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癌症幸存者重返工作的干预措施:系统评价和方法学批判。

Return to Work Interventions for Cancer Survivors: A Systematic Review and a Methodological Critique.

机构信息

Institut National du Cancer (INCa), 92100 Boulogne-Billancourt, France.

Laboratory of Psychopathology and Health Processes (EA 4057), Paris Descartes University, 92100 Boulogne-Billancourt, France.

出版信息

Int J Environ Res Public Health. 2019 Apr 14;16(8):1343. doi: 10.3390/ijerph16081343.

Abstract

Cancer patients are more at risk of being unemployed or having difficulties to return to work (RTW) compared to individuals without health concerns, and is thus a major public health issue. The aim of this systematic review is to identify and describe the interventions developed specifically to help cancer patients to RTW after treatment. Two researchers independently screened the articles for inclusion and Critical Appraisal Skills Program (CASP) checklists were used to assess the methodology of the included studies. Ten manuscripts met the inclusion criteria. The type of studies were three quasi-experimental studies, three longitudinal studies, three randomized controlled trials (RCTs) and a qualitative study. RTW interventions were conducted in or outside the hospital ( = 6 and 3 respectively), or both ( = 1). Improvements in RTW were only observed in quasi-experimental studies. No improvement in RTW was noted in RCTs, nor in other measures (e.g., quality of life, fatigue). Lack of statistically significant improvement does not necessarily reflect reality, but may be attributed to non-adapted research methods. This systematic review underscores the need for researches in the RTW field to reach a consensus on RTW criteria and their assessment. Recommendations to this effect are suggested.

摘要

癌症患者相较于无健康问题的个体,失业或重返工作岗位(RTW)困难的风险更高,因此这是一个主要的公共卫生问题。本系统综述的目的是确定和描述专门为帮助癌症患者在治疗后重返工作岗位而开发的干预措施。两位研究人员独立筛选了纳入的文章,并使用批判性评估技能计划(CASP)检查表评估了纳入研究的方法。有 10 篇手稿符合纳入标准。研究类型为三项准实验研究、三项纵向研究、三项随机对照试验(RCT)和一项定性研究。RTW 干预措施分别在医院内或医院外(分别为 6 项和 3 项)或两者都有(1 项)。只有在准实验研究中观察到 RTW 有所改善。在 RCT 中,以及在其他措施(例如生活质量、疲劳)中,均未观察到 RTW 的改善。缺乏统计学意义上的改善并不一定反映现实,但可能归因于不适应的研究方法。本系统综述强调了 RTW 领域的研究需要就 RTW 标准及其评估达成共识。对此提出了建议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f33/6518012/474ccc5791f4/ijerph-16-01343-g001.jpg

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