Community and Occupational Medicine, Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, PO Box 30.001, 9700 RB, Groningen, The Netherlands.
Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
J Cancer Surviv. 2023 Apr;17(2):290-299. doi: 10.1007/s11764-022-01190-3. Epub 2022 Mar 21.
Cognitive symptoms affect cancer survivors' functioning at work. To date, cognitive symptoms trajectories in working cancer survivors and the factors associated with these trajectories have not been examined.
Data from a heterogeneous group of working cancer survivors (n = 379) of the longitudinal "Work-Life-after-Cancer" study, linked with Netherlands Cancer Registry data, were used. The Cognitive Symptom Checklist-Work was administered at baseline (within the first 3 months after return to work), 6-, 12-, and 18-month follow-up to measure self-perceived memory and executive function symptoms. Data were analyzed using group-based trajectory modeling.
Four trajectories of memory and executive function symptoms were identified. All memory symptoms trajectories were stable and labeled as "stable-high" (15.3% of the sample), "stable-moderately high" (39.6%), "stable-moderately low" (32.0%), and "stable-low" (13.0%). Executive function symptoms trajectories changed over time and were labeled as "increasing-high" (10.1%), "stable-moderately high" (32.0%), "decreasing-moderately low" (35.5%), and "stable-low" (22.4%). Higher symptoms trajectories were associated with older age, longer time from diagnosis to return to work, more quantitative work demands, and higher levels of depressive symptoms at baseline.
In cancer survivors who returned to work, four cognitive symptoms trajectory subgroups were identified, representing different but relatively stable severity levels of cognitive symptoms.
To identify cancer survivors with higher symptoms trajectories, health care providers should assess cognitive symptoms at baseline after return to work. In case of cognitive symptoms, it is important to also screen for psychological factors to provide appropriate guidance.
认知症状会影响癌症幸存者的工作能力。迄今为止，尚未研究工作中癌症幸存者的认知症状轨迹及其与这些轨迹相关的因素。
使用来自纵向“癌症后工作生活”研究的异质工作癌症幸存者（n=379）的数据，这些数据与荷兰癌症登记处的数据相关联。在基线（返回工作后的头 3 个月内）、6 个月、12 个月和 18 个月时使用认知症状清单-工作进行测量，以评估自我感知的记忆和执行功能症状。使用基于群组的轨迹建模进行数据分析。
确定了记忆和执行功能症状的四个轨迹。所有记忆症状轨迹均保持稳定，并标记为“稳定高”（样本的 15.3%）、“稳定中高”（39.6%）、“稳定中低”（32.0%）和“稳定低”（13.0%）。执行功能症状轨迹随时间而变化，标记为“递增高”（10.1%）、“稳定中高”（32.0%）、“递减中低”（35.5%）和“稳定低”（22.4%）。较高的症状轨迹与年龄较大、从诊断到返回工作的时间较长、更多的定量工作需求以及基线时更高水平的抑郁症状相关。
在返回工作的癌症幸存者中，确定了四个认知症状轨迹亚组，代表了认知症状不同但相对稳定的严重程度水平。
为了识别症状较高的癌症幸存者，医疗保健提供者应在返回工作后基线时评估认知症状。如果存在认知症状，重要的是还要筛查心理因素，以提供适当的指导。
