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Employment status, hours working, and gainful earnings after spinal cord injury: relationship with pain, prescription medications for pain, and nonprescription opioid use.
Spinal Cord ( IF 2.2 ) Pub Date : 2019-11-01 , DOI: 10.1038/s41393-019-0374-1
James S Krause 1 , Clara E Dismuke-Greer 1 , Karla S Reed 1 , Chao Li 1
Affiliation  

STUDY DESIGN Cross-sectional self-report assessment. Econometric modeling. OBJECTIVES Identify the relationship of multiple pain indicators, prescription pain medication, nonprescription opioid use, and multiple indicators of quality employment among those with spinal cord injury (SCI). SETTING Data were collected at a medical university in the Southeastern United States (US). METHODS Participants included 4670 adults with traumatic SCI of at least one-year duration who were enrolled in a study of health and longevity. They were identified from three sources including a specialty hospital and two population-based state SCI surveillance systems. Econometric modeling was used for three outcome variables: employment status, hours per week spent working, and earnings. RESULTS Several pain parameters were significantly related to multiple employment outcomes. Prescription medication to treat pain was associated with lower odds of employment, fewer hours working, and lower conditional earnings. Nonprescription opioid use was only related to fewer hours working. Painful days, number of painful conditions, and pain intensity were all related to employment outcomes, but the pattern varied by outcome. The number of painful conditions was most consistently related to employment. Multiple demographic, injury, and educational factors were related to employment, with better outcomes among those with less severe SCI and greater educational achievements. CONCLUSIONS The presence of significant pain and use of either prescription pain medications or the use of nonprescription opioids may have a significant adverse effect on both the probability of employment and quality of employment. Rehabilitation and vocational professionals should routinely assess pain and associated medications in vocational and career planning.

中文翻译:

就业状况,工作时间和脊髓损伤后的可获收入:与疼痛,疼痛的处方药以及非处方类阿片类药物的使用之间的关系。

研究设计横断面自我报告评估。计量经济学建模。目的确定脊髓损伤(SCI)患者中多种疼痛指标,处方止痛药,非处方类阿片使用和质量就业的多种指标之间的关系。设置数据是在美国东南部(US)的一所医科大学中收集的。方法参加研究的4670名成年外伤性SCI至少持续一年的成年人参加了健康与长寿研究。它们是从三个来源确定的,包括一家专科医院和两个基于人口的州SCI监视系统。计量经济学模型用于三个结果变量:就业状况,每周工作时间和收入。结果一些疼痛参数与多种就业结果显着相关。治疗疼痛的处方药与较低的就业机会,较少的工作时间和较低的有条件收入相关。非处方阿片类药物的使用仅与减少工作时间有关。痛苦的日子,痛苦的状况数量和痛苦的强度都与就业结局有关,但模式因结局而异。痛苦状况的数量与就业最一致。多种人口统计学,伤害和教育因素与就业相关,SCI较轻且教育成就较高的人的结局更好。结论严重疼痛的存在以及使用处方止痛药或使用非处方阿片类药物均可能对就业可能性和就业质量产生​​重大不利影响。康复和职业专业人员应在职业和职业规划中例行评估疼痛和相关药物。
更新日期:2019-11-01
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