Abstract：
OBJECTIVE: Return to work (RTW) is important for quality of life after breast cancer but its analysis at the population-level remains limited in France. This study aimed to implement Electronic Healthcare Data (EHD)-based indicators and trajectories to measure RTW after breast cancer diagnosis, and to examine stakeholders\' perspectives regarding these indicators.
METHODS: We followed a mixed-methods approach that consisted of (i) implementing RTW indicators and identifying clusters of trajectories using state sequence analysis with data from a representative sample of the French National Health Data System and (ii) exploring, through qualitative focus group and interviews, stakeholders\' perceptions on the interpretation, limitations, and utility of these indicators.
RESULTS: We extracted data from 317 women aged 25-55 years with a first diagnosis of early-stage breast cancer. The median number of sickness absence periods was 2 for a total of 434 days during the 3-year follow-up, and the median time to sustainable RTW was 240 days. Three clusters of RTW trajectories were identified: \"early RTW\" (49.5% of the population), \"RTW after partial resumption\" (37.5%) and \"continuous compensation\" (12.9%). Feedback from stakeholders highlighted the multi-factorial nature of RTW and underscored the added value of EHD for studying RTW, despite certain limitations.
CONCLUSIONS: We demonstrated the feasibility of calculating RTW indicators and identifying trajectories using the French National Health Data System. These indicators can serve as outcome measures in RTW promotion and provide a basis for designing targeted interventions for breast cancer survivors.
METHODS: We followed a mixed-methods approach that consisted of (i) implementing RTW indicators and identifying clusters of trajectories using state sequence analysis with data from a representative sample of the French National Health Data System and (ii) exploring, through qualitative focus group and interviews, stakeholders\' perceptions on the interpretation, limitations, and utility of these indicators.
RESULTS: We extracted data from 317 women aged 25-55 years with a first diagnosis of early-stage breast cancer. The median number of sickness absence periods was 2 for a total of 434 days during the 3-year follow-up, and the median time to sustainable RTW was 240 days. Three clusters of RTW trajectories were identified: \"early RTW\" (49.5% of the population), \"RTW after partial resumption\" (37.5%) and \"continuous compensation\" (12.9%). Feedback from stakeholders highlighted the multi-factorial nature of RTW and underscored the added value of EHD for studying RTW, despite certain limitations.
CONCLUSIONS: We demonstrated the feasibility of calculating RTW indicators and identifying trajectories using the French National Health Data System. These indicators can serve as outcome measures in RTW promotion and provide a basis for designing targeted interventions for breast cancer survivors.
摘要：
目的：重返工作（RTW）对于乳腺癌后的生活质量很重要，但在法国，其在人群水平上的分析仍然有限。这项研究旨在实施基于电子医疗数据（EHD）的指标和轨迹，以测量乳腺癌诊断后的RTW。并检查利益相关者对这些指标的看法。
方法：我们采用了一种混合方法方法，包括（i）实施RTW指标，并使用来自法国国家卫生数据系统代表性样本的数据进行状态序列分析来识别轨迹簇，以及（ii）探索，通过定性焦点小组和访谈，利益相关者对解释的看法，局限性,以及这些指标的实用性。
结果：我们从317名年龄在25-55岁的女性中提取了数据，这些女性首次诊断为早期乳腺癌。在3年的随访期间，总共434天的疾病缺勤期的中位数为2，可持续RTW的中位时间为240天。确定了RTW轨迹的三个簇：“早期RTW”（占人口的49.5%），“部分恢复后的RTW”（37.5%）和“连续补偿”（12.9%）。利益相关者的反馈强调了RTW的多因素性质，并强调了EHD对研究RTW的附加价值，尽管有一定的局限性。
结论：我们证明了使用法国国家健康数据系统计算RTW指标和识别轨迹的可行性。这些指标可以作为RTW推广的结果指标，并为乳腺癌幸存者设计有针对性的干预措施提供基础。
方法：我们采用了一种混合方法方法，包括（i）实施RTW指标，并使用来自法国国家卫生数据系统代表性样本的数据进行状态序列分析来识别轨迹簇，以及（ii）探索，通过定性焦点小组和访谈，利益相关者对解释的看法，局限性,以及这些指标的实用性。
结果：我们从317名年龄在25-55岁的女性中提取了数据，这些女性首次诊断为早期乳腺癌。在3年的随访期间，总共434天的疾病缺勤期的中位数为2，可持续RTW的中位时间为240天。确定了RTW轨迹的三个簇：“早期RTW”（占人口的49.5%），“部分恢复后的RTW”（37.5%）和“连续补偿”（12.9%）。利益相关者的反馈强调了RTW的多因素性质，并强调了EHD对研究RTW的附加价值，尽管有一定的局限性。
结论：我们证明了使用法国国家健康数据系统计算RTW指标和识别轨迹的可行性。这些指标可以作为RTW推广的结果指标，并为乳腺癌幸存者设计有针对性的干预措施提供基础。
