From: Return to work of breast cancer survivors: a systematic review of intervention studies
Study | Participants | Number of subjects enrolled | Description intervention (s) | Length of follow up and outcomes | Proportion returning to work |
---|---|---|---|---|---|
Maguire, 1983, UK Controlled trial | Women undergoing modified radical mastectomy and full axillary clearance Setting: surgical unit Age: not mentioned | N = 152 women, N = 75 in counselling group and N = 77 in care as usual group Work status before cancer: Counselling group N = 42 Care as usual group N = 46 | Counselling group: Counselling content: - inpatient care: advice on exercises, encouragement to look at scar and discuss feelings, discuss possible external breast prosthesis - at follow-up: encouragement to return to work and become socially active Counselling frequency: - inpatient care: pre- and post- mastectomy - at follow-up: after discharge, every 2 months, home visits until it was clear patient had adapted well Counselling was given by a specialist nurse Care as usual group: Received usual care provided by surgical unit | Follow up: a few days after surgery, 3, 12 and 18 months. Outcomes: assessed using a semi-structured interview and physical assessment: - return to work - house work - social adjustment - persisting problems arm: pain, swelling, disability and range of motion - response to scar, prosthesis and breast loss | Return to work: - Counselling group: 76% (32 out of 42 patients) between 12–18 months - Care as usual group: 54% (25 out of 46 patients) between 12–18 months For return to work versus not χ2 = 4.59, p < 0.05 |
Fismen, 2000, Norway Non-Controlled study | Women who had received surgical treatment, chemotherapy and radiation therapy for breast cancer (stage 1 and 2), in combination with rehabilitation Setting: surgical unit Age: 31–66 (mean 49 years) | N = 50 women Work status before cancer: N = 46 | Content: Training of physical capacity; cognitive group discussions in small groups (2–10 persons) Examinations of psychological and physical status were performed before rehabilitation, after rehabilitation and after follow-up Frequency: 3 weeks rehabilitation program, 3 months at home and 1 week follow up at rehabilitation centre. | Follow-up: - after 3 weeks rehabilitation - after 3 months at home - after 1 week follow-up in rehabilitation centre Outcomes: assessed by questionnaires: - return to work - mental state (depression, anxiety, mood states) - quality of life and pain. In addition, assessment of lymph edema and VO2 max | Return to work: 78% (36 out of 46 patients) during the 3 month follow-up |
Sachs, 1980, USA Non-Controlled study | Women who underwent modified radical mastectomy and full axillary clearance (Mt. Sinai data) and rehabilitation Setting: surgical unit Age: not mentioned | N = 107 women Work status before cancer: not mentioned | Content: - counselling: emotional support, encouragement to look at scar, discuss feelings, discuss possible external breast prosthesis, encouragement to return to work and become socially active - exercises Frequency: 90 minutes a day, 5 days a week until discharge from hospital - counselling: on alternating days - exercises: daily Professionals involved: A team consisting of a physical therapist, a nurse, a social worker, and a Reach-To-Recovery volunteer for 3 days each week Counselling: - mastectomy rehabilitation nurse: visits with patient before and after operation, informs patient and family of programme, lends moral support - social worker: leads groups sessions in the programme Exercises: - demonstrated by physical therapist and performed daily The physician was a member of the team | Follow up: 90 days after discharge a questionnaire was sent to the participating patients Outcomes: assessed using questionnaires: - return to work - resumption of normal activities - physical recovery and rehabilitation - emotional stress | Return to work: 85% of patients. Average duration out of work: 5.9 weeks |
Winick, 1977, USA Non-Controlled study | Women who underwent *Simple or total mastectomy: **Modified radical mastectomy: + axillary lymph nodes and part pectoral muscle ***Standard or radical mastectomy: + lymph nodes and underlying pectoral muscles ****Extended radical mastectomy; + all axillary lymph nodes, underlying pectoral muscles, and medial segment chest wall All women received rehabilitation Setting: surgical unit Age: 20–91 (mean 56 years) | N = 863 women Work status before cancer: N = 317 employed full time | Same Post Mastectomy Rehabilitation Programme as study by Sachs et al. | Follow up: 3 months after discharge Outcomes: assessed using a questionnaire sent to patients: - return to work - resumption of normal activities - physical recovery and rehabilitation - emotional stress and personal relationship adjustment difficulties | Return to work: 75% of patients (237 out of 317 patients) full time return to work within 3 months: *: (n = 2), 100%, average weeks to resume: 3 **: (n = 50), 78%, average weeks to resume: 7.1 ***: (n = 241), 75%, average weeks to resume: 8.6 ****: (n = 24), 63%, average weeks to resume: 9.5 |