Exploring the affecting factors of work performance in traumatic digits amputation replanted patients: a systematic review

About 87.2% of traumatic digits amputation replanted patients would love to be employed, but the employment rate of these patients was only 20.7% in Taiwan. Their work performance was the main reason that caused the low employment rate. Therefore, to explore the factors that affected their work performance would be a key point to improve their employment rate.

Present study adopted an evidence-based systematic review of English and Chinese literature to answer the question: What are the factors that affect the work performance of traumatic digits amputation replanted patients? The PICO (P: traumatic amputation of digits, I: replantation surgery, C: intact fingers, O: work performance.) were used as keywords to search in major databases, including PubMed, Cochrane, Taiwan national library periodical literature system, and Airiti Library. Studies were included in this review if they (1) were systematic review, RCT, or case report, (2) report a least one or more digits replantation, and (3) involve work performance issues.

A total of 411 literature were searched, and 12 of them were included. The main factors that affect the work performance of traumatic digits amputation replanted patients were motor function, sensory and psychological problems. Motor functions included limited joint range of motion, weak muscle strength, and poor motor control; sensory involved the problems of hypersensitivity; and psychological problems contained the issues of declined self-image, self-esteem, and stigma. Those factors would have negative effects on the work performance of traumatic digits amputation replanted patients, though they might be able to achieve their jobs.

Most of traumatic digits amputation replanted literatures mainly focused on postoperative survival rate, nursing and wound recovery, and discussion on neurovascular function, but rarely involved employment-related issues for this group of patients. Moreover, in addition to motor function problems, psychological issues were also important problems that could affect the work performance of traumatic digits amputation replanted patients. It was implying that multi-disciplinary interventions were needed to assist traumatic digits amputation replanted patients to optimize their work performance and increase the employment rate. In order to boost the employment rate of traumatic digits amputation replanted patients, further research and discussion of the affecting factors of work performance in traumatic digits amputation replanted patients are critical and indispensable.