测量工作任重道远

Cathy J Bradley, Sara Kitchen, Kelsey M Owsley
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摘要

在癌症护理中,工作能力是一项重要的经济和福利指标。然而,临床试验和观察性研究对工作能力的研究不足,医疗记录中也往往没有这方面的记录。尽管从福利、医疗保险和经济角度来看,工作的重要性已得到共识,但在医疗环境中却缺乏收集、测量和分析工作结果的标准化方法。要缩小医疗机构中患者和护理人员就业研究方面的差距,必须要有一套通用的测量方法,包括在观察性研究和临床试验研究中替代或转化为工作结果的精神和身体功能通用测量方法、标准化的数据收集和记录方法,以及使用纵向数据来了解随着时间推移工作能力下降的后果。我们提出了将工作能力纳入结果研究的概念框架。我们介绍了可在研究中采用的就业和工作能力测量结构,这些结构可记录为患者层面的数据,并用于指导治疗决策。将重返工作岗位和工作时数、生产率以及从事类似工作的能力纳入其中,可以为指导治疗决策的对话提供支持,并最大限度地减少经济后果。我们希望,通过考虑对工作能力的影响,可以开发出更好的治疗方法,减少健康不公平现象,并将资源用于帮助患者及其护理人员平衡工作和健康需求。
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Much work to do about measuring work
Work ability is a critical economic and well-being indicator in cancer care. Yet, work ability is understudied in clinical trials and observational research and is often undocumented in medical records. Despite agreement on the importance of work from well-being, health insurance, and financial perspectives, standardized approaches for collecting, measuring, and analyzing work outcomes are lacking in the health care setting. The necessary components for closing the gap in patient and caregiver employment research in health care settings involve a common set of measures, including those that replace or translate generic measures of mental and physical functioning into work outcomes in observational and clinical trial research, standardized approaches to data collection and documentation, and the use of longitudinal data to understand the consequences of reduced work ability over time. We present a conceptual framework for the inclusion of work ability in outcomes research. We cover constructs for employment and work ability measurement that can be adopted in research, recorded as patient-level data, and used to guide treatment decisions. The inclusion of return to work and hours worked, productivity, and ability to perform in a similar job can support conversations that guide treatment decisions and minimize economic consequences. Our hope is that by considering impact on work ability, improved treatments will be developed, health inequities reduced, and resources will be directed toward aiding patients and their caregivers in balancing work and health demands.
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