Reisine Susan, Fifield Judith, Walsh Stephen J, Feinn Richard
Department of Behavioral Sciences and Community Health, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT 06030, USA.
J Rheumatol. 2003 Sep;30(9):2045-53.
To assess health status differences of women with fibromyalgia syndrome (FM) who are employed and not employed, and to evaluate whether employment and family work influence the health status of women with FM as it does for women in community studies.
Participants were 287 women recruited from 118 randomly selected rheumatology practices. They completed telephone interviews that collected data on demographic characteristics, health status, symptoms, family work, and social support. One hundred thirty-seven were employed and 150 were not employed. Formal statistical analysis, including estimation and testing, focused on the relationship between employment and 4 health status measures: Modified Health Assessment Questionnaire (MHAQ), visual analog scale (VAS) for pain on the interview day, number of painful areas, and VAS for fatigue on the interview day. The relationship between employment and these measures was evaluated using analysis of variance, chi-square, linear regression, and ordinal logistic regression.
The majority of participants reported high levels of symptoms and poor health status. In the bivariate analyses, employed women reported significantly less pain, less fatigue, and better functional status than those who were not employed. In the multivariate analyses, employment remained a significant factor in explaining number of painful areas, functional status (MHAQ), and fatigue, with employed women reporting better health status than those not employed. Employment was not associated with pain on the day of the interview when other factors were considered in the analysis. The psychological demands of family work were consistently related to all dependent measures of health status, as those with greater psychological demands reported worse health status.
As in community studies, employed women with FM report better health status than women who are not employed. The demands of family work exert a serious and significant effect on every dimension of health status and should be the focus of greater clinical attention. Further followup will assess whether employment has a protective effect for women with FM as in community studies or whether women with less severe FM tend to remain in the workforce.
评估就业和未就业的纤维肌痛综合征（FM）女性的健康状况差异，并评估就业和家务劳动是否像在社区研究中那样影响FM女性的健康状况。
参与者为从118个随机选择的风湿病诊所招募的287名女性。她们完成了电话访谈，收集了有关人口统计学特征、健康状况、症状、家务劳动和社会支持的数据。其中137名就业，150名未就业。正式的统计分析，包括估计和检验，重点关注就业与4项健康状况指标之间的关系：改良健康评估问卷（MHAQ）、访谈当天疼痛的视觉模拟量表（VAS）、疼痛部位数量以及访谈当天疲劳的VAS。使用方差分析、卡方检验、线性回归和有序逻辑回归评估就业与这些指标之间的关系。
大多数参与者报告症状水平高且健康状况差。在双变量分析中，就业女性报告的疼痛、疲劳明显少于未就业女性，功能状态也更好。在多变量分析中，就业仍然是解释疼痛部位数量、功能状态（MHAQ）和疲劳的重要因素，就业女性的健康状况比未就业女性更好。在分析中考虑其他因素时，就业与访谈当天的疼痛无关。家务劳动的心理需求始终与健康状况的所有相关指标相关，因为心理需求较大的人报告的健康状况较差。
与社区研究一样，就业的FM女性报告的健康状况比未就业女性更好。家务劳动的需求对健康状况的各个方面都产生了严重且显著的影响，应该成为更多临床关注的焦点。进一步的随访将评估就业是否像在社区研究中那样对FM女性具有保护作用，或者病情较轻的FM女性是否更倾向于留在劳动力队伍中。
