Tennessee Far reaching Disease Control Coalition.


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Tennessee Extensive Malignancy Control Coalition Summit 2009 Meharry Medicinal School April 23 - 24 Lessening the Weight of Disease in Tennessee: Work Janice Pazar, Ph.D./HSP, RN Psychosocial Oncology The West Center TC4 West Locale Psychosocial Workgroup
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Tennessee Comprehensive Cancer Control Coalition Summit 2009 Meharry Medical College April 23 - 24

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Reducing the Burden of Cancer in Tennessee: Work Janice Pazar, Ph.D./HSP, RN Psychosocial Oncology The West Clinic

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TC4 West Region Psychosocial Workgroup Survivors, Community Educators, ACS and LLS, Health organization, Oncology Social Work, Psychologists…expanding Consensus points: Work worries along the disease continuum, Health Insurance, and Financial Resources

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C.O.P.E. Model Creativity Optimism Plan Expert Information Peter Houts, Ph.D. Speedy Reference for Oncology Clinicians (2006) Holland, Greenberg, Hughes, (Eds.) APOS Institute for Research and Education

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Stuart Brown, MD The National Institute of Play is a perspective, a fundamental need, a natural commute simply like rest Anticipation, retained, shock, joy, we need to proceed with Voluntary, Builds versatility, Balance, undertaking ingenuity Lowers stretch and aides manage feeling Catalyst Work and working environment The inverse of Play is Depression

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IOM and ASCO From Cancer Patient to Cancer Survivor: Lost in Transition Impact of Survivorship on Patients and Caregivers Individualized Roadmaps for every survivor Negative results of malignancy and treatment are significant and overlooked

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IOM and ASCO From Cancer Patient to Cancer Survivor: Lost in Transition More than 60% are matured 65 and more seasoned (work, loss of salary, freedom, trouble on grown-up youngsters) More than 40% are matured somewhere around 21 and 65 (wage, head honcho based wellbeing protection, time off work, parts and obligations, sandwich era, employment changes, and so forth.)

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IOM and ASCO From Cancer Patient to Cancer Survivor: Lost in Transition Most tumor patients who worked before their finding keep on working, however they frequently oblige some sort of convenience. Reasons for alarm of occupation separation Symptoms and utilitarian constraints are more probable today to meddle with work. Need endeavors to minimize unfriendly impacts of malignancy on job in the fleeting and long haul.

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Burden of Illness in Cancer Survivors Purpose: to assess the weight of ailment in a national populace utilizing 2000 National Health Interview Survey 1823 malignancy survivors; 5469 coordinated age, sex, instruction Compared two gatherings general and subgroups stratified by tumor sort and time since conclusion Yabroff, K. R., Lawrence, W. F., Clauser, S., Davis, W.W., Brown, M.L. (2004). Weight of Illness in Cancer Survivors: Findings from a Population-Based National Sample. Diary of the National Cancer Institute, 96 (17): 1322-1330.

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Significant Findings Survivors lost a larger number of days of work than coordinated controls Patterns of business and lost profitability: confounded Newly analyzed will probably be working and lost more work days. Individuals analyzed 2 or more years back were less inclined to be working because of wellbeing issues contrasted with coordinated controls. Yabroff, K. R., Lawrence, W. F., Clauser, S., Davis, W.W., Brown, M.L. (2004). Weight of Illness in Cancer Survivors: Findings from a Population-Based National Sample. Diary of the National Cancer Institute, 96 (17): 1322-1330.

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Employment in an accomplice of bosom disease patients Purpose: to recognize conceivable separation and different snags to staying at work Method: Questionnaire with bosom tumor patients utilized at analysis. Finding was no less than 6 months before meeting. Study included 96 continuous patients matured 18 to 65 years. Villaverde, R. M., Batlle, J.F., Yllan, A. V., Gordo, A.M.J., Sanchez, A.R., Valiente, B. SJ, and Baron, M. G. (2008). Business in a companion of bosom growth patients. Word related Medicine 58 (): 509-511.

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Employment in a companion of bosom disease patients Results: After determination and amid treatment, 80% did not RTW At the end of treatment, 56% RTW. Very nearly 30% saw changes in connection with co-specialists and chiefs. Conclusion: The issues ladies experienced in RTW, for the most part connected to lingering symptoms of malady and treatment. Villaverde, R. M., Batlle, J.F., Yllan, A. V., Gordo, A.M.J., Sanchez, A.R., Valiente, B. SJ, and Baron, M. G. (2008). Job in an accomplice of bosom tumor patients. Word related Medicine 58 (): 509-511.

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Work Handbook of Cancer Survivorship (2007) Michael Feuerstein, Editor Chapter 21 “Work” Jos Verbeck and Evelien Selten, Authors Work and Cancer Survivors (2009)

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Work: Verbeek and Spelten Over 40% of malignancy patients are working grown-ups Early research concentrated on legitimate issues and separation More as of late degree has enlarged to incorporate variables affecting RTW Work related Factors Disease and Treatment Related Factors Person-Related Factors

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Literature Review 1985 - 1999 Factors with Positive Association for RTW Coworker Positive Attitudes Flexibility and Discretion with Workload and Hours Longer time since end of treatment Mobilizing social backing

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Literature Review 1985 - 1999 Factors with Negative Association for RTW Physical Demands Breast, Head and Neck, CNS, most tested Changing Attitudes: Reduced significance of work Fatigue, Depression, Sleep, Physical Symptoms, Cognitive Dysfunction, Psychological Distress

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Literature Review 1985 - 1999 Mixed Results among studies Disease Stage and Cancer Site Increasing Age Fatigue Reaction to Diagnosis: Less Confident Authors noticed all studies endured methodological shortcomings

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Work: Verbeek and Spelten Interventions to Improve RTW Intentional Variation among people is incredible Not mindful of any studies on requirement for backing consequently to work endeavors Support from treating doctors is appreciated Symptom administration/physical uprightness Adapting workplace Patient demeanors and convictions (Family)

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Work: Verbeek and Spelten For patients with musculoskeletal issue and emotional wellness issues, Patient assumptions about recuperation best indicators of RTW. (How do the patient and family understand disease?)

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Work: Verbeek and Spelten What Outcomes Should be Addressed? Misty Narrow the crevice in livelihood between growth survivors and sound controls Gap may fluctuate by nation because of government disability arrangements There may be disarray about RTW strategies Shorter (streamline) time to RTW Possibly look to lessening number of survivors who quit working for “health reasons” Referrals for physical restoration and treatment of mental trouble.

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Impact of Physical and Psychosocial components on Work Purpose: What changes do disease survivors involvement in work attributes and word related part after treatment? What physical and psychosocial components are connected with these progressions? Steiner, J.F., Cavender, T.A., Nowels, C.T., Beaty, B.L., Bradley, C.J., (2008) The effect of physical and psychosocial variables on work attributes after malignancy. Psycho-Oncology 17: 138-147

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Impact of Physical and Psychosocial elements on Work Methods: Stratified example 21-64 years from Colorado Central Cancer Registry Survey included 17 thing approved scale evaluating positive advantages related 158 phone interviews, 60 minutes, normal of 23.4 months after introductory determination Steiner, J.F., Cavender, T.A., Nowels, C.T., Beaty, B.L., Bradley, C.J., (2008) The effect of physical and psychosocial components on work attributes after disease. Psycho-Oncology 17: 138-147

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Impact of Physical and Psychosocial elements on Work Results: CHANGES : 8 of 100 quit working 35 with anticipated survival <2 yrs, 17% halted 84 with longer forecasts, 3% (4) ceased 92 who stayed working, 57% diminished week after week hours worked by normal of 15.6 20% changed obligations, 8% changed superintendents, 8% quit directing, 5% lessened from two employments to one Steiner, J.F., Cavender, T.A., Nowels, C.T., Beaty, B.L., Bradley, C.J., (2008) The effect of physical and psychosocial variables on work qualities after tumor. Psycho-Oncology 17: 138-147

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Impact of Physical and Psychosocial variables on Work Factors: Reduced work hours connected with physical indications, absence of vitality, N/V, mental manifestations, apprehensions, exhausted and pointless, discouraged Few working environment obstructions, most educated executives and associates of analysis, gatherings did not contrast Those with superintendent supported wellbeing protection, 42% abstained from evolving occupations, particularly among those decreasing their work hours. 56% reported changes in work part, 39% cut work burden and additional time. Steiner, J.F., Cavender, T.A., Nowels, C.T., Beaty, B.L., Bradley, C.J., (2008) The effect of physical and psychosocial components on work qualities after malignancy. Psycho-Oncology 17: 138-147

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Impact of Physical and Psychosocial components on Work Recommendations Measurement of work is unpredictable Consistent with IOM, suppliers get some information about effect of side effects on work Identify the individuals who can profit by forceful indication administration and restoration projects Attend to apprehensions and mental worries that may influence fill in and in addition QOL

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USA Today by Stephanie Armor, 11/20/06 “Cancer Patients Keep on Working” Employees tell numerous stories of backing Since 1992, more than 5,000 EEOC objections of separation because of malignancy Delicate circumstance with classification and protection concerns Employers are lawfully needed to make sensible convenience.

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USA Today by Stephanie Armor, 11/20/06 “Cancer Patients Keep on Working” Employees are watching…and inquiring as to whether I become ill?

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How do tumor patients settle on choices about work? Convoluted examples of business taking after determination, amid treatment, and in survivorship Individual examples shift broadly however individuals with growths of bosom, head and neck, and CNS are g

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