Alfano Catherine M, Kent Erin E, Padgett Lynne S, Grimes Melvin, de Moor Janet S
American Cancer Society, Inc, 555 11th St NW, Suite 300, Washington, DC 20004(∗).
Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD(†).
PM R. 2017 Sep;9(9S2):S398-S406. doi: 10.1016/j.pmrj.2017.06.019.
Cancer and its treatment can result in impairments that limit physical, psychosocial, and cognitive functioning, interfering with patients' ability to perform work-related functions. Because these work limitations can carry significant personal and societal costs, there is a timely need to identify and refer patients to cancer rehabilitation services to manage adverse consequences of treatment and to preserve employment. Coordinated efforts in 3 key areas will better connect patients to rehabilitation interventions that will help optimize employment. These include the following: planning for the impact of cancer on the ability to work; implementing routine screening for impairments and facilitating referrals to cancer rehabilitation specialists; and focusing rehabilitation interventions on preserving employment. Coordinated strategies are presented to achieve these 3 goals, including the following: implementing changes to clinical practice to routinely screen for impairments; working with oncology providers and patients to better understand the benefits of cancer rehabilitation to facilitate referrals and uptake; training more cancer rehabilitation providers to handle the increased need; better coordination of care across providers and with employers; and filling research gaps needed to proactively anticipate how cancer treatment would affect work for a given patient and deploy personalized interventions to preserve the ability to work.
癌症及其治疗可能导致功能障碍,限制身体、心理社会和认知功能,干扰患者履行与工作相关职能的能力。由于这些工作限制会带来巨大的个人和社会成本,因此迫切需要识别并将患者转介至癌症康复服务机构,以管理治疗的不良后果并维持就业。在三个关键领域的协同努力将更好地使患者获得康复干预措施,从而有助于优化就业。这些领域包括:规划癌症对工作能力的影响;对功能障碍进行常规筛查并促进转介至癌症康复专家;以及将康复干预重点放在维持就业上。本文提出了实现这三个目标的协同策略,包括:对临床实践进行变革以常规筛查功能障碍;与肿瘤学医护人员和患者合作,更好地了解癌症康复的益处,以促进转介和接受度;培训更多癌症康复医护人员以满足增加的需求;加强医护人员之间以及与雇主之间的护理协调;填补研究空白,以便主动预测癌症治疗对特定患者工作的影响,并采用个性化干预措施来维持工作能力。