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1.
Emergencias ; 32(5): 320-331, 2020 09.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33006832

RESUMO

OBJECTIVES: To estimate the impact of the coronavirus disease 2019 (COVID-19) pandemic on the organization of Spanish hospital emergency departments (EDs). To explore differences between Spanish autonomous communities or according to hospital size and disease incidence in the area. MATERIAL AND METHODS: Survey of the heads of 283 EDs in hospitals belonging to or affiliated with Spain's public health service. Respondents evaluated the pandemic's impact on organization, resources, and staff absence from work in March and April 2020. Assessments were for 15-day periods. Results were analyzed overall and by autonomous community, hospital size, and local population incidence rates. RESULTS: A total of 246 (87%) responses were received. The majority of the EDs organized a triage system, first aid, and observation wards; areas specifically for patients suspected of having COVID-19 were newly set apart. The nursing staff was increased in 83% of the EDs (with no subgroup differences), and 59% increased the number of physicians (especially in large hospitals and locations where the COVID-19 incidence was high). Diagnostic tests for the severe acute respiratory syndrome coronavirus 2 were the resource the EDs missed most: 55% reported that tests were scarce often or very often. Other resources reported to be scarce were FPP2 and FPP3 masks (38% of the EDs), waterproof protective gowns (34%), and space (32%). More than 5% of the physicians, nurses, or other emergency staff were on sick leave 20%, 19%, and 16% of the time. These deficiencies were greatest during the last half of March, except for tests, which were most scarce in the first 15 days. Large hospital EDs less often reported that diagnostic tests were unavailable. In areas where the COVID-19 incidence was higher, the EDs reported higher rates of staff on sick leave. Resource scarcity differed markedly by autonomous community and was not always associated with the incidence of COVID-19 in the population. CONCLUSION: The COVID-19 pandemic led to organizational changes in EDs. Certain resources became scarce, and marked differences between autonomous communities were detected.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Pesquisas sobre Serviços de Saúde , Pandemias , Pneumonia Viral/epidemiologia , Absenteísmo , Adulto , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Surtos de Doenças , Serviço Hospitalar de Emergência/organização & administração , Recursos em Saúde/provisão & distribução , Necessidades e Demandas de Serviços de Saúde , Mão de Obra em Saúde/estatística & dados numéricos , Número de Leitos em Hospital , Hospitais Públicos/organização & administração , Hospitais Públicos/estatística & dados numéricos , Humanos , Incidência , Recursos Humanos em Hospital/estatística & dados numéricos , Pneumonia Viral/diagnóstico , Alocação de Recursos , Síndrome do Desconforto Respiratório do Adulto/diagnóstico , Síndrome do Desconforto Respiratório do Adulto/etiologia , Espanha/epidemiologia , Triagem/organização & administração
2.
Orv Hetil ; 161(36): 1522-1533, 2020 09.
Artigo em Húngaro | MEDLINE | ID: mdl-32886627

RESUMO

INTRODUCTION: Health disorders may affect negatively work productivity of individuals, leading to absence from work (absenteeism) and/or decreased functioning in the workplace (presenteeism). AIM: To assess the health-related work productivity of the adult population in Hungary by the Work Productivity and Activity Impairment questionnaire (WPAI). METHOD: A cross-sectional survey was performed in 2019 involving a sample (n = 2023) representative for the adult population of Hungary. Socio-demographic characteristics were recorded. Health-related productivity of the participants was assessed by the WPAI questionnaire, health status was measured by the EQ-5D-3L measurement tool and the Minimum European Health Module (MEHM). STATISTICAL ANALYSES: Descriptive statistics were performed, subgroups were compared by Mann-Whitney and Kruskal-Wallis tests. Spearman's rank correlation was applied to analyze the relationship between WPAI, age and EQ-5D-3L index score. RESULTS: Among those in a paid job (n = 1194, 59%), altogether 70 respondents (6%) were absent from work during the week before the survey, which resulted in an average 1.9 (SD = 8.5) work hours loss per week. Presenteeism occurred in 166 (14%) cases. The average absenteeism was 3.6%, presenteeism was 4.4%, and activity impairment in the total sample was 9.5%. Absenteeism did not correlate with age and did not differ significantly across socio-demographic subgroups. Presenteeism was the highest among actively working retired people, disability pensioners and part-time employees. Presenteeism correlated moderately (r = -0.379), absenteeism weakly (r = -0.113) with EQ-5D-3L index. Correlation was significant between activity impairment and age (r = 0.412) as well as the EQ-5D-3L index score (r = -0.592). All WPAI items showed significant worsening across MEHM status levels. CONCLUSION: This is the first study in Hungary to present population reference values with the WPAI. Productivity loss due to presenteeism deserves special attention from the employers as well as from decision makers in the labour, health and social sectors. Orv Hetil. 2020; 161(36): 1522-1533.


Assuntos
Absenteísmo , Eficiência , Presenteísmo/estatística & dados numéricos , Trabalho/estatística & dados numéricos , Adulto , Estudos Transversais , Humanos , Hungria , Inquéritos e Questionários
3.
Int J Public Health ; 65(7): 1205-1216, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32888048

RESUMO

OBJECTIVES: During a pandemic, healthcare workers (HCWs) are essential to the health system response. Based on our knowledge, little information is available regarding the psychosocial impact on HCWs or interventions for supporting them during pandemics. Therefore, the study aimed to assess available literature on perceived stress and psychological responses to influenza pandemics in HCWs and identify implications for healthcare practice and future research. METHODS: This is a rapid review of the literature. The review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis. RESULTS: Across all the studies-both qualitative and quantitative-HCWs working during the epidemic reported frequent concerns regarding their own health and the fear of infecting their families, friends and colleagues. Moreover, social isolation, uncertainty, fears of stigmatization and reluctance to work or considering absenteeism were frequently reported. Moreover, many studies highlighted a high prevalence of high levels of stress, anxiety and depression symptoms, which could have long-term psychological implications in HCWs. CONCLUSIONS: This rapid review offers an overview of the major concerns regarding HCWs' psychosocial well-being and possible preventive strategies, which could be useful for the current COVID-19 outbreak and similar future pandemics. Studies suggested to invest on preventive psychological, social, family and physical support and to guaranteeing reasonable work conditions and others in order to protect HCWs from the long-lasting psychological effect of the COVID-19 pandemic.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Pessoal de Saúde/psicologia , Influenza Humana/epidemiologia , Influenza Humana/psicologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Absenteísmo , Ansiedade/epidemiologia , Betacoronavirus , Surtos de Doenças , Humanos , Pandemias , Isolamento Social/psicologia , Estigma Social , Incerteza
4.
Trials ; 21(1): 799, 2020 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-32943115

RESUMO

OBJECTIVES: The Bacille Calmette-Guérin (BCG) vaccine against tuberculosis is associated with non- specific protective effects against other infections, and significant reductions in all-cause morbidity and mortality have been reported. We aim to test whether BCG vaccination may reduce susceptibility to and/or the severity of COVID-19 and other infectious diseases in health care workers (HCW) and thus prevent work absenteeism.The primary objective is to reduce absenteeism due to illness among HCW during the COVID-19 pandemic. The secondary objectives are to reduce the number of HCW that are infected with SARS-CoV-2, and to reduce the number of hospital admissions among HCW during the COVID-19 pandemic. HYPOTHESIS: BCG vaccination of HCW will reduce absenteeism by 20% over a period of 6 months. TRIAL DESIGN: Placebo-controlled, single-blinded, randomised controlled trial, recruiting study participants at several geographic locations. The BCG vaccine is used in this study on a different indication than the one it has been approved for by the Danish Medicines Agency, therefore this is classified as a phase III study. PARTICIPANTS: The trial will recruit 1,500 HCW at Danish hospitals.To be eligible for participation, a subject must meet the following criteria: Adult (≥18 years); Hospital personnel working at a participating hospital for more than 22 hours per week.A potential subject who meets any of the following criteria will be excluded from participation in this study: Known allergy to components of the BCG vaccine or serious adverse events to prior BCG administration Known prior active or latent infection with Mycobacterium tuberculosis (M. tuberculosis) or other mycobacterial species Previous confirmed COVID-19 Fever (>38 C) within the past 24 hours Suspicion of active viral or bacterial infection Pregnancy Breastfeeding Vaccination with other live attenuated vaccine within the last 4 weeks Severely immunocompromised subjects. This exclusion category comprises: a) subjects with known infection by the human immunodeficiency virus (HIV-1) b) subjects with solid organ transplantation c) subjects with bone marrow transplantation d) subjects under chemotherapy e) subjects with primary immunodeficiency f) subjects under treatment with any anti-cytokine therapy within the last year g) subjects under treatment with oral or intravenous steroids defined as daily doses of 10 mg prednisone or equivalent for longer than 3 months h) Active solid or non-solid malignancy or lymphoma within the prior two years Direct involvement in the design or the execution of the BCG-DENMARK-COVID trial Intervention and comparator: Participants will be randomised to BCG vaccine (BCG-Denmark, AJ Vaccines, Copenhagen, Denmark) or placebo (saline). An adult dose of 0.1 ml of resuspended BCG vaccine (intervention) or 0.1 ml of sterile 0.9% NaCl solution (control) is administered intradermally in the upper deltoid area of the right arm. All participants will receive one injection at inclusion, and no further treatment of study participants will take place. MAIN OUTCOMES: Main study endpoint: Days of unplanned absenteeism due to illness within 180 days of randomisation.Secondary study endpoints: The cumulative incidence of documented COVID-19 and the cumulative incidence of hospital admission for any reason within 180 days of randomisation.Randomisation: Randomisation will be done centrally using the REDCap tool with stratification by hospital, sex and age groups (+/- 45 years of age) in random blocks of 4 and 6. The allocation ratio is 1:1.Blinding (masking): Participants will be blinded to treatment. The participant will be asked to leave the room while the allocated treatment is prepared. Once ready for injection, vaccine and placebo will look similar, and the participant will not be able to tell the difference.The physicians administering the treatment are not blinded.Numbers to be randomised (sample size): Sample size: N=1,500. The 1,500 participants will be randomised 1:1 to BCG or placebo with 750 participants in each group.Trial Status: Current protocol version 5.1, from July 6, 2020.Recruitment of study participants started on May 18, 2020 and we anticipate having finished recruiting by the end of December 2020. TRIAL REGISTRATION: The trial was registered with EudraCT on April 16, 2020, EudraCT number: 2020-001888-90, and with ClinicalTrials.gov on May 1, 2020, registration number NCT04373291.Full protocol: The full protocol is attached as an additional file, accessible from the Trialswebsite (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.


Assuntos
Vacina BCG/administração & dosagem , Betacoronavirus/patogenicidade , Infecções por Coronavirus/prevenção & controle , Pessoal de Saúde , Saúde do Trabalhador , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Vacinação , Absenteísmo , Vacina BCG/efeitos adversos , Betacoronavirus/imunologia , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Dinamarca , Feminino , Humanos , Masculino , Estudos Multicêntricos como Assunto , Admissão do Paciente , Pneumonia Viral/imunologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Licença Médica , Método Simples-Cego , Fatores de Tempo , Resultado do Tratamento
6.
Am J Disaster Med ; 15(2): 99-111, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32804390

RESUMO

OBJECTIVE: Identify operational lessons to support hospital and health system preparedness and response for sea-sonal and pandemic influenza based on firsthand experiences from the 2017-2018 influenza season. DESIGN: We conducted semistructured, retrospective interviews with New York City Health+Hospitals (NYCH+H) personnel to gather firsthand experiences from the 2017-2018 influenza season and evaluated stress data across four operational domains reported by NYCH+H hospitals during the 2017-2018 influenza season. SETTING: Frontline hospitals in the NYCH+H health system during and after the 2017-2018 influenza season. PARTICIPANTS: Interviews conducted with personnel from 5 NYCH+H frontline hospitals. Operational stress data re-ported by 11 NYCH+H hospitals during the 2017-2018 influenza season. MAIN OUTCOME MEASURES: Operational challenges and lessons from frontline hospitals responding to severe sea-sonal influenza. RESULTS: Operational stresses during the 2017-2018 influenza season varied over the influenza season, between facilities, and across operational domains. Patient surge and staff absenteeism pushed some facilities to their limits, and supply shortages highlighted shortcomings in existing procurement systems. Resources tied to pandemic influ-enza were unavailable without a pandemic declaration. CONCLUSION: Seasonal influenza poses dynamic operational stresses across health systems and cities, potentially causing major impacts outside of declared pandemics. Lessons from NYCH+H can help other hospitals and health systems anticipate operational challenges, but novel solutions are needed to mitigate effects of patient surge and per-sonnel and supply shortages during severe influenza seasons and pandemics. Improved data collection can help health systems better understand operational stresses and challenges across their facilities.


Assuntos
Assistência à Saúde/organização & administração , Pessoal de Saúde/estatística & dados numéricos , Hospitais/estatística & dados numéricos , Influenza Humana , Pacientes/estatística & dados numéricos , Absenteísmo , Pessoal de Saúde/psicologia , Planejamento em Saúde/organização & administração , Administração Hospitalar , Humanos , Influenza Humana/diagnóstico , Influenza Humana/epidemiologia , Entrevistas como Assunto , Cidade de Nova Iorque/epidemiologia , Pandemias , Estudos Retrospectivos , Estações do Ano
7.
Updates Surg ; 72(3): 693-700, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32816284

RESUMO

BACKGROUND: Observing cyclic patterns in surgical outcome is a common experience. We aimed to measure this phenomenon and to hypothesize possible causes using the experience of a high-volume pancreatic surgery department. METHODS: Outcomes of 2748 patients who underwent a Whipple procedure at a single high-volume center from January 2000 to December 2018 were retrospectively analyzed. Three different hypotheses were tested: the effect of climate changes, the "July effect" and the effect of vacations. RESULTS: Clavien-Dindo ≥ 3 morbidity was similar during warm vs. cold months (22.5% vs. 19.8%, p = 0.104) and at the beginning of activity of new trainees vs. the rest of the year (23.5 vs. 22.5%, p = 0.757). Patients operated when a high percentage of staff is on vacation showed an increased Clavien-Dindo ≥ 3 morbidity (22.3 vs. 18.5%, p = 0.022), but similar mortality (2.3 vs. 1.8%, p = 0.553). The surgical waiting list was also significantly longer during these periods (37 vs. 27 days, p = 0.037). Being operated in such a period of the year was an independent predictor of severe morbidity (OR 1.271, CI 95% 1.086-1.638, p = 0.031). CONCLUSION: Being operated when more staff is on vacation significantly affects severe morbidity rate. Future healthcare system policies should prevent the relative shortage of resources during these periods.


Assuntos
Pancreatectomia/métodos , Pancreatectomia/estatística & dados numéricos , Estações do Ano , Absenteísmo , Idoso , Feminino , Recursos em Saúde/estatística & dados numéricos , Humanos , Masculino , Corpo Clínico/estatística & dados numéricos , Pessoa de Meia-Idade , Morbidade , Pancreatectomia/mortalidade , Estudos Retrospectivos , Resultado do Tratamento
8.
PLoS One ; 15(8): e0238260, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32845941

RESUMO

BACKGROUND: Obesity and long term health condition (LTHC) are major public health concerns that have an impact on productivity losses at work. Little is known about the longitudinal association between obesity and LTHC with impaired productivity. OBJECTIVE: This study aims to explore the longitudinal association between obesity and LTHC with presenteeism or working while sick. DESIGN: Longitudinal research design. SETTING: Australian workplaces. METHODS: This study pooled individual-level data of 111,086 employees collected in wave 6 through wave 18 from the Household, Income and Labour Dynamics in Australia (HILDA) survey. The study used a Generalized Estimating Equation (GEE) model with logistic link function to estimate the association. RESULTS: The findings suggest that overweight (Odds Ratios [OR]: 1.09, 95% Confidence Interval [CI]: 1.05-1.14), obesity (OR: 1.38, 95% CI: 1.31-1.45), and LTHC (OR: 3.03, 95% CI: 2.90-3.16) are significantly positively associated with presenteeism. CONCLUSIONS: The longitudinal association between obesity and LTHC with presenteeism among Australian employees implies that interventions to improve workers' health and well-being will reduce the risk of presenteeism at work.


Assuntos
Doença Crônica/epidemiologia , Nível de Saúde , Obesidade/epidemiologia , Presenteísmo/economia , Presenteísmo/estatística & dados numéricos , Absenteísmo , Adolescente , Adulto , Austrália/epidemiologia , Eficiência , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Saúde do Trabalhador/estatística & dados numéricos , Adulto Jovem
9.
PLoS Med ; 17(8): e1003238, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32810149

RESUMO

BACKGROUND: It is estimated that vaccinating 50%-70% of school-aged children for influenza can produce population-wide indirect effects. We evaluated a city-wide school-located influenza vaccination (SLIV) intervention that aimed to increase influenza vaccination coverage. The intervention was implemented in ≥95 preschools and elementary schools in northern California from 2014 to 2018. Using a matched cohort design, we estimated intervention impacts on student influenza vaccination coverage, school absenteeism, and community-wide indirect effects on laboratory-confirmed influenza hospitalizations. METHODS AND FINDINGS: We used a multivariate matching algorithm to identify a nearby comparison school district with pre-intervention characteristics similar to those of the intervention school district and matched schools in each district. To measure student influenza vaccination, we conducted cross-sectional surveys of student caregivers in 22 school pairs (2017 survey, N = 6,070; 2018 survey, N = 6,507). We estimated the incidence of laboratory-confirmed influenza hospitalization from 2011 to 2018 using surveillance data from school district zip codes. We analyzed student absenteeism data from 2011 to 2018 from each district (N = 42,487,816 student-days). To account for pre-intervention differences between districts, we estimated difference-in-differences (DID) in influenza hospitalization incidence and absenteeism rates using generalized linear and log-linear models with a population offset for incidence outcomes. Prior to the SLIV intervention, the median household income was $51,849 in the intervention site and $61,596 in the comparison site. The population in each site was predominately white (41% in the intervention site, 48% in the comparison site) and/or of Hispanic or Latino ethnicity (26% in the intervention site, 33% in the comparison site). The number of students vaccinated by the SLIV intervention ranged from 7,502 to 10,106 (22%-28% of eligible students) each year. During the intervention, influenza vaccination coverage among elementary students was 53%-66% in the comparison district. Coverage was similar between the intervention and comparison districts in influenza seasons 2014-2015 and 2015-2016 and was significantly higher in the intervention site in seasons 2016-2017 (7%; 95% CI 4, 11; p < 0.001) and 2017-2018 (11%; 95% CI 7, 15; p < 0.001). During seasons when vaccination coverage was higher among intervention schools and the vaccine was moderately effective, there was evidence of statistically significant indirect effects: The DID in the incidence of influenza hospitalization per 100,000 in the intervention versus comparison site was -17 (95% CI -30, -4; p = 0.008) in 2016-2017 and -37 (95% CI -54, -19; p < 0.001) in 2017-2018 among non-elementary-school-aged individuals and -73 (95% CI -147, 1; p = 0.054) in 2016-2017 and -160 (95% CI -267, -53; p = 0.004) in 2017-2018 among adults 65 years or older. The DID in illness-related school absences per 100 school days during the influenza season was -0.63 (95% CI -1.14, -0.13; p = 0.014) in 2016-2017 and -0.80 (95% CI -1.28, -0.31; p = 0.001) in 2017-2018. Limitations of this study include the use of an observational design, which may be subject to unmeasured confounding, and caregiver-reported vaccination status, which is subject to poor recall and low response rates. CONCLUSIONS: A city-wide SLIV intervention in a large, diverse urban population was associated with a decrease in the incidence of laboratory-confirmed influenza hospitalization in all age groups and a decrease in illness-specific school absence rate among students in 2016-2017 and 2017-2018, seasons when the vaccine was moderately effective, suggesting that the intervention produced indirect effects. Our findings suggest that in populations with moderately high background levels of influenza vaccination coverage, SLIV programs are associated with further increases in coverage and reduced influenza across the community.


Assuntos
Absenteísmo , Vacinas contra Influenza/administração & dosagem , Serviços de Saúde Escolar/normas , População Urbana , Cobertura Vacinal/normas , Vacinação/normas , Adolescente , California/epidemiologia , Criança , Pré-Escolar , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Masculino , Instituições Acadêmicas/normas , Estudantes , Vacinação/métodos , Cobertura Vacinal/métodos
10.
PLoS One ; 15(8): e0236029, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32760082

RESUMO

Health is a critical factor for the generation of value by workers. Companies bear substantial costs associated with absenteeism and presenteeism among their employees. This study investigates the impact of the environmental conditions in the workplace on the health and job satisfaction of employees, as core factors of productivity. We provide evidence based on a natural experiment, in which 70% of the workforce of a municipality in the Netherlands was relocated to a building with a design focused on sustainability and health and well-being. We construct a longitudinal dataset based on individual surveys of the entire municipality workforce and include measures before and after the move. The estimation results show a significant improvement in the perceived environmental conditions, as well as in the health and well-being of the relocated workers, measured by the drop in incidence of sick building syndrome symptoms. Results are heterogeneous based on age: older groups of employees enjoy larger health impacts. The relocation effects remain persistent in the medium term (two years after the moving date). Importantly, a mediation analysis suggests that the achieved improvements in health and well-being lead to significantly enhanced job satisfaction and a 2% reduction in the prevalence of sick leave.


Assuntos
Arquitetura de Instituições de Saúde , Satisfação no Emprego , Saúde do Trabalhador/economia , Síndrome do Edifício Doente/epidemiologia , Local de Trabalho , Absenteísmo , Adulto , Feminino , Nível de Saúde , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Países Baixos/epidemiologia , Presenteísmo/economia , Presenteísmo/estatística & dados numéricos , Síndrome do Edifício Doente/economia , Licença Médica/economia , Licença Médica/estatística & dados numéricos , Desenvolvimento Sustentável
11.
Av. enferm ; 38(2): 234-248, May-Aug. 2020. tab, graf
Artigo em Português | LILACS, BDENF - Enfermagem, COLNAL | ID: biblio-1114693

RESUMO

Resumo Objetivo: identificar os fatores associados ao absenteísmo-doença de trabalhadores da saúde. Síntese de conteúdo: esta revisão de escopo da literatura realizada nas bases de dados Medline via PubMed incluiu 106 estudos, que totalizaram 388.381 profissionais de saúde. Foi identificado que os fatores individuais e interpessoais, relacionados ao cargo e à função, assim como os fatores ambientais e organizacionais influenciam a ocorrência do absenteísmo-doença no ambiente hospitalar. Conclusões: os fatores individuais e interpessoais, relacionados ao cargo e à função, assim como os fatores ambientais e organizacionais influenciam no absenteísmo-doença dos trabalhadores da saúde, com impacto tanto sobre a produtividade quanto sobre a continuidade da assistência prestada por esses profissionais. A ausência não programada destes leva à necessidade de contratação de outros servidores ou ao pagamento de horas excedentes para atender à demanda, o que pode agravar a situação econômica e financeira do sistema de saúde, e afetar diretamente a saúde de toda a população que depende desse sistema.


Resumen Objetivo: identificar los factores asociados con el ausentismo laboral en los trabajadores de la salud. Síntesis de contenido: esta revisión del alcance de la literatura realizada en la base de datos Medline por medio de PubMed incluyó 106 estudios, con un total de 388.381profesionales de la salud. Se identificó que los factores individuales e interpersonales relacionados con el puesto y la función, así como los factores ambientales y organizativos influyen en la aparición de la enfermedad por ausentismo en el entorno hospitalario. Conclusiones: los factores individuales e interpersonales, relacionados con el cargo y la función, así como los factores ambientales y organizativos repercuten en el ausentismo de los funcionarios de la salud, con impacto tanto en la productividad como en la continuidad de la asistencia prestada por esos profesionales. La ausencia no programada de estos profesionales lleva a la necesidad de contratación de otros servidores o el pago de horas excedentes para atender a la demanda, lo que puede agravar la situación económica y financiera del sistema de salud, y afectar profundamente la salud de toda la población dependiente de tal sistema.


Abstract Objective: to identify factors associated with sickness absenteeism-illness among health workers. Content synthesis: this literature scope review was conducted in the Medline database, via PubMed, and included 106 studies that involved 388,381 health professionals. It was identified that both individual and interpersonal factors related to the position and function, as well as environmental and organizational factors, influence the occurrence of absenteeism-illness in the hospital environment. Conclusions: individual, interpersonal, position, and function factors, as well as environmental and organizational factors, influence absenteeism of health workers, with an impact on both productivity and the continuity of care provided by these professionals. The unplanned absence of these type of workers leads to the need to hire other employees or pay extra hours to meet the demand, which can aggravate the economic and financial situation of the health system.


Assuntos
Humanos , Saúde do Trabalhador , Pessoal de Saúde , Absenteísmo , Hospitais
12.
BMC Med ; 18(1): 218, 2020 07 15.
Artigo em Inglês | MEDLINE | ID: mdl-32664927

RESUMO

BACKGROUND: School closures have been enacted as a measure of mitigation during the ongoing coronavirus disease 2019 (COVID-19) pandemic. It has been shown that school closures could cause absenteeism among healthcare workers with dependent children, but there remains a need for spatially granular analyses of the relationship between school closures and healthcare worker absenteeism to inform local community preparedness. METHODS: We provide national- and county-level simulations of school closures and unmet child care needs across the USA. We develop individual simulations using county-level demographic and occupational data, and model school closure effectiveness with age-structured compartmental models. We perform multivariate quasi-Poisson ecological regressions to find associations between unmet child care needs and COVID-19 vulnerability factors. RESULTS: At the national level, we estimate the projected rate of unmet child care needs for healthcare worker households to range from 7.4 to 8.7%, and the effectiveness of school closures as a 7.6% and 8.4% reduction in fewer hospital and intensive care unit (ICU) beds, respectively, at peak demand when varying across initial reproduction number estimates by state. At the county level, we find substantial variations of projected unmet child care needs and school closure effects, 9.5% (interquartile range (IQR) 8.2-10.9%) of healthcare worker households and 5.2% (IQR 4.1-6.5%) and 6.8% (IQR 4.8-8.8%) reduction in fewer hospital and ICU beds, respectively, at peak demand. We find significant positive associations between estimated levels of unmet child care needs and diabetes prevalence, county rurality, and race (p<0.05). We estimate costs of absenteeism and child care and observe from our models that an estimated 76.3 to 96.8% of counties would find it less expensive to provide child care to all healthcare workers with children than to bear the costs of healthcare worker absenteeism during school closures. CONCLUSIONS: School closures are projected to reduce peak ICU and hospital demand, but could disrupt healthcare systems through absenteeism, especially in counties that are already particularly vulnerable to COVID-19. Child care subsidies could help circumvent the ostensible trade-off between school closures and healthcare worker absenteeism.


Assuntos
Absenteísmo , Cuidado da Criança/economia , Infecções por Coronavirus/epidemiologia , Pessoal de Saúde/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Instituições Acadêmicas , Betacoronavirus , Criança , Simulação por Computador , Estudos de Viabilidade , Previsões , Geografia , Mão de Obra em Saúde , Humanos , Unidades de Terapia Intensiva , Determinação de Necessidades de Cuidados de Saúde , Pandemias , Estados Unidos/epidemiologia
13.
Klin Padiatr ; 232(5): 265-268, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32702763

RESUMO

INTRODUCTION: School absenteeism constitutes a severe and increasingly evident problem, which progressively concerns pediatrics as the first point of contact. It affects 2-5% of all children and adolescents who are subject to compulsory education [3]. School absenteeism is associated with an elevated risk of school dropout, drug abuse, unemployment, chronic psychiatric disease and delinquency [2, 3, 10]. To date, there is a lack of effective treatment options for chronic school absenteeism. METHODS: 67 psychiatric patients (aged 7-17 years) with chronic school absenteeism between 3 months and 2 years (median: 8 months) were treated in a multi-modal therapy setting in a psychiatric day-unit specialized in school absenteeism. 93% of the patients had a history of unsuccessful attempts at therapeutic treatment. RESULTS: 55 out of 67 patients (82%) reported continued school attendance to a regular school 6 months after discharge from the day-unit. CONCLUSION: An integrated therapy concept is essential for successful treatment of school absenteeism. This incorporates (1) intensive and interconnected psychiatric treatment of patients and - if necessary - their parents within and outside of the schooling context with long-term interdisciplinary support and continuity of therapists, (2) efficient observational learning in small groups with similarly affected patients embedded in a (multi-)family therapy context, (3) an affiliated reliable and psychologically trained "pickup and return service", which, if need be, "hauls patients out of bed" in the morning, and (4) close cooperation with the patients' original schooling institutions.


Assuntos
Absenteísmo , Transtornos Mentais/terapia , Psicoterapia , Adolescente , Criança , Humanos , Transtornos Mentais/psicologia , Pais , Instituições Acadêmicas
14.
MMWR Morb Mortal Wkly Rep ; 69(27): 853-858, 2020 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-32644979

RESUMO

During a pandemic, syndromic methods for monitoring illness outside of health care settings, such as tracking absenteeism trends in schools and workplaces, can be useful adjuncts to conventional disease reporting (1,2). Each month, CDC's National Institute for Occupational Safety and Health (NIOSH) monitors the prevalence of health-related workplace absenteeism among currently employed full-time workers in the United States, overall and by demographic and occupational subgroups, using data from the Current Population Survey (CPS).* This report describes trends in absenteeism during October 2019-April 2020, including March and April 2020, the period of rapidly accelerating transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19). Overall, the prevalence of health-related workplace absenteeism in March and April 2020 were similar to their 5-year baselines. However, compared with occupation-specific baselines, absenteeism among workers in several occupational groups that define or contain essential critical infrastructure workforce† categories was significantly higher than expected in April. Significant increases in absenteeism were observed in personal care and service§ (includes child care workers and personal care aides); healthcare support¶; and production** (includes meat, poultry, and fish processing workers). Although health-related workplace absenteeism remained relatively unchanged or decreased in other groups, the increase in absenteeism among workers in occupational groups less able to avoid exposure to SARS-CoV-2 (3) highlights the potential impact of COVID-19 on the essential critical infrastructure workforce because of the risks and concerns of occupational transmission of SARS-CoV-2. More widespread and complete collection of occupational data in COVID-19 surveillance is required to fully understand workers' occupational risks and inform intervention strategies. Employers should follow available recommendations to protect workers' health.


Assuntos
Absenteísmo , Infecções por Coronavirus/epidemiologia , Ocupações/estatística & dados numéricos , Pandemias , Pneumonia Viral/epidemiologia , Licença Médica/estatística & dados numéricos , Adolescente , Adulto , Feminino , Humanos , Masculino , Estados Unidos/epidemiologia
15.
Ann Rheum Dis ; 79(8): 1055-1062, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32522742

RESUMO

OBJECTIVE: To examine differences in clinical and patient-reported outcomes, including work, in individuals with axial spondyloarthritis (axSpA) living in rural and urban settings. METHODS: Using a sequential, explanatory mixed-method design, data from the British Society for Rheumatology Biologics Register for Ankylosing Spondylitis were used to (1) characterise participants with axSpA living in rural and urban areas and (b) assess any differences in outcome after commencement of biologic therapy (phase 1). Semistructured interviews (phase 2) further explored the results from phase 1. RESULTS: Patients with axSpA living in rural areas were older and more likely to work in a physical job. Among patients prescribed biologics, there were no differences in response to biologics, but after adjustment for age, sex and local area deprivation rural dwellers reported more presenteeism and overall work impairment. Work effects could be explained by accounting for individual differences in disease activity, fatigue, physical function and job type. Interviews highlighted the complex relationship between clinical factors, contextual factors (work environment, job demands) and work disability. The ability to work and flexibility in terms of what, when and how tasks are undertaken were important. Support from employers was variable and healthcare professionals were often perceived as unsupportive. CONCLUSIONS: Patients with axSpA living in rural areas report a greater impact of their disease on work productivity. New measures are needed to capture important contextual factors and comprehensively determine the impact of long-term conditions on work. Future European League Against Rheumatism axSpA recommendations should include support to work as a target to optimise quality of life in patients with axSpA.


Assuntos
Antirreumáticos/uso terapêutico , Eficiência/efeitos dos fármacos , Espondilartrite/complicações , Espondilartrite/tratamento farmacológico , Absenteísmo , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Presenteísmo/estatística & dados numéricos , Sistema de Registros , População Rural , Resultado do Tratamento , Reino Unido , População Urbana
16.
J Headache Pain ; 21(1): 68, 2020 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-32513174

RESUMO

BACKGROUND/OBJECTIVE: Productivity and monetary loss due to migraine in the workplace may be substantial. This study aimed to determine the impact of migraine on productivity and monetary lost among employees in the banking sectors, in a multiethnic middle income country. METHODS: A cross-sectional online survey was conducted among employees in two multinational banks in Malaysia between April and July 2019. Screening for migraine was conducted using the self-administered ID-Migraine™ questionnaire. Migraine-related disability (MIDAS) and headache frequency were recorded. Impact of migraine on work productivity and activities were evaluated using the Work Productivity and Activity Impairment (WPAI) questionnaire. RESULTS: Of the 1268 employees who submitted complete responses, 47.2% (n = 598) were screened positive for migraine. Strikingly, the mean percent productivity loss at work (presenteeism) was almost 20-fold higher than the mean percent work time missed due to migraine (absenteeism) (39.1% versus 1.9%). The mean percent productivity loss in regular activity (activity impairment) and overall work productivity loss (work impairment) was 38.4% and 39.9%, respectively. It was also found that the costs related to presenteeism (MYR 5392.6) (US$1296) was 3.5-fold higher than absenteeism (MYR1,548.3) (US$370). Highest monetary loss related to presenteeism was reported in migraineurs with frequency of headache of above 3 days (MYR 25,691.2) (US$6176), whereas highest monetary loss related to absenteeism was reported in migraineurs with MIDAS grade IV (MYR 12,369.1) (US$2973). Only 30% of migraineurs of MIDAS grade IV reported taking prescribed medication. Notably, a vast majority (96%) of migraineurs who had three or lower episodes of migraine per month did not seek treatment. CONCLUSION: The significant impact of migraine on work productivity and regular activity, appears to lead to substantial monetary loss attributed to not only absenteeism, but more importantly to presenteeism. This study also highlights the unmet needs in migraine management among employees in the banking sector.


Assuntos
Conta Bancária/economia , Eficiência/fisiologia , Transtornos de Enxaqueca/economia , Transtornos de Enxaqueca/epidemiologia , Presenteísmo/economia , Local de Trabalho/economia , Absenteísmo , Adulto , Estudos Transversais , Feminino , Humanos , Malásia/epidemiologia , Masculino , Pessoa de Meia-Idade , Transtornos de Enxaqueca/terapia , Inquéritos e Questionários
17.
Trials ; 21(1): 481, 2020 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-32503602

RESUMO

OBJECTIVES: The objectives of these two separate trials are: (1) to reduce health care workers (HCWs) absenteeism; and (2) to reduce hospital admission among the elderly during the COVID-19 pandemic through BCG vaccination. TRIAL DESIGN: Two separate multi-centre placebo-controlled parallel group randomized trials PARTICIPANTS: (1) Health care personnel working in the hospital or ambulance service where they will take care of patients with the COVID-19 infection and (2) elderly ≥60 years. The HCW trial is being undertaken in 9 hospitals. The elderly trial is being undertaken in locations in the community in Nijmegen, Utrecht, and Veghel, in the Netherlands, using senior citizen organisations to facilitate recruitment. INTERVENTION AND COMPARATOR: For both trials the intervention group will be randomized to vaccination with 0.1 ml of the licensed BCG vaccine (Danish strain 1331, SSI, Denmark, equivalent to 0.075 mg attenuated M. bovis). The placebo group consists of 0.1 ml 0.9% NaCl, which is the same amount, and has the same colour and appearance as the suspended BCG vaccine. MAIN OUTCOMES: (1) Number of days of unplanned work absenteeism in HCWs for any reason which can be continuously measured on a bi-weekly basis, and (2) the cumulative incidence of hospital admission due to documented COVID-19. RANDOMISATION: Participants will be randomized to BCG vaccine or placebo (1;1) centrally using a computer- based system, stratified by study centre. BLINDING (MASKING): Subjects, investigators, physicians and outcome assessors are blinded for the intervention. Only the pharmacist assistant that prepares- and research personnel that administers- study medicines are unblinded. NUMBERS TO BE RANDOMISED (SAMPLE SIZE): (1) The sample size for the first trial is N=1500 HCWs randomised 1:1 to either BCG vaccine (n=750) and placebo (n=750) and (2) The sample size for the second trial is N=1600 elderly persons randomised to BCG vaccine (n=800) and the placebo group (n=800). TRIAL STATUS: HCW: version 4.0, 24-04-2020. Recruitment began 25-03-2020 and was completed on the 23-04-2020. Elderly: version 3.0, 04-04-2020. Recruitment began 16-04- 2020 and is ongoing. TRIAL REGISTRATION: The HCWs trial was registered 31-03-2020 at clinicaltrials.gov (identifier: NCT04328441) and registered 20-03-2020 at the Dutch Trial Registry (trialregister.nl, identifier Trial NL8477). The elderly trial was registered 22-04-2020 at the Dutch trial registry with number NL8547. FULL PROTOCOL: The full protocols will be attached as additional files, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.


Assuntos
Absenteísmo , Vacina BCG/imunologia , Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Pessoal de Saúde , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Ensaios Clínicos Controlados Aleatórios como Assunto , Vacinação , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Multicêntricos como Assunto
18.
Salud trab. (Maracay) ; 28(1): 47-60, jun. 2020. tab, ilus
Artigo em Espanhol | LILACS, LIVECS | ID: biblio-1104337

RESUMO

En Uruguay, la información sobre absentismo laboral en trabajadores vinculados a la salud mental ha presentado dificultades en su sistematización. Surge entonces, la posibilidad de abordar dicha problemática en el único hospital psiquiátrico público del país, dado el interés de autoridades, profesionales y constatar la existencia de mejoras en la calidad de los registros institucionales. Objetivo general: Caracterizar el absentismo laboral en trabajadores del hospital psiquiátrico Vilardebó de Montevideo, durante el año 2013, según certificaciones médicas. Metodología: Convergen aspectos exploratorios, descriptivos y correlaciones, bajo un diseño cuantitativo, no experimental, transversal, retrospectivo. Resultados: El mayor ausentismo laboral se observó en el turno matutino, en mujeres auxiliares de enfermería; sin embargo, los mayores ausentismos días promedio se dieron en hombres por causa de salud mental. Asimismo, 33, 6% de la población estudiada presentó más de 2 certificaciones. Dado el Test Chi-Cuadrado se constató la no independencia entre: motivo de certificación en función del turno y/o cargo del trabajador/a. Discusión: algunos de los resultados se reconocen en otros estudios; siendo uno de los primeros trabajos en la materia se sugiere la realización de nuevas investigaciones con el fin de observar la dinámica temporal del fenómeno estudiado, dadas sus implicancias individuales, colectivas, asistenciales e institucionales(AU)


In Uruguay, the systematic gathering of information on worker absenteeism due to mental health has been difficult. We had an opportunity to address this problem in the only public psychiatric hospital in the country, given the interest of authorities, professionals on verifying improvements in the quality of institutional records. Overall objective. To describe the medical certifications of workers of the Vilardebó psychiatric hospital in Montevideo in 2013. Methodology. Approach that brings together exploratory, descriptive and correlation aspects, using a quantitative, nonexperimental, cross-sectional, retrospective study design. Results. The greatest absenteeism from work was observed in the morning shift among female nursing assistants; however, the highest average number of absenteeism days 33.6% of the study population had more than two medical certifications. Based on chi-square statistics, non-independence was found between the reason for medical certification depending on the shift and / or job title of the worker. Discussion. Some of the results are consistent with prior studies. However, being one of the first studies on this subject, more research is needed to further examine the temporal dynamics of these observations, given their individual, collective, healthcare and institutional implications(AU)


Assuntos
Uruguai , Sistema Único de Saúde , Saúde Mental , Absenteísmo , Hospitais Psiquiátricos/organização & administração , Estudos Transversais , Categorias de Trabalhadores
19.
Rev. Asoc. Esp. Espec. Med. Trab ; 29(2): 67-78, jun. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-193756

RESUMO

El sobrepeso y la obesidad son los problemas más frecuentes en la población laboral. OBJETIVO: Determinar la influencia del sobrepeso y la obesidad con el absentismo laboral debido a enfermedades comunes. MATERIAL Y MÉTODOS: Estudio transversal analítico, se utilizaron bases secundarias de resultados de exámenes médicos ocupacionales y descansos médicos. Se realizó análisis de regresión simple y múltiple utilizando modelos lineales generalizados. RESULTADOS: De 649 participantes, el sobrepeso representó el 44.2% y la obesidad el 19.1%. Las variables que muestran una influencia estadísticamente significativa (p < 0.05) con el absentismo laboral son género, puesto de trabajo, tener antecedente personal patológico, anemia, alteración osteomuscular, alteración en el examen de orina, hipoacusia y diagnóstico nutricional. El género masculino disminuyó en 51% la frecuencia de absentismo y la obesidad aumentó en 35% la frecuencia de absentismo a corto y largo plazo. CONCLUSIONES: Se encontró una frecuencia incrementada de absentismo laboral a corto y largo plazo en los trabajadores de género femenino y en aquellos que presentan obesidad


Overweight and obesity are the most frequent problems in the working population. OBJECTIVE: Determine the influence of overweight and obesity with absenteeism due to common illnesses. MATERIAL AND METHODS: Analytical cross-sectional study, secondary bases of results of occupational medical examinations and medical breaks were used. Simple and multiple regression analysis was performed using generalized linear models. RESULTS: Of 649 participants, overweight represented 44.2% and obesity 19.1%. The variables that show a statistically significant influence (p <0.05) with work absenteeism are gender, job, having a pathological personal history, anemia, musculoskeletal alteration, alteration in the urine test, hearing loss and nutritional diagnosis. The male gender decreased the frequency of absenteeism by 51% and obesity increased the frequency of absenteeism in the short and long term by 35%. CONCLUSIONS: An increased frequency of short-term and long-term absenteeism was found in female workers and in those with obesity


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Absenteísmo , Obesidade/complicações , Sobrepeso/complicações , Saúde do Trabalhador/estatística & dados numéricos , Estudos Transversais/estatística & dados numéricos , Peru
20.
PLoS One ; 15(5): e0233512, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32459804

RESUMO

BACKGROUND: Excess weight can increase absenteeism of workers and can have a negative influence on their productivity. Current evidence on this association is mostly based on cross-sectional data and there is little evidence concerning the longitudinal relationship between obesity, and disability with workplace absenteeism. Further, gender differences in this association have often ignored in the existing literature. OBJECTIVES: This study aims to examine gender differences in the longitudinal association between obesity, and disability with absenteeism in the workplace. METHODS: Data from thirteen waves (2006 to 2018) of the Household, Income and Labour Dynamics in Australia (HILDA) survey were pooled, resulting in 117,769 observations for 19,851 adult employees. The Zero-Inflated Negative Binomial (ZINB) regression model was deployed to investigate the links between obesity, and disability with workplace absenteeism for the total sample and stratified by gender. RESULTS: The findings showed that overweight (Incidence Rate Ratio [IRR]: 1.23, 95% confidence interval [CI]: 1.02-1.47), obesity (IRR: 1.35, 95% CI: 1.12-1.64) and disability (IRR: 2.83, 95% CI: 2.36-3.38) were associated with prolonged workplace absenteeism irrespective of gender. This study found that the multiplicative interaction between weight status and gender is significantly associated with absenteeism. The results reveal that the rate of absenteeism was 2.79 times (IRR: 2.79, 95% CI: 1.96-3.97) and 1.73 times (IRR: 1.73, 95% CI: 1.20-2.48) higher among overweight and obese women than male counterparts, respectively. Moreover, this study found that the weight status of male workers is not associated with absenteeism. However, disability (IRR: 3.14, 95% CI: 2.43-4.05) is positively associated with longer days of absence among male workers. Finally, the study results showed that the rate of absenteeism is 1.82 (IRR: 1.82, 95% CI: 1.36-2.44), 1.61 (IRR: 1.61, 95% CI: 1.21-2.13), and 2.63 (IRR: 2.63, 95% CI: 1.99-3.48) times higher among overweight, obese, and female workers with a disability, respectively, compared with their lower weight counterparts. CONCLUSIONS: Workplace absenteeism is significantly associated with overweight and obesity among Australian workers. An active workplace health promotion program is very important for weight management of overweight and obese workers and thus to reduce workplace absenteeism. For example, employers may provide incentives for maintaining recommended body weights, encourage exercise, and promote healthy diets amongst their workers.


Assuntos
Absenteísmo , Modelos Biológicos , Obesidade/epidemiologia , Caracteres Sexuais , Local de Trabalho , Adolescente , Adulto , Austrália/epidemiologia , Estudos Transversais , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade
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