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1.
Acta Neurol Scand ; 141(1): 56-64, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31659744

RESUMO

OBJECTIVES: A substantial proportion of individuals with stroke are of working age. After stroke, it is important to return to work (RTW), both for the individual's satisfaction with life and economically for society. The current comprehensive, long-term study aimed at investigating in what time period the RTW continues after stroke and what factors could predict RTW. MATERIALS AND METHODS: All individuals registered in the registry Riksstroke with stroke in Sweden at ages 18-58 years during 2011 were eligible for participation. RTW was based on sickness absence data from the Social Insurance Agency covering 1 year prestroke to 5 years post-stroke. Time to RTW was analyzed with Kaplan-Meier curves. Potential predictors of RTW were analyzed with Cox regression and logistic regression. RESULTS: For RTW analyses, 1695 participants were included. Almost 50% RTW within 3 months, 70% within 1 year, and 80% within 2 years post-stroke. However, the RTW continued for several years, with a total of 85% RTW. Predictors of favorable time to RTW were male sex, ischemic stroke, and long university education compared with primary school education. Predictors of unfavorable times to RTW were higher stroke severity, defined by the level of consciousness, and older ages. Participants with self-expectations of RTW 1 year post-stroke had higher odds of RTW within 5 years. CONCLUSIONS: The RTW continues for a longer time after stroke than previously known. Both self-expectations and demographical, socioeconomic, stroke-related factors were important predictors of RTW. This knowledge could assist healthcare professionals to individualize the rehabilitation post-stroke.


Assuntos
Retorno ao Trabalho/estatística & dados numéricos , Acidente Vascular Cerebral , Adolescente , Adulto , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Suécia , Adulto Jovem
2.
Bull Cancer ; 107(2): 200-208, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31864666

RESUMO

INTRODUCTION: Return to work after cancer is a determinant of patients quality of life. The aims were to describe return-to-work interventions applied in a French University Hospital and to assess its effectiveness in achieving a successful return to work. METHODS: A return-to-work questionnaire was sent to 153 patients who were accompanied by a multidisciplinary return-to-work after cancer consultation. RESULTS: hundred and twenty-one patients answered the return-to-work questionnaire. Analysis of the questionnaire found an overall rate of return to work of 50% two years after the cancer diagnosis. The rate was significantly higher in patients who had received individual psychological support for returning to work (P=0.04) and higher, but not significantly, in patients who had a consultation with the company physician during their period of sick-leave (P=0.08). Participating in support groups and performing the required actions for the recognition of handicapped worker status were not factors associated with return to work. DISCUSSION: An individual psychological support for returning to work and a consultation with the company physician during the period of sick-leave should be systematically recommended for patients suffering from cancer. Participating in support groups and recognition of handicapped worker status should be recommended on a case-by-case basis.


Assuntos
Neoplasias/psicologia , Retorno ao Trabalho/estatística & dados numéricos , Adulto , Feminino , França , Hospitais Universitários , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Neoplasias/diagnóstico , Serviços de Saúde do Trabalhador , Qualidade de Vida , Retorno ao Trabalho/psicologia , Licença Médica , Inquéritos e Questionários/estatística & dados numéricos , Fatores de Tempo
3.
Support Care Cancer ; 28(1): 185-192, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31001691

RESUMO

PURPOSE: The objective of our study was to assess the rate of work adjustments 1 year after the diagnosis in a population of female breast cancer (BC) survivors, in the context of the French system of social protection. We also characterised these adjustments and their influence on the reduction of professional exclusion of patients 1 year after the diagnosis. METHODS: This observational, prospective study was conducted from February 2015 to April 2016 among female patients with BC. Inclusion criteria were women aged between 18 and 65 years, treated for BC and integrated into the labour market at the time of diagnosis (working or on sick leave). Exclusion criteria were metastatic BC, retired patients and refusal to participate. A 1-year follow-up was scheduled, and data collection was performed with questionnaires. RESULTS: In total, 213 patients were included between February 2015 and April 2016. One year after the diagnosis (T1), among 185 BC survivors, 78 (42.2%) patients were working. Among them, 13 patients did not interrupt their occupational activity and 65 returned to work after a period of sick leave. Sixty-four patients returned to work after the end of chemotherapy (after 6 months), and one returned to work before this therapeutic threshold. Sixty-six patients (35.7%) benefited from at least one adjustment of their work conditions to facilitate their return to work (RTW) or maintenance at work: working hours were decreased for 43 patients, and workstation changes were performed for 22 patients. An occupational health physician was involved for some patients; work adjustments were prescribed to 42 patients, 7 patients had medical restrictions for physical reasons and 4 patients had restrictions for psychological reasons. Forty-three patients benefited from part-time work prescribed for therapeutic reasons. CONCLUSIONS: Referral to occupational health physicians and work adjustments remain limited in the process of RTW or maintenance at work after BC in France, despite their positive impact.


Assuntos
Neoplasias da Mama/epidemiologia , Sobreviventes de Câncer/estatística & dados numéricos , Retorno ao Trabalho , Ajustamento Social , Adaptação Psicológica/fisiologia , Adolescente , Adulto , Idoso , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/psicologia , Neoplasias da Mama/reabilitação , Sobreviventes de Câncer/psicologia , Emprego/psicologia , Emprego/estatística & dados numéricos , Feminino , França/epidemiologia , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Retorno ao Trabalho/psicologia , Retorno ao Trabalho/estatística & dados numéricos , Licença Médica/estatística & dados numéricos , Inquéritos e Questionários , Adulto Jovem
4.
Int J Radiat Oncol Biol Phys ; 106(1): 146-156, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31521718

RESUMO

PURPOSE: Human papillomavirus (HPV)-associated oropharyngeal cancer (OPC) commonly affects people of working age, yet there is limited data regarding the return-to-work experience in this cohort. This study aimed to investigate the proportion of survivors currently working after completion of radiation therapy and to explore potential facilitators and barriers to working after treatment. METHODS: A cross-sectional, single-institutional study was undertaken at the Peter MacCallum Cancer Centre, a comprehensive cancer center in Melbourne, Victoria, Australia. Eligible participants were 18 to 65 years old at diagnosis, were employed at or within the 3 months before diagnosis, and had completed curative treatment for HPV-associated OPC ≥4 months before enrollment. Participants completed a paper-based survey to assess baseline demographics, employment status, and quality of life (QOL; Functional Assessment of Cancer Therapy Head and Neck). Open-ended questions explored factors affecting return to work. Associations between current employment status and various disease, treatment, and demographic variables and with QOL were examined. Free-text items were analyzed by summarizing content analysis. RESULTS: Of 93 participants approached, 68 responded (73.1%). Mean age was 54.1 years (range, 39-64 years), and 89.7% were male. Most participants (67.6%) had stage II disease and were treated with chemoradiation (85.3%). Mean time after treatment was 2.6 years (range, 0.3-9.1 years). Fifty-eight of 68 participants (85.3%) were working at enrollment; median time to return to work was 6.0 months (interquartile range, 4-10 months); 45 (77.6%) were in the same role and 35 (60.3%) worked the same number of hours. Ten participants were not working, 3 had retired, 5 reported persistent and significant treatment toxicity preventing employment. Survivors currently working reported higher physical, functional, and global QOL scores. Access to leave and support from treating doctors were facilitators for return to work, whereas fatigue was frequently reported as a barrier to returning to work. CONCLUSION: With time, the majority of participants with HPV-associated OPC will return to work after radiation therapy. Attention to symptom management and support from the workplace may enable more successful return to work.


Assuntos
Sobreviventes de Câncer/estatística & dados numéricos , Emprego/estatística & dados numéricos , Neoplasias Orofaríngeas/terapia , Infecções por Papillomavirus/complicações , Qualidade de Vida , Retorno ao Trabalho/estatística & dados numéricos , Adulto , Sobreviventes de Câncer/psicologia , Quimiorradioterapia/efeitos adversos , Quimiorradioterapia/estatística & dados numéricos , Estudos Transversais , Fadiga/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Orofaríngeas/patologia , Neoplasias Orofaríngeas/virologia , Papillomaviridae , Pesquisa Qualitativa , Aposentadoria/estatística & dados numéricos , Retorno ao Trabalho/psicologia , Licença Médica/estatística & dados numéricos , Apoio Social , Inquéritos e Questionários , Fatores de Tempo , Vitória , Tolerância ao Trabalho Programado , Local de Trabalho
5.
Int J Radiat Oncol Biol Phys ; 106(1): 134-145, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31568813

RESUMO

PURPOSE: To assess the employment status in working-age survivors of nasopharyngeal carcinoma (NPC) and explore clinical, treatment, and sociodemographic factors that may facilitate or impede successful return to work (RTW). METHODS AND MATERIALS: This Canadian study was part of a larger cross-sectional study assessing late toxicities in 107 disease-free survivors of NPC who received curative-intent intensity modulated radiation therapy ≥4 years earlier. For this substudy, eligible participants were employed at diagnosis and were of working age (<65 years) at study enrollment. Patient-reported work status (modified Radiation Therapy Oncology Group Work Status Questionnaire), quality of life (Functional Assessment of Cancer Therapy-Head and Neck questionnaire), symptom burden (MD Anderson Symptom Inventory for head and neck cancer), anxiety and depression (Hospital Anxiety and Depression Scale), neurobehavioral functioning (Frontal Systems Behavior Scale), and neurocognitive function (Montreal Cognitive Assessment) were assessed. Univariable and multivariable logistic regression models were used to explore the impact of variables on RTW status. RESULTS: Among 73 eligible patients, the median age was 53 years (range, 32-64) and median time from intensity modulated radiation therapy completion was 7.3 years (range, 4.2-11.1). At enrollment, 45 (62%) were working, of whom 14 (31%) had reduced work hours from diagnosis by a median of 12 h/wk (range, 4-30). Overall, mean work hours decreased from 41.6 to 37.8 h/wk (P = .005). Currently employed (vs unemployed) patients were younger (P = .017) and reported better performance status (P = .013). They had higher quality of life (P = .044), lower symptom burden (P = .03), less significant change from their baseline neurobehavioral function (P = .008), and disability (P = .0025) or private health benefits (P = .035). Anxiety, depression, occupation type, income, and Montreal Cognitive Assessment score were not significantly associated with RTW in the univariable analysis. Age, change in baseline neurobehavioral function, and having private health benefits were all independent predictors of RTW. CONCLUSIONS: The majority of long-term survivors of NPC do RTW, although almost one-third report working fewer hours. Prospective research is needed to better understand and facilitate successful RTW in survivors of NPC.


Assuntos
Sobreviventes de Câncer , Carcinoma Nasofaríngeo/radioterapia , Neoplasias Nasofaríngeas/radioterapia , Retorno ao Trabalho , Adulto , Ansiedade/psicologia , Canadá , Sobreviventes de Câncer/psicologia , Sobreviventes de Câncer/estatística & dados numéricos , Estudos Transversais , Depressão/psicologia , Intervalo Livre de Doença , Emprego/estatística & dados numéricos , Feminino , Humanos , Renda , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Carcinoma Nasofaríngeo/psicologia , Neoplasias Nasofaríngeas/psicologia , Ocupações , Desempenho Físico Funcional , Qualidade de Vida , Retorno ao Trabalho/psicologia , Retorno ao Trabalho/estatística & dados numéricos , Tolerância ao Trabalho Programado
6.
Artigo em Inglês | MEDLINE | ID: mdl-31597239

RESUMO

The fast population ageing has generated and will continue to generate large social, economic and health challenges in the 21th century in Australia, and many other developed and developing countries. Population ageing is projected to lead to workforce shortages, welfare dependency, fiscal unsustainability, and a higher burden of chronic diseases on health care system. Promoting health and sustainable work capacity among mature age and older workers hence becomes the most important and critical way to address all these challenges. This paper used the pooled data from the longitudinal Household, Incomes and Labour Dynamics in Australia (HILDA) survey 2002-2011 data to investigate common and different factors predicting voluntary or involuntary workforce transitions among workers aged 45 to 64. Long term health conditions and preference to work less hours increased while having a working partner and proportion of paid years decreased both voluntary and involuntary work force transitions. Besides these four common factors, the voluntary and involuntary workforce transitions had very different underlying mechanisms. Our findings suggest that government policies aimed at promoting workforce participation at later life should be directed specifically to life-long health promotion and continuous employment as well as different factors driving voluntary and involuntary workforce transitions, such as life-long training, healthy lifestyles, work flexibility, ageing friendly workplace, and job security.


Assuntos
Envelhecimento/psicologia , Emprego/psicologia , Reorganização de Recursos Humanos/estatística & dados numéricos , Aposentadoria/psicologia , Retorno ao Trabalho/psicologia , Recursos Humanos/estatística & dados numéricos , Local de Trabalho/psicologia , Austrália , Emprego/estatística & dados numéricos , Emprego/tendências , Feminino , Previsões , Humanos , Renda , Masculino , Pessoa de Meia-Idade , Reorganização de Recursos Humanos/tendências , Aposentadoria/estatística & dados numéricos , Aposentadoria/tendências , Retorno ao Trabalho/estatística & dados numéricos , Inquéritos e Questionários , Recursos Humanos/tendências
7.
BMC Public Health ; 19(1): 1248, 2019 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-31510964

RESUMO

BACKGROUND: To date, there have not been any workforce-based Japanese cohort studies investigating work sustainability after return to work (RTW). The objective of this study was to investigate the post-RTW cumulative recurrent sick leave rate and cumulative resignation rate among female cancer survivors. METHODS: Among Japanese employees who were registered in the Japan sickness absence and return to work (J-SAR) study, the subjects were those female employees who returned to work after sick leave due to newly clinically diagnosed cancer (C01-C99; ICD-10), based on a physician's certificate, between 2000 and 2011. The last day of the follow-up period was December 31, 2012. The recurrent sickness leave rate and resignation rate were calculated using competing risk survival analysis. RESULTS: Of 223 cancer survivors, 61 took further physician-certified sick leave after their RTW. The median duration of the post-RTW work period among all cancer survivors was 10.6 years. The work continuance rates of the female cancer survivors were 83.2 and 60.4% at 1 and 5 years after they returned to work, respectively. There was a steep reduction in the work continuance rate during the first post-RTW year. There were considerable differences in the work continuance rate according to the primary cancer site. Cumulative recurrent sick leave rates of 11.8 and 28.9% were seen at 1 and 5 years after the subjects returned to work. The cumulative resignation rate was 5.0 and 10.7% at 1 and 5 years after the subjects returned to work. Most recurrent sick leave occurred in the first year after the subjects returned to work, followed by the second year. CONCLUSIONS: Sixty percent of female cancer survivors were still working at 5 years after returning to work, although the work continuance rates for different types of cancer varied significantly.


Assuntos
Sobreviventes de Câncer/estatística & dados numéricos , Retorno ao Trabalho/estatística & dados numéricos , Licença Médica/estatística & dados numéricos , Adulto , Estudos de Coortes , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Neoplasias/epidemiologia , Análise de Sobrevida
8.
Artigo em Inglês | MEDLINE | ID: mdl-31547142

RESUMO

This study aimed to investigate the mediating effect of workplace spirituality in the relation between job stress and job satisfaction as well as the level of job stress, job satisfaction, and workplace spirituality of cancer survivors returning to work. A total of 126 cancer survivors who returned to work more than six months prior to the research participated in this study. Participants were recruited through snowball sampling; they were visiting the outpatient clinic at two general hospitals located in a metropolitan city and their clinical stage was stage 0 or stage 1. The collected data were analyzed using SPSS 22.0. Job stress, workplace spirituality, and job satisfaction had a negative correlation, whereas workplace spirituality and job satisfaction had a positive correlation. The Sobel test was performed to verify the significance of the mediating effect size of workplace adaptation, the results confirmed a partial mediating effect of workplace spirituality on the relation between job stress and job satisfaction (Z = -4.72, p < 0.001). This study confirmed the mediating effect of workplace spirituality in the relation between job stress and job satisfaction. A systematic program needs to be developed to enhance workplace spirituality, a spiritual approach, to relieve job stress and increase job satisfaction.


Assuntos
Sobreviventes de Câncer/psicologia , Satisfação no Emprego , Estresse Ocupacional/psicologia , Espiritualidade , Local de Trabalho/psicologia , Adulto , Sobreviventes de Câncer/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Retorno ao Trabalho/estatística & dados numéricos
9.
Recenti Prog Med ; 110(7): 356-363, 2019.
Artigo em Italiano | MEDLINE | ID: mdl-31379371

RESUMO

Early detection and progression in the treatment of cancer patient have improved the prognosis of many patients. In view of this improvement, cancer should be considered less as a terminal illness, but as a chronic disease, and the number of cancer survivors continues to increase in the West countries. Work coud be very important for cancer patients and for society; however studies on this topic from Italy are fragmentary and very poor. MATERIAL AND METHODS: A prospective observational study started at the Medical oncology unit, Hospital of Piacenza (North Italy). All the patients between 18 and 65 years of age, diagnosed with early or metastatic cancer, admitted to the outpatient clinic, were analyzed for employment and work-related issues (job interruption, returning to work, job loss). A questionnaire with socio-demographic and job related information was submitted to each patient. RESULTS: From January 2015 to June 2017, 2,187 patients with a new diagnosis of cancer were admitted to the outpatient clinic, 550 patients (25.15%) were be-tween 18 and 65 year old, and 416 patients (75.64%) participated to the study. 278 (66.83%) women and 138 (33.17%) men, mean age 50.32±7.90 years (range 18-65), 39.18% were employees, 29.81% workers, 328 (78.85%) with subordinate job, the majority of patients had an high school or academic degree (63.46%). 196 (47.12%) patients had breast cancer, 85 (20.43%) gas-trointestinal cancer, 41 (9.86%) lung cancer, and 94 pa-tients (22.59%) had other cancer; 105 patients (25.24%) showed metastatic cancer and 134 (32.21%) had comor-bidity. After 6 months 178 patients (42.79%) interrupted their work, of these, 99 were women, 35.61% of the 278 female and 79 men, 57.25% of the 138 males, 69 worker (38.76%), 94 with low level of education (52.81%). The majority of patients (86.67%) with metastatic cancer, or treated with chemotherapy (61.60%), or with comorbidity (50.75%), left their work after 6 months from diagnosis. Only 22 of 178 patients (12.36%) in our series returned to work, of these, 20 (90.90%) were women, 17 with breast cancer (85%). DISCUSSION: Our findings suggest that there is a significant association between job loss and gender (male), low level of education/heavy works, advanced stage of cancer, chemotherapy and comorbidity. It is important that clinicians and institutions consider work-related issue in cancer patients and perform adequate organizational and normative interventions.


Assuntos
Sobreviventes de Câncer/estatística & dados numéricos , Emprego/estatística & dados numéricos , Neoplasias/epidemiologia , Retorno ao Trabalho/estatística & dados numéricos , Adolescente , Adulto , Idoso , Escolaridade , Feminino , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias/patologia , Neoplasias/terapia , Prognóstico , Estudos Prospectivos , Fatores Sexuais , Adulto Jovem
10.
Med Care ; 57(9): 718-722, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31295163

RESUMO

BACKGROUND: In addition to providing injured workers with biomedical treatment, health care providers (HCPs) can promote return to work (RTW) through various communications. OBJECTIVES: To test the effect of several types of HCP communications on time loss following injury. RESEARCH DESIGN: The authors analyzed survey and administrative claims data from a total of 730 injured workers in Victoria, Australia. Survey responses were collected around 5 months postinjury and provided data on HCP communication and confounders. Administrative claim records provided data on compensated time loss postsurvey. The authors conducted multivariate zero-inflated Poisson regressions to determine both the odds of having future time loss and its duration. MEASURES: Types of HCP communications included providing an estimated RTW date, discussing types of activities the injured worker could do or ways to prevent a recurrence, and contacting other RTW stakeholders. Each was measured in isolation as well as modified by a low-stress experience with the HCP. Time loss was the count of cumulative compensated work absence in weeks, accrued postsurvey. RESULTS: RTW dates reduced the odds of future time loss [odds ratio, 0.26; 95% confidence interval (CI), 0.09-0.82] regardless of the stressfulness of the experience. Communications that predicted shorter durations of time loss only did so with low-stress experiences: RTW date [incidence rate ratio (IRR), 0.56; 95% CI, 0.50-0.63], stakeholder contact (IRR, 0.78; 95% CI, 0.70-0.87), and prevention discussions (IRR, 0.87; 95% CI, 0.78-0.98). CONCLUSIONS: HCPs may reduce time loss through several types of communication, particularly when stress is minimized. RTW dates had the largest and most robust effect.


Assuntos
Pessoal de Saúde/psicologia , Traumatismos Ocupacionais/psicologia , Relações Profissional-Paciente , Retorno ao Trabalho/estatística & dados numéricos , Fatores de Tempo , Adulto , Comunicação , Feminino , Humanos , Masculino , Razão de Chances , Estudos Prospectivos , Retorno ao Trabalho/psicologia , Vitória
11.
BMC Public Health ; 19(1): 927, 2019 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-31291915

RESUMO

BACKGROUND: Insurance claims management practices may have a significant impact on the health and experiences of injured workers claiming in workers' compensation systems. There are few multi-jurisdictional studies of the way workers experience compensation processes, and limited data on the association between claims experience and return to work outcomes. This study sought to identify worker, claim and injury related factors associated with injured worker experiences of workers' compensation claims management processes, and to examine associations between claims experience and return to work. METHODS: A national, cross-sectional survey of injured workers involved in ten Australian workers' compensation schemes. A total of 10,946 workers completed a telephone survey at 6 to 24 months post claim acceptance. Predictors of positive or negative/neutral claims experience were examined using logistic regression. Associations between claims experience, return to work status and duration of time loss were examined using logistic regression. RESULTS: Nearly one-quarter (23.0%, n = 2515) of workers reported a negative or neutral claims experience. Injury type, jurisdiction of claim, and time to lodge claim were most strongly associated with claims experience. Having a positive claims experience was strongly associated with having returned to work after accounting for injury, worker, claim and employer factors. CONCLUSIONS: There is a strong positive association between worker experiences of the insurance claims process and self-reported return to work status. Revision and reform of workers' compensation claims management practices to enhance worker experience and the fairness of procedures may contribute to improved return to work outcomes.


Assuntos
Traumatismos Ocupacionais/economia , Retorno ao Trabalho/estatística & dados numéricos , Indenização aos Trabalhadores/estatística & dados numéricos , Adulto , Austrália , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
12.
Cien Saude Colet ; 24(6): 2341-2350, 2019 Jun 27.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31269190

RESUMO

This research aimed to investigate the factors that affect the return to work of individuals with traumatic paraplegia and to characterize post-injury work by means of a cross-sectional epidemiological study without statistical inference. The participants were patients at the Spinal Cord Injury Program of the Sarah Rehabilitation Hospital, Salvador, Brazil. The descriptive analysis used mean and standard deviation for continuous variables and proportions for categorical variables. Male predominated among the 42 respondents, with a mean age of 36 years. Mean schooling years was 9 years. Twenty-two respondents returned to work, 21 of which were in the informal labor market. Mean time to return to work was 3 years. The main reasons for returning to work were need for money, personal satisfaction and contact with other people. In this study, returning to work is relevant for adults with spinal cord injury, providing them with higher income and better quality of life. We also noted the importance of higher education level for the successful return to work. Therefore, it is necessary to improve the return to work process, the qualification and professional rehabilitation of these workers.


Assuntos
Emprego/estatística & dados numéricos , Paraplegia/reabilitação , Retorno ao Trabalho/estatística & dados numéricos , Traumatismos da Medula Espinal/reabilitação , Adulto , Brasil , Estudos Transversais , Escolaridade , Feminino , Hospitais de Reabilitação , Humanos , Renda , Masculino , Pessoa de Meia-Idade , Satisfação Pessoal , Qualidade de Vida
13.
Injury ; 50(7): 1293-1299, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31176478

RESUMO

INTRODUCTION: Road traffic crash (RTC) burden is typically reported using hospitalisations or fatalities, yet alternative measures such as work absence provide further insight into RTC impacts. This study aimed to quantify work absence due to compensable RTCs in Victoria, and to determine the characteristics associated with prolonged work absence. METHODS: In Victoria, Australia, two systems provide income support whilst unable to work, among other benefits, to those injured during RTCs either at work (workers' compensation: WC) or elsewhere (RTC compensation). Administrative data of accepted claims between July 1 2003 and June 30, 2013 were included from working age people (15-65 years) if at least one day of income support was paid. Total time (in weeks) on income support, and hence absent from work, was calculated for each person and for each predictor (age group, sex, compensation system, length of hospital stay, injury type and road user type). Cox regression was used to determine the likelihood of prolonged work absence by predictor, presented as hazard ratios (HR) with 95% confidence intervals. RESULTS: For 36,640 injured people, 1,121,863 weeks were compensated (median 10 weeks). Median work absence was shortest among those involved in a train/tram crash (2.9 weeks, HR:0.57[0.51-0.64]) and those with contusions/abrasions (3.7 weeks, HR:0.66[0.64,0.69]). Median work absence was longest among those with spinal cord injury (115.9 weeks, HR:1.56[1.26,1.92]) or severe acquired brain injury (129.6 weeks, HR:1.60[1.44,1.77]). Work absence likelihood increased with length of hospital stay. Median work absence was similar between compensation systems (WC: 10.1 weeks, RTC: 10.0 weeks) yet likelihood of greater work absence was higher in the RTC compensation system (HR:1.12[1.08,1.17]). CONCLUSIONS: Work absence is both a measureable and important metric for assessing the impact of RTC injury in those working at the time of injury. Work absence was at least ten weeks for more than half of all injured persons, reinforcing need for road safety, injury prevention, and return to work services. Furthermore, this study identified those most at risk of prolonged work absence, providing the opportunity to target specific individuals to develop strategies to reduce work absence, such as occupation-specific rehabilitation or graduated return to work.


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Retorno ao Trabalho/estatística & dados numéricos , Indenização aos Trabalhadores/estatística & dados numéricos , Ferimentos e Lesões/epidemiologia , Acidentes de Trânsito/economia , Adolescente , Adulto , Feminino , Inquéritos Epidemiológicos , Hospitalização , Humanos , Formulário de Reclamação de Seguro/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Retorno ao Trabalho/economia , Índices de Gravidade do Trauma , Vitória/epidemiologia , Indenização aos Trabalhadores/economia , Ferimentos e Lesões/economia , Adulto Jovem
14.
Work ; 63(2): 309-318, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31156204

RESUMO

As the population of individuals aged sixty-five and older continues to grow, the number of older individuals participating in the workforce rises alongside, with projections estimating as many as 72 million older workers by 2030. Due to this rapid increase in the number of older workers, new challenges to worker health and to health-related productivity will arise in the coming years. Occupational therapy practitioners are uniquely suited to address many of these challenges given their background in activity analysis, assessment and modification of job demands, health promotion and successful aging. However, there is need for continued research in this area to expand the role of the occupational therapy practitioner in prevention and return-to-work interventions focused on the older worker, and to advocate for the value occupational therapy practitioners can contribute to this field.


Assuntos
Promoção da Saúde/métodos , Terapeutas Ocupacionais/psicologia , Terapia Ocupacional/normas , Ferimentos e Lesões/prevenção & controle , Idoso , Feminino , Geriatria/métodos , Promoção da Saúde/normas , Humanos , Masculino , Saúde do Trabalhador/normas , Saúde do Trabalhador/estatística & dados numéricos , Terapeutas Ocupacionais/normas , Terapia Ocupacional/métodos , Papel Profissional/psicologia , Qualidade de Vida/psicologia , Retorno ao Trabalho/estatística & dados numéricos
15.
Int J Occup Med Environ Health ; 32(3): 379-386, 2019 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-31144676

RESUMO

OBJECTIVES: Lung transplantation not only saves a patient's life but also creates the opportunity for becoming more self-reliant and getting back to work. The aim of this single center study was to assess the prospects of employment, as well as its influence on the quality of life and physical activity, of the lung transplant recipients of the Silesian Center for Heart Diseases in Zabrze, Poland. MATERIAL AND METHODS: A retrospective study covered 67 lung transplant recipients of the Silesian Center of Heart Diseases. Only patients with ≥ 6-month follow-up were included. All of the patients gave their written consent to be included in the study before filling out the questionnaire containing questions about employment, income, education and how work affected their quality of life before and after lung transplantation. A physical capability assessment was performed by climbing flights of stairs and by means of a 6-min walk test, and spirometry parameters were also measured. RESULTS: Twenty of the patients included in the study (31.7%) were employed after lung transplantation, 63.2% of whom worked full-time. Profession was changed by 2 patients (14.3%). The patients diagnosed with cystic fibrosis were found to have the highest chance of finding employment after lung transplantation. The statistical analysis revealed that the employed patients were able to cover longer distances during the 6-min walk test (556 m, on average) than the unemployed ones (494 m, on average). CONCLUSIONS: One in 3 patients finds employment after lung transplantation. Work improves the quality of life of the majority of lung transplant recipients. The patients who are employed are also in a better physical condition, and they are more self-reliant in comparison to those who remain unemployed. Lung transplant recipients with cystic fibrosis are most likely to find employment, and so are patients with higher education. Int J Occup Med Environ Health. 2019;32(3):379-86.


Assuntos
Emprego/estatística & dados numéricos , Transplante de Pulmão/reabilitação , Retorno ao Trabalho/estatística & dados numéricos , Adulto , Idoso , Fibrose Cística/reabilitação , Fibrose Cística/cirurgia , Escolaridade , Feminino , Hospitais Especializados , Humanos , Masculino , Pessoa de Meia-Idade , Polônia , Qualidade de Vida , Estudos Retrospectivos , Caminhada
16.
Knee ; 26(4): 853-860, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31126842

RESUMO

BACKGROUND: Osteoarthritis is one of the leading causes of disability in working-age patients. The total number of working-age patients undergoing total-knee arthroplasty (TKA) is continuously increasing. The purpose of this study was to identify predictive factors related to general health, health risk behaviors and socioeconomic status influencing the rate of return to work after a TKA. METHODS: Overall there were 151,901 patients included in the Finnish Public Sector (FPS) study. The response rate varied between 65 and 73% during the study period. We used Cox proportional hazard models to examine patient-related predictive factors that may influence the rate of return to work after TKA in a cohort of patients (n = 452; n = 362 female; mean age 56.4 years). Predictive factors were measured on average 3.6 years before the operation. RESULTS: Of the patients, 87% returned to work within one year after TKA at a mean of 116 calendar days. In multivariate analysis, patients at sick-leave ≤30 days during the last year before surgery were 2.2 times (95% confidence interval 1.72-2.92) more likely to return to work compared with those with >30 days of sick-leave. Compared with patients in manual work, those in higher or lower level non-manual work showed a 2.6-fold (1.95-3.52) and 1.5-fold (1.15-1.92) increased probability of returning to work. Age, sex, health risk behaviors, obesity, physical comorbidities, common mental disorders, and other studied health-related factors were not associated with the rate of return to work. CONCLUSIONS: Non-manual job, good self-rated general health and preoperative sick leave ≤30 days are associated with a higher rate of return to work.


Assuntos
Artroplastia do Joelho , Retorno ao Trabalho/estatística & dados numéricos , Feminino , Finlândia , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Ocupações , Osteoartrite do Joelho/cirurgia , Licença Médica/estatística & dados numéricos
17.
Occup Environ Med ; 76(7): 471-478, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31126965

RESUMO

INTRODUCTION: Workplace violence carries a substantial economic loss burden. Up to 10% of all traumatic brain injury (TBI) admissions result from physical assault. There remains a paucity of research on assault as a mechanism of injury, taking into account sex, and its association with work re-entry. OBJECTIVES: The aim of this study was to characterise, by sex, the sample of workers who had sustained a work-related mild TBI (wr-mTBI) and to assess the independent influence of assault, as a mechanism of injury, on time away from work. METHODS: A population-based retrospective cohort of workers' compensation claimants in Australia (n=3129) who had sustained a wr-mTBI was used for this study. A multivariable logistic regression analysis assessed whether workers who had sustained wr-mTBI as a result of assault (wr-mTBI-assault) were more likely to claim time off work compared with workers who had sustained a wr-mTBI due to other mechanisms. RESULTS: Among claimants who sustained a wr-mTBI, 9% were as a result of assault. The distribution of demographic and vocational variables differed between the wr-mTBI-assault, and not due to assault, both in the full sample, and separately for men and women. After controlling for potential confounding factors, workers who sustained wr-mTBI-assault, compared with other mechanisms, were more likely to take days off work (OR 2.14, 95% CI 1.53 to 2.99) within a 3-month timeframe. CONCLUSION: The results have policy-related implications. Sex-specific and workplace-specific prevention strategies need to be considered and provisions to support return-to-work and well-being within this vulnerable cohort should be examined.


Assuntos
Lesões Encefálicas Traumáticas/epidemiologia , Traumatismos Ocupacionais/epidemiologia , Indenização aos Trabalhadores/estatística & dados numéricos , Violência no Trabalho , Adolescente , Adulto , Austrália/epidemiologia , Lesões Encefálicas Traumáticas/etiologia , Estudos de Coortes , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Traumatismos Ocupacionais/etiologia , Estudos Retrospectivos , Retorno ao Trabalho/estatística & dados numéricos , Fatores Sexuais
18.
BMC Public Health ; 19(1): 496, 2019 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-31046738

RESUMO

BACKGROUND: People aged over 50 years form a growing proportion of the working age population, but are at increased risk of unemployment compared to other age groups. It is often difficult to return to work after unemployment, particularly for those with health issues. In this paper, we explored the perceptions, attitudes, and experiences of returning to work after a period of unemployment (hereafter RTW) barriers among unemployed adults aged over 50 years. METHOD: In-depth semi-structured interviews were conducted with a diverse sample of 26 unemployed individuals aged 50-64 years who were engaged with the UK Government's Work Programme. Data were thematically analysed. RESULTS: Age alone was not discussed by participants as a barrier to work; rather their discussions of barriers to work focused on the ways in which age influenced other issues in their lives. For participants reporting chronic health conditions, or disabilities, there was a concern about being unfit to return to their previous employment area, and therefore having to "start again" in a new career, with associated concerns about their health status and managing their treatment burden. Some participants also reported experiencing either direct or indirect ageism (including related to their health status or need to access healthcare) when looking for work. Other issues facing older people included wider socio-political changes, such as the increased pension age, were felt to be unfair in many ways and contradicted existing expectations of social roles (such as acting as a carer for other family members). CONCLUSION: Over-50s experienced multiple and interacting issues, at both the individual and societal level, that created RTW barriers. There is a need for employability interventions that focus on supporting the over-50s who have fallen out of the labour market to take a holistic approach, working across healthcare, employability and the local labour market, providing treatment and skills training for both those out of work and for employers, in order to create an intervention that that helps achieve RTW and its associated health benefit.


Assuntos
Doença Crônica/psicologia , Pessoas com Deficiência/psicologia , Emprego/psicologia , Nível de Saúde , Retorno ao Trabalho/psicologia , Desemprego/psicologia , Idoso , Doença Crônica/epidemiologia , Pessoas com Deficiência/estatística & dados numéricos , Emprego/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ocupações , Pesquisa Qualitativa , Retorno ao Trabalho/estatística & dados numéricos , Licença Médica , Desemprego/estatística & dados numéricos
19.
Work ; 63(1): 69-80, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31127746

RESUMO

BACKGROUND: In occupational rehabilitation programs, return-to-work is a key outcome measure; however, the studies either used different definitions for return-to-work or do not provide their definition. In order to provide a solution to this issue, we developed a self-report return-to-work measure. OBJECTIVE: We investigated the reliability and validity of a self-report return-to-work questionnaire in a cohort of workers with a work-related injury. METHODS: Two research assistants independently administered the baseline questionnaires and a follow-up questionnaire. The questionnaires contained work-related questions (e.g., currently working, if duties changed) that were used to create a four-category work status measure. Pain-related and a recovery questions were also asked. We obtained loss of earnings data from the compensation board. The short-term reliability and convergent validity were assessed. RESULTS: We recruited 75 workers, and 57 completed the test-re-test baseline questionnaire, and 51 completed the follow-up. The mean age was 45.4 years and 57% were female. The participants had a mixture of musculoskeletal injuries. Most were in the acute stage, but 17% of the participants were injured for more than a year. The short-term reliability of current working status had a kappa value of 0.90. Participants who were not working had higher levels of pain-related disability than those who were working. The kappa value for the agreement between self-reported working status and administrative data on receiving any loss of earnings payment was around 0.65. CONCLUSIONS: Our study provides evidence of reliability and validity for a new return-to-work measure.


Assuntos
Traumatismos Ocupacionais/psicologia , Retorno ao Trabalho/estatística & dados numéricos , Inquéritos e Questionários/normas , Adulto , Avaliação da Deficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ontário , Medição da Dor/métodos , Reprodutibilidade dos Testes , Autorrelato
20.
Work ; 63(1): 81-97, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31127747

RESUMO

BACKGROUND: Despite the importance of the legislative and insurance systems in the return to work process after an occupational injury, the perspective of the insurer on what influences return to work has rarely been documented. OBJECTIVE: To understand the barriers or facilitators for return to work, from the perspective of the insurer. METHODS: A comprehensive qualitative approach was used. Semi-directed interviews were done with nineteen (19) insurers (claims adjudicator and rehabilitation case manager) from a Canadian workers' compensation board. A thematic analysis was done using QDA Minor Software. RESULTS: Fourteen themes (e.g. family reaction, quality of work relationship) were classified into four categories representing the main stakeholders: worker with disability, workplace, healthcare system and compensation system. Emotional, cognitive, and adaptive reactions from the worker and his family were identified. We observed that good work relations and support practices, lack of access to medical resources, focus on the employee's ability, and complexity and consequences of the compensation process are the main barriers and facilitators from the insurers' perspective. Many of the perceived elements are coherent with the compensation system's administrative and legal context. CONCLUSIONS: The results enable us to better understand the insurers' perspective regarding what influences return to work. It reinforces the necessity to consider the administrative and legal context to better understand the insurers' perspective.


Assuntos
Seguradoras , Traumatismos Ocupacionais/complicações , Retorno ao Trabalho/psicologia , Adulto , Idoso , Feminino , Humanos , Entrevistas como Assunto/métodos , Masculino , Pessoa de Meia-Idade , Traumatismos Ocupacionais/psicologia , Pesquisa Qualitativa , Quebeque , Retorno ao Trabalho/estatística & dados numéricos , Local de Trabalho/psicologia , Local de Trabalho/normas
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