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PubMed2003

Self-care practices and the need for influenza vaccination in healthy individuals.

The purpose of this research was to determine whether self-care practices in healthy individuals reduce the need for trivalent influenza vaccination and whether naturopathic influenza prevention reduces rate, duration and severity of influenza, absenteeism from work due to influenza and side-effects, as compared to trivalent influenza vaccination. A survey design was followed using exploratory, descriptive and comparative methods. The method of study was an open-label, two-group, parallel study. The data collection tool was a self-administered questionnaire. A two-group sample was obtained through non-probability, purposeful sampling. Data was analysed by means of descriptive and inferential statistics at the 0.05 level of significance. Results indicated that there was no significant difference between the rates of influenza infection of the naturopathic group as compared with the trivalent vaccination group but there was a marginal reduction in the duration of febrile illness in the former group. The naturopathic group were less likely to visit a medical practitioner in order to resolve the influenza, however, they were as likely as the trivalent vaccinated group to commence a new treatment plan. Neither method of influenza prevention resulted in a significant reduction in absenteeism from work. The trivalent vaccinated group had significantly more side-effects than the naturopathic group.

Absenteeism↗
PubMed1998

Direct and indirect costs of chickenpox in young children.

OBJECTIVE: To estimate the medical and economic or societal costs of chickenpox in young children using a descriptive study METHODS: Children under 5 years of age attending 124 Sydney childcare centres who were reported as having chickenpox were studied to assess the costs of medication use and medical consultations, days of care missed, and parental costs resulting from lost time from work and alternate childcare costs. RESULTS: There were 174 children (92 girls and 79 boys; in three the sex was not stated) who missed a mean of 5.5 days of care because of chickenpox, currently valued at $154. Medical costs were valued at $33 per child, based on 0.97 medical visits, and topical and oral medication. Labour costs resulting from parental work absenteeism were valued at $160 or $345 depending on the method of calculation, whilst direct economic costs of $24 were incurred through use of alternate childcare arrangements. Total costs including those incurred by secondary cases and by rare hospitalisations were in the range of $393-$578 per affected child. CONCLUSIONS: Medical costs of chickenpox in children are small relative to costs incurred as a result of parental work absenteeism and to costs of foregone childcare. Ascribing precise work-related costs should take into account some capacity to make up lost work time. Such data will be required when determining the cost-benefit of childhood varicella immunisation.

Absenteeism↗
PubMed2000

Work and productivity loss in the rizatriptan multiple attack study.

The objective of this study was to measure the self-reported effect of acute migraine and its treatment on paid work and productivity loss. Patients self-administered a questionnaire in which the impact of a recent migraine on paid work and productivity activities was assessed. We included the questionnaire in a randomized, double-blind, placebo-controlled, crossover, out-patient study designed to examine the safety and efficacy of rizatriptan (5-HT1B/1D receptor agonist) 10 mg p.o. in patients treating four separate migraine attacks. A total of 407 patients, aged 18-65 years, suffering from moderate to severe migrainous headaches was studied. Patients receiving rizatriptan compared with placebo reported 0.7 fewer hours (P < 0.01) of paid worked missed due to absenteeism, 0.4 fewer hours (P < 0.05) of productive time lost on the job, and 1.1 fewer total hours (P < 0.01) of work loss per migraine attack. Rizatriptan compared with placebo significantly reduced migraine-related work loss associated with absenteeism and decreased effectiveness on the job.

Absenteeism↗
PubMed1997

Loss of productivity and quality of life in migraine sufferers among French workers: results from the GAZEL cohort.

To assess the burden of migraine, we compared the productivity and the perceived health of 991 migraine sufferers (IHS criteria), 1,004 other-headache sufferers, and 1,757 nonheadache sufferers randomly chosen among volunteers from employees of the French national gas and electricity company. The extent of absenteeism was collected independently from the study subjects during a 4-year period. Performance at work was self-assessed at the end of the followup. The study subject also completed the Short-Form 36 Health Survey Questionnaire (SF36) and the Spielberger anxiety scale. The number of workdays lost due to migraine was not statistically different between the migraine and control groups, after adjustment for age, sex, and number of health impairments other than headaches. Performance was found to be greatly reduced in migraineurs. The quality of life was poorer and the anxiety level was higher in the migraine group than in the nonheadache group. There was no difference between migraineurs and other-headache sufferers for any variable. The lack of difference in absenteeism between migraineurs and nonheadache subjects calls into question prior research based on self-report. Moreover, it also calls into question the economic impact on migraine due to its direct costs found in previous studies without a control group. We found that the burden of migraine may be considered mainly in terms of reduced quality of life.

Absenteeism↗
PubMed1999

Lack of effectiveness of bed rest for sciatica.

BACKGROUND AND METHODS: Bed rest is widely advocated for sciatica, but its effectiveness has not been established. To study the effectiveness of bed rest in patients with a lumbosacral radicular syndrome of sufficient severity to justify treatment with bed rest for two weeks, we randomly assigned 183 subjects to either bed rest or watchful waiting for this period. The primary outcome measures were the investigator's and patient's global assessments of improvement after 2 and 12 weeks, and the secondary outcome measures were changes in functional status and in pain scores (after 2, 3, and 12 weeks), absenteeism from work, and the need for surgical intervention. Neither the investigators who assessed the outcomes nor those involved in data entry and analysis were aware of the patients' treatment assignments. RESULTS: After two weeks, 64 of the 92 patients in the bed-rest group (70 percent) reported improvement, as compared with 59 of the 91 patients in the control (watchful-waiting) group (65 percent) (adjusted odds ratio for improvement in the bed-rest group, 1.2; 95 percent confidence interval, 0.6 to 2.3). After 12 weeks, 87 percent of the patients in both groups reported improvement. The results of assessments of the intensity of pain, the bothersomeness of symptoms, and functional status revealed no significant differences between the two groups. The extent of absenteeism from work and rates of surgical intervention were similar in the two groups. CONCLUSIONS: Among patients with symptoms and signs of a lumbosacral radicular syndrome, bed rest is not a more effective therapy than watchful waiting.

Absenteeism↗
PubMed1998

The relationship between Schistosoma haematobium infection and school performance and attendance in Bamako, Mali.

Schistosomiasis due to Schistosoma haematobium was the most common helminth infection in school-age children from a poor area in Bamako, Mali. Almost half (47%) of the boys and 40% of the girls were infected, 18% of the children being heavily infected. There was a significant decline in academic performance and in school attendance with increasing intensity of infection. When all sources of variation were taken into consideration, absenteeism was the main factor explaining the variation in academic performance, although a significant effect of infection remained. School-based delivery of chemotherapeutic interventions is currently promoted by several international organizations. However, rates of school attendance are low in some areas and it is the absentees who appear to be at relatively high risk of ill health. Novel ways of reaching this elusive subset of the population are required.

Absenteeism↗
PubMed2005

Prevalence and health/social impacts of functional dyspepsia in Taiwan: a study based on the Rome criteria questionnaire survey assisted by endoscopic exclusion among a physical check-up population.

OBJECTIVE: Until now, the epidemiology of functional dyspepsia (FD) and its social impact on Asians have been rarely studied. The aims of this study were to determine the prevalence, social impact, and health-seeking behaviors of FD in an apparently healthy Chinese population in Taiwan. MATERIAL AND METHODS: Based on the questionnaire provided by the Rome II working team, a survey was administered to a Taiwanese population receiving paid physical check-up (n = 2865). Esophagoduodenoscopy was performed in each subject to exclude organic dyspepsia. Finally, diagnoses of functional gastrointestinal disorders were obtained by means of a computer-generated algorithm. RESULTS: The FD prevalences were 23.8% and 11.8% according to the Rome I and -II criteria, respectively. Nearly 60% of Rome I-defined FD subjects and 18.9% of Rome II-defined FD subjects had overlapping irritable bowel syndrome (IBS). Irrespective of any Rome definition, FD subjects had excessive physician visits, absenteeism, and sleep disturbances compared to dyspepsia-free controls (p < 0.01). Moreover, over half of the Rome II FD subjects were "consulters" showing excessive physician visits, absenteeism, and sleep disturbances than "non-consulters". The dysmotility-like subgroup (74.5%) comprised the majority of FD subjects and showed no differences to their ulcer-like counterparts in terms of major demographic data and social and health impacts. CONCLUSIONS: FD is a common complaint in Taiwan and also bears an obvious social and medical burden to society. Over half of our FD subjects sought medical help, which may be due to the readily accessible medical care in Taiwan. The newly defined Rome II criteria diminish the chance of co-existence of FD and IBS. Further FD classification by the main symptoms appears of limited clinical usefulness.

Absenteeism↗
PubMed2004

School-based asthma disease management.

BACKGROUND: Asthma is the most common chronic childhood illness and the leading cause of missed school days. School is a potential location for establishing an asthma education program for children and their parents/caregivers designed to improve disease management. OBJECTIVE: To determine whether a comprehensive, school-based asthma management program, in addition to a conventional disease management program, can reduce measures of asthma control, student absenteeism, and caregiver lost workdays. METHODS: School nurses recruited parents/caregivers of students with asthma from three urban elementary and middle schools. Children were identified as having asthma by a previous diagnosis from their personal physician. Parents were invited to attend educational sessions about the program. Students received peak flow meters and training in their use and had access to an interactive asthma diary to record symptoms, peak flow, and medicine usage. They received monthly asthma education at school and had access to an online asthma education program and additional handouts. Parents received several educational calls regarding asthma and had a 24-hour, 7-days-a-week emergency number to call if problems arose. RESULTS: At 6 months, missed school days and unscheduled doctor visits were reduced by two thirds (n = 41; p< 0.01 for each). Caregivers' perception of children's activity level increased by 11% (n = 26; p = 0.037). Daytime and nighttime frequency of symptoms dropped by 62% and 34%, respectively (n = 32; p < 0.007 and p<0.03 for each). These trends continued at 12 months, although only reduction in frequency of symptoms attained statistical significance. CONCLUSIONS: A comprehensive, school-based asthma management program can successfully improve asthma control and reduce absenteeism in elementary and middle school students and caregiver lost workdays.

Absenteeism↗
PubMed1994

Academic, behavioral, and social adaptation of boys with hemophilia/HIV disease.

Examined the intelligence, academic achievement, behavior, and social competency of 37 school-aged boys with hemophilia, 56% with HIV infection. IQ scores fell in the average range, but total reading scores were almost 1 standard deviation below the mean. Parent and teacher ratings of social functioning and behavior fell in the normal range. Absenteeism, an average of 27 days for the previous school year, was inversely correlated with most teacher ratings, indicating that absenteeism may be a significant factor in the academic and social adaptation of children with hemophilia. Overall, boys infected with HIV demonstrated the same level of academic and behavioral adaptation as those uninfected. The need for special education programs and interventions to enhance competency in the school setting is discussed.

Absenteeism↗
PubMed1991

Economic indicators and involvement of health professionals at worksite health services in a developing country.

Identification of accurate source lists for workplace health service research is problematic. Using the national list of health professionals registered to dispense medicines at 981 worksites in South Africa, a third of questionnaires were undelivered. A 33 per cent response rate was obtained to delivered questionnaires. Non-responders appeared to lack the information required. Although the number of employees at a worksite may influence sickness absenteeism, it does not appear to affect the absolute cost per employee nor the relative expenditure on different categories of costs incurred by worksite health services. Expenditure on staff and consumables accounts for nearly 80 per cent of worksite health service costs, regardless of workforce size. In 1988, the average cost of registered workforce health services at which medicines were dispensed and information was available, was R125 (35 pounds) per employee per year. Establishing standards and applying them to intra and inter industrial economic evaluation of workforce health services using sickness absenteeism and percentage breakdown of costs appears feasible in South African industries with both large and small workforces, provided that health professionals have access to adequate management information systems.

Absenteeism↗
PubMed2006

Low back pain and occupation among Irish health service workers.

BACKGROUND: The health services sector has been identified as a high-risk work sector for low back pain (LBP) and related absenteeism. AIMS: To establish levels and predictors of LBP prevalence and associated sick leave among health service workers. To identify if levels of LBP or related absenteeism differ between occupational groups. METHODS: A postal survey using a standardized questionnaire and disproportionate random sampling of occupational groups was conducted at a single Dublin hospital. Overall hospital LBP prevalence and sickness absence were calculated using weighted analysis methods. Univariate analysis included the use of Chi-square, Fisher's exact and Mann-Whitney tests. Multivariate logistic regression techniques were used to explore for independent predictors of lifetime LBP prevalence and LBP-related sickness absence. RESULTS: An overall response rate of 62% (n = 246) was achieved. Lifetime, annual and point prevalence rates for the hospital employees were calculated at 46, 30 and 15.5%, respectively. No significant difference in prevalence was found between occupational groups but sick leave did differ with the highest level among general support and nursing staff. Multivariate analysis confirmed that occupation was an independent predictor for LBP-related sick leave (P < 0.05). CONCLUSIONS: LBP prevalence rates did not differ significantly between occupational groups but occupation was found to be an independent predictor of LBP-related sick leave. Involvement in manual handling did not predict either LBP or related sick leave.

Absenteeism↗
PubMed1991

Effects of an exercise program on sick leave due to back pain.

The purposes of this study were to evaluate the effect of a weekly exercise program on short-term sick leave (less than 50 days) attributable to back pain and to determine whether changes in absenteeism were related to changes in cardiovascular fitness. Subjects were randomly assigned to an exercise group (n = 58) and a control group (n = 53). Sick leave attributable to back pain was determined in the intervention period of 1 1/2 years and a comparable 1 1/2-year period prior to the study. In the exercise group, the number of episodes of back pain and the number of sick-leave days attributable to back pain in the intervention period decreased by over 50%. Absenteeism attributable to back pain increased in the control group. The decrease in sick leave in the exercise group was not accompanied by any change in cardiovascular fitness. Suggestions for establishing exercise programs are given.

Absenteeism↗
PubMed2000

School consultation: a review of research on issues unique to the school environment.

OBJECTIVE: To provide clinicians with current information to assist in their consultations to schools on 4 major topics that are unique to the school environment and of serious concern to educators: absenteeism, disciplinary referrals, retention (non-promotion), and dropping out. METHOD: Computer literature searches and the major journals of the various school disciplines were used to identify empirically based articles with sound methodology. Information on each of the 4 issues is presented as general characteristics, characteristics of psychopathology, prevention and treatment, and implications for consultation. RESULTS: Findings are largely general, with little specific information on level of intelligence, learning disorders, psychopathology, or family stressors. Students under each topic have varied presentations. However, many pupils with absenteeism, disciplinary referrals, or retention appear to be characterized by chronic and serious academic and/or behavior problems, all of which can predate dropping out. CONCLUSIONS: Considerable research is still needed on all 4 school issues, especially psychopathology. Nevertheless, consultants can reasonably first help schools to identify students at risk for the 4 outcomes, followed by appropriate screening/evaluation to indicate more clearly their true intervention needs. The ongoing process can further educate school staff about psychiatric disorders in their most problematic students.

Absenteeism↗
PubMed1986

Excess sick-listing in nonulcer dyspepsia.

The pattern of sick leave among 88 patients with nonulcer dyspepsia (NUD) and 73 patients with duodenal/prepyloric ulcer disease (DU/PPU) was studied by means of a computerized register held by the National Health Insurance Service, which covered all instances in which patients received cash benefit due to sickness. Patients with either NUD or DU/PPU were associated with a considerably increased risk of being sick-listed. The risk of needing sick days was significantly higher in the NUD group than in the ulcer group (p less than 0.02), and the NUD patients had on an average 2.6 times as many sick days requiring compensation as the corresponding background population. The ulcer patients were absent from work mainly because of their abdominal symptoms; other reasons for sick-leave were rare. On the other hand, the sick-listing among NUD patients was due to a host of complaints, dominated not by abdominal but by musculoskeletal symptoms. Thus, it seems as if several factors other than dyspepsia contribute to the disposition towards absenteeism among NUD patients. Psychosocial factors might play an even greater role in NUD than in DU/PPU patients. The present study contradicts the concept of NUD and DU/PPU as different manifestations or stages of the same disease entity. In view of the high prevalence of NUD, the substantial amount of sickness absenteeism poses a considerable economic burden on society.

Absenteeism↗
PubMed1993

Comorbid anxious signs and symptoms in major depression: impact on functional work capacity and comparative treatment outcomes.

Psychological distress is a driver both of direct and indirect health care costs. Depression compromises functional well-being, such as work productivity. Comorbid anxious features often complicate the recognition of depression and may herald a poor prognosis. We report the results of a cross-sectional naturalistic study to determine the impact of three interventions (no antidepressant, fluoxetine, or tricyclic antidepressant therapy) on relative risk of work days lost in 454 French outpatients with either major or minor depression. Most depressed patients also manifested anxious features (76% with a Hamilton Rating Scale for Anxiety score > or = 12). The presence of anxiety was related to the severity of depression, work absenteeism, and current social instability. Depression severity (Hamilton Rating Scale for Depression score > or = 26, including the contributions of anxious symptoms), psychiatric comorbidity, and psychomotor retardation best predicted continued work absenteeism. Patients with major depression were more likely to receive an antidepressant if they had a past history of depressive episodes and/or previous work disability. Patients with minor depression were less likely to receive drug therapy than patients with major depression, despite their current work disability. Among patients who received fluoxetine or a tricyclic antidepressant for at least 8 weeks, fluoxetine was associated with statistically significantly lower mean anxiety and depression scores and fewer work days missed.

Absenteeism↗
PubMed1984

Estimating the prevalence of school refusal and school-related fears. A Venezuelan sample.

This study investigated the prevalence of school refusal and school-related fears in a sample of 1034 Venezuelan children from 3 to 14 years of age. Fear surveys were administered to children older than 9 years and to the younger children's parents. In addition, parents and teachers completed questionnaires regarding the children's other behavior problems, and teachers reported on the children's school achievement and attendance. Although a significant proportion (17.7 per cent) of the children expressed intense fears of school, only rarely were such fears combined with high absenteeism or with parents' or teachers' reports of school refusal problems. School refusal prevalence was calculated using six different fear and absenteeism criteria. When refusal was defined by agreement among all information sources, prevalence was .4 per cent, which is comparable to rates reported in other countries using similar criteria. However, the data indicate that there are various degrees of school aversion and refusal.

Absenteeism↗
PubMed1996

Work group culture, stress, and hostility. Correlations with organizational outcomes.

Understanding your organizational culture is necessary if you are to be successful in making and surviving the necessary changes in current environments. Although organizational culture frequently has been studied in the business community, there are fewer studies of organizational or work group culture in hospital settings at the nursing unit level. The existing studies have emphasized the need to understand the individual work group culture before successfully implementing innovation and educational programs, or hiring and orienting new employees on nursing units. This descriptive, correlational study describes the relationships among work group culture, work-place stress, and hostility and nursing unit outcomes, specifically absenteeism and turnover. Implications of the findings include the idea that increasing decision latitude in workers may positively impact absenteeism.

Absenteeism↗
PubMed1981

Evaluating primary nursing in hospitals: examination of effects on nursing staff.

Despite widespread support in the nursing literature for the adoption of primary nursing as the optimal method of organizing hospital nursing care, little empirical evidence exists as to its effects on patients or nursing staff. This study compares units that have employed primary nursing for at least five months (N = 31) with nonprimary units (N = 20) in two large university-affiliated hospitals. Comparisons are made with respect to structural attributes of nursing units, nurses' perceptions of their jobs and units, and three outcomes: nurses' job satisfaction, absenteeism rates and resignation rates for the units. No significant differences are found between primary and nonprimary nursing with respect to measures of job satisfaction. Primary units at one hospital exhibit lower resignation and absenteeism rates than do nonprimary units. The adoption of primary nursing is discussed in light of these findings.

Absenteeism↗