Vocational Rehabilitation in Dialyzed Patients

Abstract

The physicians in charge of 15 German hemodialysis units furnished data on 713 dialysis patients. Data relating to the vocational status were examined for 612 patients aged 60 years or below. It was found that the current working status varies with psychological and social factors. The data show that the vocational status is importantly influenced by the premorbid profession, the level of schooling and by the conditions of the local labor market. With the exception of severe complications or secondary diseases, no relation existed between the somatic state and the current working status. As assessed by the physicians in charge, most dialysis patients were able to work part time, but unable to work full time. Lack of facilities for, or financial disincentives against, part time employment are felt to be the single most important obstacle to vocational rehabilitation of dialysis patients.

The diagnosis of major depression in renal dialysis patients.

“…The relationship between depression and unemployment requires further elucidation. Psychologic (27) and social (28) factors are important predictors of the employment status of dialysis patients. Unemployment may contribute to depression (25) or may occur secondary to psychologic impairment.…”

Coping with chronic life-threatening illness: Psychosocial perspectives on end stage renal disease.

“…The most cogent summary concerning rehabilitation in ESRD appears as the title of an editorial in the New England Journal of Medicine (Rennie, 1981): "Renal rehabilitation -Where are the data?" Although several articles have appeared (Calsyn, Sherrard, Hyerstay & Freeman, 1981;Gutman, Stead & Robinson, 1981;Kutner & Cardenas, 1981;Rosenbaum, Atcherson & Corry, 1981;Tews, Schreiber, Huber, Zelt & Ritz, 1980), it is difficult to draw firm conclusions. The Gutman et al (1981) article is perhaps the best and consists of a survey of 2,482 ESRD patients at 18 centers in the U.S.A.; but, as the authors point out, their sampling was biased, the method of assessment probably varied among centers, their survey instruments were not validated, and the data were collected through social workers' ratings as opposed to patient report.…”

The Problem of Fatigue in Dialysis Patients

“…It is interesting that the majority of patients who had mild fatigue or no fatigue were not active in either a job or student role. As Tews et al [10] have noted, lack of employment among dialysis patients is fostered by lack of opportunities for part-time employment and by financial disincentives such as receipt of disability benefits.…”