Enhanced provider communication and patient education regarding return to work in cancer survivors following curative treatment: A pilot study

Authors: Noel, V. A., Oulvey, E., Frake, R. E., & Bond, G. R.
Year Published 2006
Publication Journal of Occupational Rehabilitation
Volume 16
Number 4
Pages 647-657
Publisher Springer Science+Business Media, LLC

Return to work continues to be a challenge among providers and cancer survivors. Cancer patients are a risk for unemployment, due to the long term side effects of cancer and related treatments. Some forms of cancer are chronic diseases and can negatively impact a person's quality of life and lead to long term problems such as fatigue, pain, depression and other functional limitations. The loss of work can further impact quality of life due to loss of income and negative impact on self esteem. Employers and society are also impacted. Cancer survivors tend to get little advice on return to work from the medical community. Work related interventions are limited and the quality of existing studies is only moderate. Interventions are needed to improve return to work outcomes for cancer survivors.


The purpose of this study is to determine if enhancing communication between the attending and the occupational physicians about a patient's status or providing educational materials with advice on return to work to a patient will enhance the individual's employment outcome.


Patients were recruited from the radiotherapy department at the a large medical center in the Netherlands.


Thirty five patients, who had a prognosis of at least 80% chance of two year survival and who were employed at the time of diagnosis, were enrolled in the study. Twenty six were able to be interviewed.

Data Collection

A self administered baseline questionnaire was completed by patients. The overall score on 8 items that were predictive of return to work, according to a previous cohort study, was treated as a predictor of return to work. Variables included:age, gender, diagnosis, type of cancer treatment, depressed mood, physical complaints, physical workload and fatigue. Additionally, satisfaction on the advice from the educational materials was gained during a semi-structured interview. At this time the participants rated the materials on a scale of one (very poor) to 10(very good). Satisfaction with each of the 10 steps, (ie.adherence to the advice), was also rated as useful, somewhat useful, not useful or redundant. Occupational physicians were also interviewed about their satisfaction and perceived influence of the letters and educational material.


In this study the subjects served as their own comparison group in pretest/post-test.


Among the 24 occupational physicians interviewed, 22 considered the information provided in the letters as "helpful". Fifty percent indicated the information influenced their rehabilitation efforts. In particular, this group noted the information on diagnosis and treatment as particularly useful. The educational leaflet was rated on a scale of 1 to 10 as 7.3 with SD of 1.0. Patients were also interviewed after treatment. They gave the educational leaflet a mean score of 7.9 with SD of 0.6. Scores ranges for this group from 6.5 to 10. Not all who rated the advice as useful, acted upon it. Time from ending treatment to return to work ranged from 0 to 133 days. After 6 months 65% of the patients had returned to work. And by month 18,92% of the sample had returned to work.


The pilot shows encouraging results on the use of the interventions to assist individuals with cancer with returning to work. Large randomized controlled trials are needed.

URL http://www.ncbi.nlm.nih.gov/pubmed/17063404
Populations Male & Female
Outcomes Return to work
Research Design Quasi-experimental
Peer Reviewed Yes