Vlieland Theodora P M Vliet, de Buck Petronella D M, van den Hout Wilbert B
Leiden University Medical Center, Department of Orthopaedics and Department of Rheumatology, The Netherlands.
Curr Opin Rheumatol. 2009 Mar;21(2):183-8. doi: 10.1097/BOR.0b013e328324e6eb.
To summarize recent literature on vocational rehabilitation interventions in patients with chronic arthritis.
The current literature shows that the prevalence of work disability, including work cessation, sick leave, and any other restriction in the work status among patients with chronic arthritis, is substantial. In some studies, a trend towards a decline in work disability in chronic arthritis is seen, possibly reflecting improvements in medical treatment. The proof of effectiveness of comprehensive vocational rehabilitation interventions aimed at individuals in various stages of work disability is scanty. With prolonged sick leave being a major determinant of job loss, interventions are nowadays developed that specifically address patients with chronic arthritis at a stage in which sick leave occurs, with promising results. Economic evidence is limited, but savings on productivity are likely to outweigh the costs of an effective intervention.
Despite advances in medical treatment, work disability among individuals with chronic arthritis is substantial. Although the (cost-)effectiveness of interventions in patients with established work disability is unclear, the results of studies on interventions employed in the early stages of threatened work ability point to a favorable effect.
总结近期关于慢性关节炎患者职业康复干预的文献。
当前文献表明,慢性关节炎患者中工作残疾的患病率很高,包括工作终止、病假以及工作状态的任何其他限制。在一些研究中,可见慢性关节炎患者工作残疾呈下降趋势,这可能反映了医疗治疗的改善。针对处于不同工作残疾阶段个体的综合职业康复干预效果的证据不足。由于长期病假是失业的主要决定因素,目前已开发出专门针对处于病假阶段的慢性关节炎患者的干预措施,效果良好。经济证据有限,但生产力的节省可能超过有效干预的成本。
尽管医疗治疗取得了进展,但慢性关节炎患者的工作残疾情况仍然严重。虽然对已出现工作残疾的患者进行干预的(成本)效益尚不清楚,但对处于工作能力受到威胁早期阶段所采用干预措施的研究结果显示出有利影响。