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Medical-professional rehabilitation after cancer – 2-years experience and evaluation of a multimodal rehabilitation concept
20 September 2018 (online)
The gain of early detection and the improvement of cancer treatment have led to an increased prevalence of cancer survivors. The return to work (RTW) after treatment is extremely important in regards to economy and rehabilitation. The aim of this study was the evaluation of a multidisciplinary rehabilitation concept (Scheidegger MBOR concept) to identify factors and barriers for a successful RTW.
During indoor rehabilitation all patients were screened for higher risk to fail RTW. After positive screening a multidisciplinary standardized treatment (job-related physio- and ergotherapy, coaching by social service and psycho-oncologists, information about aftercare) was decreed. At onset of treatment inhibitory factors for returning to work, psychical distress (NCCN distress thermometer) and presence of chronic pain (NRS) were recorded.
282 pts (˜4.4%) with positive screening were detected, 54 pts (19.1%) with symptomatic visceral metastasis were excluded. So, 228 pts were included. In 25.9% a limited illness-related pension and in 18.2% work-promoting measures were recommended. In 38.6% a gradual re-integration at workplace was advised. Pain (P = 0.13) with stronger intensity (P = 0.007) and more physical distress (P < 0.001) was complained by included patients and inhibitory factors („fatigue“ (42,5%), „mental stress“ (34,7%), „disease-promoting working conditions“ (18,4%), „lack of appreciation/mobbing“ (14,9%), „age“ (15,7%), „pain“ (13,1%)) were reported. Disease or treatment-related symptoms (CIPN, lymph edema) were specified less frequently (< 10%).
In comparison to other rehabilitation areas proportion of patients with risk to fail RTW is lower after cancer treatment. Main obstructions for RTW are fatigue, stress and work-related factors were specified.