Journal of Shanghai Jiao Tong University (Medical Science) ›› 2023, Vol. 43 ›› Issue (3): 333-341.doi: 10.3969/j.issn.1674-8115.2023.03.009
• Evidence-based medicine • Previous Articles
ZHANG Yuanyuan1(), WU Anqi2, WU Jie1, ZHU Yaqi1, LI Mengyao1, YAN Dexiu1, ZHANG Yaqing1(), HOU Lili3()
Received:
2023-01-03
Accepted:
2023-03-20
Online:
2023-03-28
Published:
2023-03-28
Contact:
ZHANG Yaqing,HOU Lili
E-mail:zhangyy@shsmu.edu.cn;zhangyqf@shsmu.edu.cn;pisces_liz@163.com
Supported by:
CLC Number:
ZHANG Yuanyuan, WU Anqi, WU Jie, ZHU Yaqi, LI Mengyao, YAN Dexiu, ZHANG Yaqing, HOU Lili. Interventions to enhance return-to-work among young and middle-aged cancer survivors: a systematic review[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2023, 43(3): 333-341.
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URL: https://xuebao.shsmu.edu.cn/EN/10.3969/j.issn.1674-8115.2023.03.009
Study | Country | Design | Participants, characteristics in intervention group | Participants, characteristics in control group | ||||||
---|---|---|---|---|---|---|---|---|---|---|
Sample size (at allocation)/n | Age/year | Gender | Cancer type | Sample size (at allocation) /n | Age/year | Gender | Cancer type | |||
BJÖRNEKLETT et al, 2013[ | Sweden | ① | 191 | 57.8 (30‒84) | Female: 100% | Breast: 100% | 191 | 58.7 (38‒83) | Female: 100% | Breast: 100% |
FAUSER et al, 2019[ | Germany | ② | 229 | 50.8±7.1 | Female: 71.2% | Breast: 31.4%, digestive tract: 14.4%, lymphatic/related tissue: 15.3%, female genitalia: 15.3% | 255 | 50.3±7.9 | Female: 63.1% | Breast: 28.2%, digestive tract: 18.4%, lymphatic/related tissue: 14.9%, female genitalia: 10.6% |
LEENSEN et al, 2017[ | Netherlands | ④ | 93 | 47.9±7.4 | Female: 90.3% | Breast: 83.9%, colorectal: 8.6%, non-Hodgkin′s lymphoma: 5.4%, other: 2.2% | ‒ | ‒ | ‒ | ‒ |
OLDERVOLL et al, 2013[ | Norway | ③ | 56 | 51 (37‒66) | NR | Breast: 91%, gynecological: 9% | 60 | 50 (32‒67) | NR | Breast: 55%, gynecological: 45% |
MOURGUES et al, 2014[ | France | ① | 85 | 51.9±8.5 | Female: 100% | Breast: 100% | 67 | 51.9±10.3 | Female: 100% | Breast: 100% |
RUSBRIDGE et al, 2013[ | UK | ④ | 34 | 46±11 | Male: 59% | Brain: 100% | ‒ | ‒ | ‒ | ‒ |
STAPELFELDT et al, 2021[ | Denmark | ① | 83 | 48.2 (44‒56) | Female: 91.6% | Breast: 78.3%, colonrectal: 13.3% | 264 | 50.0 (43.7‒54.6) | Female: 92.8% | Breast: 85.2%, colonrectal: 10.2% |
TAMMINGA et al, 2013[ | Netherlands | ① | 65 | 47.5±8.2 | Female: 99% | Breast: 64%, cervix: 23% | 68 | 47.6±7.8 | Female: 100% | Breast: 60%, cervix: 22% |
TAMMINGA et al, 2019[ | Netherlands | ① | 49 | 47.1±8.2 | Female: 98% | Breast: 61%, cervix: 22% | 57 | 47.8±7.6 | Female: 100% | Breast: 61%, cervix: 23% |
THIJS et al, 2012[ | Netherlands | ③ | 72 | 49±8.3 | Female: 88.9% | Breast: 70.8%, lymphoma: 13.8%, colorectal: 6.9% | 38 | 49±9.2 | Female: 76.3% | Breast: 68.4%, lymphoma: 18.5%, colorectal: 13.2% |
THORSEN et al, 2016[ | Norway | ④ | 106 | 48.8±8.6 | Female: 100% | Breast: 60.4%, gynaecological: 31.1% | ‒ | ‒ | ‒ | ‒ |
ZAMAN et al, 2021[ | Netherlands | ① | 42 | 54±7.7 | Male: 64% | Colonrectal: 88.1% | 46 | 56±6.6 | Male: 67% | Colonrectal: 84.8% |
Tab 1 Basic characteristics of included studies
Study | Country | Design | Participants, characteristics in intervention group | Participants, characteristics in control group | ||||||
---|---|---|---|---|---|---|---|---|---|---|
Sample size (at allocation)/n | Age/year | Gender | Cancer type | Sample size (at allocation) /n | Age/year | Gender | Cancer type | |||
BJÖRNEKLETT et al, 2013[ | Sweden | ① | 191 | 57.8 (30‒84) | Female: 100% | Breast: 100% | 191 | 58.7 (38‒83) | Female: 100% | Breast: 100% |
FAUSER et al, 2019[ | Germany | ② | 229 | 50.8±7.1 | Female: 71.2% | Breast: 31.4%, digestive tract: 14.4%, lymphatic/related tissue: 15.3%, female genitalia: 15.3% | 255 | 50.3±7.9 | Female: 63.1% | Breast: 28.2%, digestive tract: 18.4%, lymphatic/related tissue: 14.9%, female genitalia: 10.6% |
LEENSEN et al, 2017[ | Netherlands | ④ | 93 | 47.9±7.4 | Female: 90.3% | Breast: 83.9%, colorectal: 8.6%, non-Hodgkin′s lymphoma: 5.4%, other: 2.2% | ‒ | ‒ | ‒ | ‒ |
OLDERVOLL et al, 2013[ | Norway | ③ | 56 | 51 (37‒66) | NR | Breast: 91%, gynecological: 9% | 60 | 50 (32‒67) | NR | Breast: 55%, gynecological: 45% |
MOURGUES et al, 2014[ | France | ① | 85 | 51.9±8.5 | Female: 100% | Breast: 100% | 67 | 51.9±10.3 | Female: 100% | Breast: 100% |
RUSBRIDGE et al, 2013[ | UK | ④ | 34 | 46±11 | Male: 59% | Brain: 100% | ‒ | ‒ | ‒ | ‒ |
STAPELFELDT et al, 2021[ | Denmark | ① | 83 | 48.2 (44‒56) | Female: 91.6% | Breast: 78.3%, colonrectal: 13.3% | 264 | 50.0 (43.7‒54.6) | Female: 92.8% | Breast: 85.2%, colonrectal: 10.2% |
TAMMINGA et al, 2013[ | Netherlands | ① | 65 | 47.5±8.2 | Female: 99% | Breast: 64%, cervix: 23% | 68 | 47.6±7.8 | Female: 100% | Breast: 60%, cervix: 22% |
TAMMINGA et al, 2019[ | Netherlands | ① | 49 | 47.1±8.2 | Female: 98% | Breast: 61%, cervix: 22% | 57 | 47.8±7.6 | Female: 100% | Breast: 61%, cervix: 23% |
THIJS et al, 2012[ | Netherlands | ③ | 72 | 49±8.3 | Female: 88.9% | Breast: 70.8%, lymphoma: 13.8%, colorectal: 6.9% | 38 | 49±9.2 | Female: 76.3% | Breast: 68.4%, lymphoma: 18.5%, colorectal: 13.2% |
THORSEN et al, 2016[ | Norway | ④ | 106 | 48.8±8.6 | Female: 100% | Breast: 60.4%, gynaecological: 31.1% | ‒ | ‒ | ‒ | ‒ |
ZAMAN et al, 2021[ | Netherlands | ① | 42 | 54±7.7 | Male: 64% | Colonrectal: 88.1% | 46 | 56±6.6 | Male: 67% | Colonrectal: 84.8% |
Study | Intervention group | Control group | Outcome | ||||
---|---|---|---|---|---|---|---|
Content | Type | Who | How long | Where | |||
BJÖRNEKLETT et al, 2013[ | Information-based support program: information about cancer illnesses, aetiology, risk factors, etc; physical exercise, relaxation training, qi-gong and nonverbal communication; social activities such as concerts, and visits to museums and restaurants | A | Oncologists (n=4), social workers (n=2), art therapists (n=2), masseuses (n=2), a person trained in qi-gong and mental visualization (n=1) | 7 d followed by a 4-day follow-up 2 months after the initial visit | Resort | Standard follow-up routine | b |
FAUSER et al, 2019[ | Work-related medical rehabilitation: work-related diagnostics (at least 60 min), and multiprofessional team meetings; work-related functional capacity training (at least 360 min), work-related psychosocial groups (at least 240 min), and intensified social counseling (at least 90 min) | A, B | Physician, psychologist, occupational therapist, physiotherapist, social worker | 25 d in average | Rehabilitation center | Traditional medical rehabilitation program | a, c |
LEENSEN et al, 2017[ | Multidisciplinary intervention: personal counselling on work-related issues (1‒3 sessions), and supervised physical exercise (2 times per week, 12 weeks) | B | Oncological occupational physician, sport physician, physiotherapist | 4 months in average | Hospital | Without control | a①, d①, e②, f①, g① |
OLDERVOLL et al, 2013[ | Inpatient rehabilitation program: physical exercise (twice a day, 100 h during 4 weeks), patient education (each day), group discussion (each day). The focus of patient education and group discussion session: cancer treatment and side effect, physical activity, nutrition, economy and work situation, factors of return-to-work, partnership and sexuality, and psychological reaction | A | Multiprofessional team | 4 weeks | Rehabilitation center | Outpatient rehabilitation program: delivered at an academic cancer hospital, lasted for seven weeks. The focus were the same | h |
MOURGUES et al, 2014[ | Thermal water treatment: physiotherapy (2 h/d, supervised by physiotherapist), thermal water treatment (30 min/d), and basic dietary follow-up (each day) | A | Physician, nutritionist, physiotherapist | 15 d | Resort | Standard follow-up routine | a③, d④ |
RUSBRIDGE et al, 2013[ | Occupational rehabilitation program: patients-based symptom management (fatigue management, psychological support, and cognitive rehabilitation), work place intervention involving employers | B | Occupational therapist and/or neuropsychologist | 11 h sessions over 5 months | Hospital | Without control | a⑤ |
STAPELFELDT et al, 2021[ | Early, individualized vocational rehabilitation intervention: return-to-work readiness and need assessment by social worker, tailored return to work plan development by social worker, coordinating the return-to-work plan with the participant′s employer, assessing participants′ rehabilitation needs other than vocational | B | Social worker trained by psychologist | Continued until the participants returned to work or for 1 year | Hospital | Municipal sickness benefit management by Danish Sickness Benefit Act | a |
TAMMINGA et al, 2013[ TAMMINGA et al, 2019[ | Hospital-based work support intervention: delivering patient education and support at the hospital, as part of usual psycho-oncology care; improving communication between the treating physician and the occupational physician; drawing up a concrete and gradual return-to-work plan in collaboration with the cancer patient, the occupational physician, and the employer | B | Oncology nurse, medical social worker, occupational physician | A few weeks to 14 months | Hospital | Standard program by Dutch government | 1 year follow-up: a, b, d, g; 2 year follow-up: a, b, d, g |
THIJS et al, 2012[ | High-intensity physical training: strength and interval training, home-based activities | B | Physiotherapist | 18 weeks | Hospital | Standard medical care(without physical rehabilitation program) | a, b, i⑥ |
THORSEN et al, 2016[ | Rapid return-to-work program (a full day weekly): patient education (2 h), group discussion (1 h), and physical activity (60‒120 min). The first two sessions covered the topics related to cancer treatment, side effects, partnership and sexuality, economy and work situation, nutrition, physical exercise and coping strategies | B | Relevant health professionals, physiotherapist | 7 weeks | Outpatient | Without control | h (36% did not improve work status) |
ZAMAN et al, 2021[ | Early tailored work-related support intervention: individual meetings of psychosocial work-related support (30 min each); work related support: fatigue, pain and lack of support from family and friends (support Ⅰ); lack of support in work environment and neuropsychological problems (support Ⅱ); a combination of factors (support Ⅲ) | B | Support Ⅰ: oncological gastrointestinal nurse; support Ⅱ: oncological occupational physicians (OOP); support Ⅲ: multidisciplinary team (including at least a oncology nurse, a physician and a OOP) | Maximum of 9 months | Hospital | Standard psychological care provided by oncological nurse | a, b |
Tab 2 Characteristics of return-to-work interventions
Study | Intervention group | Control group | Outcome | ||||
---|---|---|---|---|---|---|---|
Content | Type | Who | How long | Where | |||
BJÖRNEKLETT et al, 2013[ | Information-based support program: information about cancer illnesses, aetiology, risk factors, etc; physical exercise, relaxation training, qi-gong and nonverbal communication; social activities such as concerts, and visits to museums and restaurants | A | Oncologists (n=4), social workers (n=2), art therapists (n=2), masseuses (n=2), a person trained in qi-gong and mental visualization (n=1) | 7 d followed by a 4-day follow-up 2 months after the initial visit | Resort | Standard follow-up routine | b |
FAUSER et al, 2019[ | Work-related medical rehabilitation: work-related diagnostics (at least 60 min), and multiprofessional team meetings; work-related functional capacity training (at least 360 min), work-related psychosocial groups (at least 240 min), and intensified social counseling (at least 90 min) | A, B | Physician, psychologist, occupational therapist, physiotherapist, social worker | 25 d in average | Rehabilitation center | Traditional medical rehabilitation program | a, c |
LEENSEN et al, 2017[ | Multidisciplinary intervention: personal counselling on work-related issues (1‒3 sessions), and supervised physical exercise (2 times per week, 12 weeks) | B | Oncological occupational physician, sport physician, physiotherapist | 4 months in average | Hospital | Without control | a①, d①, e②, f①, g① |
OLDERVOLL et al, 2013[ | Inpatient rehabilitation program: physical exercise (twice a day, 100 h during 4 weeks), patient education (each day), group discussion (each day). The focus of patient education and group discussion session: cancer treatment and side effect, physical activity, nutrition, economy and work situation, factors of return-to-work, partnership and sexuality, and psychological reaction | A | Multiprofessional team | 4 weeks | Rehabilitation center | Outpatient rehabilitation program: delivered at an academic cancer hospital, lasted for seven weeks. The focus were the same | h |
MOURGUES et al, 2014[ | Thermal water treatment: physiotherapy (2 h/d, supervised by physiotherapist), thermal water treatment (30 min/d), and basic dietary follow-up (each day) | A | Physician, nutritionist, physiotherapist | 15 d | Resort | Standard follow-up routine | a③, d④ |
RUSBRIDGE et al, 2013[ | Occupational rehabilitation program: patients-based symptom management (fatigue management, psychological support, and cognitive rehabilitation), work place intervention involving employers | B | Occupational therapist and/or neuropsychologist | 11 h sessions over 5 months | Hospital | Without control | a⑤ |
STAPELFELDT et al, 2021[ | Early, individualized vocational rehabilitation intervention: return-to-work readiness and need assessment by social worker, tailored return to work plan development by social worker, coordinating the return-to-work plan with the participant′s employer, assessing participants′ rehabilitation needs other than vocational | B | Social worker trained by psychologist | Continued until the participants returned to work or for 1 year | Hospital | Municipal sickness benefit management by Danish Sickness Benefit Act | a |
TAMMINGA et al, 2013[ TAMMINGA et al, 2019[ | Hospital-based work support intervention: delivering patient education and support at the hospital, as part of usual psycho-oncology care; improving communication between the treating physician and the occupational physician; drawing up a concrete and gradual return-to-work plan in collaboration with the cancer patient, the occupational physician, and the employer | B | Oncology nurse, medical social worker, occupational physician | A few weeks to 14 months | Hospital | Standard program by Dutch government | 1 year follow-up: a, b, d, g; 2 year follow-up: a, b, d, g |
THIJS et al, 2012[ | High-intensity physical training: strength and interval training, home-based activities | B | Physiotherapist | 18 weeks | Hospital | Standard medical care(without physical rehabilitation program) | a, b, i⑥ |
THORSEN et al, 2016[ | Rapid return-to-work program (a full day weekly): patient education (2 h), group discussion (1 h), and physical activity (60‒120 min). The first two sessions covered the topics related to cancer treatment, side effects, partnership and sexuality, economy and work situation, nutrition, physical exercise and coping strategies | B | Relevant health professionals, physiotherapist | 7 weeks | Outpatient | Without control | h (36% did not improve work status) |
ZAMAN et al, 2021[ | Early tailored work-related support intervention: individual meetings of psychosocial work-related support (30 min each); work related support: fatigue, pain and lack of support from family and friends (support Ⅰ); lack of support in work environment and neuropsychological problems (support Ⅱ); a combination of factors (support Ⅲ) | B | Support Ⅰ: oncological gastrointestinal nurse; support Ⅱ: oncological occupational physicians (OOP); support Ⅲ: multidisciplinary team (including at least a oncology nurse, a physician and a OOP) | Maximum of 9 months | Hospital | Standard psychological care provided by oncological nurse | a, b |
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