School of Nursing, Queensland University of Technology, Kelvin Grove, Australia.
Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Kelvin Grove, QLD, Australia.
BMC Cancer. 2021 Aug 2;21(1):883. doi: 10.1186/s12885-021-08583-0.
To identify subgroups of female breast cancer patients with distinct self-reported employment interference (EI) profiles and determine which demographic, clinical, and symptom characteristics, and quality of life outcomes were associated with subgroup membership.
Women with breast cancer (n = 385) were assessed for changes in EI over ten times, from prior to, through 12 months after breast cancer surgery. Latent profile analysis (LPA) was used to identify subgroups of patients with distinct EI profiles.
Three distinct EI profiles (i.e., None - 26.2% (n = 101), Low - 42.6% (n = 164), High - 31.2% (n = 120)) were identified. Compared to the None and Low groups, patients in the High group were more likely to be younger. Higher proportions in the High group were non-White, pre-menopausal prior to surgery, had more advanced stage disease, had received an axillary lymph node dissection, had received neoadjuvant chemotherapy, had received adjuvant chemotherapy, and had a re-excision or mastectomy on the affected breast within 6 months after surgery. In addition, these patients had lower quality of life scores. Compared to the None group, the High group had higher levels of trait and state anxiety, depressive symptoms, fatigue and sleep disturbance and lower levels of cognitive function.
This study provides new knowledge regarding EI profiles among women in the year following breast cancer surgery. The non-modifiable risk factors (e.g., younger age, being non-White, having more advanced stage disease) can inform current screening procedures. The potentially modifiable risk factors can be used to develop interventions to improve employment outcomes of breast cancer patients.
确定具有不同自我报告就业干扰（EI）特征的女性乳腺癌患者亚组，并确定哪些人口统计学、临床和症状特征以及生活质量结果与亚组成员身份相关。
对 385 名乳腺癌女性患者进行了 10 次以上的 EI 变化评估，从乳腺癌手术前到手术后 12 个月。采用潜在剖面分析（LPA）确定具有不同 EI 特征的患者亚组。
确定了三种不同的 EI 特征（即无 - 26.2%（n=101），低 - 42.6%（n=164），高 - 31.2%（n=120））。与无和低组相比，高组的患者更年轻。高组中更高比例的患者为非裔美国人，手术前处于绝经前，疾病分期更晚，接受了腋窝淋巴结清扫术，接受了新辅助化疗，接受了辅助化疗，并且在手术后 6 个月内对受影响的乳房进行了再次切除或乳房切除术。此外，这些患者的生活质量评分较低。与无组相比，高组的特质和状态焦虑、抑郁症状、疲劳和睡眠障碍水平更高，认知功能水平更低。
本研究为乳腺癌手术后一年女性的 EI 特征提供了新知识。不可改变的风险因素（例如，年龄较小、非裔美国人、疾病分期更晚）可以为当前的筛查程序提供信息。潜在的可改变风险因素可用于制定干预措施，以改善乳腺癌患者的就业结果。
