Return to work and psychosocial trajectories after breast cancer: a longitudinal and sequential approach.

PURPOSE: We aimed to describe the psychosocial adjustments according to return to work (RTW) trajectories in breast cancer survivors (BCS) using a sequential and temporal approach. METHODS: We used BCS data included from February 2015 to April 2016 in the Longitudinal Study on Behavioural, Economic and Sociological Changes after Cancer (ELCCA) cohort. RTW trajectories were identified using the sequence analysis method followed by a clustering. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale and the EORTC quality of life questionnaire was used at inclusion and all follow-up visits to assess Health-Related Quality of Life (HRQoL). RESULTS: Fifty-two BCS were included in the study among whom four clusters of RTW trajectories were identified and labeled: slow RTW (N = 10), quick RTW (N = 27), partial RTW (N = 8), and part-time work (N = 7). Quick and slow RTW clusters showed slightly lower baseline mean levels of anxiety and higher levels of HRQoL. In the 4 years following diagnosis, BCS in the quick RTW cluster tended to report higher HRQoL in terms of functioning and less symptoms of pain and fatigue while those in the partial RTW cluster showed a lower HRQoL on almost all dimensions. All clusters showed an increase in pain and fatigue symptoms until 6 months followed by a tendency to recover baseline levels. CONCLUSIONS: The results of this study suggest that BCS who return to full-time work (slow and quick RTW patterns) recover better than patients who return to part-time work (partial and part-time RTW patterns).

[Perceived work self-efficacy, and characteristics of return to work in women survivors of breast cancer at two reference centers in Colombia]. / Autoeficacia laboral percibida, y características del retorno al trabajo en mujeres supervivientes de cáncer de mama en Colombia.

OBJECTIVE: Return to work and permanence in employment of women who survive breast cancer are topics that become important as incidence and survival rates increase. Self-efficacy as a modifiable element is of special interest in this process. The objective of this study is to measure the level of self-efficacy in female breast cancer survivors, according to sociodemographic, work and treatment characteristics and their relationship with return to work. METHODS: This was a cross-sectional study, based on a survey of breast cancer patients about their demographic and work characteristics, the return to work process, permanence in the same job and the level of work self-efficacy. Differences in the level of self-efficacy with respect to characteristics were evaluated using bivariate analyses and hypothesis statistical testing. A value of p<0.05 was considered statistically significant. RESULTS: One hundred and twenty-four women were included, 87.9% had returned to work, the majority (56.4%) between one and six months after treatment, 67.7% remained in the same job. Higher levels of work self-efficacy were related to a higher probability of returning to work and staying there, and a shorter time to return to work; these differences were statistically significant. CONCLUSION: Occupational health and risk prevention services must consider and strengthen work self-efficacy and organizational support in breast cancer survivors to achieve a successful return to work.

OBJETIVO: El objetivo de este estudio es analizar el nivel de autoeficacia en mujeres supervivientes de cáncer de mama, según las características sociodemográficas, laborales y de tratamiento y su relación con la reincorporación laboral. Métodos: Estudio transversal, basado en una encuesta a pacientes de cáncer de mama de dos centros oncológicos sobre sus características demográficas, laborales, el proceso de retorno al trabajo, la permanencia en el mismo empleo y el nivel de autoeficacia laboral. Se evaluaron las diferencias en el nivel de autoeficacia con respecto a las características mediante análisis bivariado y pruebas estadísticas de contraste de hipótesis. Un valor de p<0.05 se consideró estadísticamente significativo. RESULTADOS: Se incluyeron 124 mujeres, de las cuales 87,9% habían retornado al trabajo, la mayoría (56,4%) entre uno y seis meses después del tratamiento, y el 67,7% permanecían en el mismo empleo. Los niveles superiores de autoeficacia laboral se relacionaron con una mayor probabilidad de retorno al trabajo y permanencia en el mismo, y menor tiempo de reincorporación, siendo estas diferencias estadísticamente significativas. Conclusión: La autoeficacia laboral y el apoyo organizacional son recursos que los servicios de salud laboral y prevención de riesgos deben considerar y fortalecer para ayudar a un retorno exitoso y sostenido al trabajo en supervivientes de cáncer de mama.

What really matters for returning to work after breast cancer? A 6-month exploratory study.

Return to work (RTW) after breast cancer (BC) may significantly impact on women recovery and quality of life. Literature hightlighed several factors associated to RTW after BC but there is still some concern about prognostic factors influencing work resumption after BC treatments. The present study aims to explore which baseline factors are associated with RTW at 6-month after BC surgery. The participants in this 6-month prospective study were 149 patients who underwent breast cancer-related surgery and accessed an Oncology Clinic for cancer therapy from March 2017 to December 2019 in Northern Italy. Participants filled in a battery of questionnaires at baseline, and they were asked whether they had returned to work at 6-month follow-up. Psychological measurements included job stress (Job Content Questionnaire), work engagement (Utrecht Work Engagement Scale), quality of life (World Health Organization Quality of Life- BREF), anxiety and depression (Hospital Anxiety and Depression Scale), resilience (Connor - Davidson Resilience Scale - 10 item) and personal expectations about RTW (ad-hoc single item). Moreover, sociodemographic, clinical, and work-related data were collected. Independent t-test and Chi-square test were used for comparisons among variables; logistic regression model was used to explore predictors of RTW. A total of 73.9 percent returned to work at6-month after surgery. In the multivariate model, chemiotherapy (B = -1.428; SE = 0.520) and baseline women's expectations about their RTW (B = -0.340; DS = 0.156) were significant predictors of RTW. These results suggest that careful individual clinical and psychological screening of risk factors at baseline can prevent from occupational disability and long sickness absence.

Factors associated with fatigue among people who have returned to work after stroke: an exploratory study.

OBJECTIVE: To explore the associations between fatigue impact and (a) personal and stroke-related characteristics, (b) functional impairments and (c) work-related factors among individuals who have returned to work after stroke. DESIGN: A cross-sectional exploratory study. SUBJECTS: 87 working stroke survivors. METHODS: This study comprises data from a postal survey targeting work ability and perceived stroke-related consequences 1 year after stroke. Fatigue was evaluated using the Fatigue Severity Scale (FSS). Factors associated with having fatigue (FSS total score ≥ 4) were identified using univariable and multivariable logistic regression analyses. Three domain-specific multivariable models and 1 final combined model were created. RESULTS: Fatigue was reported by 43% of the participants. Several factors representing all the investigated domains were associated with fatigue. In the final combined regression model, self-perceived low cognitive functioning, low decision control at work and high quantitative job demands had the strongest independent effects on the odds of having fatigue. CONCLUSION: Among people who were working 1 year after stroke, fatigue was associated with both personal and stroke-related characteristics as well as functional impairments and work-related factors. This highlights the complex nature of post-stroke fatigue. Fatigue management interventions should have a comprehensive approach and also consider the work environment.

Sustaining work ability amongst female professional workers with long COVID.

BACKGROUND: Long COVID (LC) compromises work ability (WA). Female worker WA has been more adversely impacted than WA in men. Exploration of lived experiences could elucidate the WA support required. AIMS: To explore the working conditions and circumstances experienced as affecting sustained WA amongst female workers with LC, to help mitigate worklessness risks. METHODS: Online semi-structured qualitative interviews were conducted with 10 female workers self-reporting or formally diagnosed with LC who had made some attempt to return to work (RTW). Interviews were analysed using template analysis to map themes informing WA enablers and obstacles onto a biopsychosocial model of rehabilitation. RESULTS: All participants were professionals working in an employed or self-employed capacity. Key themes reflecting circumstances that afforded sustained WA included the autonomy over where, when and how to work indicated as facilitated by a professional role, rapid health care access, predominantly sedentary work, competent colleagues able to cover for transient reduced WA, a strong interface between specialist health and management support, and accessible organizational policies that steer health management according to equity rather than equality. Highly flexible, iterative, co-produced RTW planning, tolerant of fluctuating symptom expression appears vital. In return for providing such flexibility, participants felt that employers' workforce diversity and competence would be protected and that workers would need to reciprocate flexibility. CONCLUSIONS: These qualitatively derived findings of workers' lived experiences add to existing guidance on supporting WA for people struggling with LC. Moreover, the same principles seem appropriate for tackling worklessness amongst working-age adults with complex long-term health conditions.

Process Evaluation of a Motivational Interviewing Intervention in a Social Security Setting: A Qualitative Study among Work-Disabled Patients.

Purpose Return to work (RTW) may be facilitated by motivational interviewing (MI), a counseling style designed to increase motivation towards behavior change. MI's relevance in a RTW context remains however unclear. Exploring how, for whom and in what circumstances MI works is therefore necessary. Methods Eighteen people (29-60 years; sick leave > 12 weeks) with low back pain (LBP) or medically unexplained symptoms (MUS) participated in a semi-structured interview after one MI consultation. We conducted a realist-informed process evaluation to explore MI's mechanisms of impact, its outcomes and how external factors may influence these. Data were coded using thematic analysis. Results Main mechanisms were supporting autonomy, communicating with empathy and respect, facilitating feelings of competence and focusing on RTW solutions instead of hindrances. Competence support was more salient among LBP patients, whereas MUS patients benefited more from empathy and understanding. External factors were mentioned to have impacted MI's effectiveness and/or the further RTW process, being personal (e.g. acceptance of the condition), work-related (e.g. supervisor support) and societal (e.g. possibility of gradual RTW). Conclusions These results stress the importance of self-determination theory's support for autonomy, relatedness and competence, together with a solution-focused approach when stimulating patients' engagement regarding RTW. These mechanisms' instalment during RTW counseling and their long-term impact depends on both personal and system-like external factors. Belgium's social security system's premise, based on control, might actually hinder RTW instead of facilitating it. Further longitudinal research could explore MI's long-term effects as well as its complex interaction with external factors.

The Effectiveness of Cognitive-Behavioral Therapy in Helping People on Sick Leave to Return to Work: A Systematic Review and Meta-analysis.

PURPOSE: Previous research has systematically studied the effectiveness of Cognitive Behavioral Therapy (CBT)-based interventions in managing both mental and physical symptoms of chronic disease including depression, stress-related mental disorders (SMD), and chronic pain that are common causes of sick leave. However, a systematic review focusing on the effectiveness of CBT in facilitating RTW is lacking. This study compiles research on utilizing CBT-based interventions for helping employees on sick leave return to work. METHODS: Randomized controlled trials (RCT) published between 1 January 1990 and 27 June 2022 were searched in MEDLINE, EMBASE, The Cochrane Library, Scopus, PsycINFO, Web of Science, and PubMed. The primary outcome variables included a return to work (RTW) measure and sickness absences. The secondary outcomes include psychological conditions (mental illness, stress, anxiety, and depression) and physical condition (working ability, fatigue, and physical function). RESULTS: Thirty-four RCTs were included in the analysis. Fifteen RCTs with 1727 participants reported on sick leave. Results showed that participants who completed CBT intervention had reduced sick leave in days (mean reduction - 3.654; 95%CI - 5.253, - 2.046; p < 0.001) compared to the control group. Sixteen papers with 2298 participants reported that the intervention group RTW 1.5 days earlier (95%CI 1.019, 1.722; p < 0.05). CBT-based interventions were effective in managing fatigue, mental illness, and depression, and improving physical function while it showed no effects in managing stress, anxiety and working ability. CONCLUSIONS: The findings indicate that CBT-based interventions are effective in reducing the length of sick leave and facilitating the RTW of employees in the intervention group.

Perceived vocational support needs and return-to-work outcomes in the first 12-months post-discharge in individuals with acquired brain injury and spinal cord injury: A retrospective cohort study.

BACKGROUND: Return-to-work (RTW) is often viewed as an important outcome following acquired brain injury (ABI) and spinal cord injury (SCI), although not all individuals have vocational goals and many experience barriers to RTW. OBJECTIVE: This study investigated the relationship between RTW and psychosocial functioning at 12-months post-discharge after ABI and SCI and examined patterns of RTW according to perceived need for and receipt of vocational support. METHODS: A file audit was conducted for 69 participants with ABI (n = 44) and SCI (n = 25). Data on employment status and perceived vocational support at 3- and 12-months post-discharge, home and community participation, psychological distress, and health-related quality of life were extracted. RESULTS: Individuals in paid employment at 12-months post-discharge (22%, n = 15) reported significantly better psychosocial functioning at this timepoint compared to those not employed (78%; n = 54). For those not employed, three subgroups were identified: 1) Did not perceive the need for or receive vocational support (50%; n = 27); 2) Perceived vocational support needs were unmet (19%; n = 10); and 3) Perceived and received vocational support (31%; n = 17). Psychological distress was highest for those who perceived and received vocational support but were not employed. CONCLUSION: RTW was associated with better psychosocial functioning after acquired neurological injury. The findings highlight the need for clinicians to explore and revisit individuals' perceived need for and preferences for vocational support and monitor the psychological well-being of those with RTW goals that are not yet successful.

Return-to-Work Experiences in Ontario Policing: Injured But Not Broken.

PURPOSE: Police officers and others working in police services are exposed to challenging and traumatic situations that can result in physical and/or psychological injuries requiring time off work. Safely returning to work post-injury is critical, yet little is known about current return-to-work (RTW) practices in police services. This study examines RTW practices and experiences in police services from the perspective of RTW personnel and workers with physical and/or psychological health conditions. METHODS: We used a purposive sampling approach to recruit sworn and civilian members from several police services in Ontario, Canada. The recruited members had experienced RTW either as a person in a RTW support role or as a worker with a work-related injury/illness. We conducted and transcribed interviews for analysis and used qualitative research methods to identify themes in the data. RESULTS: Five overarching themes emerged. Two pointed to the context and culture of police services and included matters related to RTW processes, injury/illness complexity, the hierarchical nature of police organizations, and a culture of stoicism and stigma. The remaining three themes pointed to the RTW processes of accommodation, communication and trust-building. They included issues related to recovery from injury/illness, meaningful accommodation, timely and clear communication, malingering and trust. CONCLUSIONS: Our findings point to potential areas for improving RTW practices in police services: greater flexibility, more clarity, stricter confidentiality and reduced stigma. More research is needed on RTW practices for managing psychological injuries to help inform policy and practice.

Work-health balance of cancer survivors returning to work: A meta-ethnography.

PURPOSE: This meta-ethnography investigates the multifaceted health-related experiences of cancer survivors returning to work (RTW), recognizing the pivotal role of employment in overall well-being, particularly in the context of increasing cancer cases among working-age adults. METHOD: Following the methodology of Noblit and Hare, a comprehensive literature search was conducted from 2013 to 2023 in databases including PubMed, Scopus, CINAHL, PsycINFO, and Embase. Qualitative studies assessing cancer survivors' experiences, motivation, concern, resilience, and need in the process of RTW were identified. Eligible studies were assessed for quality using the Critical Appraisal Skills Program Checklist, and their findings were subsequently synthesized. RESULTS: Seventeen studies were included for analysis. The finding revealed five key themes: motivations (voluntary and involuntary), cancer-related concerns, resilience, needs for cancer healthcare support, and workplace accommodation. Voluntarily RTW was primarily linked to desires of normalcy, while involuntary RTW was often financially driven. Cancer survivors often face physical, psychological, and social challenges in the RTW process. Resilience played a crucial role in their readaptation to the workplace. Participants expressed the need for additional guidance from healthcare providers and tailored support from the workplace to facilitate a smoother RTW experience. CONCLUSION: Cancer survivors aspire to be actively engaged, have their specific needs addressed, and achieve success in their return-to-work endeavors. Occupational guidance and accommodation from healthcare providers and employers play a pivotal role in empowering survivors to balance cancer and work, facilitating the return-to-work process, and enhancing the quality of survivorship.

Returning-to-work after mental health-associated sick leave: a qualitative interview study exploring the experiences of general practitioners in Germany.

BACKGROUND AND AIM: Psychiatric disorders are increasing globally. Especially when these disorders affect working people, this places a financial burden on society due to long-term sick leave, the incapacity to work and the inability to earn and pay taxes. General practitioners (GPs) are often the first health professionals to be consulted by those suffering from mental health disorders. This study investigated the experiences of GPs regarding their patients with mental health disorders and identified factors that are important for a successful return to work. METHODS: This qualitative study used semi-structured interviews to explore the opinions of GPs (n = 12) working in Munich, Germany, or its metropolitan area. The interviews were audio-recorded, transcribed, and analyzed using the reflexive thematic analysis method. RESULTS: GPs think of themselves as important players in the rehabilitation process of patients with mental health disorders. In their daily routine, they face many obstacles to ensure the best treatment and outcome for their patients. They also suffer from poor collaboration with other stakeholders, such as psychiatric hospitals, therapists or employers. They indicate that the mental health disorder of each patient is unique, including the barriers to and possibilities of a successful return to work. Additionally, the workplace appears to play a crucial role in the success rate of re-entry into work. It can exacerbate the course of mental health disorders or support recovery. Fear, shame and stigmatization of the patients are personal factors responsible for prolonged sick leave. CONCLUSION: We conclude that GPs believe that they can have a major impact on the rehabilitation of patients with mental health disorders. As such, special focus should be placed on supporting them in this context.

Factors That Predict Early Return to Work After Myocardial Infarction: Importance of Coworker Support.

Aim    Myocardial infarction (MI) affects the working-age group and cause many absences and lost days of work. Some occupational factors effect in the prognosis of MI patients. The objective of this study was to determine predictors of early, late and no return to work (RTW) after MI.Material and methods    In this cohort study, 240 pre-employed, male patients with MI from April 2020 through February 2022 provided data about their demographic, occupational, psychosocial, and medical information. Data was also collected about the treatment they received as patients, their feelings about socioeconomic support, and RTW time. RTW within two weeks after MI was defined as early RTW. The relationships of these variables and with early RTW and with late or no RTW were analyzed.Results    Ninety-four patients (39.6 %) returned to work within two weeks after MI, whereas 207 patients (87.3 %) returned to work by the end of six months. Many variables, including coworker support, were associated with early RTW in a univariate analysis. Regression analysis revealed that age, coworker support, marital status, the patient's own estimated RTW time, the number of the vessels with occlusion, and comorbidity were predictors of early RTW. Of these factors, only coworker support would be subject to modification.Conclusions    This study indicates that improving support from coworkers can increase early RTW after MI.

Return-to-work interventions for sick-listed employees with burnout: a systematic review.

Burnout is a work-related mental health problem that often causes long-term sickness absence. Return-to-work (RTW) interventions for burned-out sick-listed employees aim to prevent long-term work disability. This systematic review addresses two questions: (1) Which interventions for burned-out sick-listed employees have been studied?; (2) What is the effect of these interventions on RTW?We performed a systematic literature review and searched PubMed, Cochrane Central Register of Controlled Trials, Embase, CINAHL and Web of Science from 1 January 2000 to 31 December 2022. We searched for articles of interventions for burned-out sick-listed employees. We conducted the review in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Outcome was RTW.We identified 2160 articles after removal of all duplicates. Eight studies met inclusion criteria. RTW outcomes were number of sick-leave days, sick-leave rates, median period of RTW and worked hours per week. Five studies described person-directed interventions, one described a workplace-directed intervention, one described a combination of both intervention types and one study described all three types of intervention. Only the workplace-directed intervention showed a significant improvement in RTW compared with the comparator group: at 18-month follow-up, 89% of the intervention group had returned to work compared with 73% of the comparator group.Only a limited number of studies have explored interventions specifically focused on burned-out sick-listed employees and the effect on RTW. Due to heterogeneity and moderate to high risk of bias of these studies, no firm conclusions can be drawn on the described interventions and their effect on RTW.The study was registered with the International prospective register of systematic reviews (PROSPERO, registration number: CRD42018089155).

Readiness for return-to-work model-based analysis of return-to-work perception of young and middle-aged colorectal cancer patients with stoma in the early postoperative period: a descriptive qualitative study.

PURPOSE: With an increase in the number of young and middle-aged colorectal cancer (CRC) patients with stoma, understanding their perception about return to work (RTW) in the early postoperative period can guide medical professionals to provide appropriate rehabilitation strategies, which can eventually improve patients' readiness for return to work (RRTW) and enable them to achieve final rehabilitation. The present study aimed to investigate the RTW-related perceptions and considerations of young and middle-aged CRC patients with stoma after surgery. METHODS: From 2021 to 2022, we conducted a basic interpretive qualitative study involving semi-structured interviews with 17 CRC patients with stoma in two grade 3A hospitals in China. This study was based on the RRTW model. Data collection was continued until data saturation was reached, and all data were transcribed verbatim and analyzed by Colaizzi's phenomenological method. RESULTS: The following three key themes were identified: (1) self-efficacy; (2) decision balance; and (3) change process. Eight subthemes were formulated that were included within the respective main themes. CONCLUSION: In light of the current low self-efficacy and unsatisfactory willingness of patients with stoma about RTW, we suggest that medical staff should implement cognitive intervention and supportive interventions to improve self-efficacy, actively enhance the motivation of patients for RTW, and simultaneously resolve the pertinent difficulties; this could help patients to accept the positive change process and enable their successful transition from a change process to RTW.

[Return-to-Work - The Transition after Psychiatric Inpatient Treatment]. / Return-to-Work ­ Übergangsprozesse nach Behandlung in einem psychiatrischen Akutkrankenhaus.

OBJECTIVES: Workers on sick-leave due to a mental illness have enormous problems to return to work. The main objective of the present study is to examine, how individuals experience the transition from the mental health system to their workplace. METHODS: A qualitative research design guided by a grounded theory approach was used. Narrative interviews with ten workers on sick leave and four semi-structured interviews with return-to-work-experts were conducted. RESULTS: Relevant for returning to work is the interplay between the involved persons. Essential is the interpretation of the transition and as a result, which calls for action are made to the participants. CONCLUSION: Clinical interventions for returning to work should focus the support on the expectations of the participants and stimulate a common interpretation.

Return to Work Experiences of Ontario Public Safety Personnel with Work-Related Psychological Injuries.

PURPOSE: Public safety personnel (PSP) perform work that puts them at greater risk of psychological injury than the general public. PSP who subsequently develop posttraumatic stress disorder (PTSD) or other mental health conditions may need to take time off of work and use the workers compensation system. Very little is known about the experiences of PSP making this type of claim in Ontario to the Workplace Safety and Insurance Board (WSIB), or which healthcare professionals (HCP) PSP access as part of the treatment and return to work (RTW) process. This study captures the experiences of Ontario PSP in their RTW journeys, including with employers, WSIB, and HCPs. METHODS: A survey-based study was conducted, using email and social media platforms to distribute the survey to PSP across Ontario. Quantitative data were summarized using means and frequencies, and open text results were analyzed using qualitative framework analysis. RESULTS: 145 survey respondents met the inclusion criteria for the study. On a scale out of 5, PSP rated their experience with WSIB and employer support as poor on their first RTW attempt with an average rating of 2.93 and 2.46 respectively. The top three HCPs accessed by PSP were psychologists (61%), occupational therapists (OT; 60%) and general practitioners (GP; 44%). Respondents identified the cultural competence of HCPs in understanding their work demands and work culture as very important. CONCLUSIONS: To improve RTW experiences for PSP who make a workers compensation claim for a psychological injury, an increase in HCP cultural competence related to PSP work is indicated, as well as improved RTW processes and workplace support.

[Mental health and workplace - What tools are available to primary care physicians to facilitate the return to work for patients with workplace problems?] / Psychische Gesundheit und Arbeitsplatz.

Mental health and workplace - What tools are available to primary care physicians to facilitate the return to work for patients with workplace problems? Abstract. Patients with mental disabilities often get into difficulties at work, which can ultimately jeopardize their jobs. In these situations, low-threshold communication between the general practitioner and the employer is of particular importance in order to avoid escalations and loss of employment. The article describes the individual steps of psychosocial assessment by the general practitioner and their interaction with employers and supervisors. In making their recommendations, the authors draw on their many years of experience in training those responsible for return to work.

[How can general practitioners best help their depressed patients to resume work?] / Hausärztliche Betreuung bei der Rückkehr zur Arbeit.

How can general practitioners best help their depressed patients to resume work? Abstract. A recent Cochrane Review summarized the evidence of the effects of interventions to support depressed patients to return to work. The evidence base was quite large with 43 randomized controlled trials often leading to moderate and even high certainty evidence. For both return to work and depressive symptoms an integration of workplace interventions with clinical psychological treatment was most beneficial. Compared to care as usual, this could save 25 sick leave days on an annual basis for depressed patients. For general practitioners, it is worthwhile investing in organizing improved care with psychological treatment integrated with return-to-work measures. Simple workplace interventions such as decreased amount of working time or decreasing job demands will help if integrated in clinical care. The workplace accommodations are usually realized through the supervisor or the human resources department. Good relations with the supervisor are therefore essential. There is no evidence that antidepressant medication will help to decrease the time needed to return to work.

Returning to work in cancer survivors: a multi-center cross-sectional study in Spain / La vuelta al trabajo en supervivientes de cáncer: un estudio transversal multicéntrico en España

Objetivo: Analizar la situación laboral, así como variables sociodemográficas (edad, sexo, estado civil y titulación) relacionadas con el cáncer (tipo de cáncer, estrategia de tratamiento primario y fase de supervivencia) en supervivientes españoles de cáncer. Método y procedimiento: Estudio transversal sobre una muestra heterogénea de 772 supervivientes de cáncer de inicio en la edad adulta en edad laboral. Se realizaron análisis correlacionales y de regresión logística para estudiar la capacidad predictiva de las variables sociodemográficas y relacionadas con el cáncer sobre la situación laboral y la posible modulación de los resultados por la CVRS evaluada mediante el QLACS. Resultados: Sólo el 55% de los supervivientes de cáncer estaban empleados. La edad, la cualificación y el tipo de cáncer fueron predictores independientes de la situación laboral, así como de la fase de supervivencia en los supervivientes con una CVRS baja. Conclusiones: Un alto porcentaje de supervivientes en edad laboral no vuelve a trabajar tras la experiencia oncológica. Algunas variables sociodemográficas y relacionadas con la enfermedad pueden ayudar a la identificación precoz de la población de riesgo en la que centrar la atención (AU)

Objective: To analyze the employment status as well as sociodemographic (age, gender, marital status, and qualification) and cancer-related variables (cancer type, primary treatment strategy, and survival phase) in Spanish cancer survivors. Method and procedure: Cross-sectional study on a heterogeneous sample of 772 working-age survivors of adult-onset cancer. Correlational and logistic regression analyses were performed to study the predictive ability of sociodemographic and cancer-related variables on employment status and the possible modulation of results by HRQOL assessed by the QLACS. Results: Only 55% of cancer survivors were employed. Age, qualification, and type of cancer were independent predictors of employment status as well as the survival phase in survivors with a low HRQOL. Conclusions: A high percentage of working-age survivors do not return to work after the cancer experience. Some sociodemographic and disease-related variables can help in the early identification of the risk population on which to focus attention (AU)

Predictors of return to work for people on sick leave with depression, anxiety and stress: secondary analysis from a randomized controlled trial.

PURPOSE: Knowledge about predictors of return to work (RTW) in people on sick leave with common mental disorders (CMDs) may inform the development of effective vocational rehabilitation interventions for this target group. In this study, we investigated predictors of RTW at 6 and 12 months in people on sick leave with depression, anxiety disorders or stress-related disorders. METHODS: We have performed a secondary analysis, utilizing data from two RCTs that evaluated the efficacy of an integrated health care and vocational rehabilitation intervention. Data were obtained from mental health assessments, questionnaires and registers. Using Cox regression analysis, the relationship between baseline variables and RTW was analysed at 6 and 12 months after randomization within the group of CMD as a whole and within the subgroups of depression, anxiety and stress-related disorders. RESULTS: Symptom burden and employment status at baseline predicted RTW in the CMD group (n = 1245) and in the three diagnostic subgroups at both time points. RTW self-efficacy predicted RTW in the depression group but not in the anxiety or stress subgroups. CONCLUSION: Many predictors of RTW were similar over time and, to some extent, across the CMD subgroups. Findings highlight the need not only to take health-related and psychological factors into account when developing vocational rehabilitation interventions but also to consider workplace strategies and options for support.