Šabanagić-Hajrić Selma, Alajbegović Azra
Department of Neurology, Clinical Center of the University of Sarajevo.
Med Glas (Zenica). 2015 Feb;12(1):61-7.
To evaluate the impacts of education level and employment status on health-related quality of life (HRQoL) in multiple sclerosis patients.
This study included 100 multiple sclerosis patients treated at the Department of Neurology, Clinical Center of the University of Sarajevo. Inclusion criteria were the Expanded Disability Status Scale (EDSS) score between 1.0 and 6.5, age between 18 and 65 years, stable disease on enrollment. Quality of life (QoL) was evaluated by the Multiple Sclerosis Quality of Life-54 questionnaire (MSQoL-54). Mann-Whitney and Kruskal-Wallis test were used for comparisons. Linear regression analyses were performed to evaluate prediction value of educational level and employment status in predicting MSQOL-54 physical and mental composite scores.
Full employment status had positive impact on physical health (54.85 vs. 37.90; p les than 0.001) and mental health (59.55 vs. 45.90; p les than 0.001) composite scores. Employment status retained its independent predictability for both physical (r(2)=0.105) and mental (r(2)=0.076) composite scores in linear regression analysis. Patients with college degree had slightly higher median value of physical (49.36 vs. 45.30) and mental health composite score (66.74 vs. 55.62) comparing to others, without statistically significant difference.
Employment proved to be an important factor in predicting quality of life in multiple sclerosis patients. Higher education level may determine better QOL but without significant predictive value. Sustained employment and development of vocational rehabilitation programs for MS patients living in the country with high unemployment level is an important factor in improving both physical and mental health outcomes in MS patients.
评估教育水平和就业状况对多发性硬化症患者健康相关生活质量（HRQoL）的影响。
本研究纳入了萨拉热窝大学临床中心神经科治疗的100例多发性硬化症患者。纳入标准为扩展残疾状态量表（EDSS）评分在1.0至6.5之间，年龄在18至65岁之间，入组时病情稳定。生活质量（QoL）通过多发性硬化症生活质量-54问卷（MSQoL-54）进行评估。采用曼-惠特尼检验和克鲁斯卡尔-沃利斯检验进行比较。进行线性回归分析以评估教育水平和就业状况对预测MSQOL-54身体和心理综合评分的预测价值。
全职就业状况对身体健康综合评分（54.85对37.90；p小于0.001）和心理健康综合评分（59.55对45.90；p小于0.001）有积极影响。在线性回归分析中，就业状况对身体（r(2)=0.105）和心理（r(2)=0.076）综合评分均保持独立的预测性。与其他患者相比，拥有大学学位的患者身体（49.36对45.30）和心理健康综合评分（66.74对55.62）的中位数略高，但无统计学显著差异。
就业被证明是预测多发性硬化症患者生活质量的重要因素。较高的教育水平可能决定更好的生活质量，但无显著预测价值。对于生活在高失业率国家的MS患者，持续就业和开展职业康复项目是改善MS患者身心健康结局的重要因素。
