Quality of life
Factors affecting attainment of paid employment after lung transplantation

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Abstract

Background

Limited data exist regarding return to or attainment of paid employment after lung transplantation. Accordingly, the purpose of our study was to identify the issues relating to paid employment after this procedure.

Methods

We conducted a mailed survey using Dillman's protocol. We mailed questionnaires to surviving Toronto General Hospital lung transplant recipients (n = 190). We used descriptive statistics, t-tests, and chi-square tests to analyze the data.

Results

A total of 117 lung transplant recipients completed the questionnaires (70% response rate). The mean age of respondents was 51 ± 13 years. Fifty-one percent of the sample were women and 72% were married. Cystic fibrosis and chronic obstructive pulmonary disease were the most frequent pre-transplant diagnoses. Fifty-six percent of participants had paid employment at some point before transplant. After transplant, 37% of respondents obtained employment. Individuals who obtained paid employment were more likely to be younger (p = 0.002), to have university degrees (p = 0.02), to report higher health ratings (p = 0.001), and to feel physically able to work (p = 0.01). They also were more likely to express a desire to enter the paid workforce (p < 0.0001); to describe receiving physician encouragement to work (p < 0.0001); to identify the possibility of obtaining paid employment as a primary motivator for the transplantation (p = 0.01); and to report that their previous jobs were available after transplantation (p = 0.01). All individuals who did not obtain paid employment cited personal or transplant-related factors.

Conclusions

Medical and social factors influence attainment of paid employment after lung transplantation. Important components of the pre-transplant assessment are discussion of expectations about attaining employment and openly exploring the recipient's motivation for employment.

Section snippets

Sample

We conducted this study in accordance with the guidelines of the Human Subjects Committee, approved by the Research Ethics Board of the University Health Network. We surveyed all surviving lung transplant recipients from Toronto General Hospital who met the study criteria (n = 190). The eligibility criteria included that 1) lung transplantation had occurred at least 3 months before the survey, 2) transplantation occurred at Toronto General Hospital, and 3) the individual was ≥18 years of age.

Demographics

A total of 117 lung transplant recipients completed the questionnaire, representing a 70% response rate. Participants ranged in age from 18 to 71 years (mean and SD, 51 ± 13 years) with 16.2% being of retirement age. Women represented 51% of the participants, and 72% of participants were married. We found no differences in demographics between respondents and non-respondents in these areas.

Education and health ratings

The majority (69%) of participants had completed at least high school or vocational training, and 25% held

Discussion

With recent improvements in long-term survival rates after lung transplantation, increasing attention is now being focused on quality of life that includes re-integration into society and the workforce.11 In the current study, 37% of recipients were able to obtain paid employment after lung transplantation. These individuals were more likely to be younger, to have higher education levels, to have higher self-reported health ratings, and to indicate that the potential to work after

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