Department of Public Health, Aarhus University, Aarhus, Denmark.
DEFACTUM, Central Denmark Region, P.P. Ørums Gade 11, 1.B, 8000, Aarhus C, Denmark.
J Occup Rehabil. 2020 Dec;30(4):665-678. doi: 10.1007/s10926-020-09882-2.
Purpose The aim of the present study was to examine the predictive value of Return to Work Self-efficacy (RTWSE) on Return to Work (RTW) among employees undergoing chemotherapy for cancer and to examine the relative contribution of RTWSE as predictor variable compared to personal, health-related, illness- and treatment-related and work-related factors. Methods A sample of 114 sickness absent employees with various cancers (age 18-62) included in the study on average 33 days after initiating chemotherapy were followed for 15 months. Data sources included patient questionnaires (RTWSE, depression, fatigue, performance status), sociodemographic factors (age, sex, job type, and perceived support from the workplace), patient records (type of cancer, treatment intention, number of treatment modalities, time since diagnosis and time since initiation of chemotherapy), and Danish national registries (RTW and education). Associations between RTWSE at baseline and weeks until full RTW during 15-months follow-up were analyzed using Cox proportional hazards regression. Results In the univariate analysis, high RTWSE was associated with shorter time to RTW (Hazard Ratio (HR) 1.84, 95% confidence interval (CI) 1.12-3.03). In the multivariate model, RTWSE failed to reach statistical significance (HR 1.12, 95% CI 0.62-2.02), whereas female sex (HR 0.30, 95% CI 0.15-0.60) and receiving palliative treatment (HR 0.15, 95% CI 0.05-0.44) were significantly associated with later RTW. Conclusion Compared to other factors of significance, RTWSE was not the strongest predictor of RTW when examined among employees undergoing chemotherapy for cancer. Before using the RTWSE questionnaire to identify employees with cancer at risk of late RTW, it is important to recognize that the predictive value of RTWSE may be different for employees on sick leave due to cancer than for other sickness absence populations.
目的 本研究旨在探讨癌症化疗患者重返工作岗位自我效能（RTWSE）对重返工作岗位（RTW）的预测价值，并比较 RTWSE 作为预测变量与个人、健康相关、疾病和治疗相关以及工作相关因素的相对贡献。
方法 研究纳入了 114 名正在接受化疗的各种癌症患者（年龄 18-62 岁），他们平均在开始化疗后 33 天被纳入研究，随访时间为 15 个月。数据来源包括患者问卷（RTWSE、抑郁、疲劳、身体状况）、社会人口因素（年龄、性别、工作类型和来自工作场所的支持感知）、患者记录（癌症类型、治疗意图、治疗方式数量、诊断后时间和化疗开始后时间）和丹麦国家登记处（RTW 和教育）。使用 Cox 比例风险回归分析基线时的 RTWSE 与 15 个月随访期间完全 RTW 的周数之间的关系。
结果 在单因素分析中，高 RTWSE 与 RTW 时间较短相关（危险比（HR）1.84，95%置信区间（CI）1.12-3.03）。在多变量模型中，RTWSE 未达到统计学意义（HR 1.12，95% CI 0.62-2.02），而女性（HR 0.30，95% CI 0.15-0.60）和接受姑息治疗（HR 0.15，95% CI 0.05-0.44）与 RTW 较晚显著相关。
结论 在对接受癌症化疗的员工进行研究时，与其他重要因素相比，RTWSE 并不是 RTW 的最强预测因素。在使用 RTWSE 问卷识别有癌症风险的 RTW 延迟的员工之前，重要的是要认识到 RTWSE 的预测价值可能因因癌症而休病假的员工与其他病假人群不同。
