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Work productivity and neuropsychological function in persons with skull base tumors
Bethany D Nugent1, Jason Weimer1, Chienwen J Choi1
1University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania (B.D.N., J.W., C.J.C., C.M.B., P.R.S.); Virginia Commonwealth University Department of Healthcare Policy and Research, Richmond, Virginia (C.J.B.); University of Pittsburgh Department of Psychology, Pittsburgh, Pennsylvania (C.M.R.); University of Pittsburgh Department of Neurological Surgery, Pittsburgh, Pennsylvania (P.G).
Background:
Skull base tumors comprise many common benign brain tumors. Treatment has advanced, allowing many survivors to return to work. However, literature is limited about the neuropsychological status of these patients prior to treatment. Literature pertaining to the relationship between neuropsychological functioning and occupational ability prior to surgical intervention is even more limited. The purpose of this analysis was to evaluate the impact of neuropsychological function on work productivity in persons with skull base tumors prior to resection.
Methods:
Neuropsychological function and work productivity were assessed in adults newly diagnosed with skull base tumors (n = 45) prior to surgical intervention. Univariate analyses identified potential predictors of work limitations; variables with P < .10 were analyzed using multivariate regression analyses controlled for age, sex, tumor type, and education.
Results:
Poorer mental attention and flexibility (MF) and higher depressive symptoms (DS) were significantly associated with poor time management at work (MF: β = -0.59, P = .01; DS: β = 3.42, P < .01; R2 = 0.54). Difficulty meeting physical work demands was significantly associated with poorer visuospatial ability (VA) and higher depressive symptoms (VA: β = -3.30, P = .05; DS: β = 2.29, P < .01; R2 = 0.29). Lower learning and memory scores (LM) and higher depressive symptoms were significantly associated with difficulty meeting mental-interpersonal work demands (LM: β = -3.39, P = .04; DS: β = 3.25, P < .01; R2 = 0.47) and overall health-related loss of work productivity (LM: β = -0.72, P = .05; DS: β = 0.659, P < .001; R2 = 0.43).
Conclusion:
Domains of neuropsychological function that predicted work productivity were identified. Future research should examine neuropsychological function, depressive symptoms, and work productivity across the care trajectory from diagnosis through long-term survivorship.
