Return to Work and Quality of Life in Disease-Free Adult Patients with Soft-Tissue and Bone Sarcoma of the Extremity
Abstract
Abstract. Treatment of extremital sarcoma patients may be associated with significant functional disabilities and psychosocial distress affecting return to work (RtW) and quality of life (QoL). In this exploratory study we prospectively investigated the RtW rate, explored biomedical and psychosocial predictors of RtW, and compared generic QoL with Swiss population norms. Forty people (89 %) returned to work. Full-time employment before sarcoma diagnosis, high educational level, and low tumor grade showed an increased probability of RtW. The median age was lower in patients who returned to work, and they reported less fear of progression. Generic QoL (SF-36) was reduced in almost all dimensions when compared to a normative Swiss population. Physical functioning and fear of progression have to be addressed in the rehabilitation process.
Zusammenfassung. Patientinnen und Patienten, die an einem Extremitäten-Sarkom erkranken, leiden häufig an körperlichen Folgeschäden. Diese können zu einer psychosozialen Belastungssituation führen, die die Lebensqualität und somit die Wiederaufnahme der beruflichen Tätigkeit (RtW) nach Therapieabschluss einschränken. In dieser Studie wurden mittels Interview die RtW-Rate, prädiktive Faktoren und die Lebensqualität (QoL) erhoben. Vierzig Patientinnen und Patienten (89 %) konnten nach Therapieabschluss die Arbeit wieder aufnehmen. Vollzeitbeschäftigung vor der Sarkom-Diagnose, ein hohes Bildungsniveau sowie ein niedriger Tumorgrad zeigten eine erhöhte Wahrscheinlichkeit für RtW. Höheres Alter war mit einer niedrigeren RtW-Rate assoziiert. Betroffene mit RtW berichteten über weniger Angst vor einem Fortschreiten des Tumors. Die generische QoL (SF-36) war im Vergleich zu einer normativen Schweizer Bevölkerung in fast allen Dimensionen reduziert. Körperliche Funktionsfähigkeit und Angst vor Progression müssen im Rehabilitationsprozess berücksichtigt werden.
Résumé. Les patients souffrant de sarcomes des membres ont souvent des conséquences physiques. Celles-ci peuvent conduire à une situation de stress psychosocial, limiter la qualité de vie et donc la reprise de l’activité professionnelle (RtW) après la fin de la thérapie. Dans cette étude, le taux de RtW, les facteurs prédictifs et la qualité de vie (QoL) ont été déterminés. Quarante patients (89 %) ont pu reprendre le travail après la fin de la thérapie. L’emploi à temps plein avant le diagnostic du sarcome, un niveau d’éducation élevé et un grade de tumeur bas ont montré une probabilité accrue de RtW. Un âge plus avancé était associé à un taux de RtW plus faible. Les patients RtW ont déclaré avoir moins peur de la progression de la tumeur. La qualité de vie générique (SF-36) a été réduite dans presque toutes les dimensions par rapport à une population suisse normative. Le fonctionnement physique et la peur de la progression doivent être pris en compte dans le processus de réhabilitation.
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