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Introducción: La artritis reumatoide tiene un importante impacto sobre la función física y la productividad laboral. Objetivo: Determinar la productividad laboral de los pacientes con artritis reumatoide temprana identificando su relación con variables sociodemográficas y clínicas. Método: Se realizó un estudio observacional descriptivo de corte transversal en 53 pacientes atendidos en el Centro de Referencia de Enfermedades Reumáticas entre enero a diciembre de 2019. Para evaluar la productividad laboral se utilizó el cuestionario WPAI-AR. Resultados: Predominaron los pacientes entre los 35-55 años de edad (60,4 por ciento), el sexo femenino (60,4 por ciento). La productividad laboral medida a través de WPAI-AR reportó durante los últimos 7 días una media de 4,64 horas laborales perdidas, secundaria a la artritis reumatoide, con un porciento de pérdida por ausentismo del 16,5 por ciento y presentismo del 59,6 por ciento. Conclusiones: El mayor porciento de afectación de la productividad laboral le correspondió al presentismo. Se encontró asociación entre la pérdida de productividad laboral y la actividad clínica, la discapacidad funcional y la calidad de vida relacionada con la salud(AU)
Introduction: rheumatoid arthritis has been reported to have a significant impact on physical function and work productivity. Objectives: To determine the labor productivity of patient's diagnosis with early rheumatoid arthritis and to identify its possible relationship with sociodemographic and clinical variables. Methods: A cross-sectional descriptive observational study was carried out in 53 patients treated at the Reference Center for Rheumatic Diseases between January to December 2019. To evaluate labor productivity, the WPAIR AR questionnaire was used. Results: patients between 35-55 years of age predominated 60.4 percent, the female sex 60.4 percent. Labor productivity measured by WPAI AR reported during the last 7 days an average of 4.64 working hours lost, secondary to early rheumatoid arthritis, with a percentage of loss due to absenteeism of 16.5 percent and presenteeism of 59.6 percent. Conclusion: Conclusion: the highest percentage of affectation of labor productivity corresponded to labor presenteeism. Loss of work productivity was significantly associated with clinical activity, functional capacity, and health-related quality of lifepor ciento(AU)
Assuntos
Humanos , Artrite Reumatoide/complicações , Saúde Ocupacional/educação , Presenteísmo/métodos , Aptidão Física/fisiologia , Epidemiologia Descritiva , Estudos TransversaisRESUMO
OBJECTIVE: The objective of the study was to measure the proportion of patients who consulted for headache and of those who had a final diagnosis of migraine. We also assessed the proportion and characteristics of patients with migraine and the impact of migraine on the daily activities and the professional and social lives of patients visiting private/public medical centers in Guatemala, Costa Rica, Panama, and the Dominican Republic. BACKGROUND: Underdiagnosis of migraine is high in Central America and Caribbean urban communities. However, there is limited knowledge on characteristics of headache disorders for the appropriate classification of migraine, which is a prerequisite for targeted treatment. Hence, there is a need to improve migraine awareness among patients and medical professionals in this region. METHODS: Central America and Caribbean countries epidemioLogy study of Migraine (CALM) was a non-interventional, cross-sectional, multinational study in adults aged 18-65 years with a history of or current headache. The primary outcome was the proportion of patients with migraine visiting medical centers due to headache disorders. Using a specially designed migraine survey questionnaire, patients self-reported migraine characteristics, duration, and severity of attacks and impact on work and social life. RESULTS: Of the 313 enrolled patients, 308 (98.4%) completed the study. Approximately 75.3% (232/308) of patients with headache visiting medical centers had migraine, with episodic migraine being the most common (193 [83.2%]). Overall, 34/308 (11.0%) patients had a new diagnosis of migraine. Among patients with migraine, 66 (28.4%) had a history of migraine for ≥20 years and 59 (25.4%) experienced severe pain. Overall, 52.2% (121/232) of patients reported that migraine affected their professional life and 78.4% (182/232) reported an impact on social life. CONCLUSION: The CALM study establishes that a high proportion of patients with migraine had a long duration and high severity of migraine attacks, leading to a direct impact on work/social life as well as on costs incurred by patients in these countries.
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Transtornos de Enxaqueca , Adulto , Custos e Análise de Custo , Estudos Transversais , Cefaleia/epidemiologia , Humanos , Transtornos de Enxaqueca/terapia , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: To describe the poorly understood burden of pulmonary exacerbations experienced by primary caregivers of children (aged 2-17 years) with cystic fibrosis (CF), who frequently require prolonged hospitalizations for treatment of pulmonary exacerbations with intravenous (IV) antibiotics. STUDY DESIGN: In this prospective observational study, 88 caregivers in Germany, Ireland, the United Kingdom, and the US completed a survey during pulmonary exacerbation-related hospitalizations (T1) and after return to a "well state" of health (T2). The impact of pulmonary exacerbations on caregiver-reported productivity, mental/physical health, and social/family/emotional functioning was quantified. RESULTS: Primary caregivers of children with CF reported significantly increased burden during pulmonary exacerbations, as measured by the 12-item Short-Form Health Survey mental health component and the Work Productivity and Activity Impairment: Specific Health Problem absenteeism, presenteeism, work productivity loss, and activity impairment component scores. Compared to the "well state," during pulmonary exacerbations-related hospitalization caregivers reported lower physical health scores on the Child Health Questionnaire-Parent Form 28. Quality-of-life scores on the Caregiver Quality of Life Cystic Fibrosis scale and total support score on the Multidimensional Scale of Perceived Social Support did not differ significantly between T1 and T2. More caregivers reported a negative impact on family/social/emotional functioning during pulmonary exacerbations than during the "well state." CONCLUSIONS: Pulmonary exacerbations necessitating hospitalization impose a significant burden on primary caregivers of children with CF. Preventing pulmonary exacerbations may substantially reduce this burden.
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Adaptação Psicológica , Cuidadores/psicologia , Fibrose Cística/terapia , Eficiência , Inquéritos Epidemiológicos/métodos , Saúde Mental , Qualidade de Vida , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Fibrose Cística/epidemiologia , Alemanha/epidemiologia , Humanos , Pessoa de Meia-Idade , Morbidade/tendências , Estudos Prospectivos , Apoio Social , Reino Unido/epidemiologiaRESUMO
AIM: To evaluate the association of erectile dysfunction (ED) with work productivity loss, activity impairment and health-related quality of life (HRQoL) across Brazil, China, France, Germany, Italy, Spain, the UK and the US. METHODS: This cross-sectional observational study used data from adult men (40-70 years old; N = 52 697) from the 2015 and 2016 National Health and Wellness Surveys. ED assessment was based on self-reported difficulty in achieving or maintaining an erection in the past 6 months. Impairment to work and non-work activities and HRQoL were assessed for each country and compared against the US. Multivariable models tested interactions between ED status and country for each outcome. RESULTS: Overall ED prevalence was reported as 49.7%, with Italy reporting the highest rate (54.7%). Men with ED reported significantly higher absenteeism (7.1% vs 3.2%), presenteeism (22.5% vs 10.1%), overall work productivity impairment (24.8% vs 11.2%), activity impairment (28.6% vs 14.5%) and significantly lower Mental Component Summary scores (MCS; 46.7 vs 51.2), Physical Component Summary scores (PCS; 48.3 vs 53.0), and health state utilities (SF-6D: 0.693 vs 0.778; all, P < 0.001) than men with no ED. After adjusting for covariates, compared with the US, the association of ED status with overall work productivity impairment was greatest in the UK (26% higher; P < 0.05), and with MCS, PCS and SF-6D scores was greatest in China (-2.67, -1.58, and -0.043 points, respectively; all, P < 0.001). Greater ED severity was significantly associated with higher impairment to work and non-work activities and lower HRQoL, with China reporting the highest burden, compared with the US (most P < 0.05). CONCLUSION: ED poses a significant burden with respect to work productivity and HRQoL, with greater severity associated with worse outcomes. Better management and earlier detection may help reduce this burden, especially in countries reporting a strong association between ED and poor economic and health outcomes.
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Absenteísmo , Disfunção Erétil/epidemiologia , Qualidade de Vida/psicologia , Adulto , Idoso , Brasil/epidemiologia , China/epidemiologia , Estudos Transversais , Feminino , França/epidemiologia , Alemanha/epidemiologia , Inquéritos Epidemiológicos , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Presenteísmo , Autorrelato , Espanha/epidemiologiaRESUMO
OBJECTIVES: Estimate the prevalence of neuropathic pain (NeP) among chronic pain patients attending Brazilian hospitals and pain clinics in São Paulo, Ceara, and Bahia and explore clinical characteristics by subtypes: painful diabetic peripheral neuropathy (pDPN), central neuropathic pain (CNP), chronic low back pain with a neuropathic component (CLBP-NeP), postherpetic neuralgia (PHN), post-traumatic neuropathic pain (PTN), and post-surgical neuropathic pain (PSN). METHODS: Physicians screened patients reporting chronic pain for ≥3 months (n=2,118) for probable NeP, using the Douleur Neuropathique 4 questionnaire and physician assessment, and reported their NeP subtype(s), symptoms, and medications. Identified NeP patients completed a questionnaire including treatment experiences, quality of life EuroQol 5 Dimensions [EQ-5D]), pain severity and interference (Brief Pain Inventory [BPI]), and Work Productivity and Activity Impairment scales. Descriptive analyses were performed by NeP subtype. RESULTS: The prevalence of probable NeP was 14.5% (n=307). NeP patients were mostly female (80.5%), middle-aged (mean [M]=52.5, SD=13.9), and Pardo (44.3%). Of those diagnosed with an NeP subtype (n=209), the largest proportions were CLBP-NeP (36.8%), followed by pDPN (18.7%), CNP (17.7%), PTN (17.2%), PSN (13.4%), and PHN (3.3%). Across subtypes, the most widely reported symptoms were numbness (range: 62.2%-89.7%) and hyperalgesia (range: 32.1%-76.9%) and the most commonly prescribed pain analgesics were NSAID (range: 18.2%-57.1%), opioids (range: 0.0%-39.3%), and antiepileptics (range: 18.2%-57.1%). PTN and PSN patients reported the least favorable EQ-5D index scores (M=0.42, SD=0.19) and BPI-Pain Severity scores (M=7.0, SD=1.9), respectively. Those diagnosed with CNP had the least favorable BPI-Pain Interference scores (M=6.0, SD=2.7). Patients with PHN reported the least impairment based on EQ-5D index scores (M=0.60, SD=0.04). Those with pDPN had the most favorable BPI scores (BPI-Pain Severity: M=4.6, SD=2.3; BPI-Pain Interference: M=4.7, SD=2.7). CONCLUSION: Evaluation of chronic pain patients in Brazil yielded a 14.5% probable NeP prevalence. NSAIDs and opioids were commonly used, and there was a high incidence of NeP-related symptoms with varying levels of dysfunction across subtypes.
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Recientemente han surgido algunos conceptos en el área laboral, específicamente asociados al sector salud, que previamente no se abordaban ni se mencionaban hasta que hace algunos años se dio un cambio en el paradigma y esos nuevos conceptos, dentro de los que resalta el presentismo, vinieron a ocupar un lugar dentro del análisis global de la situación laboral. El presentismo se ha tratado de definir, de manera sencilla, como apersonarse a trabajar a pesar de presentar un problema de salud o alguna otra situación que normalmente llevaría al ausentismo. A la hora del análisis correspondiente y de sus implicaciones no se puede olvidar otros factores que inciden en la productividad y que resultan fundamentales como por ejemplo el clima organizacional. Estos factores de la mano del presentismo y el ausentismo representan un impacto mayúsculo por sus costos económicos pero principalmente también por los denominados costos ocultos o no medibles debido a que involucra una mayor incidencia de errores médicos llegando inclusive a comprometer vidas humanas.
Recently some concepts have emerged in the occupational area, specifically associated with the health sector, that previously wasnt taken into account or mentioned until some years ago, where the paradigm has changed and those new concepts, where the presenteeism plays an important role, came to take a place within the global working situation. The presenteeism has been known, like going to work even though the employee is having a health problem or some other situation that normally would take to the absenteeism. Besides, when we think in the implications of the presenteeism, we cant forget several factors that influence in the productivity, like the organizational climate. These factors altogether with the presenteeism and the absenteeism, represent a great impact, because of their economic costs, but principally the hidden or not measurable costs, because they involve a higher incidence of medical errors, leading to compromise human lives.
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Humanos , Absenteísmo , Ética Institucional , Instalações de SaúdeRESUMO
BACKGROUND AND OBJECTIVES: Pain is a prevalent clinical condition causing tremendous humanistic and economic burden worldwide. With limited research into the impact of pain on health related outcomes in Brazil, the current study examined prevalence of pain conditions, rate of diagnosis and treatment, and potential impact on health outcomes among Brazilian adults. METHOD: Data were collected from the stratified random sample of adults (n = 12,000) in thecross-sectional 2011 National Health and Wellness Survey (NHWS) in Brazil. Respondents reported on sociodemographic information, health-related quality of life (SF-12v2), work productivity and activity impairment (WPAI), comorbid conditions, and healthcare resource use. Comparisons between those reporting pain and no pain (i.e.,neuropathic pain, fibromyalgia, surgery/medical procedure-related pain, or back pain, versus controls without the respective condition; or arthritis, with vs. without experiencing pain) were conducted using Chi-square and t-tests for categorical and continuous variables, respectively. RESULTS: Back pain was the most commonly reported pain condition (12%), followed by fibromyalgia. Among those experiencing the condition neuropathic pain was the most, and back pain the least, commonly diagnosed and treated. Across conditions, to varying degrees, pain vs. no pain was associated with greater comorbid burden, higher resource utilization, and greater impairments in health status and work productivity, with few differences in sociodemographic factors. CONCLUSION: Pain-related conditions were associated with varying awareness and treatment rates among Brazilian adults. Consistent with previous US and European studies, pain was associated with various negative health outcomes. These findings highlight the under-treatment and range of potential sources of pain burden in Brazil.
JUSTIFICATIVA E OBJETIVOS: A dor é uma condição clínica prevalente que gera um fardo humanístico e econômico tremendo em todo o mundo. Tendo em vista os poucos estudos sobre o impacto da dor em resultados de saúde no Brasil, este estudo avaliou a prevalência de condições dolorosas, a taxa de diagnóstico e tratamento, e o possível impacto nos resultados de saúde entre adultos brasileiros. MÉTODO: Os dados foram coletados de uma amostra estratificada e aleatória de adultos (n = 12.000) da pesquisa transversal National Health and Wellness Survey de 2011 feita no Brasil. Os entrevistados deram informações sociodemográficas, sobre qualidade de vida relacionada à saúde (SF-12v2), produtividade no trabalho e prejuízo de suas atividades (WPAI), condições comórbidas e uso de recursos de assistência à saúde. As comparações entre os indivíduos com e sem dor (isto é, dor neuropática, fibromialgia, dor relacionada a procedimentos cirúrgicos/médicos, ou lombalgia, versus os controles sem a respectiva condição; ou artrite, com versus sem dor) foram realizadas pelos testes Qui-quadrado e t para variáveis categóricas e contínuas, respectivamente. RESULTADOS: Lombalgia foi a condição dolorosa mais comum (12%), seguida de fibromialgia. Entre os incluídos nessa condição, a dor neuropática foi a mais comumente diagnosticada e tratada, e a lombalgia foi a menos diagnosticada e tratada. Nas diferentes condições, em graus variáveis, dor versus sem dor foi associada a maior fardo comórbido, maior utilização de recursos, e maiores prejuízos ao estado de saúde e à produtividade no trabalho, com poucas diferenças nos fatores sociodemográficos. CONCLUSÃO: As condições dolorosas foram associadas a diferentes percepções e taxas de tratamento entre adultos brasileiros. Corroborando estudos anteriores norte-americanos e europeus, a dor foi associada a vários resultados negativos para a saúde. Esses achados destacam o subtratamento e uma gama de fontes potenciais de fardo da dor no Brasil.
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Efeitos Psicossociais da Doença , Eficiência Organizacional , Dor Lombar , Qualidade de VidaRESUMO
OBJECTIVE: Major depressive disorder (MDD) is often underdiagnosed, undertreated, and associated with negative health outcomes. The current study examined the prevalence of MDD signs and symptoms in Brazil, including awareness, diagnosis, treatment, and the association of MDD with health outcomes. METHODS: Data were collected from the 2011 National Health and Wellness Survey in Brazil (N = 12,000). Excluding those with bipolar disorder, respondents who met Patient Health Questionnaire-9 criteria for MDD (n = 1105) were compared with those not qualifying as having MDD or any depressive symptoms (n = 8684), analyzing separately those currently taking (n = 184) or not taking (n = 155) prescription medication for depression. Sociodemographics and health status, symptoms, experience of depression, diagnosis, MDD severity, pharmacotherapy, productivity impairment (Work Productivity and Activity Impairment questionnaire), health status (Short-Form 12, version 2), and health care resource use were measured. Results were weighted and projected to the Brazil adult population. Differences were measured with column proportion and mean tests for categorical and continuous outcomes, respectively. RESULTS: MDD prevalence was 10.2%, with only 28.1% of the individuals with MDD diagnosed and 15.6% currently using prescription medication for depression. Males were especially likely to be unaware of MDD. Compared with non-MDD controls, patients with MDD (treated or untreated) reported significantly greater overall work impairment, worse mental and physical health status, and greater health care resource utilization (all P<0.05). There was a trend for worsening health outcomes with increasing MDD severity. CONCLUSIONS: These findings suggest that Brazilians may be underdiagnosed and undertreated for MDD. Individuals with MDD reported substantially poorer health outcomes, suggesting the need to increase MDD awareness, especially among males, and provide better access to treatment.