Giornale italiano di medicina del lavoro ed ergonomia
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G Ital Med Lav Ergon · Jul 2007
[EuroQol-5D FOR quality of life assessment in cardiac rehabilitation].
EuroQol-5D (EQ-5D) is a well-known generic instrument measuring quality of life in different diseases; it includes 5 dimensions (mobility, self-care, daily activities, pain-discomfort, anxiety and depression) and a Visual Analogue Scale that evaluates patients' perceived health status. The aim of this study was to verify the utility of the EQ-5D in the Italian Cardiac Rehabilitation setting. The study population consisted of 248 consecutive cardiac rehabilitation inpatients (176 males and 72 females, aged 65.3 +/- 10.75 years), 200 of whom had recently undergone cardiac surgery (aortocoronary by-pass and/or valve replacement). ⋯ Furthermore, cardiac-surgery patients reported more problems in self-care and pain-discomfort than ischemic/heart failure patients, and patients in NYHA Classes III and IV reported more difficulties in mobility than patients in lower NYHA classes. In 15% of patients, of heterogeneous socio-demographic and clinical characteristics, no problems in any of the 5 EQ-5D dimensions were reported: this group was characterised by scores under the clinical cut-off on anxiety and depression and showed a better quality of life on the VAS. Results confirm the robustness of the EuroQol-SD psychometric properties and the instrument's utility for the routine assessment of quality of life in the Italian Cardiac Rehabilitation setting.
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G Ital Med Lav Ergon · Jul 2007
[Model of chemical risk assessment (D.L 25/2002), applied in 19 chemical industries of the Province of Bergamo].
The aim of this work is to describe a model for the evaluation of chemical risk, according to the legislative decree 25/2002, planned by U. O. ⋯ L. "Ospedali Riuniti di Bergamo", in collaboration with "Gruppo Industriali Chimici dell'Unione Industriali-Provincia di Bergamo" and applied in 19 Chemical Industries of the Province of Bergamo. The objective of the model is the rationalization of the procedures to ponder the levels of exposure and to value different typologies of risk using and manipulating chemical substances with the purpose to optimize the relationship among the attention for safety, workers health and the employment of resources.
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G Ital Med Lav Ergon · Jul 2007
[LBP and disability in nursing personnel performing manual handing of patients in a large Italian hospital].
Low back pain (LBP) has been recognized as a major cause of sickness and disability among health care workers (HCW) who perform handling of patients. A survey was carrying out to investigate risk factors for LBP and related absenteeism and disability in a group of HCW. 333 HCW were examined in 2003 and 2005 and data were collected on personal, occupational and clinical history and on risk factors for LBP and related absenteeism. Psychosocial factors and LBP related disability were evaluated by means of Karasek's Job Content questionnaire and Oswestry Low Back disability Index. ⋯ Subjects with chronic LBP referred a significantly higher level of disability as compared to acute LBP subjects. Moreover, a significantly relationship was found (p = 0.04) between high level of disability (group III e IV of ODI index) and high perceived job demand. The introduction of questionnaires to collect disability and psychosocial factors is highly recommended in periodic health surveillance program of HCW performing manual handling of patients.
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Rheumatic diseases, like many other chronic diseases, represent an important public health burden. To reduce the social and economic impact of these pathologies, an appropriate management of these conditions should be encouraged based on the use of established intervention strategies. ⋯ CBT include the teaching of life and coping skills that can assist the patient in productive problem solving and prevention or minimization of future pain episodes and stressful events. Moreover, several studies suggest that the cognitive-behavioural approach is efficacious in rheumatoid arthritis, osteoarthritis and fibromyalgia in improving not only the psychological adjustment during the course of the disease but also physical function.
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G Ital Med Lav Ergon · Jan 2007
Randomized Controlled TrialCognitive behavioural components in physiotherapy management of chronic whiplash associated disorders (WAD)--a randomised group study.
Different types of integrated management programmes have lately been introduced in the treatment of Whiplash Associated Disorders (WAD). In this study regular primary care physiotherapy and physiotherapy management with integrated components of cognitive-behavioural origin was compared in an experimental group study. The predictive value of self-efficacy was also addressed. ⋯ In conclusion cognitive behavioural components can be useful in physiotherapy treatment for patients with chronic WAD, but their contributions are not yet fully understood. Self-efficacy is related to patients' use of different coping styles. Positive long-term outcomes in WAD-patients could therefore be improved by boosting self-efficacy and by teaching patients to use active, adaptive coping strategies.