Han Su1, Hilaire J Thompson2, Kenneth Pike3, Biren B Kamdar4, Elizabeth Bridges3, Megan M Hosey5, Catherine L Hough6, Dale M Needham5, Ramona O Hopkins7. 1. School of Nursing, University of Washington, Seattle, WA, USA. Electronic address: rnhansu@gmail.com. 2. School of Nursing, University of Washington, Seattle, WA, USA; Harborview Injury Prevention and Research Center, Seattle, WA, USA. 3. School of Nursing, University of Washington, Seattle, WA, USA. 4. Division of Pulmonary, Critical Care, Sleep Medicine and Physiology, University of California, San Diego, La Jolla, CA, USA. 5. Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 6. Division of Pulmonary and Critical Care Medicine, Oregon Health & Science University, Portland, OR, USA. 7. Neuroscience Center and Psychology Department, Brigham Young University, Provo, Utah, USA; Pulmonary and Critical Care Medicine, Intermountain Health Care, Murray, Utah, USA; Center for Humanizing Critical Care, Intermountain Medical Center, Murray, Utah, USA.
Abstract
BACKGROUND: Inability to return to work (RTW) is common after acute respiratory distress syndrome (ARDS). OBJECTIVES: The aim of this study is to examine interrelationships among pre-ARDS workload, illness severity, and post-ARDS cognitive, psychological, interpersonal, and physical function with RTW at 6 and 12 months after ARDS. METHODS: We conducted a secondary analysis using the US multicentre ARDS Network Long-Term Outcomes Study. The US Occupational Information Network was used to determine pre-ARDS workload. The Mini-Mental State Examination and SF-36 were used to measure four domains of post-ARDS function. Analyses used structural equation modeling and mediation analyses. RESULTS: Among 329 previously employed ARDS survivors, 6- and 12-month RTW rates were 52% and 56%, respectively. Illness severity (standardised coefficients range: -0.51 to -0.54, p < 0.001) had a negative effect on RTW at 6 months, whereas function at 6 months (psychological [0.42, p < 0.001], interpersonal [0.40, p < 0.001], and physical [0.43, p < 0.001]) had a positive effect. Working at 6 months (0.79 to 0.72, P < 0.001) had a positive effect on RTW at 12 months, whereas illness severity (-0.32 to -0.33, p = 0.001) and post-ARDS function (psychological [6 months: 0.44, p < 0.001; 12 months: 0.33, p = 0.002], interpersonal [0.44, p < 0.001; 0.22, p = 0.03], and physical abilities [0.47, p < 0.001; 0.33, p = 0.007]) only had an indirect effect on RTW at 12 months mediated through work at 6 months. CONCLUSIONS: RTW at 12 months was associated with patients' illness severity; post-ARDS cognitive, psychological, interpersonal, and physical function; and working at 6 months. Among these factors, working at 6 months and function may be modifiable mediators of 12-month post-ARDS RTW. Improving ARDS survivors' RTW may include optimisation of workload after RTW, along with interventions across the healthcare spectrum to improve patients' physical, psychological, and interpersonal function.
BACKGROUND: Inability to return to work (RTW) is common after acute respiratory distress syndrome (ARDS). OBJECTIVES: The aim of this study is to examine interrelationships among pre-ARDS workload, illness severity, and post-ARDS cognitive, psychological, interpersonal, and physical function with RTW at 6 and 12 months after ARDS. METHODS: We conducted a secondary analysis using the US multicentre ARDS Network Long-Term Outcomes Study. The US Occupational Information Network was used to determine pre-ARDS workload. The Mini-Mental State Examination and SF-36 were used to measure four domains of post-ARDS function. Analyses used structural equation modeling and mediation analyses. RESULTS: Among 329 previously employed ARDS survivors, 6- and 12-month RTW rates were 52% and 56%, respectively. Illness severity (standardised coefficients range: -0.51 to -0.54, p < 0.001) had a negative effect on RTW at 6 months, whereas function at 6 months (psychological [0.42, p < 0.001], interpersonal [0.40, p < 0.001], and physical [0.43, p < 0.001]) had a positive effect. Working at 6 months (0.79 to 0.72, P < 0.001) had a positive effect on RTW at 12 months, whereas illness severity (-0.32 to -0.33, p = 0.001) and post-ARDS function (psychological [6 months: 0.44, p < 0.001; 12 months: 0.33, p = 0.002], interpersonal [0.44, p < 0.001; 0.22, p = 0.03], and physical abilities [0.47, p < 0.001; 0.33, p = 0.007]) only had an indirect effect on RTW at 12 months mediated through work at 6 months. CONCLUSIONS: RTW at 12 months was associated with patients' illness severity; post-ARDS cognitive, psychological, interpersonal, and physical function; and working at 6 months. Among these factors, working at 6 months and function may be modifiable mediators of 12-month post-ARDS RTW. Improving ARDS survivors' RTW may include optimisation of workload after RTW, along with interventions across the healthcare spectrum to improve patients' physical, psychological, and interpersonal function.
Authors: Biren B Kamdar; Minxuan Huang; Victor D Dinglas; Elizabeth Colantuoni; Till M von Wachter; Ramona O Hopkins; Dale M Needham Journal: Am J Respir Crit Care Med Date: 2017-10-15 Impact factor: 21.405
Authors: Biren B Kamdar; Kristin A Sepulveda; Alexandra Chong; Robert K Lord; Victor D Dinglas; Pedro A Mendez-Tellez; Carl Shanholtz; Elizabeth Colantuoni; Till M von Wachter; Peter J Pronovost; Dale M Needham Journal: Thorax Date: 2017-09-16 Impact factor: 9.139
Authors: Margaret S Herridge; Marc Moss; Catherine L Hough; Ramona O Hopkins; Todd W Rice; O Joseph Bienvenu; Elie Azoulay Journal: Intensive Care Med Date: 2016-03-30 Impact factor: 17.440
Authors: Carol Cancelliere; James Donovan; Mette Jensen Stochkendahl; Melissa Biscardi; Carlo Ammendolia; Corrie Myburgh; J David Cassidy Journal: Chiropr Man Therap Date: 2016-09-08