Associations of in-hospital recovery, cancer self-management self-efficacy, and perceived social support with early return to work in young and middle-aged patients undergoing lung cancer surgery: a prospective cohort study.

BACKGROUND

Rehabilitation nursing plays a critical role in supporting postoperative functional recovery and facilitating reintegration into daily life and work, yet evidence on factors associated with early return to work (RTW) among young and middle-aged patients with lung cancer remains limited. This study aimed to examine the associations of in-hospital recovery, cancer self-management self-efficacy, and perceived social support with early RTW at 1 month after surgery among young and middle-aged patients with lung cancer.

METHODS

This prospective cohort study recruited 160 young and middle-aged adults who underwent minimally invasive lung cancer surgery at a tertiary hospital in Shanghai from June to December 2024. Before discharge, participants completed baseline assessments including the Quality of Recovery-15 scale, the Strategies Used by People to Promote Health, and the Perceived Social Support Scale. RTW status and RTW stage were assessed 1 month postoperatively. Binary logistic regression was used to examine factors associated with early RTW.

RESULTS

Among the 160 participants, 88 (55%) had returned to work 1 month after surgery, while 72 (45%) had not. Of those who returned to work, 53 were categorized into the "uncertain maintenance" stage and 35 into the "proactive maintenance" stage. Non-RTW participants were distributed across the "precontemplation" (n = 9), "contemplation" (n = 15), "prepared for action-self-evaluative" (n = 22), and "prepared for action-behavioural" (n = 26) stages. Higher levels of in-hospital recovery quality, self-efficacy, and perceived social support were significantly associated with an increased likelihood of early RTW.

CONCLUSION

More than half of young and middle-aged lung cancer patients resumed work within 1 month after surgery; however, most remained in the "uncertain maintenance" stage. Better postoperative recovery, higher cancer self-management self-efficacy, and stronger perceived social support were associated with a greater likelihood of RTW at 1 month after surgery in this population.

CLINICAL TRIAL NUMBER: Not applicable.