Copyright
©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
Return to work in young and middle-aged colorectal cancer survivors: Factors influencing self-efficacy, fear, resilience, and financial toxicity
Dan Hu, Yue Li, Hua Zhang, Lian-Lian Wang, Wen-Wen Liu, Xin Yang, Ming-Zhao Xiao, Hao-Ling Zhang, Juan Li
Dan Hu, Yue Li, Xin Yang, Ming-Zhao Xiao, Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
Dan Hu, Department of Nursing, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Children’s Hospital of Chongqing Medical University, Chongqing 400014, China
Hua Zhang, Lian-Lian Wang, Wen-Wen Liu, Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
Hao-Ling Zhang, Department of Biomedical Science, Advanced Medical and Dental Institute, University Sains Malaysia, Penang 13200, Malaysia
Juan Li, Academic Affairs Office, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
Co-corresponding authors: Hao-Ling Zhang and Juan Li.
Author contributions: Hu D, Li Y, Zhang H, Wang LL, and Liu WW conceived the concept; Hu D and Li Y designed the questionnaire and wrote the original draft; Zhang H, Wang LL, and Liu WW collected the questionnaire data; Hu D and Yang X analyzed the data; Zhang HL and Xiao MZ reviewed and edited the manuscript; Zhang HL and Li J contributed to the supervision of this manuscript and should be considered as co-corresponding authors; and all the authors have read and approved the final manuscript.
Supported by the Chongqing Medical University Program for Youth Innovation in Future Medicine, No. W0019; and Chongqing Municipal Education Commission’s 14th Five-Year Key Discipline Support Project, No. 20240101 and No. 20240102.
Institutional review board statement: The study was conducted in accordance with the Declaration of Helsinki and approved by the ethics committee of the First Affiliated Hospital of Chongqing Medical University, approval No. 2022-K393.
Informed consent statement: The informed consent was waived by the Institutional Review Board.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Juan Li, MM, Chief Nurse, Academic Affairs Office, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuanjiagang, Yuzhong District, Chongqing 400016, China.
1005945635@qq.com
Received: August 14, 2024
Revised: October 29, 2024
Accepted: November 18, 2024
Published online: January 7, 2025
Processing time: 117 Days and 4.3 Hours
BACKGROUND
Return to work (RTW) serves as an indication for young and middle-aged colorectal cancer (CRC) survivors to resume their normal social lives. However, these survivors encounter significant challenges during their RTW process. Hence, scientific research is necessary to explore the barriers and facilitating factors of returning to work for young and middle-aged CRC survivors.
AIM
To examine the current RTW status among young and middle-aged CRC survivors and to analyze the impact of RTW self-efficacy (RTW-SE), fear of progression (FoP), eHealth literacy (eHL), family resilience (FR), and financial toxicity (FT) on their RTW outcomes.
METHODS
A cross-sectional investigation was adopted in this study. From September 2022 to February 2023, a total of 209 participants were recruited through a convenience sampling method from the gastrointestinal surgery department of a class A tertiary hospital in Chongqing. The investigation utilized a general information questionnaire alongside scales assessing RTW-SE, FoP, eHL, FR, and FT. To analyze the factors that influence RTW outcomes among young and middle-aged CRC survivors, Cox regression modeling and Kaplan-Meier survival analysis were used.
RESULTS
A total of 43.54% of the participants successfully returned to work, with an average RTW time of 100 days. Cox regression univariate analysis revealed that RTW-SE, FoP, eHL, FR, and FT were significantly different between the non-RTW and RTW groups (P < 0.05). Furthermore, Cox regression multivariate analysis identified per capita family monthly income, job type, RTW-SE, and FR as independent influencing factors for RTW (P < 0.05).
CONCLUSION
The RTW rate requires further improvement. Elevated levels of RTW-SE and FR were found to significantly increase RTW among young and middle-aged CRC survivors. Health professionals should focus on modifiable factors, such as RTW-SE and FR, to design targeted RTW support programs, thereby facilitating their timely reintegration into mainstream society.
Core Tip: This study explored the status of returning to work among young and middle-aged colorectal cancer survivors, as well as the barriers and facilitators of it. Cox regression and Kaplan-Meier survival analyses were employed to analyze the questionnaires of 209 participants. Finally, this study identified several facilitators that promote the return to work among young and middle-aged colorectal cancer survivors. These include a higher family monthly income per capita, employment in white-collar occupations, elevated return-to-work self-efficacy, and family resilience.
