Predictors for suicidal ideation after occupational injury

Depressive symptoms, suicidal ideation, and mental health care-seeking in central Mozambique

PURPOSE

There is scant research on depressive symptoms (DS), suicidal ideation (SI), and mental health care-seeking in Mozambique.

METHODS

Generalized estimating equations were used to assess factors associated with DS, SI, and mental health care-seeking among 3080 individuals interviewed in a representative household survey in Sofala and Manica provinces, Mozambique.

RESULTS

19% (CI 17-21%) of respondents reported DS in the past year and 17% (CI 15-18%) lifetime SI. Overall, only 10% (CI 8-11%) of respondents ever sought any care for mental illness, though 26% (CI 23-29%) of those reporting DS and/or SI sought care. 90% of those who sought care for DS received treatment; however, only 46% of those who sought care for SI received treatment. Factors associated with DS and SI include: female gender, divorced/separated, widowed, and > 55 years old. Respondents in the bottom wealth quintile reported lower DS, while those in upper wealth quintiles reported higher prevalence of SI. Individuals with DS or SI had significantly elevated measures of disability-especially in doing household chores, work/school activities, standing for long periods, and walking long distances. Factors associated with care-seeking include: female gender, rural residence, divorced/separated, and > 45 years old. Individuals in lower wealth quintiles and with no religious affiliation had lower odds of seeking care.

CONCLUSIONS

DS and SI are prevalent in central Mozambique and treatment gaps are high (68% and 89%, respectively). An urgent need exists for demand- and supply-side interventions to optimize the delivery of comprehensive community-based mental healthcare in Mozambique.

Quality of life at 6 years after occupational injury

PURPOSE

Occupational injuries have considerable impact on workers' lives. However, data regarding workers' health-related quality of life (HRQOL) at several years after the injury are lacking. This study assessed workers' HRQOL at 6 years after occupational injury and determined related factors in each HRQOL domain.

METHODS

Workers who sustained an occupational injury in 2009 and who responded to a previous survey at 3 or 12 months after their injury were followed up in 2015. A total of 1715 participants were candidates for this study. The Taiwanese version of the World Health Organization Quality of Life scale-abbreviated version (WHOQOL-BREF) was used to assess their HRQOL. Multiple linear regression analysis identified predictive factors for HRQOL at 6 years after occupational injury.

RESULTS

A total of 563 workers completed the questionnaire (response rate, 32.8%). Adverse life events and additional severe occupational injuries that occurred within the follow-up period, and decreased salary after the injury were significant factors for low scores in all domains of the WHOQOL-BREF. In addition, unmarried participants had low scores in the social relationship domain. Workers with family members requiring care scored low in the physical and environment domains. Workers whose injuries had major effects on their physical appearance had low scores in the physical and psychological domains. Workers with unstable employment had low scores in physical, psychological, and environment domains.

CONCLUSION

At 6 years after occupational injury, workers' HRQOL was poor among those whose salaries decreased after the injury, after adjustment for other factors.

Prevalence of Self-Reported Work-Related Injuries and Their Association with Psychological Symptoms in General Working Population of Taiwan

Objectives This study investigated the prevalence of self-reported work-related injuries across occupational groups and examined their association with the risk of psychological symptoms in general working population of Taiwan. Methods Data from a national survey conducted in 2013 of a representative sample of general working people of Taiwan was analyzed, consisting of 12,528 male and 8396 female workers aged 25~65 years. Information about work-related injuries including work-related disease occurred over the previous 12 months prior to the survey was obtained by a standardized questionnaire. The presence of psychological symptoms was assessed by the Brief Symptom Rating Scale (BSRS). Also obtained were participants' socio-demographic characteristics, working hours, job control, psychological job demands, physical job demands and job insecurity. Results Over a year, 14.91 % of male and 11.53 % of female working people had experienced work-related injuries. Workers with lower educational level, manual workers, the self-employed as well as employers of small enterprise were at higher risks for work-related injuries. Findings from multivariate logistic regression analyses with adjustment of gender, age, working hours and psychosocial work conditions showed that employees with experiences of work-related injuries over the past year were at a substantially higher risk for psychological symptoms (OR = 2.42) as compared to employees who had no experiences of work-related injuries. Conclusion A sizable proportion of workers are affected by work-related injuries and these workers are at higher risk for psychological symptoms. The psychosocial consequences of work-related injuries deserve further investigation and interventions.

The impact of psychological symptoms on return to work in workers after occupational injury

INTRODUCTION

This study aimed to investigate the impact of psychological symptoms on return to work (RTW) in workers after occupational injuries.

METHODS

Our study candidates were injured workers who were hospitalized for 3 days or longer and received hospitalization benefits from the Labor Insurance. A self-reported questionnaire including Brief Symptom Rating Scale (BSRS-50) and RTW was sent to workers at 12 weeks after injury. At 1 year, all participants were contacted again to determine whether or not they had RTW.

RESULTS

A total of 2001 workers completed the questionnaire (response rate 45.5 %) at 12 weeks after injury, among them, 1,149 had returned to work. Among the 852 who were unable to return to work at 12 weeks after injury, 225 reportedly returned to work by 1 year. A proportional hazards regression indicated that after adjusting for all possible risk factors, higher scores in BSRS-50 and BSRS-5 at 12 weeks after injury were significant risk factors for not return to work (NRTW) at 1 year after injury. Other risk factors were gender, education level, length of hospitalization, affected physical appearance, and injury type. Among 10 psycho-physiological symptoms of BSRS-50, a proportional hazards regression indicated that high score in phobic-anxiety scale was a risk factor for NRTW.

CONCLUSIONS

After considering all other factors, psychological symptoms further predicted poorer probability of returning to work after occupational injury, and phobic-anxiety was the most significant symptom predicting poor RTW. Development of preventive measures among injured workers according to the risk factors identified in this study is warranted.