BACKGROUND Return to work(RTW)serves as an indication for young and middle-aged colorectal cancer(CRC)survivors to resume their normal social lives.However,these survivors encounter significant challenges during their...BACKGROUND Return to work(RTW)serves as an indication for young and middle-aged colorectal cancer(CRC)survivors to resume their normal social lives.However,these survivors encounter significant challenges during their RTW process.Hence,scientific research is necessary to explore the barriers and facilitating factors of returning to work for young and middle-aged CRC survivors.AIM To examine the current RTW status among young and middle-aged CRC survivors and to analyze the impact of RTW self-efficacy(RTW-SE),fear of progression(FoP),eHealth literacy(eHL),family resilience(FR),and financial toxicity(FT)on their RTW outcomes.METHODS A cross-sectional investigation was adopted in this study.From September 2022 to February 2023,a total of 209 participants were recruited through a convenience sampling method from the gastrointestinal surgery department of a class A tertiary hospital in Chongqing.The investigation utilized a general information questionnaire alongside scales assessing RTW-SE,FoP,eHL,FR,and FT.To analyze the factors that influence RTW outcomes among young and middle-aged CRC survivors,Cox regression modeling and Kaplan-Meier survival analysis were used.RESULTS A total of 43.54%of the participants successfully returned to work,with an average RTW time of 100 days.Cox regression univariate analysis revealed that RTW-SE,FoP,eHL,FR,and FT were significantly different between the non-RTW and RTW groups(P<0.05).Furthermore,Cox regression multivariate analysis identified per capita family monthly income,job type,RTW-SE,and FR as independent influencing factors for RTW(P<0.05).CONCLUSION The RTW rate requires further improvement.Elevated levels of RTW-SE and FR were found to significantly increase RTW among young and middle-aged CRC survivors.Health professionals should focus on modifiable factors,such as RTW-SE and FR,to design targeted RTW support programs,thereby facilitating their timely reintegration into mainstream society.展开更多
BACKGROUND Return to work(RTW)and resumption of driving(ROD)are critical factors that influence postoperative quality of life in patients undergoing total hip arthroplasty(THA).However,few studies have focused on the ...BACKGROUND Return to work(RTW)and resumption of driving(ROD)are critical factors that influence postoperative quality of life in patients undergoing total hip arthroplasty(THA).However,few studies have focused on the minimally invasive(MIS)approach and its effect on these outcomes.AIM To investigate RTW and ROD's timelines and influencing factors following anterior MIS-THA.METHODS A retrospective analysis was conducted on 124 patients who underwent anterior MIS-THA.Data on the demographics,occupational physical demands,and RTW/ROD timelines were also collected.Clinical outcomes were measured using standardised scoring systems.Statistical analyses were performed to evaluate the differences between the groups based on employment status and physical workload.RESULTS Among employed patients,the RTW rate was 94.7%,with an average return time of five weeks.The average ROD time was 3.5 weeks across all patients.Despite similar postoperative clinical scores,RTW time was significantly influenced by occupations'physical workload,with heavier physical demands associated with delayed RTW.CONCLUSION Anterior MIS-THA facilitates early RTW and ROD,particularly in occupations with lower physical demands.These findings highlight the importance of considering occupational and physical workload in postoperative care planning to optimize recovery outcomes.展开更多
Objective:To investigate the employment status,employment readiness,and other factors affecting the ease or difficulty with which breast cancer patients effect their return to work(RTW).Methods:This study adopted a mi...Objective:To investigate the employment status,employment readiness,and other factors affecting the ease or difficulty with which breast cancer patients effect their return to work(RTW).Methods:This study adopted a mixed-method design,recruiting participants from among breast cancer patients in a cancer hospital in Hunan from December 2018 to June 2019.We approached 300 individuals,192 of whom ultimately participated in this study.The quantitative part of the study involved several scales:the Patient Health Questionnaire-9(PHQ-9),the Brief Fatigue Inventory(BFI),the Work Ability Index(WAI),and the Lam Assessment of Employment Readiness(LASER).The qualitative part involved a set of open-ended questions and written responses collected from 41 participants who had already returned to work at the time of data collection.Their written responses mainly concerned factors influencing RTW.Results:Forty-one breast cancer patients had returned to work.The results reported a median total Cognitive Symptom Checklist score of 9.00(6.00,15.25),a median WAI score of 5.00(3.50,9.75),a median BFI score of 26.00(14.75,42.00),a median total PHQ-9 score of 8.00(5.25,17.00),and a LASER score of 50.35±11.90.Multiple regression analysis showed that the participants’cancer stage,cognitive limitations,depression,fatigue,and work ability were significant predictors of employment readiness(P<0.05).Exploring the qualitative data,we found that higher skill levels,better social support,and a flexible work schedule facilitated RTW;stress,lack of confidence in one’s work skills,depression,and fatigue are all possible barriers to RTW.Conclusion:The findings indicate that breast cancer patients have a low level of employment readiness.Nurses and other healthcare providers can develop relevant interventions to promote employment readiness and ultimately achieve RTW in this study population.展开更多
Introduction: Motorcyclists bear a disproportionate burden of morbidity and mortality from road accidents. In addition, the consequences of these accidents affect the ability of victims to return to work. This study a...Introduction: Motorcyclists bear a disproportionate burden of morbidity and mortality from road accidents. In addition, the consequences of these accidents affect the ability of victims to return to work. This study aimed to determine the prevalence and factors associated with non-return to work among surviving motorcyclists involved in road accidents 12 months after the event. Materials and Methods: It was a cross-sectional study conducted using data from a cohort of motorcyclists involved in accidents and recruited in five hospitals in Benin from July 2019 to January 2020. The dependent variable was non-return to work 12 months after the accident (yes vs no). The independent variables were categorized into two groups: baseline and 12-month follow-up variables. Logistic regression was used to determine the factors associated with non-return to work at 12 months among the participants. Results: Among the 362 participants, 55 (15.19%, 95% CI = 11.84 - 19.29) had not returned to work 12 months after the accident. Risk factors for non-return to work identified were: smoking (aOR = 4.41, 95% CI = 1.44 - 13.56, p = 0.010), hospitalization (aOR = 2.87, 95% CI = 1.14 - 7.24, p Conclusion: The prevalence of non-return to work at 12 months was high among surviving motorcyclists involved in road accidents in Benin. Integrated support for patients based on identified risk factors should effectively improve their return to work.展开更多
BACKGROUND Many patients prioritize the ability to return to work(RTW)after shoulder replacement surgeries such as total shoulder arthroplasty(TSA),reverse TSA(rTSA),and shoulder hemiarthroplasty(HA).Due to satisfacto...BACKGROUND Many patients prioritize the ability to return to work(RTW)after shoulder replacement surgeries such as total shoulder arthroplasty(TSA),reverse TSA(rTSA),and shoulder hemiarthroplasty(HA).Due to satisfactory clinical and functional long-term outcomes,the number of shoulder replacements performed will continue to rise into this next decade.With younger individuals who compose a significant amount of the workforce receiving shoulder replacements,patients will begin to place a higher priority on their ability to RTW following shoulder arthroplasty.AIM To summarize RTW outcomes following TSA,rTSA,and HA,and analyze the effects of workers’compensation status on RTW rates and ability.METHODS This systematic review and analysis was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.A literature search regarding RTW following shoulder arthroplasty was performed using four databases(PubMed,Scopus,Embase,and Cochrane Library),and the Reference Citation Analysis(https://www.referencecitationanalysis.com/).All studies in English relevant to shoulder arthroplasty and RTW through January 2021 that had a level of evidence I to IV were included.Nonclinical studies,literature reviews,case reports,and those not reporting on RTW after shoulder arthroplasty were excluded.RESULTS The majority of patients undergoing TSA,rTSA,or HA were able to RTW betweenone to four months,depending on work demand stratification.While sedentary or light demand jobs generally have higher rates of RTW,moderate or heavy demand jobs tend to have poorer rates of return.The rates of RTW following TSA(71%-93%)were consistently higher than those reported for HA(69%-82%)and rTSA(56%-65%).Furthermore,workers’compensation status negatively influenced clinical outcomes following shoulder arthroplasty.Through a pooled means analysis,we proposed guidelines for the average time to RTW after TSA,rTSA,and HA.For TSA,rTSA,and HA,the average time to RTW regardless of work demand stratification was 1.93±3.74 mo,2.3±2.4 mo,and 2.29±3.66 mo,respectively.CONCLUSION The majority of patients are able to RTW following shoulder arthroplasty.Understanding outcomes for rates of RTW following shoulder arthroplasty would assist in managing expectations in clinical practice.展开更多
Objectives: Aging workforces with increasing numbers of chronic conditions require health initiatives with greater workplace focus. A regional pension insurance introduced a Return To Work (RTW) strategy for insurants...Objectives: Aging workforces with increasing numbers of chronic conditions require health initiatives with greater workplace focus. A regional pension insurance introduced a Return To Work (RTW) strategy for insurants with chronic conditions. The objective was to identify the degree of implementation of work related measures in medical rehabilitation and the extent of RTW outcomes. Methods: 5883 insurants were considered. Severe Restriction of Work Ability (SRWA), Work-related Medical Rehabilitation (WMR), and Case Management (CM) were examined for 2008 and 2012. An Index of Employment status (IoE) was used in a logistic regression. Results: Utilization of WMR raised from 12.3% in 2008 to 66.1% in 2012. The proportion of insurants with SRWA and WMR grew from 8% up to 40.1%. In 2008, 14.7% of insurants with SRWA received WMR;in 2012, it grew to 76.6%. On the other hand, in 2012 26% got WMR without SRWA and 12.2% had SRWA and got no WMR. CM was not conducted in 2008 but reached 20.2% in 2012. Across all indications, WMR resulted in positive RTW as measured by IoE: OR = 0.75 (KI-95%: 0.67 - 0.86). Conclusion: WMR was successfully implemented according to the German guideline. There is a need to optimize the linkage between SRWA and WMR and CM to provide need-based care.展开更多
BACKGROUND There has been an increasing focus in recent years on health-care disparities.Studies investigating return to work(RTW)or sports are often performed in large,urban areas.Relatively few studies have investig...BACKGROUND There has been an increasing focus in recent years on health-care disparities.Studies investigating return to work(RTW)or sports are often performed in large,urban areas.Relatively few studies have investigated rates of return to farming or other heavy labor that is of interest to patients in rural areas.AIM To evaluate the literature regarding RTW in farming or heavy labor after orthopedic hip,knee,or shoulder surgery.METHODS A search was performed in the PubMed and EMBASE databases using Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines.Studies were included if they reported patients employed in farming or heavy labor,RTW rates after orthopedic surgery of the hip,knee,or shoulder,and had a minimum 6-month follow-up.A meta-analysis of proportions using a random-effects model was performed on three single-arm observational studies to estimate the pooled RTW rate following arthroscopic shoulder surgery.RESULTS Ten studies were included,and 101 farmers were identified among 440 total patients.One study involved hip surgery,two studies involved knee surgery,and seven studies involved shoulder surgery.RTW rates across studies varied by type of surgery and follow-up interval,ranging from 24%to 100%.The RTW rate was only 53.6%at 1 year following total hip arthroplasty.No studies investigated RTW in farmers following total knee arthroplasty.Among non-comparative studies,meta-analysis revealed a pooled RTW rate of 89%following arthroscopic shoulder surgery,with low heterogeneity(I^(2)=30.1%).Among comparative studies,one study reported significantly higher RTW odds for patients undergoing anatomic total shoulder arthroplasty compared to reverse shoulder arthroplasty(odds ratio=5.45).Overall,surgical intervention for shoulder pathology was associated with a high likelihood of RTW across multiple techniques,with particularly favorable outcomes for anatomic total shoulder arthroplasty.CONCLUSION This systematic review highlights the high rates of RTW in farmers and heavy laborers after shoulder surgery.However,our findings also underscore the need for more rural-specific research to guide patient counseling,rehabilitation expectations,and shared decision-making in this underserved population,particularly for orthopedic surgery of the hip and knee.展开更多
Background:Burn injury may be associated with long-term rehabilitation and disability,while research studies on the functional performance after injuries,quality of life(QOL),and abilities to return to work of burn pa...Background:Burn injury may be associated with long-term rehabilitation and disability,while research studies on the functional performance after injuries,quality of life(QOL),and abilities to return to work of burn patients are limited.These outcomes are related not just to the degree and nature of injuries,but also to the socio-economical background of the society.This study aimed to identify the factors which might affect burn patients’abilities to reintegrate back to the society based on a sample in China's Mainland.Methods:A retrospective study was conducted to collect data of demographic characteristics,medical data about burn injuries,physical and psychological status,and self-perceived QOL at the initial phase and upon discharge from a rehabilitation hospital,timing of rehabilitation,and duration of rehabilitation intervention.Four hundred fifteen patients with burn injuries were recruited in the study.Multiple linear regression and logistic regression were used to obtain a model to predict the functional abilities and the perceived QOL at discharge and their changes during rehabilitation,as well as the post-injury work status within 6 months after discharge.Results:The functional performance at discharge and its change were significantly predicted by the functional abilities and QOL at the admission,duration of treatment,timing of rehabilitation,payer source,and total body surface area burned.The perceived QOL at discharge and its change were significantly predicted by the baseline QOL at admission and duration of treatment.The significant predictors of work status within 6 months post-discharge included age,education,payer source,total body surface area burned,perceived QOL,and bodily pain at admission.Conclusions:The present study identified a number of factors affecting the rehabilitation outcomes of people with burn injuries.Identification of these predictors may help clinicians assess the rehabilitation potential of burn survivors and assist in resource allocation.Policy makers should ensure that resources are adequate to improve the outcomes based on these factors.展开更多
Purpose:Upper limb disorders are one of the most common and important types of occupational injuries.Besides,identifying the factors influencing return to work following these injuries is essential to reduce the dimen...Purpose:Upper limb disorders are one of the most common and important types of occupational injuries.Besides,identifying the factors influencing return to work following these injuries is essential to reduce the dimensions of the problem.In this study,we investigated the return to work and associated factors following occupational injuries leading to upper limb impairment.Methods:In this retrospective cohort study,the rate of return to work and associated factors were assessed in 256 workers with work-related upper limb injury referred to a teaching hospital from March 2011 to December 2018.The inclusion criterion was a history of occupational injury resulting in upper limb impairment,and exclusion criteria included the presence of simultaneous impairment in other organs,congenital or non-occupational limb defects as well as patients with incomplete information in their medical records.Individuals’’ records,including age at the time of injury,gender,date of injury,marital status,education,level of amputation and injury,whole person impairment (WPI) and physiotherapy (prescribed by the physician) were reviewed.The WPI was calculated to assess the extent of the injury.All analyzes were performed by SPSS version 25.0.Result:The rate of return to work was 54.3%,in which 51.8% for the same job and 48.2% for a new job.The main factors associated with non-return to work were more days off work (p = 0.001),higher injury severity (p = 0.001),and dominant hand injury (p = 0.034).Conclusion:The number of days off work,the WPI,and dominant hand injury are the most important determinant in returning to work.In addition,increased job satisfaction and support from co-workers and employers are work-related factors that can lead to an increased return to work.展开更多
BACKGROUND Besides return to work(RTW)and return to sports(RTS),patients also prefer to return to daily activities(RTA)such as walking,sleeping,grocery shopping,and domestic work following total knee arthroplasty(TKA)...BACKGROUND Besides return to work(RTW)and return to sports(RTS),patients also prefer to return to daily activities(RTA)such as walking,sleeping,grocery shopping,and domestic work following total knee arthroplasty(TKA).However,evidence on the timelines and probability of patients’RTA is sparse.AIM To assess the percentage of patients able to RTA,RTW,and RTS after TKA,as well as the timeframe and influencing factors of this return.METHODS A retrospective cohort study with prospectively collected data was conducted at a medium-sized Dutch orthopedic hospital.Assessments of RTA,RTW,and RTS were performed at 3 mo and/or 6 mo following TKA.Investigated factors en-compassed patient characteristics,surgical characteristics,and preoperative patient-reported outcomes.RESULTS TKA patients[n=2063;66 years old(interquartile range[IQR]:7 years);47%male;28 kg/m2(IQR:4 kg/m2)]showed RTA ranging from 28%for kneeling to 94%for grocery shopping,with 20 d(IQR:27 d)spent for putting on shoes to 74 d(IQR:57 d)for kneeling.RTW rates varied from 62%for medium-impact work to 87%for low-impact work,taking 33 d(IQR:29 d)to 78 d(IQR:55 d).RTS ranged from 48%for medium-impact sports to 90%for low-impact sports,occurring within 43 d(IQR:24 d)to 90 d(IQR:60 d).One or more of the investigated factors influenced the return to each of the 14 activities examined,with R²values ranging from 0.013 to 0.127.CONCLUSION Approximately 80%of patients can RTA,RTW,and RTS within 6 mo after TKA.Return is not consistently in-fluenced by predictive factors.Results help set realistic pre-and postoperative expectations.展开更多
BACKGROUND Lateral ankle sprains are the most common traumatic musculoskeletal injuries of the lower extremity,with an incidence rate of 15%-20%.The high incidence and prevalence highlights the economic impact of this...BACKGROUND Lateral ankle sprains are the most common traumatic musculoskeletal injuries of the lower extremity,with an incidence rate of 15%-20%.The high incidence and prevalence highlights the economic impact of this injury.Ankle sprains lead to a high socioeconomic burden due to the combination of the high injury incidence and high medical expenses.Up to 40%of patients who suffer from an ankle sprain develop chronic ankle instability.Chronic instability can lead to prolonged periods of pain,immobility and injury recurrence.Identification of factors that influence return to work(RTW)and return to sports(RTS)after a lateral ankle sprain(LAS)may help seriously reduce healthcare costs.AIM To explore which factors may potentially affect RTW and RTS after sustaining an LAS.METHODS EMBASE and PubMed were systematically searched for relevant studies published until June 2023.Inclusion criteria were as follows:(1)Injury including LAS or chronic ankle instability;(2)Described any form of treatment;(3)Assessment of RTW or RTS;(4)Studies published in English;and(5)Study designs including randomized controlled clinical trials,clinical trials or cohort studies.Exclusion criteria were:(1)Studies involving children(age<16 year);or(2)Patients with concomitant ankle injury besides lateral ankle ligament damage.A quality assessment was performed for each of the included studies using established risk of bias tools.Additionally quality of evidence was assessed using the GRADEpro tool in cases where outcomes were included in the quantitative analysis.A best evidence synthesis was performed in cases of qualitative outcome analysis.For all studied outcomes suitable for quantitative analysis a forest plot was created to calculate the effect on RTW and RTS.RESULTS A total of 8904 patients were included in 21 studies,10 randomized controlled trials,7 retrospective cohort studies and 4 prospective cohort studies.Fifteen studies were eligible for meta-analysis.The overall RTS rate ranged were 80%and 83%in the all treatments pool and surgical treatments pool,respectively.The pooled mean days to RTS ranged from 23-93 d.The overall RTW rate was 89%.The pooled mean time to RTW ranged from 5.8-8.1 d.For patients with chronic ankle instability,higher preoperative motivation was the sole factor significantly and independently(P=0.001)associated with the rate of and time to RTS following ligament repair or reconstruction.Higher body mass index was identified as a significant factor(P=0.04)linked to not resuming sports or returning at a lower level(median 24,range 20-37),compared to those who resumed at the same or higher level(median 23,range 17-38).Patients with a history of psychological illness or brain injury,experienced a delay in their rehabilitation process for sprains with fractures and unspecified sprains.The extent of the delayed rehabilitation was directly proportional to the increased likelihood of experiencing a recurrence of the ankle sprain and the number of ankle-related medical visits.We also observed that 10%of athletes who did return to sport after lateral ankle sprain without fractures described non-ankle-related reasons for not returning.CONCLUSION All treatments yielded comparable results,with each treatment potentially offering unique advantages or benefits.Preoperative motivation may influence rehabilitation after LAS.Grading which factor had a greater impact was not possible due to the lack of comparability among the included patients.展开更多
AIM To prospectively investigate the time taken and patients' ability to resume preoperative level of physical activity after gastrocnemius recession. METHODS Endoscopic gastrocnemius recession(EGR) was performed ...AIM To prospectively investigate the time taken and patients' ability to resume preoperative level of physical activity after gastrocnemius recession. METHODS Endoscopic gastrocnemius recession(EGR) was performed on 48 feet in 46 consecutive sportspersons, with a minimum follow-up of 24 mo. The Halasi Ankle Activity Score was used to quantify the level of physical activity. Time taken to return to work and physical activity was recorded. Functional outcomes were evaluated using the short form 36(SF-36), American Orthopedic Foot and Ankle Society(AOFAS) Hindfoot score and modified Olerud and Molander(O and M) scores respectively. Patient's satisfaction and pain experienced were assessed using a modified Likert scale and visual analogue scales. P-value < 0.05 was considered statistically significant.RESULTS Ninety-one percent(n = 42) of all patients returned to their preoperative level of physical activity after EGR. The mean time for return to physical activity was 7.5(2-24) mo. Ninety-eight percent(n = 45) of all patients were able to return to their preoperative employment status, with a mean time of 3.6(1-12) mo. Ninety-six percent(n = 23) of all patients with an activity score > 2 were able to resume their preoperative level of physical activity in mean time of 8.8 mo, as compared to 86%(n = 19) of patients whose activity score was ≤ 2, with mean time of 6.1 mo. Significant improvements were noted in SF-36, AOFAS hindfoot and modified O and M scores. Ninety percent of all patients rated good or very good outcomes on the Likert scale.CONCLUSION The majority of patients were able to return to their pre-operative level of sporting activity after EGR.展开更多
This editorial critically evaluated the recent study by Ishikura et al,which examined the impact of anterior minimally invasive total hip arthroplasty(MISTHA)on postoperative quality of life,with a specific focus on t...This editorial critically evaluated the recent study by Ishikura et al,which examined the impact of anterior minimally invasive total hip arthroplasty(MISTHA)on postoperative quality of life,with a specific focus on the timeline and influencing factors for return to work and resumption of driving.Ishikura et al's research demonstrated that anterior MIS-THA could shorten recovery time,reduce postoperative pain,and significantly enhance patients'quality of life and productivity.Their findings identified occupational type and work intensity as key determinants of postoperative recovery.By synthesizing evidence from multiple studies,this analysis systematically evaluated the clinical advantages of anterior MIS-THA—including reduced soft tissue trauma and accelerated functional recovery—while acknowledging its limitations,such as a steep surgical learning curve and early postoperative complication risks.The discussion emphasized the necessity of designing personalized rehabilitation protocols that accounted for patients'occupational demands.Notably,while current findings primarily derived from retrospective analyses,the article highlighted the need for prospective cohort studies to validate these observations.The commentary also addressed ongoing debates in the field,particularly the elevated complication rates associated with the direct anterior approach compared to posterior techniques,thereby underscoring the critical role of surgeon expertise in optimizing procedural safety.Collectively,this evaluation advanced our understanding of postoperative recovery dynamics in anterior MIS-THA and provides evidencebased insights to refine clinical rehabilitation frameworks.展开更多
<strong>Background:</strong> Health-related quality of life (HRQOL) is affected for many years following cancer treatment. With an increasing number of long-term cancer survivors, HRQOL will be a key conce...<strong>Background:</strong> Health-related quality of life (HRQOL) is affected for many years following cancer treatment. With an increasing number of long-term cancer survivors, HRQOL will be a key concern in the future. There is a lack of qualitative studies investigating long-term cancer survivors’ needs and experience of late effects and HRQOL. <strong>Objective:</strong> The aim of this sub-study is to describe cancer survivors’ own experience of late effects affecting HRQOL six to eight years after diagnosis. <strong>Methods:</strong> We used a qualitative methodology with semi-structured focus group interviews to gain an in-depth understanding of participants’ experience of their HRQOL. Interviews were audio-recorded, transcribed and analyzed using thematic analysis. <strong>Results: </strong>All of the participants reported late effects at some point after the treatment. Some of the experienced late effects had improved over the years, while the late effects mentioned in this article were still prominent six to eight years after the diagnosis. They described, among others, late effects such as reduced physical strength, cognitive difficulties, lack of energy and increased sensitivity. The participants described the late effects as bearable, but still affecting their HRQOL by limiting their activity level, their ability to work and their social interactions.<strong> Conclusions: </strong>Six to eight years post-treatment, cancer survivors still experienced physical and cognitive late effects affecting their HRQOL. The findings indicate that some late effects affect HRQOL for a long time. To prepare cancer survivors for post-treatment life and to optimize their HRQOL, they need information concerning potential late effects before, during and after cancer treatment, as well as support services and follow-up in the municipalities.展开更多
Background: Researches about work limitations related to cancer treatment and survival are recent. This study describes the characteristics of patients who keep their work and house work activities during radiotherapy...Background: Researches about work limitations related to cancer treatment and survival are recent. This study describes the characteristics of patients who keep their work and house work activities during radiotherapy, and comparison between some disease data and leaving out those activities. Methods: Data were collected from medical records of patients admitted in a Brazilian Radiotherapy Private Health Service. Descriptive statistical analysis was performed, as hypotheses texts, Chi-square and Fisher’s exact test. Results: Data of 111 individuals were presented;being 65.77% of workers of paid activities and 34.34% of careers of home. Between employees, 50.7% kept their job activities, and 92.1% between house workers. The association between absence from work activities and tumor type (primary or metastasis) and between absence and KPS (p < 0.05) were observed. Discussion: It is observed that breast, brain and lung tumors significantly affect employees’ performance, causing the withdrawal of workers from their activities. Data from the literature review clearly demonstrated the importance of work activities in social support of the worker, but his overall performance may be impaired. Implications for cancer survivors: The study indicates the need for assessment of the individual, work or activity environment and required as well as the continuity research aiming at the development and validation of evaluation tools such as questionnaires or scales.展开更多
BACKGROUND Electrical burns are devastating injuries and can cause deep burns with significant morbidity and delayed sequelae.Epidemiological data regarding the etiology,socioeconomic differences and geographic variat...BACKGROUND Electrical burns are devastating injuries and can cause deep burns with significant morbidity and delayed sequelae.Epidemiological data regarding the etiology,socioeconomic differences and geographic variation are necessary to assess the disease burden and plan an effective preventive strategy.These severe injuries often lead to amputations and thus hamper quality of life in the long term AIM To identify the population at maximum risk of sustaining electrical burns.We also studied the impact of electrical burns on these patients in terms of quality of life as well as return to work.METHODS The study was conducted at a tertiary referral teaching hospital over a period of eighteen months.All patients with a history of sustaining electrical burns and satisfying the inclusion criteria were included in the study.All relevant epidemiological parameters and treatment details were recorded.The patients were subsequently followed up at 3 mo,6 mo and 9 mo.The standardized Brief Version of the Burn Specic Health Scale(BSHS-B)was adopted to assess quality of life.Statistical analysis was conducted using IBM SPSS statistics(version 22.0).A P value of<0.05 was considered statistically significant.RESULTS A total of 103 patients were included in the study.The mean age of the patients was 31.83 years(range 18-75 years).A significant majority(91.3%)of patients were male.The mean total body surface area(TBSA)in these patients was 21.1%.In most of the patients(67%),the injury was occupation-related.High voltage injuries were implicated in 72.8%of patients.Among the 75 high voltage burn patients,31(41%)required amputation.The mean number of surgeries the patients underwent in hospital was 2.03(range 1 to 4).The quality of life parameters amongst the patients sustaining high voltage electrical burns were poorer when compared to low voltage injuries at all follow-up intervals across nine domains.In eight of these domains,the difference was statistically significant.Similarly,the scores among the amputees were poorer when compared to non-amputees.The difference was statistically significant in six domains.CONCLUSION Electrical burns remain a problem in the developing world.Most injuries are occupation-related.The quality of life in patients with high voltage burns and amputees remains poor.Work resumption was almost impossible for amputees.These patients could not regain pre-injury status.Steps should be taken to create awareness and to implement an effective preventive strategy to safeguard against electrical injuries.展开更多
Purpose: To examine the benefits from a vocational rehabilitation program for patients suffering from Acquired Brain Injury (ABI) in terms of quality of life, and overall health. In addition, to examine the direct soc...Purpose: To examine the benefits from a vocational rehabilitation program for patients suffering from Acquired Brain Injury (ABI) in terms of quality of life, and overall health. In addition, to examine the direct societal costs of healthcare interventions related to vocational rehabilitation and indirect societal costs related to production loss. Method: Identified interventions in 45 patients with ABI who were discharged from a vocational rehabilitation program between 2010 and 2011 were documented, classified and translated into costs. Expenses associated with production loss were calculated by comparing sick leave production loss at first contact with the team, with sick leave production loss at discharge. Health related QoL and overall health, was measured at first contact and at discharge by using the EQ5D. Results: For vocational rehabilitation interventions, mean costs were €6303/individual/month. At first contact with the team, mean production loss was estimated to be €4409/individual/month compared;at discharge to be €2446. QoL ratings increased from first contact to discharge, although estimated health did not change. At discharge, significant correlations were found between QoL ratings and estimated health and the extent of production loss展开更多
Burninjury significantly impacts the victim's long-term quality of life, both physical y and psychosocial y. This prospective, observational study aimed to assess the physical and psychological health status in ad...Burninjury significantly impacts the victim's long-term quality of life, both physical y and psychosocial y. This prospective, observational study aimed to assess the physical and psychological health status in adult burn survivors in Sydney Australia using the Burns Specific Health Scale-Brief Version (BSHS-B) questionnaire, together with analysis of the baseline demographic data col ected from medical records. A total of 24 adult acute burn victims admitted consecutively to the Burns Unit at Concord Repatriation General Hospital, Sydney, Australia between March 2007 and February 2009 fulfil ed the inclusion criteria and participated in the study. The BSHS-B questionnaire (which includes nine domains or subscales) was administered to al 24 participants in person at time of discharge and by mail 6, 12, and 24 months post discharge. By 12 months, 11 participants dropped out and the final analysis was performed on the remaining 13 participants. The analyzed results showed that: 1) Perceived return to work was the only variable that continued to change with time at 12 months after discharge (P < 0.01);2) At 12 months;return to work was significantly correlated with simple functional ability (P < 0.05), heat sensitivity (P < 0.01), and treatment regimes (P < 0.05), but no longer with affect and body image as demonstrated at 6 months. In summary, our findings have shown that the perception of returning to work changes significantly with time post discharge and this perception is affected by certain subscales of the BSHS-B. Given that return to work is one of the most important outcome concerns and issues of recovery for adult burn injury victims and families, it is essential that therapists be aware of the factors influencing return to work and address these factors through a comprehensive rehabilitation program.展开更多
基金Supported by the Chongqing Medical University Program for Youth Innovation in Future Medicine,No.W0019Chongqing Municipal Education Commission’s 14th Five-Year Key Discipline Support Project,No.20240101 and No.20240102。
文摘BACKGROUND Return to work(RTW)serves as an indication for young and middle-aged colorectal cancer(CRC)survivors to resume their normal social lives.However,these survivors encounter significant challenges during their RTW process.Hence,scientific research is necessary to explore the barriers and facilitating factors of returning to work for young and middle-aged CRC survivors.AIM To examine the current RTW status among young and middle-aged CRC survivors and to analyze the impact of RTW self-efficacy(RTW-SE),fear of progression(FoP),eHealth literacy(eHL),family resilience(FR),and financial toxicity(FT)on their RTW outcomes.METHODS A cross-sectional investigation was adopted in this study.From September 2022 to February 2023,a total of 209 participants were recruited through a convenience sampling method from the gastrointestinal surgery department of a class A tertiary hospital in Chongqing.The investigation utilized a general information questionnaire alongside scales assessing RTW-SE,FoP,eHL,FR,and FT.To analyze the factors that influence RTW outcomes among young and middle-aged CRC survivors,Cox regression modeling and Kaplan-Meier survival analysis were used.RESULTS A total of 43.54%of the participants successfully returned to work,with an average RTW time of 100 days.Cox regression univariate analysis revealed that RTW-SE,FoP,eHL,FR,and FT were significantly different between the non-RTW and RTW groups(P<0.05).Furthermore,Cox regression multivariate analysis identified per capita family monthly income,job type,RTW-SE,and FR as independent influencing factors for RTW(P<0.05).CONCLUSION The RTW rate requires further improvement.Elevated levels of RTW-SE and FR were found to significantly increase RTW among young and middle-aged CRC survivors.Health professionals should focus on modifiable factors,such as RTW-SE and FR,to design targeted RTW support programs,thereby facilitating their timely reintegration into mainstream society.
基金approved by the Institutional Ethics Committee of Shizuoka Red Cross Hospital(No.2023-36,approval date:January 12,2024).
文摘BACKGROUND Return to work(RTW)and resumption of driving(ROD)are critical factors that influence postoperative quality of life in patients undergoing total hip arthroplasty(THA).However,few studies have focused on the minimally invasive(MIS)approach and its effect on these outcomes.AIM To investigate RTW and ROD's timelines and influencing factors following anterior MIS-THA.METHODS A retrospective analysis was conducted on 124 patients who underwent anterior MIS-THA.Data on the demographics,occupational physical demands,and RTW/ROD timelines were also collected.Clinical outcomes were measured using standardised scoring systems.Statistical analyses were performed to evaluate the differences between the groups based on employment status and physical workload.RESULTS Among employed patients,the RTW rate was 94.7%,with an average return time of five weeks.The average ROD time was 3.5 weeks across all patients.Despite similar postoperative clinical scores,RTW time was significantly influenced by occupations'physical workload,with heavier physical demands associated with delayed RTW.CONCLUSION Anterior MIS-THA facilitates early RTW and ROD,particularly in occupations with lower physical demands.These findings highlight the importance of considering occupational and physical workload in postoperative care planning to optimize recovery outcomes.
基金This research was funded by the National Natural Science Foundation of China(Grant#:72004039).
文摘Objective:To investigate the employment status,employment readiness,and other factors affecting the ease or difficulty with which breast cancer patients effect their return to work(RTW).Methods:This study adopted a mixed-method design,recruiting participants from among breast cancer patients in a cancer hospital in Hunan from December 2018 to June 2019.We approached 300 individuals,192 of whom ultimately participated in this study.The quantitative part of the study involved several scales:the Patient Health Questionnaire-9(PHQ-9),the Brief Fatigue Inventory(BFI),the Work Ability Index(WAI),and the Lam Assessment of Employment Readiness(LASER).The qualitative part involved a set of open-ended questions and written responses collected from 41 participants who had already returned to work at the time of data collection.Their written responses mainly concerned factors influencing RTW.Results:Forty-one breast cancer patients had returned to work.The results reported a median total Cognitive Symptom Checklist score of 9.00(6.00,15.25),a median WAI score of 5.00(3.50,9.75),a median BFI score of 26.00(14.75,42.00),a median total PHQ-9 score of 8.00(5.25,17.00),and a LASER score of 50.35±11.90.Multiple regression analysis showed that the participants’cancer stage,cognitive limitations,depression,fatigue,and work ability were significant predictors of employment readiness(P<0.05).Exploring the qualitative data,we found that higher skill levels,better social support,and a flexible work schedule facilitated RTW;stress,lack of confidence in one’s work skills,depression,and fatigue are all possible barriers to RTW.Conclusion:The findings indicate that breast cancer patients have a low level of employment readiness.Nurses and other healthcare providers can develop relevant interventions to promote employment readiness and ultimately achieve RTW in this study population.
文摘Introduction: Motorcyclists bear a disproportionate burden of morbidity and mortality from road accidents. In addition, the consequences of these accidents affect the ability of victims to return to work. This study aimed to determine the prevalence and factors associated with non-return to work among surviving motorcyclists involved in road accidents 12 months after the event. Materials and Methods: It was a cross-sectional study conducted using data from a cohort of motorcyclists involved in accidents and recruited in five hospitals in Benin from July 2019 to January 2020. The dependent variable was non-return to work 12 months after the accident (yes vs no). The independent variables were categorized into two groups: baseline and 12-month follow-up variables. Logistic regression was used to determine the factors associated with non-return to work at 12 months among the participants. Results: Among the 362 participants, 55 (15.19%, 95% CI = 11.84 - 19.29) had not returned to work 12 months after the accident. Risk factors for non-return to work identified were: smoking (aOR = 4.41, 95% CI = 1.44 - 13.56, p = 0.010), hospitalization (aOR = 2.87, 95% CI = 1.14 - 7.24, p Conclusion: The prevalence of non-return to work at 12 months was high among surviving motorcyclists involved in road accidents in Benin. Integrated support for patients based on identified risk factors should effectively improve their return to work.
文摘BACKGROUND Many patients prioritize the ability to return to work(RTW)after shoulder replacement surgeries such as total shoulder arthroplasty(TSA),reverse TSA(rTSA),and shoulder hemiarthroplasty(HA).Due to satisfactory clinical and functional long-term outcomes,the number of shoulder replacements performed will continue to rise into this next decade.With younger individuals who compose a significant amount of the workforce receiving shoulder replacements,patients will begin to place a higher priority on their ability to RTW following shoulder arthroplasty.AIM To summarize RTW outcomes following TSA,rTSA,and HA,and analyze the effects of workers’compensation status on RTW rates and ability.METHODS This systematic review and analysis was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.A literature search regarding RTW following shoulder arthroplasty was performed using four databases(PubMed,Scopus,Embase,and Cochrane Library),and the Reference Citation Analysis(https://www.referencecitationanalysis.com/).All studies in English relevant to shoulder arthroplasty and RTW through January 2021 that had a level of evidence I to IV were included.Nonclinical studies,literature reviews,case reports,and those not reporting on RTW after shoulder arthroplasty were excluded.RESULTS The majority of patients undergoing TSA,rTSA,or HA were able to RTW betweenone to four months,depending on work demand stratification.While sedentary or light demand jobs generally have higher rates of RTW,moderate or heavy demand jobs tend to have poorer rates of return.The rates of RTW following TSA(71%-93%)were consistently higher than those reported for HA(69%-82%)and rTSA(56%-65%).Furthermore,workers’compensation status negatively influenced clinical outcomes following shoulder arthroplasty.Through a pooled means analysis,we proposed guidelines for the average time to RTW after TSA,rTSA,and HA.For TSA,rTSA,and HA,the average time to RTW regardless of work demand stratification was 1.93±3.74 mo,2.3±2.4 mo,and 2.29±3.66 mo,respectively.CONCLUSION The majority of patients are able to RTW following shoulder arthroplasty.Understanding outcomes for rates of RTW following shoulder arthroplasty would assist in managing expectations in clinical practice.
文摘Objectives: Aging workforces with increasing numbers of chronic conditions require health initiatives with greater workplace focus. A regional pension insurance introduced a Return To Work (RTW) strategy for insurants with chronic conditions. The objective was to identify the degree of implementation of work related measures in medical rehabilitation and the extent of RTW outcomes. Methods: 5883 insurants were considered. Severe Restriction of Work Ability (SRWA), Work-related Medical Rehabilitation (WMR), and Case Management (CM) were examined for 2008 and 2012. An Index of Employment status (IoE) was used in a logistic regression. Results: Utilization of WMR raised from 12.3% in 2008 to 66.1% in 2012. The proportion of insurants with SRWA and WMR grew from 8% up to 40.1%. In 2008, 14.7% of insurants with SRWA received WMR;in 2012, it grew to 76.6%. On the other hand, in 2012 26% got WMR without SRWA and 12.2% had SRWA and got no WMR. CM was not conducted in 2008 but reached 20.2% in 2012. Across all indications, WMR resulted in positive RTW as measured by IoE: OR = 0.75 (KI-95%: 0.67 - 0.86). Conclusion: WMR was successfully implemented according to the German guideline. There is a need to optimize the linkage between SRWA and WMR and CM to provide need-based care.
文摘BACKGROUND There has been an increasing focus in recent years on health-care disparities.Studies investigating return to work(RTW)or sports are often performed in large,urban areas.Relatively few studies have investigated rates of return to farming or other heavy labor that is of interest to patients in rural areas.AIM To evaluate the literature regarding RTW in farming or heavy labor after orthopedic hip,knee,or shoulder surgery.METHODS A search was performed in the PubMed and EMBASE databases using Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines.Studies were included if they reported patients employed in farming or heavy labor,RTW rates after orthopedic surgery of the hip,knee,or shoulder,and had a minimum 6-month follow-up.A meta-analysis of proportions using a random-effects model was performed on three single-arm observational studies to estimate the pooled RTW rate following arthroscopic shoulder surgery.RESULTS Ten studies were included,and 101 farmers were identified among 440 total patients.One study involved hip surgery,two studies involved knee surgery,and seven studies involved shoulder surgery.RTW rates across studies varied by type of surgery and follow-up interval,ranging from 24%to 100%.The RTW rate was only 53.6%at 1 year following total hip arthroplasty.No studies investigated RTW in farmers following total knee arthroplasty.Among non-comparative studies,meta-analysis revealed a pooled RTW rate of 89%following arthroscopic shoulder surgery,with low heterogeneity(I^(2)=30.1%).Among comparative studies,one study reported significantly higher RTW odds for patients undergoing anatomic total shoulder arthroplasty compared to reverse shoulder arthroplasty(odds ratio=5.45).Overall,surgical intervention for shoulder pathology was associated with a high likelihood of RTW across multiple techniques,with particularly favorable outcomes for anatomic total shoulder arthroplasty.CONCLUSION This systematic review highlights the high rates of RTW in farmers and heavy laborers after shoulder surgery.However,our findings also underscore the need for more rural-specific research to guide patient counseling,rehabilitation expectations,and shared decision-making in this underserved population,particularly for orthopedic surgery of the hip and knee.
基金This study was supported by Cynthia Tang Memorial Scholarship,Department of Rehabilitation Sciences,The Hong Kong Polytechnic University
文摘Background:Burn injury may be associated with long-term rehabilitation and disability,while research studies on the functional performance after injuries,quality of life(QOL),and abilities to return to work of burn patients are limited.These outcomes are related not just to the degree and nature of injuries,but also to the socio-economical background of the society.This study aimed to identify the factors which might affect burn patients’abilities to reintegrate back to the society based on a sample in China's Mainland.Methods:A retrospective study was conducted to collect data of demographic characteristics,medical data about burn injuries,physical and psychological status,and self-perceived QOL at the initial phase and upon discharge from a rehabilitation hospital,timing of rehabilitation,and duration of rehabilitation intervention.Four hundred fifteen patients with burn injuries were recruited in the study.Multiple linear regression and logistic regression were used to obtain a model to predict the functional abilities and the perceived QOL at discharge and their changes during rehabilitation,as well as the post-injury work status within 6 months after discharge.Results:The functional performance at discharge and its change were significantly predicted by the functional abilities and QOL at the admission,duration of treatment,timing of rehabilitation,payer source,and total body surface area burned.The perceived QOL at discharge and its change were significantly predicted by the baseline QOL at admission and duration of treatment.The significant predictors of work status within 6 months post-discharge included age,education,payer source,total body surface area burned,perceived QOL,and bodily pain at admission.Conclusions:The present study identified a number of factors affecting the rehabilitation outcomes of people with burn injuries.Identification of these predictors may help clinicians assess the rehabilitation potential of burn survivors and assist in resource allocation.Policy makers should ensure that resources are adequate to improve the outcomes based on these factors.
文摘Purpose:Upper limb disorders are one of the most common and important types of occupational injuries.Besides,identifying the factors influencing return to work following these injuries is essential to reduce the dimensions of the problem.In this study,we investigated the return to work and associated factors following occupational injuries leading to upper limb impairment.Methods:In this retrospective cohort study,the rate of return to work and associated factors were assessed in 256 workers with work-related upper limb injury referred to a teaching hospital from March 2011 to December 2018.The inclusion criterion was a history of occupational injury resulting in upper limb impairment,and exclusion criteria included the presence of simultaneous impairment in other organs,congenital or non-occupational limb defects as well as patients with incomplete information in their medical records.Individuals’’ records,including age at the time of injury,gender,date of injury,marital status,education,level of amputation and injury,whole person impairment (WPI) and physiotherapy (prescribed by the physician) were reviewed.The WPI was calculated to assess the extent of the injury.All analyzes were performed by SPSS version 25.0.Result:The rate of return to work was 54.3%,in which 51.8% for the same job and 48.2% for a new job.The main factors associated with non-return to work were more days off work (p = 0.001),higher injury severity (p = 0.001),and dominant hand injury (p = 0.034).Conclusion:The number of days off work,the WPI,and dominant hand injury are the most important determinant in returning to work.In addition,increased job satisfaction and support from co-workers and employers are work-related factors that can lead to an increased return to work.
文摘BACKGROUND Besides return to work(RTW)and return to sports(RTS),patients also prefer to return to daily activities(RTA)such as walking,sleeping,grocery shopping,and domestic work following total knee arthroplasty(TKA).However,evidence on the timelines and probability of patients’RTA is sparse.AIM To assess the percentage of patients able to RTA,RTW,and RTS after TKA,as well as the timeframe and influencing factors of this return.METHODS A retrospective cohort study with prospectively collected data was conducted at a medium-sized Dutch orthopedic hospital.Assessments of RTA,RTW,and RTS were performed at 3 mo and/or 6 mo following TKA.Investigated factors en-compassed patient characteristics,surgical characteristics,and preoperative patient-reported outcomes.RESULTS TKA patients[n=2063;66 years old(interquartile range[IQR]:7 years);47%male;28 kg/m2(IQR:4 kg/m2)]showed RTA ranging from 28%for kneeling to 94%for grocery shopping,with 20 d(IQR:27 d)spent for putting on shoes to 74 d(IQR:57 d)for kneeling.RTW rates varied from 62%for medium-impact work to 87%for low-impact work,taking 33 d(IQR:29 d)to 78 d(IQR:55 d).RTS ranged from 48%for medium-impact sports to 90%for low-impact sports,occurring within 43 d(IQR:24 d)to 90 d(IQR:60 d).One or more of the investigated factors influenced the return to each of the 14 activities examined,with R²values ranging from 0.013 to 0.127.CONCLUSION Approximately 80%of patients can RTA,RTW,and RTS within 6 mo after TKA.Return is not consistently in-fluenced by predictive factors.Results help set realistic pre-and postoperative expectations.
文摘BACKGROUND Lateral ankle sprains are the most common traumatic musculoskeletal injuries of the lower extremity,with an incidence rate of 15%-20%.The high incidence and prevalence highlights the economic impact of this injury.Ankle sprains lead to a high socioeconomic burden due to the combination of the high injury incidence and high medical expenses.Up to 40%of patients who suffer from an ankle sprain develop chronic ankle instability.Chronic instability can lead to prolonged periods of pain,immobility and injury recurrence.Identification of factors that influence return to work(RTW)and return to sports(RTS)after a lateral ankle sprain(LAS)may help seriously reduce healthcare costs.AIM To explore which factors may potentially affect RTW and RTS after sustaining an LAS.METHODS EMBASE and PubMed were systematically searched for relevant studies published until June 2023.Inclusion criteria were as follows:(1)Injury including LAS or chronic ankle instability;(2)Described any form of treatment;(3)Assessment of RTW or RTS;(4)Studies published in English;and(5)Study designs including randomized controlled clinical trials,clinical trials or cohort studies.Exclusion criteria were:(1)Studies involving children(age<16 year);or(2)Patients with concomitant ankle injury besides lateral ankle ligament damage.A quality assessment was performed for each of the included studies using established risk of bias tools.Additionally quality of evidence was assessed using the GRADEpro tool in cases where outcomes were included in the quantitative analysis.A best evidence synthesis was performed in cases of qualitative outcome analysis.For all studied outcomes suitable for quantitative analysis a forest plot was created to calculate the effect on RTW and RTS.RESULTS A total of 8904 patients were included in 21 studies,10 randomized controlled trials,7 retrospective cohort studies and 4 prospective cohort studies.Fifteen studies were eligible for meta-analysis.The overall RTS rate ranged were 80%and 83%in the all treatments pool and surgical treatments pool,respectively.The pooled mean days to RTS ranged from 23-93 d.The overall RTW rate was 89%.The pooled mean time to RTW ranged from 5.8-8.1 d.For patients with chronic ankle instability,higher preoperative motivation was the sole factor significantly and independently(P=0.001)associated with the rate of and time to RTS following ligament repair or reconstruction.Higher body mass index was identified as a significant factor(P=0.04)linked to not resuming sports or returning at a lower level(median 24,range 20-37),compared to those who resumed at the same or higher level(median 23,range 17-38).Patients with a history of psychological illness or brain injury,experienced a delay in their rehabilitation process for sprains with fractures and unspecified sprains.The extent of the delayed rehabilitation was directly proportional to the increased likelihood of experiencing a recurrence of the ankle sprain and the number of ankle-related medical visits.We also observed that 10%of athletes who did return to sport after lateral ankle sprain without fractures described non-ankle-related reasons for not returning.CONCLUSION All treatments yielded comparable results,with each treatment potentially offering unique advantages or benefits.Preoperative motivation may influence rehabilitation after LAS.Grading which factor had a greater impact was not possible due to the lack of comparability among the included patients.
文摘AIM To prospectively investigate the time taken and patients' ability to resume preoperative level of physical activity after gastrocnemius recession. METHODS Endoscopic gastrocnemius recession(EGR) was performed on 48 feet in 46 consecutive sportspersons, with a minimum follow-up of 24 mo. The Halasi Ankle Activity Score was used to quantify the level of physical activity. Time taken to return to work and physical activity was recorded. Functional outcomes were evaluated using the short form 36(SF-36), American Orthopedic Foot and Ankle Society(AOFAS) Hindfoot score and modified Olerud and Molander(O and M) scores respectively. Patient's satisfaction and pain experienced were assessed using a modified Likert scale and visual analogue scales. P-value < 0.05 was considered statistically significant.RESULTS Ninety-one percent(n = 42) of all patients returned to their preoperative level of physical activity after EGR. The mean time for return to physical activity was 7.5(2-24) mo. Ninety-eight percent(n = 45) of all patients were able to return to their preoperative employment status, with a mean time of 3.6(1-12) mo. Ninety-six percent(n = 23) of all patients with an activity score > 2 were able to resume their preoperative level of physical activity in mean time of 8.8 mo, as compared to 86%(n = 19) of patients whose activity score was ≤ 2, with mean time of 6.1 mo. Significant improvements were noted in SF-36, AOFAS hindfoot and modified O and M scores. Ninety percent of all patients rated good or very good outcomes on the Likert scale.CONCLUSION The majority of patients were able to return to their pre-operative level of sporting activity after EGR.
文摘This editorial critically evaluated the recent study by Ishikura et al,which examined the impact of anterior minimally invasive total hip arthroplasty(MISTHA)on postoperative quality of life,with a specific focus on the timeline and influencing factors for return to work and resumption of driving.Ishikura et al's research demonstrated that anterior MIS-THA could shorten recovery time,reduce postoperative pain,and significantly enhance patients'quality of life and productivity.Their findings identified occupational type and work intensity as key determinants of postoperative recovery.By synthesizing evidence from multiple studies,this analysis systematically evaluated the clinical advantages of anterior MIS-THA—including reduced soft tissue trauma and accelerated functional recovery—while acknowledging its limitations,such as a steep surgical learning curve and early postoperative complication risks.The discussion emphasized the necessity of designing personalized rehabilitation protocols that accounted for patients'occupational demands.Notably,while current findings primarily derived from retrospective analyses,the article highlighted the need for prospective cohort studies to validate these observations.The commentary also addressed ongoing debates in the field,particularly the elevated complication rates associated with the direct anterior approach compared to posterior techniques,thereby underscoring the critical role of surgeon expertise in optimizing procedural safety.Collectively,this evaluation advanced our understanding of postoperative recovery dynamics in anterior MIS-THA and provides evidencebased insights to refine clinical rehabilitation frameworks.
文摘<strong>Background:</strong> Health-related quality of life (HRQOL) is affected for many years following cancer treatment. With an increasing number of long-term cancer survivors, HRQOL will be a key concern in the future. There is a lack of qualitative studies investigating long-term cancer survivors’ needs and experience of late effects and HRQOL. <strong>Objective:</strong> The aim of this sub-study is to describe cancer survivors’ own experience of late effects affecting HRQOL six to eight years after diagnosis. <strong>Methods:</strong> We used a qualitative methodology with semi-structured focus group interviews to gain an in-depth understanding of participants’ experience of their HRQOL. Interviews were audio-recorded, transcribed and analyzed using thematic analysis. <strong>Results: </strong>All of the participants reported late effects at some point after the treatment. Some of the experienced late effects had improved over the years, while the late effects mentioned in this article were still prominent six to eight years after the diagnosis. They described, among others, late effects such as reduced physical strength, cognitive difficulties, lack of energy and increased sensitivity. The participants described the late effects as bearable, but still affecting their HRQOL by limiting their activity level, their ability to work and their social interactions.<strong> Conclusions: </strong>Six to eight years post-treatment, cancer survivors still experienced physical and cognitive late effects affecting their HRQOL. The findings indicate that some late effects affect HRQOL for a long time. To prepare cancer survivors for post-treatment life and to optimize their HRQOL, they need information concerning potential late effects before, during and after cancer treatment, as well as support services and follow-up in the municipalities.
文摘Background: Researches about work limitations related to cancer treatment and survival are recent. This study describes the characteristics of patients who keep their work and house work activities during radiotherapy, and comparison between some disease data and leaving out those activities. Methods: Data were collected from medical records of patients admitted in a Brazilian Radiotherapy Private Health Service. Descriptive statistical analysis was performed, as hypotheses texts, Chi-square and Fisher’s exact test. Results: Data of 111 individuals were presented;being 65.77% of workers of paid activities and 34.34% of careers of home. Between employees, 50.7% kept their job activities, and 92.1% between house workers. The association between absence from work activities and tumor type (primary or metastasis) and between absence and KPS (p < 0.05) were observed. Discussion: It is observed that breast, brain and lung tumors significantly affect employees’ performance, causing the withdrawal of workers from their activities. Data from the literature review clearly demonstrated the importance of work activities in social support of the worker, but his overall performance may be impaired. Implications for cancer survivors: The study indicates the need for assessment of the individual, work or activity environment and required as well as the continuity research aiming at the development and validation of evaluation tools such as questionnaires or scales.
文摘BACKGROUND Electrical burns are devastating injuries and can cause deep burns with significant morbidity and delayed sequelae.Epidemiological data regarding the etiology,socioeconomic differences and geographic variation are necessary to assess the disease burden and plan an effective preventive strategy.These severe injuries often lead to amputations and thus hamper quality of life in the long term AIM To identify the population at maximum risk of sustaining electrical burns.We also studied the impact of electrical burns on these patients in terms of quality of life as well as return to work.METHODS The study was conducted at a tertiary referral teaching hospital over a period of eighteen months.All patients with a history of sustaining electrical burns and satisfying the inclusion criteria were included in the study.All relevant epidemiological parameters and treatment details were recorded.The patients were subsequently followed up at 3 mo,6 mo and 9 mo.The standardized Brief Version of the Burn Specic Health Scale(BSHS-B)was adopted to assess quality of life.Statistical analysis was conducted using IBM SPSS statistics(version 22.0).A P value of<0.05 was considered statistically significant.RESULTS A total of 103 patients were included in the study.The mean age of the patients was 31.83 years(range 18-75 years).A significant majority(91.3%)of patients were male.The mean total body surface area(TBSA)in these patients was 21.1%.In most of the patients(67%),the injury was occupation-related.High voltage injuries were implicated in 72.8%of patients.Among the 75 high voltage burn patients,31(41%)required amputation.The mean number of surgeries the patients underwent in hospital was 2.03(range 1 to 4).The quality of life parameters amongst the patients sustaining high voltage electrical burns were poorer when compared to low voltage injuries at all follow-up intervals across nine domains.In eight of these domains,the difference was statistically significant.Similarly,the scores among the amputees were poorer when compared to non-amputees.The difference was statistically significant in six domains.CONCLUSION Electrical burns remain a problem in the developing world.Most injuries are occupation-related.The quality of life in patients with high voltage burns and amputees remains poor.Work resumption was almost impossible for amputees.These patients could not regain pre-injury status.Steps should be taken to create awareness and to implement an effective preventive strategy to safeguard against electrical injuries.
文摘Purpose: To examine the benefits from a vocational rehabilitation program for patients suffering from Acquired Brain Injury (ABI) in terms of quality of life, and overall health. In addition, to examine the direct societal costs of healthcare interventions related to vocational rehabilitation and indirect societal costs related to production loss. Method: Identified interventions in 45 patients with ABI who were discharged from a vocational rehabilitation program between 2010 and 2011 were documented, classified and translated into costs. Expenses associated with production loss were calculated by comparing sick leave production loss at first contact with the team, with sick leave production loss at discharge. Health related QoL and overall health, was measured at first contact and at discharge by using the EQ5D. Results: For vocational rehabilitation interventions, mean costs were €6303/individual/month. At first contact with the team, mean production loss was estimated to be €4409/individual/month compared;at discharge to be €2446. QoL ratings increased from first contact to discharge, although estimated health did not change. At discharge, significant correlations were found between QoL ratings and estimated health and the extent of production loss
文摘Burninjury significantly impacts the victim's long-term quality of life, both physical y and psychosocial y. This prospective, observational study aimed to assess the physical and psychological health status in adult burn survivors in Sydney Australia using the Burns Specific Health Scale-Brief Version (BSHS-B) questionnaire, together with analysis of the baseline demographic data col ected from medical records. A total of 24 adult acute burn victims admitted consecutively to the Burns Unit at Concord Repatriation General Hospital, Sydney, Australia between March 2007 and February 2009 fulfil ed the inclusion criteria and participated in the study. The BSHS-B questionnaire (which includes nine domains or subscales) was administered to al 24 participants in person at time of discharge and by mail 6, 12, and 24 months post discharge. By 12 months, 11 participants dropped out and the final analysis was performed on the remaining 13 participants. The analyzed results showed that: 1) Perceived return to work was the only variable that continued to change with time at 12 months after discharge (P < 0.01);2) At 12 months;return to work was significantly correlated with simple functional ability (P < 0.05), heat sensitivity (P < 0.01), and treatment regimes (P < 0.05), but no longer with affect and body image as demonstrated at 6 months. In summary, our findings have shown that the perception of returning to work changes significantly with time post discharge and this perception is affected by certain subscales of the BSHS-B. Given that return to work is one of the most important outcome concerns and issues of recovery for adult burn injury victims and families, it is essential that therapists be aware of the factors influencing return to work and address these factors through a comprehensive rehabilitation program.
