title: Predictors of employment among cancer survivors after medical rehabilitation--a prospective study.
abstract: OBJECTIVE
  This study aimed to (i) investigate cancer survivor's employment status one year after the completion of a medical rehabilitation program and (ii) identify demographic, cancer, and psychosocial, treatment-, and work-related predictors of return to work (RTW) and time until RTW.
  
  
  METHODS
  A total of 1520 eligible patients were consecutively recruited on average 11 months post diagnosis and assessed at the beginning (t(0)) (N=1148) and end of rehabilitation (t(1)) (N=1060) and 12 months after rehabilitation (t(2)) (N=750). Participants completed validated measures assessing functional impairments, pain, anxiety, depression, quality of life, social support, and work-related characteristics including work ability, sick leave absence, job requirements, work satisfaction, self-perceived employer accommodation, and perceived job loss. Physicians estimated the degree of cancer-entity-specific functional impairment.
  
  
  RESULTS
  In a mean time of six weeks after rehabilitation, 568 patients (76%) had returned to work. The multivariate hierarchical logistic regression analysis indicated that baseline RTW intention [odds ratio (OR) 6.22, 95% confidence interval (95% CI) 1.98-19.51], perceived employer accommodation (OR 1.93, 95% CI 0.33-0.99), high job requirements (OR=1.84, 95% CI 1.02-3.30), cancer recurrence or progression (OR=0.27, 95% CI 0.12 - 0.63), baseline sick leave absence (OR=0.26, 95% CI 0.09-0.77), and problematic social interactions (OR=0.58, 95% CI 0.33-0.99) emerged as significant predictors for RTW. The explained variance of the total model was Nagelkerke's R²=0.59 (P<0.001).
  
  
  CONCLUSIONS
  Our findings emphasize the high relevance of motivational factors. Occupational motivation and skepticism towards returning to work should be carefully assessed at the planning of the rehabilitation program.
authors.affiliation: Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. mehnert@uke.de
authors.forename: Anja
authors.initials: A
authors.lastname: Mehnert
authors.forename: Uwe
authors.initials: U
authors.lastname: Koch
mesh_terms: D000328:Adult; D000367:Age Factors; D004651:Employment / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006304:Health Status; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009042:Motivation; D009369:Neoplasms / Q000523:psychology / Q000534:rehabilitation*; D011446:Prospective Studies; D011788:Quality of Life; D062707:Return to Work / Q000523:psychology / Q000706:statistics & numerical data*; D012944:Social Support; D012959:Socioeconomic Factors; D017741:Survivors / Q000523:psychology / Q000706:statistics & numerical data*