Cancer, Cognitive Impairment, and Work-Related Outcomes: An Integrative Review

Ah, Diane Von; Storey, Susan; Tallman, Eileen F.; Nielsen, Adele; Johns, Shelley A.; Pressler, Susan J.

doi:10.1188/16.onf.602-616

Cited by 39 publications

(35 citation statements)

References 55 publications

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“…Overall, fatigue results are consistent with a need to return to normality despite feeling noticeably fatigued (44)(45)(46). The results relating to mental fatigue are consistent with a large body of evidence implying that cognitive impairments are one of the main psychological barriers to RTW in cancer patients (18). The other CRF dimensions, such as physical fatigue, did not seem to influence RTW during the treatment period, but further work is needed to conclude that there is no link between these variables.…”

Section: Discussionsupporting

confidence: 72%

“…The main finding relating to changes in QOL and CRF was that an increase in mental fatigue in the 6 months following the beginning of adjuvant treatment reduced probability of RTW. Until now no study had investigated the impact of these changes on RTW in women with BC, so our result provide evidence that, early in the course of treatment, cognitive impairments should be taken into account when considering work issues after cancer diagnosis (18).…”

Section: Discussionmentioning

confidence: 66%

“…Moreover, higher cognitive functioning was also associated with RTW at the end of adjuvant treatment, whereas Hedayati et al (8) did not detect any link between cognitive functioning and RTW 8 months after BC diagnosis. These results are interesting in that a recent integrative review highlighted the impact of cognitive impairments on workrelated outcomes after cancer (18) and a qualitative study revealed that ability to manage the professional tasks is influenced by an awareness of cognitive impairment following chemotherapy (42). Another study concluded that reported cognitive impairments in BC patients (particularly with regard to memory and executive functions) were linked to productivity at work (43).…”

Section: Discussionmentioning

confidence: 94%

“…In contradiction of the results of Hedayati et al (8), cognitive functioning has been identified as a RTW determinant for cancer survivors. An integrative review concluded that cognitive impairments had a deleterious effect on work-related outcomes such as RTW (18). Therefore, additional data are needed to understand which aspects of QOL facilitate RTW during this period.…”

Section: Introductionmentioning

confidence: 99%

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Quality of life, fatigue and changes therein as predictors of return to work during breast cancer treatment

Porro

Michel

Zinzindohoué³

et al. 2019

Scandinavian Caring Sciences

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Purpose To our knowledge, only one study has assessed Quality of Life (QOL) as a predictor of return to work (RTW) during breast cancer treatment and one has evaluated multidimensional cancer‐related fatigue (CRF) as a determinant of RTW. However, no study has assessed the impact of changes in these variables on RTW. The objective of this study was to evaluate QOL, multidimensional CRF and changes in these variables as determinants of RTW during breast cancer treatment. Methods We performed a longitudinal study of 68 patients with a mean age of 46.97 years (SD = 6.92), who were employed at the time of diagnosis. Women were assessed at the beginning of adjuvant treatments (T0) and followed up with by telephone at three (T1) and 6 months later (T2), using questionnaires (QLQ‐C30; MFI‐20). Results Global QOL, OR = 1.12 [1.01–1.25], sleep disturbance, OR = 1.04 [1.002–1.08], fatigue (QLQ‐C30), OR = 0.93 [0.88–0.99], nausea‐vomiting, OR = 0.84 [0.73–0.97], reduced motivation, OR = 1.49 [1.05–2.11] and general fatigue, OR = 0.79 [0.63–0.99] at T0 were associated with RTW at T1. At T2 global QOL, OR = 1.09 [1.01–1.17], cognitive functioning, OR = 1.10 [1.03–1.17], general fatigue, OR = 1.82 [1.04–3.17] and mental fatigue, OR = 0.29 [0.11–0.81] were associated with RTW. Furthermore, changes in mental fatigue were associated with RTW at T2, OR = 0.02 [0.001–0.29]. Conclusions Quality of life, fatigue and their changes in them, especially cognitive functioning and mental fatigue, can play an important role in predicting the RTW of women with breast cancer. This confirms the importance of multidisciplinary care for cancer and the emergence of a theoretical psychological model of RTW.

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Section: Discussionsupporting

confidence: 72%

Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Quality of life, fatigue and changes therein as predictors of return to work during breast cancer treatment

Porro

Michel

Zinzindohoué³

et al. 2019

Scandinavian Caring Sciences

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“…From the literature so far, cognitive impairment seems to be only weakly associated with RTW (13), but it's impact on work-related problems at the workplace appears to be substantial (10). This underlines the need for effective vocational cognitive rehabilitation, implemented in a phase that patients already have achieved RTW.…”

Section: Introductionmentioning

confidence: 99%

Internet-based cognitive rehabilitation for WORking Cancer survivors (i-WORC): study protocol of a randomized controlled trial.

Klaver

Duijts

Geusgens

et al. 2020

Preprint

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Background Cognitive problems are common in non-central nervous system cancer survivors. These problems are perceived as an important contributor to decline in work performance and work ability. Various interventions for cognitive problems have been proposed, but effectiveness regarding work-related outcomes has not yet been established. Effective treatment options to alleviate the adverse influence of cognitive problems on work performance are needed for working cancer survivors. In this paper, we will describe the design of a randomized, controlled, multicenter trial that evaluates the (cost-)effectiveness of an internet-based cognitive rehabilitation program for occupationally active cancer survivors confronted with cognitive problems. Methods/ Design A three-armed randomized controlled trial will be conducted, including two intervention groups (i.e., basic and extensive cognitive rehabilitation program) and one waitlist control group. In total, 261 cancer survivors (18 – 65 years) who have returned to work, and who experience cognitive problems will be recruited. Patients with and without cognitive impairment as established in a neuropsychological assessment, will be eligible; stratification will take place based on the presence of this cognitive impairment. The extensive intervention arm will contain a comprehensive training program (including psycho-education, fatigue management, and cognitive strategy training) with individual guidance (blended intervention). The basic intervention arm will contain a brief cognitive training program (including psycho-education and fatigue management) without individual guidance. The primary outcome will be accomplishment of an individually defined work-related treatment goal. Secondary outcomes include, among others, subjective cognitive functioning, work functioning, and quality of life. Primary and secondary outcomes will be measured at baseline (T0), and at 12 weeks (T1) and 26 weeks (T2) post-randomization. Discussion About 40-50% of the cancer patients worldwide are of working age at time of diagnosis. Many of the occupationally active cancer survivors experience cognitive problems. Both from an individual and a societal perspective, it is important to sustain cancer survivors’ employability. An effective treatment to alleviate the impact of cognitive decline and to improve work ability might help cancer survivors to sustain employability.Trial registration The trial is registered at ClinicalTrials.gov (NCT03900806) at 03 April 2019 (current status: ongoing),https://clinicaltrials.gov/ct2/show/NCT03900806?term=NCT03900806&draw=2&rank=1.

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Cognition and Return to Work Status 2 Years After Breast Cancer Diagnosis

Lange,

Lequesne,

Dumas

et al. 2024

JAMA Netw Open

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ImportanceReturn to work after breast cancer (BC) treatment depends on several factors, including treatment-related adverse effects. While cancer-related cognitive impairment is frequently reported by patients with BC, to date, no longitudinal studies have assessed its association with return to work.ObjectiveTo examine whether cognition, assessed using objective and subjective scores, was associated with return to work 2 years after BC diagnosis.Design, Setting, and ParticipantsIn a case series of the French Cancer Toxicities (CANTO) cohort, a study of patients with stage I to III BC investigated cognition from April 2014 to December 2018 (2 years’ follow-up). Participants included women aged 58 years or younger at BC diagnosis who were employed or looking for a job.Main Outcomes and MeasuresThe outcome was return to work assessed 2 years after BC diagnosis. Objective cognitive functioning (tests), cognitive symptoms, anxiety, depression, and fatigue were prospectively assessed at diagnosis (baseline), 1 year after treatment completion, and 2 years after diagnosis. Multivariable logistic regression models were used to explain return to work status at year 2 according to each cognitive measure separately, adjusted for age, occupational class, stage at diagnosis, and chemotherapy.ResultsThe final sample included 178 women with BC (median age: 48.7 [range, 28-58] years), including 37 (20.8%) who did not return to work at year 2. Patients who returned to work had a higher (ie, professional) occupational class and were less likely to have had a mastectomy (24.1% vs 54.1%; P &lt; .001). Return to work at year 2 was associated with lower overall cognitive impairment (1-point unit of increased odds ratio [1-pt OR], 0.32; 95% CI, 0.13-0.79; P = .01), higher working memory (1-pt OR, 2.06; 95% CI, 1.23-3.59; P = .008), higher processing speed (1-pt OR, 1.97; 95% CI, 1.20-3.36; P = .01) and higher attention performance (1-pt OR, 1.63; 95% CI, 1.04-2.64; P = .04), higher perceived cognitive abilities (1-pt OR, 1.12; 95% CI, 1.03-1.21; P = .007), and lower depression (1-pt OR, 0.83; 95% CI, 0.74-0.93; P = .001) at year 2 assessment. Return to work at year 2 was associated with several measures assessed at baseline and year 1: higher processing speed (1-pt OR, 2.38; 95% CI, 1.37-4.31; P = .003 and 1.95; 95% CI, 1.14-3.50; P = .02), higher executive performance (1-pt OR, 2.61; 95% CI, 1.28-5.75; P = .01, and 2.88; 95% CI, 1.36-6.28; P = .006), and lower physical fatigue (10-pt OR, 0.81; 95% CI, 0.69-0.95; P = .009 and 0.84; 95% CI, 0.71-0.98; P = .02).Conclusions and RelevanceIn this case series study of patients with BC, return to work 2 years after diagnosis was associated with higher cognitive speed performance before and after BC treatment. Cognitive difficulties should be assessed before return to work to propose suitable management.

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Cancer, Cognitive Impairment, and Work-Related Outcomes: An Integrative Review

Cited by 39 publications

References 55 publications

Quality of life, fatigue and changes therein as predictors of return to work during breast cancer treatment

Quality of life, fatigue and changes therein as predictors of return to work during breast cancer treatment

Internet-based cognitive rehabilitation for WORking Cancer survivors (i-WORC): study protocol of a randomized controlled trial.

Cognition and Return to Work Status 2 Years After Breast Cancer Diagnosis

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