Return-to-work support in cancer patients: Which methodology?

INTRODUCTION: Return to work after cancer is a determinant of patients quality of life. The aims were to describe return-to-work interventions applied in a French University Hospital and to assess its effectiveness in achieving a successful return to work. METHODS: A return-to-work questionnaire was sent to 153 patients who were accompanied by a multidisciplinary return-to-work after cancer consultation. RESULTS: hundred and twenty-one patients answered the return-to-work questionnaire. Analysis of the questionnaire found an overall rate of return to work of 50% two years after the cancer diagnosis. The rate was significantly higher in patients who had received individual psychological support for returning to work (P=0.04) and higher, but not significantly, in patients who had a consultation with the company physician during their period of sick-leave (P=0.08). Participating in support groups and performing the required actions for the recognition of handicapped worker status were not factors associated with return to work. DISCUSSION: An individual psychological support for returning to work and a consultation with the company physician during the period of sick-leave should be systematically recommended for patients suffering from cancer. Participating in support groups and recognition of handicapped worker status should be recommended on a case-by-case basis.

Giving up work after cancer: An exploratory qualitative study of three clinical cases.

BACKGROUND: Enabling cancer survivors to resume employment has become a public health issue in France, but not all survivors wish to or would benefit from doing so. OBJECTIVE: This French exploratory qualitative study was designed to identify the psychological factors that influence the decision of some cancer survivors not to return to work, despite their doctor's permission. METHODS: We conducted semi structured interviews with two women and one man. Each interview lasted around 90 minutes. Qualitative analysis of the interviews (clinical case studies) highlighted a number of similarities and differences among these three patients. RESULTS: Comparisons revealed six similarities: 1. the issue of income and its importance had no part in the decision-making process; 2. patients anticipated work return problems; 3. they therefore abandoned their plans to go back; 4. work lost its meaning for them; 5. repressed affects surfaced or they reassessed their career plans; and 6. their life trajectories were disrupted, with the stages being telescoped together. There were also two differences: 1. feelings of social exclusion for two participants, and 2. gendered experiences of quitting employment. CONCLUSIONS: Health professionals and job retention support services need to take this clinical reality into account and acknowledge that not all patients wish to resume work or would benefit from doing so.

[Advantages of a specialized return to work consultation after cancer]. / Intérêts d'une consultation spécialisée d'aide à la reprise du travail après cancer.

BACKGROUND: To help patients suffering from cancer to return to work, a multidisciplinary medico-psycho-social consultation after cancer was created in Upper Normandy in 2006. AIMS: To describe the organization and the experiences of the consultation. METHODS: The 3 actors of the consultation explained their point of view. Characteristics of the consultants, advises given to them and becoming of the patients were analysed by studying medical observations and questionnaires given to patients. RESULTS: Hundred and fifty patients, principally suffering from breast cancer (64%), consulted for returning to their current job (3/4) or for finding a new job (1/4). The return to work rate was 64% (95% CI=54-73), in a mean time of 7 months after the first "return to work" consultation. Ninety-three percent of the patients found that this consultation was useful. This consultation offers a transition between the hospital and the work environments, it guides patients to the good return to work actors, it gives specific advices about cancer and return to work. It gives specialised advices to workers who usually have not.