work-related medical rehabilitation;
oncology;
cancer;
quality of life;
cluster-randomized trial;
LIFE;
INSTRUMENT;
CARE;
D O I:
10.1055/a-0604-0157
中图分类号:
R49 [康复医学];
学科分类号:
100215 ;
摘要:
Background Rehabilitation programs that support return to work become increasingly relevant for cancer survivors. In Germany, such programs were established as work-related medical rehabilitation (WMR). The study investigated whether WMR leads to better results compared to medical rehabilitation (MR). We report effects on secondary outcomes when the rehabilitation program was completed. Methods Clusters of participants were randomly assigned to WMR or MR. Patients of working age and an elevated risk of not returning to work were included. The grade of implementation was assessed by dose delivered and dose received. Study outcomes were assessed using scales measuring functioning and symptoms, coping with illness as well as self-reported work ability. Treatment effects were estimated using mixed linear models. Results From 232 planned randomized intervention groups, 165 (71 %) were realized. In total, 476 patients were included. Mean age of participants was 50.7 years (SD = 7.3). Most frequent primary diagnoses were malignant neoplasms of the breast. Participants in the WMR program reported significantly better outcomes regarding quality of life (SMD = 0.17-0.25), fatigue (SMD = 0.18-0.27), coping with illness (SMD = 0.17-0.22), and self-reported work-ability (SMD = 0.16) compared to participants in MR program (all p < 0.05). Conclusion The results indicate a positive effect in favor of WMR for cancer patients with an elevated risk of not returning to work at the end of their treatment.