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[癌症患者确诊后立即影响其继续工作的因素]

[Factors influencing work continuation of cancer patients immediately after diagnosis].

作者信息

Mukai Tomoyo, Morioka Ikuharu

机构信息

Graduate School of Health and Nursing Science, Wakayama Medical University.

出版信息

Sangyo Eiseigaku Zasshi. 2020 Oct 9;62(5):173-182. doi: 10.1539/sangyoeisei.2019-018-B. Epub 2020 Feb 8.

Abstract

OBJECTIVES

In recent years, efforts made by cancer patients to balance their work schedules and treatment regimens have gained increasing attention. Such workers tend to resign when diagnosed with cancer. A particularly prominent issue is that many of these employees resign immediately after diagnosis. This study aimed to clarify factors influencing continuation of employment from the period immediately after diagnosis up to the first treatment.

METHODS

Study aims were explained to 68 employees, who were 20‒64 years and had received a definitive diagnosis of cancer in the last two years. After obtaining informed consent, structured interviews were conducted.

RESULT

Informed consent was obtained from 61 patients, of which 60 (98.4%) wished to continue working after diagnosis. Of these 60 patients, 15 (25.0%) had not been working (including those on leave) and 45 (75.0%) had continued employment. The latter comprised the continuation group. There were no significant differences in attributes, company type and size, nor in employment status between the two groups. Subjects in the continuation group sought significantly more consultation for the questionnaire item "Disease, treatment, and symptoms," whereas significantly less consultation was sought for the item "Concerning expenses such as medical bills and living costs." The number of those who had disclosed their illness to colleagues was significantly higher in the continuation group, while the number of those hoping for a "Probationary period for returning to work" and complaining of "Prejudice and misunderstanding of cancer patient's continuation of work" was significantly smaller in the continuation group. The number of those who had undergone surgery and who received a score of 0 to 1 (light work acceptable) on the Eastern Cooperative Oncology Group performance status was significantly higher in the continuation group. As for other factors that had influenced subjects' decision to continue working or not, subjects described two situational attitudes: first, "Gratitude for understanding, consideration, and encouragement of superiors and colleagues" and second, "Impossibility of thinking about work immediately after diagnosis."

CONCLUSION

Results revealed that continuation of work immediately after diagnosis was related to the stage of the patient's cancer, their general condition, and whether they had undergone surgery or not. Support from superiors and/or colleagues at the workplace was also beneficial. Medical staff should therefore provide patients with support in overcoming the crisis in which they feel the continuation of work immediately after diagnosis to be an impossibility, and to assist them in making an informed choice regarding their employment status.

摘要

目的

近年来,癌症患者平衡工作安排与治疗方案的努力日益受到关注。这类患者在被诊断出癌症后往往会辞职。一个特别突出的问题是,许多这类员工在确诊后立即辞职。本研究旨在阐明从确诊后到首次治疗期间影响继续工作的因素。

方法

向68名年龄在20至64岁之间、在过去两年中被确诊为癌症的员工解释了研究目的。在获得知情同意后,进行了结构化访谈。

结果

61名患者获得了知情同意,其中60名(98.4%)希望在确诊后继续工作。在这60名患者中,15名(25.0%)此前未工作(包括休假者),45名(75.0%)继续就业。后者组成了继续工作组。两组在属性、公司类型和规模以及就业状况方面均无显著差异。继续工作组的受试者在问卷项目“疾病、治疗和症状”上寻求咨询的次数显著更多,而在“关于医疗费用和生活费用等开支”项目上寻求咨询的次数显著更少。继续工作组中向同事透露病情的人数显著更多,而希望有“重返工作试用期”以及抱怨“对癌症患者继续工作存在偏见和误解”的人数在继续工作组中显著更少。继续工作组中接受过手术且东部肿瘤协作组体能状态评分为0至1分(可从事轻度工作)的人数显著更多。至于影响受试者决定是否继续工作的其他因素,受试者描述了两种情境态度:第一,“对上级和同事的理解、体贴和鼓励心怀感激”;第二,“确诊后无法立即考虑工作”。

结论

结果显示,确诊后立即继续工作与患者癌症的阶段、总体状况以及是否接受过手术有关。工作场所上级和/或同事的支持也很有益。因此,医务人员应帮助患者克服那种认为确诊后立即继续工作不可能的危机,并协助他们就就业状况做出明智选择。

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