Nyland Morten, Naess Halvor, Birkeland Jon Steinar, Nyland Harald
Institute of Clinical Medicine, University of Bergen, Bergen, Norway.
Institute of Clinical Medicine, University of Bergen, Bergen, Norway Department of Neurology, Haukeland University Hospital, Bergen, Norway.
BMJ Open. 2014 Nov 26;4(11):e005798. doi: 10.1136/bmjopen-2014-005798.
To examine the effect of early clinical and demographic factors on occupational outcome, return to work or awarded permanent disability pension in young patients with chronic fatigue syndrome (CFS).
Longitudinal cohort study.
A written self-management programme including a description of active coping strategies for daily life was provided.
SETTING, PARTICIPANTS: Patients with CFS after mononucleosis were evaluated at Department of Neurology, Haukeland University Hospital during 1996-2006 (contact 1). In 2009 self-report questionnaires were sent to all patients (contact 2).
Primary measure was employment status at contact 2. Secondary measures included clinical symptoms, and Fatigue Severity Scale (FSS) scores on both contacts, and Work and Social Adjustment Scale (WSAS) at contact 2.
Of 111 patients at contact 1, 92 (83%) patients returned the questionnaire at contact 2. Mean disease duration at contact 1 was 4.7 years and at contact 2 11.4 years. At contact 1, 9 (10%) were part-time or full-time employed. At contact 2, 49 (55%) were part-time or full-time employed. Logical regression analysis showed that FSS≥5 at contact 2 was associated with depression, arthralgia and long disease duration (all at contact 1).
About half of younger patients with CFS with long-term incapacity for work experienced marked improvement including full-time or part-time employment showing better outcomes than expected. Risk factors for transition to permanent disability were depression, arthralgia and disease duration.
探讨早期临床和人口统计学因素对慢性疲劳综合征(CFS)青年患者职业结局、重返工作岗位或获得永久性残疾抚恤金的影响。
纵向队列研究。
提供一份书面自我管理方案,其中包括对日常生活积极应对策略的描述。
地点、参与者:1996 - 2006年期间,在豪克兰大学医院神经科对单核细胞增多症后患有CFS的患者进行评估(首次接触)。2009年,向所有患者发送自我报告问卷(第二次接触)。
主要指标是第二次接触时的就业状况。次要指标包括两次接触时的临床症状、疲劳严重程度量表(FSS)得分,以及第二次接触时的工作和社会适应量表(WSAS)得分。
在首次接触的111名患者中,92名(83%)患者在第二次接触时返回了问卷。首次接触时的平均病程为4.7年,第二次接触时为11.4年。首次接触时,9名(10%)患者为兼职或全职工作。第二次接触时,49名(55%)患者为兼职或全职工作。逻辑回归分析显示,第二次接触时FSS≥5与抑郁、关节痛和病程较长(均在首次接触时)相关。
约一半长期无法工作的CFS青年患者病情有显著改善,包括全职或兼职工作,结果好于预期。转为永久性残疾的危险因素是抑郁、关节痛和病程。