血清阴性脊柱关节病患者的工作残疾评估。

Assessment of work disability in seronegative spondyloarthritis.

机构信息

St. Joseph's Health Care, Department of Rheumatology, London, Ontario, Canada.

出版信息

Clin Exp Rheumatol. 2010 Jan-Feb;28(1):35-40.

PMID:20346236

Abstract

OBJECTIVES

Seronegative spondyloarthropathy (SpA) such as ankylosing spondylitis (AS) affects patients during their working years and may contribute to work disability (WD). We determined the prevalence of WD (not working due to illness) and limitations in work productivity in AS using surveys, including the Work Limitations Questionnaire (WLQ).

METHODS

This cross sectional study consisted of 203 patients with SpA received a mailed questionnaire asking about work status, the WLQ, HAQ, BASDAI, BASFI, BAS-G and Functional Comorbidity Index. Relationships between WD, WLQ, demograghics and disease activity were assessed through bivariate correlations and independent t-tests.

RESULTS

Response rate was 40%; 64% had AS; 18.5% were work disabled. Those with WD were significantly older than non-WD, and had significantly higher scores on BASFI, BAS-G and patient global assessment of health. WD also had significantly more comorbid diseases than non-WD. WD prevalence was not associated with current longer duration of disease, higher HAQ scores or higher BASDAI scores. Using the WLQ, the average decrease in work productivity attributable to health was 8.3%. Decreases in time management (37.3%), physical demands (28.5%), mental-interpersonal demands (23.0%) and output (33.1%) were noted. Reduced productivity was not associated with demographic factors. Productivity loss for those still working was highly correlated (r>0.6) with the HAQ, BASFI, BASDAI, and BAS-G. Subjects with primary AS had less WD than those with other SpA (related to psoriasis, inflammatory bowel disease or reactive arthritis). WD was associated with older age and, HAQ scores and self-reported function on the BASFI. Losses in work productivity in those still working were highly correlated with the HAQ, BASFI, BASDAI and BAS-G. AS had less work disability than other SpA. Adjusting for gender, age, and duration of diseased did not affect the results.

CONCLUSIONS

WD occurred in 18.5% of SpA, and work productivity (in those working) was reduced by 8.3%. WD was associated with older age and greater SpA disease activity. Losses in work productivity were highly correlated with currently used clinical outcome measures such as HAQ, BASFI, BASDAI and BAS-G.

摘要

目的

血清阴性脊柱关节病（SpA），如强直性脊柱炎（AS），会在患者的工作年龄段影响他们，并可能导致工作残疾（WD）。我们通过问卷调查，包括工作限制问卷（WLQ），确定 AS 患者的 WD（因病无法工作）患病率和工作生产效率受限的情况。

方法

本横断面研究纳入了 203 名 SpA 患者，他们收到了一份邮寄问卷，询问工作状况、WLQ、HAQ、BASDAI、BASFI、BAS-G 和功能合并症指数。通过双变量相关性和独立 t 检验评估 WD、WLQ、人口统计学和疾病活动之间的关系。

结果

应答率为 40%；64%为 AS 患者；18.5%为 WD。WD 患者明显比非 WD 患者年龄更大，BASFI、BAS-G 和患者整体健康评估的评分也更高。WD 患者的合并症也明显多于非 WD 患者。WD 的患病率与当前疾病持续时间较长、HAQ 评分较高或 BASDAI 评分较高无关。使用 WLQ，健康导致的工作生产效率平均下降 8.3%。时间管理（37.3%）、身体需求（28.5%）、精神人际需求（23.0%）和产出（33.1%）下降。生产力下降与人口统计学因素无关。仍在工作的患者的生产力损失与 HAQ、BASFI、BASDAI 和 BAS-G 高度相关（r>0.6）。原发性 AS 患者的 WD 发生率低于其他 SpA（与银屑病、炎症性肠病或反应性关节炎相关）。WD 与年龄较大、HAQ 评分和 BASFI 自我报告功能有关。仍在工作的患者的工作生产效率损失与 HAQ、BASFI、BASDAI 和 BAS-G 高度相关。AS 的 WD 发生率低于其他 SpA。调整性别、年龄和疾病持续时间并不影响结果。