DESIGN: This post hoc descriptive exploration of data from the large international very early rehabilitation trial (A Very Early Rehabilitation Trial (AVERT)) examined the four common post acute rehabilitation pathways (inpatient rehabilitation, home with community rehabilitation, inpatient rehabilitation then community rehabilitation and home with no rehabilitation) experienced by participants in the 3 months post stroke and describes their 12-month outcomes.
SETTING: Hospital stroke units in AUS, UK and SE Asia.
PARTICIPANTS: Patients who had an acute stroke recruited within 24 hours who were ≤65 years.
RESULTS: 668 participants were ≤65 years; 99% lived independently, and 88% no disability (modified Rankin Score (mRS)=0) prior to stroke. We had complete data for 12-month outcomes for n=631 (94%). The proportion receiving inpatient rehabilitation was higher in AUS than other regions (AUS 52%; UK 25%; SE Asia 23%), whereas the UK had higher community rehabilitation (UK 65%; AUS 61%; SE Asia 39%). At 12 months, 70% had no or little disability (mRS 0-2), 44% were depressed, 28% rated quality of life as poor or worse than death. For those working prior to stroke (n=228), only 57% had returned to work. A noteworthy number of working age survivors received no rehabilitation services within 3 months post stroke.
CONCLUSIONS: There was considerable variation in rehabilitation pathways and post acute service use across the three regions. At 12 months, there were high rates of depression, poor quality of life and low rates of return to work.
TRIAL REGISTRATION NUMBER: Australian New Zealand Clinical Trials Registry (ACTRN12606000185561).
OBJECTIVE: The aim was to understand the local prevalence and factors associated with returning to work in Malaysia after a cardiac event.
METHODS: A cross sectional design was used. All patients attending the cardiac rehabilitation program after major cardiac event during an 11-months period (2011-2012) were included. Data relating to socio-demographic, work-related, risk factors and acute myocardial infarction were collected. The SF-36 questionnaire was used to assess quality of life. Regression analysis was used to determine the predicting factors to return to work.
RESULTS: A total of 398 files were screened, 112 respondents agreed to participate giving a response rate of 47.3%. The prevalence of returned to work (RTW) was 66.1% [95% CI: 57.2-75.0]. Factors associated with work resumption were age (Adj. OR: 0.92 (95% CI: 0.84-0.99), diabetes mellitus (Adj. OR: 3.70, 95% CI: 1.35-10.12), Mental Component Summary (MCS) score (Adj. OR: 1.05 (95% CI: 1.01-1.09) and baseline angiography findings. Patients with single vessel and two vessel disease were 8.9 times and 3.78 times more likely to return to work compared to those with 3 vessels (Adj. OR: 8.90 (95% CI: 2.29-34.64) and Adj. OR: 3.78, (95% CI: 1.12, 12.74).
CONCLUSIONS: We proposed a cardiac rehabilitation program to emphasize mental health as it may improve successful return to work after cardiac event.
METHODS: A pre-validated questionnaire survey was done on dentists across India. Structural Equation Modelling and path analysis were applied to the data collected.
RESULTS: The results of the study supported the hypothesis that factors like physical and mental health, activities, relationship status, and workplace influenced the work-life balance directly. A significant imbalance was seen amongst the female dentists.
CONCLUSION: The present study proved the unpreparedness among dental professionals. Hence an evolutionary phase in every field with better working protocols, robust mental health support, and a focus on strategies to face future such emergencies is required.
DESIGN: A cross-sectional study.
SETTING: 11 manufacturing factories in Malaysia.
PARTICIPANTS: 177 night-shift workers aged 40-65 years old were compared with 317 non-night-shift workers.
PRIMARY AND SECONDARY OUTCOMES: Participants completed a self-administered questionnaire on socio-demographics and lifestyle factors, 12-item Short Form Health Survey V.2 (SF-12v2) and the Pittsburgh Sleep Quality Index (PSQI). The Baron and Kenny's method, Sobel test and multiple mediation model with bootstrapping were applied to determine whether PSQI score or its components mediated the association between night-shift work and HRQoL.
RESULTS: Night-shift work was associated with sleep impairment and HRQoL. Night-shift workers had significantly lower mean scores in all the eight SF-12 domains (p<0.001). Compared with non-night-shift workers, night-shift workers were significantly more likely to report poorer sleep quality, longer sleep latency, shorter sleep duration, sleep disturbances and daytime dysfunction (p<0.001). Mediation analyses showed that PSQI global score mediated the association between night-shift work and HRQoL. 'Subjective sleep quality' (indirect effect=-0.24, SE=0.14 and bias corrected (BC) 95% CI -0.58 to -0.01) and 'sleep disturbances' (indirect effect=-0.79, SE=0.22 and BC 95% CI -1.30 to -0.42) were mediators for the association between night-shift work and physical well-being, whereas 'sleep latency' (indirect effect=-0.51, SE=0.21 and BC 95% CI -1.02 to -0.16) and 'daytime dysfunction' (indirect effect=-1.11, SE=0.32 and BC 95% CI -1.86 to -0.58) were mediators with respect to mental well-being.
CONCLUSION: Sleep quality partially explains the association between night-shift work and poorer HRQoL. Organisations should treat the sleep quality of night-shift workers as a top priority area for action to improve their employees' overall wellbeing.