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上肢功能和就业状况对中风后蓝领工人重返工作岗位的影响。

Impact of Upper Limb Function and Employment Status on Return to Work of Blue-Collar Workers after Stroke.

作者信息

Fukuda Shinya, Ueba Yusuke, Fukuda Hitoshi, Kangawa Takumi, Nakashima Yumi, Hashimoto Yasuko, Ueba Tetsuya

机构信息

Department of Rehabilitation, Wafukai-Hashimoto Hospital, Mitoyo, Kagawa, Japan; Department of Neurosurgery, Kochi University Graduate School of Medicine, Nankoku, Kochi, Japan.

Department of Neurosurgery, Kochi University Graduate School of Medicine, Nankoku, Kochi, Japan.

出版信息

J Stroke Cerebrovasc Dis. 2019 Aug;28(8):2187-2192. doi: 10.1016/j.jstrokecerebrovasdis.2019.04.036. Epub 2019 May 22.

Abstract

BACKGROUND AND PURPOSE

Return to work (RTW) after stroke is the ultimate goal of the working population to achieve economic independence and well-being. Previous studies have reported lower RTW rates of blue-collar workers versus white-collar workers. Thus, investigating predictive factors for RTW of blue-collar workers is meaningful to improve RTW after stroke. Here, we investigate the physical, cognitive, and social factors associated with the RTW of blue-collar workers after stroke.

METHODS

Poststroke rehabilitation data for 71 patients aged 15-64 years who had been active blue-collar workers at stroke onset were analyzed from a single-center observational cohort database. Baseline characteristics, social background factors, and quantitative assessments of the upper limb, lower limb, and cognitive functions at discharge were analyzed to identify any association with RTW. Receiver operating characteristic curve analysis was performed to determine the optimal cutoff value of continuous valuables with significant associations.

RESULTS

Functional upper limb represented by an increasing Simple Test for Evaluating hand Function (STEF) score was independently associated with RTW of blue-collar workers by multivariable logistic regression analysis (odds ratio [OR], 1.08; 95% confidence interval [CI], 1.01-1.14; p = .017). Correlation with self-employment status was also significant compared to that with employee status (OR, 185; 95% CI, 1.05-32400; p = .048). The cutoff value of the 100-point scale STEF to discriminate between RTW and non-RTW was 82.

CONCLUSIONS

Functional upper limb and self-employment status were independent predictors for the RTW of blue-collar workers after stroke.

摘要

背景与目的

中风后重返工作岗位(RTW)是劳动人群实现经济独立和幸福生活的最终目标。既往研究报道,与白领工人相比,蓝领工人的RTW率较低。因此,研究蓝领工人RTW的预测因素对于改善中风后的RTW具有重要意义。在此,我们调查了与中风后蓝领工人RTW相关的身体、认知和社会因素。

方法

从一个单中心观察性队列数据库中分析了71例年龄在15 - 64岁之间、中风发作时为在职蓝领工人的中风后康复数据。分析基线特征、社会背景因素以及出院时上肢、下肢和认知功能的定量评估,以确定与RTW的任何关联。进行受试者工作特征曲线分析,以确定具有显著关联的连续变量的最佳截断值。

结果

通过多变量逻辑回归分析,以评估手功能的简单测试(STEF)评分增加为代表的功能性上肢与蓝领工人的RTW独立相关(优势比[OR],1.08;95%置信区间[CI],1.01 - 1.14;p = 0.017)。与受雇状态相比,自营职业状态的相关性也很显著(OR,185;95% CI,1.05 - 32400;p = 0.048)。用于区分RTW和非RTW的100分制STEF的截断值为82。

结论

功能性上肢和自营职业状态是中风后蓝领工人RTW的独立预测因素。

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