Department of Rheumatology, Lund University Hospital, SE-221 85 Lund, Sweden.
Rheumatology (Oxford). 2010 Sep;49(9):1739-46. doi: 10.1093/rheumatology/keq145. Epub 2010 May 28.
To identify factors, individual and work related, influencing work ability, and to assess the association between work ability and employment status, activities of daily life (ADLs) and quality of life in patients with SSc.
Fifty-seven consecutive patients (53 females/4 males) with SSc (47 lcSSc/10 dcSSc) were included. Median age was 58 [interquartile range (IQR) 47-62] years and disease duration 14 (9-19) years. The patients were assessed for socio-demographic characteristics, disease parameters, symptoms, work ability, empowerment and adaptations in a workplace, social support, ADLs and quality of life.
Work ability, assessed with the Work Ability Index (WAI) could be evaluated in 48 of 57 patients. The correlation between employment status and WAI was good (r(s) = 0.79, P < 0.001). Thirteen patients had good or excellent WAI, 15 had less good and 20 had poor WAI. There were no significant differences between subgroups of WAI and socio-demographic characteristics, disease duration or degree of skin and lung involvement. However, patients with good WAI expressed milder perceived symptoms (pain, fatigue and impaired hand function; P < 0.001). Patients with better WAI had better competence (P < 0.001), better possibility of adaptations at work (P < 0.01) and impact at work (P < 0.01) than those with poorer WAI.
In SSc, pain, fatigue and impaired hand function have a dominant impact on the WAI. Employment interventions should include support in job adaptations as well as self-management strategies to help patients deal with pain and fatigue and to enhance the confidence to perform their work.
确定影响工作能力的个体和工作相关因素，并评估工作能力与 SSc 患者的就业状况、日常生活活动（ADL）和生活质量之间的关系。
纳入 57 例连续 SSc 患者（53 名女性/4 名男性）（47 例局限性硬皮病/10 例弥漫性硬皮病）。中位年龄为 58 岁（四分位距 47-62 岁），病程 14 年（9-19 年）。评估患者的社会人口统计学特征、疾病参数、症状、工作能力、工作场所的赋权和适应能力、社会支持、ADL 和生活质量。
57 例患者中有 48 例可评估工作能力，采用工作能力指数（WAI）评估。就业状况与 WAI 之间的相关性较好（r(s)=0.79，P<0.001）。13 例患者的 WAI 较好或优秀，15 例为一般，20 例为较差。WAI 亚组与社会人口统计学特征、病程或皮肤和肺部受累程度无显著差异。然而，WAI 较好的患者感知症状较轻（疼痛、疲劳和手部功能受损；P<0.001）。WAI 较好的患者工作能力较好（P<0.001），工作适应能力较好（P<0.01），工作影响较小（P<0.01）。
在 SSc 中，疼痛、疲劳和手部功能受损对 WAI 有显著影响。就业干预应包括工作适应的支持以及自我管理策略，以帮助患者应对疼痛和疲劳，增强完成工作的信心。
