Occupational status among adult survivors following allo-SCT.

Being in work or the equivalent is an important goal after allo-SCT and is used as an indicator of recovery. The aim was to elucidate occupational status and factors associated with work among SCT survivors. Adults in working age with a haematological disease (n=177) were followed up within a median of 8 (range 28) years post allo-SCT. Predictors of not being in work at all or working part-time because of sick leave, disability pension or early old-age pension were analyzed using logistic regression analyses. At diagnosis, 82% of the participants were working full-time and 2% were on sick leave or old-age pension. At follow-up, 52% were working full-time, 27% were working part-time and 17% were on sick leave, disability pension or old-age pension. Not working at all was associated with multi-morbidity (P=0.01) and poorer health (P=0.00). Working part-time was associated with a higher age at diagnosis (P=0.00), being a woman (P=0.03), being born abroad (P=0.03) and multi-morbidity (P=0.00). In conclusion, the majority of survivors were in paid work at follow-up; however, a substantial number were not working or worked part-time.

Women's reflections and actions regarding working after breast cancer surgery - a focus group study.

BACKGROUND: To better understand processes affecting return to work (RTW) after breast cancer, more knowledge from the perspective of sickness absentees is warranted. Still, research based on women's own reasoning and actions in RTW is very scarce. This study aims to elucidate how women with breast cancer reflect and act on work-related issues. MATERIAL AND METHODS: Thematic analyses of data from four focus group interviews with 23 women who had had breast cancer surgery in the previous 3-13 months were carried out. RESULTS: The five following themes of reflections regarding RTW were identified: 'health and functioning', 'self-esteem/integrity', 'value of work', 'relationships at work', and 'social circumstances'. These reflections were associated with the three identified themes of actions taken by the women: 'to work or to be sickness absent', 'to adjust work according to own needs or not', and 'to disclose or to hide one's cancer'. There was a distinct difference between women who experienced work as a source of well-being and those who needed a respite from work. CONCLUSION: This study adds knowledge to the process of RTW after breast cancer and focuses on factors that lead the women to an active role in this process. We point to the interplay between women's own preferences, perceived competence, outer opportunities, and the actions each woman take with regard to RTW, which need to be recognized by all stakeholders involved. Furthermore, it continues to be essential to address the specific issue of disclosure in the workplace because this may be distressing for women.

Health-related quality of life and distress in cancer patients: results from a large randomised study.

To compare the effectiveness of individual support, group rehabilitation and a combination of the two in improving health-related quality of life (HRQOL) and psychological well-being in cancer patients during 24 months after diagnosis, as compared with standard care (SC). Furthermore, to compare the study sample and a random sample of the Swedish population with regard to HRQOL. A total of 481 consecutive patients, newly diagnosed with cancer, were randomly assigned to one of the four alternatives. Data on HRQOL and psychological well-being were collected at baseline and after 3, 6, 12 and 24 months. The interventions did not improve HRQOL or psychological well-being, as compared with SC. At 3 months, the study sample reported an HRQOL comparable with the normal population. Many cancer patients are able to manage their cancer-related concerns with the support available from SC. However, it is reasonable to assume that the findings suffer from a lack of data from especially vulnerable patients and a possible Hawthorne effect. It cannot be concluded that cancer patients have no need for additional psychosocial interventions. Future projects should include screening and target interventions for those at risk for significant and prolonged psychological distress.

Group rehabilitation for cancer patients: satisfaction and perceived benefits.

Satisfaction with a group rehabilitation programme (GR) was evaluated in a heterogeneous group of cancer patients. Of the patients that were invited, 67% (N = 132) participated in the GR. The GR included eight sessions plus one booster-session, each including information and/or cognitive-behavioural techniques combined with physical training and relaxation and started approximately 4 months after diagnosis. Men and women participated to the same extent. A mailed questionnaire was used to assess patients' satisfaction, perceived benefits and level of difficulty of the GR components. The majority of patients stated that the number of sessions and timing of the GR was adequate. The usefulness of the GR components were rated in the following descending order: relaxation, physical training, encountering others in the same situation, breathing exercises, information and cognitive-behavioural skills. Patients were more satisfied with diagnosis-specific group meetings than with those including several diagnoses. Assessment of patient satisfaction seems appropriate to elucidate patient priorities.