Screening Young Adult Cancer Patients for Vocational Rehabilitation Services: A Vocational Rehabilitation Readiness Screening Tool.

Abstract

Purpose: We aimed to develop an online vocational rehabilitation (VR) readiness screening (VRRS) tool for young adults diagnosed with cancer. VR readiness was defined as being physically and cognitively ready to enter or return to work or school.

Methods: We developed an initial VRRS tool informed by previous studies, a scoping review to determine such a tool had not already been developed, and consultation with subject matter experts. We iteratively refined the tool on the basis of four rounds of interviews with young adults with cancer. The refined VRRS was then administered online to patients before they attended scheduled clinic appointments. We evaluated the VRRS completion rate; the ability of the online VRRS tool to assess patients' readiness for VR; and the concordance between clinical interview and that of the online VRRS tool, which was determined by using Cohen's κ or a fitting alternative; κ ≥ .61 suggested clinical utility.

Results: The proportion of study participants completing the VRRS was 72.3% (136/188, 95% CI [65.4%, 78.6%]) and 69.2% (81/117, 95% CI [60.0%, 77.4%]) of participants who completed a clinical interview also completed the online VRRS tool. All clinical interview determinations and 93.8% (76/81) of online VRRS tool indicated participants' VR readiness. The VRRS-clinical interview agreement rate was 93.8% (95% CI [86.2%, 98.0%]). The prevalence index, bias index, and prevalence- and bias-adjusted κ statistic with 95% CIs were 0.938 [- 0.991, - 0.886], 0.062 [0.009, 0.114], and 0.877 [0.724, 0.959], respectively.

Conclusion: The VRRS tool is thus both feasible and effective in this sample of young adults with cancer.