Wienert Julian, Schwarz Betje, Bethge Matthias
Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany.
BMC Cancer. 2016 Jul 27;16:544. doi: 10.1186/s12885-016-2563-z.
Work is a central resource for cancer survivors as it not only provides income but also impacts health and quality of life. Additionally, work helps survivors to cope with the perceived critical life event. The German Pension Insurance provides medical rehabilitation for working-age patients with chronic diseases to improve and restore their work ability, and support returning to or staying at work, and thus tries to sustainably avoid health-related early retirement. Past research showed that conventional medical rehabilitation programs do not support returning to work sufficiently and that work-related medical rehabilitation programs report higher return-to-work rates across several health conditions, when compared to medical rehabilitation. Therefore, the current study protocol outlines an effectiveness study of such a program for cancer survivors.
To evaluate the effectiveness of work-related medical rehabilitation in cancer patients we conduct a cluster-randomized multicenter trial. In total, 504 rehabilitation patients between 18 and 60 years with a Karnofsky Performance Status of ≥70 %, a preliminary positive social-medical prognosis of employability for at least 3 h/day within the next 6 months and an elevated risk of not returning to work will be recruited in four inpatient rehabilitation centers. Patients are randomized to the work-related medical rehabilitation program or the conventional medical rehabilitation program based on their week of arrival at each rehabilitation center. The work-related medical rehabilitation program comprises additional work-related diagnostics, multi-professional team meetings, an introductory session as well as work-related functional capacity training, work-related psychological groups, and social counseling. All additional components are aimed at the adjustment of the patients' capacity in relation to their individual job demands. Role functioning defines the main study outcome and will be assessed with the EORTC-QLQ30. Secondary outcome measures are the remaining scales of the EORTC-QLQ30, fatigue, self-rated work ability, disease coping, participation in working life, realization of work-related goals and therapies during rehabilitation, and treatment satisfaction.
A positive evaluation of work-related medical rehabilitation in cancer patients is expected due to the promising findings on the effectiveness of such programs for patients with other health conditions. Results may support the dissemination of work-related medical rehabilitation programs in German cancer rehabilitation.
German Clinical Trials Register DRKS00007770 . Registered 13 May 2015.
工作是癌症幸存者的一项核心资源，因为它不仅能提供收入，还会影响健康和生活质量。此外，工作有助于幸存者应对这一被视为重大的生活事件。德国养老保险为患有慢性病的适龄患者提供医学康复服务，以改善和恢复他们的工作能力，支持他们重返工作岗位或继续工作，从而努力可持续地避免与健康相关的提前退休。过去的研究表明，传统的医学康复项目对重返工作岗位的支持不足，而且与医学康复相比，与工作相关的医学康复项目在多种健康状况下的重返工作岗位率更高。因此，本研究方案概述了针对癌症幸存者的此类项目的有效性研究。
为了评估与工作相关的医学康复对癌症患者的有效性，我们开展了一项整群随机多中心试验。总共将在四个住院康复中心招募504名年龄在18至60岁之间、卡氏评分≥70%、初步社会医学就业预后为在未来6个月内每天至少有3小时就业可能性且重返工作岗位风险较高的康复患者。根据患者抵达每个康复中心的周次，将他们随机分配到与工作相关的医学康复项目或传统医学康复项目。与工作相关的医学康复项目包括额外的与工作相关的诊断、多专业团队会议、一次介绍会以及与工作相关的功能能力培训、与工作相关的心理小组和社会咨询。所有额外的组成部分都旨在根据患者的个人工作需求调整其能力。角色功能定义了主要研究结果，并将使用欧洲癌症研究与治疗组织核心生活质量问卷（EORTC-QLQ30）进行评估。次要结果指标包括EORTC-QLQ30的其余量表、疲劳、自我评估的工作能力、疾病应对、参与工作生活、在康复期间实现与工作相关的目标和治疗以及治疗满意度。
鉴于此类项目对其他健康状况患者有效性的有前景的研究结果，预计对癌症患者与工作相关的医学康复会有积极评价。研究结果可能支持在德国癌症康复中推广与工作相关的医学康复项目。
德国临床试验注册中心DRKS00007770。2015年5月13日注册。
