Study On The Status Of Readiness To Return To Work And Its Influencing Factors After Surgery In Young And Middle-aged Patients With Colorectal Cancer

Objective:Investigation of young and middle-aged patients with colorectal cancer to return to work and explore the influence of middle-aged and young patients with colorectal cancer postoperative’s readiness to return to work related factors,analysis of the level of social support and self-efficacy of young and middle-aged patients with colorectal surgery’s readiness to return to work,in order to carry out vocational rehabilitation interventions to promote young and middle-aged postoperative patients with postoperative colorectal cancer to return to work.Methods:This study was a cross-sectional investigation.A total of 313 patients who met the inclusion criteria and returned to the First Affiliated Hospital of Xi ’an Jiao tong University from July 2020 to December 2020 were selected as the subjects by means of convenient sampling.General data(including basic demographic data,illness,and occupational conditions),the ready-to-return to work scale,the social support scale,and the self-management efficacy scale were used.Epidata3.0 software was used for double entry of the recovered questionnaires,and SPSS26.0 software was used to analyze the data.The frequency and composition ratio were used to describe the demographic data,disease-related data and personal occupation related information in the general data.Mean ± standard deviation was used to describe the scores of social support level and self-efficacy level.The frequency and composition ratio were used to describe the five stages of the patient’s readiness to return to work(pre-intention,intention,action readiness assessment,action readiness action,uncertainty maintenance,and active maintenance).Mann-Whitney U test and Kruskal-Wallis H test were used for univariate analysis to analyze the differences in general demographic and disease-related data of young and middle-aged patients with intestinal cancer in their readiness to return to work. Spearman correlation analysis was used to analyze the correlation between the readiness to return to work,the level of social support and the self-management efficacy of middle-aged and young intestinal cancer patients who returned to work and those who did not return to work.Multivariate analysis used statistically significant variables in univariate analysis as independent variables and readiness to return to work as outcome variables.Multiple ordered logistic regression was used for patients who did not return to work,and binary logistic regression was used for patients who had returned to work.To further analyze the main influencing factors of the readiness to return to work in young and middle-aged patients with intestinal cancer and their influence intensity.Results:1.Questionnaire collection: A total of 323 questionnaires were sent out,313 of which were verified as valid questionnaires with effective recovery rate of 96.9%.2.Status of readiness of young and middle-aged patients with colorectal cancer to return to work: among the 313 cases of young and middle-aged patients surveyed in this study,67.7% did not return to work and 32.3% had returned to work,indicating a relatively low rate of patients returning to work overall.The evaluation results of the scale of readiness to return to work showed that the degree of readiness to return to work was at a low level.Among the patients who did not return to work,29.7% were in the pre-intention stage,30.7% were in the intention stage,30.2% were in the actions-evaluation stage,and the least were in the actions-behavior stage,only9.4%.Among the patients who had returned to work,the patients’ readiness to return to work was relatively at a medium level,wherein 55.4% of the patients were in the state of uncertainty and 44.6% were in the stage of active maintenance.Among them,the score of pre-intention dimension was(2.58±0.54),intention dimension was(2.93±0.36),action readiness--assessment dimension was(3.78±0.39),action readiness--behavior dimension was(3.04±0.35),and uncertainty and maintenance dimension was(1.98±0.56).The score of active maintenance dimension was(2.61±0.59).3.Univariate analysis results showed that there were significant differences in age,education level,residence,per capita monthly income of the family,operation method, and occupation type before the disease among the middle-aged and young colorectal cancer patients who did not return to work and those who had returned to work(P <0.05);However,there were only differences in the readiness to return to work among the groups of patients who did not return to work,such as postoperative complications,TNM stage of cancer,current adjuvant therapy,adjuvant therapy,other chronic underlying diseases,nature of work and mode of work(P < 0.05).However,there was only difference in the degree of preparation for returning to work among the patients who had returned to work(P < 0.05).4.Spearman analysis results showed that there was a positive correlation between the readiness to return to work and social support in the patients who did not return to work/those who had returned to work,with statistical significance(P < 0.05).The patients who did not return to work had a positive correlation with the total score of positive attitude and self-efficacy(P < 0.05),and the patients who had returned to work had a significant positive correlation with the level of self-efficacy.5.The results of multiple ordered logistic regression analysis showed that good social support and positive attitude among patients who returned to work were protective factors for patients to establish a positive level of readiness to return to work.The risk factors for the patients who did not return to work were 41 ~ 50 years old and 51 ~ 59 years old,Ⅲ stage of cancer,chemotherapy,the occupation of migrant workers.The results of binary logistic regression analysis showed that among the patients who had returned to work,the age of 51 ~ 59 years old and the complication of stomy were the risk factors for reducing the readiness of patients to return to work,which was not conducive to the maintenance of work.The protective factors were bachelor’s degree and above,social support and self-management efficacy.Conclusion:1.The survey of young and middle-aged patients with colorectal cancer to return to work after rate is low,the overall readiness to return to work remains to be improved,with the intention to return patients before and intention is given priority to,already return the patient is given priority to with uncertainty to maintain work,did not return patients social support and self-efficacy of self-management is already back at low levels.2.In the multivariate regression analysis,some demographic characteristics and disease data have significant effects on patients’ readiness to return to work.Good social support level and self-management efficacy level can positively promote patients’ readiness to return to work.3.Based on the analysis results of factors influencing the degree of readiness to return to work,medical staff can guide caregivers from a targeted and positive perspective,pay attention to the actual needs of patients to return to work,formulate interventions to improve patients’ sense of social support and self-management efficacy,and promote patients to return to work after illness.