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Vlaski T, Slavic M, Caspari R, Bilsing B, Fischer H, Brenner H, Schöttker B. From a Clustering of Adverse Symptoms after Colorectal Cancer Therapy to Chronic Fatigue and Low Ability to Work: A Cohort Study Analysis with 3 Months of Follow-Up. Cancers (Basel) 2024; 16:202. [PMID: 38201629 PMCID: PMC10778495 DOI: 10.3390/cancers16010202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/28/2023] [Accepted: 12/29/2023] [Indexed: 01/12/2024] Open
Abstract
In colorectal cancer (CRC) patients, apart from fatigue, psychological and physical symptoms often converge, affecting their quality of life and ability to work. Our objective was to ascertain symptom clusters within a year following CRC treatment and their longitudinal association with persistent fatigue and reduced work ability at the 3-month follow-up. We used data from MIRANDA, a multicenter cohort study enrolling adult CRC patients who are starting a 3-week in-patient rehabilitation within a year post-curative CRC treatment. Participants completed questionnaires evaluating symptoms at the start of rehabilitation (baseline) and after three months. We performed an exploratory factor analysis to analyze the clustering of symptoms at baseline. Longitudinal analysis was performed using a multivariable linear regression model with dichotomized symptoms at baseline as independent variables, and the change in fatigue and ability to work from baseline to 3-month-follow-up as separate outcomes, adjusted for covariates. We identified six symptom clusters: fatigue, gastrointestinal symptoms, pain, psychosocial symptoms, urinary symptoms, and chemotherapy side effects. At least one symptom from each factor was associated with higher fatigue or reduced ability to work at the 3-month follow-up. This study highlights the interplay of multiple symptoms in influencing fatigue and work ability among CRC patients post-rehabilitation.
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Affiliation(s)
- Tomislav Vlaski
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (T.V.); (M.S.); (H.B.)
- Medical Faculty Heidelberg, Heidelberg University, 69117 Heidelberg, Germany
| | - Marija Slavic
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (T.V.); (M.S.); (H.B.)
| | - Reiner Caspari
- Clinic Niederrhein, 52474 Bad Neuenahr-Ahrweiler, Germany;
| | | | | | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (T.V.); (M.S.); (H.B.)
- National Center for Tumor Diseases (NCT), German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Ben Schöttker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany; (T.V.); (M.S.); (H.B.)
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Vlaski T, Slavic M, Caspari R, Fischer H, Brenner H, Schöttker B. Development Trajectories of Fatigue, Quality of Life, and the Ability to Work among Colorectal Cancer Patients in the First Year after Rehabilitation-First Results of the MIRANDA Study. Cancers (Basel) 2023; 15:3168. [PMID: 37370777 DOI: 10.3390/cancers15123168] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 06/09/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
Cancer-related fatigue, low quality of life (QoL), and low ability to work are highly prevalent among colorectal cancer (CRC) patients after tumor surgery. We aimed to analyze their intercorrelations and trajectories in the first year after in-patient rehabilitation in the German multicenter MIRANDA cohort study. Recruitment is ongoing, and we included the first 147 CRC patients in this analysis. Participants filled out questionnaires at the beginning of in-patient rehabilitation (baseline) and at 3, 6, 9, and 12 months after the baseline. The EORTC-QLQ-C30-General-Health-Status (GHS)/QoL, the FACIT-F-Fatigue Scale, and the FACIT-F-FWB-ability-to-work items were used to evaluate QoL, fatigue, and ability to work, respectively. The fatigue and QoL scales were highly correlated (r = 0.606). A moderate correlation was observed between the fatigue and ability to work scales (r = 0.487) and between the QoL and ability to work scales (r = 0.455). Compared to the baseline, a statistically significant improvement in the QoL, ability to work, and fatigue scales were observed at the 3-month follow-up (Wilcoxson signed rank test, all p < 0.0001). The three scales plateaued afterward until the 12-month follow-up. In conclusion, fatigue, QoL, and ability to work were highly interrelated, improved quickly during/after in-patient rehabilitation, and did not change much afterward in German CRC patients.
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Affiliation(s)
- Tomislav Vlaski
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- Medical Faculty Heidelberg, Heidelberg University, 69120 Heidelberg, Germany
| | - Marija Slavic
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Reiner Caspari
- Clinic Niederrhein, 53474 Bad Neuenahr-Ahrweiler, Germany
| | | | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- National Center for Tumor Diseases (NCT), German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Ben Schöttker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
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Yarotsky SY, Kazakov AS, Kochubey VV, Kochubey AV. [PERSONAL GROWTH AND PERCEIVED ABILITY TO WORK OF HEADS OF DEPARTMENTS OF MEDICAL ORGANIZATIONS]. Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med 2022; 30:1167-1172. [PMID: 36385093 DOI: 10.32687/0869-866x-2022-30-s1-1167-1172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Despite the need for the heads of departments to implement the labor functions of a clinician and manager, the study of personal growth and perceived ability to work in this category of medical workers was not carried out. THE PURPOSE OF THE STUDY determining the relationship of personal growth and perceived ability to work of heads of departments of medical organizations, as well as the impact on self-esteem of various characteristics of this category of respondents. METHODS A correspondence survey was conducted of 216 heads of clinical departments in the section «personal growth» of the questionnaire «psychological well-being of Riff» and the questionnaire «perceived ability to work» of the Institute of Social Research of the University of Michigan. The personal growth index is the average score according to the statements of the 1st questionnaire. The index of ability to work is the sum of points for each of the statements of the 2nd questionnaire. The average length of service is 23.1 ± 8.60 years, the average age is 47.9 ± 8.08 years. 123 (56.9%) men, 117 (54.2%) worked in a hospital, 114 (52.8%) worked in the «red zone», 111 (51.4%) have a second higher education, 138 (63.89%) have a qualification category, 63 (29.1%) have an academic degree. The Spearman correlation coefficients and the Student's criterion are calculated to assess the relationship and significance of differences between indices and characteristics. RESULTS The personal growth index is 4.89 ± 0.818, the work ability index is 33.60 ± 4.564 points. Respondents aged 41-50 have significantly (p < 0.001) lower indices. There was no significant difference between the index of personal growth and the index of ability to work in respondents of different sexes (р = 0.864 and р = 0.951), those who worked in inpatient and outpatient settings (р = 0.834 and р = 0.848); those who worked in the «red zone» (р = 0.727 and р = 0.775), respondents with a qualification category (р = 0.543 and р = 0.404), with an academic degree (р = 0.871 and р = 0.898), with the second highest education (р = 0.443 and р = 0.588). There is an average direct correlation of personal growth indices and perceived ability to work (r = 0.6; p < 0.001). CONCLUSION The relationship between personal growth indices and perceived ability to work, significantly lower indices in the group of 41-50 years and over 60 years must be taken into account to ensure the professional development of department heads.
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Affiliation(s)
- S Y Yarotsky
- Federal Scientific and Clinical Center of Specialized Types of Medical Care of the Federal Medical and Biological Agency of Russia
| | - A S Kazakov
- Research Institute for Healthcare Organization and Medical Management of Moscow Healthcare Department
| | - V V Kochubey
- A. I. Yevdokimov Moscow State University of Medicine and Dentistry of the Ministry of Healthcare of the Russian Federation
| | - A V Kochubey
- Federal Scientific and Clinical Center of Specialized Types of Medical Care of the Federal Medical and Biological Agency of Russia
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Bergman E, Löyttyniemi E, Myllyntausta S, Rautava P, Korhonen PE. Temporal changes in self-reported sleep quality, sleep duration and sleep medication use in relation to temporal changes in quality of life and work ability over a 1-year period among Finnish municipal employees. J Sleep Res 2022; 31:e13605. [PMID: 35429092 PMCID: PMC9787037 DOI: 10.1111/jsr.13605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 03/24/2022] [Accepted: 03/24/2022] [Indexed: 12/30/2022]
Abstract
In this prospective follow-up study, we aimed to examine whether changes in self-reported sleep quality, sleep duration, and sleep medication use are temporally associated with changes in quality of life and work ability in municipal employees when several confounding factors are considered. The study was conducted in Finland among 637 municipal employees (88% women, mean [SD] age 48 [10] years) in 2014 and 2015. Information about the participants was collected by self-administered questionnaire and from medical history. Predicting variables were changes in self-reported sleep quality, sleep duration, and sleep medication use. Outcome variables were changes in the EUROHIS-QOL eight-item index and the Work Ability Score. Improved or unchanged sleep quality compared to worse sleep quality were associated with a preferable change in quality of life (both p < 0.001). No change in sleep duration compared to a decrease and no change in sleep medication use compared to increased use were also associated with favourable changes in quality of life. Increased use of sleep medication was associated with a decline in work ability, and the change in Work Ability Score also differed significantly between improved and worsened sleep quality. In this study, changes in sleep were widely associated with changes in quality of life and work ability of municipal employees. Programmes aiming for better sleep health would probably be beneficial both from a health-oriented and an economical point of view. Special attention should be paid to employees with a need for sleep medication.
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Affiliation(s)
- Elina Bergman
- Department of General Practice, Institute of Clinical MedicineUniversity of Turku and Turku University HospitalTurkuFinland
| | | | - Saana Myllyntausta
- Department of Psychology and Speech‐Language PathologyUniversity of TurkuTurkuFinland
| | - Päivi Rautava
- Department of Public HealthUniversity of TurkuTurkuFinland,Turku University Hospital, Clinical Research CentreTurkuFinland
| | - Päivi E. Korhonen
- Department of General Practice, Institute of Clinical MedicineUniversity of Turku and Turku University HospitalTurkuFinland
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Visser A, Alma MA, Bakker SJL, Bemelman FJ, Berger SP, van der Boog PJM, Brouwer S, Hilbrands LB, Standaar DSM, Stewart RE, Gansevoort RT. Employment and ability to work after kidney transplantation in the Netherlands: The impact of preemptive versus non-preemptive kidney transplantation. Clin Transplant 2022; 36:e14757. [PMID: 35716362 PMCID: PMC9788192 DOI: 10.1111/ctr.14757] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 02/14/2022] [Accepted: 06/11/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Work can have a major positive impact on health and wellbeing. Employment of kidney transplant recipients (KTR) of working age is much lower than in the general population. The first aim of this study was to examine the impact of a preemptive kidney transplantation (PKT) on employment, in addition to other possible influencing factors. The second aim was to explore differences in work ability, absenteeism and work performance among employed KTR with different types of transplantations. METHODS A cross-sectional survey study was conducted between 2018 and 2019 in nine Dutch hospitals. PKT as potential predictor of employment was examined. Furthermore, work ability, absenteeism and loss of work performance were compared between employed preemptive recipients with a living donor (L-PKT) and non-preemptive recipients with a living donor (L-nPKT) and with a deceased donor (D-nPKT). RESULTS Two hundred and twenty four KTR participated; 71% reported having paid work. Paid work was more common among PKT recipients (82% vs. 65% in L-nPKT and 55% in D-nPKT) and recipients who were younger (OR .950, 95%CI .913-.989), had no comorbidities (1 comorbidity: OR .397, 95%CI .167-.942; 2 comorbidities: OR .347, 95%CI .142-.844), had less fatigue (OR .974, 95%CI .962-.987) and had mentally demanding work tasks (only in comparison with physically demanding tasks, OR .342, 95%CI .145-.806). If recipients were employed, D-nPKT recipients worked fewer hours (mean 24.6±11.3 vs. PKT 31.1±9.6, L-nPKT 30.1±9.5) and D-nPKT and L-nPKT recipients received more often supplemental disability benefits (32 and 33.3%, respectively) compared to PKT recipients (9.9%). No differences were found for self-reported ability to work, sick leave (absenteeism) and loss of work performance with the exception of limitations in functioning at work. CONCLUSIONS Preemptive kidney transplantation recipients with a kidney from a living donor are employed more often, work more hours per week (only in comparison with D-nPKT) and have a partial disability benefit less often than nPKT recipients. More knowledge regarding treatments supporting sustainable participation in the labor force is needed as work has a positive impact on recipients' health and wellbeing and is also beneficial for society as a whole.
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Affiliation(s)
- Annemieke Visser
- Department of Applied Health ResearchHealth SciencesUniversity Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| | - Manna A. Alma
- Department of Applied Health ResearchHealth SciencesUniversity Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| | - Stephan J. L. Bakker
- Department of NephrologyUniversity Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| | - Frederike J. Bemelman
- Department of NephrologyUniversity of Amsterdam's Faculty of MedicineAmsterdamThe Netherlands
| | - Stefan P. Berger
- Department of NephrologyUniversity Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| | | | - Sandra Brouwer
- Department of Health Sciences, Community and Occupational MedicineUniversity Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| | - Luuk B. Hilbrands
- Department of NephrologyRadboud University Medical CenterNijmegenThe Netherlands
| | - Dorien S. M. Standaar
- Department of NephrologyUniversity of Amsterdam's Faculty of MedicineAmsterdamThe Netherlands
| | - Roy E. Stewart
- Department of Health Sciences, Community and Occupational MedicineUniversity Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
| | - Ron T. Gansevoort
- Department of NephrologyUniversity Medical Center GroningenUniversity of GroningenGroningenThe Netherlands
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Fauser D, Zeuner AK, Zimmer JM, Golla A, Schmitt N, Mau W, Bethge M. Work ability score as predictor of rehabilitation, disability pensions and death? A German cohort study among employees with back pain. Work 2022; 73:719-728. [PMID: 35431217 DOI: 10.3233/wor-210987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Sickness absence, disability pensions, and use of healthcare due to disabling back pain are a high economic burden in Germany. Assessment are needed to identify employees who are likely to need intensive support. OBJECTIVE The cohort study examined whether rehabilitation, disability pensions and death can be predicted by a simple self-reported rating of work ability in employees with back pain in Germany. METHODS Employees aged 45 to 59 years who reported back pain in the last 3 months completed the Work Ability Score in 2017 (0-10 points). Individual scores were categorized into poor (0-5 points), moderate (6-7) and at least good (8-10) work ability. Outcomes were extracted from administrative records covering the period until the end of 2018. Proportional hazard models were fitted to determine the prognostic benefit of the Work Ability Score. RESULTS Data for 6,917 participants were included (57.8% women). The median follow-up time was 20 months. Of the participants, 52.1% had a good or excellent, 27.7% a moderate, and 20.2% a poor Work Ability Score. During follow-up, 548 persons were granted rehabilitation measures, 57 persons disability pensions, and 23 died. Fully adjusted analyses showed an increased risk of a rehabilitation measure (hazard ratio = 2.65; 95% CI 2.11; 3.34) and a disability pension (HR = 4.12; 95% CI 2.02; 8.39) in employees with poor work ability. A premature death was not associated with poor work ability. CONCLUSIONS The Work Ability Score is a potential tool to identify individuals, reporting back pain, with an increased risk of health-related early retirement and work disability.
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Affiliation(s)
- David Fauser
- Institute for Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - Ann-Kathrin Zeuner
- Institute for Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - Julia-Marie Zimmer
- Institute for Rehabilitation Medicine, Interdisciplinary Centre of Health Sciences, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - André Golla
- Institute for Rehabilitation Medicine, Interdisciplinary Centre of Health Sciences, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Nadine Schmitt
- Institute for Rehabilitation Medicine, Interdisciplinary Centre of Health Sciences, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Wilfried Mau
- Institute for Rehabilitation Medicine, Interdisciplinary Centre of Health Sciences, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Matthias Bethge
- Institute for Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
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Dénes Z, Masát O. [Rehabilitation results after severe traumatic brain injury]. Ideggyogy Sz 2022; 75:31-37. [PMID: 35112519 DOI: 10.18071/isz.75.0031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND AND PURPOSE To assess the rehabilitation outcome after severe traumatic brain injury. METHODS Retrospective evaluation of the rehabilitation process and prospective follow-up five years after discharge. Patients - Patients treated in 2013 at the Traumatic Brain Injury Unit, National Institute for Medical Rehabilitation were included in the study (n = 232). RESULTS Ninety-nine of 232 patients were treated with severe traumatic brain injury. Data were available for 66/99 patients (67%). Fifty patients (13 women and 37 men) were successfully contacted for follow-up (51%), three patients deceased. The mean age of the patients was 42 years (range: 22-72). The majority of them (36/50) was injured in traffic accidents. The mean duration of coma and post-traumatic amnesia were 19 (1-90) and 45 days (5-150), respectively. Patients were admitted for rehabilitation on the 44th (11-111) day after the injury and were rehabilitated for 95 days (10-335). Thirty-eight patients became independent at daily living activity during the rehabilitation period, and none during the follow-up. Two patients needed moderate and one a little help for the daily life. After successful rehabilitation 4 patients continued their higher education, 24 patients worked (six in sheltered, six in the original, 12 in other workplaces). Twenty-two patients did not have permanent jobs, two of whom were retired. CONCLUSION The majority of the patients were successfully reintegrated into society. More than half of the patients returned to work or continued their studies. These successes were greatly facilitated by the 40 years of experience and the multidisciplinary team working in the National Institute for Medical Rehabilitation.
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Affiliation(s)
- Zoltán Dénes
- Országos Orvosi Rehabilitációs Intézet, Agysérültek Rehabilitációs Osztálya, Budapest
- Semmelweis Egyetem, Rehabilitációs Medicina Tanszék, Budapest
| | - Orsolya Masát
- Országos Orvosi Rehabilitációs Intézet, Agysérültek Rehabilitációs Osztálya, Budapest
- Semmelweis Egyetem, Rehabilitációs Medicina Tanszék, Budapest
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Niedermoser DW, Kalak N, Meyer M, Schweinfurth N, Walter M, E. Lang U. How a Depressive Medical Doctor Profited in the Long-Term from a New and Short Psychological Group-Treatment against Major Depressive Disorder. Int J Environ Res Public Health 2021; 18:ijerph18041925. [PMID: 33671189 PMCID: PMC7922573 DOI: 10.3390/ijerph18041925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/03/2021] [Accepted: 02/07/2021] [Indexed: 11/29/2022]
Abstract
Background: Individuals suffering from major depressive disorder (MDD) often describe workplace-related stress as one of the main causes of their disorder. Here, we present the story of a 33 year old “Bob” (a pseudonym) who suffered from a moderate (Hamilton-21 = 18) major depressive episode. Workplace-related stress seemed to be the main stressor for Bob at the time. We were interested in long-lasting effects of a newly established group called “work-related interpersonal Psychotherapy, W-IPT”. W-IPT consists of eight weekly 90 min sessions. The follow-ups were 12 weeks after the group-treatment and 18 months later. Bob was chosen because he agreed in advance to participate in a follow-up. We were interested if the group-treatment of W-IPT also has a persistent positive effect. Case presentation: We present the case of a 33-year-old man “Bob”. He was included in our previous published pilot-study 2020 with diagnosed moderate MDD, and he attended the group treatment. This case report focuses on a follow-up period of 18 months. A structured clinical interview for DSM-IV was carried out in order to be included in the study, and no comorbid diagnoses were detected. Conclusions: However, the psychotherapeutic effects in this case seem enduring and prolonged. Of course, additional research to study the long-term effects of W-IPT is needed, and more patients need to be included.
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Affiliation(s)
- Daryl Wayne Niedermoser
- Department of Addictive Disorders, Psychiatric University Clinic Basel, 4002 Basel, Switzerland; (N.K.); (M.M.); (N.S.); (M.W.); (U.E.L.)
- Department of Economics, Kalaidos University of Applied Sciences, 8050 Zürich, Switzerland
- Correspondence:
| | - Nadeem Kalak
- Department of Addictive Disorders, Psychiatric University Clinic Basel, 4002 Basel, Switzerland; (N.K.); (M.M.); (N.S.); (M.W.); (U.E.L.)
| | - Martin Meyer
- Department of Addictive Disorders, Psychiatric University Clinic Basel, 4002 Basel, Switzerland; (N.K.); (M.M.); (N.S.); (M.W.); (U.E.L.)
| | - Nina Schweinfurth
- Department of Addictive Disorders, Psychiatric University Clinic Basel, 4002 Basel, Switzerland; (N.K.); (M.M.); (N.S.); (M.W.); (U.E.L.)
| | - Marc Walter
- Department of Addictive Disorders, Psychiatric University Clinic Basel, 4002 Basel, Switzerland; (N.K.); (M.M.); (N.S.); (M.W.); (U.E.L.)
| | - Undine E. Lang
- Department of Addictive Disorders, Psychiatric University Clinic Basel, 4002 Basel, Switzerland; (N.K.); (M.M.); (N.S.); (M.W.); (U.E.L.)
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Niedermoser DW, Kalak N, Kiyhankhadiv A, Brand S, Walter C, Schweinfurth N, Lang UE. Workplace-Related Interpersonal Group Psychotherapy to Improve Life at Work in Individuals With Major Depressive Disorders: A Randomized Interventional Pilot Study. Front Psychiatry 2020; 11:168. [PMID: 32256402 PMCID: PMC7090238 DOI: 10.3389/fpsyt.2020.00168] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 02/21/2020] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES Individuals suffering from major depressive disorder (MDD) often report workplace-related stress as the major cause of their disorder. Accordingly, workplace-related stress was established as a fifth psychosocial problem area of Interpersonal Psychotherapy (workplace-related Interpersonal Psychotherapy, W-IPT). The aim of the study was to investigate the influence of W-IPT on depressive symptoms and on workplace-related issues in individuals with MDD compared to a treatment-as-usual (TAU) condition. METHODS A total of 27 individuals with MDD (mean age = 43 years, 48% males) were randomly assigned either to eight weekly group sessions of W-IPT or to the TAU condition. At baseline, 8 weeks later at the end of the intervention, and 20 weeks later at follow-up, the Hamilton Rating Scale for Depression was conducted. In addition, the participants completed the Beck Depression Inventory, the Work Ability Index (WAI), the Return to Work Attitude (RTW-SE), and the Insomnia Severity Index (ISI). RESULTS Symptoms of depression in experts' ratings as well as in self-rated ratings decreased over time, but more so in the W-IPT condition compared to the TAU condition [experts rating: large effect size (d = 1.25) and self-assessment: large effect sizes (d = 0.94)]. The subjective ability to work (WAI) [medium effect size (d = 0.68)], self-efficacy to returning to work RTW-SE [medium effect size (d = 0.57)], and subjective symptoms of insomnia (ISI) [large effect size (d = 1.15)] increased over time, but again more so in the W-IPT condition compared to the TAU condition. The effects of the intervention remained stable from the end of the intervention to follow-up. CONCLUSIONS The pattern of results of this pilot study suggests that a newly established fifth IPT focus on workplace-related stress appeared to be particularly efficient in individuals with MDD due to work-related stress in reducing depressive symptoms and reducing sleep complaints as well as in improving occupational outcomes.
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Affiliation(s)
- Daryl Wayne Niedermoser
- University Psychiatric Clinics (UPK), University of Basel, Basel, Switzerland.,Departement of Business, Kalaidos University of Applied Sciences, Zurich, Switzerland
| | - Nadeem Kalak
- University Psychiatric Clinics (UPK), University of Basel, Basel, Switzerland
| | - Anna Kiyhankhadiv
- University Psychiatric Clinics (UPK), University of Basel, Basel, Switzerland
| | - Serge Brand
- University Psychiatric Clinics (UPK), University of Basel, Basel, Switzerland.,Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland.,School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Corinna Walter
- University Psychiatric Clinics (UPK), University of Basel, Basel, Switzerland
| | - Nina Schweinfurth
- University Psychiatric Clinics (UPK), University of Basel, Basel, Switzerland
| | - Undine E Lang
- University Psychiatric Clinics (UPK), University of Basel, Basel, Switzerland
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Sugawara N, Yasui-Furukori N, Tsuji T, Hayashi S, Ajisawa Y, Ochiai T, Imagawa H, Shimoda K. The Relationship Between Baseline Clinical Symptom Characteristics and Working Ability in Japanese Patients Treated for Major Depressive Disorder and Painful Physical Symptoms. Neuropsychiatr Dis Treat 2020; 16:3063-3070. [PMID: 33335397 PMCID: PMC7737943 DOI: 10.2147/ndt.s274608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 11/20/2020] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The objective of this post hoc analysis was to explore the relationship, including changes over time, between baseline clinical symptom characteristics and working ability, judged by investigators, after 12 weeks of antidepressant monotherapy in Japanese patients with major depressive disorder (MDD) and painful physical symptoms (PPS) in a real-world clinical setting. PATIENTS AND METHODS This prospective, observational study in patients treated with duloxetine or selective serotonin reuptake inhibitors was conducted from 2014 to 2016. Both treatment groups were pooled and divided into 2 groups, "working ability recovered" or "working ability not recovered," based on working ability at the end of the study. Patients were also divided into 4 subgroups by the presence or absence of previous depressive episodes and working ability. Main outcome measures included baseline demographics and clinical characteristics, and the 17-item Hamilton Rating Scale for Depression (HAM-D17). RESULTS Comparison between "working ability recovered" (n=122) and "working ability not recovered" (n=91) showed that the percentage of patients with complications and psychotherapy at baseline, and baseline HAM-D17 total, insomnia, somatic, and anxiety scores, were significantly different. The results of subgroup analyses were mostly the same as the results analyzed by working ability alone. Although statistical differences were observed for some outcome measures, the differences at baseline, except use of psychotherapy, may not be applicable clinically, and there were no specific trends observed that could predict working ability. CONCLUSION This post hoc analysis suggested that most baseline clinical characteristics, including the presence or absence of previous depressive episodes, were not predictive of working ability recovery. However, the use of psychotherapy in parallel with antidepressant monotherapy may be positively associated with working ability recovery. All outcome measures improved over time, reinforcing the importance of continuous treatment and observation to improve and accurately judge working ability in patients with MDD and PPS.
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Affiliation(s)
- Norio Sugawara
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Norio Yasui-Furukori
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Toshinaga Tsuji
- Medical Affairs Department, Shionogi & Co., Ltd., Osaka, Japan
| | - Shinji Hayashi
- Medical Affairs Department, Shionogi & Co., Ltd., Osaka, Japan
| | | | | | - Hideyuki Imagawa
- Medicines Development Unit Japan, Eli Lilly Japan K.K., Kobe, Japan
| | - Kazutaka Shimoda
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Tochigi, Japan
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Rybacki M, Wiszniewska M, Wdówik P, Marcinkiewicz A, Pas-Wyroślak A, Śliwińska-Kowalska M, Walusiak-Skorupa J. [Health criteria and scope of workers' periodic health check-ups for selected types of work and exposure factors - Nofer Institute of Occupational Medicine guidelines]. Med Pr 2019; 70:125-137. [PMID: 30653199 DOI: 10.13075/mp.5893.00843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Workers' medical prophylactic examinations referred to in the Labor Code are one of the tasks of the occupational medicine services. They are regulated by law which has been in force for more than 20 years in unchanged form. During this period, new harmful, burdensome or dangerous to health factors appeared in the workplaces, for which no preventive health check-up standard was defined. In the meantime, the health criteria for drivers and persons applying for driving licenses have also been significantly liberalized. The above changes, the authors' own experience, comments and problems reported by physicians who provide workers' prophylactic health care and employers as well as analysis of literature related to workers' health care in other countries have created the need to harmonize and update guidelines on health requirements for selected types of work. In addition the scope and frequency of prophylactic examinations for exposures, which are not included in applicable legal acts, has been developed. Med Pr. 2019;70(1):125-37.
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Affiliation(s)
- Marcin Rybacki
- Instytut Medycyny Pracy im. prof. J. Nofera / Nofer Institute of Occupational Medicine, Łódź, Poland (Klinika Chorób Zawodowych i Zdrowia Środowiskowego, Centrum Ochrony Zdrowia Pracujących / Department of Occupational Diseases and Environmental Health, Workers' Health Protection Center).
| | - Marta Wiszniewska
- Instytut Medycyny Pracy im. prof. J. Nofera / Nofer Institute of Occupational Medicine, Łódź, Poland (Klinika Chorób Zawodowych i Zdrowia Środowiskowego, Oddział Chorób Zawodowych / Department of Occupational Diseases and Environmental Health, Department of Occupational Diseases).
| | - Paweł Wdówik
- Mazowiecki Wojewódzki Ośrodek Medycyny Pracy, Oddział w Radomiu / Mazovian Voivodeship Center of Occupational Medicine, a branch in Radom, Poland.
| | - Andrzej Marcinkiewicz
- Instytut Medycyny Pracy im. prof. J. Nofera / Nofer Institute of Occupational Medicine, Łódź, Poland (Klinika Chorób Zawodowych i Zdrowia Środowiskowego, Pracownia Polityki Zdrowotnej / Department of Occupational Diseases and Environmental Health, Health Policy Unit).
| | - Alicja Pas-Wyroślak
- Instytut Medycyny Pracy im. prof. J. Nofera / Nofer Institute of Occupational Medicine, Łódź, Poland (Klinika Chorób Zawodowych i Zdrowia Środowiskowego, Przychodnia Chorób Zawodowych / Department of Occupational Diseases and Environmental Health, Occupational Diseases Clinic).
| | - Mariola Śliwińska-Kowalska
- Instytut Medycyny Pracy im. prof. J. Nofera / Nofer Institute of Occupational Medicine, Łódź, Poland (Klinika Audiologii i Foniatrii / Audiology and Phoniatrics Clinic).
| | - Jolanta Walusiak-Skorupa
- Instytut Medycyny Pracy im. prof. J. Nofera / Nofer Institute of Occupational Medicine, Łódź, Poland (Klinika Chorób Zawodowych i Zdrowia Środowiskowego / Department of Occupational Diseases and Environmental Health).
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Waszkowska M, Wężyk A. [Psychological examinations in occupational health services: Legal regulations. Part II]. Med Pr 2018; 69:673-684. [PMID: 30468207 DOI: 10.13075/mp.5893.00732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
This paper constitutes a continuation of the critical analysis of legal aspects of psychological examinations in some group of workers. In this part the appeal procedure, documentation, costs of examinations and supervision are discussed. The analysis has shown many deficiencies in regulations related to all aspects of psychological examinations. They arise from incoherence of legal regulations and the lack of regulations of some questions. This legal standing is restricted to occupational work and adversely affects the quality of supplied services. Therefore acts of law and regulations relevant to psychological examinations for the purpose of fitness-to-work certification need necessary adjustments. According to authors it is desirable to end the legal procedure amending the act of law on a profession of psychology and the self-government of psychologists, as well as to develop and implement executive regulations. Med Pr 2018;69(6):673-684.
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Affiliation(s)
- Małgorzata Waszkowska
- Instytut Medycyny Pracy im. prof. J. Nofera / Nofer Institute of Occupational Medicine, Łódź, Poland (Zakład Psychologii Zdrowia i Pracy / Department of Health and Work Psychology).
| | - Agata Wężyk
- Instytut Medycyny Pracy im. prof. J. Nofera / Nofer Institute of Occupational Medicine, Łódź, Poland (Zakład Psychologii Zdrowia i Pracy / Department of Health and Work Psychology).
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Waszkowska M, Wężyk A. [Psychological examinations in occupational health services: Legal regulations. Part I]. Med Pr 2018; 69:561-572. [PMID: 30136706 DOI: 10.13075/mp.5893.00731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
In Poland psychological assessment for the purpose of fitness-to-work certification is regulated by the law. In the majority of cases, only psychologists registered with the occupational health services are authorized to conduct the assessment procedures. In this study 32 legal documents (17 acts and 15 directives) have been analyzed to identify the most problematic issues pertaining to psychological examination and to suggest certain changes in the regulations, as well as to raise the psychologists' awareness of the legal aspects of their work. Due to the number of the topics explored, the results of the study will be published as two separate, yet related articles. The first one concentrates on the qualifications of psychologists, the examination reference process, the aim and scope of the psychological assessment, and the validity of the assessment results. In part II other issues, not directly related to the diagnostic process, will be discussed. Med Pr 2018;69(5):561-572.
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Affiliation(s)
- Małgorzata Waszkowska
- Instytut Medycyny Pracy im. prof. J. Nofera / Nofer Institute of Occupational Medicine, Łódź, Poland (Zakład Psychologii Zdrowia i Pracy / Department of Health and Work Psychology).
| | - Agata Wężyk
- Instytut Medycyny Pracy im. prof. J. Nofera / Nofer Institute of Occupational Medicine, Łódź, Poland (Zakład Psychologii Zdrowia i Pracy / Department of Health and Work Psychology).
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Nurmela K, Mattila A, Heikkinen V, Uitti J, Ylinen A, Virtanen P. Identification of Depression and Screening for Work Disabilities among Long-Term Unemployed People. Int J Environ Res Public Health 2018; 15:E909. [PMID: 29751563 PMCID: PMC5981948 DOI: 10.3390/ijerph15050909] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 04/30/2018] [Accepted: 05/02/2018] [Indexed: 11/30/2022]
Abstract
The study explores whether clinical screening targeted at work disabilities among long-term unemployed people reveals eligible individuals for a disability pension and the importance of depression in granting the disability pensions. A total of 364 participants of the screening project were considered as eligible to apply for disability pension. Among them, 188 were diagnosed as clinically depressed. They were classified into those with earlier depression diagnosis (n = 85), those whose depression had not been diagnosed earlier (n = 103), and those without diagnosed depression (n = 176). The association of this ‘Depression identification pattern’ with being granted a disability pension was explored by logistic regression analyses. Compared to those with earlier diagnosis, those whose depression had not been diagnosed earlier were granted disability pension more commonly (72% vs. 54% OR 2.2, p = 0.012). Corresponding figures of the undepressed were 73%, OR 2.3, p = 0.002. The adjustments did not affect the results. Clinical examination of the long-term unemployed people in terms of work disability seems to be worthwhile. In particular, the examination reveals new depression diagnoses, which contribute more to the award of disability pension than depression diagnosed earlier by regular health care. Novel ways to detect depression among the unemployed should be implemented in the health and employment services.
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Affiliation(s)
- Kirsti Nurmela
- Faculty of Social Sciences, Health Sciences, University of Tampere, 33014 Tampere, Finland.
- Mental Health and Substance Abuse Services, 33900 Tampere, Finland.
| | - Aino Mattila
- Faculty of Social Sciences, Health Sciences, University of Tampere, 33014 Tampere, Finland.
- Department of Adult Psychiatry, Tampere University Hospital, 33521 Tampere, Finland.
| | - Virpi Heikkinen
- Department of Neurosciences and Rehabilitation, Tampere University Hospital, 33521 Tampere, Finland.
| | - Jukka Uitti
- Faculty of Medicine and Life Sciences, University of Tampere, 33521 Tampere, Finland.
- Clinic of Occupational Medicine, Tampere University Hospital, 33521 Tampere, Finland.
- Finnish Institute of Occupational Health, 33100 Tampere, Finland.
| | - Aarne Ylinen
- Department of Neurological Sciences, Faculty of Medicine, University of Helsinki, 00100 Helsinki, Finland.
- Department of Neurology, Helsinki University Central Hospital, 00260 Helsinki, Finland.
| | - Pekka Virtanen
- Faculty of Social Sciences, Health Sciences, University of Tampere, 33014 Tampere, Finland.
- Department of Public Health, Faculty of Medicine, Uppsala University, 75124 Uppsala, Sweden.
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Garberi C, Ravizza R, Colombo R, Borromeo F, Rossetti C, Cisini S, Motta M, Birkhoff JM. Unusual case of traumatic carotid artery dissection occurred during a work-related activity. A case report. Med Lav 2018; 110:387-390. [PMID: 30378589 PMCID: PMC7682173 DOI: 10.23749/mdl.v110i5.7642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 09/24/2018] [Indexed: 11/17/2022]
Abstract
Carotid artery dissection secondary to cervical blunt trauma is a rare and potentially life-threatening condition that can cause a variety of clinical presentations, including stroke, headache, neck pain, tinnitus, Horner syndrome and cranial neuropathies and is associated with long-term sequelae. We report a case of a 49-year-old industrial vehicles mechanic who was projected to the ground by the explosion of the tire of a heavy truck he was inflating. In the following hours he presented various neurological signs and symptoms and was admitted to the Emergency Department. During hospitalization the patient underwent clinical and instrumental investigations with AngioCT and MR finding of left internal carotid artery dissection in correspondence of its cervical segment and three acute ischemic lesions in the left temporal, parietal and occipital lobes. Medical management was successful and the patient was discharged from the hospital three weeks after the admission but he wasn't able to get back to work due to neurological sequelae. This case report illustrates that traumatic carotid artery dissection, although rare, should be considered in patients who present neurological symptoms after an explosion, can meet the criteria for a work-related injury and may lead to a permanent decrease in the ability to work.
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Affiliation(s)
- Cesare Garberi
- Department of Biotechnology and Life Sciences, University of Insubria, Italy
| | - Rossana Ravizza
- Department of Biotechnology and Life Sciences, University of Insubria, Italy
| | - Riccardo Colombo
- Department of Biotechnology and Life Sciences, University of Insubria, Italy
| | - Federica Borromeo
- Department of Biotechnology and Life Sciences, University of Insubria, Italy
| | - Chiara Rossetti
- Department of Biotechnology and Life Sciences, University of Insubria, Italy
| | - Simone Cisini
- Department of Biotechnology and Life Sciences, University of Insubria, Italy
| | - Marco Motta
- Forensic Medicine Unit, Ospedale di Circolo e Fondazione Macchi, Azienda Socio Sanitaria Territoriale dei Sette Laghi, Varese, Italy
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Kutner NG, Zhang R. Ability to Work among Patients with ESKD: Relevance of Quality Care Metrics. Healthcare (Basel) 2017; 5:E42. [PMID: 28783094 DOI: 10.3390/healthcare5030042] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 07/28/2017] [Accepted: 08/02/2017] [Indexed: 12/02/2022] Open
Abstract
Enabling patient ability to work was a key rationale for enacting the United States (US) Medicare program that provides financial entitlement to renal replacement therapy for persons with end-stage kidney disease (ESKD). However, fewer than half of working-age individuals in the US report the ability to work after starting maintenance hemodialysis (HD). Quality improvement is a well-established objective in oversight of the dialysis program, but a more patient-centered quality assessment approach is increasingly advocated. The ESKD Quality Incentive Program (QIP) initiated in 2012 emphasizes clinical performance indicators, but a newly-added measure requires the monitoring of patient depression—an issue that is important for work ability and employment. We investigated depression scores and four dialysis-specific QIP measures in relation to work ability reported by a multi-clinic cohort of 528 working-age maintenance HD patients. The prevalence of elevated depression scores was substantially higher among patients who said they were not able to work, while only one of the four dialysis-specific clinical measures differed for patients able/not able to work. Ability to work may be among patients’ top priorities. As the parameters of quality assessment continue to evolve, increased attention to patient priorities might facilitate work ability and employment outcomes.
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Abstract
A physical activity is a key factor contributing to the improvement and maintenance of one's general health. Although this issue is by no means limited to the workplace, it is precisely the work environment that can provide the basis for keeping and reinforcing more health-conscious attitudes and lifestyles, including programs promoting a physical activity. The paper presents an analysis of the literature on the effectiveness of physical activity intervention at the workplace. Particular attention is paid to the impact of the physical activity programs on musculoskeletal disorders, absenteeism, work ability, physical capacity and body weight of the participants. Given a marginal extent of programs of this kind in Poland, the authors' intention was to show the benefits resulting from implementation of and participation in such initiatives. Med Pr 2017;68(2):277-301.
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Affiliation(s)
- Marzena Malińska
- Centralny Instytut Ochrony Pracy - Państwowy Instytut Badawczy / Central Institute for Labour Protection - National Research Institute, Warszawa, Poland (Zakład Ergonomii, Pracownia Fizjologii i Higieny Pracy / Department of Ergonomics, Laboratory of Physiology and Hygiene of Work).
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Świderski P, Żaba C, Macioszek N. [Health state assessment in people sentenced to the penalty of restriction of liberty]. Med Pr 2016; 67:765-775. [PMID: 28005085 DOI: 10.13075/mp.5893.00439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Assessment of the health state of people sentenced to the penalty of restriction of liberty makes up a significant percentage of cases annually elaborated in the Department of Forensic Medicine, Poznan University of Medical Sciences. The analysis of such cases was accomplished to point out the difficulties that expert physicians could encounter in formulating their opinions. MATERIAL AND METHODS The analysis involved 1051 medico-legal opinions issued in the years 2004-2013, considering the health state of people performing the duty of free, controlled social labor. The authors collected data on age, sex, type of diseases and the ability to control social work of convicted subjects. RESULTS Among those sentenced to the penalty of restriction of liberty the men aged 51-60 were in the majority. Individuals able to work only in specified conditions were the most numerous group (56.3%). People able to work in all conditions were the smallest set (9.5%). Light work was the type of work most frequently recommended to the persons able to work only in specific conditions (58.4%). The largest group of diseases comprised spondylopathies and osteoarthropathies (51.4%). It was followed by the group of cardiac diseases and angiopathies, including hypertension (38.7%). CONCLUSIONS The number of cases concerning the ability of the sentenced persons to serve the penalty of restriction of liberty annually elaborated in the Department of Forensic Medicine, Poznan University of Medical Sciences and the number of sentences imposed on the national scale indicate that medical experts may be obliged to provide opinions of this kind. Assessment of the health state of people sentenced to the penalty of restriction of liberty in some cases can be a difficult task for the expert physicians because of frequent lack of information about a specific type of work performed by the sentenced persons having only the data about their diseases. Med Pr 2016;67(6):765-775.
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Affiliation(s)
- Paweł Świderski
- Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu / Poznan University of Medical Sciences, Poznań, Poland (Wydział Lekarski, Katedra i Zakład Medycyny Sądowej / Faculty of Medicine, Department of Forensic Medicine).
| | - Czesław Żaba
- Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu / Poznan University of Medical Sciences, Poznań, Poland (Wydział Lekarski, Katedra i Zakład Medycyny Sądowej / Faculty of Medicine, Department of Forensic Medicine)
| | - Natalia Macioszek
- Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu / Poznan University of Medical Sciences, Poznań, Poland (Wydział Lekarski, Katedra i Zakład Medycyny Sądowej / Faculty of Medicine, Department of Forensic Medicine)
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Elzi L, Conen A, Patzen A, Fehr J, Cavassini M, Calmy A, Schmid P, Bernasconi E, Furrer H, Battegay M. Ability to Work and Employment Rates in Human Immunodeficiency Virus (HIV)-1-Infected Individuals Receiving Combination Antiretroviral Therapy: The Swiss HIV Cohort Study. Open Forum Infect Dis 2016; 3:ofw022. [PMID: 26955645 PMCID: PMC4777901 DOI: 10.1093/ofid/ofw022] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 01/28/2016] [Indexed: 11/13/2022] Open
Abstract
Background. Limited data exist on human immunodeficiency virus (HIV)-infected individuals' ability to work after receiving combination antiretroviral therapy (cART). We aimed to investigate predictors of regaining full ability to work at 1 year after starting cART. Methods. Antiretroviral-naive HIV-infected individuals <60 years who started cART from January 1998 through December 2012 within the framework of the Swiss HIV Cohort Study were analyzed. Inability to work was defined as a medical judgment of the patient's ability to work as 0%. Results. Of 5800 subjects, 4382 (75.6%) were fully able to work, 471 (8.1%) able to work part time, and 947 (16.3%) were unable to work at baseline. Of the 947 patients unable to work, 439 (46.3%) were able to work either full time or part time at 1 year of treatment. Predictors of recovering full ability to work were non-white ethnicity (odds ratio [OR], 2.06; 95% confidence interval [CI], 1.20-3.54), higher education (OR, 4.03; 95% CI, 2.47-7.48), and achieving HIV-ribonucleic acid <50 copies/mL (OR, 1.83; 95% CI, 1.20-2.80). Older age (OR, 0.55; 95% CI, .42-.72, per 10 years older) and psychiatric disorders (OR, 0.24; 95% CI, .13-.47) were associated with lower odds of ability to work. Recovering full ability to work at 1 year increased from 24.0% in 1998-2001 to 41.2% in 2009-2012, but the employment rates did not increase. Conclusions. Regaining full ability to work depends primarily on achieving viral suppression, absence of psychiatric comorbidity, and favorable psychosocial factors. The discrepancy between patients' ability to work and employment rates indicates barriers to reintegration of persons infected with HIV.
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Affiliation(s)
- Luigia Elzi
- Division of Infectious Diseases and Hospital Epidemiology, Departments of Medicine and Clinical Research , University Hospital Basel
| | - Anna Conen
- Division of Infectious Diseases , Cantonal Hospital Aarau
| | - Annalea Patzen
- Division of Infectious Diseases and Hospital Epidemiology, Departments of Medicine and Clinical Research , University Hospital Basel
| | - Jan Fehr
- Division of Infectious Diseases and Hospital Epidemiology , University Hospital Zurich
| | - Matthias Cavassini
- Infectious Diseases Service, University Hospital and University of Lausanne
| | - Alexandra Calmy
- Division of Infectious Diseases , University Hospital Geneva
| | - Patrick Schmid
- Division of Infectious Diseases , Cantonal Hospital , St. Gallen
| | - Enos Bernasconi
- Division of Infectious Diseases , Regional Hospital , Lugano
| | - Hansjakob Furrer
- Department of Infectious Diseases , University Hospital Bern and University of Bern , Switzerland
| | - Manuel Battegay
- Division of Infectious Diseases and Hospital Epidemiology, Departments of Medicine and Clinical Research , University Hospital Basel
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Buchberger B, Heymann R, Huppertz H, Friepörtner K, Pomorin N, Wasem J. The effectiveness of interventions in workplace health promotion as to maintain the working capacity of health care personal. GMS Health Technol Assess 2011; 7:Doc06. [PMID: 22031811 PMCID: PMC3198117 DOI: 10.3205/hta000097] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background The increasing proportion of elderly people with respective care requirements and within the total population stands against aging personnel and staff reduction in the field of health care where employees are exposed to high load factors. Health promotion interventions may be a possibility to improve work situations and behavior. Methods A systematic literature search is conducted in 32 databases limited to English and German publications since 1990. Moreover, internet-searches are performed and the reference lists of identified articles are scanned. The selection of literature was done by two reviewers independently according to inclusion and exclusion criteria. Data extraction and tables of evidence are verified by a second expert just like the assessment of risk of bias by means of the Cochrane Collaboration’s tool. Results We identified eleven intervention studies and two systematic reviews. There were three randomized controlled trials (RCT) and one controlled trial without randomization (CCT) on the improvement of physical health, four RCT and two CCT on the improvement of psychological health and one RCT on both. Study duration ranged from four weeks to two years and the number of participants included from 20 to 345, with a median of 56. Interventions and populations were predominantly heterogeneous. In three studies intervention for the improvement of physical health resulted in less complaints and increased strength and flexibility with statistically significant differences between groups. Regarding psychological health interventions lead to significantly decreased intake of analgesics, better stress management, coping with workload, communication skills and advanced training. Discussion Taking into consideration the small to very small sample sizes, other methodological flaws like a high potential of bias and poor quality of reporting the validity of the results has to be considered as limited. Due to the heterogeneity of health interventions, study populations with differing job specializations and different lengths of study durations and follow-up periods, the comparison of results would not make sense. Conclusions Further research is necessary with larger sample sizes, with a sufficient study duration and follow-up, with a lower risk of bias, by considering of relevant quality criteria and with better reporting in publications.
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Affiliation(s)
- Barbara Buchberger
- University of Duisburg-Essen, Institute for Health Care Management and Research, Essen, Germany
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Flachenecker P, Stuke K, Elias W, Freidel M, Haas J, Pitschnau-Michel D, Schimrigk S, Zettl UK, Rieckmann P. Multiple sclerosis registry in Germany: results of the extension phase 2005/2006. Dtsch Arztebl Int 2008; 105:113-9. [PMID: 19633761 DOI: 10.3238/arztebl.2008.0113] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2006] [Accepted: 10/30/2007] [Indexed: 11/27/2022]
Abstract
INTRODUCTION In 2001, a nationwide multiple sclerosis (MS) registry was initiated in Germany under the auspices of the German MS Society, (DMSG Bundesverband e.V.). The project aimed at collecting epidemiological data and information on health care provision for MS patients in Germany. METHODS After a 2-year pilot phase, the original entry mask was modified, and new centers were recruited, resulting in the registration of a total of 5821 patients in 2005 and 2006. Following a 2 stage quality control process, standardized data sets for 5445 patients (93.5%) were able to be analyzed. RESULTS Mean duration from onset of disease to diagnosis was 3.5 years. More than 70% of patients received immunomodulatory drugs, whereas symptomatic treatments were less commonly administered. The number of participating centers as of 31 December 2006 was 57 (29 neurological hospitals, 11 rehabilitation units, 13 specialized practitioners, and 4 regional MS centers). DISCUSSION The MS registry provides valuable data on patterns of care for MS patients in Germany, and may help to improve service provision and overall quality of life for these patients.
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Affiliation(s)
- Peter Flachenecker
- Neurologisches Rehabilitationszentrum Quellenhof, Kuranlagenallee 2, Bad Wildbad, Germany.
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