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postgraduate thesis: Return to work and work productivity among Chinese cancer survivors

TitleReturn to work and work productivity among Chinese cancer survivors
Authors
Advisors
Issue Date2022
PublisherThe University of Hong Kong (Pokfulam, Hong Kong)
Citation
So, C. S. [蘇儁儀]. (2022). Return to work and work productivity among Chinese cancer survivors. (Thesis). University of Hong Kong, Pokfulam, Hong Kong SAR.
AbstractThis thesis reports an examination of return to work, work productivity and activity impairment in cancer survivors who were employed at the time of cancer diagnosis by: (1) identifying the impact of cancer and its treatment in terms of physical functioning, psychosocial resources, RTW situation, work productivity and activity impairment; (2) identifying predictors of RTW, changes in work productivity and activity impairment; and (3) exploring changes in RTW status, work productivity, and activity impairment in patients after cancer treatment. Two longitudinal studies were conducted in Chinese cancer survivors. Study I assessed 593 Chinese patients who were employed at the time of diagnosis at 6-months, 9-months, 12-months, 18-months, 24-months, and 30-months after cancer treatment; detailed work status, work productivity and activity impairment, psychological distress, physical symptom distress, supportive care needs, health-related quality of life, illness perception were assessed. Descriptive analyses examined RTW status at baseline. Fully-adjusted multinominal regression determined RTW predictors at baseline. Latent class analysis identified distinct RTW patterns. Fully-adjusted multiple regression identified predictors of RTW patterns. Latent growth curve analysis identified change in work productivity and activity impairment. Fully-adjusted multiple regression confirmed predictors of change in work productivity and activity impairment. Study II assessed 232 Chinese women with breast cancer at 6-months 10- months, 12-months and 18-months after primary surgery; detailed work status, work productivity and activity impairment, work-related factors, RTW self-efficacy, financial toxicity, illness perception, health-related quality of life, psychological distress were assessed. Descriptive analyses examined RTW status at baseline. Kaplan-Meier method identified predictors of RTW rate. Multivariate Cox regression examined factors related to RTW rate. Fully-adjusted Cox regression modelled the effect of various mediator variables between the effect of medical factors on RTW. Latent growth curve analysis identified change in work productivity and activity impairment. Fully-adjusted multiple regression identified predictors of change in work productivity and activity impairment. Study I identified that cancer patients who had more physically demanding jobs and poorer physical functioning delayed work resumption more, those who perceived greater illness impacts were unemployed. Baseline physical symptom distress, negative illness perceptions, and poor mental functioning predicted greater work productivity loss. Patients reporting lower social status, perceived greater illness impacts, and poorer mental functioning, reported more impairments in regular activities. Study II identified that manual work, chemotherapy and targeted therapy history were associated with delay in work resumption. Patients who worked manual job, with targeted therapy history, inadequate psychosocial resources and unfavourable work-related factors delayed work resumption. The effect of medical factor on RTW was not mediated by demographic factors and study correlates. Patients who had completed more complex surgery, had poorer physical functioning, inadequate psychosocial resources, and unfavourable work-related factors reported higher work productivity loss. Patients who had completed more complex surgery, inferior physical functioning, and inadequate psychosocial resources were associated with greater activity impairment. Cancer survivors who worked more physically demanding jobs and had inadequate psychosocial resources delayed work resumption. Unmanaged physical dysfunction and inadequate psychosocial resources hindered work productivity, lower social status and inadequate psychosocial resources hindered activity functioning in cancer survivors.
DegreeDoctor of Philosophy
SubjectCancer - Patients - Employment
Cancer - Patients - Rehabilitation
Dept/ProgramPublic Health
Persistent Identifierhttp://hdl.handle.net/10722/318395

 

DC FieldValueLanguage
dc.contributor.advisorLam, WWT-
dc.contributor.advisorNi, MY-
dc.contributor.advisorLiao, Q-
dc.contributor.authorSo, Chun-yee, Serana-
dc.contributor.author蘇儁儀-
dc.date.accessioned2022-10-10T08:18:53Z-
dc.date.available2022-10-10T08:18:53Z-
dc.date.issued2022-
dc.identifier.citationSo, C. S. [蘇儁儀]. (2022). Return to work and work productivity among Chinese cancer survivors. (Thesis). University of Hong Kong, Pokfulam, Hong Kong SAR.-
dc.identifier.urihttp://hdl.handle.net/10722/318395-
dc.description.abstractThis thesis reports an examination of return to work, work productivity and activity impairment in cancer survivors who were employed at the time of cancer diagnosis by: (1) identifying the impact of cancer and its treatment in terms of physical functioning, psychosocial resources, RTW situation, work productivity and activity impairment; (2) identifying predictors of RTW, changes in work productivity and activity impairment; and (3) exploring changes in RTW status, work productivity, and activity impairment in patients after cancer treatment. Two longitudinal studies were conducted in Chinese cancer survivors. Study I assessed 593 Chinese patients who were employed at the time of diagnosis at 6-months, 9-months, 12-months, 18-months, 24-months, and 30-months after cancer treatment; detailed work status, work productivity and activity impairment, psychological distress, physical symptom distress, supportive care needs, health-related quality of life, illness perception were assessed. Descriptive analyses examined RTW status at baseline. Fully-adjusted multinominal regression determined RTW predictors at baseline. Latent class analysis identified distinct RTW patterns. Fully-adjusted multiple regression identified predictors of RTW patterns. Latent growth curve analysis identified change in work productivity and activity impairment. Fully-adjusted multiple regression confirmed predictors of change in work productivity and activity impairment. Study II assessed 232 Chinese women with breast cancer at 6-months 10- months, 12-months and 18-months after primary surgery; detailed work status, work productivity and activity impairment, work-related factors, RTW self-efficacy, financial toxicity, illness perception, health-related quality of life, psychological distress were assessed. Descriptive analyses examined RTW status at baseline. Kaplan-Meier method identified predictors of RTW rate. Multivariate Cox regression examined factors related to RTW rate. Fully-adjusted Cox regression modelled the effect of various mediator variables between the effect of medical factors on RTW. Latent growth curve analysis identified change in work productivity and activity impairment. Fully-adjusted multiple regression identified predictors of change in work productivity and activity impairment. Study I identified that cancer patients who had more physically demanding jobs and poorer physical functioning delayed work resumption more, those who perceived greater illness impacts were unemployed. Baseline physical symptom distress, negative illness perceptions, and poor mental functioning predicted greater work productivity loss. Patients reporting lower social status, perceived greater illness impacts, and poorer mental functioning, reported more impairments in regular activities. Study II identified that manual work, chemotherapy and targeted therapy history were associated with delay in work resumption. Patients who worked manual job, with targeted therapy history, inadequate psychosocial resources and unfavourable work-related factors delayed work resumption. The effect of medical factor on RTW was not mediated by demographic factors and study correlates. Patients who had completed more complex surgery, had poorer physical functioning, inadequate psychosocial resources, and unfavourable work-related factors reported higher work productivity loss. Patients who had completed more complex surgery, inferior physical functioning, and inadequate psychosocial resources were associated with greater activity impairment. Cancer survivors who worked more physically demanding jobs and had inadequate psychosocial resources delayed work resumption. Unmanaged physical dysfunction and inadequate psychosocial resources hindered work productivity, lower social status and inadequate psychosocial resources hindered activity functioning in cancer survivors. -
dc.languageeng-
dc.publisherThe University of Hong Kong (Pokfulam, Hong Kong)-
dc.relation.ispartofHKU Theses Online (HKUTO)-
dc.rightsThe author retains all proprietary rights, (such as patent rights) and the right to use in future works.-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subject.lcshCancer - Patients - Employment-
dc.subject.lcshCancer - Patients - Rehabilitation-
dc.titleReturn to work and work productivity among Chinese cancer survivors-
dc.typePG_Thesis-
dc.description.thesisnameDoctor of Philosophy-
dc.description.thesislevelDoctoral-
dc.description.thesisdisciplinePublic Health-
dc.description.naturepublished_or_final_version-
dc.date.hkucongregation2022-
dc.identifier.mmsid991044600203903414-

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