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Frändemark Å, Törnblom H, Simrén M, Jakobsson S. Maintaining work life under threat of symptoms: a grounded theory study of work life experiences in persons with Irritable Bowel Syndrome. BMC Gastroenterol 2022; 22:73. [PMID: 35183112 PMCID: PMC8858507 DOI: 10.1186/s12876-022-02158-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 02/15/2022] [Indexed: 12/31/2022] Open
Abstract
Background Irritable Bowel Syndrome (IBS) is a highly prevalent functional gastrointestinal disorder. Earlier studies have shown that IBS can limit the ability to perform at work and lead to absenteeism. However, few studies focus on work life experiences based on patients’ narratives. The purpose of this study was to construct a theory for how persons with IBS maintain their work life. Methods A qualitative study was performed using constructivist grounded theory. Semi-structured interviews with 15 women and 8 men with IBS (26–64 years of age) were conducted. Fourteen participants worked full-time, six worked part-time and three were on sick leave. The interviews were transcribed verbatim and coded line-by-line, incident-by-incident and thereafter focused coding was done. From the data and codes, categories were generated. Finally, a core category was constructed explaining the process of maintaining work life when living with IBS. Results Balancing work life while being under threat of symptoms constituted of four categories, being prepared, restricting impact, reconciling and adjusting. Persons with IBS restricted the impact of IBS on work by using strategies and upholding daily routines and strived to being prepared by exerting control over work life. These ongoing processes served to limit the influence of IBS on work by symptoms being less intense, perceived as less frequent, or not as bothersome. Reconciling IBS with work life was understood as a successful outcome from being prepared and restricting impact but was also influenced by the individual’s outlook on life. Adjusting to other people at work interfered with the strategies of being prepared, restricting impact, and reconciling, leaving persons with IBS more susceptible to symptoms. Conclusions This study deepens the understanding of the work situation for persons with IBS. Health care professionals can use the results of this study in the dialogue with the patient discussing work ability and sick leave. The results imply that although balancing work life under threat of symptoms can be a struggle, there are strategies that persons with IBS and employers together can initiate and use to reduce impact on work on several different levels.
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McCormack C, Cullivan S, Kehoe B, McCaffrey N, Gaine S, McCullagh B, Moyna NM, Hardcastle SJ. "It is the fear of exercise that stops me" - attitudes and dimensions influencing physical activity in pulmonary hypertension patients. Pulm Circ 2021; 11:20458940211056509. [PMID: 34777786 PMCID: PMC8573491 DOI: 10.1177/20458940211056509] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 10/12/2021] [Indexed: 11/16/2022] Open
Abstract
Pulmonary hypertension is a progressive cardiorespiratory disease that is characterized by considerable morbidity and mortality. While physical activity can improve symptoms and quality of life, engagement in this population is suboptimal. The aim of this study was to explore attitudes towards exercise and the dimensions that influence physical activity participation in individuals with pulmonary hypertension. Virtual, semi-structured interviews were conducted with individuals, with a formal diagnosis of pulmonary hypertension. Participants were recruited through the Pulmonary Hypertension Association of Ireland. Interviews were transcribed and analysed using thematic analysis. Nineteen patients were interviewed (n = 19). There was a female preponderance (n = 13) and the mean age was 50 ± 12 years. Three themes were identified and included fear, perceived value of exercise and environmental factors. Fear was the primary theme and included three sub-themes of fear of (i) over-exertion, (ii) physical damage and (iii) breathlessness. The perceived value of exercise encompassed two distinct sub-themes of perceived (i) exercise importance and (ii) benefits of exercise. Environmental factors included the terrain, weather conditions and location. Fear of overexertion, harm and dyspnoea strongly influenced attitudes to and engagement in physical activity. This study revealed heterogenous patient perspectives regarding the importance of physical activity and exercise. Future interventions that mitigate fear and promote the value of physical activity for individuals with pulmonary hypertension may have considerable benefits in promoting physical activity engagement. Such interventions require multidisciplinary involvement, including specialised pulmonary hypertension clinicians and exercise and behaviour change specialists.
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Affiliation(s)
- Ciara McCormack
- School of Health & Human Performance, Dublin City University, Dublin, Ireland
- National Pulmonary Hypertension Unit, Mater Misericordiae University Hospital, Dublin, Ireland
- Ciara McCormack, School of Health & Human Performance, Dublin City University, Glasnevin Campus, Glasnevin, Dublin 9, Ireland.
| | - Sarah Cullivan
- National Pulmonary Hypertension Unit, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Brona Kehoe
- Department of Sport & Exercise Science, Waterford Institute of Technology, Waterford City, Ireland
| | | | - Sean Gaine
- National Pulmonary Hypertension Unit, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Brian McCullagh
- National Pulmonary Hypertension Unit, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Niall M. Moyna
- School of Health & Human Performance, Dublin City University, Dublin, Ireland
| | - Sarah J. Hardcastle
- School of Health & Human Performance, Dublin City University, Dublin, Ireland
- Institute for Health Research, University of Notre Dame, Fremantle, Western Australia
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3
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Naser AY, Mansour MM, Alanazi AFR, Sabha O, Alwafi H, Jalal Z, Paudyal V, Dairi MS, Salawati EM, Alqahtan JS, Alaamri S, Mustafa Ali MK. Hospital admission trends due to respiratory diseases in England and Wales between 1999 and 2019: an ecologic study. BMC Pulm Med 2021; 21:356. [PMID: 34749696 PMCID: PMC8573565 DOI: 10.1186/s12890-021-01736-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 11/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Identifying trends of hospital admissions for respiratory diseases is crucial for public health and research to guide future clinical improvements for better outcomes. This study aims to define the trends of respiratory disease-related hospital admissions (RRHA) in England and Wales between 1999 and 2019. METHODS An ecological study was conducted using hospital admission data taken from the Hospital Episode Statistics database in England and the Patient Episode Database for Wales. Hospital admissions data for respiratory diseases were extracted for the period between April 1999 and March 2019. The trend in hospital admissions was assessed using a Poisson model. RESULTS Hospital admission rate increased by 104.7% [from 1535.05 (95% CI 1531.71-1538.38) in 1999 to 3142.83 (95% CI 3138.39-3147.26) in 2019 per 100,000 persons, trend test, p < 0.01]. The most common causes were influenza and pneumonia, chronic lower respiratory diseases, other acute lower respiratory infections, which accounted for 26.6%, 26.4%, and 14.9%, respectively. The age group 75 years and above accounted for 34.1% of the total number of hospital admissions. Males contributed to 50.5% of the total number of hospital admissions. Hospital admission rate in females increased by 119.8% [from 1442.18 (95% CI 1437.66-1446.70) in 1999 to 3169.38 (95% CI 3163.11-3175.64) in 2019 per 100,000 persons, trend test, p < 0.001]. Hospital admission rate increased by 92.9% in males [from 1633.25 (95% CI 1628.32-1638.17) in 1999 to 3149.78 (95% CI 3143.46-3156.09) in 2019 per 100,000 persons, trend test, p < 0.001]. CONCLUSION During the study period, hospital admissions rate due to respiratory diseases increased sharply. The rates of hospital admissions were higher among males for the vast majority of respiratory diseases. Further observational studies are warranted to identify risk factors for these hospital admissions and to offer relevant interventions to mitigate the risk.
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Affiliation(s)
- Abdallah Y Naser
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman, 11622, Jordan.
| | - Munthir M Mansour
- Department of Internal Medicine, University of Arkansas for Medical Center, Little Rock, AR, 72205, USA
| | - Abeer F R Alanazi
- Department of Pharmaceutical and Biological Sciences, UCL School of Pharmacy, London, UK
| | - Omar Sabha
- Al Khalidi Hospital and Medical Center, Amman, 11183, Jordan
| | - Hassan Alwafi
- Faculty of Medicine, Umm Al Qura University, Mecca, 21514, Saudi Arabia
| | - Zahraa Jalal
- School of Pharmacy, Institute of Clinical Sciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - Vibhu Paudyal
- School of Pharmacy, Institute of Clinical Sciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - Mohammad S Dairi
- Faculty of Medicine, Umm Al Qura University, Mecca, 21514, Saudi Arabia
| | - Emad M Salawati
- Family Medicine Department, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Jaber S Alqahtan
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | - Shalan Alaamri
- Faculty of Medicine, Jeddah University, Jeddah, 24231, Saudi Arabia
| | - Moaath K Mustafa Ali
- Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD, 20742, USA
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Blakey SM, Halverson TF, Evans MK, Patel TA, Hair LP, Meyer EC, DeBeer BB, Beckham JC, Pugh MJ, Calhoun PS, Kimbrel NA. Experiential avoidance is associated with medical and mental health diagnoses in a national sample of deployed Gulf War veterans. J Psychiatr Res 2021; 142:17-24. [PMID: 34314990 PMCID: PMC8429252 DOI: 10.1016/j.jpsychires.2021.07.033] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/17/2021] [Accepted: 07/21/2021] [Indexed: 12/14/2022]
Abstract
A substantial minority of deployed Gulf War veterans developed posttraumatic stress disorder (PTSD), depression, and several chronic illnesses. Although military combat and exposure to certain nuclear, biological, and chemical agents (NBCs) increase risk for post-deployment health problems, they do not fully explain many Gulf War veteran health diagnoses and are not viable treatment targets. Experiential avoidance (EA; one's unwillingness to remain in contact with unpleasant internal experiences) is a modifiable psychosocial risk factor associated with PTSD and depression in veterans as well as pain and gastrointestinal diseases in the general population. In this study, we recruited a national sample of deployed Gulf War veterans (N = 454) to test the hypothesis that greater EA would be significantly associated with higher lifetime odds of PTSD, depression, "Gulf War Illness" (GWI/CMI), and other chronic illnesses common in this veteran cohort. Participants completed a self-report battery assessing demographic, military-related, and health-related information. Multivariate analyses showed that after adjusting for age, sex, race, combat exposure, and NBC exposure, worse EA was associated with higher lifetime odds of PTSD, depression GWI/CMI, gastrointestinal problems, irritable bowel syndrome, arthritis, fibromyalgia, and chronic fatigue syndrome (ORs ranged 1.25 to 2.89; effect sizes ranged small to large), but not asthma or chronic obstructive pulmonary disease. Our findings suggest medical and mental health providers alike should assess for EA and potentially target EA as part of a comprehensive, biopsychosocial approach to improving Gulf War veterans' health and wellbeing. Study limitations and future research directions are also discussed.
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Affiliation(s)
- Shannon M Blakey
- Durham VA Health Care System, 508 Fulton Street, Durham, NC, 27705, USA; VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, 3022 Croasdaile Dr., Durham, NC, 27705, USA.
| | - Tate F Halverson
- Durham VA Health Care System, 508 Fulton Street, Durham, NC, 27705, USA.
| | - Mariah K Evans
- Duke University School of Medicine Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, DUMC 3625, Durham, NC, 27710, USA.
| | - Tapan A Patel
- Durham VA Health Care System, 508 Fulton Street, Durham, NC, 27705, USA.
| | - Lauren P Hair
- Durham VA Health Care System, 508 Fulton Street, Durham, NC, 27705, USA; Duke University School of Medicine Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, DUMC 3625, Durham, NC, 27710, USA.
| | - Eric C Meyer
- University of Pittsburgh Department of Rehabilitation Science and Technology, 4028 Forbes Tower, Pittsburgh, PA, 15260, USA.
| | - Bryann B DeBeer
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center, 1700 N Wheeling St, G-3-116M, Aurora, CO, 80045, USA; Department of Physical Medicine and Rehabilitation, Anschutz Medical Campus, University of Colorado, 12631 E 17th Ave, Aurora, CO, 80045, USA.
| | - Jean C Beckham
- Durham VA Health Care System, 508 Fulton Street, Durham, NC, 27705, USA; VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, 3022 Croasdaile Dr., Durham, NC, 27705, USA; Duke University School of Medicine Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, DUMC 3625, Durham, NC, 27710, USA.
| | - Mary J Pugh
- VA Salt Lake City Healthcare System, 500 Foothill Dr, Salt Lake City, UT, 84148, USA; University of Utah School of Medicine Department of Medicine, 30 N. 1900 E, Salt Lake City, UT, 84132, USA.
| | - Patrick S Calhoun
- Durham VA Health Care System, 508 Fulton Street, Durham, NC, 27705, USA; VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, 3022 Croasdaile Dr., Durham, NC, 27705, USA; Duke University School of Medicine Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, DUMC 3625, Durham, NC, 27710, USA.
| | - Nathan A Kimbrel
- Durham VA Health Care System, 508 Fulton Street, Durham, NC, 27705, USA; VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, 3022 Croasdaile Dr., Durham, NC, 27705, USA; Duke University School of Medicine Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, DUMC 3625, Durham, NC, 27710, USA.
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Bijnsdorp FM, Pasman HRW, Boot CRL, van Hooft SM, van Staa A, Francke AL. Profiles of family caregivers of patients at the end of life at home: a Q-methodological study into family caregiver' support needs. BMC Palliat Care 2020; 19:51. [PMID: 32316948 PMCID: PMC7175554 DOI: 10.1186/s12904-020-00560-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 04/08/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Family caregivers of patients at the end of life often experience care-related burden. To prevent caregiver burden and to enhance the capacity to provide care it is important to have insight in their support needs. The purpose of this study was to identify profiles of family caregivers who provide care to patients at the end of life at home. METHODS A Q-methodological study was conducted in which family caregivers ranked 40 statements on support needs and experiences with caregiving. Thereafter they explained their ranking in an interview. By-person factor analysis was used to analyse the rankings and qualitative data was used to support the choice of profiles. A set of 41 family caregivers with a variety on background characteristics who currently or recently provided care for someone at the end of life at home were included. RESULTS Four distinct profiles were identified; profile (1) those who want appreciation and an assigned contact person; profile (2) was bipolar. The positive pole (2+) comprised those who have supportive relationships and the negative pole (2-) those who wish for supportive relationships; profile (3) those who want information and practical support, and profile (4) those who need time off. The profiles reflect different support needs and experiences with caregiving. CONCLUSIONS Family caregivers of patients at the end of life have varying support needs and one size does not fit all. The profiles are relevant for healthcare professionals and volunteers in palliative care as they provide an overview of the main support needs among family caregivers of patients near the end of life. This knowledge could help healthcare professionals giving support.
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Affiliation(s)
- Femmy M Bijnsdorp
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, Expertise Center for Palliative Care, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.
| | - H Roeline W Pasman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, Expertise Center for Palliative Care, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Cécile R L Boot
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Susanne M van Hooft
- Research Centre Innovations in Care, Rotterdam University, Rotterdam, The Netherlands
| | - AnneLoes van Staa
- Research Centre Innovations in Care, Rotterdam University, Rotterdam, The Netherlands.,Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Anneke L Francke
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, Expertise Center for Palliative Care, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.,Nivel, Netherlands institute for health services research, Utrecht, The Netherlands
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Achten D, Westendorp T, Herweijer H, Reneman MF. Pain Rehabilitation During Adolescence; Work in Adulthood? A Long-Term Follow-Up Study to Explore the Facilitators and Barriers for Work. Pain Pract 2020; 20:491-500. [PMID: 32030853 DOI: 10.1111/papr.12876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 01/03/2020] [Accepted: 01/22/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Adolescents with chronic musculoskeletal pain face different impairments in daily life. After an inpatient pain rehabilitation program, adolescents function better on several domains. The aim of this study was to explore the long-term work participation of adults who followed inpatient pain rehabilitation during adolescence because of chronic musculoskeletal pain and to identify potential facilitators and barriers regarding work in later life. METHODS A mixed-methods study with standardized questionnaires and semi-structured interviews. The questionnaires measured pain, disability, work status, and the quality and quantity of the work. The interviews contained questions about work participation. Potential participants were all patients who had participated in an inpatient pain rehabilitation program 15 to 20 years previously. Analyses were performed by thematic analysis. Using the Sherbrooke model as guidance, themes were classified into 4 systems: healthcare, workplace, legislative/insurance, and personal. RESULTS Fourteen patients consented to participate (12 females). Seventy-one percent of them had paid work. The mean self-reported quality of the work delivered was 9.6 (standard deviation = 0.5). Eighteen facilitators and 12 barriers regarding work participation later on in life were mentioned. The inpatient pain rehabilitation program was the most frequently mentioned facilitator (n = 5), while the personal system and coping-related factors were the most frequently mentioned barriers (n = 5). CONCLUSIONS Ten out of 14 participants are currently working, most of them despite experiencing pain. Several factors based on the 4 systems of the Sherbrooke model contribute as facilitators or barriers regarding current work participation. Pain rehabilitation is mostly regarded as a facilitator for work participation later on in life.
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Affiliation(s)
- Diana Achten
- Department of Rehabilitation Medicine, Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Tessa Westendorp
- Research and Development Department, Rijndam Rehabilitation, Rotterdam, The Netherlands
| | - Hester Herweijer
- Revalidatie Friesland Center for Rehabilitation, Beetsterzwaag, The Netherlands
| | - Michiel F Reneman
- Department of Rehabilitation Medicine, Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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van der Meide H, Teunissen T, Visser LH, Visse M. Trapped in my lungs and fighting a losing battle. A phenomenological study of patients living with chronic obstructive and pulmonary disease. Scand J Caring Sci 2019; 34:118-127. [PMID: 31099083 PMCID: PMC7074040 DOI: 10.1111/scs.12713] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 04/14/2019] [Indexed: 12/01/2022]
Abstract
Chronic obstructive and pulmonary disease (COPD) has detrimental effects on individuals with the disease. COPD causes breathlessness, morbidity and associated psychosocial distress. This study was guided by the phenomenological question what is it like to have COPD and situated in Van Manen's phenomenology of practice. Experiential material was gathered through phenomenological interviews. Four themes emerged from the lived experiences of patients living with COPD: breath as a possibility; being vigilant; fighting a losing battle; and feeling isolated from others. For patients with COPD, breathing becomes ever-present and shifts from the invisible background of daily living to the central activity around which everyday life is organised. COPD patients always monitor their own breath and scrutinise the environment on possible dangers that can affect their breathing. Whenever moving or being involved in an activity, a part of their mind is preoccupied with the breathing. Although COPD patients realise that no amount of good behaviour will matter and that the decline of their lungs is inevitable, they make every effort to take good care of their body. They anticipate and avoid triggers of breathlessness isolating them from social interactions and activities. The appearance of the body as a source of social embarrassment also has an isolating effect. This study shows that breathlessness is a constant horizon that frames the experience of COPD patients. It is a limiting factor and determines their entire life. A more profound understanding of these experiences in healthcare professionals will contribute to person-centred care for COPD patients.
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Affiliation(s)
- Hanneke van der Meide
- University of Humanistic Studies, Utrecht, The Netherlands.,Tilburg University, Tilburg, Tranzo Scientific Center for Care and welfare, The Netherlands
| | | | - Leo H Visser
- University of Humanistic Studies, Utrecht, The Netherlands.,Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands
| | - Merel Visse
- University of Humanistic Studies, Utrecht, The Netherlands
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Heinrichs K, Hummel S, Gholami J, Schultz K, Li J, Sheikh A, Loerbroks A. Psychosocial working conditions, asthma self-management at work and asthma morbidity: a cross-sectional study. Clin Transl Allergy 2019; 9:25. [PMID: 31168356 PMCID: PMC6509772 DOI: 10.1186/s13601-019-0264-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 04/24/2019] [Indexed: 11/29/2022] Open
Abstract
Background Adverse psychosocial working conditions—in particular poor job decision latitude and poor social support at work—may impair the effective implementation of asthma self-management behaviour at work and may be associated with increased asthma morbidity. In this study, we investigate for the first time the association of job decision latitude and social support at work with (1) four asthma-specific self-management behaviours at work (i.e., physical activity, trigger avoidance, acute symptom management, and communication) and with (2) asthma morbidity.
Methods A total of 221 employees with asthma recruited through three rehabilitation clinics completed questionnaires (response rate = 29.3%). Job decision latitude and social support were measured using items from the Copenhagen Psychosocial Questionnaire. The four asthma self-management behaviours were mainly assessed by self-developed items. We used the Asthma Control Test and the Marks Asthma Quality of Life Questionnaire to measure asthma morbidity. We dichotomized all variables and conducted logistic regression analyses to calculate odds ratios with 95% CIs. Results Low job decision latitude and low social support were significantly associated with poorer trigger avoidance (odds ratios ≥ 2.09) and poorer acute symptom management (odds ratios ≥ 2.29); low social support was further related to significantly less communication (odds ratio = 2.82). Low job decision latitude and low social support were also associated with significantly poorer asthma control (odds ratios ≥ 1.95) and poorer asthma-specific quality of life (odds ratios ≥ 2.05). The relationships with asthma morbidity were attenuated after adjustment for the four asthma self-management behaviours (odds ratios ranging from 1.1 to 1.9). Conclusions Adverse psychosocial working conditions are associated with poorer asthma self-management behaviour at work and with increased asthma morbidity. The latter association may be mediated by asthma self-management behaviour. Trial registration German Clinical Trials Register, registration number: DRK S00011309, date of registration: 22.12.2016. Electronic supplementary material The online version of this article (10.1186/s13601-019-0264-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Katherina Heinrichs
- 1Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Universitätsstraße 1, 40225 Düsseldorf, Germany
| | - Stefan Hummel
- MEDIAN Klinik Heiligendamm, Kinderstrand 1, 18209 Bad Doberan, Germany
| | - Jalal Gholami
- Nordseeklinik Borkum der DRV Rheinland, Bubertstraße 4, 26757 Borkum, Germany
| | - Konrad Schultz
- 4Klinik Bad Reichenhall der DRV Bayern Süd, Salzburger Str. 8, 83435 Bad Reichenhall, Germany
| | - Jian Li
- 1Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Universitätsstraße 1, 40225 Düsseldorf, Germany.,5Department of Environmental Health Sciences, Fielding School of Public Health, Los Angeles, CA 90095-1772 USA.,6School of Nursing, University of California Los Angeles, Los Angeles, CA 90095-1772 USA
| | - Aziz Sheikh
- 7Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Old Medical School, Teviot Place, Edinburgh, EH8 9AG UK
| | - Adrian Loerbroks
- 1Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Universitätsstraße 1, 40225 Düsseldorf, Germany
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Heinrichs K, Vu-Eickmann P, Hummel S, Gholami J, Loerbroks A. What are the perceived influences on asthma self-management at the workplace? A qualitative study. BMJ Open 2018; 8:e022126. [PMID: 30158229 PMCID: PMC6119450 DOI: 10.1136/bmjopen-2018-022126] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Asthma can represent a substantial challenge to the affected individual, but is usually well controlled by adequate asthma self-management behaviour (SMB). Asthma SMB comprises symptom prevention, symptom monitoring, acute symptom management and communication with important others. The implementation of asthma SMB seems to depend on contextual factors. For employed adults, working conditions may be important in this respect. We, therefore, aimed to explore the perceived influences on effective asthma SMB at work. DESIGN Our qualitative study built on semi-structured interviews and qualitative content analysis. SETTING Participants were recruited in two pulmonary rehabilitation clinics in Northern Germany. PARTICIPANTS We conducted 27 interviews among employees with asthma (female: n=15) who worked at least 20 hours per week and were diagnosed with asthma at least 6 months prior to interviewing. Patients with chronic obstructive pulmonary disease were excluded. RESULTS According to participants, the most influential factors with regard to asthma SMB at work appeared to be job decision latitude (JDL) and social support. JDL (ie, the control over one's tasks and when and how things were done) was perceived to affect symptom prevention, symptom monitoring, and acute symptom management, but not communication. Support by colleagues, line managers, and the employer, for example, practical, emotional, or structural support, was perceived to exert effects on symptom prevention, acute symptom management, and communication (ie, self-disclosure of one's condition). CONCLUSIONS Perceived JDL and social support were experienced as influencing successful implementation of asthma SMB at the workplace. TRIAL REGISTRATION NUMBER German Clinical Trials Register no: DRKS00011309.
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Affiliation(s)
- Katherina Heinrichs
- Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany
| | - Patricia Vu-Eickmann
- Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany
| | - Stefan Hummel
- Department of Pneumology and Allergy, MEDIAN Klinik Heiligendamm, Bad Doberan, Germany
| | - Jalal Gholami
- Department of Pneumology, Nordseeklinik Borkum, Borkum, Germany
| | - Adrian Loerbroks
- Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany
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10
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Heinrichs K, Angerer P, Loerbroks A. Psychosocial working conditions as determinants of asthma self-management at work: A systematic review. J Asthma 2017; 55:1095-1104. [PMID: 29200315 DOI: 10.1080/02770903.2017.1396469] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Asthma exerts a considerable impact on patients and their employers. While adequate self-management is able to improve patients' prognosis, its actual implementation in everyday life may depend on contextual factors. We aimed to review the literature on the potential determinants of asthma self-management at the workplace. DATA SOURCES We systematically searched Medline and PsycINFO using terms related to the key concepts of interest (i.e., adult asthma, working conditions, and self-management). STUDY SELECTION We included original studies published in peer-reviewed journals in English or German since 1992 addressing any type of asthma self-management behavior as the outcome and any type of working condition as the determinant. RESULTS Upon implementation of a multi-stage selection process, seven articles were included. As those studies showed considerable methodological heterogeneity, a qualitative analysis was applied. A first study identified three different adaptation profiles among employees with asthma with implications for self-management behavior. Another study suggested that concerns about taking time off from work may be associated with the utilization of emergency ambulance services for asthma. Five studies among workers with various chronic illnesses addressed determinants of self-disclosure, coping with acute symptoms (e.g., medication use at work), and the potential effect of practical and emotional support from line managers or colleagues on self-management. CONCLUSION Our review indicates that the evidence for a potential link of occupational factors with asthma self-management at work is relatively sparse. Future research should take a more comprehensive approach by considering multiple types of working conditions and asthma self-management behaviors simultaneously.
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Affiliation(s)
- Katherina Heinrichs
- a Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine , University of Düsseldorf , Düsseldorf , Germany
| | - Peter Angerer
- a Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine , University of Düsseldorf , Düsseldorf , Germany
| | - Adrian Loerbroks
- a Institute of Occupational, Social, and Environmental Medicine, Centre for Health and Society, Faculty of Medicine , University of Düsseldorf , Düsseldorf , Germany
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Shepherd LM, Tahrani AA, Inman C, Arlt W, Carrick-Sen DM. Exploration of knowledge and understanding in patients with primary adrenal insufficiency: a mixed methods study. BMC Endocr Disord 2017; 17:47. [PMID: 28764794 PMCID: PMC5540290 DOI: 10.1186/s12902-017-0196-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 07/10/2017] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Primary adrenal insufficiency (PAI) is a rare and severe condition requiring lifelong steroid replacement. During acute illness or stressful events, it is important to appropriately adjust glucocorticoid dose; failure to do so may lead to an adrenal crisis. The aim of the study was to explore patients PAI knowledge and understanding of the condition, steroid replacement adjustment during acute illness or stress and provided education. METHODS Ten adult patients with PAI were purposefully recruited from two hospitals in a tertiary NHS Trust in England, UK. Data was collected using a mixed method approach utilising semi-structured audio-recorded interviews and hospital case note review. Interviews were transcribed verbatim and analysed using Burnard's content analysis framework. Information from the hospital case note review was captured using a matrix table based on pre-defined criteria. RESULTS Four key themes emerged: 'Addison's disease and hydrocortisone replacement'; 'stress and corticosteroids'; 'patient compliance/adherence' and 'transition'. Patients reported feelings of 'going through a transition from uncertainty to adaption' following diagnosis. All participants had a good level of knowledge and understanding of required medication however application in times of need was poor. Medication adherence and prevention of a crisis relied not only on patient knowledge and application but also the support of family and health professionals. Health care professional knowledge required improvement to aid diagnosis and management of PAI. CONCLUSION Patients with PAI did not apply existing knowledge to adjust steroid dose during acute illness or stress. Although a sample of limited size, our study identified there is a need to further explore why patients with Addison's disease do not apply existing knowledge during times of increased need. Future research should consider appropriate behaviour change interventions to promote medication adherence to reduce risk of an adrenal crisis.
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Affiliation(s)
- L. M Shepherd
- Department of Diabetes & Endocrinology, Heart of England NHS Foundation Trust, Birmingham Heartlands Hospital, Bordesley Green East, Birmingham, West Midlands B9 5SS UK
- Institute of Metabolism & Systems Research, University of Birmingham, IBR Tower, Level 2, Edgbaston, Birmingham, West Midlands B15 2TT UK
| | - A. A Tahrani
- Department of Diabetes & Endocrinology, Heart of England NHS Foundation Trust, Birmingham Heartlands Hospital, Bordesley Green East, Birmingham, West Midlands B9 5SS UK
- Institute of Metabolism & Systems Research, University of Birmingham, IBR Tower, Level 2, Edgbaston, Birmingham, West Midlands B15 2TT UK
- Birmingham Health Partners, University of Birmingham & Centre for Endocrinology, Diabetes and Metabolism (CEDAM), Birmingham, B15 2TT UK
| | - C Inman
- Department of Public Health & Community Health, Birmingham City University Faculty of Health, City South Campus, Westbourne Road, Birmingham, B15 3TN UK
| | - W Arlt
- Institute of Metabolism & Systems Research, University of Birmingham, IBR Tower, Level 2, Edgbaston, Birmingham, West Midlands B15 2TT UK
- Birmingham Health Partners, University of Birmingham & Centre for Endocrinology, Diabetes and Metabolism (CEDAM), Birmingham, B15 2TT UK
| | - D. M Carrick-Sen
- School of Nursing, Institute of Clinical Sciences, College of Medical & Dental Sciences, University of Birmingham, Edgbaston, Birmingham, West Midlands B15 2TT UK
- Heart of England NHS Foundation Trust, Birmingham Heartlands Hospital, Bordesley Green East, Birmingham, B9 5SS UK
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Holas P, Michałowski J, Gawęda Ł, Domagała-Kulawik J. Agoraphobic avoidance predicts emotional distress and increased physical concerns in chronic obstructive pulmonary disease. Respir Med 2017; 128:7-12. [PMID: 28610672 DOI: 10.1016/j.rmed.2017.04.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 04/03/2017] [Accepted: 04/17/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Anxiety and panic attacks are more common in chronic obstructive pulmonary disease (COPD) than in the overall population. Individuals with panic attacks often attempt to avoid situations perceived as at risk of eliciting bodily sensations such as dyspnea, which paradoxically may lead to anxiety-related responsivity. Although there is some evidence that COPD individuals restrict their participation in various life activities because they fear that these may trigger breathlessness, little is known about agoraphobic avoidance and its impact on cognitions and emotional distress in this population. It was thus our aim to investigate the degree of agoraphobic avoidance in COPD individuals, its clinical concomitants and consequences. METHODS A total of 48 patients with COPD and 48 matched controlled subjects completed measures of anxiety sensitivity, agoraphobic avoidance, anxiety and depression. Objective COPD severity was measured using forced expiratory volume in the first second. RESULTS Patients showed significant impairment in respiratory functioning and psychological distress. Relative to the control, the COPD group exhibited greater depression, anxiety, physical symptom concerns and avoidance (alone and accompanied), irrespective of whether they were panickers or not. Patients with high avoidance showed more intense physical concerns when compared to those with low avoidance. Importantly, the level of avoidance predicted emotional distress and increased physical concerns in COPD. CONCLUSIONS Physical concerns scores in COPD patients are partially explained by avoidance in this group. The results of the study provide evidence for the importance of evaluating avoidance in COPD patients and implicate targeting this behavior in therapeutic interventions.
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Affiliation(s)
- Pawel Holas
- Faculty of Psychology, University of Warsaw, Krakowskie Przedmieście 26/28, 00 927 Warsaw, Poland.
| | - Jaroslaw Michałowski
- SWPS University of Social Sciences and Humanities, Faculty of Social Sciences and Design in Poznan, Department of Psychology, Poznan, Poland
| | - Łukasz Gawęda
- II Department of Psychiatry, Medical University of Warsaw, ul. Kondratowicza 8, 03-242 Warsaw, Poland; Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Joanna Domagała-Kulawik
- Department of Internal Medicine, Pneumonology and Allergology, Medical University of Warsaw, Poland
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Kiongera GM, Houde SC. Inpatient Pulmonary Rehabilitation Program in a Long-Term Care Facility: Short-Term Outcomes and Patient Satisfaction. J Gerontol Nurs 2015; 41:44-52. [PMID: 26248143 DOI: 10.3928/00989134-20150622-01] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Accepted: 06/10/2015] [Indexed: 11/20/2022]
Abstract
The purpose of the current study was to evaluate short-term outcomes of inpatient pulmonary rehabilitation (IPR) programs for older patients with chronic obstructive pulmonary disease (COPD). IPR comprises medical management, exercise, nutrition counseling, and coping skills education programs, among other interventions. The current study used a pretest-posttest design with 21 participants evenly split by gender between the ages of 46 and 95. Effects of IPR on functional tolerance exercise capacity and perceived dyspnea on exertion level had a statistically significant difference by the end of the program. Scores for health-related quality of life and subscales of symptoms, impact, and activity in participants younger than 65 were not statistically significant, whereas St. George's Respiratory Questionnaire scores for participants older than 65 showed a statistically significant improvement. Results showed that early IPR is an effective intervention for the management of symptoms of COPD in older adults recovering from a COPD exacerbation.
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Solomon BK, Wilson KG, Henderson PR, Poulin PA, Kowal J, McKim DA. A Breathlessness Catastrophizing Scale for chronic obstructive pulmonary disease. J Psychosom Res 2015; 79:62-8. [PMID: 25498317 DOI: 10.1016/j.jpsychores.2014.11.020] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Revised: 11/22/2014] [Accepted: 11/25/2014] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Catastrophizing about breathlessness may be related to disability in patients with chronic obstructive pulmonary disease (COPD), but assessment options are limited. This study reports the initial validation of a 13-item Breathlessness Catastrophizing Scale (BCS). METHOD Pulmonary rehabilitation inpatients completed spirometric, functional performance and questionnaire assessments at admission (N=242) and discharge (n=186). RESULTS The BCS comprised a unifactorial scale that demonstrated excellent internal consistency (Cronbach's alpha=.96) and correlated with measures of anxiety sensitivity, depression, and self-efficacy, but not with performance on walk and stair-climbing tests. BCS scores improved robustly with rehabilitation, approaching a medium effect size (d=.43), and demonstrated a modest association with enhanced performance in a stair-climbing test of exercise tolerance. CONCLUSION The BCS is a reliable measure of catastrophizing in severe COPD that has good convergent validity and sensitivity to change. Its association with functional performance requires further investigation. However, it appears that a high level of catastrophizing about breathlessness is not a barrier to functional improvement with inpatient pulmonary rehabilitation.
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Affiliation(s)
| | - Keith G Wilson
- Department of Psychology, The Ottawa Hospital Rehabilitation Centre, Canada
| | - Peter R Henderson
- Department of Psychology, The Ottawa Hospital Rehabilitation Centre, Canada
| | | | - John Kowal
- Department of Psychology, The Ottawa Hospital Rehabilitation Centre, Canada
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Cramm JM, Leensvaart L, Berghout M, van Exel J. Exploring views on what is important for patient-centred care in end-stage renal disease using Q methodology. BMC Nephrol 2015; 16:74. [PMID: 26018544 PMCID: PMC4446837 DOI: 10.1186/s12882-015-0071-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 05/21/2015] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND This study aimed to explore views on what is considered important for Patient-Centred Care (PCC) among patients and the healthcare professionals treating them in a haemodialysis department. METHODS Interviews were conducted among 14 patients with end-stage renal disease receiving dialysis and 12 healthcare professionals (i.e. 2 doctors, 4 staff members, and 6 nurses) working at a haemodialysis department. Participants were asked to rank-order 35 statements representing eight dimensions of PCC previously discussed in the literature. Views on PCC, and communalities and differences between them, were explored using by-person factor analysis. RESULTS Four views on what is important for PCC in end-stage renal disease were identified. In viewpoint 1, listening to patients and taking account of their preferences in treatment decisions is considered central to PCC. In viewpoint 2, providing comprehensible information and education to patients so that they can take charge of their own care is considered important. In viewpoint 3, several aspects related to the atmosphere at the department were put forward as important for PCC. In viewpoint 4, having a professional or acquaintance that acts as care coordinator, making treatment decisions with or for them, was considered particularly beneficial. All views agreed about the relative importance of certain PCC dimensions; the patient preferences and information and education dimensions were generally considered most important, while the family and friends and the access to care dimensions were considered least important. CONCLUSIONS The four views on PCC among patients in a haemodialysis department and the professionals treating them suggest that there is no one size fits all strategy for providing PCC to patients with end-stage renal disease. Some patients may benefit from educational interventions to improve their self-management skills and place them in charge of their own care, whereas other patients may benefit more from the availability of a care coordinator to make decisions for them, or with them. Furthermore, our results suggest that not all eight dimensions of PCC need to be given equal consideration in the care for patients with end-stage renal disease in order to improve patient outcomes.
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Affiliation(s)
- Jane M Cramm
- Institute of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
| | - Laszlo Leensvaart
- Institute of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
| | - Mathilde Berghout
- Institute of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
| | - Job van Exel
- Institute of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
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Public views on principles for health care priority setting: findings of a European cross-country study using Q methodology. Soc Sci Med 2014; 126:128-37. [PMID: 25550076 DOI: 10.1016/j.socscimed.2014.12.023] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Resources available to the health care sector are finite and typically insufficient to fulfil all the demands for health care in the population. Decisions must be made about which treatments to provide. Relatively little is known about the views of the general public regarding the principles that should guide such decisions. We present the findings of a Q methodology study designed to elicit the shared views in the general public across ten countries regarding the appropriate principles for prioritising health care resources. In 2010, 294 respondents rank ordered a set of cards and the results of these were subject to by-person factor analysis to identify common patterns in sorting. Five distinct viewpoints were identified, (I) "Egalitarianism, entitlement and equality of access"; (II) "Severity and the magnitude of health gains"; (III) "Fair innings, young people and maximising health benefits"; (IV) "The intrinsic value of life and healthy living"; (V) "Quality of life is more important than simply staying alive". Given the plurality of views on the principles for health care priority setting, no single equity principle can be used to underpin health care priority setting. Hence, the process of decision making becomes more important, in which, arguably, these multiple perspectives in society should be somehow reflected.
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Boot CRL, Deeg DJH, Abma T, Rijs KJ, van der Pas S, van Tilburg TG, van der Beek AJ. Predictors of having paid work in older workers with and without chronic disease: a 3-year prospective cohort study. JOURNAL OF OCCUPATIONAL REHABILITATION 2014; 24:563-572. [PMID: 24322825 DOI: 10.1007/s10926-013-9489-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND As the prevalence of chronic disease amongst older workers is high and increasing, it is important to know if the large subgroup of older workers with chronic disease has specific needs when it comes to prolonging participation in paid work. OBJECTIVES To investigate differences and similarities in predictors of having paid work in workers aged 55+ with and without chronic disease. METHODS Workers aged 55-62 years were selected from the 2002-2003 cohort of the Longitudinal Aging Study Amsterdam (n = 333). Potential predictors were: health, personality, work characteristics, and demographics. Per potential predictor, a logistic regression coefficient for 'having paid work in 2005-2006' was calculated for workers with and without chronic disease. A pooled estimate was computed and differences between the pooled estimate and the coefficients were tested. Results Follow-up data were available for 95 %, of whom 67 % still had paid work. Predictors of having paid work were similar for workers with and without chronic diseases, except for physical workload (χ(2) = 5.37; DF = 1) and psychosocial resources at work (χ(2) = 5.94; DF = 1). Having more psychosocial resources (OR = 3.57; 95 %CI 1.33-10.0) was predictive for having paid work in workers with chronic disease and not in workers without chronic disease. Lower age, more weekly working hours, no functional limitations, fewer depressive symptoms, lower neuroticism scores, and more sense of mastery were significantly associated with having paid work in all workers. CONCLUSIONS Differences between predictors of having paid work between workers with and without chronic disease should be taken into account when aiming to prevent exit from the workforce. In particular the vulnerable subgroup of older workers with chronic disease and low psychosocial resources at work is more likely to quit working.
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Affiliation(s)
- Cécile R L Boot
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Van Der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands,
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Workers with a chronic disease and work disability. Problems and solutions. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2013; 56:406-14. [PMID: 23455558 DOI: 10.1007/s00103-012-1621-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The prevalence of chronic diseases in the age group 18-65 years is high. Cardiometabolic conditions and musculoskeletal diseases are the most frequent chronic diseases. Depending on disease and comorbidity, the employment rates are considerably lower than for healthy individuals. Chronically ill workers may have problems in meeting job demands, they may experience physical, cognitive or sensory limitations, have fatigue or pain complaints or other disease symptoms. Psychological distress, depressive feelings, feelings of shame or guilt, lack of coping or communicative skills, and non-supportive colleagues and supervisors may add to work-related problems. The ICF Model (International Classification of Functioning, Disability and Health) of the WHO offers a framework for understanding and considering health-related problems at work and finding solutions. Interventions to prevent problems in functioning, sickness absence and work disability may focus on the worker, the workplace, or health care. Multidisciplinary vocational rehabilitation, exercise therapy, cognitive behavioural interventions, workplace interventions and empowerment are interventions with at least some evidence of effectiveness. Future policy could focus more on promotion of workers' health and future research should include the interests and motivations of employers concerning disability management, skills of line managers, the feasibility of interventions to prevent work disability and the context sensitivity of study outcomes.
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Backhaus R, van Exel J, de Bont A. Employees' views on home-based, after-hours telephone triage by Dutch GP cooperatives. Int J Emerg Med 2013; 6:42. [PMID: 24188407 PMCID: PMC4177141 DOI: 10.1186/1865-1380-6-42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Accepted: 10/17/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dutch out-of-hours (OOH) centers find it difficult to attract sufficient triage staff. They regard home-based triage as an option that might attract employees. Specially trained nurses are supposed to conduct triage by telephone from home for after-hours medical care. The central aim of this research is to investigate the views of employees of OOH centers in The Netherlands on home-based telephone triage in after-hours care. METHODS The study is a Q methodology study. Triage nurses, general practitioners (GPs) and managers of OOH centers ranked 36 opinion statements on home-based triage. We interviewed 10 participants to help develop and validate the statements for the Q sort, and 77 participants did the Q sort. RESULTS We identified four views on home-based telephone triage. Two generally favor home-based triage, one highlights some concerns and conditions, and one opposes it out of concern for quality. The four views perceive different sources of credibility for nurse triagists working from home. CONCLUSION Home-based telephone triage is a controversial issue among triage nurses, GPs and managers of OOH centers. By identifying consensus and dissension among GPs, triagists, managers and regulators, this study generates four perspectives on home-based triage. In addition, it reveals the conditions considered important for home-based triage.
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Affiliation(s)
| | | | - Antoinette de Bont
- Institute of Health Policy and Management, Erasmus University Rotterdam, P,O, Box 1738, 3000 DR, Rotterdam, The Netherlands.
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Slatore CG, Harber P, Haggerty MC. An Official American Thoracic Society Systematic Review: Influence of Psychosocial Characteristics on Workplace Disability among Workers with Respiratory Impairment. Am J Respir Crit Care Med 2013; 188:1147-60. [DOI: 10.1164/rccm.201309-1656st] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Corcoran KJ, Jowsey T, Leeder SR. One size does not fit all: the different experiences of those with chronic heart failure, type 2 diabetes and chronic obstructive pulmonary disease. AUST HEALTH REV 2013; 37:19-25. [PMID: 23158955 DOI: 10.1071/ah11092] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2011] [Accepted: 02/12/2012] [Indexed: 11/23/2022]
Abstract
INTRODUCTION The Australian federal government is developing a policy response to chronic disease in Australia. The Serious and Continuing Illness Policy and Practice Study examined the experience of individuals with chronic heart failure (CHF), chronic obstructive pulmonary disease (COPD) or type 2 diabetes mellitus (diabetes) in the Australian Capital Territory (ACT) and Western Sydney. This paper describes the disease-specific experiences of people interviewed. METHODS We conducted semi-structured interviews with 40 individuals aged 45-85 years with CHF, COPD or diabetes in 2008. Interviews were recorded and transcribed. Qualitative content analysis was performed, assisted by QSR Nvivo 8 qualitative data software. RESULTS Participants with CHF (n=9) came to terms with the prospect of unpredictable sudden death. Participants with COPD (n=15) were angry about limitations it imposed on their lives. Participants with diabetes (n=16) experienced a steep learning curve in self-management of their condition surrounded by high levels of uncertainty. CONCLUSION Although people with chronic illness share many experiences, a person's overall experience of living with chronic illness is significantly shaped by the nature of their specific dominant disease. Policies for patient-centred care must take account of both generic and disease-specific elements.
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Boot CRL, van den Heuvel SG, Bültmann U, de Boer AGEM, Koppes LLJ, van der Beek AJ. Work adjustments in a representative sample of employees with a chronic disease in the Netherlands. JOURNAL OF OCCUPATIONAL REHABILITATION 2013; 23:200-8. [PMID: 23592014 DOI: 10.1007/s10926-013-9444-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
PURPOSE The aims of this study are: (1) to describe the prevalence of needed and implemented work adjustments in a representative sample of Dutch employees with a chronic disease; and (2) to assess the effects of needed and implemented work adjustments on sick leave. METHODS The prevalence of work adjustments was assessed in employees with a chronic disease, aged between 15 and 65 years (n = 7,687) from the 2007 Netherlands Working Conditions Survey (NWCS). Of these, N = 2,631 employees participated in the Netherlands Working Conditions Cohort Study (NWCCS) measurements in 2008 and 2009. The NWCCS data were used to investigate the effects of work adjustments on sick leave. All data were self-reported. A repeated measures ANOVA was performed to analyse differences in sick leave in 2007, 2008 and 2009 between employees with and without a need for work adjustments, for those who reported an implemented work adjustment and those who did not. RESULTS In 2007, the prevalence of implemented work adjustments among Dutch employees with a chronic disease was 22 %, while 30 % reported the need of a work adjustment. In employees with and without a need for work adjustments in 2007, a work adjustment in 2008 was significantly associated with a decrease in sick leave from 2007 to 2009. CONCLUSION The need for work adjustments is higher than the implementation of work adjustments. Work adjustments should be considered more often for employees with chronic diseases, because implementation of a work adjustment is associated with a decrease in sick leave.
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Affiliation(s)
- Cécile R L Boot
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.
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Akyil RÇ, Ergüney S. Roy's adaptation model-guided education for adaptation to chronic obstructive pulmonary disease. J Adv Nurs 2012; 69:1063-75. [DOI: 10.1111/j.1365-2648.2012.06093.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Rahşan Çevik Akyil
- Internal Nursing Department; Atatürk University Faculty of Health Sciences; Erzurum; Turkey
| | - Seher Ergüney
- Internal Nursing Department; Atatürk University Faculty of Health Sciences; Erzurum; Turkey
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Janssens T, De Peuter S, Stans L, Verleden G, Troosters T, Decramer M, Van den Bergh O. Dyspnea Perception in COPD. Chest 2011; 140:618-625. [DOI: 10.1378/chest.10-3257] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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de Vries HJ, Brouwer S, Groothoff JW, Geertzen JHB, Reneman MF. Staying at work with chronic nonspecific musculoskeletal pain: a qualitative study of workers' experiences. BMC Musculoskelet Disord 2011; 12:126. [PMID: 21639884 PMCID: PMC3121659 DOI: 10.1186/1471-2474-12-126] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2010] [Accepted: 06/03/2011] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Many people with chronic nonspecific musculoskeletal pain (CMP) have decreased work ability. The majority, however, stays at work despite their pain. Knowledge about workers who stay at work despite chronic pain is limited, narrowing our views on work participation. The aim of this study was to explore why people with CMP stay at work despite pain (motivators) and how they manage to maintain working (success factors). METHODS A semi-structured interview was conducted among 21 subjects who stay at work despite CMP. Participants were included through purposeful sampling. Interviews were audio-recorded, transcribed verbatim, and imported into computer software Atlas.ti. Data was analyzed by means of thematic analysis. The interviews consisted of open questions such as: "Why are you working with pain?" or "How do you manage working while having pain?" RESULTS A total of 16 motivators and 52 success factors emerged in the interviews. Motivators were categorized into four themes: work as value, work as therapy, work as income generator, and work as responsibility. Success factors were categorized into five themes: personal characteristics, adjustment latitude, coping with pain, use of healthcare services, and pain beliefs. CONCLUSIONS Personal characteristics, well-developed self-management skills, and motivation to work may be considered to be important success factors and prerequisites for staying at work, resulting in behaviors promoting staying at work such as: raising adjustment latitude, changing pain-coping strategies, organizing modifications and conditions at work, finding access to healthcare services, and asking for support. Motivators and success factors for staying at work may be used for interventions in rehabilitation and occupational medicine, to prevent absenteeism, or to promote a sustainable return to work. This qualitative study has evoked new hypotheses about staying at work; quantitative studies on staying at work are needed to obtain further evidence.
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Affiliation(s)
- Haitze J de Vries
- Department of Rehabilitation Medicine, Center for Rehabilitation, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Sandra Brouwer
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Johan W Groothoff
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Jan HB Geertzen
- Department of Rehabilitation Medicine, Center for Rehabilitation, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Michiel F Reneman
- Department of Rehabilitation Medicine, Center for Rehabilitation, University Medical Center Groningen, University of Groningen, The Netherlands
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Buljac-Samardzic M, van Wijngaarden JDH, van Wijk KP, van Exel NJA. Perceptions of team workers in youth care of what makes teamwork effective. HEALTH & SOCIAL CARE IN THE COMMUNITY 2011; 19:307-316. [PMID: 21156005 DOI: 10.1111/j.1365-2524.2010.00978.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
In youth care, little is known about what makes teamwork effective. What is known mostly reflects the view of managers in care organisations, as objective outcome measures are lacking. The objective of this article was to explore the views of youth care workers in different types of teams on the relative importance of characteristics of teamwork for its effectiveness. Q methodology was used. Fifty-one respondents rank-order 34 opinion statements regarding characteristics of teamwork. Individual Q sorts were analysed using by-person factor analysis. The resulting factors, which represented team workers' views of what is important for effective teamwork, were interpreted and described using composite rankings of the statements for each factor and corresponding team workers' explanations. We found three views of what makes teamwork effective. One view emphasised interaction between team members as most important for team effectiveness. A second view pointed to team characteristics that help sustain communication within teams as being most important. In the third view, the team characteristics that facilitate individuals to perform as a team member were put forward as most important for teamwork to be effective. In conclusion, different views exist on what makes a team effective in youth care. These views correspond with the different types of teams active in youth care as well as in other social care settings.
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Affiliation(s)
- M Buljac-Samardzic
- Department of Health Policy Management (iBMG), Erasmus University Rotterdam, The Netherlands.
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van Rijssen HJ, Schellart AJM, Anema JR, van der Beek AJ. A typology of sick-listed claimants to improve communication skills for social insurance physicians during medical disability assessment interviews. JOURNAL OF OCCUPATIONAL REHABILITATION 2011; 21:66-75. [PMID: 20623165 DOI: 10.1007/s10926-010-9254-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
INTRODUCTION Role play with standardised simulated patients is often included in communication training. However, regarding physician-patient encounters in medical disability assessment interviews it is unclear what should be included in the scenarios for actors. The first objective of this study was to determine which types of medical disability claimants can be distinguished based on behavioural determinants. The second objective was to determine if these types of claimants differed in their perception of communication behaviour and their satisfaction with the communication with physicians. METHODS Questionnaire data were collected from 56 Dutch claimants for 13 behavioural determinants before their assessment interview, and for 12 behavioural and satisfaction variables afterwards. For the first objective cluster analyses were performed and for the second objective linear regression analyses were performed. RESULTS The results showed that three types of claimants could be distinguished: insecure support-seeking claimants, confident claimants, and socially isolated claimants. Overall, claimants were positive about the communication with the physician: insecure support-seeking claimants were satisfied and confident claimants were highly satisfied, but socially isolated claimants were unsatisfied. CONCLUSION Scenarios for standardised simulated patients should include different types of claimants. In training, special attention should be given to communication with socially isolated claimants.
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Affiliation(s)
- H J van Rijssen
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
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