Return to work in young and middle-aged colorectal cancer survivors: Factors influencing self-efficacy, fear, resilience, and financial toxicity

BACKGROUND Return to work (RTW) serves as an indication for young and middle-aged colorectal cancer (CRC) survivors to resume their normal social lives. However, these survivors encounter significant challenges during their RTW process. Hence, scientific research is necessary to explore the barriers and facilitating factors of returning to work for young and middle-aged CRC survivors. AIM To examine the current RTW status among young and middle-aged CRC survivors and to analyze the impact of RTW self-efficacy (RTW-SE), fear of progression (FoP), eHealth literacy (eHL), family resilience (FR), and financial toxicity (FT) on their RTW outcomes. METHODS A cross-sectional investigation was adopted in this study. From September 2022 to February 2023, a total of 209 participants were recruited through a convenience sampling method from the gastrointestinal surgery department of a class A tertiary hospital in Chongqing. The investigation utilized a general information questionnaire alongside scales assessing RTW-SE, FoP, eHL, FR, and FT. To analyze the factors that influence RTW outcomes among young and middle-aged CRC survivors, Cox regression modeling and Kaplan-Meier survival analysis were used. RESULTS A total of 43.54% of the participants successfully returned to work, with an average RTW time of 100 days. Cox regression univariate analysis revealed that RTW-SE, FoP, eHL, FR, and FT were significantly different between the non-RTW and RTW groups (P < 0.05). Furthermore, Cox regression multivariate analysis identified per capita family monthly income, job type, RTW-SE, and FR as independent influencing factors for RTW (P < 0.05). CONCLUSION The RTW rate requires further improvement. Elevated levels of RTW-SE and FR were found to significantly increase RTW among young and middle-aged CRC survivors. Health professionals should focus on modifiable factors, such as RTW-SE and FR, to design targeted RTW support programs, thereby facilitating their timely reintegration into mainstream society.