Identifying Expectations of Delayed Return to Work in Patients with Prostate Cancer at the Beginning of a Cancer Rehabilitation Program

  • Anneke UllrichEmail author
  • Hilke Maria Rath
  • Ullrich Otto
  • Christa Kerschgens
  • Martin Raida
  • Christa Hagen-Aukamp
  • Corinna Bergelt


Purpose To investigate factors associated with expectations of delayed return to work (RTW) in patients with prostate cancer recently admitted to a cancer rehabilitation program. Methods In this multicenter study, data about expected time until RTW and potential correlates (personal, medical, psychosocial and work-related factors) were obtained from 822 employed cancer rehabilitation participants at the beginning of the program. Participants expecting early RTW (≤ 3 months) and delayed RTW (> 3 months) were compared. Hierarchical multivariate logistic regression was applied to study which factors are associated with expecting delayed RTW. Results In total, 171 cancer rehabilitation participants (21%) expected delayed RTW. Group comparison showed education, type of occupation, income, number of comorbid conditions, tumor stage according to the staging system of the Union for International Cancer Control (UICC), anxiety and depression, quality-of-life functioning scales, urinary and treatment-related symptoms, duration of sick leave, subjective work ability, perceived ability to return to the former job, intention to apply for a disability pension, effort-reward-imbalance and occupational stress to be associated in bivariate analysis with participants’ expectations. Multivariate analysis revealed UICC tumor stage III (compared to stages I/II, OR 2.36), lower subjective work ability (OR 0.82), perceived inability to return to the former job (OR 1.88) and intention to apply for a disability pension (OR 1.94) to increase the likelihood of expecting delayed RTW. Conclusions Negative or non-beneficial RTW expectations, which are related to self-perception and behavioral intention, seem to be key factors for expecting delayed RTW. Interventions to early identify and adjust such expectations might empower cancer rehabilitation participants to develop appropriate expectations for work recovery.


Cancer Prostate cancer Return to work Rehabilitation Expectation Regression analysis 



We thank all patients for their effort in participating in the present study. General non-financial advisory support has been provided by the COST Action IS1211 CANWON (C. Bergelt).


This work was funded by the North Rhine-Westfalia Association for the Fight against Cancer, Germany (no assigned reference number). The funding source was not involved in conduct of the research (collection, analysis and interpretation of the data) and preparation of the article (writing the report, decision to submit the manuscript for publication). The corresponding author had full access to all the data and had responsibility for the decision to submit for publication.

Compliance with Ethical Standards

Conflict of interest

Authors Ullrich, Rath, Otto, Kerschgens, Raida, Hagen-Aukamp and Bergelt declare that they have no competing interest.

Ethical Approval

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5).

Informed Consent

Informed consent was obtained from all patients for being included in the study. The study was approved by the ethics committee of the General Medical Council of Hamburg (PV3547) as well as the department of data security of the German Pension Insurance Agency, Berlin.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Medical Psychology, Center for Psychosocial MedicineUniversity Medical Center Hamburg-EppendorfHamburgGermany
  2. 2.Rehabilitation Clinics Hartenstein GmbH, Clinic QuellentalBad WildungenGermany
  3. 3.Vivantes Rehabilitation Clinic GmbHBerlinGermany
  4. 4.HELIOS Rehabilitation Clinic Bergisch-LandWuppertalGermany
  5. 5.Niederrhein Rehabilitation ClinicKorschenbroichGermany

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