Function, coping and health as predictors of sick leave after rehabilitation

Abstract Background Function, coping and health are central factors in rehabilitation after injury or sickness. To investigate how these factors are associated with sick leave during 12 months after rehabilitation is the aim of this study. Methods A sample of 412 rehabilitation patients ≤ 67years were included. They were all employed, and referred to inter-professional rehabilitation in western Norway. Rehabilitation consisted of physical activity/exercise, cognitive approaches and pain management. In two surveys patients reported mental (MCS) and physical (PCS) function (SF-36), self-perceived health (EQ-VAS) and coping (SOC-13). Register data on sick leave during 12 months in the calendar year after rehabilitation was retrieved from Statistics Norway and categorised to; non, (n = 168), ≤ 364 days (n = 152) and 365 days (n = 92). Ordinal regression was used to analyse association between sick leave and MCS, PCS, EQ-VAS and SOC-13, adjusted for age, sex and diagnoses. Results The levels of MCS and PCS (SF-36) were found to be associated with sick leave; OR 0.96, 95% CI 0.92-0.99, p = 0.004 and OR 0.93, 95% CI 0.90-0.97, p < 0.001, respectively (Pseudo R2 = 0.1133). EQ-VAS and SOC-13 were significant predictors of sick leave in crude analysis (EQ-VAS: OR 0.97, 95% CI 0.96-0.98, p < 0.001. SOC-13: OR 0.98, 95% CI 0.95-0.98, p < 0.001), but not in the fully adjusted model (EQ-VAS: OR 0.98, 95% CI 0.96-1.01, p = 0.178. SOC-13: OR 0.99, 95% CI 0.99-1.03, p = 0.479). Conclusions Patientś self-reported mental and physical function were associated with sick leave 12 months after inter-professional rehabilitation. Higher level of function was associated with no sick leave. In our study, patient’s self-reported health and coping were not associated with sick leave. This suggest that interventions for functional improvement are beneficial in health care strategies to help patients return to work after injury or sickness. Key messages • Achieved higher physical and mental function after rehabilitation seems to contribute to reduced sick leave after injury or sickness. • Improving function should remain a central factor in rehabilitation.


Background:
Function, coping and health are central factors in rehabilitation after injury or sickness. To investigate how these factors are associated with sick leave during 12 months after rehabilitation is the aim of this study.

Methods:
A sample of 412 rehabilitation patients 67years were included. They were all employed, and referred to interprofessional rehabilitation in western Norway. Rehabilitation consisted of physical activity/exercise, cognitive approaches and pain management. In two surveys patients reported mental (MCS) and physical (PCS) function (SF-36), selfperceived health (EQ-VAS) and coping . Register data on sick leave during 12 months in the calendar year after rehabilitation was retrieved from Statistics Norway and categorised to; non, (n = 168), 364 days (n = 152) and 365 days (n = 92). Ordinal regression was used to analyse association between sick leave and MCS, PCS, EQ-VAS and SOC-13, adjusted for age, sex and diagnoses.

Conclusions:
Patientś self-reported mental and physical function were associated with sick leave 12 months after inter-professional rehabilitation. Higher level of function was associated with no sick leave. In our study, patient's self-reported health and coping were not associated with sick leave. This suggest that interventions for functional improvement are beneficial in health care strategies to help patients return to work after injury or sickness. Key messages: Achieved higher physical and mental function after rehabilitation seems to contribute to reduced sick leave after injury or sickness.
Improving function should remain a central factor in rehabilitation. Globally, the reforms of healthcare systems aim to bring back the patient at the centre of these organisations after the issues related to the COVID-19 outbreak. The patient returns to be fully considered, as an individual whose must be protected physical and psychological health as well as social well-being. Humanization of care is returning to the foreground. For centuries, art has been used throughout Europe in the health context for its power to support patients in their disease. Today, this approach can be rediscovered in historical hospitals, where tradition, art and assistance coexist. This study aims to investigate the interest for the development of projects for the humanization of care exploiting the artistic heritage of the historical hospitals owned by Health Authorities. The cross-case analysis was chosen as study design. The case studies are the historical hospitals in the city centre of Venice, Florence, and Rome. The evaluation of the proposal was carried out through semi-structured interviews with the general managers of the Health Authorities, the medical directors of the selected hospitals and the delegates for the protection and promotion of cultural heritage. The results were analysed using a qualitative model (coding). All respondents welcomed the proposal to launch projects for the humanization of care that foresee the use of the artistic heritage of the historical hospitals to involve patients in the field of health care. Interviewees expressed the desire to invest human and structural resources in the development of these projects. Moreover, directors suggest choosing a specific target with which to start the experimentation and to dispense a specific training to future engaged social and health personnel. The implementation of projects for the humanization of care using the artistic heritage of historical hospitals can be replicated worldwide where healthcare institutions have a cultural wealth to be handed down, shared and valued. Key messages: In the post COVID-19 era, it is strategic to exploit artistic heritage owned by the Health Authority for the positive impact in the patient's experience. Artistic heritage claims its role as a health service for supporting patients, caregivers and also health workforce.

Background:
The core spirit of the Hospitalist system aims to set up dedicated wards, integrate physician manpower, focus on whole-person care, in order to cope with the aging population and Covid-19 pandemic, and to ensure that both parties, the medical personnel and patients, can provide or receive complete medical care. As the Taiwan medical system is facing a paradigm shift, the Taiwan hospitalist system will play iii528 European Journal of Public Health, Volume 32 Supplement 3, 2022