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Zhang X, Zhao Q, Wang M, Yang M, Fan X. Fear of movement and its associated psychosocial factors in heart failure patients: A cross-sectional study. Eur J Cardiovasc Nurs 2022; 22:273-281. [PMID: 35989416 DOI: 10.1093/eurjcn/zvac075] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 08/13/2022] [Accepted: 08/17/2022] [Indexed: 11/13/2022]
Abstract
AIMS Fear of movement is a significant obstacle to daily activities, which may lead to adverse outcomes in patients with heart failure. This study aimed to examine the prevalence of fear of movement and to identify psychosocial factors associated with fear of movement in heart failure patients. METHODS AND RESULTS In this cross-sectional study, a total of 305 heart failure patients were recruited from three cardiovascular units of a university hospital. Self-reported questionnaires were used to measure fear of movement, cardiac anxiety, depressive symptoms, subjective social status, education, monthly income, and employment status. The results showed that 178 (58.4%) patients were accompanied with fear of movement. Hierarchical linear regression analysis showed that scores for cardiac anxiety (β=0.254, p < 0.001) and depressive symptoms (β=0.308, p < 0.001), as well as being employed (β=0.186, p < 0.001) were positively associated with fear of movement score, while the score for subjective social status (β=-0.101, p = 0.038) was negatively associated with fear of movement score. The four independent variables accounted for 30.3% of the variance in fear of movement. CONCLUSIONS Fear of movement is common in patients with heart failure. Cardiac anxiety, depressive symptoms, subjective social status, and employment status were associated with patients' fear of movement. This indicates that measures should be taken to screen and manage patients' fear of movement. Furthermore, alleviating cardiac anxiety and depressive symptoms may be important to consider in relieving fear of movement in heart failure patients, especially for those who are employed and with low subjective social status.
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Affiliation(s)
- Xiuting Zhang
- Candidate, School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Qiuge Zhao
- Candidate, School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Mei Wang
- Master Candidate, School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Mei Yang
- Master Candidate, School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Xiuzhen Fan
- Professor and Associate Dean, School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
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Pasanen J, Luoma A. How can social insurers promote return to work in occupational rehabilitation? A quantitative, cross-sectional study. BMC Public Health 2021; 21:1687. [PMID: 34530777 PMCID: PMC8444422 DOI: 10.1186/s12889-021-11758-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 08/30/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Earlier studies indicate a correlation between disability claims experience and return to work outcomes. Thus, the insurer's role and actions may affect the self-rated health of the disabled worker and the outcomes of occupational rehabilitation. This study diversifies the existing empirical evidence on the role of the insurer in the rehabilitation process and reveals the critical actions that best promote success. MATERIALS AND METHODS Explorative factor analysis (EFA) and confirmatory factor analysis (CFA), followed by binary regression, were used to analyse survey data of disabled workers (n = 661) who had undergone an occupational rehabilitation within an earnings-related pension insurance system in Finland. RESULTS The claimant's perceptions of the insurer's (1) high-quality informing and guidance, (2) customer orientation, (3) smooth process flow and (4) positive service attitude had substantial and statistically significant effects on the success of occupational rehabilitation after adjusting for all likely confounding variables. CONCLUSIONS The insurer's actions are significant predictors of the outcome of occupational rehabilitation. The insurer can promote the health of rehabilitees most effectively by ensuring a smooth process flow and adopting a customer-oriented approach.
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Affiliation(s)
- Jarna Pasanen
- Faculty of Management and Business, Tampere University, FI-33014, Tampere, Finland.
| | - Arto Luoma
- Faculty of Management and Business, Tampere University, FI-33014, Tampere, Finland
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Pasanen J. The nature of positive encounters between disabled workers and insurers in the return to work process. Work 2021; 70:287-300. [PMID: 34511472 DOI: 10.3233/wor-213573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Previous research regarding interaction between disabled workers and insurers indicates that encounters between these parties are predominantly negative in nature and may result in psychosocial harm for workers. Further research is required to investigate positive interactions to foster return to work after illness or injury. OBJECTIVE To explore and conceptualize perceived positive encounters between disabled workers and insurers in order to identify the mechanisms that support successful rehabilitation outcomes. METHODS This qualitative study explored the experiences of twenty-four disabled workers who had undergone an occupational rehabilitation process. Data were collected with in-depth semi-structured interviews, transcribed, coded, and analyzed using inductive content analysis. RESULTS Four main themes arose from the 24 key concepts relating to the positive encounters: (1) process flow, (2) customer orientation, (3) information and guidance, and (4) service attitude. The results also reveal that perceived positive encounters promote the return to work not only directly, but also indirectly by improving the informants' motivation, which has previously been found to be one of the most significant factors explaining the outcomes of rehabilitation. CONCLUSIONS The positive relationship between disabled workers and insurers during an occupational rehabilitation could be better understood through a conceptualization of perceived positive encounters. Underlining the importance of positive encounters and their ability to improve the rehabilitee's motivation may contribute to better support methods for the return to work.
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Affiliation(s)
- Jarna Pasanen
- Faculty of Management and Business, Tampere University, Tampere, Finland. Tel.: +358 400 254 312; E-mail:
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Collie A, Sheehan L, Lane TJ, Gray S, Grant G. Injured worker experiences of insurance claim processes and return to work: a national, cross-sectional study. BMC Public Health 2019; 19:927. [PMID: 31291915 PMCID: PMC6621963 DOI: 10.1186/s12889-019-7251-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 06/28/2019] [Indexed: 11/23/2022] Open
Abstract
Background Insurance claims management practices may have a significant impact on the health and experiences of injured workers claiming in workers’ compensation systems. There are few multi-jurisdictional studies of the way workers experience compensation processes, and limited data on the association between claims experience and return to work outcomes. This study sought to identify worker, claim and injury related factors associated with injured worker experiences of workers’ compensation claims management processes, and to examine associations between claims experience and return to work. Methods A national, cross-sectional survey of injured workers involved in ten Australian workers’ compensation schemes. A total of 10,946 workers completed a telephone survey at 6 to 24 months post claim acceptance. Predictors of positive or negative/neutral claims experience were examined using logistic regression. Associations between claims experience, return to work status and duration of time loss were examined using logistic regression. Results Nearly one-quarter (23.0%, n = 2515) of workers reported a negative or neutral claims experience. Injury type, jurisdiction of claim, and time to lodge claim were most strongly associated with claims experience. Having a positive claims experience was strongly associated with having returned to work after accounting for injury, worker, claim and employer factors. Conclusions There is a strong positive association between worker experiences of the insurance claims process and self-reported return to work status. Revision and reform of workers’ compensation claims management practices to enhance worker experience and the fairness of procedures may contribute to improved return to work outcomes.
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Affiliation(s)
- Alex Collie
- Insurance Work and Health Group, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia.
| | - Luke Sheehan
- Insurance Work and Health Group, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia
| | - Tyler J Lane
- Insurance Work and Health Group, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia
| | - Shannon Gray
- Insurance Work and Health Group, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia
| | - Genevieve Grant
- Australian Centre for Justice Innovation, Faculty of Law, Monash University, Wellington Road, Clayton, Victoria, 3770, Australia
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Schofield D, Cunich M, Shrestha R, Passey M, Veerman L, Tanton R, Kelly S. The indirect costs of ischemic heart disease through lost productive life years for Australia from 2015 to 2030: results from a microsimulation model. BMC Public Health 2019; 19:802. [PMID: 31226965 PMCID: PMC6588908 DOI: 10.1186/s12889-019-7086-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Accepted: 05/31/2019] [Indexed: 11/12/2022] Open
Abstract
Background Most studies measure the impact of ischemic heart disease (IHD) on individuals using quality of life metrics such as disability-adjusted life-years (DALYs); however, IHD also has an enormous impact on productive life years (PLYs). The objective of this study was to project the indirect costs of IHD resulting from lost PLYs to older Australian workers (45–64 years), government, and society 2015–2030. Methods Nationally representative data from the Surveys of Disability, Ageing and Carers (2003, 2009) were used to develop the base population in the microsimulation model (Health&WealthMOD2030), which integrated data from established microsimulation models (STINMOD, APPSIM), Treasury’s population and workforce projections, and chronic conditions trends. Results We projected that 6700 people aged 45–64 were out of the labour force due to IHD in 2015, increasing to 8100 in 2030 (21 increase). National costs consisted of a loss of AU$273 (US$263) million in income for people with IHD in 2015, increasing to AU$443 ($US426) million (62% increase). For the government, extra welfare payments increased from AU$106 (US$102) million in 2015 to AU$143 (US$138) million in 2030 (35% increase); and lost income tax revenue increased from AU$74 (US$71) million in 2015 to AU$117 (US$113) million in 2030 (58% increase). A loss of AU$785 (US$755) million in GDP was projected for 2015, increasing to AU$1125 (US$1082) million in 2030. Conclusions Significant costs of IHD through lost productivity are incurred by individuals, the government, and society. The benefits of IHD interventions include not only improved health but also potentially economic benefits as workforce capacity.
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Affiliation(s)
- Deborah Schofield
- Department of Economics, Faculty of Business and Economics, Centre for Economic Impacts of Genomic Medicine (GenIMPACT), Macquarie University, Sydney, NSW, 2109, Australia
| | - Michelle Cunich
- The Boden Institute of Obesity, Nutrition, Exercise & Eating Disorders, Charles Perkins Centre, The University of Sydney, and Sydney Health Economics, Sydney Local Health District, John Hopkins Drive, Camperdown, NSW, 2006, Australia.
| | - Rupendra Shrestha
- Department of Economics, Faculty of Business and Economics, Centre for Economic Impacts of Genomic Medicine (GenIMPACT), Macquarie University, Sydney, NSW, 2109, Australia.,Faculty of Pharmacy, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Megan Passey
- University Centre for Rural Health, School of Public Health, The University of Sydney, Lismore, NSW, 2480, Australia
| | - Lennert Veerman
- Cancer Council NSW, 153 Dowling Street, Woolloomooloo, NSW, 2011, Australia.,Griffith University, School of Medicine, Gold Coast campus, Southport, QLD, 4222, Australia
| | - Robert Tanton
- National Centre for Social and Economic Modelling, University of Canberra, Canberra, ACT, Australia
| | - Simon Kelly
- National Centre for Social and Economic Modelling, University of Canberra, Canberra, ACT, Australia
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Nordgren L, Söderlund A. Social support, self-rated health and low mood in people on sick leave due to heart failure: a cross-sectional study. Scand J Public Health 2017; 46:606-612. [PMID: 29160157 DOI: 10.1177/1403494817718070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
AIMS The aim of this study was to investigate social support in relation to self-rated health and the prevalence of low mood in people on sick leave due to heart failure. METHODS A cross-sectional design was used, and 590 individuals on sick leave due to heart failure in Sweden responded to the postal questionnaire. The questions therein concerned received and needed functional and structural support from managers, work colleagues, families and friends. Multivariate analyses were conducted. RESULTS The variables of income and needed support from family contributed significantly and negatively to self-rated health. Those who perceived that they needed more support from their manager reported experiencing low mood more frequently. CONCLUSIONS The results showed a negative relation between manager support and low mood. Thus, support from managers and perceptions of low mood during sick leave are negatively associated, however, we do not know anything about the causality of this association. The results also indicated that needed support from family was negatively associated with self-rated health. The results also highlighted a multidimensional frailty in people with heart failure that needs to be recognized in future research as well as in clinical practice.
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Affiliation(s)
- Lena Nordgren
- 1 Centre for Clinical Research Sörmland, Uppsala University, Sweden.,2 Department of Public Health and Caring Sciences, Uppsala University, Sweden
| | - Anne Söderlund
- 3 School of Health, Care and Social Welfare, Mälardalen University, Sweden
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Nordgren L, Söderlund A. Emotions and encounters with healthcare professionals as predictors for the self-estimated ability to return to work: a cross-sectional study of people with heart failure. BMJ Open 2016; 6:e009896. [PMID: 28186921 PMCID: PMC5129055 DOI: 10.1136/bmjopen-2015-009896] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES To live with heart failure means that life is delimited. Still, people with heart failure can have a desire to stay active in working life as long as possible. Although a number of factors affect sick leave and rehabilitation processes, little is known about sick leave and vocational rehabilitation concerning people with heart failure. This study aimed to identify emotions and encounters with healthcare professionals as possible predictors for the self-estimated ability to return to work in people on sick leave due to heart failure. DESIGN A population-based cross-sectional study design was used. SETTING The study was conducted in Sweden. Data were collected in 2012 from 3 different sources: 2 official registries and 1 postal questionnaire. PARTICIPANTS A total of 590 individuals were included. STATISTICS Descriptive statistics, correlation analysis and linear multiple regression analysis were used. RESULTS 3 variables, feeling strengthened in the situation (β=-0.21, p=0.02), feeling happy (β=-0.24, p=0.02) and receiving encouragement about work (β=-0.32, p≤0.001), were identified as possible predictive factors for the self-estimated ability to return to work. CONCLUSIONS To feel strengthened, happy and to receive encouragement about work can affect the return to work process for people on sick leave due to heart failure. In order to develop and implement rehabilitation programmes to meet these needs, more research is needed.
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Affiliation(s)
- Lena Nordgren
- Centre for Clinical Research in Sörmland/Uppsala University, Uppsala, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Anne Söderlund
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
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Nordgren L, Söderlund A. Heart failure clients' encounters with professionals and self-rated ability to return to work. Scand J Occup Ther 2015; 23:115-26. [PMID: 26337863 DOI: 10.3109/11038128.2015.1078840] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND People with heart failure are sick listed for long periods and disability pension is common. Healthcare professionals need knowledge about factors that can enhance their return to work processes. AIMS This study focus on people on sick leave due to heart failure and their encounters with healthcare professionals/social insurance officers. Specifically, it aimed to investigate associations between: (1) encounters and socio-demographic factors and, (2) encounters and self-rated ability to return to work. MATERIAL AND METHODS A cross-sectional study based on registry data and a postal questionnaire to people on sick leave due to heart failure (n = 590). Bivariate correlation analyses and logistic regression analyses were used. Results Gender, income, and age were strongly associated with encounters with both social insurance officers and healthcare professionals. Self-rated ability to return to work was associated with the encounters 'Made reasonable demands', 'Gave clear and adequate information/advice' and 'Did not keep our agreements'. CONCLUSION AND SIGNIFICANCE To enhance clients' abilities to return to work demands should be reasonable, information and advice need to be clear, and agreements should be kept. These results can be used by healthcare professionals as occupational therapists involved in vocational rehabilitation for people on sick leave due to heart failure.
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Affiliation(s)
- Lena Nordgren
- a School of Health, Care and Social Welfare, Caring Sciences, Mälardalen University , Sweden ;,b Centre for Clinical Research Sörmland/Uppsala University , Sweden ;,c Department of Public Health and Caring Sciences , Uppsala University , Sweden
| | - Anne Söderlund
- a School of Health, Care and Social Welfare, Caring Sciences, Mälardalen University , Sweden
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Klompstra L, Jaarsma T, Strömberg A. Physical activity in patients with heart failure: barriers and motivations with special focus on sex differences. Patient Prefer Adherence 2015; 9:1603-10. [PMID: 26635469 PMCID: PMC4646589 DOI: 10.2147/ppa.s90942] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Adherence to recommendations for physical activity is low in both male and female patients with heart failure (HF). Men are more physically active than women. In order to successfully promote physical activity, it is therefore essential to explore how much and why HF patients are physically active and if this is related to sex. The aim of this study was therefore to evaluate physical activity in HF patients, to describe the factors related to physical activity, and to examine potential barriers and motivations to physical activity with special focus on sex differences. METHODS The study had a cross-sectional survey design. HF patients living at home received a questionnaire during May-July 2014, with questions on physical activity (from the Short Form-International Physical Activity Questionnaire), and potential barriers and motivations to physical activity. RESULTS A total of 154 HF patients, 27% women, with a mean age of 70±10 were included. In total, 23% of the patients reported a high level of physical activity, 46% a moderate level, and 34% a low level. Higher education, self-efficacy, and motivation were significantly associated with a higher amount of physical activity. Symptoms or severity of the disease were not related to physical activity. All the potential barriers to exercise were reported to be of importance. Psychological motivations were most frequently rated as being the most important motivation (41%) to be physically active. Physical motivations (33%) and social motivations were rated as the least important ones (22%). Women had significantly higher total motivation to be physically active. These differences were found in social, physical, and psychological motivations. DISCUSSION One-third of the HF patients had a low level of physical activity in their daily life. Severity of the disease or symptoms were not related, whereas level of education, exercise self-efficacy, and motivation were important factors to take into account when advising a HF patient about physical activity. Women reported higher motivation to be physically active than men, but there was no difference in the reported level of physical activity.
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Affiliation(s)
- Leonie Klompstra
- Department of Social and Welfare Studies, Faculty of Health Sciences, Linköping University, Linköping, Sweden
- Correspondence: Leonie Klompstra, Department of Social and Welfare Studies, Linköping University, Norrköping, 601 74 Linköping, Sweden, Tel +46 11 363 629, Fax +46 11 125 448, Email
| | - Tiny Jaarsma
- Department of Social and Welfare Studies, Faculty of Health Sciences, Linköping University, Linköping, Sweden
| | - Anna Strömberg
- Department of Medical and Health Sciences, Division of Nursing, Linköping University, Linköping, Sweden
- Department of Cardiology, Linköping University, Linköping, Sweden
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