Han Su1, Nathan J Dreesmann1, Catherine L Hough2, Elizabeth Bridges3, Hilaire J Thompson3. 1. University of Washington School of Nursing, Seattle, WA, USA. 2. Oregon Health & Science University, Portland, OR, USA. 3. Department of Biobehavioral Nursing and Health Informatics, University of Washington, Seattle, WA, USA.
Abstract
AIMS: To synthesize data on prevalence and risk factors for return to work (RTW) in ICU survivors. DESIGN: Systematic review and meta-analysis. DATA SOURCES: PUBMED, CINAHL, EMBASE and PsycINFO databases were searched from 2000-Feb 2020. REVIEW METHODS: Peer-reviewed articles that included adult ICU survivors and employment outcomes. Two investigators independently reviewed articles following the PRISMA protocol. Pooled prevalence for RTW was calculated. Meta-regression analyses were performed to assess the association between disability policies, temporal factors and RTW following ICU. RESULTS: Twenty-eight studies (N = 8,168) met the inclusion criteria. All studies were scored as 'low risk of bias'. Using meta-analysis, the proportion (95% CI) of RTW following ICU was 29% (0.20,0.42), 59% (0.50,0.70), 56% (0.50,0.62), 63% (0.54,0.72), 58% (0.37,0.91), 58% (0.42,0.81), and 44% (0.25,0.76) at 3, 4-6, 7-12, 13-24, 25-36, 37-48, and 49-60 months, respectively. Time and disability policy support are factors associated with the proportion of ICU survivors who RTW. Through meta-regression, there is a 20% increase (95% CI: 0.06, 0.33) in the proportion of individuals who RTW per year. However, the average rate of increase slows by 4% (-0.07, -0.1) per year. In countries with high support policies, the proportion of RTW is 32% higher compared with countries with low support policies (0.08, 0.24). However, as subsequent years pass, the additional proportion of individuals RTW in high support countries declines (β = -0.06, CI: -0.1, -0.02). CONCLUSIONS: Unemployment is common in ICU survivors. Countries with policies that give higher support for disabled workers have a higher RTW proportion to 3 years following ICU admission. However, from 3-5 years, there is a shift to countries with lower support policies having better employment outcomes. IMPACT: Health care policies have an impact on RTW rate in survivors of ICU. Healthcare providers, including nurses, can function as public advocates to facilitate policy change.
AIMS: To synthesize data on prevalence and risk factors for return to work (RTW) in ICU survivors. DESIGN: Systematic review and meta-analysis. DATA SOURCES: PUBMED, CINAHL, EMBASE and PsycINFO databases were searched from 2000-Feb 2020. REVIEW METHODS: Peer-reviewed articles that included adult ICU survivors and employment outcomes. Two investigators independently reviewed articles following the PRISMA protocol. Pooled prevalence for RTW was calculated. Meta-regression analyses were performed to assess the association between disability policies, temporal factors and RTW following ICU. RESULTS: Twenty-eight studies (N = 8,168) met the inclusion criteria. All studies were scored as 'low risk of bias'. Using meta-analysis, the proportion (95% CI) of RTW following ICU was 29% (0.20,0.42), 59% (0.50,0.70), 56% (0.50,0.62), 63% (0.54,0.72), 58% (0.37,0.91), 58% (0.42,0.81), and 44% (0.25,0.76) at 3, 4-6, 7-12, 13-24, 25-36, 37-48, and 49-60 months, respectively. Time and disability policy support are factors associated with the proportion of ICU survivors who RTW. Through meta-regression, there is a 20% increase (95% CI: 0.06, 0.33) in the proportion of individuals who RTW per year. However, the average rate of increase slows by 4% (-0.07, -0.1) per year. In countries with high support policies, the proportion of RTW is 32% higher compared with countries with low support policies (0.08, 0.24). However, as subsequent years pass, the additional proportion of individuals RTW in high support countries declines (β = -0.06, CI: -0.1, -0.02). CONCLUSIONS: Unemployment is common in ICU survivors. Countries with policies that give higher support for disabled workers have a higher RTW proportion to 3 years following ICU admission. However, from 3-5 years, there is a shift to countries with lower support policies having better employment outcomes. IMPACT: Health care policies have an impact on RTW rate in survivors of ICU. Healthcare providers, including nurses, can function as public advocates to facilitate policy change.
Authors: Han Su; Hilaire J Thompson; Kenneth Pike; Biren B Kamdar; Elizabeth Bridges; Megan M Hosey; Catherine L Hough; Dale M Needham; Ramona O Hopkins Journal: Aust Crit Care Date: 2022-02-21 Impact factor: 3.265
Authors: Han Su; Hilaire J Thompson; Susanne May; Victor D Dinglas; Catherine L Hough; Megan M Hosey; Ramona O Hopkins; Biren B Kamdar; Dale M Needham Journal: Chest Date: 2021-03-14 Impact factor: 10.262