Background Inability to return to work (RTW) is common after acute respiratory distress syndrome (ARDS). Mismatch in an individual’s job workload and his or her functional ability, termed work ability imbalance, is negatively associated with RTW, but has not been evaluated in ARDS survivors.
Object We examine associations between work ability imbalance at 6 months and RTW at 6 months and 12 months, as well as the ability to sustain employment in ARDS survivors.
Methods Previously employed participants from the ARDS Network Long-Term Outcomes Study (N=341) were evaluated. Pre-ARDS workload was determined based on the US Occupational Information Network classification. Post-ARDS functional ability was assessed using self-reported 36-Item Short Form Health Survey (SF-36) physical functioning, social functioning and mental health subscales, and Mini-Mental State Examination. ARDS survivors were categorised into four work ability imbalance categories: none, psychosocial, physical, and both psychosocial and physical.
Results Almost 90% of ARDS survivors had a physical and/or psychosocial work ability imbalance at both 6-month and 12-month follow-up. Compared with survivors with no imbalance at 6 months, those with both physical and psychosocial imbalance had lower odds of RTW (6 months: OR=0.33, 95% CI=0.13 to 0.82; 12 months: OR=0.22, 95% CI=0.07 to 0.65). Thirty-eight (19%) of those who ever RTW were subsequently jobless at 12 months.
Conclusion Interventions aimed at rebalancing ARDS survivors’ work ability by addressing physical and psychosocial aspects of their functional ability and workload should be explored as part of efforts to improve RTW, maintain employment and reduce the financial impact of joblessness.
- critical care
Data availability statement
Data are available upon reasonable request.
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Correction notice This article has been corrected since it was published Online First. Author affiliations and some author names have been amended.
Contributors HS conceived the work. HS performed the statistical analyses and data interpretation and wrote the initial draft of the manuscript. HJT and SM supervised the analysis. RH, BBK, SM, VDD, CLH, KLJ, MH, DMN and HJT contributed substantially to the study design, data interpretation and critically revised the manuscript for important intellectual content. All authors gave final approval of the submitted version of the manuscript and agreed to be accountable for the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Funding HS is supported by The Hester McLaws Dissertation Research Award from University of Washington. This research was supported by grants N01HR56170, R01HL091760 and 3R01HL091760-02S1 along with funding for the ALTA, EDEN, OMEGA and SAILS trials (NHLBI contracts HHSN268200536165C to HHSN268200536176C and HHSN268200536179C).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.