Mark C Hornbrook1, Marcia Grant2, Christopher Wendel3, Joanna E Bulkley4, Carmit K Mcmullen5, Andrea Altschuler6, Larissa Kf Temple7, Lisa J Herrinton8, Robert S Krouse9. 1. Senior Investigator Emeritus at the Center for Health Research in Portland, OR. mark.c.hornbrook@gmail.com. 2. Distinguished Professor in the Department of Nursing Research and Education at the City of Hope National Medical Center in Duarte, CA. mgrant@coh.org. 3. Instructor at the University of Arizona College of Medicine and Arizona Center on Aging in Tucson. cwendel@aging.arizona.edu. 4. Research Associate at the Center for Health Research in Portland, OR. joanna.e.bulkley@kpchr.org. 5. Medical Anthropologist and Investigator in the Science Programs Department at the Center for Health Research in Portland, OR. carmit.mcmullen@kpchr.org. 6. Research Project Manager for the Division of Research in Oakland, CA. andrea.altschuler@kp.org. 7. Chief of the Division of Colorectal Surgery at the University of Rochester Medical Center in NY. larissa_temple@urmc.rochester.edu. 8. Research Scientist for the Division of Research in Oakland, CA. lisa.herrinton@kp.org. 9. Instructor of Surgery at the University of Pennslvania School of Medicine and Chief of Surgery for the CMC Veterans Affairs Medical Center in Philadelphia. robert.krouse@uphs.upenn.edu.
Abstract
CONTEXT: Rectal cancer and its treatment impair survivors' productivity. OBJECTIVE: To assess determinants of market and nonmarket employment, job search, volunteering, and homemaking among survivors five years or longer after diagnosis. DESIGN: We mailed questionnaires to 1063 survivors who were members of Kaiser Permanente (Northern California, Northwest) during 2010 and 2011. MAIN OUTCOME MEASURES: Productive activities, functional health status, and bowel management at the time of the survey. RESULTS: Response rate was 60.5% (577/953). Higher comorbidity burdens were associated with lower productivity for men and women rectal cancer survivors. Productive survivors were younger and had lower disease stage and age at diagnosis, higher household income and educational attainment, and fewer comorbidity burdens and workplace adjustments than did nonproductive survivors (p < 0.05 each; 2-sided). Productive rectal cancer survivors were evenly split by sex. CONCLUSION: Staying productive is associated with better mental health for rectal cancer survivors. Rectal cancer survivors with multiple chronic conditions, higher disease stage, lower productive activities, and older age need better access to medical care and closer monitoring of the quality of their care, including self-care. To capture the full extent of the involvement of survivors in all types of productive activities, research should routinely include measures of employment, searching for employment, homemaking, and volunteering. Counting market and nonmarket productive activities is innovative and recognizes the continuum of contributions survivors make to families and society. Health care systems should routinely monitor rectal cancer survivors' medical care access, comorbidities, health-related quality of life, and productive activities.
CONTEXT: Rectal cancer and its treatment impair survivors' productivity. OBJECTIVE: To assess determinants of market and nonmarket employment, job search, volunteering, and homemaking among survivors five years or longer after diagnosis. DESIGN: We mailed questionnaires to 1063 survivors who were members of Kaiser Permanente (Northern California, Northwest) during 2010 and 2011. MAIN OUTCOME MEASURES: Productive activities, functional health status, and bowel management at the time of the survey. RESULTS: Response rate was 60.5% (577/953). Higher comorbidity burdens were associated with lower productivity for men and womenrectal cancer survivors. Productive survivors were younger and had lower disease stage and age at diagnosis, higher household income and educational attainment, and fewer comorbidity burdens and workplace adjustments than did nonproductive survivors (p < 0.05 each; 2-sided). Productive rectal cancer survivors were evenly split by sex. CONCLUSION: Staying productive is associated with better mental health for rectal cancer survivors. Rectal cancer survivors with multiple chronic conditions, higher disease stage, lower productive activities, and older age need better access to medical care and closer monitoring of the quality of their care, including self-care. To capture the full extent of the involvement of survivors in all types of productive activities, research should routinely include measures of employment, searching for employment, homemaking, and volunteering. Counting market and nonmarket productive activities is innovative and recognizes the continuum of contributions survivors make to families and society. Health care systems should routinely monitor rectal cancer survivors' medical care access, comorbidities, health-related quality of life, and productive activities.
Authors: Mark C Hornbrook; Christopher S Wendel; Stephen Joel Coons; Marcia Grant; Lisa J Herrinton; M Jane Mohler; Carol M Baldwin; Carmit K McMullen; Sylvan B Green; Andrea Altschuler; Susan M Rawl; Robert S Krouse Journal: Med Care Date: 2011-03 Impact factor: 2.983
Authors: Tenbroeck Smith; Kevin D Stein; C Christina Mehta; Chiewkwei Kaw; James L Kepner; Trent Buskirk; Jeremy Stafford; Frank Baker Journal: Cancer Date: 2007-01-01 Impact factor: 6.860
Authors: Raymond Skeps; Carmit K McMullen; Christopher S Wendel; Joanna Bulkley; Marcia Grant; Jane Mohler; Mark C Hornbrook; Robert S Krouse; Lisa J Herrinton Journal: J Geriatr Oncol Date: 2012-10-27 Impact factor: 3.599
Authors: Joanna Bulkley; Carmit K McMullen; Mark C Hornbrook; Marcia Grant; Andrea Altschuler; Christopher S Wendel; Robert S Krouse Journal: Psychooncology Date: 2013-06-07 Impact factor: 3.894
Authors: Virginia Sun; Marcia Grant; Carmit K McMullen; Andrea Altschuler; M Jane Mohler; Mark C Hornbrook; Lisa J Herrinton; Carol M Baldwin; Robert S Krouse Journal: J Wound Ostomy Continence Nurs Date: 2013 Jan-Feb Impact factor: 1.741
Authors: Melissa S Y Thong; Floortje Mols; Xin S Wang; Valery E P P Lemmens; Tineke J Smilde; Lonneke V van de Poll-Franse Journal: Eur J Cancer Date: 2013-03-01 Impact factor: 9.162
Authors: Andrea Altschuler; Michelle Ramirez; Marcia Grant; Christopher Wendel; Mark C Hornbrook; Lisa Herrinton; Robert S Krouse Journal: J Wound Ostomy Continence Nurs Date: 2009 May-Jun Impact factor: 1.741
Authors: J Jason Lundy; Stephen Joel Coons; Christopher Wendel; Mark C Hornbrook; Lisa Herrinton; Marcia Grant; Robert S Krouse Journal: Qual Life Res Date: 2009-01-10 Impact factor: 4.147
Authors: Robert S Krouse; Marcia Grant; Christopher S Wendel; M Jane Mohler; Susan M Rawl; Carol M Baldwin; Stephen Joel Coons; Ruth McCorkle; Clifford Y Ko; C Max Schmidt Journal: Dis Colon Rectum Date: 2007-12 Impact factor: 4.585