1
|
Cramer CL, Marsh K, Krebs ED, Mehaffey JH, Beller JP, Chancellor WZ, Teman NR, Yarboro LT. Long term employment following heart transplantation in the United States. J Heart Lung Transplant 2023; 42:880-887. [PMID: 36669942 DOI: 10.1016/j.healun.2022.12.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 11/28/2022] [Accepted: 12/27/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Employment is an important metric of post-transplant functional status and the quality of life yet remains poorly described after heart transplant. We sought to characterize the prevalence of employment following heart transplantation and identify patients at risk for post-transplant unemployment. METHODS Adults undergoing single-organ heart transplantation (2007-2016) were evaluated using the UNOS database. Univariable analysis was performed after stratifying by employment status at 1-year post-transplant. Fine-Gray competing risk regression was used for risk adjustment. Cox regression evaluated employment status at 1 year with mortality. RESULTS Of 10,132 heart transplant recipients who survived to 1 year and had follow-up, 22.0% were employed 1-year post-transplant. Employment rate of survivors increased to 32.9% by year 2. Employed individuals were more likely white (70.8% vs 60.4%, p < 0.01), male (79.6% vs 70.7% p < 0.01), held a job at listing/transplant (37.6% vs 7.6%, p < 0.01), and had private insurance (79.1% vs 49.5%, p < 0.01). Several characteristics were independently associated with employment including age, employment status at time of listing or transplant, race and ethnicity, gender, insurance status, education, and postoperative complications. Of 1,657 (14.0%) patients employed pretransplant, 58% were working at 1-year. Employment at 1year was independently associated with mortality with employed individuals having a 26% decreased risk of mortality. CONCLUSION Over 20% of heart transplant patients were employed at 1 year and over 30% at 2 years, while 58% of those working pretransplant had returned to work by 1-year. While the major predictor of post-transplant employment is preoperative employment status, our study highlights the impact of social determinants of health.
Collapse
Affiliation(s)
| | - Katherine Marsh
- University of Virginia Health System, Charlottesville, Virginia
| | | | | | - Jared P Beller
- University of Virginia Health System, Charlottesville, Virginia
| | | | | | - Leora T Yarboro
- University of Virginia Health System, Charlottesville, Virginia.
| |
Collapse
|
2
|
Halvachizadeh S, Muller D, Baechtold M, Hauswirth F, Probst P, Muller MK. Bariatric metabolic surgery eliminates body mass index as a risk factor for unemployment. Surg Obes Relat Dis 2023; 19:356-363. [PMID: 36424328 DOI: 10.1016/j.soard.2022.10.017] [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: 04/02/2022] [Revised: 09/26/2022] [Accepted: 10/12/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND The effects of bariatric metabolic surgery (BMS) on health and comorbidities are well-known. Socioeconomic factors have been increasingly in focus in recent investigations. OBJECTIVE The aim of this study was to analyze the effects of BMS on predictive variables for unemployment. SETTING This study as performed in one reference center for BMS. Patients were treated between 2011 and 2017. METHODS The study design was a retrospective cohort study. Inclusion criteria were Roux-en-Y gastric bypass surgery, follow-up of 60 months, and complete data on employment rate. Exclusion criteria were secondary BMS, secondary referral, loss of follow-up, or patients aged 60 years and above. Patients were stratified as employed independent of part-time work and as unemployed if the patient had no current employment at the time of the visit. Follow-up visits were performed after 6, 12, 24, 48, and 60 months. RESULTS This study included 623 patients; prior to BMS, 239 (38.36%) patients were employed and 384 (61.64%) unemployed. Risk factors for baseline unemployment included increased body mass index (BMI) (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.01 to 1.05; P = .010) and increased American Society of Anesthesiology (ASA) score (OR, 3.55; 95% CI, 2.56 to 4.90; P < .001). Unemployment rate dropped to 32.4% after 24 months (P < .001) and increased to 62.8% after 60 months. The BMI continuously decreased. Following BMS, the unemployment rate was no longer associated with BMI (24 months: OR, 0.97; 95% CI, 0.95 to 1.01; P = .220; 60 months: 1.04; 95% CI, 0.97 to 1.11; P = .269). The initial ASA status remained associated with unemployment (OR, 2.20; 95% CI, 1.60 to 3.01; P < .001). CONCLUSION BMI showed some association with the unemployment rate prior to BMI. The unemployment rate significantly decreased 24 months after BMS but increased to baseline values after 60 months. Following BMS, BMI was no longer associated with unemployment.
Collapse
Affiliation(s)
- Sascha Halvachizadeh
- Department of Surgery, Cantonal Hospital Thurgau, Frauenfeld, Frauenfeld, Switzerland.
| | - Domink Muller
- Department of Surgery, Cantonal Hospital Thurgau, Frauenfeld, Frauenfeld, Switzerland
| | - Matthias Baechtold
- Department of Surgery, Cantonal Hospital Thurgau, Frauenfeld, Frauenfeld, Switzerland
| | - Fabian Hauswirth
- Department of Surgery, Cantonal Hospital Thurgau, Frauenfeld, Frauenfeld, Switzerland
| | - Pascal Probst
- Department of Surgery, Cantonal Hospital Thurgau, Frauenfeld, Frauenfeld, Switzerland
| | - Markus K Muller
- Department of Surgery, Cantonal Hospital Thurgau, Frauenfeld, Frauenfeld, Switzerland
| |
Collapse
|
3
|
Moon I, Han J. Moderating Effects of Physical Activity on the Relationship between Adverse Childhood Experiences and Health-Related Quality of Life. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:668. [PMID: 35055490 PMCID: PMC8775782 DOI: 10.3390/ijerph19020668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 01/01/2022] [Accepted: 01/05/2022] [Indexed: 11/16/2022]
Abstract
The effects of adverse childhood experiences (ACEs) on health-related quality of life (HRQOL) and their associations with physical activities (PA) are well-documented. However, the specific effects of different types of ACEs (e.g., child abuse and household dysfunction) on HRQOL and the role of PA are inconclusive. The purpose of this study is to find the buffering role of PA as a moderator that may reduce the negative impact of ACEs in general and the specific effects of different types of ACEs on HRQOL, perceived physical health, and mental health over time. The 2019 Behavioral Risk Fact Surveillance System (BRFSS), a state-based surveillance system supported by the CDC in the U.S., was used for this study. A total of 127,370 respondents from 17 states were selected for this study. First, descriptive statistics were generated and correlation analyses were conducted to find the association among variables and examine the possible predictors of HRQOL. Moderation models were then tested using Structural Equation Modeling (SEM). HRQOL in adults is negatively associated with ACEs, but is positively associated with PA. We found buffering effects of physical activity in the following relationships: (1) child abuse and HRQOL, (2) child abuse and perceived physical health, (3) ACEs and perceived mental health, (4) child abuse and perceived mental health, and (5) household dysfunction and perceived mental health. Our findings suggest that improvement of PA level is a significant predictor of improved HRQOL of adults with ACEs.
Collapse
Affiliation(s)
- Ingyu Moon
- School of Social Work, Nyack College, New York, NY 10004, USA
| | - Junghee Han
- Department of Social Work, University of Southern Indiana, Evansville, IN 47712, USA;
| |
Collapse
|
4
|
Earnings and employment for women after bariatric surgery: a matched cohort study. Int J Obes (Lond) 2021; 45:766-775. [PMID: 33495524 DOI: 10.1038/s41366-021-00737-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 10/27/2020] [Accepted: 01/04/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND/OBJECTIVES Bariatric surgery induces durable weight loss and improves health and quality of life. Less is known about how bariatric surgery affects labour market outcomes. This study examined the development of earnings and employment status among women with obesity who underwent bariatric surgery versus matched comparators. SUBJECTS/METHODS This study included two cohorts of women in Sweden who gave birth between 1992 and 2014: a cohort with bariatric patients and their full sisters (sister cohort) and a cohort with bariatric patients and comparators matched on BMI, education, birth year, and previous cardiovascular, psychiatric, and musculoskeletal inpatient care diagnoses (BMI-matched cohort). Taxable annual earnings were retrieved from the Swedish Income Tax Register from 2 years before to 5 years after surgery. Employment status was measured dichotomously (employed/not employed) based on earnings data. Adjusted mean and prevalence differences were estimated for earnings and employment by ordinary least squares regression. RESULTS The sister cohort included 1400 patient-sister pairs. At baseline, patients and their sisters were of similar age (38.3 vs. 38.6 years) but had different BMI (37.3 vs. 26.7 kg/m2). The BMI-matched cohort included 2967 patient-comparator pairs with similar age (36.1 vs. 36.2 years) and BMI (37.1 vs. 37.0 kg/m2) before surgery. During follow-up, similar developments of earnings and employment status were observed between bariatric patients and the comparators in both cohorts. When comparing absolute levels of earnings in the sister cohort, the difference in earnings at 2 years before surgery [mean difference -$4137 (95% CI -5245 to -3028)] was similar to the difference in earnings at 5 years after surgery [-$5620 (-7024 to -4215)]. Similar results were found in the BMI-matched cohort, but of smaller magnitude. CONCLUSIONS Bariatric surgery had little influence on the development of annual earnings and employment for women with obesity in Sweden over 5 years after surgery.
Collapse
|
5
|
Mahirah D, Sauter C, Thach TQ, Dunleavy G, Nazeha N, Christopoulos GI, Soh CK, Car J. Factors associated with health-related quality of life in a working population in Singapore. Epidemiol Health 2020; 42:e2020048. [PMID: 32660219 PMCID: PMC7871151 DOI: 10.4178/epih.e2020048] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 06/29/2020] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES This study aimed to evaluate the determinants of health-related quality of life (HRQoL) among workers in Singapore. METHODS We analysed data from a cross-sectional study of 464 participants from 4 companies in Singapore. Physical and mental components of HRQoL were assessed using the Short-Form 36 version 2.0 survey. A generalized linear model was used to determine factors associated with the physical component summary (PCS) and mental component summary (MCS) scores of HRQoL. RESULTS The overall mean PCS and MCS scores were mean±standard deviation 51.6±6.7 and 50.2±7.7, respectively. The scores for subscales ranged from 62.7±14.7 for vitality to 83.5±20.0 for role limitation due to emotional problems. Ethnicity, overweight/obesity, and years working at the company were significantly associated with physical HRQoL, and age and stress at work were significantly associated with mental HRQoL. Moreover, sleep quality was significantly associated with both physical and mental HRQoL. CONCLUSIONS These findings could help workplaces in planning strategies and initiatives for employees to maintain a worklife balance that encompasses their physical, emotional, and social well-being.
Collapse
Affiliation(s)
- Dhiya Mahirah
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Charlotte Sauter
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Thuan-Quoc Thach
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Gerard Dunleavy
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Nuraini Nazeha
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - George I. Christopoulos
- Division of Strategy, Management and Organisation, Nanyang Business School, College of Business, Nanyang Technological University, Singapore
| | - Chee Kiong Soh
- School of Civil and Environmental Engineering, College of Engineering, Nanyang Technological University, Singapore
| | - Josip Car
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| |
Collapse
|
6
|
Body Mass Index (BMI) and Work Ability in Older Workers: Results from the Health and Employment after Fifty (HEAF) Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051647. [PMID: 32138365 PMCID: PMC7084316 DOI: 10.3390/ijerph17051647] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 02/25/2020] [Accepted: 02/28/2020] [Indexed: 11/17/2022]
Abstract
This study explores associations between BMI and prolonged sickness absence; cutting down at work; and health-related job loss (HRJL) over two years of follow-up among workers aged ≥50 years. A cohort of 2299 men and 2425 women (aged 50–64 years) self-reported height and weight at baseline and provided information about work ability at 12 and 24 months for the Health and Employment after Fifty (HEAF) Study. Associations between BMI and work ability were assessed by logistic regression and HRJL by multiple-record Cox’s proportional hazards models, with adjustment for other risk factors. The prevalence of obesity/severe obesity was 22.6%/1.2% amongst men and 21.4%/2.6% amongst women, respectively. In men and women, obesity and severe obesity predicted having to cut down at work for health over two years. In women, severe obesity predicted prolonged sickness absence, and also HRJL even after adjustment for age, proximity to retirement, financial difficulties, and lifestyle factors (hazard ratio [HR] 2.93, 95% CI 1.38, 6.23), and additional adjustment for health conditions (HR 2.52, 95% CI 1.12, 5.67). Obesity, and particularly severe obesity, negatively impacts work ability amongst people aged 50–64 years, with greatest effects in women. Obesity can be expected to hinder attempts to encourage work to older ages.
Collapse
|
7
|
Generic Health-Related Quality of Life May Not Be Associated with Weight Loss 4 Years After Bariatric Surgery: a Cross-Sectional Study. Obes Surg 2018; 28:3142-3150. [DOI: 10.1007/s11695-018-3332-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|
8
|
Vayr F, Charras L, Savall F, Soulat JM, Ritz P, Herin F. The Impact of Bariatric Surgery on Employment: A Systematic Review. Bariatr Surg Pract Patient Care 2018. [DOI: 10.1089/bari.2018.0014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Flora Vayr
- Occupational and Environmental Medicine Department, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Lydie Charras
- Public Health and Social Medicine Department, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Frederic Savall
- Laboratoire d'Anthropologie Moléculaire AMIS, Centre Hospitalier Universitaire de Toulouse, UMR 5288 CNRS, UPS, Toulouse, France
| | - Jean Marc Soulat
- Public Health and Social Medicine Department, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Patrick Ritz
- Cardiovascular and Metabolic Disease Department, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Fabrice Herin
- Public Health and Social Medicine Department, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| |
Collapse
|
9
|
Accardi R, Fave AD, Ronchi S, Terzoni S, Racaniello E, Destrebecq A. The Role of Quality of Life Instruments in Obesity Management: Review. Bariatr Surg Pract Patient Care 2017. [DOI: 10.1089/bari.2017.0015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Roberto Accardi
- Department of Surgery, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Antonella Delle Fave
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Silvia Ronchi
- Department of Surgery, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefano Terzoni
- San Paolo Bachelor School of Nursing, San Paolo Teaching Hospital, Milan, Italy
| | - Emanuela Racaniello
- Department of Surgery, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Anne Destrebecq
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| |
Collapse
|
10
|
Accardi R, Ronchi S, Racaniello E, Terzoni S, Destrebecq A. Italian Version of the Laval Questionnaire: Validity and Reliability. Bariatr Surg Pract Patient Care 2017. [DOI: 10.1089/bari.2017.0017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Roberto Accardi
- Department of Surgery, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Silvia Ronchi
- Department of Surgery, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Emanuela Racaniello
- Department of Surgery, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefano Terzoni
- San Paolo Bachelor School of Nursing, San Paolo Teaching Hospital, Milan, Italy
| | - Anne Destrebecq
- Department of Biomedical Sciences for Health, University of Milan (Italy), Milan, Italy
| |
Collapse
|
11
|
Changes in Health-Related Quality of Life After Gastric Bypass in Patients With and Without Obesity-Related Disease. Obes Surg 2016; 25:2408-16. [PMID: 26003550 DOI: 10.1007/s11695-015-1717-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND A substantial proportion of severely obese patients undergoing bariatric surgery have not developed disease as a consequence of obesity. Little is known about the effects of bariatric surgery on health-related quality of life (HRQL) in this patient group. In a prospective study at a public hospital, we compared HRQL in gastric bypass patients with and without obesity-related disease before and 2 years after surgery. METHODS HRQL was assessed in 232 severely obese patients before, 1 year, and 2 years after Roux-en-Y gastric bypass. We used a general HRQL questionnaire, the Short Form 36, and an obesity-specific questionnaire, the Obesity-related Problems scale. The patients were divided into two groups based on the presence of obesity-related disease (n = 146) or not (n = 86) before surgery. We defined obesity-related disease as having at least one of the following conditions: type 2 diabetes mellitus, hypertension, dyslipidemia, coronary heart disease, obstructive sleep apnea, gastroesophageal reflux disease, or osteoarthritis. Linear mixed models were used to analyze the HRQL outcomes. RESULTS Before surgery, patients with no obesity-related disease reported equal HRQL compared with patients with obesity-related disease. Two years after gastric bypass, substantial improvements in all subscales of Short Form 36 and in Obesity-related Problems scale were observed in both groups, and the improvements were similar in 7 out of 8 subscales of Short Form 36 as well as for the Obesity-related Problems scale. CONCLUSIONS Baseline HRQL was similar in patients with and without obesity-related disease prior to gastric bypass. After surgery, patients with no comorbidity had similar positive changes in HRQL as patients with one or several comorbidities. These findings indicate that other factors than obesity-related disease are at least as important for severely obese patients' impaired HRQL.
Collapse
|
12
|
Oudghiri DE, Ruiz-Cabello P, Camiletti-Moirón D, Fernández MDM, Aranda P, Aparicio VA. Influence of weight status on physical and mental health in Moroccan perimenopausal women. Pan Afr Med J 2016; 23:153. [PMID: 27303571 PMCID: PMC4894727 DOI: 10.11604/pamj.2016.23.153.8208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Accepted: 03/18/2016] [Indexed: 11/30/2022] Open
Abstract
Introduction There is a lack of information about fitness and other health indicators in women from countries such as Morocco. This study aims to explore the association of weight status with physical and mental health in Moroccan perimenopausal women. Methods 151 women (45-65 years) from the North of Morocco were analyzed by standardized field-based fitness tests to assess cardiorespiratory fitness, muscular strength, flexibility, agility and balance. Quality of life was assessed by means of the Short-Form-36 Health Survey. Resting heart rate, blood pressure and plasma fasting glucose, total cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides were also measured. Results Blood pressure (P=0.001), plasma triglycerides (P=0.041) and the prevalence of metabolic syndrome (P<0.001) increased as weight status increased. Levels of cardiorespiratory fitness, upper-body flexibility (both, P<0.001), static balance (P<0.05) and dynamic balance (P<0.01) decreased as weight status increased. Pairwise comparisons showed differences mainly between normal-weight and overweight vs. obese groups. No differences between groups were observed on quality of life. Conclusion Cardiovascular and lipid profile and fitness, important indicators of cardiovascular disease risk, worsened as weight status increased, whereas quality of life appears to be independent of weight status. Exercise and nutritional programs focus on weight management may be advisable in this under studied population.
Collapse
Affiliation(s)
- Dia Eddine Oudghiri
- Department of Physiology and Pathophysiology, University AbdelmalekEssaadi, Tetouan, Morocco
| | - Pilar Ruiz-Cabello
- Department of Physiology and Institute of Nutrition and Food Technology, Faculty of Pharmacy and School of Sport Sciences, University of Granada, Granada, Spain
| | - Daniel Camiletti-Moirón
- Department of Physiology and Institute of Nutrition and Food Technology, Faculty of Pharmacy and School of Sport Sciences, University of Granada, Granada, Spain
| | - María Del Mar Fernández
- Department of Physiology and Institute of Nutrition and Food Technology, Faculty of Pharmacy and School of Sport Sciences, University of Granada, Granada, Spain
| | - Pilar Aranda
- Department of Physiology and Institute of Nutrition and Food Technology, Faculty of Pharmacy and School of Sport Sciences, University of Granada, Granada, Spain
| | - Virginia Ariadna Aparicio
- Department of Physiology and Institute of Nutrition and Food Technology, Faculty of Pharmacy and School of Sport Sciences, University of Granada, Granada, Spain; Department of Public and Occupational Health, VU University and EMGO+ Institute for Health and Care Research, Amsterdam, The Netherlands
| |
Collapse
|
13
|
Work participation among the morbidly obese seeking bariatric surgery: an exploratory study from Norway. Obes Surg 2015; 25:271-8. [PMID: 24980085 DOI: 10.1007/s11695-014-1333-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND The aim of this study is to assess the rate of work participation and disability pension, and identify predictors for sickness absence and disability pension, among morbidly obese individuals. METHODS The data were collected from the Obesity Surgery Registry at Førde Central Hospital and consists of patients undergoing bariatric surgery between April 2001 and February 2013. Multivariate logistic regression was performed to identify predictors of sickness absence and disability pension. RESULTS The sample consisted of 576 patients (63.9 % females) with a mean (range, SD) age of 41.7 (18-66, 10.6) and a mean body mass index (BMI) of 47.7 (32.5-80.8, 7.7). Patients working full- or part-time comprised 55.6 % of the sample and 29.7 % received a disability pension; only 46.4 % of the sample received an income from paid work without additional benefits. Having a BMI above 50, lower levels of education, and suffering from four or more comorbidities were significant predictors of sickness absence. Female gender, psychiatric disorders, lower levels of education, asthma, heart failure and suffering from four or more comorbidities were significant predictors of disability pension. CONCLUSIONS The proportion of the work participation and disability pension among this morbidly obese population is of substantial concern, as work participation has proven important for the health-related quality of life. This, combined with the fact that these patients are significantly less educated than the general population, can potentially have grave socioeconomic consequences. Increased knowledge of obesity development and the work history of these patients are needed to implement policies that ensure increased rates of work participation.
Collapse
|
14
|
Andersen JR, Hernæs UJ, Hufthammer KO, Våge V. Employment status and sick-leave following obesity surgery: a five-year prospective cohort study. PeerJ 2015; 3:e1285. [PMID: 26468438 PMCID: PMC4592158 DOI: 10.7717/peerj.1285] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 09/10/2015] [Indexed: 11/20/2022] Open
Abstract
Background. Severe obesity is a risk factor for lower participation in paid work, but whether employment increases and sick leave decreases after obesity surgery is not well documented. Methods. We assessed 224 Norwegian patients with severe obesity (mean age: 40; mean BMI: 49; 61% female) regarding employment status (working versus not working) and the number of days of sick leave during the preceding 12 months, before and five years after obesity surgery (75% follow-up rate). Logistic regression analysis was used to study preoperative predictors of employment status after surgery. Results. There were no change in the employment rate over time (54% versus 58%), but the number of days of sick leave per year was significantly reduced, from a mean of 63 to a mean of 26, and from a median of 36 to a median of 4. Most of this change was attributable to patients with zero days of sick leave, which increased from 25% to 41%. Being female, older, having low education level, receiving disability pension and not being employed before obesity surgery were important risk factors for not being employed after obesity surgery. The type of obesity surgery, BMI and marital status were not useful predictors. Conclusions. Our findings suggest that undergoing obesity surgery is not associated with a higher rate of employment, although it may reduce the number of days of sick leave. Additional interventions are likely needed to influence the employment status of these patients. The significant preoperative predictors of not being employed in this study provide suggestions for further research.
Collapse
Affiliation(s)
- John Roger Andersen
- Faculty of Health Studies, Sogn og Fjordane University College, Førde, Norway
- Centre of Health Research, Førde Hospital Trust, Førde, Norway
| | - Ulrikke J.V. Hernæs
- Centre of Health Research, Førde Hospital Trust, Førde, Norway
- Department of Research and Development, Haukeland University Hospital, Bergen, Norway
| | | | - Villy Våge
- Centre of Health Research, Førde Hospital Trust, Førde, Norway
- Department of Surgery, Voss Hospital, Helse Bergen Health Trust, Voss, Norway
| |
Collapse
|
15
|
Health-related quality of life in morbid obesity: the impact of laparoscopic sleeve gastrectomy. Open Med (Wars) 2014. [DOI: 10.2478/s11536-013-0294-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AbstractOur aim in this prospective study was to determine the impact of laparoscopic sleeve gastrectomy on the quality of life of patients with morbid obesity in comparison with population standards. The study evaluated 76 morbidly obese patients who underwent laparoscopic sleeve gastrectomy. The short version of the World Health Organization Quality of Life questionnaire (WHOQOL-BREF) was used to evaluate quality of life in the following four areas: physical health, mental health, social relations, and environment. Patients completed the questionnaire before their planned operation and again 3 and 6 months after surgery. Compared with the population standard, patients with morbid obesity had significantly lower quality of life scores in the physical and mental health domains, including on independent questions related to of overall health and quality of life (p<0.001). Women scored lower on indicators of mental health than men. Three and 6 months following surgery a significant trend of body mass index (BMI) reduction was seen, as well as increased quality of life in all indicated areas (p<0.001). Laparoscopic sleeve gastrectomy treatment in morbidly obese patients reduced BMI on a long-term basis, a change seen as early as 3 months after surgery. By 6 months after surgery, patients had the same quality of life scores as the reference population.
Collapse
|
16
|
Caixàs A, Lecube A, Morales MJ, Calañas A, Moreiro J, Cordido F, Díaz MJ, Masmiquel L, Moreno B, Vidal J, Goday A, Arrizabalaga JJ, García-Luna PP, Iglesias P, Burguera B, Rubio MA, Monereo S, Crosby RD, Kolotkin RL. Weight-related quality of life in Spanish obese subjects suitable for bariatric surgery is lower than in their North American counterparts: a case-control study. Obes Surg 2013; 23:509-14. [PMID: 23090430 DOI: 10.1007/s11695-012-0791-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Obesity impairs quality of life, but the perception of the impairment could be different from one country to another. The purpose was to compare weight-related quality of life (QOL) between cohorts from Spain and North America. METHODS A cross-sectional case-control study was performed between two populations. Four hundred Spanish and 400 North American obese subjects suitable for bariatric surgery closely matched for race, gender, age, and body mass index (BMI) were included. Two non-obese control groups matched for gender, age, and BMI from each population were also evaluated (n = 400 in each group). The participants completed the Impact of Weight on Quality of Life-Lite (IWQOL-Lite) questionnaire, a measure of weight-related QOL. RESULTS Spanish morbidly obese patients showed poorer QOL than their North American counterparts in physical function, sexual life, work, and total score. By contrast, Spanish non-obese control subjects reported better QOL in all domains than their North American counterparts. Women, both in Spain and North America, reported reduced QOL compared to men on the domain of self-esteem. In addition, North American women reported reduced QOL on the sexual life domain compared to men. BMI correlated negatively with all domains of QOL except for self-esteem in both national groups. CONCLUSIONS Spanish obese subjects suitable for bariatric surgery report poorer weight-related quality of life than their North American counterparts, and obese women, regardless of nationality, perceive a reduced quality of life compared to men.
Collapse
Affiliation(s)
- Assumpta Caixàs
- S. Endocrinología y Nutrición, Corporació Sanitaria Univ. Parc Taulí, Institut de Recerca Parc Taulí (UAB), C/Parc Taulí s/n, 08208, Sabadell, Barcelona, Spain.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Karlsen TI, Søhagen M, Hjelmesæth J. Predictors of weight loss after an intensive lifestyle intervention program in obese patients: a 1-year prospective cohort study. Health Qual Life Outcomes 2013; 11:165. [PMID: 24090083 PMCID: PMC3851047 DOI: 10.1186/1477-7525-11-165] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Accepted: 09/28/2013] [Indexed: 12/18/2022] Open
Abstract
Background Studies of lifestyle intervention programs in morbid obesity report large variations in weight loss outcomes. This is reported not only between but also within standardized programs. Such reports point to participants’ characteristics as possible predictors of this outcome. The aim of this prospective cohort study was to identify predictors of weight loss after a 1-year partly residential intensive lifestyle intervention program (ILI). Methods Morbidly obese patients (n=199), all Caucasian, 71% women, mean (SD) age 45.2 (11.1) years, body mass index (BMI) 42.0 (6.2) kg/m2, and excess body weight (>BMI=25 kg/m2) 49.4 (19.6) kg, were referred from public hospitals to a rehabilitation center and enrolled consecutively. The 1-year ILI comprised of four (n=104) or five (n=95) stays at the rehabilitation center. In both cases there was one main stay for 4 weeks and the remaining stays lasted 1 week each. In the home periods the patients were followed up by telephone and by their general practitioners (GP). The patients were also encouraged to use a predefined paper based diary. Health related quality of life (HRQL), diagnostic, anthropometric, socio-demographic, psychosocial and intervention characteristics were measured at baseline, 12 weeks and 1 year. Multiple linear regression analyses were performed to extract possible predictors of weight loss at 1-year. Direct and indirect effects of these predictors were tested through structural equation modeling. Results The mean (SD) 1-year weight loss was 10 (11) kg, corresponding to an 8 (8) % reduction of body weight from baseline. Mean excess weight loss (EWL) was 20 (22) % ranging from 104% to -77%. The adherence to a diary (r=.16), type 2 diabetes (r=-.14) and frequency of GP-visits (r=.23) were significantly associated with EWL at 12 weeks. Predictors of 1-year EWL were 12 week EWL (r=.66), occupational status (r=.11), age (r=.19), and mental HRQL (r=-.16), all p<.05. The path model explained 50% of the variation (r2=.50) of 1-year EWL. Conclusion Larger 12 week weight loss, being employed, lower mental HRQL and being older predicts larger weight loss after 1 year in morbidly obese patients following ILI. Not having type 2 diabetes, using a diary combined with regular GP follow-up influence the 12-week weight loss. Trial registration Clinicaltrials.gov: NCT00477399
Collapse
Affiliation(s)
- Tor-Ivar Karlsen
- Department of Health and Nursing Sciences, University of Agder, Jon Lilletuns vei 9, Grimstad, 4879, Norway.
| | | | | |
Collapse
|
18
|
Brandheim S, Rantakeisu U, Starrin B. BMI and psychological distress in 68,000 Swedish adults: a weak association when controlling for an age-gender combination. BMC Public Health 2013; 13:68. [PMID: 23347701 PMCID: PMC3564918 DOI: 10.1186/1471-2458-13-68] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Accepted: 01/11/2013] [Indexed: 11/23/2022] Open
Abstract
Background Study results concerning associations between body mass index (BMI) and psychological distress are conflicting. The purpose of this study was to describe the shape of the association between BMI and psychological distress in a large sample of Swedish adults. Methods Data was measured with the General Health Questionnaire-12 (GHQ-12), in 68,311 adults aged 18–74. Self-reported data was derived from a merger of the 2000, 2004 and 2008 Life and Health (Liv och Hälsa) questionnaires focusing general perceived distress as well as living conditions. Logistic regression analysis was used to describe the association between BMI and psychological distress when controlled for age and gender in combination. Results Women reported an overall higher psychological distress than men. A significant pattern of decreasing psychological distress with increasing age emerged among women in all BMI categories. Trends of this same pattern showed for men. Small or no differences were seen in psychological distress between those in normal weight, overweight, and obesity I categories (among women: 20.4%, 18.4%, 20.5%; among men: 12.8%, 11.2%, 12.9%). For both genders, any notable increase in psychological distress appeared first in the obesity II category (among women: 27.2%. Among men: 17.8%). Conclusions Psychological distress decreases with increasing age regardless of BMI; a pattern more obvious for women. Being categorized with obesity II leads to a markedly higher psychological distress than being categorized with normal weight, overweight or obesity I. From this, we suggest that future obesity research focusing on psychological distress could investigate the role of stigma and norm susceptibility in relationships where people are evaluated through the eyes of the other.
Collapse
Affiliation(s)
- Susanne Brandheim
- Department of Social and Psychological Studies, Karlstad University, Karlstad, SE 651 88, Sweden.
| | | | | |
Collapse
|
19
|
Andenæs R, Fagermoen MS, Eide H, Lerdal A. Changes in health-related quality of life in people with morbid obesity attending a learning and mastery course. A longitudinal study with 12-months follow-up. Health Qual Life Outcomes 2012; 10:95. [PMID: 22901031 PMCID: PMC3462106 DOI: 10.1186/1477-7525-10-95] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2011] [Accepted: 06/27/2012] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Severe obesity is a complex condition that is associated with a wide range of serious health complications and reduced health-related quality of life (HRQoL). In addition to physiological factors, activity and participation, environmental factors, and personal factors are related to an individual's overall quality of life HRQoL. In Norway, a course based on cognitive behavioral principles is offered to people seeking medical treatment for weight management. The aim is to assist participants to achieve a healthier lifestyle and thereby improve their HRQoL. We therefore investigated changes in HRQoL in participants after they attended this learning and mastery course, and explored how well sociodemographic variables, paid work, social support, personal factors, and surgery predicted HRQoL at 12-month follow-up. METHODS A single-group longitudinal study was conducted. Data were collected by self-reported questionnaires. This article reports on those who had completed the questionnaire at the 12-month (n = 69) follow-up. HRQoL was assessed with the EQ-5D. Other standardized instruments measured employment, social support, self-efficacy, and surgery. RESULTS At the 12-month follow-up, participants scored higher on all dimensions of the EQ-5D and on the EQ-VAS. Generalized linear model showed that having paid work, and social support were statistically significant predictors of HRQoL at the 12-month follow-up. Sex, self-efficacy, and surgery were not statistically significant associated with HRQoL. CONCLUSIONS Participation in paid work, and receiving social support from persons with whom they had a close relationship were strongly related to HRQoL in obese people 12 months after participating in a learning and mastery course. TRIAL REGISTRATION The study is registered in Clinical Trials: NCT01336725.
Collapse
Affiliation(s)
- Randi Andenæs
- Dept of Nursing, Faculty of Health Science, Oslo and Akershus University College of Applied Sciences, Box 4, St. Olavs plass, 0130, Oslo, Norway
| | - May S Fagermoen
- Department of gastroenterology, Oslo University Hospital, Oslo and Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Hilde Eide
- Department of Health Sciences, Buskerud University College, Buskerud, Drammen
| | - Anners Lerdal
- Lovisenberg Diakonale Hospital, Oslo, Norway &Department of gastroenterology, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
20
|
Kocełak P, Chudek J, Naworska B, Bąk-Sosnowska M, Kotlarz B, Mazurek M, Madej P, Skrzypulec-Plinta V, Skałba P, Olszanecka-Glinianowicz M. Psychological disturbances and quality of life in obese and infertile women and men. Int J Endocrinol 2012; 2012:236217. [PMID: 22844280 PMCID: PMC3403244 DOI: 10.1155/2012/236217] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Accepted: 05/21/2012] [Indexed: 11/17/2022] Open
Abstract
Anovulatory cycles and endometriosis are the main causes of female infertility. The most frequently anovulatory cycles are related to polycystic ovary syndrome (PCOS) commonly associated with obesity and hormonal disturbances in the course of obesity. Recently published studies revealed that infertility affects about one in six couples during their lifetime and is more frequent in obese. Obesity is also associated with male infertility related to erectile dysfunction, hormonal disturbances and lower semen quality. Any of these above mentioned disorder is the important risk factor of psychological disturbances and poor quality of life among women and men in the reproductive age. On the other hand the mood disorders may exacerbate the hormonal disturbances and worsen the effectiveness of infertility management. Infertility, its therapy with accompanying psychological disturbances may also significantly affect the partners relationships. The review summarize the results described in the current literature on the association between obesity and infertility and psychological disturbances as well as their impact on quality of life and sexual functioning in women and men. Moreover, the impact of infertility and psychological disturbances on partners relationships is discussed.
Collapse
Affiliation(s)
- Piotr Kocełak
- Health Promotion and Obesity Management Unit, Department of Pathophysiology, Medical University of Silesia, 40-752 Katowice, Poland
| | | | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Kramer L, Hirsch O, Schlössler K, Träger S, Baum E, Donner-Banzhoff N. Associations between demographic, disease related, and treatment pathway related variables and health related quality of life in primary care patients with coronary heart disease. Health Qual Life Outcomes 2012; 10:78. [PMID: 22776102 PMCID: PMC3464887 DOI: 10.1186/1477-7525-10-78] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Accepted: 06/19/2012] [Indexed: 11/11/2022] Open
Abstract
Background Coronory heart disease (CHD) is a common medical problem worldwide that demands shared care of general practitioners and cardiologists for concerned patients. In order to improve the cooperation between both medical specialists and to optimize evidence-based care, a treatment pathway for patients with CHD was developed and evaluated in a feasibility study according to the recommendation for the development and evaluation of complex interventions of the British Medical Research Council (MRC). In the context of this feasibility study the objective of the present research was to investigate the contributions of different disease related (e.g. prior myocardial infarction), pathway related (e.g. basic medication) and demographic variables on patients` perceived health related quality of life (HRQoL) as a relevant and widely used outcome measure in cardiac populations. Methods Data assessing demographic, disease and pathway related variables of CHD patients included in the study were collected in a quasi-experimental design with three study arms (pathway developers, users, control group) via case record forms and questionnaires at baseline and after 6 and 12 (intervention groups), and 9 months (control group), respectively after the initial implementation on GP level. Additionally, at the same measuring points the CHD patients participating in the study were interviewed by phone regarding their perceived HRQoL, measured with the EuroQol EQ-5D as an index-based health questionnaire. Due to the hierarchical structure of the data, we performed cross-sectional and longitudinal linear mixed models to investigate the impact of disease related, pathway related and demographic variables on patients` perceived HRQoL. Results Of 334 initially recruited patients with CHD, a total of 290 were included in our analysis. This was an average 13.2% dropout rate from baseline assessment to the 12-month follow-up. At all assessment points, patients` HRQoL was associated with a variety of sociodemographic variables (e.g. gender, employment, education) in each study group, but there was no association with pathway related variables. In both cross-sectional and longitudinal analyses highest HRQoL values in patients were reported in the physician group that had developed the pathway. In the longitudinal analyses there were no significant changes in the reported HRQoL values of the three groups over time. Conclusions The found associations between sociodemographic variables and the perceived HRQoL of patients with CHD are in line with other research. As there are no associations of HRQoL with pathway related variables like the basic medication, possible weaknesses in the study design or the choice of outcome have to be considered before planning and conducting an evaluation study according to the MRC recommendations. Additionally, as patients in the developer group reported the highest HRQoL values over time, a higher commitment of the GPs in the developer group can be assumed and should be considered in further research.
Collapse
Affiliation(s)
- Lena Kramer
- Department of General Practice/Family Medicine, Philipps University of Marburg, Karl-von-Frisch-Strasse 4, 35043, Marburg, Germany.
| | | | | | | | | | | |
Collapse
|