Geuskens Goedele A, Burdorf Alex, Hazes Johanna M W
Department of Rheumatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
J Rheumatol. 2007 Jun;34(6):1248-60. Epub 2007 Apr 1.
To obtain quantitative estimates of restrictions in participation, i.e., the performance of social roles, in patients with rheumatoid arthritis (RA).
Participation categories were selected from the International Classification of Functioning, Disability and Health (ICF) (preliminary) Comprehensive Core Set for RA. A literature search was performed utilizing PubMed and PsychInfo. Articles were included if: (1) performance in at least one of the participation categories was described; (2) patients with RA were compared to a healthy reference population or their performance over time was described; (3) published between 1995 and 2005; and (4) written in English.
Seven participation categories were selected from the Comprehensive Core Set for RA, resulting in 50 articles included in the review. Almost all studies focused on remunerative employment (n = 30), recreation and leisure (n = 17), or both (n = 3). RA patients had an increased risk of being without a paid job compared to well adjusted reference groups (absolute difference 4% to 28%, odds ratios 1.2 to 3.4). Restrictions in employment occurred already within the early phase of RA and varied greatly among studies. Two years after diagnosis, disability benefits increased up to roughly 30% in some European cohorts. In the category of recreation and leisure most studies focused on socializing (n = 16). Patients with longstanding RA experienced a decrease in socializing (range, Cohen's d, -0.46 to -1.0), but changes over time were minor.
RA patients experience restrictions in the performance of remunerative employment and in recreation and leisure (socializing). Due to the lack of studies, no conclusions on other ICF categories describing social roles could be made.
获取类风湿关节炎（RA）患者参与度受限情况的定量评估，即社会角色表现情况。
参与类别选自国际功能、残疾和健康分类（ICF）（初步版）RA综合核心集。利用PubMed和PsychInfo进行文献检索。纳入的文章需满足以下条件：（1）描述了至少一个参与类别的表现；（2）将RA患者与健康对照人群进行了比较，或描述了其随时间的表现；（3）发表于1995年至2005年之间；（4）用英文撰写。
从RA综合核心集中选取了七个参与类别，最终纳入综述的文章有50篇。几乎所有研究都聚焦于有偿工作（n = 30）、娱乐和休闲（n = 17）或两者（n = 3）。与调整良好的对照组相比，RA患者无薪工作的风险增加（绝对差异4%至28%，优势比1.2至3.4）。就业受限在RA早期就已出现，且不同研究之间差异很大。诊断两年后，一些欧洲队列中的残疾福利增加了约30%。在娱乐和休闲类别中，大多数研究聚焦于社交（n = 16）。患有长期RA的患者社交活动减少（范围，科恩d值，-0.46至-1.0），但随时间的变化较小。
RA患者在有偿工作以及娱乐和休闲（社交）方面的表现受到限制。由于缺乏研究，无法对描述社会角色的其他ICF类别得出结论。
