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      Work ability and productivity in patients with diabetic foot

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          Abstract

          OBJECTIVE:

          To assess work ability and productivity in patients with diabetic foot.

          METHODS:

          This investigation was a cross-sectional controlled study. A total of 117 individuals were selected from March to June 2014 and allocated to group A (patients without diabetes, n=43), group B (diabetes patients without foot ulcers, n=43), or group C (patients with diabetic foot, n=31). Two validated instruments, the Work Limitations Questionnaire (WLQ) and the Work Productivity and Activity Impairment Questionnaire General Health v2.0 (WPAI-GH), were used to assess work ability and productivity.

          RESULTS:

          The groups were homogeneous regarding age and sex; however, patients in group C had a lower education level than the other participants ( p=0.006). The median WLQ scores for groups A, B, and C were 0.0121, 0.0146, and 0.0852, respectively ( p<0.0001). The WPAI-GH scores revealed a mean productivity loss of 20% for groups A and B and 100% for group C ( p<0.0001).

          CONCLUSIONS:

          Patients with diabetic foot showed decreased work ability and productivity.

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          Most cited references29

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          The Work Limitations Questionnaire

          The objective of this work was to develop a psychometrically sound questionnaire for measuring the on-the-job impact of chronic health problems and/or treatment ("work limitations").
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            Work performance of employees with depression: the impact of work stressors.

            Depressed employees are vulnerable to adverse work outcomes. We hypothesized that work performance is impaired by depression and is worsened by exposure to psychosocial work stressors. Longitudinal cohort study with surveys administered at baseline, 6, 12, and 18 months. Recruitment in primary care offices. A total of 14,268 were screened; 286 depressed, employed adults (18-62 years) and 193 controls were enrolled. At-work limitations (presenteeism) and absenteeism were measured with the Work Limitations Questionnaire (WLQ) and WLQ Work Absence Module, respectively. Work stressors were assessed using a modified version of the Job Content Questionnaire. Univariate and multivariate tests assessed the degree to which at-work limitations were related to depression and/or stressful work. Presenteeism and absenteeism were significantly worse for the depression group at each time point (p < or = .001). In cross-sectional models, presenteeism was associated with more severe depression symptoms, poorer general physical health, psychologically demanding work, the interaction ofpsychologically demanding work with depression, and less job control (r2 range = .33-.54). Absences were explained by depression symptom severity and poorer general physical health but not work stressors (r2 = .19). Because of minimal change in the work stressors, their longitudinal effects on outcomes were mostly nonsignificant. This study found that depression symptoms are related to work absences and impaired work performance, and results partly confirmed that work stressors add to this impact. Results suggest that workers with depression may benefit from care involving medical and vocational interventions.
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              Prevention of diabetic foot complications

              This paper discussed the importance of prevention of diabetic foot ulcers and our institution’s protocol for prevention, reviewing the existing evidence in the literature regarding the effectiveness of the preventive approach. Diabetes mellitus is the second most significant cause of disease in Singapore after ischaemic heart disease. National University Hospital, Singapore, adopts a two-pronged strategy for the management of diabetic foot ulcers. The most important strategy is prevention, and education is key. Education should mainly be directed at patients and caregivers, but also professionals (general practitioners, allied health professionals and nurses) so that they can effectively educate patients and caregivers. Patient education includes care of diabetes mellitus, care of the foot and use of appropriate footwear. Patients also tend to have poor foot hygiene. Annual foot screening for diagnosed diabetics plays an important role. However, prolonged and sustained government intervention is necessary to provide education and screening on a national scale.
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                Author and article information

                Journal
                Clinics (Sao Paulo)
                Clinics (Sao Paulo)
                Clinics
                Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
                1807-5932
                1980-5322
                19 March 2019
                2019
                : 74
                : e421
                Affiliations
                [I ]Mestrado Profissional em Ciencias Aplicadas a Saude, Universidade do Vale do Sapucai (UNIVAS), Pouso Alegre, MG, BR
                [II ]Departamento de Enfermagem, Mestrado Profissional em Ciencias Aplicadas a Saude, Universidade do Vale do Sapucai (UNIVAS), Pouso Alegre, MG, BR
                [III ]Departamento de Bioestatistica, Universidade do Vale do Sapucai (UNIVAS), Pouso Alegre, MG, BR
                [IV ]Divisao de Cirurgia Plastica, Mestrado Profissional em Ciencias Aplicadas a Saude, Universidade do Vale do Sapucai (UNIVAS), Pouso Alegre, MG, BR
                Author notes
                *Corresponding author. E-mail: souzadiba@ 123456gmail.com
                Author information
                http://orcid.org/0000-0002-0728-5788
                http://orcid.org/0000-0002-1793-012X
                http://orcid.org/0000-0002-1549-685X
                http://orcid.org/0000-0002-8713-2940
                Article
                cln_74p1
                10.6061/clinics/2019/e421
                6424068
                0e515df2-9bbf-492d-861c-b0adde85e375
                Copyright © 2019 CLINICS

                This is an Open Access article distributed under the terms of the Creative Commons License ( http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.

                History
                : 25 May 2018
                : 19 December 2018
                Categories
                Original Article

                Medicine
                diabetes mellitus,diabetic foot,efficiency,absenteeism,work
                Medicine
                diabetes mellitus, diabetic foot, efficiency, absenteeism, work

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