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癌症患者返岗 18 个月后,疲劳和抑郁症状虽有所改善,但仍与工作功能呈负相关。

Fatigue and depressive symptoms improve but remain negatively related to work functioning over 18 months after return to work in cancer patients.

机构信息

Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, FA10, Room 417, 9713, AV, Groningen, The Netherlands.

Robert Stempel College of Public Health and Social Work, Department of Health Policy and Management, Florida International University, Miami, FL, USA.

出版信息

J Cancer Surviv. 2018 Jun;12(3):371-378. doi: 10.1007/s11764-018-0676-x. Epub 2018 Feb 5.

Abstract

PURPOSE

The aims of this study are to investigate the course of work functioning, health status, and work-related factors among cancer patients during 18 months after return to work (RTW) and to examine the associations between these variables and work functioning over time.

METHODS

Data were used from the 18-month longitudinal "Work Life after Cancer" (WOLICA) cohort, among 384 cancer patients who resumed work. Linear mixed models were performed to examine the different courses during 18-month follow-up. Linear regression analyses with generalized estimating equations (GEE) were used to examine the associations and interactions.

RESULTS

Cancer patients reported an increase of work functioning and a decrease of fatigue and depressive symptoms in the first 12 months, followed by a stable course between 12 and 18 months. Cognitive symptoms were stable during the first 18 months. Working hours increased and social support decreased during the first 6 months; both remained stable between 6 and 18 months. Fatigue, depressive, and cognitive symptoms were negatively associated with work functioning over time; working hours and supervisor social support were positively associated.

CONCLUSIONS

Interventions to improve cancer patients' work functioning over time might be promising if they are aimed at reducing fatigue, depressive symptoms, cognitive symptoms, and encouraging supervisor social support.

IMPLICATIONS FOR CANCER SURVIVORS

It is important to monitor cancer patients not only in the period directly after RTW but up to 18 months after RTW, allowing for timely interventions when needed.

摘要

目的

本研究旨在探讨癌症患者在重返工作岗位(RTW)后 18 个月内工作功能、健康状况和与工作相关因素的变化过程,并探讨这些变量与工作功能随时间变化的关系。

方法

本研究使用了“癌症后工作生活”(WOLICA)队列的 18 个月纵向数据,该队列包括 384 名恢复工作的癌症患者。采用线性混合模型分析 18 个月随访期间的不同变化过程。采用广义估计方程(GEE)线性回归分析来检验关联和交互作用。

结果

癌症患者报告在最初 12 个月内工作功能逐渐增加,疲劳和抑郁症状逐渐减轻,随后在 12 至 18 个月期间保持稳定。认知症状在最初 18 个月内保持稳定。工作时间在最初的 6 个月内增加,社会支持在最初的 6 个月内减少,之后两者均在 6 至 18 个月期间保持稳定。疲劳、抑郁和认知症状与工作功能随时间呈负相关,工作时间和主管社会支持与工作功能呈正相关。

结论

如果旨在减少疲劳、抑郁症状、认知症状和鼓励主管社会支持,那么针对癌症患者随时间改善工作功能的干预措施可能具有前景。

启示

不仅在 RTW 后立即监测癌症患者,而且在 RTW 后长达 18 个月监测癌症患者,以便在需要时及时进行干预非常重要。

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