-
JBI Database of Systematic Reviews and... Sep 2016Carpal tunnel syndrome (CTS) is a common problem, that can be effectively managed by surgery. Screening for prognostic factors is important to identify workers who are... (Review)
Review
BACKGROUND
Carpal tunnel syndrome (CTS) is a common problem, that can be effectively managed by surgery. Screening for prognostic factors is important to identify workers who are at a greater risk of a poor work outcome in order to implement tailored interventions to facilitate their return-to-work.
OBJECTIVE
To synthesize the best available evidence on the association of preoperative prognostic factors with work-related outcomes in people who have undergone carpal tunnel surgery.
INCLUSION CRITERIA TYPES OF PARTICIPANTS
Participants included those who were employed at the time of surgery, underwent carpal tunnel surgery and planned to return-to-work.
OUTCOMES
The primary outcome was return-to-work.
TYPES OF STUDIES
Quantitative studies investigating at least one prognostic factor for a work-related outcome in studies of workers who had carpal tunnel surgery were considered.
SEARCH STRATEGY
Eleven electronic databases were searched from their respective inception date up to July 2015. A total of 3893 publications were reviewed.
METHODOLOGICAL QUALITY
The quality of the included studies was assessed by two reviewers using a modified version of an appraisal tool (Joanna Briggs Institute Meta-analysis of Statistical Assessment and Review Instrument [JBI-MAStARI]). The following criteria were evaluated: study population representativeness, clearly defined prognostic factors and outcomes, potential confounding variables and appropriate statistical analysis.
DATA EXTRACTION
Data extraction was performed using a modified version of the standardized extraction tool from JBI-MAStARI.
DATA SYNTHESIS
Statistical pooling was not possible. Findings are presented in tables and narrative format.
RESULTS
Eleven studies (13 publications) investigating 93 prognostic factors for delayed return-to-work or prolonged work disability outcomes and 27 prognostic factors for work role functioning in 4187 participants were identified.Prognostic factors associated with workers' increased likelihood of an earlier return-to-work in a moderate-to-high-quality study included worker expected or desired fewer days off work, occupation, lower pain anxiety and if CTS had not altered their work role.Prognostic factors for a poorer work-related outcome included older age, lower household income, greater upper extremity functional limitation, greater than two musculoskeletal pain sites, lower recovery expectations, worse mental health status, job accommodation availability, high job strain, high job demands with high job control, poor co-worker relationships, poor baseline work role functioning, less-supportive workplace policies, preoperative work absence due to CTS or work disability of any cause, workers' compensation status, attorney involvement, and post-diagnosis surgical wait time.
CONCLUSION
For workers who have had carpal tunnel surgery, there are a number of factors which may be modified in order to improve return-to-work times.
Topics: Carpal Tunnel Syndrome; Humans; Prognosis; Return to Work
PubMed: 27755324
DOI: 10.11124/JBISRIR-2016-003099 -
Oncology Nursing Forum May 2016To determine (a) the average levels of emotional exhaustion (EE), depersonalization (D), and personal accomplishment (PA) among oncology nurses; (b) the prevalence of... (Review)
Review
PROBLEM IDENTIFICATION
To determine (a) the average levels of emotional exhaustion (EE), depersonalization (D), and personal accomplishment (PA) among oncology nurses; (b) the prevalence of low, medium, and high levels of burnout for each dimension; and (c) the risk factors for burnout. .
LITERATURE SEARCH
A systematic review was carried out using the CUIDEN, CINAHL®, LILACS, ProQuest, PubMed, SciELO, and Scopus databases. .
DATA EVALUATION
The 436 search results obtained were reduced to a final sample of 27 articles after applying the inclusion and exclusion criteria. .
SYNTHESIS
With respect to levels of burnout, published results differ in their conclusions. In general, they indicate that oncology nurses feel little sense of PA and suffer from EE, although few signs of D exist. .
CONCLUSIONS
Oncology nurses present high levels of EE and of reduced PA. A large proportion of these nurses are at risk of developing burnout. Age, work experience, workload, and communication skills are among the factors that may influence development of the syndrome. .
IMPLICATIONS FOR PRACTICE
Programs should be developed to identify interventions that would reduce EE and enhance feelings of PA. In addition, risk factors and protective measures should be studied more comprehensively.
Topics: Adult; Burnout, Professional; Female; Humans; Job Satisfaction; Male; Middle Aged; Nursing Staff, Hospital; Oncology Nursing; Prevalence; Risk Factors; Spain; Stress, Psychological; Surveys and Questionnaires
PubMed: 27105202
DOI: 10.1188/16.ONF.E104-E120 -
Acta Medica Croatica : Casopis... Mar 2015Low back pain is the second most common symptom-related reason for physician visits and the first reason of working disability. Low back pain is a ubiquitous complaint,... (Review)
Review
Low back pain is the second most common symptom-related reason for physician visits and the first reason of working disability. Low back pain is a ubiquitous complaint, with particularly high prevalence among people in their working years (67%). For many individuals, episodes of back pain are self-limited and resolve without specific therapy. For others, however, back pain is recurrent or chronic, causing significant pain that interferes with employment and quality of life. Many occupations have been anecdotally linked to certain low back pain syndrome. However, the relationship between the work environment and the patient's symptoms, though clearly perceived by the patient to be causative, may be less certain. The injury model of an occupational disorder proposes that specific work activities are the cause of the patient's pain. The injury model for low back pain; implicating a causal connection with specific work activities, is complex and controversial. Determining whether a patient's low back pain is a consequence of his or her occupational activity, and how best to treat symptoms to maximize functionality and potential for a return to full employment capacity, can be challenging. In this systematic review which included patients/employees with low back pain, the following databases were searched: Pub Med, Embase, Medline and Web of science. The role of occupational mechanical exposure e.g. lifting as a risk factors for low back surgery has been debated for several decades. Diagnostic uncertainty exists even for those with back symptoms and well-described findings on scan, as these findings are common even in subjects without back pain, and may be unrelated to the symptoms. As an example, herniated disks can be identified in significant numbers of CT or MRI low back studies in subjects with no back pain. In further analysis, lifestyle factors and occupational psychosocial exposures will be addressed. Many physicians, including those practicing in primary care settings where back pain is most often seen, lack training and confidence in addressing workplace issues. Occupational factors that have a significant influence on the development of low back pain disorders are not only mechanical and postural order but also organisational, social and psychological. Organisational changes and physical and psychological job demands should not be overestimated as causal factors. In the early phase of a work disability more emphasis should be laid however on appropriate information and medication and, in case of persistant impairment, active treatment (after 3 weeks or relapse). There is some evidence that catastrophizing as a stress coping strategy might lead to delayed recovery. Long-term work (sick) absence can be estimated through evaluation and observation of LBP risks and characteristics of the each individual case. An early return at workplace and to activities of daily life is urgent. To reduce LBS and its consequences, employers need to adopt a multifaced approach: concentrate on improving physical conditions as well as the psychosocial and environmental aspects of working environment. In cases at risk for chronification and/or with obstacles to reintegration at work an interdisciplinary work-oriented rehabilitation and occupational rehabilitation interventions (occupational reintegration) should be provided.
Topics: Disability Evaluation; Female; Humans; Low Back Pain; Male; Occupational Diseases; Occupational Health; Occupations; Prevalence; Primary Prevention; Workplace
PubMed: 26606785
DOI: No ID Found -
Sportverletzung Sportschaden : Organ... Jun 2015The patellofemoral pain syndrome (PFPS) is one of the most commonly encountered disorders involving the knee. The symptoms often lead to a reduction of physical... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The patellofemoral pain syndrome (PFPS) is one of the most commonly encountered disorders involving the knee. The symptoms often lead to a reduction of physical activities resulting in sport- and job-related disabilities and the potential occurrence of severe disorders. Different theories for the development of the syndrome exist which result in different therapy modalities. A change in foot posture and its effect on lower limb kinematics seem to be one potential risk factor for the development of the syndrome. This leads to the assumption that foot orthoses might be a potential therapy device.
OBJECTIVES
The aims of this study were to outline the state of evidence for the treatment of PFPS with foot orthoses and to identify the effect of foot orthoses on PFPS.
STUDY DESIGN
A systematic review of clinical (CT) and randomized controlled trials (RCT) was undertaken.
METHODS
A systematic search for studies (CT, RCT) was conducted using the databases of Medline (PubMed), Cochrane library, and PEDro. The relevance for further analysis of studies was reviewed on the basis of title and abstract. An additional search was undertaken using the reference lists of the included studies and additional literature as well as the PubMed function "related articles".
RESULTS
11 studies were included in this analysis. The effect of different types of foot orthoses on pain, function and kinematics of the lower limb and muscle activation of selected lower limb muscles was analysed. Significant effects on pain and function were determined. A slight effect on kinematics of the lower limb and muscle activation of selected lower limb muscles was identified.
CONCLUSION
Foot orthoses seem to be an effective treatment device in the therapy for PFPS. An immediate and long-term reduction in pain and an improvement of function occurred following the intervention. There was just a slight change in lower limb kinematics and muscle activation of selected lower limb muscles. The relationship between biomechanical effects of orthoses and pain still seems to be unclear.
Topics: Arthralgia; Foot Orthoses; Humans; Patellofemoral Pain Syndrome; Prevalence; Risk Factors; Treatment Outcome
PubMed: 25675398
DOI: 10.1055/s-0034-1399002 -
Sleep & Breathing = Schlaf & Atmung Mar 2015The aim of this systematic literature review was to assess the impact of obstructive sleep apnea syndrome (OSAS) on patients' occupational health. (Review)
Review
PURPOSE
The aim of this systematic literature review was to assess the impact of obstructive sleep apnea syndrome (OSAS) on patients' occupational health.
METHODS
We selected 19 studies that dealt with issues related to job performance and productivity, absenteeism, and psychosocial health of patients with OSAS and assessed the risk of bias in their conclusions.
RESULTS
Although methodologically rigorous studies are needed to confirm these findings, the results obtained suggest the existence of multiple relationships between OSAS and work limitations of patients (i.e., difficulties maintaining attention, learning new tasks, or performing monotonous tasks). The studies reviewed reached more scientifically consistent conclusions about such patients' risk of taking more days of sick leave or having work disability, particularly if they reported excessive daytime sleepiness. Very few studies have explored the relationship between OSAS and psychosocial occupational health of patients. Thus, there is a need for research to clarify these aspects of occupational medicine.
CONCLUSIONS
OSAS has numerous effects on patients' occupational health, yet, in general, results should be confirmed by studies with sufficiently large samples in which OSAS is diagnosed with reliable methods and occupational variables are assessed with standardized and validated questionnaires.
Topics: Absenteeism; Efficiency; Humans; Job Description; Occupational Diseases; Risk Factors; Sleep Apnea, Obstructive; Work Performance
PubMed: 24952614
DOI: 10.1007/s11325-014-1015-8