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奥地利肾移植后就业状况及其与工作能力、生活质量和心理健康的关系。

Employment Status and Associations with Workability, Quality of Life and Mental Health after Kidney Transplantation in Austria.

机构信息

Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.

Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria.

出版信息

Int J Environ Res Public Health. 2020 Feb 15;17(4):1254. doi: 10.3390/ijerph17041254.

Abstract

Kidney transplantation (KTx) in end-stage renal disease is associated with a significant increase in quality of life (QoL) and self-perceived health, optimally leading to the maintenance of employment or return to work (RTW) in working-age patients. The aim of this study was to assess individual factors including the QoL and mental health of kidney transplant recipients (KTRs) associated with employment after transplantation. A cross-sectional study including working-age patients with a history of KTx after 2012 was conducted at two Austrian study centers (Vienna and Graz). Brief Symptom Inventory (BSI-18), World Health Organization Quality of Life (WHOQOL-Bref) and Workability Index (WAI) were assessed along with detailed questionnaires on employment status. Out of = 139 KTRs (43.2 ± 9.07 years; 57.6% male), 72 (51.8%) were employed. Employed patients were more frequently in a partnership ( = 0.018) and had higher education levels ( = 0.01) and QoL scores (<0.001). Unemployed KTRs reported fatigue and mental health issues more often ( < 0.001), and had significantly higher anxiety, depression and somatization scores (BSI-18). In unadjusted logistical regression, workability score (WAS; odds ratio (OR) = 3.39; 95% confidence interval (CI) = 1.97-5.82; < 0.001), partnership (OR = 5.47; 95% CI 1.43-20.91; = 0.013) and no psychological counseling after KTx (OR = 0.06; 95% CI = 0.003-0.969; = 0.048) were independently associated with employment. Self-assessed mental health, workability and QoL were significantly associated with employment status after KTx. Thus, in order to facilitate RTW after KTx in Austria, vocational rehabilitation and RTW programs addressing KTRs should focus on increasing social support and care for their mental health.

摘要

终末期肾病患者进行肾移植(KTx)后生活质量(QoL)和自我感知健康显著提高,这使工作年龄段患者能够最佳地维持就业或重返工作岗位(RTW)。本研究的目的是评估与移植后就业相关的个体因素,包括肾移植受者(KTR)的 QoL 和心理健康。在奥地利的两个研究中心(维也纳和格拉茨)进行了一项包括 2012 年后有 KTx 史的工作年龄段患者的横断面研究。评估了简明症状量表(BSI-18)、世界卫生组织生活质量(WHOQOL-Bref)和工作能力指数(WAI),并结合了关于就业状况的详细问卷。在 139 名 KTR 中(43.2 ± 9.07 岁;57.6%为男性),有 72 名(51.8%)就业。就业患者更频繁地处于伴侣关系中( = 0.018),教育程度更高( = 0.01),QoL 评分更高(<0.001)。失业 KTR 更频繁地报告疲劳和心理健康问题(<0.001),焦虑、抑郁和躯体化评分显著更高(BSI-18)。在未经调整的逻辑回归中,工作能力评分(WAS;优势比(OR)=3.39;95%置信区间(CI)=1.97-5.82;<0.001)、伴侣关系(OR=5.47;95%CI 1.43-20.91;=0.013)和 KTx 后无心理辅导(OR=0.06;95%CI=0.003-0.969;=0.048)与就业独立相关。自我评估的心理健康、工作能力和 QoL 与 KTx 后的就业状况显著相关。因此,为了在奥地利促进 KTx 后的 RTW,针对 KTR 的职业康复和 RTW 计划应侧重于增加社会支持和关注他们的心理健康。

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