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Impact of illness perception, mental adjustment, and sociodemographic characteristics on return to work in patients with head and neck cancer

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Abstract

Purpose

To examine the effects of emotional distress, illness perception, and mental adjustment on return to work (RTW) among patients with head and neck cancer (HNC) and identify factors associated with RTW.

Methods

A cross-sectional study with convenience sampling was conducted in Taiwan. Structured questionnaires were used to collect data on RTW status and to explore possible factors related to RTW. RTW status was assessed by a single question. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale, illness perception was assessed by the Brief Illness Perception Questionnaire, and mental adjustment was assessed using the Mini-mental Adjustment to Cancer Scale. Sociodemographic and disease background data were also collected and analyzed. Factors related to RTW were identified by multivariate logistic regression.

Results

A total of 150 patients with HNC were recruited into the study. Of them, 58 (38.7%) returned to work after treatment. Compared to those who did not RTW, patients who did RTW had lower levels of emotional distress (anxiety and depression), better illness perception (cognitive illness representations and illness comprehensibility), and better mental adjustment (hopelessness and helplessness, anxious preoccupation, avoidance, and fatalism). Multivariable analysis indicated that anxiety (OR = 0.863, p < 0.05), avoidance (OR = 1.280, p < 0.001), cognitive illness representations (OR = 0.891, p < 0.01), illness comprehensibility (OR = 1.271, p < 0.05), higher education level (OR = 3.048–3.609, p < 0.05), married status (OR = 5.220, p < 0.05), tumor site in oral cavity (OR = 5.057, p < 0.05), and no reconstruction (OR = 3.415, p < 0.05) were significantly associated with RTW.

Conclusion

The issue of RTW among patients with HNC is related to multidimensional factors, including sociodemographic, psychological, and disease-related situations. We suggest that programs for emotional rehabilitation and occupational counseling need to be developed to assist patients with HNC to RTW at an early stage.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgments

The authors thank the patients who participated in the study.

Funding

This study was supported by the Ministry of Science and Technology (MOST106-2314-B-212 -001).

Author information

Authors and Affiliations

  1. Department of Nursing, Da-Yeh University, Changhua, Taiwan

    Yen-Ju Chen & Kuo-Yang Tsai

  2. Department of Nursing, College of Medicine, National Taiwan University & Hospital, Taipei, Taiwan

    Yeur-Hur Lai & Yun-Hsiang Lee

  3. Department of Otorhinolaryngology – Head and Neck Surgery, Changhua Christian Hospital, Changhua, Taiwan

    Kuo-Yang Tsai

  4. Department of Oral and Maxillofacial Surgery, Changhua Christian Hospital, Changhua, Taiwan

    Mu-Kuan Chen & Ming-Yu Hsieh

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  1. Yen-Ju Chen
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Contributions

Yen-Ju Chen and Yeur-Hur Lai designed the model and the computational framework. Yen-Ju Chen and Yun-Hsiang Lee analyzed and wrote the manuscript with input from all authors. Kuo-Yang Tsai, Mu-Kuan Chen, and Ming-Yu Hsieh contributed to the implementation of the research.

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Correspondence to Yen-Ju Chen.

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Conflict of interest

The authors declare that they have no conflicts of interest.

Ethics approval

Approval was obtained from the ethics committee of Changhua Christian Hospital. The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

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Chen, YJ., Lai, YH., Lee, YH. et al. Impact of illness perception, mental adjustment, and sociodemographic characteristics on return to work in patients with head and neck cancer. Support Care Cancer 29, 1519–1526 (2021). https://doi.org/10.1007/s00520-020-05640-5

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  • DOI: https://doi.org/10.1007/s00520-020-05640-5

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