Predictors of Return to Work Among Patients Attending a Long-term Treatment and Rehabilitation Service for Functional Neurological Disorder (FND) and Related Conditions
Notice bibliographique
Résumé
INTRODUCTION: Limited data is available on the prognosis of patients with FND concerning their ability to return to work. OBJECTIVES: To identify factors associated with the ability to return to work in patients with FND following treatment and rehabilitation. METHODS: We retrospectively assessed the employment outcomes of 79 consecutively evaluated patients. Patients were referred at the inception of an FND Program for adults. The majority of patients were unemployed, on sickness leave and or disability benefits at the time of their referral (n=71). Their median age was 48 years. Most patients were of female gender (n=50), in a relationship (n=53), with no dependants (n=64). Most patients had a referral diagnosis of mixed functional neurological symptoms (n=35), presenting with a combination of motor, sensory, cogniform or dissociative seizure symptoms. Among patients distinct phenomenological presentations, the most common referral diagnosis was functional sensory disorder (n=16). Twenty two patients had a concurrent structural neurological disorder. Seven patients had an accident compensation claim, and twenty had a workers’ compensation or employment insurance claim at the time of referral. RESULTS: Approximately 30 % of patients were able to return to some work (n=24) within five years or less, and all those who were in employment at the time of the referral continued to hold a job for the duration of their treatment. We identified a negative correlation between patients’ ability to return to work and the length of employment interruption, with patients more recently out of work (within a year prior to the referral) being most able to return to work (odds ratio = 2; 95% CI, 1.2 to 3.8). We previously analyzed employment figures at 18 months of the service operation. Return to work was moderately lower at that point at 19%, but with maintained negative correlation with the length of employment interruption. There was a negative correlation between having a work-related financial claim and the ability to return to work (p <0.001). There was no statistically significant correlation between demographic variables (gender, age, relationship status, or having dependants) and the ability to return to work, nor was there a statistically significant correlation between the phenomenology of Functional Neurological Disorder (motor, sensory, cogniform, non-epileptic attack disorder or mixed) and the ability to return to work. CONCLUSIONS: Early and continuous treatment of employed or recently unemployed patients with Functional Neurological Disorder is associated with better occupational outcomes. Having a work-related compensation claim is correlated with negative occupational outcomes. There is a need for further research into occupational rehabilitation, specially for patients receiving work-related compensation claim. DISCLOSURE OF INTEREST: None Declared
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».