Returning to Work After Stroke

Abstract Objectives: This exercise aimed to validate New Taipei City’s strategic plan for a city lockdown in response to COVID-19. The main goal of all solutions was the principle of “reducing citizen activity and strengthening government control”. Methods: We created a suitable exercise, and creating 15 hypothetical situations for three stages. All participating units designed and proposed policy plans and execution protocols according to each situation. Results: In the course of the exercise, many existing policies and execution protocols were validated to address. Situations occurring in Stage 1, when the epidemic was spreading to the point of lockdown preparations, approaches to curb the continued spread of the epidemic in Stage 2, and returning to work after the epidemic is controlled and lockdown is lifted in Stage 3. Twenty response units participated in the exercise. Although favourable outcomes were obtained, the evaluators provided comments suggesting further improvements. Conclusions: Our exercise demonstrated a successful example to help policy making and revision in a large city over 4 million population during COVID-19 pandemic. It also enhanced participants’ subject knowledge and familiarity with the implementation of a city lockdown. For locations intending to go into lockdown, similar tabletop exercises are an effective verification option.

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Workplace experience of parents coping with perinatal loss: A scoping review

Work ◽

10.3233/wor-213487 ◽

2021 ◽

pp. 1-11

Author(s):

Sophie Meunier ◽

Francine de Montigny ◽

Sabrina Zeghiche ◽

Dominique Lalande ◽

Chantal Verdon ◽

...

Keyword(s):

Interpersonal Relationships ◽

Scoping Review ◽

Qualitative Methodology ◽

Scientific Literature ◽

Current Knowledge ◽

Perinatal Loss ◽

Quantitative Studies ◽

Workplace Experience ◽

Returning To Work ◽

Perinatal Grief

BACKGROUND: Perinatal loss affects many parents in the workforce. Yet, current knowledge about their workplace experience while facing this difficult event is sparse. OBJECTIVES: The goal of this study was to review and synthesize the extent of scientific literature on the specific experiences of workers coping with perinatal loss and the resulting bereavement. METHODS: A scoping review was carried out using eight different databases. A total of 15 references, all using a qualitative methodology, were identified. Most of the references focused on the experience of mothers and on late perinatal loss (from the 20th week of pregnancy). RESULTS: All references highlighted the taboo and the non-recognition of perinatal grief and bereavement in both organizational practices and interpersonal relationships with colleagues and immediate supervisors. They also emphasized the difficulties associated with returning to work after the loss and the significant changes in the meaning attributed to work. CONCLUSIONS: While the studies included in this review clearly indicate that perinatal loss can affect working life, larger, quantitative studies are needed to quantify this phenomenon and its impact on employees and their organizations.

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Qualitative Evidence from Studies of Interventions Aimed at Return to Work and Staying at Work for Persons with Chronic Musculoskeletal Pain

Journal of Clinical Medicine ◽

10.3390/jcm10061247 ◽

2021 ◽

Vol 10 (6) ◽

pp. 1247

Author(s):

Gunilla M. Liedberg ◽

Mathilda Björk ◽

Elena Dragioti ◽

Christina Turesson

Keyword(s):

Return To Work ◽

Musculoskeletal Pain ◽

Health Professionals ◽

Management Strategies ◽

Chronic Musculoskeletal Pain ◽

Moderate Evidence ◽

Staying At Work ◽

Significant Burden ◽

Returning To Work ◽

Key Terms

Chronic musculoskeletal pain is a significant burden for employees, employers, and society. However, more knowledge is needed about which interventions reduce sick leave. Interventions were defined as the act or an instance of intervening, provided by different stakeholders. This review synthesizes the experiences of patients, employers, and health professionals concerning the interventions that influence returning to work and staying at work for persons with chronic musculoskeletal pain. A literature search was performed using several combinations of key terms. Overall, 18 qualitative studies published between 2002 and 2018 were included. Qualitative analysis assessed how much confidence could be placed in each review finding. Moderate evidence was found for factors improving the return to work process such as collaboration between stakeholders, including the persons with chronic musculoskeletal pain and support from all involved actors in the process. Moderate evidence was found for self-management strategies and workplace adjustments needed to facilitate more persons to returning to work and staying at work despite pain. This review provides stakeholders, employers, and health professionals’ information that could be used to develop and implement interventions to increase the possibilities for persons with chronic musculoskeletal pain returning to work or staying at work

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Economic impact of sudden cardiac arrest

European Heart Journal ◽

10.1093/ehjci/ehaa946.3542 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

E Paratz ◽

L Rowsell ◽

J Ball ◽

D Zentner ◽

S Parsons ◽

...

Keyword(s):

Cardiac Arrest ◽

Economic Impact ◽

Terminal Illness ◽

Sudden Cardiac Arrest ◽

Economic Security ◽

Funding Source ◽

Economic Modelling ◽

Markov Modelling ◽

Healthcare Budget ◽

Returning To Work

Abstract Background Each year, there are approximately 5,000 out-of-hospital cardiac arrests (OHCAs) in the state of Victoria, Australia (population 6.4 million, state healthcare budget AUD$2.9 billion / €1.8billion). Mortality from OHCA approaches ninety percent. High mortality rates and survivors not returning to work is likely to have an adverse effect on the Victorian economy but this has not been previously investigated. Purpose To model the economic impact of OHCA mortality and survivors not returning to work. Methods Data on all OHCAs transported by Ambulance Victoria from July 2017- June 2018 in Victoria, Australia was collected, including age, gender, survival to hospital, survival to discharge, and survival to 12 months. Cases were excluded if arrest was precipitated by trauma, exsanguination, overdose, terminal illness, hanging, SIDS, electrocution, sepsis, respiratory causes, drowning, or neurological causes. Pre-arrest employment status of patients was modelled using the Australian Bureau of Statistics Economic Security dataset, which provides contemporary employment rates for gender-matched five-year cohorts for Australians aged 15–79 years. For survivors to 12 months, pre-arrest and post-arrest work status were confirmed. Economic impact was then calculated to a five year horizon utilizing a Markov model with probabilistic sensitivity analysis. Results 4,934 arrests meeting the inclusion criteria were transported by Ambulance Victoria in twelve months, of whom 4,639 were determined to be cardiac arrests without any exclusion criteria as a precipitant. 695 patients survived to hospital (15.0%), and 325 to discharge (7.0%). At 12 months, 303 patients were alive (6.5% of overall cases, 93.2% of those discharged from hospital). Economic modelling of age and gender-matched data indicated that 1516 patients (35%) would have been employed pre-cardiac arrest, but only 216 survivors (4.7%) would be employed at five years post-arrest. Using Markov modelling incorporating estimated earnings and the pre-determined value of a statistical life, the annual economic burden of cardiac arrest approximated AUD$4 billion (€2.5 billion) at a five-year horizon. Conclusion The annual economic impact of cardiac arrest in Victoria, Australia is approximately AUD$4 billion (€2.5 billion) in a five-year horizon. As the annual Victorian state budget for all healthcare is AUD$2.93 billion (€1.8 billion), our data suggests that the economic impact of cardiac arrest is under-appreciated. Therefore, research in this area and providing state-of-the-art care for all cardiac arrest patients should be a healthcare priority. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): NHMRC/NHF Postgraduate Scholarship, RACP JJ Billings Scholarship

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Effectiveness of a breastfeeding program for mothers returning to work in Japan: a quasi-experimental study

International Breastfeeding Journal ◽

10.1186/s13006-020-00351-3 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Kaori Nakada

Keyword(s):

Maternal Employment ◽

Comparison Group ◽

Primary Objective ◽

Continuation Rate ◽

Breastfeeding Support ◽

Significant Difference ◽

Quasi Experimental ◽

Returning To Work ◽

Program Intervention ◽

Continuation Rates

Abstract Background Maternal employment has been described as a barrier to breastfeeding in many countries. In Japan, many mothers quit breastfeeding after returning to work because they do not know how to continue breastfeeding. The primary objective of this study was to investigate the effectiveness of a breastfeeding support program for mothers. The secondary objective was to explore the effectiveness of a pamphlet for mothers returning to work. Methods This was a quasi-experimental design study with a program group (n = 48), pamphlet group (n = 46) and comparison group (n = 47) that took place from February 2017 to August 2018. Participants in the program and pamphlet groups were women who planned to return to work within 4–12 months after giving birth, while the comparison group included women who had been back at work for at least 3 months. The program involved a 90-min breastfeeding class, a pamphlet, a newsletter, and email consultation. The pamphlet group was sent only the pamphlet, while the comparison group received no intervention. The outcome was breastfeeding continuation rate at 3 months after returning to work. Results The breastfeeding continuation rate 3 months after returning to work was significantly higher in the program group than in the comparison group (79.2% vs. 51.1%, p = 0.004). After adjusting for background factors, the program intervention had an effect on breastfeeding rates (adjusted odds ratio = 4.68, 95% confidence interval: 1.57, 13.96; p = 0.006). However, comparing the pamphlet and comparison groups revealed no significant differences in breastfeeding continuation rates at 3 months after returning to work (69.6% vs. 51.1%, p = 0.07). Conclusions Program intervention was associated with a significant increase in breastfeeding continuation rates 3 months after returning to work. Randomized controlled trials are needed to make this program applicable in practice. Pamphlet intervention resulted in no significant difference. Further study is necessary after examining the contents of the pamphlet.

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Significance of patient-reported outcomes for occupational resumption and quality of life after cardiac rehabilitation

European Heart Journal ◽

10.1093/ehjci/ehaa946.3107 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

A Salzwedel ◽

I Koran ◽

E Langheim ◽

A Schlitt ◽

J Nothroff ◽

...

Keyword(s):

Quality Of Life ◽

Physical Performance ◽

Well Being ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Funding Source ◽

Patient Reported ◽

Returning To Work

Abstract Introduction Comprehensive cardiac rehabilitation (CR) programs based on the bio-psycho-social approach of the international classification of functioning and disease are carried out to achieve improved prognosis, superior health-related quality of life (HRQL) and social integration. We aimed to identify predictors of returning to work (RTW) and HRQL among cardiovascular risk factors and physical performance as well as patient-reported outcome measures (PROMs) modifiable during CR. Methods We designed a prospective observational multi-center study and enrolled 1,586 patients (2017/18) in 12 German rehabilitation centers regardless of their primary allocation diagnoses (e.g. acute myocardial infarction (AMI), coronary artery bypass grafting (CABG), coronary artery disease (CAD), valvular disease). Besides general data (e.g. age, gender, diagnoses), parameters of risk factor management (e.g. smoking, lipid profile, hypertension, lifestyle change motivation), physical performance (e.g. maximum exercise capacity, endurance training load, 6-min walking distance), and PROMs (e.g. depression, heart-focused anxiety, HRQL, subjective well-being, somatic and mental health, pain, general self-efficacy, pension desire as well as self-assessment of occupational prognosis using several questionnaires) were documented at CR admission and discharge. 6 months after discharge, status of RTW and HRQL (SF-12) were captured by a follow-up (FU) survey and analyzed in multivariable regression models with multiple imputation of missing values. Results Out of the study participants, 1,262 patients (54±7 years, 77% men) responded to the follow-up survey and could be analyzed regarding the outcome parameters. Most of them were assigned to CR primarily due to AMI (40%) or CAD without myocardial infarction (18%), followed by heart valve diseases in 12% of patients and CABG (8%). 864 patients (69%) returned to work within the follow-up period. Pension desire, negative self-assessed occupational prognosis, heart-focussed anxiety, major life events, smoking and heart failure were negatively associated with RTW, while higher endurance training load, HRQL and work stress were positively associated (Figure 1). HRQL after 6 months was determined more by PROMs (e.g. pension desire, heart-focused anxiety, physical/mental HRQL in SF-12, physical/mental health in indicators of rehab-status questionnaire (IRES-24), stress, well-being in the World Health Organization well-being index and self-efficacy expectations) than by clinical parameters or physical performance. Conclusions Patient-reported outcome measures predominantly influenced RTW and HRQL in heart-disease patients, whereas patients' pension desire and heart-focussed anxiety had a dominant impact on all investigated endpoints. Therefore, the multi-component CR approach focussing on psychosocial support is crucial for subjective health prognosis and occupational resumption. Figure 1. Predictors of returning to work Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): German pension insurance

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