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PubMed1997

Influence on asthma morbidity of asthma education programs based on self-management plans following treatment optimization.

The objective of this study was to evaluate the effectiveness of an asthma education program on morbidity, knowledge, and compliance with inhaled corticosteroid treatment using a prospective, randomized, controlled, one-year-before/one-year-after protocol. After rigorous optimization of asthma therapy under the care of respirologists, patients were assigned to one of three groups: Group C (control group: no formal education), Group P (education and action plan based on peak-flow monitoring), and Group S (education with action plan based on monitoring of asthma symptoms). A total of 188 subjects with moderate to severe asthma were enrolled and 149 completed the study. Asthma morbidity decreased significantly in all groups (p = 0.001). Mean values one-year-before/one-year-after in Groups C, P, and S were: unscheduled medical visits, 2.4/0.8, 2.3/0.7, and 1.9/ 0.7; hospitalizations, 0.21/0.04, 0.24/0.04, and 0.40/0.09; oral steroid treatments; 1.3/0.5, 1.2/0.7, and 1.3/0.9; absenteeism from work/school, 9.6/5.2, 8.8/2.2, and 6.3/2.9. Between-group differences did not reach statistical significance (p > 0.05). Asthma knowledge increased in both educated groups compared with the control group (p < 0.001) as did short-term compliance with inhaled corticosteroids. These results confirm that treatment optimization coupled with sustained high quality care in motivated patients can lead to a significant decrease in asthma morbidity. In such clinical settings, structured asthma education significantly improved short-term compliance with treatment and knowledge about asthma, although it could not add extra benefit with regard to morbidity. Nevertheless, this study does not refute the potential benefit of educational interventions aimed at improving asthma-related morbidity over a longer time period or in patients with less optimal care or with high-risk factors.

Absenteeism↗
PubMed1978

A comparison of depression and physical illness in men and women.

A limited self-rating depression scale given to male and female factory workers indicated that subclinical depressive symptoms were correlated with visits to the factory health service for females and with absenteeism from work for males. In general, the females acknowledged more depression symptoms.

Absenteeism↗
PubMed1993

Learning, school performance, and children with asthma: how much at risk?

Children with asthma may be at risk for decreased school functioning due to acute exacerbations, increased absenteeism, iatrogenic effects of their asthma medication, and the stress associated with a chronic illness. The purpose of this article is to critically review extant research pertaining to the school functioning of children with asthma, including studies of school attendance, school performance, the effects of asthma medications on learning and behavior, and the role of psychological variables in the development of functional impairments. There is not sufficient evidence to suggest that children with asthma are at significantly higher risk for poor school performance than children without asthma. Factors that may contribute to poor school performance among children with asthma include iatrogenic effects of oral steroids, poor medical management of the disease, and psychological problems. Recommendations for improving the school functioning of children with asthma are discussed.

Absenteeism↗
PubMed1993

Health promotion at work.

This study examined health promotion intervention amongst council employees and determined the extent that any changes were subsequently maintained. The results showed that even with modest intervention, beneficial changes were observed in alcohol consumption, diastolic blood pressure, body mass, waist/hips ratio, body fat, aerobic capacity and arm strength. Behavioural measures tended not to change, but this could be a consequence of unfocused questioning or insufficient intensity of the health promotion activities. The sickness and absenteeism rates improved during the intervention and maintenance phases, making a strong case for health promotion from the employer's perspective. A critique of the experimental procedure suggested that the testing venue, the methods of obtaining consent, the continuity of subjects, initial attitudes, the intensity of the intervention and the project delivery were all features that would contribute to a successful outcome.

Absenteeism↗
PubMed1998

Comparative view of the socioeconomic impact of migraine versus low back pain.

The burden of migraine in terms of cost and impact on socioeconomic indicators is still controversial. In a recent comparative study between migraineurs and controls from the French general population, we show that only general practitioner (GP) consultations and complementary examinations are more frequent in migraineurs. In this paper, we compare the socioeconomic impact of migraine versus another common neurological disease, low back pain, which has similar consequences in term of deficiencies, disabilities, and handicaps. Our study is a subproject of the Gazel cohort study, conducted on 20,000 volunteers working in the "Electricité et Gaz de France" company. The socioeconomic impact was evaluated prospectively by the number of workdays missed between 1989 and 1992 in 436 subjects with migraine but without low back pain (M group), 590 subjects with low back pain but without migraine (L group), 555 subjects with migraine and low back pain (ML group), and in 1005 subjects without headache or low back pain (C group). Moreover, in 1993 all subjects completed a mailed questionnaire on their 6-months' history of use of medical services. The number of workdays missed during this 4-year period was statistically greater in the ML group (58.1 days), followed by the L group (38.4 days), the C group (35.1 days), and the M group (31.8 days) (p = 0.0001). For the use of medical services, the results were different according to the different indicators: GP consultations were more frequent in the ML and M groups, specialist consultations and complementary examinations in the L and C groups. In conclusion, migraine and low back pain seem to have a similar socioeconomic impact. Absenteeism is particularly high when both neurological disorders are present.

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PubMed2002

Quality improvement projects related to pediculosis management.

Concern about student absenteeism related to repeated pediculosis infestations and the consequent risk for unsuccessful school achievement led to a quality improvement program comprised of 6 projects. The goal was to identify effective nursing interventions for children and families incurring repeated infestations. One project addressed the prevalence of infestation, frequency of school exclusion, and duration of consequential lost school days. Affirmed were low contagion in classrooms and multiple social and emotional challenges in students having chronic infestations. From other projects, the importance of establishing effective relationships with parents, students, and school staff to work toward effective management outcomes was apparent. Also identified was the need to better match hair texture with the selection of a lice comb for effective mechanical removal of lice and nits. There is a need to replicate these projects with larger numbers of students in different geographic locations. It is important to have evidence-based information about the communicability and management strategies for pediculosis to contribute to sound treatment and policy formation.

Absenteeism↗
PubMed2003

The impact of school nursing on school performance: a research synthesis.

School nurses work in an educational setting. Due to budget cuts, different goals, and confusion between educators and nurses regarding the school nurse role, school nurses are being asked to demonstrate their effectiveness and justify their presence in elementary and secondary schools. Although school nursing was first initiated 100 years ago, a review of the literature published since 1965 indicates that 15 studies have been conducted that examine the impact of school nurses on academic performance. However, today many articles have recommended more research linking school nursing to educational outcomes. This article synthesizes the results of 15 research articles. Findings from these studies indicate that nursing interventions targeted at specific populations, including parents, have had significant effects. A relationship between school nurses' interventions and absenteeism is also suggested. Limitations of these studies are discussed, along with suggestions for future research.

Absenteeism↗
PubMed2004

Effect of full-time versus part-time school nurses on attendance of elementary students with asthma.

Asthma, the most common chronic disease in children today, is the leading cause of absenteeism among students. It accounts for nearly 20 million lost school days annually. This study examined whether full-time (5 days per week) or part-time (2 days per week) school nurses would have a differential effect on the frequency of absences among elementary school students with asthma. This study found that students with asthma who were poor or who were African American and in schools with full-time nurses missed significantly fewer days (3 days, or 23% fewer missed days) than did their counterparts with asthma in schools with part-time nurses.

Absenteeism↗
PubMed1990

School absences, school achievements and personality traits of the haemophilic child.

Cross-sectional comparisons between haemophiliacs and their healthy classmates were made in the years 1971-72 and 1987-88. The more recent set of data indicated no difference in respect to school absenteeism and school achievements between haemophiliacs and classmates in contrast to the older data, which showed such differences. In 1987-1988 the personality of the haemophilic boy was assessed both by teacher-ratings as well as by self-rating scales, and they indicated that the haemophiliacs were self-assured and independent but also less caring, less joyful, less open and more bullied than their healthy classmates. The mildly to moderately affected haemophiliacs tended to have more emotional disturbances than classmates and severely affected haemophiliacs. The latter were the least likely to avoid potentially hazardous activities. The haemophiliac's conflicts about adapting to a restricting chronic disease were elucidated.

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PubMed2006

Effect of HIV/AIDS on the control environment.

OBJECTIVE: The management of organizations is responsible for risk management and control systems. HIV/AIDS could be a great threat in the achievement of strategic business objectives, implicating a great concern for management. Management needs to understand this possible risk. This study aims to identify the effect that HIV/AIDS could have on the different elements of the control environment. METHODOLOGY: The archival research method was used. It was established that no formal research was conducted to date on the effect of HIV/AIDS on the control environment as a whole. Various studies have included the effect of HIV/AIDS on certain factors of the control environment. These studies will be discussed briefly to identify relevant findings. RESULTS: The study indicated that the disease could affect various aspects of the control environment, namely: competency of the workforce (e.g. productivity, quality of work, absenteeism, loss of skills and knowledge, training and recruitment, etc.); organizational structure (e.g. increase use of technology labour, disruption of processes, level of employees affected by the disease); human resource (HR) policies and practices (e.g. legislation applicable, prevention and awareness programmes, compensation and benefits). Research limitation: HIV/AIDS is a relatively new potential risk to organizations. Knowledge of the disease is limited. HIV/AIDS is also a very sensitive issue as people fear the disease and do not like to discuss its existence. Government determined that it should be a non-notifiable disease and the disease is currently greatly stigmatized. The databases of companies investigated by other research studies were not developed to gather all the relevant information. CONCLUSION: Management should be aware that HIV/AIDS poses a possible risk to organizations. Data on the effect of HIV/AIDS should be gathered and used in the decision-making process on how to manage this risk. To be able to fulfil this duty, management first has to determine: whether HIV/AIDS is a risk; the relevant cost involved that the disease is costing the organization; how to control these costs.

Absenteeism↗
PubMed2002

Empowering a tea-plantation community to improve its micronutrient health.

This project was designed to convince and empower management and plantation workers to improve their own nutritional health status and productivity. Plantations are generally bypassed by the government's primary health-care system. A nine-month intervention with iron (60 mg of elemental iron) and vitamin A supplementation and iodized salt was performed on the Balanoor Plantations in India. Of the women tea pickers, 99% (n = 334) received the supplements and bought the iodized salt from the plantation ration shop. Their mean hemoglobin level rose significantly from 11.0 to 11.9 g/dl. The women pickers gave the supplements to their families as well as themselves. The results were the same whether iron was given once or twice a week. The mean hemoglobin level of the women pickers rose significantly from 11.1 to 12.0 g/dl with the twice-weekly dose and from 10.9 to 11.8 g/dl with the weekly dose. The prevalence of clinical signs of vitamin A deficiency in the entire plantation population (about 2,500) was reduced significantly (from 19% to 4%), as was iodine deficiency (from 17% to 7%). Common health problems decreased from 88% to 54%. The number of patients referred to larger hospitals decreased significantly from 116 to 86. Absenteeism was not affected.

Absenteeism↗
PubMed2006

Juggling work and elder caregiving: work-life balance for aging American workers.

As the American work force ages, the demands of caring for aging relatives increase. Family caregiving often interferes with workplace responsibilities, creating physical, emotional, and financial stress for caregivers. Employers must address the productivity losses created by absenteeism of workers who struggle with work-life issues created by caregiving roles. Occupational health nurses must understand the factors that affect workers in their caregiving roles and make appropriate nursing interventions. They are in key positions to help aging employees and their employers face the increased demands on work-life balance created by elder caregiving.

Absenteeism↗
PubMed2004

The impact of a worksite migraine intervention program on work productivity, productivity costs, and non-workplace impairment among Spanish postal service employees from an employer perspective.

BACKGROUND: Migraine is associated with a significant productivity loss to employers, who may benefit from making a migraine intervention available to their employees. OBJECTIVE: To evaluate changes in migraine-related productivity and non-workplace impairment associated with a migraine intervention program from the employer perspective. METHODS: This was a pre-test post-test study of Spanish Postal Service employees with migraine. The intervention consisted of counseling from occupational health physicians and rizatriptan 10 mg for symptomatic treatment of two subsequent migraine headaches. Physicians also prescribed additional medications for migraine prophylaxis, treatment of tension headaches, and rescue medications. Migraine-related work loss and non-workplace impairment (interference with daily and social activities) were self-reported at baseline (pre-intervention) and separately following each migraine headache (post-intervention) with the aid of a diary. Migraine-related work loss was reported as work loss due to absenteeism, reduced productivity while at work, and the sum of the two (total lost work day equivalents [LWDE]). An employer perspective was taken for the cost analysis, and thus productivity costs were the only costs considered. RESULTS: A total of 436 patients comprised the population for analysis. The number of migraine-related LWDE per migraine attack were 0.48 days per migraine headache in the month before the intervention, decreasing to 0.20 days and 0.07 days per migraine headache during the first and second migraine headaches following the intervention (p < 0.0001 vs. baseline). Total migraine-related productivity costs per migraine headache were 34 euros/patient before the intervention, decreasing to 14 euros/patient and 5 euros/patient during the first and second headaches following the intervention (p < 0.0001). Non-workplace activity impairment was also significantly reduced (p < 0.0001) following the intervention. The main limitations of the study were the lack of a parallel control group and the potential for differential recall bias between the usual care and the intervention periods. In addition, the results may not be generalizable to other employers or other countries. CONCLUSION: This study documents the value of a workplace migraine intervention program, which focused on migraine prevention and rizatriptan-based symptomatic treatment. It also highlights the important role occupational health clinics can play in helping employers and employees reduce the burden of migraine.

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PubMed2003

Sick leave certification: a unique perspective on frequency and duration of episodes - a complete record of sickness certification in a defined population of employees in Malta.

BACKGROUND: In Malta, sickness certificates are needed from the first day of illness, and are issued by family physicians (FPs) either employed by the government primary health care system, self-employed in private practice, or employed by an employer for this purpose alone. The latter system, when applied by the employer, is compulsory. In order to contribute to the debate on the role of the FP in this context, electronic data collected by a group of company-employed FPs was used to study the phenomenon of sickness certification. This database is a complete record of the selected employees' sick leave certification during the study period. METHODS: Data collected by company-employed FPs from a defined population was used: all employees of selected Maltese companies served by a group of FPs. The database included episode-based data from home visits over three years (01/01/1997 - 31/12/1999), by 9 company-appointed FPs regarding 421 employees of five companies. RESULTS: 3015 episodes of sickness absenteeism, with an average duration of 2.9 days, were documented. Employees who did intensive manual work had relatively higher rates. Furthermore, a relatively higher incidence of work injury, sprains and strains, anxiety and depression and low back pain as found in manual workers, and in male workers. This trend was shown to be statistically significant. CONCLUSIONS: The frequency of sick-leave certification in Malta is comparable to that in other European countries, but the average duration of certificates is much less than reported in other studies that generally did not include data on short-term illness and certification. This has important implications on future research in the field. A number of common disorders were found to be significantly more prevalent causes of sickness certification in manual workers, amongst them anxiety and depression.

Absenteeism↗
PubMed2004

Measuring the effects of acupuncture and homoeopathy in general practice: an uncontrolled prospective documentation approach.

BACKGROUND: Despite the increasing demand for acupuncture and homoeopathy in Germany, little is known about the effects of these treatments in routine care. We set up a pragmatic documentation study in general practice funded within the scope of project launched by a German health insurer. Patients were followed-up for up to four years. METHODS: The aim of the project was to study the effects and benefits of acupuncture and/or homoeopathy, and to assess patient satisfaction within a prospective documentation of over 5000 acupuncture and over 900 homoeopathy patients. As data sources, we used the documentation made available by therapists on every individual visit and a standardised quality-of-life questionnaire (MOS SF-36); these were complemented by questions concerning the patient's medical history and by questions on patient satisfaction. The health insurer provided us with data on work absenteeism. RESULTS: Descriptive analyses of the main outcomes showed benefit of treatment with middle to large-sized effects for the quality of life questionnaire SF-36 and about 1 point improvement on a rating scale of effects, given by doctors. Data on the treatment and the patients' and physicians' background suggests chronically ill patients treated by fairly regular schemes. CONCLUSION: Since the results showed evidence of a subjective benefit for patients from acupuncture and homoeopathy, this may account for the increase in demand for these treatments especially when patients are chronically ill and unsatisfied with the conventional treatment given previously.

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PubMed2004

Cost-effectiveness of an intensive group training protocol compared to physiotherapy guideline care for sub-acute and chronic low back pain: design of a randomised controlled trial with an economic evaluation. [ISRCTN45641649].

BACKGROUND: Low back pain is a common disorder in western industrialised countries and the type of treatments for low back pain vary considerably. METHODS: In a randomised controlled trial the cost-effectiveness and cost-utility of an intensive group training protocol versus physiotherapy guideline care for sub-acute and chronic low back pain patients is evaluated. Patients with back pain for longer than 6 weeks who are referred to physiotherapy care by their general practitioner or medical specialist are included in the study. The intensive group training protocol combines exercise therapy with principles of behavioural therapy ("graded activity") and back school. This training protocol is compared to physiotherapy care according to the recently published Low Back Pain Guidelines of the Royal Dutch College for Physiotherapy. Primary outcome measures are general improvement, pain intensity, functional status, work absenteeism and quality of life. The direct and indirect costs will be assessed using cost diaries. Patients will complete questionnaires at baseline and 6, 13, 26 and 52 weeks after randomisation. DISCUSSION: No trials are yet available that have evaluated the effect of an intensive group training protocol including behavioural principles and back school in a primary physiotherapy care setting and no data on cost-effectiveness and cost-utility are available.

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PubMed2006

Quality of life in patients with psoriasis.

Psoriasis is one of the prevalent skin conditions in the United States. This chronic condition has a significant negative impact on patients' quality of life. Psoriasis has been linked to the depression and suicidal tendencies in the patients. The costs associated with decrements in quality of life, lost productivity, and work absenteeism may be enormous, increasing overall costs associated with the disease management. This review attempts to outline different quality of life measures available for psoriasis and describes their use in studies examining patient reported outcomes associated with pharmacological interventions for psoriasis. Factors associated with quality of life in psoriasis patients are described. It further describes physician's role in the psoriasis management to improve patients' overall well-being.

Absenteeism↗
PubMed1997

Burden of migraine: societal costs and therapeutic opportunities.

Migraine imposes an enormous health burden on individual headache sufferers and on society. The condition affects about 18% of women and about 6% of men across their lifespan. Because prevalence peaks during the most productive years, between the ages of 25 and 55, migraine is an important cause of lost work time. Despite the widespread underdiagnosis and undertreatment of migraine, health care costs for the condition are considerable. Add to this the indirect costs, in the form of absenteeism and reduced productivity at work, and the overall burden of migraine becomes apparent. Work loss is not uniformly distributed, with the most disabled half of migraineurs accounting for more than 80% of all work loss. Although improvements in health care delivery for migraine may increase direct cost (i.e., drug or medical care), this may be offset by savings in indirect costs (i.e., reduced and lost productivity).

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