Robert Rhonda, Andersen Clark R, Murphy Kathleen M, Medina-George Sandra, Scardaville Melissa, Conley Sha-Ron, Farris David, Roth Michael, Nguyen Vinh, Frieden Lex
Department of Pediatrics-Patient Care, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Mailroom FCT3.4021, Unit 1487, Houston, TX, 77030-4009, USA.
J Occup Rehabil. 2025 Jan 28. doi: 10.1007/s10926-025-10270-x.
We aimed to develop an online vocational rehabilitation (VR) readiness screening (VRRS) tool for young adults diagnosed with cancer. VR readiness was defined as being physically and cognitively ready to enter or return to work or school.
We developed an initial VRRS tool informed by previous studies, a scoping review to determine such a tool had not already been developed, and consultation with subject matter experts. We iteratively refined the tool on the basis of four rounds of interviews with young adults with cancer. The refined VRRS was then administered online to patients before they attended scheduled clinic appointments. We evaluated the VRRS completion rate; the ability of the online VRRS tool to assess patients' readiness for VR; and the concordance between clinical interview and that of the online VRRS tool, which was determined by using Cohen's κ or a fitting alternative; κ ≥ .61 suggested clinical utility.
The proportion of study participants completing the VRRS was 72.3% (136/188, 95% CI [65.4%, 78.6%]) and 69.2% (81/117, 95% CI [60.0%, 77.4%]) of participants who completed a clinical interview also completed the online VRRS tool. All clinical interview determinations and 93.8% (76/81) of online VRRS tool indicated participants' VR readiness. The VRRS-clinical interview agreement rate was 93.8% (95% CI [86.2%, 98.0%]). The prevalence index, bias index, and prevalence- and bias-adjusted κ statistic with 95% CIs were 0.938 [- 0.991, - 0.886], 0.062 [0.009, 0.114], and 0.877 [0.724, 0.959], respectively.
The VRRS tool is thus both feasible and effective in this sample of young adults with cancer.
我们旨在为被诊断患有癌症的年轻人开发一种在线职业康复（VR）准备情况筛查（VRRS）工具。VR准备情况被定义为在身体和认知上准备好进入或重返工作或学校。
我们在前人研究的基础上开发了初始VRRS工具，进行了一项范围审查以确定尚未开发出这样的工具，并与主题专家进行了咨询。我们根据对癌症青年患者进行的四轮访谈对该工具进行了反复完善。然后在患者参加预定的门诊预约之前，将完善后的VRRS在线提供给他们。我们评估了VRRS完成率；在线VRRS工具评估患者VR准备情况的能力；以及临床访谈与在线VRRS工具之间的一致性，这是通过使用科恩κ系数或合适的替代方法确定的；κ≥0.61表明具有临床实用性。
完成VRRS的研究参与者比例为72.3%（136/188，95%可信区间[65.4%，78.6%]），完成临床访谈的参与者中有69.2%（81/117，95%可信区间[60.0%，77.4%]）也完成了在线VRRS工具。所有临床访谈判定结果以及在线VRRS工具的93.8%（76/81）表明参与者具备VR准备情况。VRRS与临床访谈的一致率为93.8%（95%可信区间[86.2%，98.0%]）。患病率指数、偏差指数以及患病率和偏差调整后的κ统计量及其95%可信区间分别为0.938[-0.991，-0.886]、0.062[0.009，0.114]和0.877[0.724，0.959]。
因此，VRRS工具在这个癌症青年患者样本中既可行又有效。
