直肠癌的诊断与治疗对于有偿劳动者与无偿劳动者的影响

作     者：Van Den Brink M. Van Den Hout W.B. Kievit J. A.M. Stiggelbout 郑世成 

作者机构：Department of Medical Decision Making Leiden University Medical Center J10-S P.O. Box 9600 2300 RC Leiden Netherlands.Dr 

出 版 物：《世界核心医学期刊文摘（胃肠病学分册）》 (Core Journals in Gastroenterology)

年 卷 期：2006年第2卷第3期

页      面：25-26页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：有偿劳动 生活质量问卷 多中心临床试验 全身健康 人口统计数据 患者样本 化疗者 相关性因素 样本人 

摘      要：PURPOSE: This study was designed to describe the consequences of diagnosis and treatment of rectal cancer for paid and unpaid labor over time and to identify sociodemographic-related factors, treatment-related factors, and quality of life-related factors associated with paid and unpaid labor. METHODS: Data were assessed prospectively in two samples of patients with primary rectal cancer, participating in a multicenter clinical trial, who were randomized to receive surgery with or without 5 ×5Gy preoperative radiotherapy. For paid labor, 292 patients who indicated paid labor before treatment filled out quality of life questionnaires, which included questions on paid labor at 3, 6, 12, 18, and 24 months after surgery. For unpaid labor, another sample of 92 patients also filled out the Health and Labor questionnaire, which included questions on unpaid labor, before treatment, and at 3 and 12 months after treatment. RESULTS: From 3 to 18 months after surgery, paid labor resumption increased from 19 to 63 percent (P 0.001). At 24 months after surgery, paid labor resumption was 61 percent. In a multivariate analysis, age older than 55 years (P ≤0.001), lower education level (P ≤0.003), shorter time since surgery (P 0.001), preoperative radiotherapy (P = 0.02), lower valuation of overall health (P 0.01), more physical symptom distress (P 0.001), and more limitations in daily activities (P 0.001) were all associated with less or later resumption of paid labor. The average amount of unpaid labor increased from 17.3 hours per week at 3 months to 21 hours per week at 12 months after surgery. In a multivariate analysis, only shorter time since surgery (P = 0.03) and male gender (P 0.001) were related to less unpaid labor. CONCLUSIONS: Diagnosis and treatment of rectal cancer affect paid and unpaid labor. The impact on paid labor is most pronounced. Multiple other sociodemographic and quality of life-related variables also were associated with paid labor. Patient inf