Employment 12 months after kidney transplantation: An in-depth bio-psycho-social analysis of the Swiss Transplant Cohort

• Published in: PloS one 2017-04, Vol.12 (4, Art. e0175161), p.17-12:4, Art. e0175161<17
• Main Authors: Danuser, Brigitta, Simcox, Amira, Studer, Regina, Koller, Michael, Wild, Pascal
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age; Aged; Anxiety; Berufliche Reintegration; Biology and Life Sciences; Chronic illnesses; Chronische Krankheit; Cohort Studies; Demographics; Depression (Psy); Diabetes; Diabetes mellitus; Dialyse; Dialysis; Education; Employment; Employment - psychology; Employment - statistics & numerical data; End-stage renal disease; Erwerbsbeteiligung; Erwerbsquote; Female; Gesundheitszustand; Human health and pathology; Humans; Kidney diseases; Kidney transplantation; Kidney Transplantation - psychology; Kidney Transplantation - statistics & numerical data; Kidney transplants; Life Sciences; Liver; Male; Medicine and Health Sciences; Medizin; Medizinische Rehabilitation; Mental depression; Mental health; Middle Aged; Models, Statistical; Occupational health; Patients; Physical Sciences; Population; Psychosozialer Faktor; Qualifikation; Quality of life; Rehabilitand; Research and Analysis Methods; Santé publique et épidémiologie; Schweiz; Social analysis; Social Class; Social factors; Social Sciences; Society; Studies; Surgery; Switzerland; Transplantation; Transplants & implants; Urology and Nephrology; Young Adult
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0175161

Return to work with or after a chronic disease is a dynamic process influenced by a variety of interactions between personal, work, societal and medical resources or constraints. The aim of this study was to identify predictors for employment 12 months after transplantation in kidney patients, applying a bio-psycho-social model. All kidney patients followed in the Swiss Transplant Cohort between May 2008 and December 2012, aged 18 to 65 were assessed before, 6 and 12 months after transplantation. Of the 689 included patients, 56.2% worked 12 months post- transplantation compared to 58.9% pre-transplantation. Age, education, self-perceived health (6 months post- transplantation), pre- transplantation employment and receiving an organ from a living donor are significant predictors of employment post- transplantation. Moreover, while self-perceived health increased post- transplantation, depression score decreased only among those employed 12 months post- transplantation. Pre- transplantation employment status was the main predictor for post- transplantation employment (OR = 18.6) and was associated with sex, age, education, depression and duration of dialysis. An organ from a living donor (42.1%) was more frequent in younger patients, with higher education, no diabetes and shorter waiting time to surgery. Transplantation did not increase employment in end-stage kidney disease patients but helped maintaining employment. Pre-transplantation employment has been confirmed to be the most important predictor of post-transplantation employment. Furthermore, socio-demographic and individual factors predicted directly and indirectly the post-transplantation employment status. With living donor, an additional predictor linked to social factors and the medical procedure has been identified.