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259 Return to work of cancer patients after a multidisciplinary intervention including occupational counselling and physical exercise: a prospective study
  1. Angela GEM de Boer1,
  2. Monique CJ Leensen1,
  3. Iris F Groeneveld2,
  4. Iris van der Heide1,
  5. Tomas Rejda3,
  6. Peter LJ van Veldhoven4,
  7. Sietske van Berkel5,
  8. Aernout Snoek5,
  9. Wim van Harten6,7,8,
  10. Monique HW Frings-Dresen1
  1. 1Coronel Institute of Occupational Health, Academic Medical Centre, Amsterdam Public Health research institute, Amsterdam, The Netherlands
  2. 2Rijnlands Rehabilitation Centre, Leiden, The Netherlands
  3. 3Leiden University Medical Centre, Leiden, The Netherlands
  4. 4Department of Sports Medicine, Haaglanden Medical Centre, The Hague, The Netherlands
  5. 5Department of Sports Medicine, Isala, Zwolle, The Netherlands
  6. 6University Twente, Enschede, The Netherlands
  7. 7Rijnstate Hospital, Arnhem, The Netherlands
  8. 8The Netherlands Cancer Institute, Amsterdam, The Netherlands

Abstract

Introduction To support return to work among cancer patients, a multidisciplinary rehabilitation program was developed which combined occupational counselling with a supervised physical exercise program during chemotherapy. Aim was to investigate return to work (RTW) rates of cancer patients and to evaluate changes in work-related, quality of life and physical outcomes.

Methods This was a longitudinal prospective intervention study using a one-group design. Patients with primary diagnosis of cancer from two medical centres were included if they were treated curatively with chemotherapy and on sick leave from paid work. The 12 week multidisciplinary rehabilitation program combined occupational counselling with a supervised physical exercise program. Patients completed questionnaires on RTW, importance of work, work ability (WAI), RTW self-efficacy, fatigue (MFI), and quality of life (EORTC QLQ C-30) at baseline and 6, 12 and 18 months follow-up. Before and after the exercise program 1-Repetition Maximum (RM) muscle strength and cardiorespiratory fitness (VO2 peak) were assessed.

Result 93 Patients were included. Six months after the start, 59% of the cancer patients returned to work, 86% at 12 months and 83% at 18 months. In addition, significant improvements (p<0.05) in importance of work, work ability, RTW self-efficacy, and quality of life were observed, whereas fatigue levels were significantly reduced. After completing the exercise program, 1-RM muscle strength was significantly increased but there was no improvement in VO2 peak.

Discussion Return to work rates of cancer patients were high after completion of the multidisciplinary rehabilitation program. A multidisciplinary rehabilitation program which combines occupational counselling with a supervised physical exercise program is likely to result in improved return to work rates, reduced fatigue and increased importance of work, work ability, and improved quality of life.

  • Oncology
  • sick leave
  • chemotherapy

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