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Critical care
Original research
Association of imbalance between job workload and functional ability with return to work in ARDS survivors
  1. Han Su1,
  2. Ramona Hopkins2,3,
  3. Biren Bharat Kamdar4,
  4. Susanne May5,
  5. Victor D Dinglas6,
  6. Kurt L Johnson7,
  7. Megan Hosey8,
  8. Catherine L Hough9,
  9. Dale M Needham10,11,
  10. Hilaire J Thompson5
  1. 1School of Nursing, University of Washington Seattle Campus, Seattle, Washington, USA
  2. 2Psychology Department and Neuroscience Center, Brigham Young University, Provo, Utah, USA
  3. 3Center for Humanizing Critical Care, Intermountain Medical Center, Murray, Utah, USA
  4. 4Pulmonary Critical Care and Sleep Medicine, University of California San Diego, La Jolla, California, USA
  5. 5Department of Biostatistics, University of Washington Seattle Campus, Seattle, Washington, USA
  6. 6Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
  7. 7Department of Rehabilitation Medicine, University of Washington Seattle Campus, Seattle, Washington, USA
  8. 8Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
  9. 9Division of Pulmonary and Critical Care Medicine, OHSU SOM, Portland, Oregon, USA
  10. 10Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, Maryland, USA
  11. 11Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, USA
  1. Correspondence to Han Su, School of Nursing, University of Washington Seattle Campus, Seattle, WA 98105, USA; rnhansu{at}gmail.com

Abstract

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.

  • ARDS
  • critical care

Data availability statement

Data are available upon reasonable request.

https://doi.org/10.1136/thoraxjnl-2020-216586

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    Data availability statement

    Data are available upon reasonable request.

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    Footnotes

    • Twitter @sleepicu, @terri_hough, @DrDaleNeedham, @hilairet

    • 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.

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