Return to work during first year after intensive care treatment and the impact of demographic, clinical and psychosocial factors

Mona Austenå; Tone Rustøen; Milada Cvancarova Småstuen; Åse Valsø; Kjetil Sunde; Kirsti Tøien

doi:10.1016/j.iccn.2023.103384

Return to work during first year after intensive care treatment and the impact of demographic, clinical and psychosocial factors

Intensive Crit Care Nurs. 2023 Jun:76:103384. doi: 10.1016/j.iccn.2023.103384. Epub 2023 Jan 12.

Authors

Mona Austenå¹, Tone Rustøen², Milada Cvancarova Småstuen³, Åse Valsø⁴, Kjetil Sunde⁵, Kirsti Tøien⁶

Affiliations

¹ Department of Postoperative and Intensive Care, Division of Emergencies and Critical Care, Oslo University Hospital, P.O. Box 4950 Nydalen, N-0424 Oslo, Norway; Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, P.O. Box 4950 Nydalen, N-0424 Oslo, Norway; Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, P.O. Box 1078 Blindern, NO-0316 Oslo, Norway. Electronic address: maustena@ous-hf.no.
² Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, P.O. Box 4950 Nydalen, N-0424 Oslo, Norway; Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, P.O. Box 1078 Blindern, NO-0316 Oslo, Norway. Electronic address: tone.rustoen@medisin.uio.no.
³ Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, P.O. Box 4950 Nydalen, N-0424 Oslo, Norway; Faculty of Health Sciences, Oslo Metropolitan University, P.O. Box 4, St. Olavs Plass, N-0130 Oslo, Norway. Electronic address: milasm@oslomet.no.
⁴ Department of Postoperative and Intensive Care, Division of Emergencies and Critical Care, Oslo University Hospital, P.O. Box 4950 Nydalen, N-0424 Oslo, Norway; Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, P.O. Box 1078 Blindern, NO-0316 Oslo, Norway; Lovisenberg Diaconal University College, Lovisenberggt. 15b, 0456 Oslo, Norway. Electronic address: UXVALS@ous-hf.no.
⁵ Department of Anesthesiology, Division of Emergencies and Critical Care, Oslo University Hospital, P.O. Box 4950 Nydalen, N-0424 Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, P.O. Box 1078 Blindern, NO-0316 Oslo, Norway. Electronic address: kjetil.sunde@medisin.uio.no.
⁶ Department of Postoperative and Intensive Care, Division of Emergencies and Critical Care, Oslo University Hospital, P.O. Box 4950 Nydalen, N-0424 Oslo, Norway; Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, P.O. Box 4950 Nydalen, N-0424 Oslo, Norway. Electronic address: UXTOIE@ous-hf.no.

PMID: 36640528
DOI: 10.1016/j.iccn.2023.103384

Abstract

Objectives: To describe work participation in survivors during first year after intensive care unit discharge and examine the impact of selected demographic, clinical and psychosocial factors on return to work 12 months after discharge.

Research methodology/design: A predefined sub-study (prospective cohort study) of a randomised controlled trial.

Setting: A Norwegian single-centre university hospital. Medical and surgical adult intensive care survivors, working/on sick leave before admission, in the intensive care unit ≥24 h, were included.

Main outcome measures: Return to work three, six and 12 months after discharge, and impact of age, pre-existing comorbidities, previous serious life events, coping ability, hope and social support on return to work 12 months after discharge.

Results: Included were 284 patients, with mean age 47 years (SD 13.9) and 47 % women. One year after discharge, 69 % were back at work. In the regression analysis, with working at 12 months (yes/no) as the dependent variable, 178 patients, completing questionnaires at three as well as 12 months, were included. Lower age (OR 0.96, 95 % CI [0.93-0.99]), lower pre-existing comorbidities (OR 0.65, 95 % CI [0.43-0.97]), previous serious life events (OR 6.53, 95 % CI [2.14-19.94]), and greater hope at three months (OR 1.09, 95 % CI [1.01-1.17]) were all independently associated with higher odds of returning to work.

Conclusion: Following intensive care, age, pre-existing comorbidities, experience of previous serious life events and hope all have a significant impact on return to work, and are important variables to consider during intensive care treatment and rehabilitation.

Implications for clinical practice: Attention must be paid to patients with prior working capability to ensure return to work after intensive care treatment. Older adults with pre-existing comorbidities might benefit from early, individualised rehabilitation to regain previous working capacity. In addition, there is also a need to support patients' hope during and after critical illness.

Keywords: Follow-up; Hope; Intensive care; Return to work.

Publication types

Randomized Controlled Trial

MeSH terms

Aged
Critical Care* / psychology
Demography
Female
Humans
Infant
Intensive Care Units
Male
Middle Aged
Prospective Studies
Return to Work* / psychology