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      Role of physical medicine for cancer rehabilitation and return to work under the premise of the “Wiedereingliederungsteilzeitgesetz”

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          Summary

          Background

          With the intention of enabling people a phased return to work after long-term sick leave the so-called “Wiedereingliederungsteilzeitgesetz” (WIETZ) was implemented in Austria on 1 July 2017.

          Methods

          To explore the overall awareness about the WIETZ and the value of physical modalities together with further supporting measures in return to work of cancer survivors, a survey by using a self-constructed questionnaire was performed in 30 experts 6 months after the WIETZ came into force.

          Results

          The awareness of Austrian specialists regarding the WIETZ seems to be excellent. Regarding expert opinions, return to work in cancer survivors is notable hampered in workplaces with great physical stress even in times of the WIETZ, whereas for professions in offices and banks it is easier to return to work, with and without WIETZ. The highest impact on return to work seems to be due to exercise, as an intervention of the field of physical medicine and rehabilitation to improve sensorimotor functions and to increase endurance capacity as well as muscular strength.

          Conclusion

          Early information about cancer rehabilitation and the WIETZ seems to be necessary to facilitate return to work of cancer survivors. Furthermore, exercise interventions seem to be the most important measures from the field of physical medicine and rehabilitation.

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          Most cited references25

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          Cancer survivors and unemployment: a meta-analysis and meta-regression.

          Nearly half of adult cancer survivors are younger than 65 years, but the association of cancer survivorship with employment status is unknown. To assess the association of cancer survivorship with unemployment compared with healthy controls. A systematic search of studies published between 1966 and June 2008 was conducted using MEDLINE, CINAHL, EMBASE, PsycINFO, and OSH-ROM databases. Eligible studies included adult cancer survivors and a control group, and employment as an outcome. Pooled relative risks were calculated over all studies and according to cancer type. A Bayesian meta-regression analysis was performed to assess associations of unemployment with cancer type, country of origin, average age at diagnosis, and background unemployment rate. Twenty-six articles describing 36 studies met the inclusion criteria. The analyses included 20,366 cancer survivors and 157,603 healthy control participants. Studies included 16 from the United States, 15 from Europe, and 5 from other countries. Overall, cancer survivors were more likely to be unemployed than healthy control participants (33.8% vs 15.2%; pooled relative risk [RR], 1.37; 95% confidence interval [CI], 1.21-1.55). Unemployment was higher in breast cancer survivors compared with control participants (35.6% vs 31.7%; pooled RR, 1.28; 95% CI, 1.11-1.49), as well as in survivors of gastrointestinal cancers (48.8% vs 33.4%; pooled RR, 1.44; 95% CI, 1.02-2.05), and cancers of the female reproductive organs (49.1% vs 38.3%; pooled RR, 1.28; 95% CI, 1.17-1.40). Unemployment rates were not higher for survivors of blood cancers compared with controls (30.6% vs 23.7%; pooled RR, 1.41; 95% CI, 0.95-2.09), prostate cancers (39.4% vs 27.1%; pooled RR, 1.11; 95% CI, 1.00-1.25), or testicular cancer (18.5% vs 18.1%; pooled RR, 0.94; 95% CI, 0.74-1.20). For survivors in the United States, the unemployment risk was 1.5 times higher compared with survivors in Europe (meta-RR, 1.48; 95% credibility interval, 1.15-1.95). After adjustment for diagnosis, age, and background unemployment rate, this risk disappeared (meta-RR, 1.24; 95% CI, 0.85-1.83). Cancer survivorship is associated with unemployment.
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            Sustained employability and health-related quality of life in cancer survivors up to four years after diagnosis.

            Most cancer survivors are able to return to work at some point after diagnosis. However, literature on sustained employability and health-related quality of life (HRQoL) is limited. Therefore, the aims of this study were to explore the influence of change in employment status on HRQoL in cancer survivors long term after diagnosis, and to identify predictors of work continuation in occupationally active survivors.
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              Cancer and the meaning of work.

              J Peteet (2000)
              The importance of work in patients with cancer has received relatively little attention. This article reviews the existing literature and uses case examples to illustrate the themes that characterize work-related distress. Whereas loss of occupational identity can be a source of significant anxiety and depression, continuing or returning to the workplace allows many patients to maintain a sense of normalcy or control. The experience of discrimination can become a focus for strong feelings about fairness. Clinicians need to both address work-related distress directly and appreciate the larger significance these themes may have in their patients' coping. A closer look at the importance of work in oncology suggests several areas for future research.
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                Author and article information

                Contributors
                +43-1-4040043300 , richard.crevenna@meduniwien.ac.at
                Journal
                Wien Klin Wochenschr
                Wien. Klin. Wochenschr
                Wiener Klinische Wochenschrift
                Springer Vienna (Vienna )
                0043-5325
                1613-7671
                13 May 2019
                13 May 2019
                2019
                : 131
                : 19
                : 455-461
                Affiliations
                [1 ]GRID grid.22937.3d, ISNI 0000 0000 9259 8492, Department of Physical Medicine, Rehabilitation and Occupational Medicine, , Medical University of Vienna, ; Währinger Gürtel 18–20, 1090 Vienna, Austria
                [2 ]Rosalienhof, Bad Tatzmannsdorf, Burgenland Austria
                Author information
                http://orcid.org/0000-0002-9177-0101
                Article
                1504
                10.1007/s00508-019-1504-7
                6795628
                31087151
                374f231c-eb16-4627-a5e3-ba3b4da70273
                © The Author(s) 2019

                Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                : 16 February 2019
                : 24 April 2019
                Funding
                Funded by: Medical University of Vienna
                Categories
                Main Topic
                Custom metadata
                © Springer-Verlag GmbH Austria, part of Springer Nature 2019

                Medicine
                workability,part-time reintegration,exercise,experts’ survey,cancer
                Medicine
                workability, part-time reintegration, exercise, experts’ survey, cancer

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