在职和病休的慢性重复性劳损患者的生活质量与疾病认知
Quality of life and illness perception in working and sick-listed chronic RSI patients.
作者信息
Sluiter Judith K, Frings-Dresen Monique H W
机构信息
Coronel Institute of Occupational Health, Academic Medical Center, Universiteit van Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
出版信息
Int Arch Occup Environ Health. 2008 Feb;81(4):495-501. doi: 10.1007/s00420-007-0222-z. Epub 2007 Jul 19.
OBJECTIVE
To study differences between working and sick-listed chronic repetitive strain injury (RSI) patients in the Netherlands with respect to indices of quality of life and illness perception.
METHODS
In a cross-sectional design, one questionnaire was sent to all 3,250 members of the national RSI patient association. For descriptive purposes, demographics, work status and complaint-related variables such as severity, type, duration, and extent of complaints were asked for. Indices of quality of life were assessed through seven SF-36 subscales (physical (role) functioning, emotional role functioning, social functioning, pain, mental health and vitality). A work-ability estimate and VAS scales were used to assess complaint-related decrease in quality of life. Illness perception was assessed through the brief illness perception questionnaire (IPQ-B). Working patients and sick-listed patients were identified. Tests between the two independent groups were performed and P-values < 0.01 were considered significant.
RESULTS
Data from 1,121 questionnaires were used. Two-thirds of the respondents worked and one-third were sick-listed. Average duration of complaints was over 5 years in both groups. The sick-listed patients reported significantly more severe and extensive complaints than did the working patients. In addition, sick-listed patients reported significantly poorer mental health, physical (role) functioning, emotional role functioning, pain, vitality, and work-ability. With respect to illness perception, both groups showed the same concerns about their complaints, but sick-listed patients had significantly more distorted perceptions in their emotional response, identity, treatment control, personal control, timeline, and life consequences. Complaint-related decrease in quality of life was 31% in the working patients and 49% in the sick-listed patients.
CONCLUSION
The study found a greater number and severe complaints among sick-listed chronic RSI patients and a considerably decreased quality of life because of their complaints. These findings may allow for a better treatment focus in the future.
目的
研究荷兰在职和已列入病假的慢性重复性劳损（RSI）患者在生活质量指标和疾病认知方面的差异。
方法
采用横断面设计，向全国RSI患者协会的3250名成员发送了一份问卷。为了进行描述，询问了人口统计学、工作状态以及与投诉相关的变量，如投诉的严重程度、类型、持续时间和范围。通过七个SF - 36子量表（身体（角色）功能、情感角色功能、社会功能、疼痛、心理健康和活力）评估生活质量指标。使用工作能力评估和视觉模拟量表（VAS）来评估与投诉相关的生活质量下降情况。通过简短疾病认知问卷（IPQ - B）评估疾病认知。确定了在职患者和已列入病假的患者。对两个独立组进行了测试，P值<0.01被认为具有统计学意义。
结果
使用了1121份问卷的数据。三分之二的受访者在职，三分之一已列入病假。两组的投诉平均持续时间均超过5年。已列入病假的患者报告的投诉比在职患者严重得多且范围更广。此外，已列入病假的患者报告的心理健康、身体（角色）功能、情感角色功能、疼痛、活力和工作能力明显较差。在疾病认知方面，两组对自己的投诉都有相同的担忧，但已列入病假的患者在情感反应、身份认同、治疗控制、个人控制、时间线和生活后果方面的认知明显更扭曲。在职患者中与投诉相关的生活质量下降为31%，已列入病假的患者中为49%。
结论
该研究发现，已列入病假的慢性RSI患者的投诉数量更多、更严重，且由于投诉导致生活质量大幅下降。这些发现可能有助于未来更好地聚焦治疗。
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