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Ackerman IN, Fotis K, Pearson L, Schoch P, Broughton N, Brennan-Olsen SL, Bucknill A, Cross E, Bunting-Frame N, Page RS. Impaired health-related quality of life, psychological distress, and productivity loss in younger people with persistent shoulder pain: a cross-sectional analysis. Disabil Rehabil 2021; 44:3785-3794. [PMID: 33620022 DOI: 10.1080/09638288.2021.1887376] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE To investigate wellbeing and work impacts in younger people with persistent shoulder pain. MATERIALS AND METHODS People aged 20-55 years with shoulder pain of >6 weeks' duration (excluding those with recent fracture or dislocation) were recruited from orthopaedic clinics at three major public hospitals. Health-related quality of life (HRQoL) and psychological distress were evaluated using the Assessment of Quality of Life (AQoL) and K10 instruments and compared to population norms. Shoulder-related absenteeism and presenteeism were quantified using the Work Productivity and Activity Impairment (WPAI) Questionnaire. RESULTS Of the 81 participants (54% male), 69% had shoulder pain for over 12 months. Substantial HRQoL impairment was evident (mean reduction from population norms 0.33 AQoL units, 95% CI -0.38 to -0.27; minimal important difference 0.06 AQoL units). High or very high psychological distress was three times more prevalent among participants than the general population (relative risk 3.67, 95% CI 2.94 to 4.59). One-quarter of participants had ceased paid employment due to shoulder pain and 77% reported shoulder-related impairment at work. CONCLUSIONS The broader impacts of painful shoulder conditions on younger people extend well beyond pain and upper limb functional limitations. In particular, the work-related impacts should form a routine part of patient assessment and rehabilitation.Implications for rehabilitationPersistent shoulder pain in younger people (aged 20-55 years) is associated with substantially reduced health-related quality of life and greater psychological distress, compared to population norms, as well as work participation and productivity impacts.As rotator cuff conditions, shoulder capsule pathology, and glenohumeral instability are relatively common, our data suggest that persistent shoulder pain is likely to have a high community impact among people of working age.Information resources that people with painful shoulder conditions can share with their families, employers, and colleagues may assist others to better understand the broader impacts of these conditions.Work-related challenges associated with shoulder pain should be considered within routine clinical care, and may require referral to an occupational health clinician or vocational rehabilitation service.
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Affiliation(s)
- Ilana N Ackerman
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Kathy Fotis
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Lauren Pearson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Peter Schoch
- Physiotherapy Department, Barwon Health, Geelong, Australia
| | - Nigel Broughton
- Orthopaedic Department, Frankston Hospital, Frankston, Australia.,Department of Surgery, Central Clinical School, Monash University, Melbourne, Australia
| | - Sharon L Brennan-Olsen
- Department of Medicine - Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, Australia.,Australian Institute for Musculoskeletal Science, Melbourne, Australia.,School of Health and Social Development, Deakin University, Geelong, Australia.,Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Andrew Bucknill
- Department of Orthopaedic Surgery, The Royal Melbourne Hospital, Melbourne, Australia.,Department of Surgery, The University of Melbourne, Melbourne, Australia
| | - Emily Cross
- Physiotherapy Department, The Royal Melbourne Hospital, Melbourne, Australia
| | | | - Richard S Page
- Barwon Centre for Orthopaedic Research and Education (B-CORE), St John of God Hospital and Barwon Health, Geelong, Australia.,School of Medicine, Deakin University, Geelong, Australia
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Ackerman IN, Page RS, Fotis K, Schoch P, Broughton N, Brennan-Olsen SL, Bucknill A, Cross E. Exploring the personal burden of shoulder pain among younger people in Australia: protocol for a multicentre cohort study. BMJ Open 2018; 8:e021859. [PMID: 30030319 PMCID: PMC6059320 DOI: 10.1136/bmjopen-2018-021859] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION Persistent musculoskeletal conditions can impact profoundly on younger people's quality of life, psychological distress and capacity to work, as shown by previous research involving younger people with osteoarthritis. The personal impacts, in particular, work and parenting impacts, of other musculoskeletal conditions (such as persistent shoulder pain) on younger patient groups remain poorly understood. Furthermore, the personal financial burden associated with managing musculoskeletal conditions is rarely documented. This study aims to investigate well-being, work participation and productivity, shoulder-related parenting disability and out-of-pocket healthcare expenditure among younger people with shoulder pain and evaluate changes over 12 months. METHODS AND ANALYSIS One hundred and fifty people aged 20-55 years with shoulder pain of more than 6 weeks' duration (excluding those with recent history of fracture or dislocation) will be recruited for this cohort study. Participants will be recruited from three major public hospitals in Victoria, Australia, following screening of orthopaedic outpatient clinics lists and referrals. Participants will be asked to complete a baseline questionnaire and 2-week healthcare costs diary, with follow-up data collected at 12 months. Patient-reported outcomes will be collected, including health-related quality of life (HRQoL), shoulder pain and function, psychological distress, shoulder-related parenting disability and work productivity. Information on sociodemographics, employment, health services utilisation and shoulder-related healthcare expenditure will also be collected. Descriptive analysis of baseline data will provide a comprehensive snapshot of the personal burden of shoulder pain. Baseline HRQoL and psychological distress data will be compared with Australian population norms to provide context around well-being. Associations between sociodemographic factors and patient-reported outcomes will be evaluated using univariate and multivariate analyses. Changes in patient-reported outcomes from baseline to 12 months will be analysed using paired t-tests. ETHICS AND DISSEMINATION Ethics approval has been obtained. The study findings will be submitted to peer-reviewed journals and presented at relevant scientific meetings.
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Affiliation(s)
- Ilana N Ackerman
- Department of Epidemiology and Preventive Medicine, Monash University Faculty of Medicine Nursing and Health Sciences, Melbourne, Victoria, Australia
| | - Richard S Page
- Barwon Orthopaedic Research and Education, Barwon Health and School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Kathy Fotis
- Department of Epidemiology and Preventive Medicine, Monash University Faculty of Medicine Nursing and Health Sciences, Melbourne, Victoria, Australia
| | - Peter Schoch
- Physiotherapy Department, Barwon Health, Geelong, Victoria, Australia
| | - Nigel Broughton
- Orthopaedic Department, Frankston Hospital, Frankston, Victoria, Australia
- Department of Surgery, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Sharon L Brennan-Olsen
- Department of Medicine - Western Health, The University of Melbourne, Melbourne, Victoria, Australia
- Australian Institute for Musculoskeletal Science, Melbourne, Victoria, Australia
| | - Andrew Bucknill
- Department of Orthopaedic Surgery, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Emily Cross
- Physiotherapy Department, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
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