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转移性乳腺癌患者就业及工作生活质量的相关因素

Factors Associated With Employment and Quality of Working Life in Patients With Metastatic Breast Cancer.

作者信息

Kias Alina, Schmidt Martina E, Hiensch Anouk E, Clauss Dorothea, Monninkhof Evelyn M, Pelaez Mireia, Belloso Jon, Gunasekara Nadira, Sweegers Maike G, Trevaskis Mark, Rundqvist Helene, Müller Jana, Wiskemann Joachim, van der Wall Elsken, Aaronson Neil K, Lachowicz Milena, Urruticoechea Ander, Zopf Eva M, Bloch Wilhelm, Stuiver Martijn M, Wengström Yvonne, May Anne M, Steindorf Karen

机构信息

German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT) Heidelberg (a Partnership Between DKFZ and University Medical Center Heidelberg), Heidelberg, Germany.

Medical Faculty, University of Heidelberg, Heidelberg, Germany.

出版信息

Cancer Med. 2025 Aug;14(15):e71074. doi: 10.1002/cam4.71074.

Abstract

PURPOSE

As survival of patients with metastatic breast cancer (MBC) improves, their work situation is gaining importance. The aim of the current study was to identify factors associated with work status and quality of working life (QWL) in patients with MBC. Additionally, we investigated the effects of an exercise intervention on work status.

METHODS

Within the multinational PREFERABLE-EFFECT exercise trial, 287 patients with MBC of working age (18-65 years) reported on their working situation over 9 months as a secondary endpoint. Among a subgroup of participants, QWL was assessed by the Quality of Working Life Questionnaire for Cancer Survivors (QWLQ-CS) (N = 59).

RESULTS

At baseline, 157 (54.7%) participants were employed, of whom one-third reported having recently reduced their amount of work because of fatigue (41.7%), cognitive problems (33.3%), or inability to meet work demands (33.3%). Participants wished for more flexible working hours (29.2%) and less productivity pressure (37.5%). Participants were less likely to work if they experienced higher levels of pain (p = 0.014). Among working participants, an academic education and higher levels of psychological distress were associated with a higher number of working hours (all p < 0.05). Fatigue, an academic education, and performing mentally strenuous tasks at work were negatively associated with QWL (all p < 0.05). The exercise intervention did not affect the number of hours worked during the study.

CONCLUSIONS

Symptom management might be important for patients' ability to work. To help patients stay employed and improve QWL, employers should consider offering more flexible work arrangements and adapting to their employees' changing needs and abilities.

TRIAL REGISTRATION

The PREFERABLE-EFFECT trial was registered with ClinicalTrials.gov on October 9, 2019 (NCT04120298).

摘要

目的

随着转移性乳腺癌(MBC)患者生存率的提高,他们的工作状况变得愈发重要。本研究的目的是确定与MBC患者工作状态及工作生活质量(QWL)相关的因素。此外,我们还研究了运动干预对工作状态的影响。

方法

在多国PREFERABLE-EFFECT运动试验中,287名工作年龄(18 - 65岁)的MBC患者将其9个月内的工作情况作为次要终点进行了报告。在一部分参与者亚组中,通过癌症幸存者工作生活质量问卷(QWLQ-CS)评估了QWL(N = 59)。

结果

在基线时,157名(54.7%)参与者受雇,其中三分之一报告称最近因疲劳(41.7%)、认知问题(33.3%)或无法满足工作要求(33.3%)而减少了工作量。参与者希望有更灵活的工作时间(29.2%)和更低的生产率压力(37.5%)。如果经历更高水平的疼痛,参与者工作的可能性较小(p = 0.014)。在工作的参与者中,受过学术教育和较高水平的心理困扰与工作时间较多相关(所有p < 0.05)。疲劳、学术教育以及工作中从事脑力高强度任务与QWL呈负相关(所有p < 0.05)。运动干预在研究期间未影响工作时长。

结论

症状管理对患者的工作能力可能很重要。为帮助患者保持就业并改善QWL,雇主应考虑提供更灵活的工作安排,并适应员工不断变化的需求和能力。

试验注册

PREFERABLE-EFFECT试验于2019年10月9日在ClinicalTrials.gov注册(NCT04120298)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11b9/12296696/13838ab3b146/CAM4-14-e71074-g001.jpg

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