Employment Status as an Indicator of Recovery and Function One Year after Hematopoietic Stem Cell Transplantation
Employment Status as an Indicator of Recovery and Function One Year after Hematopoietic Stem Cell Transplantation
复制标题
DOI：
10.1016/j.bbmt.2016.05.013
复制
发表时间：
2016-09-01
影响因子：
4.3
通讯作者：
Gastineau, Dennis A.
中科院分区：
文献类型：
--
作者：
Morrison, Eleshia J.;Ehlers, Shawna L.;Gastineau, Dennis A.
造血干细胞移植（HSCT）后的就业是移植后恢复和功能的指标，具有经济和社会意义。随着HSCT生存率的不断提高，可以更加重视影响移植后生存质量的因素，包括恢复就业的能力。采集自体或异体HSCT受者样本（n = 1000），以完成移植前和移植后1年的纵向生活方式调查。本研究探讨了就业和患者特征，疾病变量，疾病状态和1年生存者（n = 702）的生活质量之间的关联。参与者的平均年龄为55岁（范围为18至78岁），主要为男性（59.7%），已婚/伴侣（77.1%）和非西班牙裔白人（89.5%）;大多数（79.4%）接受了自体移植。在690名报告在疾病诊断前有某种形式工作的参与者中，62.4%在HSCT后1年重返工作岗位。HSCT后1年的全职工作与疾病缓解、疾病改善、移植后住院次数减少、疲劳和疼痛减少、生活质量提高和自觉健康评分提高显著相关。那些因健康原因而失业的人报告说，疲劳和疼痛的比例最高，生活质量最低，他们最有可能报告自己的健康状况不佳。这些研究结果突出表明，重新融入工作是移植后幸存者总体调整的重要结果和标志。确定影响移植后就业的因素，为针对可改变的风险因素进行行为干预提供了机会，以优化移植后生存率，包括增加重返工作岗位的比率和降低相关残疾的比率。(C)2016年美国血液和骨髓移植学会。
Employment after hematopoietic stem cell transplantation (HSCT) is an indicator of post-transplantation recovery and function, with economic and social implications. As survival rates for HSCT continue to improve, greater emphasis can be placed on factors affecting the quality of post-transplantation survival, including the ability to resume employment. A sample of recipients of autologous or allogeneic HSCT was accrued (n = 1000) to complete a longitudinal lifestyle survey before transplantation and at 1 year after transplantation. The present study examines associations between employment and patient characteristics, disease variables, illness status, and quality of life among 1-year survivors (n = 702). Participants had a mean age of 55 years (range, 18 to 78) and were predominately male (59.7%), married/partnered (77.1%), and non Hispanic Caucasian (89.5%); most (79.4%) had received autologous transplantation. Of the 690 participants reporting some form of employment before illness diagnosis, 62.4% had returned to work by 1 year after HSCT. Full-time employment at 1 year after HSCT was significantly associated with remission of illness, improved illness, fewer post-transplantation hospitalizations, less fatigue and pain, higher quality of life, and higher rating of perceived health. Those unemployed because of their health reported the highest rates of fatigue and pain and lowest quality of life, and they were most likely to report poor perceived health. These findings highlight work reintegration as an important outcome and marker of survivors' overall adjustment after transplantation. Identifying factors affecting post-transplantation employment offers opportunities for behavioral interventions to target modifiable risk factors to optimize post-transplantation survivorship, inclusive of increased rates of return to work and decreased rates of associated disability. (C) 2016 American Society for Blood and Marrow Transplantation.