Department of Rheumatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Rheumatology (Oxford). 2011 Apr;50(4):789-98. doi: 10.1093/rheumatology/keq359. Epub 2010 Dec 13.
To determine the influence of job characteristics on the prognosis of patients with early inflammatory joint conditions.
In a prospective cohort study of 210 workers with inflammatory joint conditions present for <12 months, data were collected by questionnaires and medical examination at baseline and after 6 and 12 months. Outcomes were self-reported pain and physical functioning, and the presence of at least one swollen joint. Generalized estimation equations were used to study the influence of job characteristics on prognosis in pain and function, and logistic regression analysis to study prognosis in swollen joints.
Pain and physical functioning strongly improved during the first 6-month period (40 and 14%, respectively), and improvement slowed considerably in the second 6-month period. The proportion of workers with swollen joints dramatically decreased from 58 to 20 then 7%. The good prognosis in pain and physical functioning in the first 6 months was hampered by persistent high levels of inflammation, older age, low perceived health control and low social support. Job characteristics had no influence on the prognosis of pain and swollen joints, whereas workers with frequent manual material handling or high job demands improved ∼50% less in physical functioning.
Job characteristics had no influence on the disease characteristics pain and swollen joints, but strongly affected the consequences of disease in physical functioning. Among patients with early inflammatory joint conditions, who do not recover in functional abilities, adjustments in working conditions may be imperative.
确定工作特征对早期炎症性关节疾病患者预后的影响。
在一项前瞻性队列研究中,对 210 名炎症性关节疾病患者(发病<12 个月)进行了研究,通过问卷和基线及 6 个月和 12 个月时的医学检查收集数据。结果为自我报告的疼痛和身体功能,以及至少一个关节肿胀的存在。广义估计方程用于研究工作特征对疼痛和功能预后的影响,逻辑回归分析用于研究关节肿胀的预后。
疼痛和身体功能在最初的 6 个月内显著改善(分别为 40%和 14%),而在第二个 6 个月内改善速度明显减慢。关节肿胀的工人比例从 58%急剧下降到 20%,然后是 7%。前 6 个月疼痛和身体功能的良好预后受到持续高水平的炎症、年龄较大、感知健康控制能力较低和社会支持较低的阻碍。工作特征对疼痛和关节肿胀的预后没有影响,而经常进行手动物料搬运或高工作要求的工人在身体功能方面的改善程度要低约 50%。
工作特征对疾病特征疼痛和关节肿胀没有影响,但对身体功能的疾病后果有很大影响。在早期炎症性关节疾病患者中,如果不能恢复身体功能,可能需要调整工作条件。