI = 2.73-11.52). Inverse predictors of early retirement were cancer remission (OR = 0.23, 95% CI = 0.10-0.53), perceived productivity (OR = 0.38, 95% CI = 0.18-0.83), work satisfaction (OR = 0.36, 95% CI = 0.17-0.77) and mental quality of life (OR = 0.94, 95% CI = 0.91-0.98). This underlines the need for cancer-specific multi-professional rehabilitation and occupational therapy programmes.
这项纵向研究旨在评估患者提前退休的意愿，并调查哪些癌症相关特征和心理社会特征与提前退休有关。我们在癌症住院康复开始时（t₁）、结束时（t₂）以及结束后12个月（t₃）对750名癌症患者进行了评估。在t₁时，22%的患者有提前退休的意愿。与其他患者相比，这些患者报告的病假时间明显更长，工作环境更不理想，工作能力更低，心理困扰更高，生活质量更低。在t₂时，12.5%的患者领取了临时或永久性提前退休养老金。在t₁时有提前退休意愿的所有患者中，43%在t₃时已重返工作岗位。这一亚组患者的身体生活质量明显低于其他重返工作岗位的患者。提前退休最具影响力的预测因素是休病假（OR = 6.50，95%CI = 1.97 - 21.47）和提前退休意愿（OR = 5.61，95%CI = 2.73 - 11.52）。提前退休的反向预测因素是癌症缓解（OR = 0.23，95%CI = 0.10 - 0.53）、感知生产力（OR = 0.38，95%CI = 0.18 - 0.83）、工作满意度（OR = 0.36，95%CI = 0.17 - 0.77）和心理生活质量（OR = 0.94，95%CI = 0.91 - 0.98）。这凸显了针对癌症的多专业康复和职业治疗计划的必要性。
