The quality of working life questionnaire for cancer survivors (QWLQ-CS): factorial structure, internal consistency, construct validity and reproducibility.

BACKGROUND: To assess the factorial structure, internal consistency, construct validity and reproducibility of the Quality of Working Life Questionnaire for Cancer Survivors (QWLQ-CS). METHODS: An Exploratory Factor Analysis (EFA) was performed on QWLQ-CS data from a sample of employed cancer survivors to establish the final number of items and factorial structure of the QWLQ-CS. Internal consistency was assessed using Cronbach's alpha. In a second sample of (self-)employed cancer survivors, construct validity was tested by convergent validity (correlations of QWLQ-CS with construct-related questionnaires), and discriminative validity (difference in QWLQ-CS scores between cancer survivors and employed people without cancer). In a subgroup of stable cancer survivors subtracted from the second sample, reproducibility was evaluated by Intraclass Correlation Coefficient (ICC) and Standard Error of Measurement (SEM). RESULTS: EFA on QWLQ-CS data of 302 cancer survivors resulted in 23 items and five factors. The internal consistency of the QWLQ-CS was Cronbach's α = 0.91. Convergent validity on data of 130 cancer survivors resulted in r = 0.61-0.70. QWLQ-CS scores of these cancer survivors statistically differed (p = 0.04) from employed people without cancer (N = 45). Reproducibility of QWLQ-CS data from 87 cancer survivors demonstrated an ICC of 0.84 and a SEM of 9.59. CONCLUSIONS: The five-factor QWLQ-CS with 23 items and adequate internal consistency, construct validity, and reproducibility at group level can be used in clinical and occupational healthcare, and research settings.

The Quality of Working Life Questionnaire for Cancer Survivors: Sufficient responsiveness for use as a patient-reported outcome measurement.

To assess the responsiveness and interpretability of the Quality of Working Life Questionnaire for Cancer Survivors (QWLQ-CS). A cohort study was conducted in which 130 (self-)employed cancer survivors completed the QWLQ-CS at baseline and 107 at follow-up and six single-item external anchors to measure change. Cancer survivors were diagnosed between 3 months and 10 years previously. To measure responsiveness we assessed the Area Under the Curve (AUC) of Receiver Operation Characteristic (ROC). To assess interpretability we compared Minimal Important Change (MIC) to Smallest Detectable Change at group level (SDC_group). The MIC was based on the mean change method and the SDC on the measurement error. We found sufficient responsiveness for improvement with AUC of 0.72 and sufficient interpretability with MIC (3.9) exceeding the SDC_group (2.8). Accordingly, we found sufficient responsiveness for deterioration with AUC of 0.27 and sufficient interpretability with MIC (-7.4) exceeding SDC_group (2.8). An improvement of 3.9 on the QWLQ-CS is meaningful to cancer survivors as is a deterioration of -7.4, both of which can be reliably measured at group level. The QWLQ-CS can be used as a patient-reported outcome measurement (PROM) of an intervention in research or practice at group level.

Quality of Working Life of cancer survivors: associations with health- and work-related variables.

PURPOSE: This study aimed to (1) describe the Quality of Working Life (QWL) of cancer survivors and (2) explore associations between the QWL of cancer survivors and health- and work-related variables. METHODS: Employed and self-employed cancer survivors were recruited through hospitals and patient organizations. They completed the Quality of Working Life Questionnaire for Cancer Survivors (QWLQ-CS) and health- and work-related variables in this cross-sectional study. The QWL scores of cancer survivors were described, and associations between QWL and health- and work-related variables were assessed. RESULTS: The QWLQ-CS was completed by 302 cancer survivors (28% male) with a mean age of 52 ± 8 years. They were diagnosed between 0 and 10 years ago with various types of cancer, such as breast cancers, gastrointestinal cancers, urological cancers, and haematological cancers. The QWL mean score of cancer survivors was 75 ± 12 (0-100). Cancer survivors had statistically significant lower QWL scores when they had been treated with chemotherapy or when they reported co-morbidity (p ≤ 0.05). Cancer survivors without managerial positions, with low incomes or physically demanding work, and who worked a proportion of their contract hours had statistically significantly lower QWL scores (p ≤ 0.05). CONCLUSIONS: This study described the QWL of cancer survivors and associations between QWL and health- and work-related variables. Based on these variables, it is possible to indicate groups of cancer survivors who need more attention and support regarding QWL and work continuation.

The Quality of Working Life Questionnaire for Cancer Survivors (QWLQ-CS): a Pre-test Study.

BACKGROUND: Returning to and continuing work is important to many cancer survivors, but also represents a challenge. We know little about subjective work outcomes and how cancer survivors perceive being returned to work. Therefore, we developed the Quality of Working Life Questionnaire for Cancer Survivors (QWLQ-CS). Our aim was to pre-test the items of the initial QWLQ-CS on acceptability and comprehensiveness. In addition, item retention was performed by pre-assessing the relevance scores and response distributions of the items in the QWLQ-CS. METHODS: Semi-structured interviews were conducted after cancer survivors, who had returned to work, filled in the 102 items of the QWLQ-CS. To improve acceptability and comprehensiveness, the semi-structured interview inquired about items that were annoying, difficult, confusing, twofold or redundant. If cancer survivors had difficulty explaining their opinion or emotion about an item, the interviewer used verbal probing technique to investigate the cancer survivor's underlying thoughts. The cancer survivors' comments on the items were analysed, and items were revised accordingly. Decisions on item retention regarding the relevance of items and the response distributions were made by means of pre-set decision rules. RESULTS: The 19 cancer survivors (53 % male) had a mean age of 51 ± 11 years old. They were diagnosed between 2009 and 2013 with lymphoma, leukaemia, prostate cancer, breast cancer, or colon cancer. Acceptability of the QWLQ-CS was good - none of the items were annoying - but 73 items were considered difficult, confusing, twofold or redundant. To improve acceptability, for instance, the authors replaced the phrase 'disease' with 'health situation' in several items. Consequently, comprehensiveness was improved by the authors rephrasing and adjusting items by adding clarifying words, such as 'in the work situation'. The pre-assessment of the relevance scores resulted in a sufficient number of cancer survivors indicating the items as relevant to their quality of working life, and no evident indication for uneven response distributions. Therefore, all items were retained. CONCLUSIONS: The 104 items of the preliminary QWLQ-CS were found relevant, acceptable and comprehensible by cancer survivors who have returned to work. The QWLQ-CS is now suitable for larger sample sizes of cancer survivors, which is necessary to test the psychometric properties of this questionnaire.

Quality of working life issues of employees with a chronic physical disease: a systematic review.

PURPOSE: To assess issues that contribute to the Quality of Working Life (QWL) of employees with a chronic physical disease. METHODS: A systematic literature search was conducted using the databases PubMed, PsycINFO and EMBASE. Experiences and perceptions during the working life of employees with a chronic physical disease were extracted and synthesized into issues that contributed to their QWL. We organized these synthesized QWL issues into higher order themes and categories with qualitative data analysis software. RESULTS: From a total of 4,044 articles identified by the search, 61 articles were included. Data extraction and data synthesis resulted in an overview of 73 QWL issues that were classified into 30 themes. The following five categories of themes were identified: (1) job characteristics with issues such as job flexibility and work-site access; (2) the social structure and environment containing issues about disclosure, discrimination, misunderstanding, and awareness by employers or colleagues; (3) organizational characteristics with issues such as requesting work accommodations; (4) individual work perceptions including issues about enjoyment and evaluating work or life priorities; and (5) effect of the disease and treatment including issues about cognitive and physical health and work ability. CONCLUSION: This systematic review offers an extensive overview of issues that might contribute to the QWL of employees with a chronic physical disease. This overview may function as a starting point for occupational support, such as monitoring and evaluating the QWL of employees with a chronic physical disease during return-to-work and work continuation processes.

The potential of using hair cortisol to measure chronic stress in occupational healthcare; a scoping review.

OBJECTIVES: Workplace-based selective prevention of mental health problems currently relies on subjective evaluation of stress complaints. Hair cortisol captures chronic stress responses and could be a promising biomarker for the early identification of mental health problems. The objective was to provide an overview of the state-of-the-art knowledge on the practical value of hair cortisol in the occupational setting. METHODS: We performed a scoping review of cross-sectional and longitudinal studies in PubMed, Embase, and PsycINFO up to November 2019 assessing the relations of hair cortisol with work-related stressors, perceived stress, and mental health outcomes in healthy workers. RESULTS: We found five longitudinal studies, of which two observed an increase in work-related stressors to be associated with higher hair cortisol, one found a relation with lower hair cortisol and one did not find a relationship. Findings of cross-sectional studies were also mixed. The one available longitudinal study regarding mental health showed that hair cortisol was not related to depressive symptoms. CONCLUSIONS: Hair cortisol measurement within occupational health research is still in its early stage and more longitudinal studies are urgently needed to clarify its relationship with work-related stressors and perceived stress before hair cortisol can be used to identify workers at risk for mental health problems.

Quality of working life of cancer survivors: development of a cancer-specific questionnaire.

PURPOSE: The aim of this study was to generate, and select quality of working life issues for the development of an initial version of the Quality of Working Life Questionnaire for Cancer Survivors (QWLQ-CS). METHODS: Quality of working life issues were generated through focus groups with cancer survivors and oncological occupational physicians, and interviews with employers, supervisors, and organization officers. A selection of these quality of working life issues was made based on relevance and importance by conducting an online questionnaire among the cancer survivors and oncological occupational physicians. Researchers formulated the issues into items for the QWLQ-CS. RESULTS: A total of 24 cancer survivors, six oncological occupational physicians and 11 employers, supervisors, and organization officers participated. The 222 quality of working life issues identified through the focus groups, interviews, and literature were converted into an online questionnaire. Cancer survivors (N = 20) found 44 issues not relevant or important with respect to their quality of working life. The researchers reviewed the remaining 178 issues and formulated them into 102 items classified by five categories: work perception, job characteristics, the social structure and environment, organizational characteristics, and the effect of the disease and treatment. CONCLUSIONS: The initial version of the QWLQ-CS exists out of 102 items which cover the experiences and perceptions of cancer survivors in the work environment. All items were indicated by working cancer survivors as relevant and important. IMPLICATIONS FOR CANCER SURVIVORS: This initial version of the QWLQ-CS may increase awareness of the potential problems or emotional difficulties working cancer survivors face during the work continuation process.