論文No2864
Association of Job Characteristics and Functional Impairments on Return to Work After ARDS
Han Su,Hilaire J. Thompson,Susanne May,...Ramona O. Hopkins,Biren B. Kamdar,Dale M. Needham
CHEST, VOLUME 160, ISSUE 2, P509-518, AUGUST 01, 2021
＜背景＞
ARDS後に無職になることはよくある。しかし、相対的リスク因子は不明である。
＜目的＞
ARDS生存者のARDS前の仕事負荷とARDS後の復職(RTW)時の機能障害、疼痛、倦怠感との関連を検討する。
＜方法＞
US職業情報ネットワーク(O*NET)を使用して、
the ARDS Network Long-Term Outcomes Study (ALTOS)の参加者のARDS前の仕事負担について決定した。
ARDS後の機能障害はthe Mini-Mental State Examination(MMSE)と、
SF-36身体機能、社会希望、精神健康サブスケールで評価し、
障害なし、精神社会障害のみ、身体障害＋軽度精神社会障害、身体障害＋高度精神社会障害に分類された。
ARDS後の疼痛、倦怠感はSF-36疼痛項目と慢性疾患治療-倦怠感スケール倦怠感スケールの機能評価を使用して評価した。
一般化線形混合モデル法を使用してARDS前の仕事負担とARDS後の機能障害、
ARDS後RTW時の疼痛症状、倦怠感との関連を評価した。
＜結果＞
ARDS前の仕事負担はARDS後のRTWと関連していなかった。
しかし、機能障害のない生存者と比較すると
精神社会障害のみ群(OR [CI]: 0.18 [0.06-0.50])、身体障害＋軽度精神社会障害群 (0.08 [0.03-0.22])、
身体障害＋高度精神社会障害群(0.01 [0.003-0.05]) は仕事のオッズ比が低かった。
疼痛 (0.06 [0.03-0.14])、倦怠感 (0.07 [0.03-0.16]) もRTWと負の相関を示した。
＜感想＞
ARDS前の仕事負担量とは関連なく、ARDS後には身体障害、精神社会障害、疼痛、倦怠感が復職の妨げになっていたようです。
Background
Joblessness is common after ARDS, but related risk factors are not fully understood.
Research Question
What is the association between survivors’ pre-ARDS workload and post-ARDS functional impairment, pain, and fatigue with their return to work (RTW) status?
Study Design and Methods
The U.S. Occupational Information Network (O∗NET) was used to determine pre-ARDS workload for participants in the ARDS Network Long-Term Outcomes Study (ALTOS). Post-ARDS functional impairment was assessed using the Mini-Mental State Examination and SF-36 Physical Functioning, Social Functioning, and Mental Health sub-scales, and categorized as either no impairments, only psychosocial impairment, physical with low psychosocial impairment, or physical with high psychosocial impairment. Post-ARDS pain and fatigue were assessed using the SF-36 pain item and Functional Assessment of Chronic Illness Therapy—Fatigue Scale fatigue scale, respectively. Generalized linear mixed modeling methods were used to evaluate associations among pre-ARDS workload, post-ARDS functional impairment, and symptoms of pain and fatigue with post-ARDS RTW.
Results
Pre-ARDS workload was not associated with post-ARDS RTW. However, as compared with survivors with no functional impairment, those with only psychosocial impairment (OR [CI]: 0.18 [0.06-0.50]), as well as physical impairment plus either low psychosocial impairment (0.08 [0.03-0.22]) or high psychosocial impairment (0.01 [0.003-0.05]) had lower odds of working. Pain (0.06 [0.03-0.14]) and fatigue (0.07 [0.03-0.16]) were also negatively associated with RTW.
Interpretation
For previously employed survivors of ARDS, post-ARDS psychosocial and physical impairments, pain, and fatigue were negatively associated with RTW, whereas pre-ARDS workload was not associated. These findings are important for designing and implementing vocational interventions for ARDS survivors.
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