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骨关节炎初级保健咨询者预期的显著工作限制:一项前瞻性队列研究。

Anticipated significant work limitation in primary care consulters with osteoarthritis: a prospective cohort study.

作者信息

Wilkie Ross, Phillipson Chris, Hay Elaine M, Pransky Glenn

机构信息

Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Keele, Staffordshire, UK.

School of Social Sciences, The University of Manchester, Manchester, UK.

出版信息

BMJ Open. 2014 Sep 4;4(9):e005221. doi: 10.1136/bmjopen-2014-005221.

Abstract

OBJECTIVE

To describe the prevalence of expected work limitations (EWL) prior to future retirement age in osteoarthritis consulters, and the associated health, sociodemographic and workplace factors.

DESIGN

Population-based prospective cohort study.

SETTING

General practices in Staffordshire, England.

PARTICIPANTS

297 working adults aged 50-65, who had consulted primary care for osteoarthritis.

OUTCOME

EWL was defined using a single question, "Do you think joint pain will limit your ability to work before you reach 69 years old?"

RESULTS

51 (17.2%) indicated that joint pain would not limit their ability to work until 69, 79 (26.6%) indicated EWL and 167 (56.2%) did not know if joint pain would limit work before 69. In bivariate analysis, physical function (OR 0.93; 95% CI 0.91 to 0.96), depression (4.51; 1.81 to 11.3), cognitive symptom (3.84; 1.81 to 8.18), current smoker (2.75; 1.02 to 7.38), age (0.69; 0.58 to 0.82), physically demanding job (3.18; 1.50 to 6.72), no opportunities to retrain (3.01; 1.29 to 7.05) and work dissatisfaction (3.69; 1.43 to 9.49) were associated with EWL. The final multivariate model included physical function and age.

CONCLUSIONS

Only one in five osteoarthritis consulters expected that joint pain would not limit their work participation before 69 years of age. Given the expectation for people to work until they are older, the results highlight the increasing need for clinicians to include work participation in their consultation and implement strategies to address work loss/limitation. Targeting pain-related functional limitation and effective communication with employers to manage workplace issues could reduce EWL.

摘要

目的

描述骨关节炎患者在未达到法定退休年龄之前预期的工作限制(EWL)的患病率,以及相关的健康、社会人口统计学和工作场所因素。

设计

基于人群的前瞻性队列研究。

地点

英国斯塔福德郡的全科医疗诊所。

参与者

297名年龄在50至65岁之间、因骨关节炎而咨询初级医疗服务的在职成年人。

结果

51人(17.2%)表示关节疼痛在69岁之前不会限制他们的工作能力,79人(26.6%)表示存在预期工作限制,167人(56.2%)不知道关节疼痛在69岁之前是否会限制工作。在双变量分析中,身体功能(比值比[OR] 0.93;95%置信区间[CI] 0.91至0.96)、抑郁(4.51;1.81至11.3)、认知症状(3.84;1.81至8.18)、当前吸烟者(2.75;1.02至7.38)、年龄(0.69;0.58至0.82)、体力要求高的工作(3.18;1.50至6.72)、没有再培训机会(3.01;1.29至7.05)和工作不满意(3.69;1.43至9.49)与预期工作限制相关。最终的多变量模型包括身体功能和年龄。

结论

只有五分之一的骨关节炎患者预计关节疼痛在69岁之前不会限制他们的工作参与度。鉴于人们期望工作到更高年龄,研究结果凸显了临床医生在诊疗过程中纳入工作参与度考量并实施应对工作丧失/限制策略的需求日益增加。针对与疼痛相关的功能限制并与雇主进行有效沟通以解决工作场所问题,可能会减少预期工作限制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9350/4158206/cfcb0d9d78ec/bmjopen2014005221f01.jpg

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