Nour Nazanin, Heck Carol S, Ross Heather
Toronto General Hospital, University Health Network, 4EB-316-200 Elizabeth Street, Toronto, ON, M2G 2C4, Canada,
J Occup Rehabil. 2015 Mar;25(1):38-51. doi: 10.1007/s10926-014-9519-4.
Following kidney transplantation, recipients often have difficulty returning to meaningful occupations, including paid employment. The purpose of the current study was to describe the sociodemographic profile of kidney transplant recipients at a major Canadian Transplant Centre and to identify factors perceived to affect participation in paid work post-transplant.
Of the 530 kidney recipients who had received a kidney transplant at our facility between 2003 and 2008, 144 recipients were randomly selected, and mailed a questionnaire.
There were 60 returned questionnaires (41.7 % response rate). The average age of responders was 49.4 years and the majority were male (68.3 %). While the rate of employment decreased significantly (p = 0.00) from 68.3 % pre- to 38.3 % post-transplant, retirement rates increased significantly (p = 0.00) from 8.3 % pre- to 18.3 % post-transplant. The responders, who were not working post-transplant, more likely lived alone (p = 0.05), had a lower level of education (p = 0.02), and had lower perceived emotional (p = 0.00) and physical (p = 0.00) health status compared to those who returned to work post-transplant. Gender, donor type, age, and post-transplant complications did not differ (p > 0.05) between the working and not working groups. Both person- and work-related factors impacted on return to paid work post-transplant. Most responders (working and not working) reported feeling emotionally and physically ready to work after their transplant. Work-related enablers included positive employer attitude towards medical history and employer agreement that recipients could take time off for medical appointments. Of those returning to work, the nature of their jobs changed from heavy physical demands to sedentary work. There was a 20.0 % increase in reliance on government disability insurance post-transplant. Responders recommended the development of a rehabilitation program focused on working and consulting with transplant recipients' employers to further enable successful reintegration into the workplace after transplantation.
The ability to return to paid work after kidney transplant is a complex phenomenon, likely impacted by a combination of person- and work-related factors, which contributed to how individuals perceived their abilities to attain or return to paid work. It is important that in facilitating renal transplant recipients to resume valued life occupations such as paid work, the dynamic interactions between personals values, perception of one's abilities, skills, job requirements and employer characteristics be considered.
肾移植后，受者往往难以回归有意义的职业，包括带薪工作。本研究的目的是描述加拿大一家主要移植中心肾移植受者的社会人口学特征，并确定被认为会影响移植后参与带薪工作的因素。
在2003年至2008年间于我们机构接受肾移植的530名肾移植受者中，随机选取144名受者，并向其邮寄问卷。
共收到60份回复问卷（回复率为41.7%）。回复者的平均年龄为49.4岁，大多数为男性（68.3%）。移植前的就业率为68.3%，移植后的就业率显著下降（p = 0.00）至38.3%，而退休率从移植前的8.3%显著上升（p = 0.00）至18.3%。与移植后重返工作岗位的受者相比，移植后未工作的回复者更有可能独居（p = 0.05）、受教育程度较低（p = 0.02），且自我感觉情绪（p = 0.00）和身体（p = 0.00）健康状况较差。工作组和未工作组在性别、供体类型、年龄和移植后并发症方面没有差异（p > 0.05）。个人因素和与工作相关的因素都对移植后重返带薪工作产生影响。大多数回复者（包括工作和未工作的）表示移植后在情绪和身体上已准备好工作。与工作相关的促进因素包括雇主对病史持积极态度，以及雇主同意受者可因医疗预约请假。在重返工作岗位的受者中，他们的工作性质从体力要求高的工作转变为久坐的工作。移植后对政府残疾保险的依赖增加了20.0%。回复者建议制定一项康复计划，重点是与移植受者的雇主合作并为其提供咨询，以进一步促进移植后成功重新融入工作场所。
肾移植后重返带薪工作的能力是一个复杂的现象，可能受到个人因素和与工作相关因素的综合影响，这些因素影响了个体对自己获得或重返带薪工作能力的认知。在帮助肾移植受者恢复如带薪工作等有价值的生活职业时，考虑个人价值观、对自身能力的认知、技能、工作要求和雇主特征之间的动态相互作用非常重要。
