Occupational Status and Hematological Disease
Condition: Chronic Myeloid Leukemia; Chronic Lymphocytic Leukemia; Myelodysplastic Syndrome; Chronic Thrombocytopenia; Hodgkin Disease
MeSH terms: Leukemia; Leukemia, Lymphocytic, Chronic, B-Cell; Leukemia, Myelogenous, Chronic, BCR-ABL Positive; Hodgkin Disease; Myelodysplastic Syndromes; Thrombocytopenia; Hematologic Diseases
Study type: Observational

Summary: 
      Diseases do not only have a physical role in people's live, but they usually involve changes
      in life as whole. They may modify the structure of the conjunction with life setting, thus,
      deeply impacting relationships with others. While clinical results of new therapies for
      hematological diseases are well documented in scientific literature in terms of prolonged
      life expectancy or remission from disease, less is known about problems and barriers
      preventing the return of patients with a chronic blood ailment to everyday life.

      Indeed, there are no published data on this topic within the Italian context. The present
      explorative study aims at identifying the main problems with which patients affected by a
      Chronic Hematological Disease (CHD) deal when returning to everyday working life, factors
      associated with work reintegration and, finally, to understand the need for facilitators
      enhancing reintegration outcomes.

      Results from this study will be also helpful to raise consciousness about the problem of
      reintegration into the labour market of workers with CHD and to call for awareness campaigns
      for the general public and health professionals.
    

Detailed description: 
      A disease doesn't have only a physical side but usually involves changes in the person as
      whole. It changes the structure of the relationship between a person and his life setting,
      deeply impacting the way her/he relates to others and to himself. While clinical results of
      new therapies about hematological pathologies are well documented in scientific literature in
      terms of prolonged life expectancy or remission from disease, less is known about problems
      and barriers preventing the return of patients with a chronic blood ailment to everyday life.

      A number of economists have argued that there is a causal link between increasing inequality
      and the financial crisis. Evidence from different EU Member States shows that people who
      declare themselves as being permanently disabled are over-represented among people at risk of
      poverty or social exclusion compared to the whole population.

      In Italy, in the second quarter of 2011, 6 million 556 thousand people aged 15-64 years
      (16.5% of the population of this age group) claimed to be suffering from one or more
      longstanding health problems or functional difficulties.

      Health problems represent a barrier to the inclusion in the labour market. More than 50% of
      those suffering from more than one health problem or functional difficulties is inactive,
      this share decreases significantly among those who complain about one problem or difficulty
      (39.9%) and no problem (35.5%).

      Among persons employed who complain of poor health conditions, about one in 10 may rely on
      one or more types of assistance in their place of work: availability of special equipment or
      workplace adaptations, personal service, special working arrangements. Among people who do
      not have a job, however, more than a quarter (26.6%) would need to receive at least one type
      of assistance in order to work.

      People with long-term illnesses have an higher probability of leaving the workforce at an
      early age and people who continue to work despite health problems are likely to be less
      productive than healthy people. Thus, without a timely and appropriate reintegration, they
      may be less likely to return to work.

      In this scenario it's of utmost importance to increase the overall capability to deliver
      targeted actions in order to be able to support people at risk of social -work exclusion.

      Policy instruments being able to provide access to the labour market also play an important
      role, as well as measures in favor of education. Studies have shown several benefits
      associated with returning to work after cancer, including addressing financial needs,
      providing a distraction and an overall improvement in quality of life. Health professionals
      advice and support and the role of the employers in providing a sound workplace accommodation
      may play an important role in this regard but, on the other hand, a number of studies show an
      association between cancer survivorship and risk of unemployment.

      The impact of returning to work after (or during) a long-term illness must be evaluated also
      from the perspective of the family and of the community. It could be very hard for partners
      and other relatives to conciliate their work duties with the task of taking care of the sick
      person - in terms of time and of mental strain. While laws usually allow for a number of
      measures to ease this issue, more information is often needed to workers and to employers.

      The cost of a sick worker, from the viewpoint of the community, includes not only the cost of
      health care and rehabilitation but also the lost productivity of those who quit work and the
      cost linked to the possible impoverishment of the worker and her/his family for the years to
      come.

      At present time there are no published studies that investigated these issues in patients
      with hematological malignancies in the Italian context. This explorative study aims at
      identifying the main problems that patients of Chronic Hematological Disease (CHD) deal when
      returning to everyday working life, factors associated with job reintegration and to
      understand the need for facilitators enhancing reintegration outcomes.

      Results from this study will be also helpful in the effort of raising consciousness about the
      problem of reintegration in the labour market of workers with CHD and to call for awareness
      campaigns for the general public and health professionals.
    

Intervention name(s): Study questionnaire; SF-36 Questionnaire
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Questionnaire based on work situation of enrolled patients.; Version 1.6
Observational model: Cohort
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        Patients with a chronic hematological disease aged between 15 and 74 years old fully able
        to understand Italian.
      
Keywords: Chronic Hematological Diseases; work; job