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ABSTRACT: A systematic review of the prevalence rates of chronic health conditions in populations of children with intellectual disability was provided. We identified 2,994 relevant studies by searching Medline, Cinahl, and PsycINFO databases from 1996 to 2008. We included the 31 studies that had sufficient methodological quality. The 6 most prevalent chronic health conditions in children with intellectual disability were epilepsy (22.0/100), cerebral palsy (19.8/100), any anxiety disorder (17.1/100), oppositional defiant disorder (12.4/100), Down syndrome (11.0/100), and autistic disorder (10.1/100). The reported prevalence rates of chronic health conditions in this population was much higher than in the general population. However, both the number of studies that were included and the number of chronic health conditions they reported about were limited. There is an urgent need for better evidence on the prevalence of chronic health conditions among children with intellectual disability.
Intellectual and developmental disabilities 04/2011; 49(2):59-85. · 1.44 Impact Factor
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ABSTRACT: This prospective study explores and compares the relationship between patients' self-rated health (SRH) after kidney transplantation (KT) at different follow-up periods and its medical and nonmedical predictors over time.
Patients (n = 128) who completed a questionnaire (the SRH question of the SF-36 and the End-Stage Renal Disease Symptom Checklist - Transplantation Module) were enrolled. Clinical data were retrieved from medical files. The sample was stratified into early (n = 89) and late (n = 39) cohorts according to time since KT at baseline. Linear regression was used to identify predictors of SRH at follow-up.
In both cohorts, a change in glomerular filtration rate (GFR) over time remained a predictor of SRH; in the early cohort, age was an additional predictor; in the late cohort, a change in transplantation-associated psychological distress over time and the number of late acute rejection episodes during the observation period were additional predictors.
Improvement in GFR over time predicted better SRH at each period after KT. Decreased transplantation-associated psychological distress and fewer late acute rejection episodes seemed to predict better SRH at a later follow-up period. Despite these observations, higher SRH was associated with better clinical outcomes.
American Journal of Nephrology 03/2011; 33(4):364-9. · 2.54 Impact Factor
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ABSTRACT: To describe the degree of loneliness among the visually impaired elderly and to make a comparison with a matched reference group of the normally sighted elderly. In addition, we examined self-management abilities (SMAs) as determinants of loneliness among the visually impaired elderly.
In a cross-sectional study, 173 visually impaired elderly persons completed telephone interviews. Loneliness and SMAs were assessed with the Loneliness Scale of De Jong Gierveld and the SMAS-30, respectively.
The prevalence of loneliness among the visually impaired elderly was higher compared with the reference group (50% vs. 29%; p < .001). Multivariate hierarchical regression analysis showed that the SMA self-efficacy, partner status, and self-esteem were determinants of loneliness. Severity and duration of visual impairment had no effect on loneliness.
The relationship between SMAs (i.e., self-efficacy) and loneliness is promising, as SMAs can be learned through training. Consequently, self-management training may reduce feelings of loneliness.
Journal of Aging and Health 03/2011; 23(5):843-61. · 1.56 Impact Factor
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ABSTRACT: The aims of this study were: (i) to determine the relation between chronological and functional age; (ii) to examine the association between chronological age and work outcomes; and (iii) to examine the association between functional age and work outcomes. An overview of the most reported work outcomes is outlined.
Chronological age refers to the calendar age; functional age was measured with perceived health status (SF-36) and the presence of a chronic health condition. Perspectives on experienced problems, barriers, facilitators and support needs due to ageing and the Work Ability Index were gathered out as work outcomes.
The association of chronological and functional age of workers aged ≥45 years (n = 2971) on work outcomes were significant but small, except for the presence of a chronic health condition. The presence of a chronic health condition was not related to chronological age. Older workers (60-64 years) reported better scores on social functioning, mental health and vitality compared with workers aged 45-59 years. Most reported problems due to ageing were energy decline, muscle function decline, concentration lapses and memory deterioration. Experienced barriers were concentration, work pace problems and mobility; facilitators were support from colleagues, informal relations at work and supervisors. Individual agreement had to be met to continue working life.
This study confirmed that both chronological and functional age were associated with a decrease in work outcomes. Workers >60 years did not experience more problems and barriers compared with workers between 45 and 49 years of age.
The European Journal of Public Health 03/2011; 22(3):424-9. · 2.73 Impact Factor
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ABSTRACT: This study examined the accuracy and reproducibility of a body-fixed sensor-based assessment for quantifying frontal plane angular movements of the (upper) thorax and pelvis of patients with hip osteoarthritis at different walking speeds. To evaluate accuracy, the angular movements of sensors attached to the thorax and pelvis of three patients were compared with results based on an optical motion analysis system. Accuracy was high, with small and consistent mean differences (<1.0 degree) and corresponding standard deviations (<1.3 degrees) between optical motion analysis system and body-fixed sensor data. To evaluate reproducibility, angular trunk movements were assessed twice in 15 patients. Reproducibility was high (intraclass correlation coefficients ranged from 0.86 to 0.97), and the values of the mean differences between the test and retest were small, with the 95% confidence interval containing zero. This body-fixed sensor-based assessment is an accurate and reproducible method for quantifying frontal plane compensatory trunk movements during gait of patients with hip osteoarthritis at different walking speeds.
American journal of physical medicine & rehabilitation / Association of Academic Physiatrists 03/2011; 90(8):681-7. · 1.56 Impact Factor
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ABSTRACT: Parental employment status is an important and often overlooked contextual factor that may influence parent-adolescent relationships. The aim of this study is to examine the effect of parental support on adolescents' health within the context of parental employment status. Data on perceived mother's and father's support, mother's and father's employment status and adolescents' perceived health were collected among 1992 adolescents (mean age 16.9) and analysed using chi-square and logistic regression. Father's support was significantly more often perceived as low when the father was unemployed, while the perception of mother's support did not differ in regards to the mother's employment. Among those with an unemployed father, mother's support appeared protective for adolescents' health, while when a mother was unemployed, father's support was more strongly associated with good health. Our results suggest that in the case of unemployment of one parent, support from the other parent may be more important for children.
Journal of Adolescence 02/2011; 34(1):141-9. · 2.05 Impact Factor
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ABSTRACT: This study investigated whether short episodes of sickness absence were associated with job satisfaction.
199 wage earners who reported sick due to the common cold between January 2003 and April 2003.
Job satisfaction was assessed on the first day of sickness absence and associated with the duration of sickness absence using a multiple logistic regression model to which demographics, working conditions, and the week day on which sick-leave was taken were stepwise added as covariates.
Workers with low job satisfaction scores had higher odds (odds ratio [OR] =3.85; 95% confidence interval [CI] 1.74 to 8.51) of being > 3 days absent from work due to the common cold compared to satisfied workers. However, the duration of sickness absence due to the common cold was more strongly related to the day of taking sick-leave with workers who reported sick on Monday or Tuesday being longer absent (OR=5.36; 95% CI 1.44 to 9.90) than those who reported sick on Friday.
When having a common cold, dissatisfied workers are longer absent from work although the duration of short episodes of sickness absence seems to be determined by the week day on which sick-leave is taken rather than working conditions or perceptions about work.
Work 01/2011; 39(3):305-13. · 0.52 Impact Factor
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ABSTRACT: To assess the degree of participation of the visually impaired elderly and to make a comparison with population-based reference data.
This cross-sectional study included visually impaired elderly persons (≥55 years; n = 173) who were referred to a low-vision rehabilitation centre. Based on the International Classification of Functioning, Disability and Health (ICF) participation in: (1) domestic life, (2) interpersonal interactions and relationships, (3) major life areas, and (4) community, social and civic life was assessed by means of telephone interviews. In addition, we assessed perceived participation restrictions.
Comparison with reference data of the elderly showed that visually impaired elderly persons participated less in heavy household activities, recreational activities and sports activities. No differences were found for the interpersonal interactions and relationships domain. Participants experienced restrictions in household activities (84%), socializing (53%), paid or voluntary work (92%), and leisure activities (88%).
Visually impaired elderly persons participate in society, but they participate less than their peers. They experience restrictions as a result of vision loss. These findings are relevant, since participation is an indicator for successful aging and has a positive influence on health and subjective well-being.
Disability and Rehabilitation 01/2011; 33(1):63-72. · 1.50 Impact Factor
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ABSTRACT: Regional differences in alcohol-related mortality might reflect strong socioeconomic differences between regions. The present study examines the contribution of education, unemployment, income and minority proportion on regional differences in alcohol-related mortality for inhabitants aged 20-64 years. Linear regression analysis and a non-parametric regression tree analysis were used separately for males and females. The unemployment rate and low education appeared as important determinants of regional alcohol-related mortality, while the proportion of Roma and income were not significantly associated with alcohol-related mortality among males in Slovak districts. A district's unemployment rate was assumed to be the strongest predictor of the outcome measure.
Health & Place 01/2011; 17(3):701-9. · 2.67 Impact Factor
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ABSTRACT: Besides the important beneficial effects of regular physical activity on general health, some of the musculoskeletal effects of physical activity are of particular interest for older adults after total hip arthroplasty (THA). However, research on physical activity behavior of patients after THA is scarce.
The purpose of this study was to gain insight into the physical activity behavior and fulfillment of guidelines for health-enhancing physical activity of patients 1 year after THA. Design This was a prospective multicenter cohort study.
To determine level of physical activity, 653 participants (response rate=77%) completed the Short QUestionnaire to ASsess Health-enhancing physical activity (SQUASH). Comparisons were made between participants in 2 age groups (≤75 and >75 years). Determinants of physical activity behavior were assessed.
The participants were physically active a mean of 1,468 minutes per week. Most time was spent in household and leisure activities. Younger participants were physically more active than older participants. A lower body mass index was predictive of a higher level of physical activity. Participants adhered to the guidelines of health-enhancing physical activity in 67% of cases. The guidelines were met more often by younger participants, male participants, and those without problems in the lower extremities. Limitations A nonresponse analysis was not conducted; thus, there might have been a selection bias. Use of a self-administered recall questionnaire to assess physical activity behavior may have been subject to memory and recall skill limitations of the participants, and patients tend to overestimate their physical activity level.
This study gives detailed insight into the physical activity of patients 1 year after primary THA. As among the general population, a considerable number of patients were found to be insufficiently physically active.
Physical Therapy 01/2011; 91(3):373-80. · 3.11 Impact Factor
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ABSTRACT: Many people with chronic nonspecific musculoskeletal pain (CMP) have decreased work ability. The majority, however, stays at work despite their pain. Knowledge about workers who stay at work despite chronic pain is limited, narrowing our views on work participation. The aim of this study was to explore why people with CMP stay at work despite pain (motivators) and how they manage to maintain working (success factors).
A semi-structured interview was conducted among 21 subjects who stay at work despite CMP. Participants were included through purposeful sampling. Interviews were audio-recorded, transcribed verbatim, and imported into computer software Atlas.ti. Data was analyzed by means of thematic analysis. The interviews consisted of open questions such as: "Why are you working with pain?" or "How do you manage working while having pain?"
A total of 16 motivators and 52 success factors emerged in the interviews. Motivators were categorized into four themes: work as value, work as therapy, work as income generator, and work as responsibility. Success factors were categorized into five themes: personal characteristics, adjustment latitude, coping with pain, use of healthcare services, and pain beliefs.
Personal characteristics, well-developed self-management skills, and motivation to work may be considered to be important success factors and prerequisites for staying at work, resulting in behaviors promoting staying at work such as: raising adjustment latitude, changing pain-coping strategies, organizing modifications and conditions at work, finding access to healthcare services, and asking for support. Motivators and success factors for staying at work may be used for interventions in rehabilitation and occupational medicine, to prevent absenteeism, or to promote a sustainable return to work. This qualitative study has evoked new hypotheses about staying at work; quantitative studies on staying at work are needed to obtain further evidence.
BMC Musculoskeletal Disorders 01/2011; 12:126. · 1.58 Impact Factor
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ABSTRACT: Sickness absence leads to understaffing and interferes with nursing efficiency and quality. It has been reported in literature that managerial leadership is associated with self-reported sickness absence in the working population.
This study investigated the relationship between managerial leadership and sickness absence in health care by associating nurse managers' leadership styles with registered sickness absence among their nursing staff.
The cross-sectional study included 699 nurses working in six wards (staff range = 91-140 employees) of a Dutch somatic hospital employing a total of 1,153 persons. The nurse managers heading the wards were asked to complete the Leadership Effectiveness and Adaptability Description questionnaire for situational leadership. The Leadership Effectiveness and Adaptability Description scores were linked to employer-registered nursing staff sickness absence.
High relationship-high task behavior (odds ratio [OR] = 0.76, 95% confidence interval [CI] = 0.65-0.85) and high relationship-low task behavior (OR = 0.37, 95% CI = 0.14 -0.98) were inversely related to the number of short (one to seven consecutive days) episodes of sickness absence among the staff. Low relationship-high task styles (OR = 2.44, 95% CI = 1.14-5.22) as well as low relationship-low task styles (OR = 2.44, 95% CI = 1.26-4.71) were positively associated with the number of short episodes of sickness absence. However, the leadership styles only explained 10% of the variance in short episodes of sickness absence.
Leadership styles are associated with registered sickness absence. The nursing staff of relationship-oriented nurse managers has fewer short episodes of sickness absence than the staff of task-oriented managers. Training nurse managers in relational leadership styles may reduce understaffing and improve nursing efficiency and quality.
Health care management review 12/2010; 36(1):58-66. · 1.30 Impact Factor
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ABSTRACT: The two primary objectives of this study were to the assess consultation load of occupational health physicians (OHPs), and their difficulties and needs with regard to their sickness certification tasks in sick-listed employees with severe medical unexplained physical symptoms (MUPS). Third objective was to determine which disease-, patient-, doctor- and practice-related factors are associated with the difficulties and needs of the OHPs.
In this cross-sectional study, 43 participating OHPs from 5 group practices assessed 489 sick-listed employees with and without severe MUPS. The OHPs filled in a questionnaire about difficulties concerning sickness certification tasks, consultation time, their needs with regard to consultation with or referral to a psychiatrist or psychologist, and communication with GPs. The OHPs also completed a questionnaire about their personal characteristics.
OHPs only experienced task difficulties in employees with severe MUPS in relation to their communication with the treating physician. This only occured in cases in which the OHP attributed the physical symptoms to somatoform causes. If they attributed the physical symptoms to mental causes, the OHPs reported a need to consultate a psychiatrist about the diagnosis and treatment.
OHPs experience few difficulties with their sickness certification tasks and consultation load concerning employees with severe MUPS. However, they encounter problems if the diagnostic uncertainties of the treating physician interfere with the return to work process. OHPs have a need for psychiatric expertise whenever they are uncertain about the psychiatric causes of a delayed return to work process. We recommend further training programs for OHPs. They should also have more opportunity for consultation and referral to a psychiatrist, and their communication with treating physicians should be improved.
BMC Health Services Research 11/2010; 10:305. · 1.66 Impact Factor
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ABSTRACT: Exploring the associations of regional differences in infant mortality with selected socioeconomic indicators and ethnicity could offer important clues for designing public health policy measures.
Data included perinatal and infant mortality in the 79 districts of the Slovak population in 2004. Linear regression was used to analyse the contribution of education, unemployment, income and proportion of Roma population on regional differences in perinatal and infant mortality rates.
All the explored socioeconomic indicators and ethnicity individually contributed significantly to both perinatal and infant mortality, with the exception of income. In the model exploring the influence of all these variables together on perinatal and infant mortality, only the effect of the proportion of Roma population remained significant. This model explained 34.9% of the variance for perinatal and 36.4% of the variance for infant mortality.
Living in Roma settlements indicates an accumulation of socioeconomic disadvantage. Health literacy, health-related behaviour and many other factors might contribute to the explanation of the differences in infant mortality, and a better understanding of these processes might help us to design tailored interventions.
International Journal of Public Health 10/2010; 56(5):523-31. · 2.54 Impact Factor
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ABSTRACT: Symptoms of posttraumatic stress disorder (PTSD) in patients with hand injuries may delay return to work, even when criteria of the Diagnostic and Statistical Manual of Mental Disorders-IV are not met. This study investigated which biomedical and psychosocial factors relate to symptoms of acute PTSD in hand-injured patients.
Sixty-seven employed patients with hand injuries completed a number of questionnaires. The following factors were investigated: sociodemographic characteristics, injury severity, accident location, pain, satisfaction with hand functioning, aesthetics of the hand, social support, and coping styles. The primary outcome measure was the number of symptoms of PTSD. We analyzed factors that were univariately significantly associated with symptoms of PTSD using linear regression analysis, and explored interaction effects.
One patient met the criteria for PTSD; 44 patients experienced symptoms but did not meet the criteria (median, 1; interquartile range (IQR), 0-2); 22 patients experienced no symptoms of PTSD. Patients had a median pain score of 30 (IQR, 10-45), median satisfaction score of 60 (IQR, 45-70), median aesthetics score of 66.7 (IQR, 45.8-79.2), median palliative coping style score of 16 (IQR, 14.8-17.3), and median avoidance coping style of 15 (IQR, 13-16). Symptoms of PTSD were associated with pain (r, .530; p < .001), satisfaction with hand function (r, -.451; p < .001), aesthetics (r, -.320; p = .009), palliative coping style (r, .281; p = .022) and avoidance coping style (r, .283; p = .022). Pain and aesthetics remained significant after regression analysis. No interaction effects were significant.
Pain and aesthetics statistically predict symptoms of acute PTSD in patients with acute hand injuries. Patients with disproportionate pain or dissatisfaction with aesthetics should be evaluated for PTSD.
Prognostic IV.
The Journal of hand surgery 06/2010; 35(6):961-7. · 1.33 Impact Factor
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ABSTRACT: This systematic review focuses on the role of the intensity of fear in patient's delay in cancer and in myocardial infarction.
In a search of literature published between 1990 and June 2009, 161 articles were found. After the use of inclusion and exclusion criteria, 11 articles in cancer and 4 articles in myocardial infarction remained.
High levels of fear are associated with earlier help-seeking in both diseases; for low levels of fear, the picture is unclear.
The level of fear is an important factor, which should be taken into account when facilitating help-seeking by patients.
International Journal of Public Health 05/2010; 55(5):459-68. · 2.54 Impact Factor
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ABSTRACT: Common mental disorders (CMDs) are an important cause of work disability. Although CMDs are known to have high recurrence rates, little is known about the recurrence of sickness absence due to CMDs. This study examines the recurrence risk of sickness absence due to CMDs.
A cohort of 9,904 employees with a sickness absence due to CMDs, working in the Dutch Post or Telecommunication company, was studied over a 7-year period. Recurrence was defined as the start of at least one new episode of sickness absence with CMDs after complete return to work for at least 28 days. The recurrence density (RD) of sickness absence with CMDs was calculated per 1,000 person-years.
Of the 9,904 employees with a first absence due to CMDs 1,925 (19%) had a recurrence, 90% of recurrences occurred within 3 years. The RD of sickness absence due to CMDs was 84.5 employees per 1,000 person-years (95% CI=80.7-88.3). The RD of sickness absence due to CMDs was similar in women and in men. In men, depressive symptoms were related to higher recurrence of sickness absence due to CMDs than distress symptoms and adjustment disorders. In women, no difference by diagnostic category was found.
Employees with a previous episode of sickness absence with CMDs are at increased risk of recurrent sickness absence with CMDs. Relapse prevention consultations are recommended for a period of 3 years after return to work.
Archiv für Gewerbepathologie und Gewerbehygiene 05/2010; 84(2):193-201. · 1.89 Impact Factor
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ABSTRACT: The primary objectives were to compare the duration of sickness absence in employees with high levels of somatic symptom severity (HLSSS) with employees with lower levels of somatic symptom severity, and to establish the long-term outcomes concerning return to work (RTW), disability and discharge. Secondary objective was to evaluate determinants of the duration of sickness absence in employees with HLSSS.
489 sick-listed employees registered with five Occupational Health Physician (OHP) group practices were included in this study. We measured their baseline scores for somatic symptoms severity, depressive disorders, anxiety disorders, health anxiety, distress and functional impairment. The OHPs filled in a questionnaire on their diagnosis. A prospective 2-year follow-up was carried out to assess the long-term outcomes concerning sickness absence, and retrospective information was gathered with regard to sickness absence during the 12 months before the employees were sick-listed.
The median duration of sickness absence was 78 days longer for employees with HLSSS. They more often remained disabled and were discharged more often, especially due to problems in the relationship between the employer and the employee. HLSSS, health anxiety and older age contributed to a longer duration of sickness absence of employees.
High levels of somatic symptom severity are a determinant of prolonged sickness absence, enduring disabilities and health-related job loss. Occupational health physicians should identify employees who are at risk and adhere to guidelines for medically unexplained somatic symptoms.
Journal of Occupational Rehabilitation 04/2010; 20(2):264-73. · 2.80 Impact Factor
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ABSTRACT: The aim is to explore the association between self-rated health and employment status in patients with multiple sclerosis (MS) when controlling for age, gender, functional disability, disease duration, anxiety and depression.
One hundred eighty-four people with MS completed a sociodemographic questionnaire that included questions on employment status, the first item of the Short Form-36 Health Survey and the Hospital Anxiety and Depression Scale. Functional disability was assessed using the Expanded Disability Status Scale. The probability of good self-rated health in employed persons was investigated using stepwise logistic regression analyses.
Patients with MS who reported good self-rated health were 2.46 times more likely to be employed (95% confidence interval [CI]: 1.08-5.59). Patients without anxiety were 2.64 times more likely to be employed (95%CI: 1.23-5.67). Patients with higher EDSS scores were 0.49 times less likely to be employed (95%CI: 0.33-0.70). Age, gender, disease duration and the presence of depression did not show an increased chance of patient employment.
Patients with MS with good self-rated health are more likely to be employed, even after adjusting for age, gender, education, functional disability, disease duration, depression and anxiety. Dependent on the findings of longitudinal studies unravelling the relevant causal pahways, self-rated health might be used as a quick and cheap prognostic marker, which could warn about the possible loss of employment, or changes in functional disability.
Disability and Rehabilitation 03/2010; 32(21):1742-8. · 1.50 Impact Factor
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ABSTRACT: Assessment of efforts to promote return-to-work (RTW) includes all efforts (vocational and non-vocational) designed to improve the work ability of the sick-listed employee and increase the chance to return to work. Aim of the study was to investigate whether in 13 European countries these RTW efforts are assessed and to compare the procedures by means of six criteria.
Data were gathered in the taxonomy project of the European Union of Medicine in Assurance and Social Security and by means of an additional questionnaire.
In seven countries RTW efforts are subject of the assessment in relation to the application for disability benefits. Description of RTW efforts is a prerequisite in five countries. Guidelines on the assessment of RTW efforts are only available in the Netherlands and no countries report the use of the ICF model. Based on the results of the additional questionnaire, the assessor is a social scientist or a physician. The information used to assess RTW efforts differs, from a report on the RTW process to medical information. A negative outcome of the assessment leads to delay of the application for disability benefits or to application for rehabilitation subsidy.
RTW efforts are assessed in half of the participating European countries. When compared, the characteristics of the assessment of RTW efforts in the participating European countries show both similarities and differences. This study may facilitate the gathering and exchange of knowledge and experience between countries on the assessment of RTW efforts.
The European Journal of Public Health 02/2010; 20(6):689-94. · 2.73 Impact Factor
