Rückkehr in das Erwerbsleben nach Krebs – eine systematische Übersichtsarbeit zu Prädiktoren in Deutschland

Zusammenfassung

Einleitung Mehr als ein Drittel der Krebsüberlebenden befinden sich im erwerbsfähigen Alter. Die Rückkehr ins Erwerbsleben (englisch: return to work – RTW) mit und nach Krebs ist für diese Gruppe deshalb ein wichtiges Thema – häufig jedoch mit vielen Herausforderungen verbunden. Ziel dieser systematischen Übersichtsarbeit ist es, die Prädiktoren für RTW nach Krebs spezifisch für Deutschland aus der Literatur zu identifizieren sowie diese Faktoren zeitlich in den onkologischen Behandlungsverlauf einzuordnen.

Methode Die systematische Recherche wurde im Juni 2022 mit PubMed durchgeführt. Eingeschlossen wurden alle deutsch- oder englischsprachigen Originalarbeiten, die zwischen den Jahren 2000 und 2022 unabhängig vom Studiendesign veröffentlicht wurden, und die sich auf ein/e deutsche/s Stichprobe/Sample beziehen.

Ergebnisse Von insgesamt 8.381 Treffern in der Meta-Datenbank wurden schließlich 30 Publikationen bei der Synthese der Ergebnisse berücksichtigt. Ein höheres Alter, niedrigere Bildung, niedrigerer sozioökonomischer Status, ein höheres Erkrankungsstadium, ein progressiverer Krankheitsverlauf, stärkere Nebenwirkungen der Behandlung, (schwerere) Fatigue, höhere psychische Belastung, ein schlechterer Gesundheitsstatus, die berufliche Stellung als Arbeiter*in und handwerkliche Tätigkeiten, Erwerbslosigkeit vor der Diagnose, eine negativere Wahrnehmung der Arbeits(platz)umgebung und eine geringere Intention zur Arbeit und geringere Arbeitsfähigkeit/subjektive Erwerbsprognose gingen in der Literatur mit einer geringeren Wahrscheinlichkeit zum RTW nach Krebs einher. Auch die Behandlungsart und Inanspruchnahme einer Rehabilitation wurden mit der Wahrscheinlichkeit zum RTW in Verbindung gebracht.

Diskussion Es wurden soziodemografische, krankheitsbezogene und psychosoziale sowie arbeits-bezogene Prädiktoren für RTW nach Krebs in Deutschland identifiziert. Die Ergebnisse können dazu beitragen, zielgerichtete Unterstützungsmaßnahmen zu entwickeln, die in konkreten Phasen der Behandlung angewendet werden können. Die Vergleichbarkeit und Bewertungsmöglichkeiten der Literatur zu den Prädiktoren für RTW sind aufgrund einer hohen Heterogenität bei der Operationalisierung von RTW und dem methodischen Vorgehen eingeschränkt. Es bedarf hier weiterer Vereinheitlichung.

Abstract

Introduction More than one third of cancer survivors are of working age. Return to work (RTW) with and after cancer treatment is therefore an important issue for this group – but this is often accompanied with many challenges. The aim of this systematic review was to identify predictors of RTW after cancer from the literature specifically for Germany and to place these factors chronologically in the oncological course of treatment.

Methods A systematic search was performed using PubMed in June 2022. Included were all papers original published in German or English between 2000 and 2022 and referring to a German sample, regardless of study design.

Results From a total of 8,381 hits in the meta-database, 30 publications were finally considered in the synthesis of results. Higher age, lower education, lower socioeconomic status, higher disease stage, more progressive disease course, more severe side effects of treatment, (more severe) fatigue, higher psychological distress, worse health status, occupational status as a blue collar worker and manual labor, unemployment prior to diagnosis, more negative perceptions of the work(place) environment, and lower intention to work and lower work ability/ subjective prognosis of employability were associated with lower likelihood of RTW after cancer in the literature. Treatment type and use of rehabilitation were also found to be associated with RTW.

Discussion Sociodemographic, disease-related, psychosocial, and work-related predictors of RTW after cancer in Germany were identified. The results may help to develop targeted support measures that can be applied in specific phases of treatment. The comparability of the literature on predictors for RTW is limited due to a high heterogeneity in the operationalization of RTW and methodological approaches. There is need for further standardization in this area.

Schlüsselwörter

return to work - Onkologie - Rehabilitation

Keywords

return to work - cancer survivors - neoplasms

Publication History

Article published online:
25 June 2024

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