Employment Status and Associations with Workability, Quality of Life and Mental Health after Kidney Transplantation in Austria
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants
- Male and female post-KTx outpatients
- KTx performed after 2012 and at least 6 months prior to inclusion
- Age between 18 and 55 years
- Sufficient knowledge of German language
- Signed declaration of informed consent
- Dyspnea NYHA classification III-IV
- Unsigned declaration of consent
- Major physical and psychological impairments
- Inadequate compliance for answering the questionnaires
- Significant barrier of language
2.2. Methods
2.3. Questionnaires
- Sociodemographic and general information about the health status was obtained in the first part of the questionnaire. This included questions on various social and demographic aspects (employment status, education level, family members) and questions on health (height and weight, smoking status, alcohol consumption, physical activity levels).
- Occupational history included questions on the working life, including all working experiences, types of occupational activity performed, as well as subjective satisfaction with the working conditions.
- Brief Symptoms Inventory 18 (BSI-18) is a self-administered questionnaire comprising of a list with 18 symptoms where the participants determined the intensity of symptoms during the past 7 days on a Likert type scale (0–4; 0 = not at all, 4 = very much). Scores are calculated by sum scores. The BSI-18 has 3 subscales: depression, anxiety and somatization and the Scale Global Severity Index. This questionnaire was chosen as previous multiple application studies indicated that BSI-18 is a suitable instrument for measuring psychological distress. A validated German language version of the questionnaire was used [28].
- Workability Index (WAI) is a widely used instrument in occupational health to assess the workability and covers several dimensions of workability including current workability in relation to job demands and their lifetime best level of workability, number of comorbidities and the estimated impairment arising from disease or other limiting conditions, amount of sick leave and prognosis of one’s workability. The items are a variation of single-, multiple-choice and Likert-type scale questions, with a score being derived by summation. Given that the WAI can only be applied in subjects who are currently employed, we also calculated the Workability Score (WAS) which is a subscore derived from a single item of the WAI, which is valid and suitable for both currently employed as well as unemployed participants [29].
- World Health Organization Quality of Life Questionnaire Bref is a shorter form of the WHOQOL-100. The items are divided into 4 domains (physical, psychological, social relationships and environment) that are scored on a Likert-type scale (ranging from 1 to 5, 1 indicating low or negative perceptions and 5 high or positive ones). The scores are a sum, with some items being not scaled in a positive direction. We used the official German translation of the World Health Organization Quality of Life (WHOQOL-Bref) [30].
2.4. Statistical Analysis
2.5. Ethical Consideration
3. Results
4. Discussion
5. Limitations
6. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Variables | Total n = 139 (n, %) | Employed (n = 72) | Unemployed (n = 67) | p-Value | |
---|---|---|---|---|---|
Study Center | 0.319 | ||||
Graz | 33 (24.6) | 20 (27.8) | 13 (19.4) | ||
Vienna | 106 (76.3) | 52 (72.2) | 54 (80.6) | 1 | |
Gender | |||||
Male | 80 (57.6) | 41 (56.9) | 39 (58.2) | ||
Female | 59 (42.4) | 31 (43.1) | 28 (41.8) | ||
Education Level | 0.01 | ||||
Primary | 45 (32.4) | 15 (20.8) | 21 (31.3) | ||
Vocational training | 48 (34.5) | 27 (37.5) | 30 (44.8) | ||
Secondary | 31 (22.3) | 22 (30.6) | 9 (13.4) | ||
Tertiary | 15 (10.8) | 8 (11.1) | 7 (10.4) | ||
Partnership status | 0.018 | ||||
Single | 37 (26.6) | 17 (23.6) | 20 (29.9) | ||
Partnership | 22 (15.8) | 15 (20.8) | 7 (10.4) | ||
Married | 56 (40.3) | 33 (45.8) | 23 (34.3) | ||
Divorced | 23 (16.5) | 6 (8.3) | 17 (25.4) | ||
Widowed | 1 (0.7) | 1 (1.4) | 0 | ||
Underage children in household | 0.273 | ||||
Yes | 44 (31.7) | 26 (36.1) | 18 (26.9) | ||
No | 94 (67.6) | 45 (62.5) | 49 (73.1) | ||
Missing | 1 (1.4) | 0 | |||
Providing care for family members | 0.599 | ||||
Yes | 16 (11.5) | 7 (9.7) | 9 (13.4) | ||
No | 122 (87.8) | 64 (88.9) | 58 (86.6) | ||
Missing | 1 (0.7) | 1 (1.4) | 0 | ||
Employed | |||||
Yes | 72 (51.8) | ||||
No | 67 (48.2) | ||||
Employment | |||||
Full time | 69.4 (50) | ||||
Part time | 26.4 (19) | ||||
Marginally | 4.2 (3) | ||||
Place of employment | |||||
Private company | 43 (60.6) | ||||
Family owned | 8 (11.3) | ||||
Public sector | 20 (28.2) | ||||
Early retired | |||||
Yes | 31 (22.3) | ||||
No | 104 (74.8) | ||||
Missing | 4 (2.9) | ||||
Type of occupational activity at last job | 0.059 | ||||
Mostly physical work | 12 (20.3) | 5 (50.0) | 7 (14.3) | ||
Mostly intellectual work | 15 (25.4) | 1 (10.0) | 14 (28.6) | ||
Both in equal measure | 32 (54.2) | 4 (40.0) | 28 (57.1) | ||
Years employed (Mean, SD) | 20.40 (10.67) | 21.49 (9.74) | 19.23 (11.54) | 0.229 | |
Age in years (Mean, SD) | 43.20 (9.07) | 42.49 (8.47) | 43.95 (9.67) | 0.346 |
Variables | Total n = 139 (n, %) | Employed (n = 72) | Unemployed (n = 67) | p-Value | |
---|---|---|---|---|---|
Height in cm (Mean, SD) | 171.59 (9.86) | 172.32 (9.28) | 170.81 (10.45) | 0.386 | |
Weight in kg (Mean, SD) | 76.70 (16.33) | 77.24 (16.83) | 76.13 (15.88) | 0.693 | |
BMI (kg/m2) (Mean, SD) | 25.98 (4.79) | 25.88 (4.57) | 26.09 (5.05) | 0.799 | |
Smoking status | 0.427 | ||||
Smoker | 33 (23.7) | 15 (20.8) | 18 (26.9) | ||
Non-smoker | 105 (75.5) | 57 (79.2) | 48 (71.6) | ||
Missing | 1 (0.7) | 0 | 1 (1.5) | ||
Drinking alcohol | 0.054 | ||||
Yes | 52 (37.4) | 33 (45.8) | 19 (28.4) | ||
No | 85 (61.2) | 39 (54.2) | 46 (68.7) | ||
Missing | 2 (1.4) | 0 | 2 (3.0) | ||
Alcohol consumption frequency | 1.146 | ||||
No alcohol | 85 (62.0) | 39 (54.2) | 46 (70.8) | ||
Occasionally (few times monthly) | 43 (31.4) | 26 (36.1) | 17 (26.2) | ||
Frequently (few times a week) | 8 (5.8) | 6 (8.3) | 2 (3.1) | ||
Daily consumption | 1 (0.7) | 1 (1.4) | 0 | ||
Regular exercise | 0.469 | ||||
Yes | 76 (54.7) | 37 (51.4) | 39 (58.2) | ||
No | 63(45.3) | 35 (48.6) | 28 (41.8) | ||
Exercise frequency | 0.813 | ||||
Less than 4 times a month | 5 (6.9) | 3 (8.3) | 2 (5.6) | ||
Once a week | 15 (20.8) | 9 (25.0) | 6 (16.7) | ||
Several times a week | 39 (54.2) | 18 (50.0) | 21 (58.3) | ||
Daily | 13 (18.1) | 6 (16.7) | 7 (19.4) | ||
Surgery number (only Vienna) | 0.834 | ||||
1. KTx | 85 (80.2) | 44 (84.6) | 41 (75.9) | ||
2. KTx | 13 (12.3) | 5 (9.6) | 8 (14.8) | ||
3. KTx | 4 (3.8) | 2 (3.8) | 2 (3.7) | ||
5. KTx | 1 (0.9) | 0 | 1 (1.9) | ||
KTx + PTx | 3 (2.8) | 1 (1.9) | 2 (3.7) | ||
Offered psychological support before surgery | 0.734 | ||||
Yes | 64 (46.0) | 32 (44.4) | 32 (47.8) | ||
No | 73 (52.5) | 39 (54.2) | 34 (50.7) | ||
Missing | 2 (1.4) | 1 (1.4) | 1 (1.5) | ||
Offered psychological support after surgery | 0.376 | ||||
Yes | 50 (36.7) | 23 (31.9) | 27 (40.3) | ||
No | 86 (61.2) | 47 (65.3) | 39 (58.2) | ||
Missing | 3 (2.1) | 2 (2.8) | 1 (1.5) | ||
Taken psychological support before surgery | 0.098 | ||||
Yes | 30 (21.6) | 11 (15.3) | 19 (28.4) | ||
No | 108 (77.7) | 60 (83.3) | 48 (71.6) | ||
Missing | 1 (0.7) | 1 (1.4) | 0 | ||
Taken psychological support after surgery | 0.019 | ||||
Yes | 22 (15.8) | 6 (8.3) | 16 (23.9) | ||
No | 116 (83.5) | 65 (90.3) | 51 (76.1) | ||
Missing | 1 (0.7) | 1 (1.4) | 0 | ||
Experiencing fatigue | <0.001 | ||||
Yes | 77 (55.4) | 44 (61.1) | 53 (79.1) | ||
No | 57 (41.0) | 24 (33.3) | 13 (19.4) | ||
Missing | 5 (3.6) | 4 (5.6) | 1 (1.5) |
Workability Score | ||||
---|---|---|---|---|
Variables | Total n = 139 (n, %) | Employed (n = 72) | Unemployed (n = 67) | p-Value |
WAS (Mean, SD) | 5.83 (2.84) | 7.82 (1.55) | 3.69 (2.30) | <0.001 |
WAS Category | <0.001 | |||
Bad | 58 (41.7) | 4 (6.0) | 54 (80.6) | |
Moderate | 28 (20.1) | 21 (31.3) | 7 (10.4) | |
Good | 33 (23.7) | 28 (41.8) | 5 (7.5) | |
Very good | 15 (10.8) | 14 (20.9) | 1 (1.5) | |
Brief Symptoms Inventory | ||||
Variables | Total n = 139 (n, %) | Employed (n = 72) | Unemployed (n = 67) | p-Value |
Global Symptoms Index (Mean, SD) | 11.72 (12.50) | 6.33 (7.51) | 17.51 (14.15) | <0.001 |
Somatization | 4.12 (4.67) | 2.10 (2.67) | 6.28 (5.35) | <0.001 |
Depression | 3.58 (4.53) | 1.75 (3.02) | 5.54 (5.05) | <0.001 |
Anxiety | 4.03 (4.73) | 2.49 (3.26) | 5.69 (5.46) | <0.001 |
WHO Quality of Life Questionnaire | ||||
Variables | Total n = 139 (n, %) | Employed (n = 72) | Unemployed (n = 67) | p-Value |
Quality of life score | 76.37 (24.71) | 84.68 (21.73) | 67.31 (24.72) | <0.001 |
Global QoL | 51.04 (29.75) | 58.08 (30.43) | 43.36 (27.19) | 0.003 |
Physical domain | 44.56 (21.42) | 49.23 (23.28) | 39.47 (18.01) | 0.006 |
Psychological domain | 49.66 (24.43) | 52.90 (25.60) | 46.14 (22.76) | 0.105 |
Social relationship domain | 56.15 (29.65) | 58.06 (30.51) | 54.05 (28.76) | 0.429 |
Environment domain | 58.06 (28.75) | 62.55 (30.90) | 53.16 (25.53) | 0.053 |
Variables | Odds Ratio | 95% Confident Interval | p-Value | |
---|---|---|---|---|
Education | ||||
Vocational (Ref) | 1 | |||
Primary | 0.335 | 0.059 | 1.9 | 0.217 |
Secondary | 0.616 | 0.256 | 10.009 | 0.616 |
Tertiary | 8.849 | 0.424 | 184.733 | 0.16 |
Partnership | ||||
Single (Ref) | 1 | |||
Partnered | 5.47 | 1.43 | 20.911 | 0.013 |
Psychological help before surgery | ||||
No (Ref) | 1 | |||
Yes | 1.386 | 0.207 | 9.283 | 0.737 |
Psychological help after surgery | ||||
No (Ref) | 1 | |||
Yes | 0.055 | 0.003 | 0.969 | 0.048 |
Alcohol consumption | ||||
No (Ref) | 1 | |||
Yes | 1.882 | 0.485 | 7.304 | 0.361 |
WAS | 3.369 | 7.979 | 5.827 | <0.001 |
Global Symptoms Index | 0.769 | 0.272 | 0.436 | 0.367 |
BSI Somatization | 1.148 | 0.63 | 2.094 | 0.652 |
BSI Depression | 0.959 | 0.499 | 1.844 | 0.900 |
BSI Anxiety | 1.766 | 0.924 | 3.375 | 0.085 |
WHOQOL-Bref Score | 0.978 | 0.933 | 1.025 | 0.356 |
Global Quality of Life | 0.986 | 0.922 | 1.056 | 0.693 |
Physical domain | 1.073 | 0.97 | 1.188 | 0.172 |
Psychological domain | 0.915 | 0.835 | 1.002 | 0.055 |
Environmental domain | 1.022 | 0.95 | 1.099 | 0.561 |
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Jordakieva, G.; Grabovac, I.; Steiner, M.; Winnicki, W.; Zitta, S.; Stefanac, S.; Brooks, M.; Sunder-Plaßmann, G.; Rosenkranz, A.R.; Godnic-Cvar, J. Employment Status and Associations with Workability, Quality of Life and Mental Health after Kidney Transplantation in Austria. Int. J. Environ. Res. Public Health 2020, 17, 1254. https://doi.org/10.3390/ijerph17041254
Jordakieva G, Grabovac I, Steiner M, Winnicki W, Zitta S, Stefanac S, Brooks M, Sunder-Plaßmann G, Rosenkranz AR, Godnic-Cvar J. Employment Status and Associations with Workability, Quality of Life and Mental Health after Kidney Transplantation in Austria. International Journal of Environmental Research and Public Health. 2020; 17(4):1254. https://doi.org/10.3390/ijerph17041254
Chicago/Turabian StyleJordakieva, Galateja, Igor Grabovac, Margarete Steiner, Wolfgang Winnicki, Sabine Zitta, Sinisa Stefanac, Moritz Brooks, Gere Sunder-Plaßmann, Alexander R. Rosenkranz, and Jasminka Godnic-Cvar. 2020. "Employment Status and Associations with Workability, Quality of Life and Mental Health after Kidney Transplantation in Austria" International Journal of Environmental Research and Public Health 17, no. 4: 1254. https://doi.org/10.3390/ijerph17041254