Study On The Readiness For Return-To-Work And Its Influential Factors In Patients With Cirrhosis

Research ObjectTo investigate the current situation of the readiness for return-to-work in patients with cirrhosis,and to explore the influence of patients' general disease information,coping style,social support and self-efficacy on the readiness for return-to-work,so as to provide theoretical basis for the intervention measures to improve the readiness for return-to-work.Research MethodThis study is a cross-sectional survey,using convenient sampling method,patients with liver cirrhosis who were hospitalized in hepatology Department of three first-class hospitals in Shandong Province from January 2019 to December 2019 were selected as the research object,and were investigated with questionnaire at the time of reexamination one month after discharge.The survey tools were general information and disease-related factors questionnaire,readiness for return-to-work,coping style,and disease uncertainty,social support and self-efficacy questionnaire,a total of 335 questionnaires were distributed and 318 of them were valid,the effective collecting rate was 94.93%.The data were input by two persons and analyzed by SPSS22.0 software.The main statistical analysis methods include statistical description analysis,rank sum test(Mann Whitney U test and Kruskal Wallis H test),Spearman rank correlation analysis,ordered multiple logistic regression analysis and binary logistic regression analysis.Research Result1.Among 318 patients with cirrhosis,202 were not returned to work,116 were returned to work,and the return rate was 36.48%.In patients who did not return to work,112 patients(55.45%)were identified in the pre-contemplation stage,54 patients(26.73%)in the contemplation stage,17 patients(8.42%)in the action preparation self-evaluation stage,19 patients(9.40%)in the action preparation behavior stage.In patients who have returned to work,78 patients(67.20%)were identified in the active maintenance stage and 38 patients in the uncertain maintenance stage(32.80%).2.Univariate analysis showed that age,marriage status,economic income and medical expense types were the factors which have significant effects on the levels of the readiness for Return-To-Work Scale in all patients(P<0.05);while the number of hospitalizations only had significant effects in patients who have not returned to work(P<0.05),and the duration only in patients who have returned to work(P<0.05).3.Spearman rank correlation analysis showed that the level of readiness for return-to-work was positively correlated with the level of positive response,social support and self-efficacy(rs>0,P<0.05),and was negatively correlated with the average level of negative response and disease uncertainty(rs<0,P<0.05).4.The orderly multiple logistic regression analysis showed that positive coping and self-efficacy were the protective factors for the readiness for return-to-work of the patients with cirrhosis who did not return to work,while ages 50 to 60,non self paying medical treatment,the level of disease uncertainty and negative coping were the risk factors.According to the binary logistic regression,positive response,social support and family support were the protective factors for the readiness for return-to-work of returned cirrhosis patients,while the level of disease uncertainty was the independent risk factor.conclusion1.The overall return rate of patients with cirrhosis is low.The patients who have not returned to work tended to have low levels of the readiness for return-to-work,and most of them were in the pre-contemplation stage or contemplation stage.The patients who have returned to work tend to have high levels of the readiness for return-to-work,and most of them can maintain their work actively.2.The level of readiness for return-to-work in patients who have not returned to work would be affected by age,type of medical expenses,coping style,level of disease uncertainty and level of self-efficacy.The readiness of returned cirrhosis patients for return-to-work would be affected by positive coping style,social support and the level of disease uncertainty.3.Positive coping and self-efficacy were the protective factors for the readiness for return-to-work of cirrhotic patients who did not return to work.The risk factors were age 50-60,non self paying medical treatment,disease uncertainty and negative coping.Medical staff should strengthen the education of disease knowledge,reduce the level of patients'disease uncertainty,improve their self-efficacy,and then change the coping style of patients to help patients who have not returned to work to a higher level of preparation.4.Active response and family support were protective factors for the readiness for return-to-work of returned cirrhosis patients.The level of disease uncertainty was a risk factor.Medical staff should mobilize family support,guide the patients to actively respond,reduce their disease uncertainty,and then help the returned patients to maintain a high level of readiness.