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多发性硬化症患者的自评健康状况和就业状况。

Self-rated health and employment status in patients with multiple sclerosis.

机构信息

Department of Neurology, Faculty of Medicine, University of PJ Safarik, Kosice, Slovakia.

出版信息

Disabil Rehabil. 2010;32(21):1742-8. doi: 10.3109/09638281003734334.

DOI:10.3109/09638281003734334
PMID:20350069
Abstract

PURPOSE

The aim is to explore the association between self-rated health and employment status in patients with multiple sclerosis (MS) when controlling for age, gender, functional disability, disease duration, anxiety and depression.

METHOD

One hundred eighty-four people with MS completed a sociodemographic questionnaire that included questions on employment status, the first item of the Short Form-36 Health Survey and the Hospital Anxiety and Depression Scale. Functional disability was assessed using the Expanded Disability Status Scale. The probability of good self-rated health in employed persons was investigated using stepwise logistic regression analyses.

RESULTS

Patients with MS who reported good self-rated health were 2.46 times more likely to be employed (95% confidence interval [CI]: 1.08-5.59). Patients without anxiety were 2.64 times more likely to be employed (95%CI: 1.23-5.67). Patients with higher EDSS scores were 0.49 times less likely to be employed (95%CI: 0.33-0.70). Age, gender, disease duration and the presence of depression did not show an increased chance of patient employment.

CONCLUSIONS

Patients with MS with good self-rated health are more likely to be employed, even after adjusting for age, gender, education, functional disability, disease duration, depression and anxiety. Dependent on the findings of longitudinal studies unravelling the relevant causal pahways, self-rated health might be used as a quick and cheap prognostic marker, which could warn about the possible loss of employment, or changes in functional disability.

摘要

目的

本研究旨在控制年龄、性别、功能障碍、疾病持续时间、焦虑和抑郁等因素后,探讨多发性硬化症(MS)患者自感健康状况与就业状况之间的关系。

方法

184 名 MS 患者完成了一份社会人口学问卷,其中包括就业状况、健康调查简表(SF-36)的第一项和医院焦虑抑郁量表(HADS)的问题。使用扩展残疾状况量表(EDSS)评估功能障碍。采用逐步逻辑回归分析调查就业人群中自感健康状况良好的概率。

结果

自感健康状况良好的 MS 患者就业的可能性是对照组的 2.46 倍(95%置信区间[CI]:1.08-5.59)。无焦虑的患者就业的可能性是对照组的 2.64 倍(95%CI:1.23-5.67)。EDSS 评分较高的患者就业的可能性降低 0.49 倍(95%CI:0.33-0.70)。年龄、性别、疾病持续时间和抑郁的存在并没有增加患者就业的机会。

结论

即使在调整年龄、性别、教育程度、功能障碍、疾病持续时间、抑郁和焦虑等因素后,自感健康状况良好的 MS 患者更有可能就业。基于揭示相关因果途径的纵向研究结果,自感健康状况可能被用作一种快速且廉价的预后标志物,可以预测可能的失业或功能障碍变化。

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