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PubMed2004

Emotional quality-of-life and outcomes in adolescents with asthma.

OBJECTIVE: Examine the association between emotional quality-of-life (QOL) and asthma morbidity in adolescents with asthma. STUDY DESIGN: Cross-sectional survey of 185 adolescents with asthma 11 to 17 years of age cared for in three managed care organizations (MCOs) in the United States. The asthma-specific Pediatric Asthma Quality of Life Questionnaire (PAQLQ) and a short version of the generic Child Health and Illness Profile-Adolescent Edition (CHIP-AE) were used to assess emotional QOL. Asthma morbidity measures were: asthma control, emergency department (ED) visits, hospitalizations, doctor visits for worsening asthma, and missed school because of asthma. RESULTS: Of the adolescents surveyed, 45% reported feeling depressed, 41% had ED visits, and 30% missed >or=1 day of school because of asthma. Poorer asthma-specific emotional QOL was associated with poorer control of asthma symptoms ( P < .0001), missed school (OR 7.1, P < .05), and doctor visits for worsened asthma (OR = 7.0, P < .05). CONCLUSIONS: Emotional symptoms related to asthma are common in adolescents with persistent asthma and asthma-specific QOL is related to increased asthma morbidity, healthcare use, and school absenteeism. Adolescents with high morbidity from asthma exhibit poorer QOL. Therefore, the evaluation of asthma-specific emotional QOL should be included in the assessment of adolescents with asthma.

Absenteeism↗
PubMed2006

Employed men and women substance abusers: job troubles and treatment outcomes.

The majority of U.S. adults with substance abuse or dependence are gainfully employed. However, little is known about outcomes among stably employed people in treatment for substance dependence. Participants (N = 212) entering a residential treatment program completed the Addiction Severity Index (ASI) at intake and 6 and 12 months follow-up. Significant improvements were seen in absenteeism, number of employment problem days, and whether their job was in jeopardy 12 months later. Overall, 65% were retained by their original employer. ASI composite alcohol, drug, legal, family, and psychiatric scores also improved significantly. Continuous abstinence was achieved by 65% and 51% at 6 and 12 months, respectively. Although less likely to be referred to treatment by their employer, women responded to treatment as well as men, reporting similar abstinence rates and overall quality of life during the year following discharge from treatment.

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PubMed2003

Survivors and victims of hospital restructuring and downsizing: who are the real victims?

This study reports the results of a longitudinal study of the effects of hospital restructuring and downsizing on nursing staff satisfaction and psychological well-being. Participants completed questionnaires in November 1996 and November 1999. All were employed as hospital-based nurses in 1996 but some had left hospital nursing for other jobs by 1999. Nurses still employed in hospital settings (N=744) were compared with nurses now employed elsewhere (N=74). Hospital-based nursing staff reported less job satisfaction, more absenteeism, greater psychological burnout and poorer psychological well-being than nurses now employed elsewhere.

Absenteeism↗
PubMed1985

School achievement and absence in children with chronic health conditions.

Families of 270 children with chronic health conditions observed in 11 subspecialty clinics at a tertiary care center were surveyed to assess the relation of demographic and health variables to school achievement and absenteeism. National achievement test scores and school days absent were compared with North Carolina state results. The mean days absent for children with chronic health conditions was 16 days, compared with the state average of less than 7 days, during the 1981-1982 academic year. The mean national achievement score for the chronically ill children was at the 51st percentile, compared with the 63rd percentile for the state's sixth graders. Log of school days absent was correlated with the number of clinic visits, physician rating of activity limitations, sex, and specific health conditions (R2 = 0.17, P = 0.001). National achievement scores were mainly related to socioeconomic factors and specific health conditions (R2 = 0.44, P = 0.001), but were unrelated to school absence. Children with spina bifida, sickle cell disease, or epilepsy, and children with the added burden of low socioeconomic status, were at particular risk for poor school achievement.

Absenteeism↗
PubMed2000

[Disability from low back pain in Spain].

BACKGROUND: Nonspecific low back pain (LBP) is very common and the economic impact of absenteeism has not been completely established in Spain. MATERIAL AND METHOD: We have valued LBP and the cost of worker's compensation in Spain with the available information between 1993-1997. RESULTS: The mean LBP was 55,388 per year (SD 9,230.1). The transitory LBP disability was 21.9 days, with a range between 19.7 and 24.2 days. The total cost of worker's compensation LBP claims was 11,000 million pesetas/year, and the mean cost by worker was 209,666 pesetas/year. CONCLUSIONS: The worker's compensation LBP claims was higher in Spain that in the European Union.

Absenteeism↗
PubMed1995

Self-management teaching programs and morbidity of pediatric asthma: a meta-analysis.

BACKGROUND: Self-management teaching programs are becoming an important asset in the management of pediatric asthma. OBJECTIVE: The study was designed to evaluate the impact of self-management teaching programs on the morbidity of pediatric asthma. METHODS: The meta-analysis included randomized clinical trials, published between 1970 and 1991, addressing the outcome of morbidity. Studies were retrieved from searches of MEDLINE, American Journal of Nursing International Index, and Dissertation Abstracts Online Database. The quality of studies was assessed with the scale of Chalmers. The pooled effect size was calculated by the method of Hedges. RESULTS: The literature search retrieved 23 randomized clinical trials, but 12 studies had to be excluded. Global score of quality of studies (Chalmers' scale) was fair, 51.6% +/- 9.9%. As indicated by the effect size (ES) of the pooled studies, self-management teaching did not reduce school absenteeism (ES: 0.04 +/- 0.08), asthma attacks (ES: 0.09 +/- 0.14), hospitalizations (ES: 0.06 +/- 0.08), hospital days (ES: -0.11 +/- 0.08), or emergency visits (0.14 +/- 0.09). CONCLUSION: Self-management teaching programs do not seem to reduce morbidity, and future programs should focus more on intermediate outcomes such as behavior.

Absenteeism↗
PubMedDate not supplied

[The temporary work incapacities of professional administrative workers and nurses].

We show the results of a retrospective study designed to assess the features of transient job disability (TJD) episodes of workers from two groups (clerks and nurses) from an urban health basic zone with 24,536 inhabitants, out of which 6,009 were active workers registered in social security databases. Population pyramid and job distribution in active workers were obtained from a random sample including 5% of the active population, out of which 17% were clerks and 5.54% nurses. There were 1098 TJD episodes in 1990; 32.4% of them involved clerks and 8.3% nurses. The mean length of episodes was 28.2 days in nurses and 27.8 days among clerks, compared to 32.4 days in the active population. These differences remained (p < 0.001) even after excluding TJD episodes of pregnant women, in whose case the mean length of episodes involving male or female workers was the same. The percentage of TJD episodes was higher among female nurses and clerks, than among the whole female population. Influenza was responsible for 20.5% of TJD in clerks against 14.3% among nurses and 14.8% in the whole active population. We conclude that, in the groups studied, the rate of job absenteeism was higher than in the whole population, and higher in female than in males. However, in the whole population, there were no differences in TJD rates between males and females. We discuss that several factors other than illness may explain the differences among groups.

Absenteeism↗
PubMed2004

[Relationship between asthma or asthma-related symptoms and school problems among French children attending kindergarden].

BACKGROUND: The impact of chronic respiratory symptoms on school performance has been studied less than its impact on children's health. Our survey explored the relationship between chronic respiratory symptoms and school problems among children attending kindergarten. It assessed the impact of school absenteeism, sport practise in a club and health care access for school problems among pupils with chronic respiratory symptoms. METHODS: A population-based study was carried out by school physicians on a representative sample of pupils attending third-year kindergarten, in Alsace - France. Assessments included school problems, sociodemographic and health care access characteristics. Health conditions, notably chronic respiratory symptoms, were asked to include the pupils in one of the three study groups: physician-diagnosed asthma, asthma-related symptoms not associated with diagnosed asthma, and without current health problems (controls). Logistic regression was used to compare the odds ratio of school problems for the three study groups, overall and stratified by income. RESULTS: The 2,632 included pupils aged 5 to 6 Years, were assigned to the three groups according to their respiratory status: 179 with diagnosed asthma, 176 with asthma related symptoms and 2,277 healthy pupils. Diagnosed asthma was not linked with school problems. The overall association between asthma related symptoms and school problems was significant (OR=1.5, 95% CI: 1.0-2.2). After adjustment, this association persisted among pupils whose mother's education level was intermediary (technical or vocational diploma) (OR=2.3, 95% CI: 1.2-4.6). Among the diagnosed asthma group, pupils practising a sport in a club had less school problems than those not taking part in sports (ORadjusted=0.2, 95% CI: 0.03-0.8). CONCLUSION: In our study, asthmatic children were not at higher risk of school problems. So developing programs preventing school problems which focus on asthmatic children is not needed. Among the pupils having a mother with an intermediary education level, asthma-related symptoms were associated with school problems. It is important to identify unknown asthmatics to institute to treatment for their respiratory symptoms in order to prevent the consequences of the functional impact of asthma on their scholarship.

Absenteeism↗
PubMed2003

Does smoking affect the outcome of patient education and self-management in asthmatics?

Information on the potential effect of smoking on the outcome of patient education in asthma is lacking. We randomly allocated 78 asthmatics to either a control or intervention group. Intervention consisted of two 2-h group sessions followed by 1-2 individual sessions each by a nurse and a physiotherapist. Self-management was emphasised following a stepwise treatment plan at exacerbations. Smokers experienced more general practitioner (GP) visits (P=0.001) and absenteeism from work (P=0.02), a greater need for rescue medication (P=0.03), a larger drop in FEV1 (P=0.02) and worse St. George's respiratory questionnaire (SGRQ) scores (P<0.001) compared to non-smokers during the 1-year follow-up. In multiple linear and logistic regression models smoking was still associated with worse SGRQ scores, a drop in FEV1, higher need for GP visits and rescue medication and higher total costs. We, thus, conclude that smoking was associated with reduced health related quality of life, a drop in FEV1, increased need for rescue medication and GP visits and higher costs after patient education during the 1-year follow-up, compared to no smoking.

Absenteeism↗
PubMed1996

Partners in Health: a case study of a comprehensive disability management program.

When absenteeism threatened to raise health care costs and affect the quality of care at Tillsonburg District Memorial Hospital, a multidisciplinary team came together to develop a strategic response. The hospital seized the opportunity to initiate the ¿Partners in Health¿ program, an innovative and collaborative disability management program designed to improve its response to the health issues of all its staff. This paper describes how the program was developed and outlines its comprehensive approach. Partners in Health has proven to be extremely successful at increasing attendance awareness, improving work accommodation and/or rehabilitation after illness or injury, and reducing costs associated with health and lost-time claims. Partners in Health was recognized with the 1995 Health Care Quality Team Award sponsored by the Canadian College of Health Service Executives and 3M.

Absenteeism↗
PubMed1998

Silent dropouts in health surveys: are nonrespondent absent teenagers different from those who participate in school-based health surveys?

OBJECTIVE: To compare the health problems, needs and behavior of pupils absent from school with participants in the Swiss Multicenter Adolescent Survey on Health. METHODS: The present pupils' group (N = 3324; adolescents between 15 and 20 years old, randomly selected from high schools and professional centers of French-speaking Switzerland) answered a self-administered anonymous questionnaire. The absent pupils group (N = 96) was questioned on the phone by means of a shorter but similar version of the questionnaire. RESULTS: The proportion of respondents reporting skin problems, weight concerns, sleep difficulties, headaches, stomach aches, as well as vision or dental problems was higher in the present pupils sample (p < 0.01). The percentages of teenagers reporting the need for help were higher in the present pupils sample than in the absent group: nutrition (21.8 vs. 9.4, p < 0.01) stress (44.2 vs. 31.3, p < 0.05), depression (28.4 vs. 18.9, p < 0.05), sleep problems (21.3 vs. 12.1, p < 0.05), sports (9.2 vs. 4.2, p < 0.05), and love life (31.5 vs. 14.5, p < 0.01). The rates of hospitalizations and injuries were lower among absent pupils (28.2 vs. 40.1, p < 0.01). A higher proportion of absent students were sexually active (p < 0.05). They had a tendency to use tobacco, alcohol, and cannabis more frequently than did present pupils (p < 0.05). CONCLUSION: Within the Swiss context, nonparticipation owing to school absenteeism is probably related less to physical or chronic health problems that to lifestyles which predispose these students to truancy.

Absenteeism↗
PubMed1997

Epilepsy in a Dutch working population: are employees diagnosed with epilepsy disadvantaged?

The present study was designed to determine whether employees diagnosed with epilepsy, in contrast to comparable colleagues, encounter disadvantages in their professional careers. Attention was focused on education, job training, number of jobs performed, sickness absenteeism, accidents at work and wages. A group of 34 employees diagnosed with epilepsy was selected and compared with matched, non-epileptic colleagues. Slight differences between both groups were found for all items except for education. Only for wages was a statistically significant difference found. It is concluded that workers diagnosed with epilepsy and comparable colleagues both received the same educational and vocational training in order to reach their position. The data did not substantiate the proposition that employees diagnosed with epilepsy have poor attendance records, higher number of accidents in the workplace or that they are at a disadvantage in securing a job. However their salaries appear to be lower than the earnings of colleagues who hold comparable jobs.

Absenteeism↗
PubMed2005

A pilot examination of the impact of cancer patients' fatigue on their spousal caregivers.

OBJECTIVE: In this pilot project we examined the quality of life of spouses of cancer patients who had significant fatigue. METHODS: We assessed both the spouses of cancer patients and the patients who presented with chemotherapy-induced fatigue and anemia. Study endpoints included the impact that cancer patients' fatigue had on their spouses' quality of life, including their own levels of fatigue, depressive symptoms, activity levels, work absenteeism, and marital adjustment. We examined the extent to which changes in patients' fatigue from baseline to one month follow-up were associated with changes in spouses' quality of life indices. RESULTS: 25 couples completed the study. Seven (28%) spousal caregivers reported handling fewer responsibilities at work, 8 (32%) had reduced their work hours, and 8 (32%) felt that they were less effective overall at work. Spousal caregivers also missed a significant amount of time at work during the month long study, missing an average of 2.7 (SD = 2.95) days, with an additional 1.29 (SD = 2.97) sick days and 1.76 (SD = 2.63) vacation days during that time. Spouses reporting greater levels of caregiver strain were more likely to have increased fatigue at baseline (F1,23 = 8.11, p < .01), and worse dyadic adjustment at both time points (baseline: F1,23 = 7.80, p < .01; follow-up: F1,21 = 9.24, p < .01). Also, those with more caregiver strain were less likely to engage in social activity at baseline (F1,23 = 6.11, p < .05) and more likely to engage in less work by the one month follow-up (F1,20 = 8.36, p < .01). SIGNIFICANCE OF RESULTS: Spouses who were identified as having elevated burden experienced more personal fatigue, had worse dyadic adjustment, reported poor energy levels, and tended to engage in fewer work and social activities; the impact of patient's fatigue level on these parameters was highly variable in this small pilot study.

Absenteeism↗
PubMed2003

Views of laypersons on the role employers play in return to work when sick-listed.

Sickness absenteeism is an increasing public health problem, but few studies have examined the views of laypersons regarding factors that promote return to work. The present investigation concerns the opinions of such individuals on the role employers play in this context. Data from five focus-group interviews of laypersons with experience of long-term sickness absence were subjected to grounded theory analysis. When asked about factors that hinder or promote return to work, the laypersons spontaneously emphasized the importance of the employer. Specifically, they stressed the need for a structured back-to-work program at each workplace, which should include contacting absent employees and informing fellow workers of possible changes in task assignments upon return of the absent person. Reported hindering factors included lack of such information, leading to envy and harassment. Respondents also asserted the importance of work supervisors in creating a positive emotional atmosphere.

Absenteeism↗
PubMed1994

Predictors and outcomes of elder-care-based interrole conflict.

The authors propose and test a model of the predictors and outcomes of the role conflicts experienced by individuals simultaneously holding full-time employment and providing care for elderly parents. It is proposed that interrole conflict is predicted by physical and psychological involvement in elder care and predicts both partial absenteeism from work and psychological strain. In turn, psychological strain predicts marital interactions. Data from 141 full-time employees from 2 universities provided strong support for the proposed mediational model using LISREL VII. In contrast, 2 alternative models were not supported by the data.

Absenteeism↗
PubMed1997

Worker social identity and health-related costs for organizations: a comparative study between ethnic groups.

Health implications of value conflicts at work and 3 coping resources (self-esteem, collective esteem, and social support at work) were examined for 38 African American and 64 European American workers. Comparisons indicated that the African American participants reported higher levels of value conflicts and collective esteem, but lower levels of social support. They also reported more health actions (i.e., absenteeism and doctor visits) likely to create organizational costs. Value conflicts and the 3 coping resources predicted health-related behavior. Collective esteem predicted health only for African American workers, though social support was a significant predictor only for European American workers. The study findings are integrated with existing literature on social identity at work, social support, and work influences on health.

Absenteeism↗
PubMed1997

Balancing elder care responsibilities and work: two empirical studies.

It was hypothesized that workers with elder care responsibilities, compared with noncaregiving workers, would be more likely to suffer physical symptoms of stress and to be absent more days. In Study 1, 67 (32 noncaregivers, 35 caregivers) employees of a financial institution were interviewed. In Study 2, 169 (118 noncaregivers, 51 caregivers) employees of a health care institution completed a questionnaire. In Study 1, caregivers were absent more days than noncaregivers, and caregiver status was related to the incidence of weight loss or gain, drowsiness, and inability to sleep. In Study 2, caregiver status was related to the incidence of weight loss or gain, drowsiness, inability to sleep, frequent headaches, and nervousness. Caregivers were not significantly different from noncaregivers in absenteeism. Results indicate that caregivers' responsibilities may negatively affect work performance.

Absenteeism↗
PubMed2003

Treatment costs and work time loss due to episodic adenolymphangitis in lymphatic filariasis patients in rural communities of Orissa, India.

OBJECTIVE: To determine the economic loss in terms of treatment costs and loss of productive time because of acute episodes of adenolymphangitis (ADL) caused by lymphatic filariasis (LF) in a rural population of coastal Orissa, India. METHODS: Data on expenditure on treatment and loss of work along with other epidemiological information were collected through a 1-year surveillance of 113 acute episodes of ADL from 72 individuals of the study population (5.42%). The activity patterns of patients for 24 h of one episode were documented, and data on age- and sex-matched controls were also collected. Standardized Z-test, paired t-test, logistic and multiple regressions were used. RESULTS: Those patients who did incur expenses spent Indian Rupees 92 on average (approximately US$ 1.85) on each episode. The ADL episodes curtailed the productive activity of patients. Patients (88%) were unable to attend to any economic activity compared with 47% of controls who had no history of disease. Similarly during 55% of episodes, females (vs. 8% of controls) could not attend to any domestic work. The mean number of hours spent on economic or domestic activities was significantly lower among patients. Disease status and sex had significant influence on total absenteeism from gainful employment; and similarly, age, family type and disease status influenced total domestic work hours among women. CONCLUSIONS: The results demonstrate the extent of the economic burden caused by acute LF and provide justification for strengthening the ongoing LF elimination programme.

Absenteeism↗