Association of imbalance between job workload and functional ability with return to work in ARDS survivors

Abstract

BackgroundInability to return to work (RTW) is common after acute respiratory distress syndrome (ARDS). Mismatch in an individual’s job workload and his or her functional ability, termed work ability imbalance, is negatively associated with RTW, but has not been evaluated in ARDS survivors.ObjectWe examine associations between work ability imbalance at 6 months and RTW at 6 months and 12 months, as well as the ability to sustain employment in ARDS survivors.MethodsPreviously employed participants from the ARDS Network Long-Term Outcomes Study (N=341) were evaluated. Pre-ARDS workload was determined based on the US Occupational Information Network classification. Post-ARDS functional ability was assessed using self-reported 36-Item Short Form Health Survey (SF-36) physical functioning, social functioning and mental health subscales, and Mini-Mental State Examination. ARDS survivors were categorised into four work ability imbalance categories: none, psychosocial, physical, and both psychosocial and physical.ResultsAlmost 90% of ARDS survivors had a physical and/or psychosocial work ability imbalance at both 6-month and 12-month follow-up. Compared with survivors with no imbalance at 6 months, those with both physical and psychosocial imbalance had lower odds of RTW (6 months: OR=0.33, 95% CI=0.13 to 0.82; 12 months: OR=0.22, 95% CI=0.07 to 0.65). Thirty-eight (19%) of those who ever RTW were subsequently jobless at 12 months.ConclusionInterventions aimed at rebalancing ARDS survivors’ work ability by addressing physical and psychosocial aspects of their functional ability and workload should be explored as part of efforts to improve RTW, maintain employment and reduce the financial impact of joblessness.

Post-intensive care syndrome (PICS): recent updates

“…Patients with pain or fatigue were less likely to return to work [ 61 ]. At 6 and 12 months, the imbalance between occupational workload requirements and ARDS survivors’ functional ability occurred in 90% of ALTOS participants [ 62 ]. Furthermore, having imbalance in both physical and psychosocial areas at 6 months was significantly associated with joblessness at 6 and 12 months [ 62 ].…”

“…At 6 and 12 months, the imbalance between occupational workload requirements and ARDS survivors’ functional ability occurred in 90% of ALTOS participants [ 62 ]. Furthermore, having imbalance in both physical and psychosocial areas at 6 months was significantly associated with joblessness at 6 and 12 months [ 62 ]. The findings from these studies highlight the need to improve patient’s functional abilities, and to decrease work load via workplace accommodations for ICU survivors [ 62 , 63 ].…”

“…Furthermore, having imbalance in both physical and psychosocial areas at 6 months was significantly associated with joblessness at 6 and 12 months [ 62 ]. The findings from these studies highlight the need to improve patient’s functional abilities, and to decrease work load via workplace accommodations for ICU survivors [ 62 , 63 ].

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Recovery, rehabilitation and follow-up services following critical illness: an updated UK national cross-sectional survey and progress report

“…26 Likewise, occupational therapy is another example of a key profession that would benefit from greater prevalence within services compared with the levels seen in the current findings, especially in the context of long-term cognitive impairment in critical illness survivors, [27][28][29] and the challenges of returning to work in this patient population. [30][31][32][33] Engagement with primary care reduced from inpatient to outpatient stages of management. Partnership with primary care is key to optimising quality of critical illness recovery 34 ; qualitative exploration of unplanned hospital readmission in ICU survivors highlights many contributing themes that primary care clinicians would be ideally placed to support during recovery, for example, multimorbidity, polypharmacy, inadequate social support and challenges with specialist equipment.…”

Acute respiratory distress syndrome in adults: diagnosis, outcomes, long-term sequelae, and management

“…133,[136][137][138][139][140] Kamdar and colleagues 139,140 have shown that 44% of previously employed survivors of ARDS were jobless at 1 year, and at 5 years 30% had never returned to work. Su and colleagues 141 found that one in five survivors of ARDS who had returned to work were subsequently unable to sustain work. In another study, Brown and colleagues 138 showed the percentage of survivors of ARDS living independently at home at 6 months reduced from a pre-existing baseline of 91% to 45% at 6 months.…”