Return to Work in Patients with Hematological Cancers 1 Year after Treatment: A Prospective Longitudinal Study.

BACKGROUND: Although hematological cancer survivors have a high risk of disability, data on work-related issues are scarce for this population. METHODS: We investigated return to work (RTW) and work ability (Work Ability Index, WAI) in hematological cancer patients 6 months and 1 year after cancer treatment. We explored associations between baseline sociodemographic and medical characteristics and RTW as well as work ability at follow-up. RESULTS: The participation rate was 42% (baseline n = 91, after 12 months n = 40 (44%)). 6 months after cancer treatment, 33% (95% confidence interval 21%-46%) of the remaining patients had returned to work. After 12 months, the RTW rate was 58% (42%-73%). Mean WAI sum score ± SD significantly increased from 18.5 ± 7.3 at baseline to 28.3 ± 8.3 after 12 months (p = 0.001). Patients with lymphoma (r = 0.31, p = 0.02) and patients who received radiation therapy (r = 0.29, p = 0.04) were significantly more likely to return to work. Work ability after 6 months was most strongly associated with higher education (r = 0.60, p < 0.01). Patients' subjective prognosis of gainful employment before cancer treatment predicted work ability after 6 (r = 0.62, p < 0.01) and 12 months (r = 0.51, p < 0.01). CONCLUSION: The chance of returning to work of hematological malignancy survivors is similar to that of other cancer patients.

Assessment of patients' dignity in cancer care: preliminary psychometrics of the German version of the Patient Dignity Inventory (PDI-G).

CONTEXT: The Patient Dignity Inventory (PDI) is a valid and reliable instrument designed to measure different sources of dignity-related distress in cancer patients receiving palliative care. OBJECTIVES: We investigated item characteristics, factor structure, reliability, and concurrent validity of the German version of the PDI (PDI-G) among patients with cancer. METHODS: PDI was translated into the German language following state-of-the-art criteria. In a sample of 112 inpatients with mixed tumor types, principal component analysis, reliability analysis (Cronbach's coefficient alpha), and correlation analysis were performed. Concurrent validity was evaluated by validated measures of distress, demoralization, anxiety, depression, hopelessness, quality of life, sense of meaning and purpose, and supportive care needs. RESULTS: Cronbach's coefficient alpha for PDI-G was 0.96; factor analysis resulted in a four-factor solution, accounting for 71% of the overall variance, with factor loadings ranging from 0.49 to 0.86. Factor labels include Loss of Sense of Worth and Meaning, Anxiety and Uncertainty, Physical Symptom Distress and Body Image, and Loss of Autonomy, showing high internal consistencies ranging from Cronbach's α 0.80 to 0.95. Evidence for concurrent validity was established by significant associations between PDI-G scales and concurrent measures of distress. CONCLUSION: Although we were unable to replicate the five-factor structure provided by Chochinov, this study gave strong support to an alternative four-factor solution of PDI-G, capturing all 25 items. We conclude that PDI-G is a psychometrically sound instrument assessing a broad range of dignity-related distress issues in patients with cancer.