Cancer, fatigue and the return of patients to work - a prospective cohort study
Cancer, fatigue and the return of patients to work - a prospective cohort study
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DOI：
10.1016/s0959-8049(03)00364-2
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发表时间：
2003-07-01
影响因子：
8.4
通讯作者：
Sprangers, MAG
中科院分区：
文献类型：
--
作者：
Spelten, ER;Verbeek, JHAM;Sprangers, MAG
疲劳是癌症幸存者中一种非常普遍且令人衰弱的症状。本研究的目的是评估疲劳和其他癌症相关症状对癌症幸存者重返工作岗位的影响。一项为期 12 个月随访的前瞻性初始队列研究已启动。在病假第一天后的 6 个月内，除了临床、社会人口统计和工作相关因素外，还对疲劳、抑郁、睡眠问题、身体不适、认知功能障碍和心理困扰的程度进行了评估。数据来自荷兰的一家学术医院和两家综合医院。纳入了 235 名初步诊断为癌症并接受治愈性治疗的患者。在 6、12 和 18 个月时测量了重返工作岗位的比率。计算病假第一天后长达 18 个月的病假期间的风险比 (HR)。在病假第一天后，重返工作岗位的比率从 6 个月时的 24% 上升到 18 个月时的 64%。疲劳、诊断、治疗类型、年龄、性别、抑郁、身体不适和工作量都与重返工作岗位所需的时间有关。疲劳评分也与诊断、身体不适和抑郁评分密切相关。 6 个月时的疲劳预示着更长的病假，根据诊断、治疗类型、年龄和性别进行调整后，风险比为 0.71（95% 置信区间 (C.I.) 0.59-0.85）。在多变量 Cox 回归分析中，诊断、治疗、年龄、身体不适和工作量仍然是病假持续时间的唯一重要预测因素。 64% 的癌症幸存者在 18 个月内重返工作岗位。疲劳程度预示着重返工作岗位。这与诊断和治疗无关，但与其他癌症相关症状无关。因此，需要更好地管理癌症相关症状，以促进癌症患者重返工作岗位。 (C) 2003 Elsevier Ltd. 保留所有权利。
Fatigue is a highly prevalent and debilitating symptom in cancer survivors. The aim of this study was to assess the impact of fatigue and other cancer-related symptoms on the return to work of cancer survivors. A prospective inception cohort study with 12 months of follow-up was initiated. At 6 months following the first day of sick leave, levels of fatigue, depression, sleep problems, physical complaints, cognitive dysfunction and psychological distress were assessed, in addition to clinical, sociodemographic and work-related factors. Data were obtained from one academic hospital and two general hospitals in the Netherlands. 235 patients who had a primary diagnosis of cancer and underwent treatment with curative intent were included. The rate of return to work was measured at 6, 12 and 18 months. Hazard ratios (HRs) for the duration of sick leave up to 18 months following the first day of sick leave were calculated. The rate of return to work increased from 24% at 6 months to 64% at 18 months following the first day of sick leave. Fatigue, diagnosis, treatment type, age, gender, depression, physical complaints and workload were all related to the time taken to return to work. Fatigue scores were also strongly related to diagnosis, physical complaints, and depression scores. Fatigue at 6 months predicted a longer sick leave with a hazard ratio of 0.71 (95% Confidence Interval (C.I.) 0.59-0.85), adjusted for diagnosis, treatment type, age and gender. In a multivariate Cox regression analysis, diagnosis, treatment, age, physical complaints and workload remained the only significant predictors of duration of the sick leave. 64% of cancer survivors returned to work within 18 months. Fatigue levels predicted the return to work. This was independent of the diagnosis and treatment, but not of other cancer-related symptoms. Better management of cancer-related symptoms is therefore needed to facilitate the return to work of cancer patients. (C) 2003 Elsevier Ltd. All rights reserved.