Evaluation of a Hospital-Based Return to Work intervention for Breast Cancer Patients

Abstract

Background: International research indicates that patients’ needs for return-to-work (RTW) support should be addressed and integrated within the curative healthcare process and as early as possible in the treatment process. Using intervention mapping, a hospital based RTW intervention, named BRIDGE (Bridging health care and workspace), was developed with an emphasis on bridging the gap between healthcare and the workplace. The aims of this evaluation were (a) to determine whether BRIDGE contributes to restoring participation and increasing quality of life for BC patients during their RTW process; and (b) to identify the needs and experiences of patients and healthcare professionals during this transmural intervention process. This paper describes the quantitative and qualitative evaluation of the intervention. Method: The mixed-method design of this study assessed quantitative outcome measures on patient level (perceived Quality of life), number of days on sick leave, relapse and experience with RTW support; and on healthcare worker level (days of duration of the RTW guided process, perception of satisfaction with RTW support and time spent by the occupational therapist and the multidisciplinary team). Semi structured interviews were used to evaluate qualitative measures on patient level, focus-group discussion was used to collect healthcare providers’ perceptions. Results: Of all eligible patients (n =179), 79 accepted to participate. Randomisation attributed 43 participants to the intervention group (IG) and 36 to the control group (CG). The outcomes showed that patients felt respected and empowered in their choices and actions regarding their professional career and that health care providers perceive the intervention as valuable support for their patients. Conclusions: The BRIDGE intervention is highly appreciated both by HCPs and BC patients. Improvements can be made by elaborating the thoughtful follow-up which enables the BCM to stay in touch, to enable indication of the right moment for each patient to engage in the RTW process. It also would reinforce insights for the BCM to provide the type of service that fits patients’ and all other stakeholders’ needs. On the other hand, HCPs are not comfortable with the content as well as the potential impact. More emphasis on the thoughtful follow-up is needed to motivate HCPs to align with the idea of the BRIDGE intervention.