Assessing Barriers and Facilitators to Return to Work for Kidney Cancer Survivors: A 6-Month Longitudinal Study

Abstract

Objectives

This study aimed to investigate the factors that impact the readiness and success of kidney cancer survivors returning to work, providing insights for healthcare professionals, employers, and policymakers.

Methods

A prospective longitudinal study was conducted at Sun Yat-sen University Cancer Center from April 2022 to June 2023. The study enrolled 282 kidney cancer survivors aged 18 to 60 who completed three surveys at 1, 3, and 6 months postsurgery. Data collection involved telephone interviews and self-administered questionnaires, capturing sociodemographic information, medical history, and employment status, while follow-up assessments tracked return-to-work readiness. The scales used for analysis included the Generalized Anxiety Disorder Scale, the Patient Health Questionnaire, the Return-to-Work Self-Efficacy Questionnaire, the Perceived Social Support Scale, and the Brief Fatigue Inventory. Generalized Estimation Equations were applied to identify significant factors, with both single-factor and multivariate analyses performed to pinpoint the most critical variables.

Results

Return-to-work rates at 1, 3, and 6 months postsurgery were 26.9%, 59.9%, and 76.2%, respectively. Higher levels of anxiety, lower self-efficacy, older age, and greater fatigue were associated with reduced return-to-work rates. Physically demanding jobs posed more barriers compared to nonmanual roles. Significant factors identified in multivariate analysis included anxiety, self-efficacy, fatigue, and the nature of the patient's work.

Conclusion

Psychological, physical, and job-related factors play a crucial role in determining whether kidney cancer survivors can successfully return to work. Tailored support and flexible work arrangements could help kidney cancer survivors reintegrate into the workforce, leading to better long-term outcomes.

Implication for Nursing Practice

Nursing professionals can play a vital role in assessing and supporting kidney cancer survivors during their recovery process by addressing both psychological and physical factors. Incorporating return-to-work readiness into postoperative care plans, offering mental health support, and liaising with employers to create flexible working conditions could enhance the reintegration of survivors into the workforce.