Explore the vast range of titles available.

People exposed to coronavirus disease 2019 (COVID-19) and a series of imperative containment measures could be psychologically stressed, yet the burden of and factors associated with mental health symptoms remain unclear. To investigate the prevalence of and risk factors associated with mental health symptoms in the general population in China during the COVID-19 pandemic. This large-sample, cross-sectional, population-based, online survey study was conducted from February 28, 2020, to March 11, 2020. It involved all 34 province-level regions in China and included participants aged 18 years and older. Data analysis was performed from March to May 2020. The prevalence of symptoms of depression, anxiety, insomnia, and acute stress among the general population in China during the COVID-19 pandemic was evaluated using the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Insomnia Severity Index, and Acute Stress Disorder Scale. Logistic regression analyses were used to explore demographic and COVID-19-related risk factors. Of 71 227 individuals who clicked on the survey link, 56 932 submitted the questionnaires, for a participation rate of 79.9%. After excluding the invalid questionnaires, 56 679 participants (mean [SD] age, 35.97 [8.22] years; 27 149 men [47.9%]) were included in the study; 39 468 respondents (69.6%) were aged 18 to 39 years. During the COVID-19 pandemic, the rates of mental health symptoms among the survey respondents were 27.9% (95% CI, 27.5%-28.2%) for depression, 31.6% (95% CI, 31.2%-32.0%) for anxiety, 29.2% (95% CI, 28.8%-29.6%) for insomnia, and 24.4% (95% CI, 24.0%-24.7%) for acute stress. Participants with confirmed or suspected COVID-19 and their family members or friends had a high risk for symptoms of depression (adjusted odds ratios [ORs], 3.27 [95% CI, 1.84-5.80] for patients; 1.53 [95% CI, 1.26-1.85] for family or friends), anxiety (adjusted ORs, 2.48 [95% CI, 1.43-4.31] for patients; 1.53 [95% CI, 1.27-1.84] for family or friends), insomnia (adjusted ORs, 3.06 [95% CI, 1.73-5.43] for patients; 1.62 [95% CI, 1.35-1.96] for family or friends), and acute stress (adjusted ORs, 3.50 [95% CI, 2.02-6.07] for patients; 1.77 [95% CI, 1.46-2.15] for family or friends). Moreover, people with occupational exposure risks and residents in Hubei province had increased odds of symptoms of depression (adjusted ORs, 1.96 [95% CI, 1.77-2.17] for occupational exposure; 1.42 [95% CI, 1.19-1.68] for Hubei residence), anxiety (adjusted ORs, 1.93 [95% CI, 1.75-2.13] for occupational exposure; 1.54 [95% CI, 1.30-1.82] for Hubei residence), insomnia (adjusted ORs, 1.60 [95% CI, 1.45-1.77] for occupational exposure; 1.20 [95% CI, 1.01-1.42] for Hubei residence), and acute stress (adjusted ORs, 1.98 [95% CI, 1.79-2.20] for occupational exposure; 1.49 [95% CI, 1.25-1.79] for Hubei residence). Both centralized quarantine (adjusted ORs, 1.33 [95% CI, 1.10-1.61] for depression; 1.46 [95% CI, 1.22-1.75] for anxiety; 1.63 [95% CI, 1.36-1.95] for insomnia; 1.46 [95% CI, 1.21-1.77] for acute stress) and home quarantine (adjusted ORs, 1.30 [95% CI, 1.25-1.36] for depression; 1.28 [95% CI, 1.23-1.34] for anxiety; 1.24 [95% CI, 1.19-1.30] for insomnia; 1.29 [95% CI, 1.24-1.35] for acute stress) were associated with the 4 negative mental health outcomes. Being at work was associated with lower risks of depression (adjusted OR, 0.85 [95% CI, 0.79-0.91]), anxiety (adjusted OR, 0.92 [95% CI, 0.86-0.99]), and insomnia (adjusted OR, 0.87 [95% CI, 0.81-0.94]). The results of this survey indicate that mental health symptoms may have been common during the COVID-19 outbreak among the general population in China, especially among infected individuals, people with suspected infection, and people who might have contact with patients with COVID-19. Some measures, such as quarantine and delays in returning to work, were also associated with mental health among the public. These findings identify populations at risk for mental health problems during the COVID-19 pandemic and may help in implementing mental health intervention policies in other countries and regions.

Purpose We systematically reviewed the evidence on factors that predict duration of sick leave in workers after 6 weeks low back pain (LBP) related sick leave. We hypothesized that different factors affect the duration of the leave depending on the time away from work. Methods The review occurred in seven phases: (1) developing the central question, (2) conducting the literature search, (3) identifying relevant publications, (4) quality appraisal, (5) data extraction, (6) evidence synthesis, and (7) knowledge translation. We searched for studies that reported episodes of LBP and sick leave that lasted more than 6 weeks. All included studies reported at least one prognostic factor where return to work was the outcome. Results We identified twenty-two relevant publications. The impact of pain, functional status and radiating pain seems to change with duration of work disability. Workers’ recovery expectations remain important after 6 weeks. Modified duties are rarely studied in later phases of work disability. Depression/mental health did not appear to be an important factor in later phases. Workplace physical factors remain important. There is insufficient evidence that pain catastrophising and fear avoidance are predictive factors in later phases. There was moderate evidence for age in the later phases. Functional capacity and claim related factors were supported by some evidence. Discusion Physical demands in the workplace are preventing workers from getting back to work in a timely fashion across phases. The psychosocial work environment is understudied in later phases. Overall, we cannot conclude that prognostic factors change over time.

PurposeTo assess the association between professional reintegration and mental health, quality of life (QoL) and community reintegration of stroke survivors.MethodsUsing a cross-sectional study design, a structured questionnaire was administered to previously working stroke survivors, 18–24 months post-stroke. Data on sociodemographic characteristics, professional reintegration (prevalence of return to work (RTW), period of RTW, job placement, function at work, reintegration support, association of stroke with work and number of working hours), mental health (Hospital Anxiety and Depression Questionnaire), QoL (Stroke Specific Quality of Life Scale) and community integration (Community Integration Questionnaire) were reported by 553 stroke survivors.ResultsTwenty months after stroke, 313 (56.6%; 95%CI 52.4–60.8) stroke survivors had return to work. RTW was positively associated with both global and sub-domains scores of Community Integration Questionnaire (CIQ) (global CIQ β = 3.50; 95%CI 3.30–3.79) and with depressive symptomatology (β = 0.63; 95%CI 0.20–1.46) measured by the Hospital Anxiety and Depression Scale. No significant differences were found regarding QoL, according to RTW status. For those who RTW, no significant associations were found between any of the professional reintegration determinants assessed and mental health, QoL and community integration scores.ConclusionsRTW seems to be associated to better community integration after stroke, but appears to be negatively associated to stroke survivor’s mental health, namely considering depression symptoms. Future studies should explore the barriers to stroke survivors’ RTW and the challenges and strategies used to overcome them, to allow the development of professional reintegration policies.Plain english summaryStroke represents a leading cause of death and a major cause of disability. In professionally active ages, stroke has a major impact on stroke survivors’ professional reintegration and on return to work, and special attention should be paid on how much this is associated with their quality of life, anxiety and depression symptoms, and community integration. This knowledge contributes to the development of patient centered interventions, across their rehabilitation pathway. The present study indicate that most stroke survivors return to work within the first six months after event, without any social or vocational support, and that return to work seems to be associated to better community integration. There was no difference on quality of life between stoke survivors who return to work and those who did not. Survivors who return to work appear to have more depressive symptoms than those who do not. Authors believe that lack of vocational support after stroke contributes to a maladaptive return to work that do not consider stroke survivors’ needs appropriately. These results highlight the importance of investing in professional reintegration with structured vocational programs to improve stroke survivors’ quality of life and mental health.

To explore treatment-related, socio-economic, and psychological factors influencing body image and return to work. 137 patients participated in the study. A questionnaire was completed before surgery and at 1-year follow-up, where patients were also interviewed in person with questions modified from the Body Image Scale and the sexual adjustment scale as well as questions about their work status. There was a significant decline in body image score from baseline to 1-year follow-up related to younger age, more extensive surgery and post-surgery treatments. Treatment with adjuvant chemotherapy was associated with a lower rating on ability to work in relation to mental requirements and later return to work. Higher anxiety scores at baseline were associated with both a decline in body image and a delay in return to work. Breast cancer surgery can affect body image and especially adjuvant chemotherapy seems to affect work ability. However, personal characteristics are also involved and thus should be considered when planning for treatment of breast cancer. •Surgery type and treatment of breast cancer influence body image and return to work.•The study indicated that breast cancer surgery, especially mastectomy, was associated with a decrease in body image.•Almost all patients had returned to work at 1-year follow-up, but adjuvant chemotherapy was related to later return to work.

Purpose To evaluate whether a protocol for early intervention addressing the psychosocial risk factors for delayed return to work in workers with soft tissue injuries would achieve better long-term outcomes than usual (stepped) care. Methods The study used a controlled, non-randomised prospective design to compare two case management approaches. For the intervention condition, workers screened within 1–3 weeks of injury as being at high risk of delayed returned to work by the Örebro Musculoskeletal Pain Screening Questionnaire—short version (ÖMPSQ-SF) were offered psychological assessment and a comprehensive protocol to address the identified obstacles for return to work. Similarly identified injured workers in the control condition were managed under usual (stepped) care arrangements. Results At 2-year follow-up, the mean lost work days for the Intervention group was less than half that of the usual care group, their claim costs were 30% lower, as was the growth trajectory of their costs after 11 months. Conclusions The findings supported the hypothesis that brief psychological risk factor screening, combined with a protocol for active collaboration between key stakeholders to address identified psychological and workplace factors for delayed return to work, can achieve better return on investment than usual (stepped) care.

PurposeWorking women often experience difficulties associated with balancing family and career, particularly if they choose to have children. This systematic literature review aimed at investigating women’s experience in returning to work after maternity leave.MethodsThe review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The literature search led to the identification of 52 articles, which underwent data extraction and qualitative analysis.ResultsResults were organized in 5 categories: (1) Work-life balance; (2) Women’s mental and physical health; (3) Job-related wellbeing and working experience; (4) Breastfeeding. Women’s both mental and physical health seem connected to a longer maternity leave and a greater coworkers’ and supervisors’ support. Returning to work seems to constitute one of the most important barriers for exclusive breastfeeding or breastfeeding continuation. A shorter duration of maternity leave, a higher workload and the lack of occupational policies supporting breastfeeding seem to be hindering factors. Partner and family support, and the opportunity for fathers to work under a flextime system after childbirth seem to increase both breastfeeding initiation and duration. Women who continue breastfeeding after returning to work seem to experience more family-to-work conflict and overload.ConclusionsThis paper show that there are still many understudied aspects in exploring women’s experience of returning to work after maternity leave. This represents an important gap in the literature, since returning to work represents a particularly critical time in women’s personal and occupational life, in which challenges and barriers may arise, potentially affecting their experience in the immediate future and years to come.

To explore potential categories of cancer survivors’ return to work adaptability, analyze associated influences, and identify the associations between different categories and financial toxicity. 412 cancer survivors were selected as participants. Data were collected using the general information questionnaire, the adaptability to return to work scale, and the comprehensive scores for financial toxicity based on patient-reported outcome measures. Cancer survivors’ return to work adaptability was categorized using potential profile analysis. Financial toxicity was analyzed using multivariate logistic regression in potential categories. Cancer survivors’ return to work adaptability was categorized into three groups, namely, “poor CSs-RTWA group”, “moderate CSs-RTWA-adjustment group”, and “high CSs-RTWA-harmonization group”. Age, place of residence, education level, type of family, per capita monthly family income, main economic sources, nature of work, nature of work unit, occupation type, current working status, sick pay, financial toxicity were the factors influencing the potential categories of cancer survivors’ return to work adaptability. The cancer survivors’ return to work adaptability has obvious population heterogeneity and financial toxicity is an important factor influencing adaptability classification. We must focus on the cancer survivors in the group with poor adaptability. On the basis of identifying different potential categories of cancer survivors’ return to work adaptability, reducing financial toxicity could be taken as an important intervention to precisely improve cancer survivors’ return to work adaptability and help them achieve comprehensive physical, mental and social rehabilitation. In the future, large-scale and multi-center studies and stratified based on cancer types and cultural factors should be conducted to enhance the universality of the results.

Purpose Despite existing rehabilitation services, return to work (RTW) rates among stroke survivors are quite low. An increased number of qualitative studies have been conducted to identify facilitators and barriers to RTW after stroke and to derive recommendations for future interventions. The aim of our study was to carry out a meta-synthesis of those studies and thus strengthen evidence in the field. Methods To identify relevant studies (qualitative studies focusing on RTW after stroke, published in English or German between 2000 and 2015), we conducted a systematic literature search in PubMed, OVID, and Web of Science. After assessing the quality of eligible studies, we synthesized their findings according to meta-ethnographic methodology. Results Fourteen out of 553 studies—three of very high, seven of high, three of medium, and one of low quality—met the inclusion criteria. After the extraction of all first-order concepts and their translation into 64 second-order interpretations, we synthesized the findings by developing a model of RTW factors after stroke. It contains factors related to the person (impairments, coping/adaptation, significance of work/RTW motivation), workplace (job demands/work adaptations, disability management, work climate/social support), and rehabilitation services (availability, accessibility, appropriateness), as well as relevant factors in the interaction of these three stakeholders (work capacity, performance and capability, and initial RTW experiences). Three basic principles—adaptiveness, purposefulness, and cooperativeness—complete the model and led us to its name: the APC model. Conclusions Successful RTW after stroke depends on diverse factors and stakeholders. Rehabilitation strategies have to consider this; otherwise they become RTW barriers themselves.

Background Cancer patients’ return to work is a growing aspect of survivorship care, yet limited studies have been conducted in Korea to understand the work-related experience of cancer patients. The purpose of this study was to understand the unmet needs of cancer patients and identify the necessary factors to develop a vocational intervention program based on cancer patients’ work-related experience after cancer diagnosis. Methods Semi-structured individual in-depth interviews were conducted with 50 cancer patients who were working at the time of diagnosis at a university hospital in Seoul, South Korea from July to September of 2017. Interview data were analyzed using qualitative content analysis. Results ‘The changes patients experienced after cancer diagnosis’ were categorized into Personal and socio-environmental changes. ‘Personal changes’ were changes within the patient that were further divided into ‘physical’, ‘psychological’ and ‘spiritual’ changes while ‘socio-environmental changes’ were changes in either ‘attitude’ and ‘relationship’ of other people cancer patients encountered. In addition to these post-diagnosis changes, the following 4 major factors related to return-to-work were identified to affect patients’ experience: ‘fear of cancer recurrence’, ‘financial status’, ‘informational support’, and ‘job-related work environment’. Conclusion Cancer patients’ working status was determined by personal and socio-environmental changes after the cancer diagnosis which as well as psychological distress and practical issues such as fear of cancer recurrence, financial burden, and work environment. Educational materials and intervention programs informing patients on these changes and factors may facilitate their return-to-work after diagnosis.

Purpose: As paid work is the occupation that people spend the most amount of their time doing, it is an important provider of personal meaning in their lives. This meaning has been shown to vary from person to person and to be important to health and well being. When a person is unable to work due to a disabling condition, it is unclear whether this meaning remains or is replaced by other meanings. The purpose of this scoping review was to explore what was known in the existing literature on what work means to those with work disability. Methods: The review involved identifying and selecting relevant studies, charting the data and collating and summarizing the results. Results: Fifty-two studies explored the meaning of work for those with cancer, mental illness, musculoskeletal disorders, brain injuries, paraplegia, and AIDS. The studies revealed that, for most, work continued to be meaningful and important. Common themes across all types of disability included work being a source of identity, feelings of normality, financial support, and socialization. These meanings were found to be both motivating for return to work and health promoting. Conversely, a small number of studies found that the meanings and values ascribed to work changed following disability. New meanings, found either at home or in modified work, replaced the old and contributed to new identities. Conclusions: The exploration of the meaning of work has been shown to provide important understanding of the experience of work and disability. This understanding can guide rehabilitation professionals in their interventions with the work disabled.