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Frontiers in Psychology 2023Little is known about the effects of routine mental health care on return-to-work (RTW) outcomes. This systematic review aimed to summarize and evaluate the effects of...
OBJECTIVE
Little is known about the effects of routine mental health care on return-to-work (RTW) outcomes. This systematic review aimed to summarize and evaluate the effects of clinical representative psychotherapy on RTW among patients with a common mental disorder (CMD), treated within public mental health care.
METHOD
A systematic search was conducted using PubMed, PsycINFO, Embase, and SveMED+. Primary outcomes were RTW, sick leave status, or self-reported work functioning. Studies limited to specific treatments and/or specific patient groups were excluded.
RESULTS
Out of 1,422 records, only one article met the preregistered inclusion criteria. After broadening of criteria, a total of nine studies were included. Six were randomized controlled trials (RCT), two were register-based studies, and one was a quasi-experimental study. Descriptions of treatment duration and intensity of usual care were rarely specified but ranged from a few sessions to 3 years of psychotherapy. In the RCTs, two studies favored the intervention, one favored routine care, and three found no difference between conditions. Choice of outcomes differed greatly and included RTW rates (full or partial), number of days until RTW, change in sick leave status, and net days/months of work absence. Time points for outcome assessment also varied greatly from 3 months to 5 years after treatment.
CONCLUSION
There is inconclusive evidence to establish to what extent routine mental healthcare is associated with improved RTW outcomes for patients with CMD. There is a need for more and better clinical trials and naturalistic studies detailing the content of routine treatment and its effect on RTW.
SYSTEMATIC REVIEW REGISTRATION
This study was pre-registered at PROSPERO (CRD42022304967), https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022304967.
PubMed: 38039327
DOI: 10.3389/fpsyg.2023.1167058 -
RMD Open Nov 2023Axial spondyloarthritis (axSpA) can limit work participation. Our objective was to characterise productivity in patients with axSpA, including changes after 12-16 weeks... (Meta-Analysis)
Meta-Analysis
Work productivity in patients with axial spondyloarthritis initiating biological or targeted synthetic disease-modifying antirheumatic drugs: a systematic literature review and meta-analysis.
BACKGROUND
Axial spondyloarthritis (axSpA) can limit work participation. Our objective was to characterise productivity in patients with axSpA, including changes after 12-16 weeks of treatment with biological and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs).
METHODS
A systematic literature review identified studies published from 1 January 2010 to 21 October 2021 reporting work productivity using the Work Productivity and Activity Impairment (WPAI) questionnaire in patients with axSpA initiating b/tsDMARDs. Baseline and Week 12-16 overall work productivity, absenteeism, presenteeism and activity impairment scores were used in a random-effects meta-analysis to calculate absolute mean change from baseline for each WPAI-domain.
RESULTS
Eleven studies in patients with axSpA who received either placebo (n=727) or treatment with adalimumab, bimekizumab, etanercept, ixekizumab, secukinumab or tofacitinib (n=994) were included. In working patients initiating a b/tsDMARD, mean baseline overall work productivity impairment, absenteeism and presenteeism scores were 52.1% (N=7 studies), 11.0% and 48.8% (N=6 studies), respectively. At Week 12-16, the pooled mean change from baseline in overall work impairment for b/tsDMARDs or placebo was -21.6% and -12.3%. When results were extrapolated to 1 year, the potential annual reductions in cost of paid and unpaid productivity loss per patient ranged from €11 962.88 to €14 293.54.
CONCLUSIONS
Over 50% of employed patients with active axSpA experienced work impairment, primarily due to presenteeism. Overall work productivity improved at Weeks 12-16 to a greater extent for patients who received b/tsDMARDs than placebo. Work productivity loss was associated with a substantial cost burden, which was reduced with improvements in impairment.
Topics: Humans; Antirheumatic Agents; Spondylitis, Ankylosing; Efficiency; Etanercept; Axial Spondyloarthritis
PubMed: 38035757
DOI: 10.1136/rmdopen-2023-003468 -
Frontiers in Psychology 2023This research article focuses on the significance of Workplace Civility, defined as the respectful and courteous behavior exhibited by individuals toward their... (Review)
Review
This research article focuses on the significance of Workplace Civility, defined as the respectful and courteous behavior exhibited by individuals toward their colleagues in the workplace. The primary objective of this study is to conduct a systematic review and a meta-analysis that synthesizes existing research by: (1) identifying operational definitions of the construct, (2) underlying the strongest correlations with other variables, (3) summarizing the effective strategies for promoting Workplace Civility, and (4) highlighting gaps in the literature, using the theory-characteristics-context-methodology (TCCM) framework. Multiple databases were meticulously searched, yielding 691 results, and ultimately 51 documents were included in the systematic review final sample following the application of predefined exclusion criteria. Then, a meta-analysis has been conducted including those studies with sufficient statistical data ( = 24) which allowed us to calculate 45 Effect Sizes. The review findings expose a notable dearth of research on Workplace Civility when compared to studies on incivility. This dearth highlights the pressing need for additional research endeavors to precisely define Workplace Civility, establish a robust theoretical framework, and develop reliable scales for its measurement. Related to the desirable correlates, organizational commitment, job satisfaction and mental health showed a high ES value, and for undesirable correlates, intention to quit showed a high ES value, while Emotional exhaustion only reached a medium ES value and physical symptoms showed a low ES value. Importantly, this study emphasizes that fostering civility in the workplace can yield significant benefits such as improved physical and mental well-being for workers, reduced burnout, and absenteeism rates. Thus, the promotion of civility in the workplace not only leads to healthier organizations but also enhances cost-efficiency, effectively averting the loss of both human and economic capital.
PubMed: 38023015
DOI: 10.3389/fpsyg.2023.1277188 -
Healthcare (Basel, Switzerland) Nov 2023This systematic review aimed to assess COVID-19-associated absenteeism among healthcare personnel (HCP). PubMed was searched on 4 February 2023. Inclusion criteria were... (Review)
Review
This systematic review aimed to assess COVID-19-associated absenteeism among healthcare personnel (HCP). PubMed was searched on 4 February 2023. Inclusion criteria were the presentation of original data on COVID-19-associated absenteeism among HCP. Exclusion criteria were absenteeism associated with burnout, mental health illness, post-COVID syndrome, or child-care. Nineteen articles were identified; fifteen concerned almost exclusively the first pandemic year. Hospitals accounted for most data. There was heterogeneity across studies in terms of presentation of absenteeism data. Before COVID-19 vaccines became available, COVID-19 was a major driver of HCP absenteeism with excess costs, while the mean duration of absenteeism ranged from 5.82 to 33 days per episode of absence. Determinant factors of absenteeism rates were department of employment, high-risk exposure, age, profession, and work experience of HCP, suspected COVID-19, SARS-CoV-2 testing, SARS-CoV-2 positivity, and return-to-work strategy. Two studies demonstrated that COVID-19 vaccination significantly reduced the burden of absenteeism. Routine testing of asymptomatic HCP and use of personal protective equipment also significantly ameliorated absenteeism. In conclusion, COVID-19 has been a major driver of HCP absenteeism. Research is needed to assess how COVID-19 will impact HCP in the next years, considering the new SARS-CoV-2 variants, the co-circulation of other respiratory viruses, and the newer COVID-19 vaccines. Networks are needed to survey morbidity and absenteeism among HCP in real-time and guide vaccination policies.
PubMed: 37998442
DOI: 10.3390/healthcare11222950 -
Journal of Managed Care & Specialty... Dec 2023Multiple sclerosis (MS) is chronic progressive disease that poses a significant economic burden to patients and health care systems in the United States. We conducted a... (Review)
Review
BACKGROUND
Multiple sclerosis (MS) is chronic progressive disease that poses a significant economic burden to patients and health care systems in the United States. We conducted a systematic literature review to provide up-to-date insights on the economic burden of MS in the United States.
OBJECTIVE
To comprehensively review and summarize the latest published evidence on the economic burden of MS with a focus on cost, resource use, and work productivity.
METHODS
A systematic literature search was conducted using the Embase and Medline databases to identify studies, published between January 2011 and July 2022, reporting cost, resource use, or work productivity outcomes among people with MS in the United States. Clinical trials, economic modeling studies, and review articles were excluded. Details of eligible studies, including study design, patient population, and study outcomes for the overall population, as well as subgroups of interest, were extracted and summarized qualitatively.
RESULTS
Overall, 65 studies reporting cost, resource use, or work productivity data were included with majority of studies using claims data. The direct costs associated with MS ranged from $16,614 (2006) to $72,744 (2017) per patient per year with diseasemodifying therapies (DMTs) being the major cost contributors accounting for 43%-78%. The indirect costs reported ranged from $9,122 (2017) to $30,601 (2011) per patient per year with absenteeism, early retirement, and informal care being the key drivers for indirect costs. Costs, resource use, and work impairment were significantly higher for patients with severe disability compared with those with mild disability. Pharmacy costs were the major cost drivers in patients with mild, moderate, and severe disability. Similarly, patients with relapses incurred significantly higher costs, resource use, and work impairment compared with those without relapses. Additional hospitalization charges were the major driver of higher costs in patients who experienced relapses compared with those without relapses.
CONCLUSIONS
Direct costs, particularly DMTs, appear to be the major cost drivers for people with MS in the United States. Availability of lower-cost therapies may considerably decrease the economic burden on these patients and the health care systems. Future research focusing on indirect costs, intangible costs, and their contributors would contribute to further understanding of economic burden to avoid underestimation of the financial burden experienced by the patients.
Topics: Humans; United States; Multiple Sclerosis; Financial Stress; Cost of Illness; Chronic Disease; Recurrence; Health Care Costs
PubMed: 37976077
DOI: 10.18553/jmcp.2023.23039 -
JBI Evidence Synthesis Apr 2024The objective of this review was to determine the effect of educational programs that have been implemented in acute health care settings to manage or prevent aggressive...
OBJECTIVE
The objective of this review was to determine the effect of educational programs that have been implemented in acute health care settings to manage or prevent aggressive behaviors toward staff perpetrated by patients, families, or visitors.
INTRODUCTION
Health care staff working within acute-level and tertiary-level hospitals are at high risk of exposure to aggressive behaviors by patients, their family, or visitors. Negative staff and organizational impacts reported in the literature include individual psychological or emotional distress and severe harm, increased absenteeism, high staff turnover, and awarded compensation. Reports of this kind of occupational violence are increasing globally; therefore, strategies to address prevention and management are needed to mitigate the risk of harm to staff and the wider hospital service. Various educational activities have been implemented to address the issue, but the overall effect of these is unclear.
INCLUSION CRITERIA
Experimental and quasi-experimental studies were considered for inclusion if they reported on an educational program or intervention for staff working within an acute hospital setting and aimed at managing or preventing occupational violence perpetrated by patients, family, or visitors. Reports of programs implemented to address occupational violence, whether verbal or physical, were included. Studies were excluded if they reported on upward violence or bullying, patients in psychiatric or dementia facilities, or pediatric patients, due to the specific care needs of these cohorts.
METHODS
The following databases were searched: PubMed (PubMed Central), CINAHL (EBSCOhost), PsycINFO (EBSCOhost), Embase, ERIC (ProQuest), Cochrane Central Register of Controlled Trials (Cochrane Library), and Scopus. ProQuest Dissertations and Theses was searched for unpublished studies. To obtain a wider perspective of the issue, studies published in Chinese were also searched in WanFang Database, China National Knowledge Infrastructure, and Chongqing VIP. A date filter of 2008-2023 was applied in a deliberate effort to expand from previous work. No language filters were applied. The review was conducted in accordance with JBI methodology for systematic reviews of effectiveness, and reported as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
RESULTS
The search process retrieved 4681 citations. A total of 32 studies representing 3246 health staff were included in the review. The studies were either before-and-after or pre-test/post-test study designs. Methodological quality of studies varied, with the main issues being absence of CIs within statistical analysis, limited detail on participant selection or attrition/non-response, and underreporting of confounding factors. Educational programs varied in content and duration. Content delivery across the studies also varied, with several didactic, role-play, debriefing, group work, and simulation exercises reported. While studies reported some improvement in self-reported confidence levels, results were mixed for other outcomes. Determining overall effect of included studies was challenging due to heterogeneity within and across studies with regard to intervention types, populations, measurement tools, and outcomes.
CONCLUSIONS
This review is unable to determine which workplace educational programs had an effect on staff outcomes or on the number of occupational violence incidents. In the future, educators and researchers could use the findings of this review to guide the design of educational programs and employ measures that are comparable to their settings.
REVIEW REGISTRATION
PROSPERO CRD42020190538.
SUPPLEMENTAL DIGITAL CONTENT
A Chinese-language version of the abstract of this review is available [ http://links.lww.com/SRX/A33 ].
Topics: Humans; Child; Delivery of Health Care; Health Facilities; Exercise; Hospitals; China
PubMed: 37851359
DOI: 10.11124/JBIES-22-00409 -
Frontiers in Psychology 2023Although successful educational practices (SEPs) in higher education institutions have well-established student outcomes, the vast majority do not meet physical...
Although successful educational practices (SEPs) in higher education institutions have well-established student outcomes, the vast majority do not meet physical education standards in schools. Despite the promising nature of policy initiatives supporting schools, there is scant evidence of how these SEPs affect student outcomes. This review aimed to determine the status of the literature and the type of evidence regarding school SEPs. Several studies have demonstrated that these SEPs contribute directly or indirectly to improving student outcomes. Three objectives were examined and synthesized in our review of SEP research findings. The first goal is to identify different types of impacts on students in schools. The second goal is to provide educators, principals, and policymakers with a unified and comprehensive framework. Lastly, we provide suggestions for future SEP research. The review identified 45 studies that met our inclusion criteria. Our reviewed studies documented impacts on the individual level. It encompasses both students' instrumental abilities and their sense of self-esteem and motivation. Secondly, improving interpersonal relationships, reducing conflict, and increasing group cohesion are important components at the group level. Finally, there are factors at the community level, including absenteeism reduction, parental involvement, and changes in attitudes toward school. Current research supports the effectiveness of successful school practices. It stresses the importance of implementing policies to maximize student outcomes. Finally, the review concludes by discussing findings implications and future research directions.
PubMed: 37849483
DOI: 10.3389/fpsyg.2023.1280871 -
Atencion Primaria Jan 2024To analyze educational interventions in pediatric asthmatic patients to achieve an adequate inhalation technique and improve their self-management.
OBJECTIVE
To analyze educational interventions in pediatric asthmatic patients to achieve an adequate inhalation technique and improve their self-management.
DESIGN
Systematic review based on the PRISMA recommendations.
DATA SOURCES
Pubmed, Scopus, Cuiden, Web of Science and Google Scholar databases were reviewed.
STUDY SELECTION
Sixteen articles published between 2014 and 2021 were included, with access to full text, languages: English, French and Spanish and pediatric population: 0-18 years.
DATA EXTRACTION
Two thousand three hundred and thirteen children were participated. The variables analyzed were: level of care, type of intervention, correct performance of the inhalation technique, follow-up of the technique, delivery of written recommendations, professional-educator category, variables related to respiratory pathology, school absenteeism, quality of life and economic costs.
RESULTS
The health care level was primary, hospital and community care, where specialist doctors, nurses and pharmacists stood out as educators. The most prevalent educational interventions are on-site demonstration and delivery of recommendations or multimedia interventions. Several articles report that asthma education is not carried out correctly, others state that their technique improves after the intervention, but most of them highlight the importance of periodic review of the technique.
CONCLUSIONS
The authors report improvement in the inhalation technique in all of them, as well as greater self-management of the disease and adherence to treatment. It is necessary to intensify the education of patients in the correct handling of the devices, and the follow-up and subsequent review to optimize the control of the disease.
Topics: Child; Humans; Quality of Life; Asthma
PubMed: 37741186
DOI: 10.1016/j.aprim.2023.102721 -
Disability and Rehabilitation Sep 2023Lower limb osteoarthritis (OA) is a prevalent condition that has a profound impact on an individual's life in several domains, including occupational activities. The...
PURPOSE
Lower limb osteoarthritis (OA) is a prevalent condition that has a profound impact on an individual's life in several domains, including occupational activities. The objective of this study was to systematically describe and compare work-related outcomes (e.g., employment status, absenteeism, and productivity loss) in individuals with and without lower limb OA.
MATERIALS AND METHODS
Five databases were searched until 17 June 2023. Studies were eligible for inclusion if they compared work-related outcomes between individuals with lower limb OA and healthy controls (e.g., people without OA or the general population).
RESULTS
Seven studies met the inclusion criteria of which two were included in a meta-analysis. Meta-analysis revealed that individuals with OA were less frequently in paid employment than control individuals (odds ratio: 0.25; 95% confidence intervals: 0.12, 0.53). Evidence from single studies indicated greater absenteeism and presenteeism and poorer functional capacity in people with lower limb OA compared to controls.
CONCLUSIONS
This systematic review suggests that individuals with lower limb OA have poorer work-related outcomes than those without OA. Low study numbers and lack of consistency in the way work outcomes are defined and measured make accurate quantification of the impact of OA on work challenging. registration number: CRD42020178820.
PubMed: 37740531
DOI: 10.1080/09638288.2023.2259304 -
Journal of Religion and Health Jun 2024Burnout syndrome implies exhaustion, loss of motivation, low performance, and absenteeism. Catholic clergy are not exempt. This systematic review compiles and analyzes...
Burnout syndrome implies exhaustion, loss of motivation, low performance, and absenteeism. Catholic clergy are not exempt. This systematic review compiles and analyzes evidence related to burnout in Catholic clergy and potential modulating variables. Following the PRISMA methodology, systematic searches in different scientific databases identified 17 studies, revealing that burnout is related to age, personality traits, and type of priesthood. No relation between burnout and social support, self-care, spiritual practice, or workload was detected. It is necessary to adapt conceptual models to the peculiarities of burnout among clergy, extending assessment strategies and introducing working and organizational perspectives in the analysis of modulating variables, and in the development of prevention and intervention programs.
Topics: Humans; Clergy; Catholicism; Burnout, Professional
PubMed: 37682353
DOI: 10.1007/s10943-023-01883-8