Center for Psychosocial Medicine, Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
Rehabilitation Clinics Hartenstein GmbH, Clinic Quellental, Bad Wildungen, Germany.
Support Care Cancer. 2017 Oct;25(10):3007-3015. doi: 10.1007/s00520-017-3790-9. Epub 2017 Jul 11.
Approximately 60% of patients are able to work following a cancer diagnosis. The return-to-work (RTW) process after disability can be conceptualized as a multi-phase construct. This study investigated RTW outcomes throughout the RTW process among survivors of prostate cancer (PC) attending a cancer rehabilitation measure.
The study was based on a sample of 837 employed PC survivors enrolled in a longitudinal multicenter study. Data was collected at the beginning of the rehabilitation measure, at the end and at 12-month follow-up by means of self-report questionnaires. We compared outcomes with regard to age (<60 and ≥60 years) and socio-economic status (SES; lower, middle, higher) using t tests or univariate ANOVA for metrical and chi-square test or Fisher's exact test for categorical variables.
In the off-work phase, most survivors reported positive expectations regarding future work, including responsiveness of their work environment. Nevertheless, one fourth intended to apply for a disability pension. At 12-month follow-up, the RTW rate was 87% and 62% when applying more conservative criteria of RTW. Among survivors who had returned to work, most reported stability of the work situation. Survivors with lower SES showed least favorable outcomes throughout the RTW process, while older age was less consistently of negative impact.
Survivors reported many favorable RTW outcomes, but low SES might be a barrier at various stages of the RTW process. Thus, special attention must be paid to the role of social inequalities during rehabilitation and work reintegration to help survivors managing the RTW process.
大约 60%的癌症患者在确诊后能够重返工作岗位。残疾后的重返工作（RTW）过程可以被概念化为一个多阶段的结构。本研究调查了参加癌症康复措施的前列腺癌（PC）幸存者在 RTW 过程中的 RTW 结果。
该研究基于一项参加纵向多中心研究的 837 名在职 PC 幸存者的样本。通过自我报告问卷，在康复措施开始时、结束时和 12 个月随访时收集数据。我们使用 t 检验或单变量 ANOVA 比较了年龄（<60 岁和≥60 岁）和社会经济地位（SES；低、中、高）的结果，对于分类变量使用卡方检验或 Fisher 精确检验。
在停工期，大多数幸存者对未来工作表示积极的期望，包括对工作环境的响应性。然而，四分之一的人打算申请残疾抚恤金。在 12 个月的随访中，当采用更保守的 RTW 标准时，RTW 率为 87%和 62%。在已经重返工作岗位的幸存者中，大多数人报告工作情况稳定。SES 较低的幸存者在整个 RTW 过程中表现出最不利的结果，而年龄较大的影响则不那么一致。
幸存者报告了许多有利的 RTW 结果，但 SES 较低可能是 RTW 过程各个阶段的障碍。因此，在康复和重返工作的过程中，必须特别关注社会不平等的作用，以帮助幸存者管理 RTW 过程。
