Medical staff's sense of awareness of informed consent for adolescent cancer patients and the need for decision-making support practiced from the perspective of trauma-informed approach.

It has not been established how to assess children's and adolescents' decision-making capacity (DMC) and there has been little discussion on the way their decision-making (DM). The purpose of this study was to examine actual situation and factors related to difficulties in explaining their disease to adolescent cancer patients or obtaining informed consent (IC). The cross-sectional questionnaire survey was conducted. Physicians who have been treating adolescent cancer patients for at least five years answered a self-administered questionnaire uniquely developed about clinical difficulties in explaining, IC and factors related patient's refusal of medical treatment (RMT). Descriptive statistics for each item and a polychoric correlation analysis of the problems and factors related to the explanation were conducted. As a result, fifty-six physicians were participated (rate of return: 39%). Explaining the disease and treatment to patients (83.9%), IC to patients (80.4%), and explaining the disease and treatment to parents (78.6%) was particularly problematic. Difficulties to provide support related with patient's refusal of medical treatment and to explain disease and treatment for patient and parents were related to difficulties obtaining IC for the patient. Conclusion: There are clinically difficult to explain for the patient or parents and to obtain IC for the patient. It is necessary to establish a disease acceptance assessment tool for the adolescence generation so that it can be applied in the field.

Diabetes severity measured by treatment control status and number of anti-diabetic drugs affects presenteeism among workers with type 2 diabetes.

BACKGROUND: The number of people with diabetes is increasing and resulting in major economic losses. Presenteeism accounts for the majority of economic losses, so measures against presenteeism are important. This study investigated the relationship between severity of type 2 diabetes and presenteeism. METHODS: A cross-sectional study was conducted among workers over 40 years of age. Participants were classified as normal group or diabetic treatment group using their medical examination results and health insurance claims data. Diabetic treatment groups were described by degree of treatment control: Good (HbA1c < 7%), Intermediate (7% ≤ HbA1c < 8%), and Poor (8% ≤ HbA1c). Therapy type was also divided into monotherapy and combination therapy. Logistic regression analysis was performed to predict presenteeism loss using the Quantity and Quality method. RESULTS: Data on 13,271 workers were analyzed. Presenteeism loss was significantly higher in all treatment control groups compared with the normal group, particularly for the intermediate and poor control groups. The monotherapy group did not differ from the normal group, but presenteeism loss was significantly higher in the combination therapy group than the normal group. CONCLUSIONS: Presenteeism loss in workers with diabetes may be affected by diabetes severity, and even if treatment control were good, presenteeism loss could occur when the number of anti-diabetic drugs was high. Therefore, it is important to provide early intervention and continuous support as a preventive measure against not only diabetes and diabetes-related complications but also presenteeism.

Association between overtime work hours and preventive dental visits among Japanese workers.

BACKGROUND: This study aimed to examine the association between overtime work and the frequency of preventive dental visits among workers in Japan. METHODS: A self-administered questionnaire was completed by 14,847 daytime-workers. We used a logistic regression model stratified by sex and age and adjusted for marital status, occupation, education, and oral status to investigate the association between overtime work hours and the frequency of preventive dental visits. RESULTS: In total 1037 men (9.3%) and 511 women (13.9%) attended quarterly preventive dental visits, and 2672 men (23.9%) and 1165 women (31.8%) attended annual preventive dental visits. Overtime work was statistically significantly associated with quarterly preventive dental visits among men aged 50-59 years, with adjusted odds ratios (aOR) and 95% confidence intervals (CI) of 0.73 (0.56-0.95), 0.75 (0.54-1.04), and 0.55 (0.34-0.90) for < 20, 20-39, and ≥40 h overtime/month, respectively. No such trends were observed for men aged < 50 years and women of all ages. Overtime work of < 20, 20-40, and ≥40 h overtime/month was statistically significantly associated with annual preventive dental visits among men aged 40-49 years (aOR [95%CI]: 0.76 [0.61-0.95], 0.84 [0.65-1.09], and 0.72 [0.51-1.00], respectively) and 50-59 years (aOR [95%CI]: 0.75 [0.61-0.91], 0.76 [0.59-0.97], and 0.63 [0.45-0.88], respectively). No such trends were observed in men < 40 years and women of all ages. CONCLUSIONS: Our study revealed associations between overtime and preventive dental visits among male workers aged in their 40s and 50s.

Industry and workplace characteristics associated with the downloading of a COVID-19 contact tracing app in Japan: a nation-wide cross-sectional study.

BACKGROUND: To combat coronavirus disease 2019 (COVID-19), many countries have used contact tracing apps, including Japan's voluntary-use contact-confirming application (COCOA). The current study aimed to identify industry and workplace characteristics associated with the downloading of this COVID-19 contact tracing app. METHODS: This cross-sectional study of full-time workers used an online survey. Multiple logistic regression analysis was used to evaluate the associations of industry and workplace characteristics with contact tracing app use. RESULTS: Of the 27,036 participants, 25.1% had downloaded the COCOA. Workers in the public service (adjusted odds ratio [aOR] = 1.29, 95% confidence interval [CI] 1.14-1.45) and information technology (aOR = 1.38, 95% CI 1.20-1.58) industries were more likely to use the app than were those in the manufacturing industry. In contrast, app usage was less common among workers in the retail and wholesale (aOR = 0.87, 95% CI 0.76-0.99) and food/beverage (aOR = 0.81, 95% CI 0.70-0.94) industries, but further adjustment for company size attenuated these associations. Workers at larger companies were more likely to use the app. Compared with permanent employees, the odds of using the app were higher for managers and civil servants but lower for those who were self-employed. CONCLUSIONS: Downloading of COCOA among Japanese workers was insufficient; thus, the mitigating effect of COCOA on the COVID-19 pandemic is considered to be limited. One possible reason for the under-implementation of the contact tracing app in the retail and wholesale and food/beverage industries is small company size, as suggested by the fully adjusted model results. An awareness campaign should be conducted to promote the widespread use of the contact tracing app in these industries.

Improved Sleep Quality and Work Performance Among Shift Workers Consuming a "Foods with Function Claims" Containing Asparagus Extract.

The purpose of this study was to examine whether Foods with Function Claims (FFC) containing asparagus extract effectively improved sleep quality and work performance in shift workers. An intervention study with a before-and-after intervention design was conducted on nurses engaged in two-shift work at a hospital, ingesting a FFC containing asparagus extract. The evaluation period lasted at least two weeks, including three nights shifts during the period. Before and after ingestion, Pittsburgh Sleep Questionnaire Index (PSQI), Utrecht Work Engagement Scale (UWES), Sleep quality (VAS-rated), impaired work functioning, and psychiatric symptoms were evaluated. A diary record, wearing of an activity meter, and a Psychomotor vigilance test were also performed at baseline and after intervention. Data were analyzed by the paired t-test or the Wilcoxon rank sum test. Among 34 participants, 33 completed the study. The results of the primary outcome measures showed significant improvements in PSQI and Sleep Quality in the night of the day after a night shift (PSQI total score: base line 7.41/ post intervention 6.03: P < 0.001; sleep quality: base line 4.48/post intervention 6.00: P < 0.001). The results of the secondary outcome measures showed significant improvements in UWES and feeling of fatigue. There was also trend of improvement in sleep efficiency and the reaction time. There was no significant improvement in impaired work functioning. This study showed that regular consumption of an FFC containing asparagus extract could improve sleep quality, feeling of fatigue, and work engagement among shift workers. Some caution, however, is needed when interpreting the results because of the before-and-after intervention design without a control group.

Work-Related Factors Affecting the Occurrence of Presenteeism － Recent Research Trends and Future Directions.

Productivity loss due to presenteeism accounts for a large proportion of economic losses caused by workers' health problems. To reduce presenteeism, it is necessary to identify its causes, but, in contrast to the large amount of research on the effects of diseases and lifestyles, there is not enough research on the effects of work-related factors on presenteeism. In this study, those factors include the work environment and the work-related psychological status of workers. The purpose of this review was to identify research trends in presenteeism, defined as work-related productivity loss, and to examine future directions for presenteeism research. We conducted a search with only the keyword "presenteeism" using MEDLINE/PubMed for the last 5 years and extracted 30 relevant articles, most of which were cross-sectional studies. The articles were categorized into the following themes: 1) studies on the associations of various stress models and factors with presenteeism; 2) studies on the mediators and the pathways of association between stress factors and presenteeism; 3) studies on the relationships between organizational factors and presenteeism; and 4) studies on the link between workers' positive and negative psychological status and presenteeism. Our findings showed that, over the last 5 years, the relationship between psychological stress and presenteeism has been extended to include a variety of stress models and stressors. In addition, by putting many models and factors into a single statistical model and adjusting for their interrelationships, important factors have been examined by ensuring that a significant relationship with presenteeism remains. As there is still a lack of longitudinal studies necessary to discuss causality, more research of higher quality is needed.

Relationship Between Work Engagement and the Onset of Long-term Sickness Absence Due to Mental Disorders: A 4-year Retrospective Cohort Study.

The aim of the present study was to investigate the association between work engagement and long-term sickness absence due to mental disorders such as mood disorders and anxiety, and whether the relationship differs between men and women, during a 4-year follow-up period. Data were obtained from 21,293 workers at four pharmaceutical companies belonging to the Collabo-Health Study Group in 2014. The baseline data were collected by self-administered questionnaires. We obtained information about long-term sickness absence from the personnel records of the surveyed companies from the baseline survey in 2014 until March 2018. Hazard ratios (HRs) and 95% confidence intervals (CIs) using the low work engagement group as a reference were calculated by Cox proportional hazards analysis as the outcome, defined as the period leading to mental health-related sick leave. A total of 12,025 participants had complete data for analysis, and 123 exhibited long-term sickness absence during a 4-year follow-up period. The high work engagement group for men had a significantly lower HR (0.52, 95% CI: 0.31-0.88, P = 0.015) compared with the low work engagement group. Conversely, among women, the moderate work engagement group had a significantly higher HR (2.44, 95% CI: 1.03-5.84, P = 0.043) compared with the low work engagement group. Work engagement in men may predict the occurrence of long-term sickness absence due to mental disorders in the subsequent four years, but this relationship was different in women. Further research is needed to clarify this issue.

Effect of Psychological Distress on the Association of Workplace Social Capital with Presenteeism and Sickness Absence.

Greater workplace social capital (WSC) can be related to workers' health and productivity. We sought to clarify the association between horizontal WSC and presenteeism and sickness absence (SA) and to examine the effects of psychological distress on these associations among Japanese workers. A cross-sectional study was conducted in 2017 at seven large Japanese companies. Logistic regression analysis was performed with presenteeism and SA as the dependent variables, horizontal WSC as an independent variable, and sociodemographic characteristics and psychological distress as covariates. After adjustment for sociodemographic characteristics, the results showed that greater horizontal WSC was associated with lower presenteeism and SA. The odds ratios for the relationship between horizontal WSC and presenteeism and that between horizontal WSC and SA dropped moderately after adjustment for psychological distress but remained significant. Further exploration of the factors underlying the relationship between WSC and productivity is needed to confirm if WSC enhances workers' health and productivity and to inform the development of effective occupational health initiatives.

Changes in Presenteeism Six Months After Returning from Sick Leave Due to Mental Illness.

This study examines how psychological distress (measured by the K10 screening test) and presenteeism (measured by the quality and quantity method) change in the six months after returning to work from having taken a sick leave because of a mental illness. In a manufacturing company with approximately 2,600 employees, 23 employees returned to work after experiencing mental illness between April 2015 and March 2016, and all 23 agreed to participate in the study. We analyzed 18 cases for which we had sufficient data. Two of the employees were absent from work in the sixth month. We performed multilevel analysis for K10 and presenteeism over time on the 16 without recurrence. A significant decreasing trend was observed for both K10 and presenteeism. Eleven of the 16 employees were consistently below the K10 cutoff value of 10 for six months, and 5 had zero presenteeism in the sixth month, whereas 6 employees showed improvement in presenteeism that stopped midway through the study. An occupational physician judged that the employees could work normally with presenteeism of zero. After returning to work, it is important to monitor not only psychiatric symptoms but also presenteeism.

Occupational Health Services Improve Effective Coverage for Hypertension and Diabetes Mellitus at Japanese Companies.

The World Health Organization (WHO) aims to enable all people to receive health services, and has proposed effective coverage (EC) as an index for this aim. EC refers to "the fraction of potential health gain that is actually delivered to the population through the health system, given its capacity," and is used to indicate the percentage of the population whose diseases are well controlled among those who require treatment or are receiving treatment. This study aimed to evaluate the effects of occupational health services on EC. We hypothesized that occupational health services provided to employees by full-time occupational health practitioners, such as occupational physicians and occupational health nurses, improve EC for hypertension, diabetes mellitus and hyperlipidemia compared to those services provided by part-time occupational health practitioners. We conducted a cross-sectional study to analyze the results of general medical examinations, personnel information, and medical expense claims in fiscal year 2011. A total of 91,351 male employees at a company group participated in the study. The EC for hypertension, diabetes mellitus and hyperlipidemia was measured and compared between the employees in workplaces with occupational health practitioners (OH group) and the employees in workplaces without occupational health practitioners (non-OH group). The EC for hypertension and diabetes mellitus was significantly greater in the OH group than in the non-OH group (aOR: 1.41, 95% CI: 1.20 - 1.66 for hypertension; aOR: 1.53, 95% CI: 1.17 - 2.00 for diabetes mellitus), while the EC for hyperlipidemia was comparable (aOR: 1.11, 95% CI: 0.92 - 1.34). Occupational health services provided by full-time occupational health practitioners greatly improve health management after a medical examination.

Occupational safety and health aspects of corporate social responsibility reporting in Japan from 2004 to 2012.

BACKGROUND: A number of companies publish corporate social responsibility (CSR) reporting in booklets and other publicly available formats. The purpose of this paper is to clarify the nine-year (2004-2012) trend of occupational safety and health (OSH) activities as described in CSR reporting (by industry sector and company size). METHODS: We investigated CSR reporting on the website in all Japanese companies listed on the first section of the Tokyo Stock Exchange. The data were extracted from CSR reporting of each company every year from 2004 to 2012. We counted the pages dedicated to information on OSH activities by industry sector and company size and calculated the rate of OSH divided by total CSR-related activities. RESULTS: The number of companies publishing CSR reports increased in all industry sectors, although the rate of inclusion of OSH activity within CSR reports increased only among sectors such as construction, manufacturing, transportation, and commerce. Among all company size, CSR reporting increased constantly throughout all observed years. The proportion of companies that had described OSH in CSR reporting increased from 2004 to 2012, and 76.5% companies had described OSH activities in 2012. The average number of pages of CSR-related report was 34.2 in 2004, increasing to 43.1 in 2012. The proportion of described pages of OSH activities in total CSR reporting increased gradually, and 2.7% in 2012. The focus of CSR reporting gradually shifted from 'environment' to 'social activity including OSH'. CONCLUSIONS: Majority of companies are putting more emphasis on OSH in CSR reporting in Japan.

Role of Supervisor Consultation Toward Work Engagement: A Prospective Cohort Study.

Background: We examined the association between supervisor consultation, as an actual practice representing supervisor support, and work engagement. Methods: This was a prospective cohort study in Japan, involving 14,026 participants who met the requirement for a one-year follow-up. Supervisor consultation was measured using a single question, and work engagement was defined using the Japanese version of the nine-item Utrecht Work Engagement Scale (UWES-9). Associations were examined using linear regression analysis. Results: Supervisor consultation was positively associated with work engagement after adjusting for gender, age, education, income, and industry (ß = 3.474; p < 0.001). The relationship remained significant after adjustment for perceived supervisor support, although the coefficient decreased (ß = 1.315; p < 0.001). Conclusion: Supervisor consultation probably acted on work engagement in different ways than perceived supervisor support.

Role of perceived organization support to promote diabetes treatment among workers.

This study investigated association of Perceived Organization Support (POS) with diabetes treatment among workers. This prospective cohort study was conducted online, and parts of nations wide study stratified similarly with workers' characteristic in Japan. Samples were screened to those who had diabetes in the baseline years. Binary regression analysis and p for trend were used for statistical analysis. There were 1,203 participants with diabetes followed up regarding their treatment behavior. Higher POS were likely to seek appropriate diabetes treatment after adjustment with personal and occupational factors (p=0.032) but became marginally significant when adjusted with night shift status (p=0.051). Further analysis found that POS was only associated with diabetes treatment among workers with night shift. Higher POS was likely associated with proper diabetes treatment specifically among workers with night shift.

Association between exposure to technological advances in the workplace and work engagement: a prospective cohort study.

OBJECTIVES: The study objective was to measure the association between exposure to technological advances and work engagement, adjusting for personal and workplace factors. METHODS: We conducted a nationwide online longitudinal survey study in Japan. The sample was stratified to represent Japanese workforce conditions. Work engagement was measured using the Japanese version of the Utrecht Work Engagement Scale-9. Exposure to technological advances was measured using a single question with Likert scale responses. Industry characteristics that were more/less likely to be replaced by automation were also measured. Linear regression was used for statistical analysis. RESULTS: There were 16 629 participants. We found that exposure to technological advances was associated with work engagement after adjustment for age, sex, education, income, and industry characteristics. We observed a significant interaction between age and exposure to technological advances (coefficient 0.891, P < .001), and conducted an age-stratified linear regression analysis. The significant association between age and exposure to technological advances reduced as age increased, and disappeared after adjustment for baseline work engagement. CONCLUSIONS: Longitudinal observations showed that exposure to technological advances was not significantly associated with work engagement.

A prospective cohort study of perceived organizational support and occupational accidents and near-miss events among Japanese workers.

INTRODUCTION: Preventing occupational accidents is a major global challenge, and employee safety practices play a crucial role in accident prevention. Although perceived organizational support (POS) is related to safety practices, there is currently insufficient evidence supporting a relationship between POS and occupational accidents. We investigated the relationships between POS and both occupational accidents and near-miss events that can lead to accidents in the following year among workers in various industries in Japan. METHOD: This prospective cohort study was conducted from March 2022 to March 2023 using a questionnaire survey. In total, 9916 participants who completed the follow-up survey and met our inclusion criteria were analyzed. The follow-up survey asked participants about both occupational accidents and near-miss events experienced in the year following the baseline assessment. POS was evaluated at baseline using the eight-item version of the Survey of Perceived Organizational Support. Odds ratios (ORs) for the relationships between POS and occupational accidents and near-miss events were estimated using multilevel logistic regression analyses nested by industries. RESULTS: The ORs for self-reported occupational accidents were significantly higher for the moderate (OR = 1.41, 95% confidence interval [CI]: 1.10-1.82), low (OR = 1.49, 95%CI: 1.18-1.89), and very low (OR = 2.03, 95%CI: 1.61-2.56) POS groups compared with the very high group. The ORs for self-reported near-miss events were also significantly higher for the moderate (OR = 1.21, 95%CI: 1.03-1.43), low (OR = 1.20, 95%CI: 1.03-1.40), and very low (OR = 1.56, 95%CI: 1.34-1.82) groups than the very high group. CONCLUSIONS: Our findings suggest lower POS is related to a higher occurrence of occupational accidents and near-miss events in the following year. Organizations should consider enhancing employees' POS to reduce occupational accidents and near-miss events. PRACTICAL APPLICATIONS: To enhance employees' POS, organizations should address identified antecedents of POS (e.g., fairness, supervisor support, rewards, favorable job conditions, and human resource practices).

Relationship Between Companies' Responses to Near-Miss Reports and Turnover Intentions of Workers: A Nationwide Cross-Sectional Study.

Background: Effective near-miss management is important in preventing workplace accidents. A company's inadequate response to near-miss reports can lead workers to feel insecure and dissatisfied with the company. We investigated the relationship between companies' responses to near-miss reports and turnover intentions of workers. Methods: We conducted a cross-sectional study using online self-administered questionnaire survey to workers aged ≥20 years in Japan in March 2022. The analysis included 5,071 participants who had near-miss experiences and reported them to their companies. The independent variable was companies' responses to near-miss reports, classified into three categories: adequate response group, inadequate response group, and no response group. The dependent variable was turnover intentions. We calculated the odds ratio and 95% confidential interval (CI) using multilevel logistic regression analyses nested for industries and adjusted for covariates. Results: Of the 5,071 participants, 3,058 (60.3%) were adequate response group, 1,484 (29.3%) were inadequate response group, and 529 (10.4%) were no response group. In multivariable adjusted model, compared with adequate response group, the odds ratio of inadequate response group and no response group were 1.80 (95% CI: 1.56-2.08) and 2.63 (95% CI: 2.15-3.22), respectively. Conclusion: Our results suggested that there was a relationship between companies' responses to the near-miss reports and turnover intentions of workers. It is important not only to collect near-misses but also to respond appropriately to the reports and provide feedback to workers.

Relationship between diabetes treatment status and occupational accidents.

AIMS: To evaluate the relationship between diabetes treatment status and occupational accidents. METHODS: A cross-sectional study was conducted using an online questionnaire survey completed in March 2022 among workers aged 20 years or older. The questionnaire included questions about diabetes treatment status and occupational accidents. The association between the treatment status of diabetes and occupational accidents was examined using a logistic regression analysis. RESULTS: The study included 25,756 participants with no diabetes, 1,364 participants receiving diabetes treatment, 177 participants who had interrupted diabetes treatment, and 396 participants who needed diabetes treatment but had not seen a doctor. Compared with those with diabetes treatment, the odds ratio of occupational accidents among participants without diabetes was 0.40 (95% CI: 0.32-0.49), the odds ratio among participants with interrupted diabetes treatment was 4.15 (95% CI: 2.86-6.01), and the odds ratio among participants who needed diabetes treatment but had not seen a doctor was 1.25 (95% CI: 0.89-1.77). CONCLUSIONS: This study showed that diabetes treatment status was related to occupational accidents, and it may be important for workers with diabetes to be supported to balance their diabetes management and their work commitments.

Effect of Side Jobs and Psychological Distress on Employee Turnover in Japanese Employees: A Nationwide Prospective Cohort Study.

OBJECTIVES: We investigated the impact of engaging in side jobs on turnover and its interaction with psychological distress among Japanese employees. METHODS: A prospective cohort study was conducted using a questionnaire-based survey. We investigated 2783 full-time employees in companies permitting side jobs. Multiple logistic regression analyses were used to examine the relationship between side jobs and turnover, and its relationship stratified by psychological distress. RESULTS: Employees engaging in side jobs had higher odds ratios (ORs) for turnover after adjusting for covariates, including psychological distress (OR, 1.54; 95% confidence interval, 1.22 to 1.93). Among those under psychological distress, ORs for turnover were significantly higher (OR, 1.96; 95% confidence interval, 1.39 to 2.76). Conversely, in employees without distress, no significant difference was observed. CONCLUSIONS: Side job engagement correlates with higher turnover, particularly among employees under psychological distress.

Association Between Workaholism and Headaches Causing Presenteeism: A Cross-sectional Study in Japan.

OBJECTIVES: This study investigates the association between workaholism and headaches causing presenteeism among Japanese employees. METHODS: Used data from self-reporting questionnaire and annual health checkups. Workaholism was assessed using the Dutch Workaholic Scale and headaches causing presenteeism were identified as the symptom hindering work. We performed a logistic regression analysis adjusted for covariates. RESULTS: Among 5802 respondents, 3.7% cited headaches as the symptom hindering work. We found an association between workaholism and such headaches (odds ratios [OR]: 1.05, 95% confidence intervals [CI]: 1.03-1.08). Both working excessively (OR: 1.08, 95% CI: 1.04-1.12) and working compulsively (OR: 1.10, 95% CI: 1.05-1.15) subscales were also related. CONCLUSIONS: Workaholism may lead to productivity loss due to headaches, and addressing workaholism can prevent this loss. Combining health examination data with work hours data may enable the early detection of workaholism.

Perioperative Rehabilitation in Collaboration with the Department of Occupational Medicine for Patients with Cholangiocarcinoma: A Case Report.

INTRODUCTION: Although the number of cancer survivors has increased, the role of physical therapy in return to work (RTW) for employed patients with cancer remains unclear. CASE PRESENTATION: The patient is a 50-year-old man diagnosed with cholangiocarcinoma who worked as a liquefied petroleum gas station filler. He started perioperative rehabilitation and underwent pancreaticoduodenectomy for cholangiocarcinoma. He developed a postoperative pancreatic fistula, which improved with conservative treatment over 40 days. Although he achieved independence regarding day-to-day activities, his physical condition and workability worsened, as his skeletal muscle index decreased from 8.7 to 7.7, 6-min walk distance from 518 to 460 m, and work ability index (WAI) from 37 to 20 points. His physical therapist was concerned about his RTW and recommended that he receive RTW support from the Department of Occupational Medicine (DOM). The DOM employed a team approach for the RTW strategy, and the primary physician, occupational physician, and company collaborated to support the patient. After the outpatient treatment protocol and RTW support plans were formulated, the patient was discharged. The physical therapist reported declining physical performance and WAI at the DOM's multidisciplinary conference. After consulting with multiple professionals, the team recommended work resumption in stages: part-time for three months and full-time for four months after surgery while undergoing oral adjuvant chemotherapy. The WAI improved to 35 points after RTW. CONCLUSION: This case report suggests that physical therapists are vital in providing continuous patient support, from perioperative rehabilitation to DOM intervention, to build physical strength for return to work.