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Cognitive challenges while at work and work output in breast cancer survivors employed in a rapidly evolving economy

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Abstract

Objective

To determine whether work output was related to cognitive limitations while at work in occupationally active breast cancer survivors (BCS) employed in a rapidly developing economy.

Methods

Measures of demographics, job type, job stress, general distress (anxiety, depression), fatigue, work-related cognitive limitations, and work output were obtained using self-report measures in a cross-sectional study in both BCS and controls (n = 267/group).

Results

Groups had similar educational backgrounds, job types, and levels of job stress. The BCS group was a median of 3.2 years post-primary treatment, slightly older, more likely to be divorced, have children, and was more likely working part-time. The BCS group reported higher levels of fatigue, general distress, and lower levels of work output (p < .05). A multivariate regression adjusting for group differences indicated that cognitive symptoms at work were related to lower levels of quantity, quality, and timeliness of completed work in the BCS group (adj. R2 = .57, unstandardized coefficient = 1.062, 95% CI = .436 to 1.689).

Conclusion

When reported in the context of work, cognitive limitations were associated with lower levels of reported work output exclusively in the BCS group.

Implications for Cancer Survivors

This study provides further evidence that cognitive limitations reported in the context of work in a developing country is similar to that of BCS working in more developed economies and is specific to BCS and not healthy workers with similar job types and job stress. Solutions to this problem may be applicable across countries.

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References

  1. Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin. 2015;65(2):87–108.

    Article  Google Scholar 

  2. World Bank. The World Bank in China. 2018. http://www.worldbank.org/en/country/china/overview. Accessed March 2018.

  3. Chen W, Zheng R, Baade PD, Zhang S, Zeng H, Bray F, et al. Cancer statistics in China, 2015. CA Cancer J Clin. 2016;66(2):115–32.

    Article  Google Scholar 

  4. China National Cancer Institute. Annual oncology report. Beijing: Ministry of Health, Bureau of Disease Prevention; 2012.

    Google Scholar 

  5. Mehnert A. Employment and work-related issues in cancer survivors. Crit Rev Oncol Hematol. 2011;77(2):109–30.

    Article  Google Scholar 

  6. Wefel JS, Schagen SB. Chemotherapy-related cognitive dysfunction. Curr Neurol Neurosci Rep. 2012;12(3):267–75.

    Article  CAS  Google Scholar 

  7. Player L, Mackenzie L, Willis K, Loh SY. Women’s experiences of cognitive changes or ‘chemobrain’ following treatment for breast cancer: a role for occupational therapy? Aust Occup Ther J. 2014;61(4):230–40.

    Article  Google Scholar 

  8. Hansen AJ, Feuerstein CM, Calvio HL, Olsen HC. Breast cancer survivors at work. J Occup Environ Med. 2008;50(7):777–84.

    Article  Google Scholar 

  9. Von AD, Habermann B, Carpenter JS, Schneider BL. Impact of perceived cognitive impairment in breast cancer survivors. Eur J Oncol Nurs. 2013;17(2):236–41.

    Article  Google Scholar 

  10. Oberst K, Bradley C, Gardiner J, Schenk M, Given C. Work task disability in employed breast and prostate cancer patients. J Cancer Surviv. 2010;4(4):322–30.

    Article  Google Scholar 

  11. Von AD, Storey S, Crouch A. Relationship between self-reported cognitive function and work-related outcomes in breast cancer survivors. J Cancer Surviv. 2018;12(2):246–55.

    Article  Google Scholar 

  12. Ho S-Y, Rohan KJ, Parent J, Tager FA, McKinley PS. A longitudinal study of depression, fatigue, and sleep disturbances as a symptom cluster in women with breast cancer. J Pain Symptom Manag. 2015;49(4):707–15.

    Article  Google Scholar 

  13. Dorland H, Abma F, Stewart R, Amick B, Ranchor A, Roelen C, et al. Fatigue and depressive symptoms improve but remain negatively related to work functioning over 18 months after return to work in cancer patients. J Cancer Surviv. 2018;12:371–8. https://doi.org/10.1007/s11764-018-0676-x.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Zeng Y, Cheng ASK, Feuerstein M. Cognitive limitations at work among employed breast Cancer survivors in China. Rehabil Nurs. 2017;42(6):347–53.

    Article  Google Scholar 

  15. Luo SX, Cheng ASK, Xiao SQ, Su YL, Feuerstein M. Breast cancer survivors report similar concerns related to return to work in developed and developing nations. J Occup Rehabil. 2018; https://doi.org/10.1007/s10926-018-9762-1.

  16. Hunt E, Madhyastha TM. Cognitive demands of the workplace. J Neurosci Psychol Econ. 2012;5(1):18–37.

    Article  Google Scholar 

  17. Calvio LL, Peugeot LM, Bruns LG, Todd LB, Feuerstein LM. Measures of cognitive function and work in occupationally active breast cancer survivors. J Occup Environ Med. 2010;52(2):219–27.

    Article  Google Scholar 

  18. Centers for Disease Control and Prevention. Behavioral risk factor surveillance system (BRFSS) survey questionnaire. Atlanta, GA: centers for disease control and. Prevention. 1999;

  19. Alexander S, Palmer C, Stone P. Evaluation of screening instruments for depression and anxiety in breast cancer survivors. Breast Cancer Res Treat. 2010;122(2):573–8.

    Article  Google Scholar 

  20. Katz MR, Kopek N, Waldron J, Devins GM, Tomlinson G. Screening for depression in head and neck cancer. Psycho-Oncology. 2004;13(4):269–80.

    Article  Google Scholar 

  21. Huang H-S, Zhang J-P, Deng X-M, Xu L. Application of psychological rating scales for patients with cancer. Nurs L Clin PLA. 2006;23(5):59–62.

    CAS  Google Scholar 

  22. Zhang W, Wang W-L, Hong J-F, Chen Y. Research on critical value of hospital anxiety and depression scale in screening anxiety and depression of hospitalized cancer patients. Chin J Nurs. 2012;19(19):1–4.

    Google Scholar 

  23. Wan C, Meng Q, Yang Z, Tu X, Feng C, Tang X, et al. Validation of the simplified Chinese version of EORTC QLQ-C30 from the measurements of five types of inpatients with cancer. Ann Oncol. 2008;19(12):2053–60.

    Article  CAS  Google Scholar 

  24. Paiva C, Carneseca E, Barroso E, Camargos M, Alfano A, Rugno F, et al. Further evaluation of the EORTC QLQ-C30 psychometric properties in a large Brazilian cancer patient cohort as a function of their educational status. Support Care Cancer. 2014;22(8):2151–60.

    PubMed  Google Scholar 

  25. Pullens MJJ, De Vries J, Roukema JA. Subjective cognitive dysfunction in breast cancer patients: a systematic review. Psycho-Oncology. 2010;19(11):1127–38.

    Article  Google Scholar 

  26. Kohli S, Griggs JJ, Roscoe JA, Jean-Pierre P, Bole C, Mustian KM, et al. Self-reported cognitive impairment in patients with cancer. Journal Oncol Pract. 2007;3(2):54–9. https://doi.org/10.1200/JOP.0722001.

    Article  Google Scholar 

  27. Ganz PA, Kwan L, Castellon SA, Oppenheim A, Bower JE, Silverman DHS, et al. Cognitive complaints after breast cancer treatments: examining the relationship with neuropsychological test performance. J Natl Cancer Inst. 2013;105(11):791–801.

    Article  CAS  Google Scholar 

  28. Kitahata R, Nakajima S, Uchida H, Hayashida T, Takahashi M, Nio S, et al. Self-rated cognitive functions following chemotherapy in patients with breast cancer: a 6-month prospective study. Neuropsychiatr Dis and Treat. 2017;13:2489–96.

    Article  Google Scholar 

  29. Ahles T, Saykin A, McDonald B, Furstenberg C, Cole B, Hanscom B, et al. Cognitive function in breast cancer patients prior to adjuvant treatment. Breast Cancer Res Treat. 2008;110(1):143–52.

    Article  CAS  Google Scholar 

  30. Zeng Y, Cheng ASK, Song T, Sheng X, Zhang Y, Liu X, et al. Subjective cognitive impairment and brain structural networks in Chinese gynaecological cancer survivors compared with age-matched controls: a cross-sectional study. BMC Cancer. 2017 Nov 28;17(1):796. https://doi.org/10.1186/s12885-017-3793-4.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Ottati A, Feuerstein M. Brief self-report measure of work-related cognitive limitations in breast cancer survivors. J Cancer Surviv. 2013;7(2):262–73.

    Article  Google Scholar 

  32. Cheng ASK, Zeng Y, Feuerstein M. Validation of the Chinese version of the cognitive symptom checklist-Work-21 in breast cancer survivors. J Occup Rehabil. 2015;25(4):685–95.

    Article  Google Scholar 

  33. Dorland H, Abma F, Roelen C, Smink A, Feuerstein M, Amick B, et al. The cognitive symptom checklist-work in cancer patients is related with work functioning, fatigue and depressive symptoms: a validation study. J Cancer Surviv. 2016;10(3):545–52.

    Article  CAS  Google Scholar 

  34. Tamminga S, Verbeek J, Frings-Dresen M, Boer A. Measurement properties of the work limitations questionnaire were sufficient among cancer survivors. Qual Life Res. 2014;23(2):515–25.

    Article  Google Scholar 

  35. Cheng ASK, Lau LOC, Ma YNH, Ngai RH, Fong SSL. Impact of cognitive and psychological symptoms on work productivity and quality of life among breast cancer survivors in Hong Kong. Hong Kong J Occup Th. 2016;28(1):15–23.

    Article  Google Scholar 

  36. Zeng Y, Cheng ASK, Feuerstein M. Cognitive limitations at work among employed breast cancer survivors in China. Hoboken: Wiley-Blackwell; 2016. p. 2.

    Google Scholar 

  37. Gandubert C, Carrière I, Escot C, Soulier M, Hermès A, Boulet P, et al. Onset and relapse of psychiatric disorders following early breast cancer: a case–control study. Psycho-Oncology. 2009;18(10):1029–37.

    Article  Google Scholar 

  38. Jones J, Olson K, Catton P, Catton C, Fleshner N, Krzyzanowska M, et al. Cancer-related fatigue and associated disability in post-treatment cancer survivors. J Cancer Surviv. 2016;10(1):51–61.

    Article  Google Scholar 

  39. Pinto AC, de Azambuja E. Improving quality of life after breast cancer: dealing with symptoms. Maturitas. 2011;70(4):343–8.

    Article  Google Scholar 

  40. Austin PC, Steyerberg EW. The number of subjects per variable required in linear regression analyses. J Clin Epidemiol. 2015;68(6):627–36.

    Article  Google Scholar 

  41. Zeng Y, Cheng ASK, Liu X, Feuerstein M. Symptom profiles, work productivity and quality of life among Chinese female cancer survivors. Gynecol Obstet (Sunnyvale). 2016;06 https://doi.org/10.4172/2161-0932.1000357.

  42. Stergiou-Kita M, Pritlove C, Kirsh B. The “big C”—stigma, cancer, and workplace discrimination. J Cancer Surviv. 2016;10(6):1035–50.

    Article  Google Scholar 

  43. Greidanus MA, de Boer AGEM, de Rijk AE, Tiedtke CM, Dierckx de Casterlé B, Frings-Dresen MHW, et al. Perceived employer-related barriers and facilitators for work participation of cancer survivors: a systematic review of employers' and survivors' perspectives. Psycho-Oncology. 2018;27(3):725–33.

    Article  CAS  Google Scholar 

  44. Moskowitz M, Todd B, Chen R, Feuerstein M. Function and friction at work: a multidimensional analysis of work outcomes in cancer survivors. J Cancer Surviv. 2014;8(2):173–82.

    Article  Google Scholar 

  45. Lerner D, Amick BC 3rd, Lee JC, Rooney T, Rogers WH, Chang H, et al. Relationship of employee-reported work limitations to work productivity. Med Care. 2003;41(5):649–59.

    PubMed  Google Scholar 

  46. Fassier J-B, Lamort-Bouche M, Broc G, Guittard L, Peron J, Rouat S, et al. Developing a return to work intervention for breast cancer survivors with the intervention mapping protocol: challenges and opportunities of the needs assessment. Front Public Health. 2018;6 https://doi.org/10.3389/fpubh.2018.00035.

  47. Bilodeau K, Tremblay D, Durand M-J. Exploration of the contexts surrounding the implementation of an intervention supporting return-to-work after breast cancer in a primary care setting: sStarting point for an intervention development. J Multidiscip Healthc. 2018;11:75–83.

    Article  Google Scholar 

  48. Lewis J, Chapparo C, Mackenzie L, Ranka J. Work after breast cancer: identification of cognitive difficulties using the perceive, recall, plan, and perform (PRPP) system of task analysis. Br J Occup Ther. 2016;79(5):323–32.

    Article  Google Scholar 

  49. Sandberg JC, Strom C, Arcury TA. Strategies used by breast cancer survivors to address work-elated limitations during and after treatment. Women Health Iss. 2014;24(2):e197–204.

    Article  Google Scholar 

  50. Kirsh D. A few thoughts on cognitive overload. 2000. http://intellectica.org/SiteArchives/archives/n30/30_01_Kirsh.pdf. Accessed July 2018.

    Article  Google Scholar 

  51. Xie H, Wang F, Hao Y, Chen J, An J, Wang Y, et al. The more total cognitive load is reduced by cues, the better retention and transfer of multimedia learning: a meta-analysis and two meta-regression analyses. PLoS One. 2017;12(8):e0183884. https://doi.org/10.1371/journal.pone.0183884.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong

    Andy S. K. Cheng, Cindy T. T. Kwok & Raymond C. K. Chung

  2. The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China

    Yingchun Zeng

  3. Department of Nursing, Hunan Cancer Hospital, Changsha, China

    Xiangyu Liu

  4. Rehabilitation Medicine Center, West China Hospital of Sichuan University, Chengdu, China

    Shaxin Liu

  5. Department of Occupational Therapy, Princess Margaret Hospital, Kwai Chung, New Territories, Hong Kong

    Stella W. C. Cheng

  6. The Third Xiangya Hospital of Central South University, Changsha, China

    Jianfei Xie

  7. Gaithersburg, USA

    Michael Feuerstein

Authors
  1. Andy S. K. Cheng
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  5. Stella W. C. Cheng
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  6. Cindy T. T. Kwok
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  7. Raymond C. K. Chung
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  8. Jianfei Xie
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  9. Michael Feuerstein
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Corresponding author

Correspondence to Andy S. K. Cheng.

Ethics declarations

The study protocol was approved by the Ethics Committees for Human Subjects at the four hospitals and the Hong Kong Polytechnic University.

Conflict of interest

All authors report no conflicts of interest. Dr. Feuerstein is Editor-in-Chief of JCSU; however, this paper went through peer review and revision.

Ethical approval

The study protocol and all procedures performed in this study were approved by the Ethics Committees for Human Subjects at the four hospitals and the Hong Kong Polytechnic University.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Cheng, A.S.K., Zeng, Y., Liu, X. et al. Cognitive challenges while at work and work output in breast cancer survivors employed in a rapidly evolving economy. J Cancer Surviv 12, 753–761 (2018). https://doi.org/10.1007/s11764-018-0712-x

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  • DOI: https://doi.org/10.1007/s11764-018-0712-x

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