Rochester General Health System, Rochester, New York, USA.
Arthritis Care Res (Hoboken). 2012 Feb;64(2):176-83. doi: 10.1002/acr.20676.
To examine the productivity of patients with scleroderma (systemic sclerosis [SSc]) both outside of and within the home in a large observational cohort.
One hundred sixty-two patients completed the Work Productivity Survey. Patients indicated whether or not they were employed outside of the home, how many days per month they missed work (employment or household work) due to SSc, and how many days per month productivity was decreased by ≥50%. Patients also completed other patient-reported outcome measures. We developed binomial regression models to assess the predictors of days missed from work (paid employment or household activities). The covariates included: type of SSc, education, physician and patient global assessments, Health Assessment Questionnaire (HAQ) disability index (DI), Functional Assessment of Chronic Illness Therapy-Fatigue, and Center of Epidemiologic Studies Depression Scale Short Form.
The mean age of patients was 51.8 years and 52% had limited cutaneous SSc. Of the 37% of patients employed outside of the home, patients reported missing 2.6 days per month of work and had 2.5 days per month of productivity reduced by half. Of the 102 patients who were not employed, 39.4% were unable to work due to their SSc. When we assessed patients for household activities (n = 162), patients missed an average of 8 days of housework per month and had productivity reduced by an average of 6 days per month. In the regression models, patients with lower education and poor assessment of overall health by a physician were more likely to miss work outside of the home. Patients with limited cutaneous SSc and high HAQ DI scores were more likely to miss work at home.
SSc has a major impact on productivity at home and at work. Nearly 40% of patients reported disability due to their SSc.
在一个大型观察队列中,检查硬皮病(系统性硬皮病[SSc])患者的家庭内外的生产力。
162 名患者完成了工作生产力调查。患者表明他们是否在家庭以外就业,由于 SSc 每月缺勤多少天(带薪就业或家务劳动),以及每月有多少天生产力下降≥50%。患者还完成了其他患者报告的结果测量。我们开发了二项式回归模型来评估工作缺勤(带薪就业或家务活动)的预测因素。协变量包括:SSc 的类型、教育程度、医生和患者的总体评估、健康评估问卷(HAQ)残疾指数(DI)、慢性疾病治疗疲劳的功能评估以及流行病学研究抑郁量表简短形式。
患者的平均年龄为 51.8 岁,52%为局限性皮肤 SSc。在 37%的在外就业的患者中,患者报告每月缺勤 2.6 天,每月有 2.5 天的生产力下降一半。在 102 名未就业的患者中,有 39.4%因 SSc 而无法工作。当我们评估患者的家务活动(n=162)时,患者每月平均缺勤 8 天家务,每月生产力平均下降 6 天。在回归模型中,教育程度较低且医生对整体健康状况评估较差的患者更有可能在外就业缺勤。局限性皮肤 SSc 和较高 HAQ DI 评分的患者更有可能在家中缺勤。
SSc 对家庭和工作的生产力有重大影响。近 40%的患者因 SSc 而残疾。