Stepanikova Irena, Powroznik Karen, Cook Karen S, Tierney D Kathryn, Laport Ginna
Sociology Department, University of Alabama Birmingham, Birmingham, AL, USA.
Stanford Institute for Research in the Social Sciences, Stanford, CA, USA.
Maturitas. 2017 Nov;105:119-125. doi: 10.1016/j.maturitas.2017.07.002. Epub 2017 Jul 8.
Little is known about how long-term cancer survivors adapt in the realm of work and finances, and whether there are differences in these adaptations based on overall health status. We hypothesize that survivors with better health-related quality of life (HQL) have better work and financial outcomes.
Cross-sectional study with 200 adult recipients of autologous hematopoietic cell transplantation (HCT) 3-26 years after transplant using self-administered questionnaires and medical records extraction.
Questionnaires assessed work status, financial satisfaction, and perceived improvements in financial status since transplant.
Nearly half the survivors were employed (37.2% full-time, 8.7% part-time); 37.2% had retired. Higher scores on the functional HQL were linked to a lower relative risk of having retired (RRR 0.85, CI 0.75-0.98) and of being neither in the workforce nor retired (RRR 0.84, CI 0.72-0.99) compared with working full-time. Higher functional HQL also related to higher financial satisfaction (b 0.06, CI 0.01-0.10) and increased odds of perceived improvements in one's financial situation since transplant (OR 1.15, CI 1.04-1.17). Patients receiving HCT at age ≥60 were more likely than counterparts receiving HCT at age 18-39 to work part-time (RRR 18.24, 95% CI 1.19-280.24) and to have retired (Model 1 RRR 579.14, 95% CI 49.53-6771.54) than to be working full-time.
Survivors with poorer HQL may be at risk for overall poorer work and financial adaptation. Interventions targeting this group and specifically focusing on re-integration into the world of paid work should be considered.
对于长期癌症幸存者如何在工作和财务领域进行适应，以及基于总体健康状况这些适应是否存在差异，人们了解甚少。我们假设健康相关生活质量（HQL）较好的幸存者有更好的工作和财务结果。
采用自填式问卷和病历提取方法，对200名自体造血细胞移植（HCT）成年受者在移植后3至26年进行横断面研究。
问卷评估工作状态、财务满意度以及自移植以来对财务状况的感知改善情况。
近一半的幸存者受雇（37.2%全职，8.7%兼职）；37.2%已退休。与全职工作相比，功能性HQL得分较高与退休的相对风险较低（风险比降低率0.85，可信区间0.75 - 0.98）以及既不在劳动力队伍中也未退休的相对风险较低（风险比降低率0.84，可信区间0.72 - 0.99）相关。较高的功能性HQL还与较高的财务满意度（b 0.06，可信区间0.01 - 0.10）以及自移植以来财务状况感知改善几率增加（优势比1.15，可信区间1.04 - 1.17）相关。60岁及以上接受HCT的患者比18至39岁接受HCT的患者更有可能从事兼职工作（风险比降低率18.24，95%可信区间1.19 - 280.24），并且比全职工作更有可能已退休（模型1风险比降低率579.14，95%可信区间49.53 - 6771.54）。
HQL较差的幸存者可能面临总体工作和财务适应较差的风险。应考虑针对该群体并特别关注重新融入有偿工作领域的干预措施。
