Low employment and low willingness of being reemployed in Chinese working-age maintained hemodialysis patients.
Low employment and low willingness of being reemployed in Chinese working-age maintained hemodialysis patients.
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DOI：
10.1080/0886022x.2017.1361834
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发表时间：
2017-11
期刊：
影响因子：
3
通讯作者：
Chen J
中科院分区：
文献类型：
--
作者：
Huang B;Lai B;Xu L;Wang Y;Cao Y;Yan P;Chen J
目的：回归社会对改善维持性血液透析（MHD）患者的生活质量具有重要作用，而保留就业是其核心推动力之一。本研究旨在评估中国维持性血液透析患者的就业状况，并确定失业的变量。方法：中国上海四个透析中心的MHD患者入选。我们评估患者的就业状况，目前的社会功能，血液透析方式，年收入和一般健康状况。对目前失业的劳动年龄段患者进行离职原因和再就业意愿评估。结果：共纳入231例患者，其中114例患者在血液透析前1年未工作。在117名就业患者中，16名患者在透析开始前辞职，49名患者在透析开始时辞职，26名患者在透析几个月后辞职。离职的主要原因是身体不适、透析与工作时间冲突、缺乏雇主的支持和家人的抵制。在166名处于工作年龄的患者中，26名患者有工作。失业患者具有年龄较大、文化程度较低、家庭年收入较高、女性比例较高、血流量较低、身体功能和社会功能较低、周末血液透析和HDF/HF频率较低的特点。在140名失业患者中，只有47名患者有再就业的意愿。年龄大（OR 3.13，95%CI，1.08-9.1）、受教育程度低（OR 1.97，95%CI，1.05-5.92）、家庭收入高（OR 7.75，95%CI，2.49-24.14）与失业状况呈正相关。结论：MHD工作年龄段患者的就业率和再就业意愿较低。缺乏社会和家庭的支持也阻碍了患者重返社会，但HD治疗质量仍有问题。
Aim: Returning to society plays an important role in improving the quality of life in maintenance hemodialysis (MHD) patients, and retention of employment is one of the core enablers. The study is to assess the employment status and to determine the variables for unemployment in Chinese MHD patients. Methods: Prevalent MHD patients from four dialysis centers in Shanghai China were enrolled. We assessed patients’ employment status, current social functioning, hemodialysis modality, annual income and general health condition. Among current unemployed working-age patients, the reasons of quitting jobs and willingness of being reemployed were evaluated. Results: A total of 231 patients were studied, among which 114 patients were unemployed 1 year before hemodialysis. Among 117 employed patients, 16 patients quitted jobs before dialysis inception, while 49 patients quitted jobs at the initiation of HD, and 26 patients followed after a few months’ HD. The main reasons for ceasing employment were physical insufficiency, conflict between dialysis and work schedules, lack of support from employers and resistance from family members. Among the 166 patients who were in their working age, 26 patients were employed. The unemployed patients had the characters of elder age, lower education level, higher annual family income, higher female ratio, lower blood flow, lower physical functioning, and social functioning and lower frequency of weekend hemodialysis and HDF/HF. Among the 140 unemployed patients, only 47 patients had the willingness of being reemployed. Their unemployment status was positively associated with elder age ((OR) 3.13, 95% CI, 1.08–9.1), lower education level ((OR) 1.97, 95% CI, 1.05–5.92), and higher family income ((OR) 7.75, 95% CI, 2.49–24.14). Conclusion: Ratio of employment and willingness of being reemployed was low in MHD working-age patients. Lack of social and family’s support also hampered patient’s returning to society except for the HD treatment quality.