Division of Gynecologic Oncology, Department of Obstetrics & Gynecology, University of Alabama at Birmingham, Birmingham, AL, United States of America; Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL, United States of America; O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, United States of America.
School of Public Health, University of Alabama at Birmingham, Birmingham, AL, United States of America.
Gynecol Oncol. 2022 Sep;166(3):481-486. doi: 10.1016/j.ygyno.2022.07.021. Epub 2022 Jul 25.
Our objective was to obtain perspectives from ovarian cancer patients on job demands, cancer demands, and workplace or cancer resources and strategies to manage the cancer-work interface using the cancer-work management conceptual framework.
We recruited ovarian cancer patients receiving systemic therapy who screened positive for financial distress using Comprehensive Score for Financial Toxicity <26. Interviews were conducted with participants about their costs of care, including employment concerns. Interviews were recorded, transcribed verbatim, and analyzed by three researchers using an inductive thematic analysis.
Of 22 participants, the average age was 57 years old, 36% were Black, 68% had income <$40,000, 41% had public insurance, and 68% were being treated for recurrent disease. Job demands included decreased productivity, inability to return to work, and worry about losing a job or employer-based health insurance coverage. Cancer demands included physical and cognitive limitations due to cancer treatment and reliance on caregivers, especially for transportation. Workplace resources/strategies including having a supportive employer, modifying job responsibilities, and utilizing family medical leave. Cancer care resources/strategies included planning appointments ahead of time and utilizing resources, such as disability.
Cancer care teams should consider screening patients for employment concerns; streamline care to minimize the side effects, time, and transportation demands of treatment on patients and caregivers; maximize utilization of available resources; and proactively communicate with employers to accommodate patients and caregivers who want or need to work.
本研究旨在利用癌症-工作管理概念框架,从卵巢癌患者的角度了解工作需求、癌症需求以及工作场所或癌症资源和策略,以管理癌症-工作界面。
我们招募了正在接受系统治疗且综合财务毒性评分(Comprehensive Score for Financial Toxicity,CSFT)<26 的卵巢癌患者。通过访谈了解患者的护理成本,包括就业问题。使用归纳主题分析法,由 3 位研究人员对访谈内容进行记录、逐字转录和分析。
在 22 名参与者中,平均年龄为 57 岁,36%为黑人,68%的收入<40000 美元,41%有公共保险,68%正在接受复发性疾病治疗。工作需求包括生产力下降、无法重返工作岗位以及担心失业或雇主提供的医疗保险覆盖范围。癌症需求包括癌症治疗导致的身体和认知限制以及对照顾者的依赖,尤其是在交通方面。工作场所资源/策略包括有一个支持性的雇主、调整工作责任以及利用家庭病假。癌症护理资源/策略包括提前安排预约以及利用残疾等资源。
癌症护理团队应考虑对患者的就业问题进行筛查;简化护理流程,以最大限度地减少治疗对患者和照顾者的副作用、时间和交通需求;最大限度地利用现有资源;并主动与雇主沟通,以满足希望或需要工作的患者和照顾者的需求。