Association of Job Characteristics and Functional Impairments on Return to Work after Acute Respiratory Distress Syndrome.

Joblessness is common after ARDS, but related risk factors are not fully understood.What is the association between survivors' pre-ARDS workload and post-ARDS functional impairment, pain, and fatigue with their return to work (RTW) status?The U.S. Occupational Information Network (O*NET) was used to determine pre-ARDS workload for participants in the ARDS Network Long-Term Outcomes Study (ALTOS). Post-ARDS functional impairment was assessed using the Mini-Mental State Examination and SF-36 Physical Functioning, Social Functioning, and Mental Health sub-scales, and categorized as either: no impairments, only psychosocial impairment, physical with low psychosocial impairment, or physical with high psychosocial impairment. Post-ARDS pain and fatigue were assessed using the SF-36 pain item and FACIT-fatigue scale, respectively. Generalized linear mixed modeling methods were used to evaluate associations among pre-ARDS workload, post-ARDS functional impairment, and symptoms of pain and fatigue with post-ARDS RTW.Pre-ARDS workload was not associated with post-ARDS RTW. However, as compared to survivors with no functional impairment, those with only psychosocial impairment (OR [CI]: 0.18 [0.06, 0.50]), as well as physical impairment plus either low psychosocial impairment (0.08 [0.03, 0.22]) or high psychosocial impairment (0.01 [0.003, 0.05]) had lower odds of working. Pain (0.06 [0.03, 0.14]) and fatigue (0.07 [0.03, 0.16]) were also negatively associated with RTW.For previously employed survivors of ARDS, post-ARDS psychosocial and physical impairments, pain, and fatigue were negatively associated with RTW, while pre-ARDS workload was not associated. These findings are important for designing and implementing vocational interventions for ARDS survivors.

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Authors: Han Su, Hilaire J Thompson, Susanne May, Victor D Dinglas, Catherine L Hough, Megan M Hosey, Ramona O Hopkins, Biren B Kamdar, Dale M Needham