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应对方式对多发性硬化症长期就业的影响:一项前瞻性研究。

The influence of coping styles on long-term employment in multiple sclerosis: A prospective study.

机构信息

KG Jebsen MS Research Centre, Institute of Clinical Medicine, University of Bergen, Bergen, Norway/Norwegian Multiple Sclerosis Competence Centre, Department of Neurology, Haukeland University Hospital, Bergen, Norway.

Norwegian Multiple Sclerosis Competence Centre, Department of Neurology, Haukeland University Hospital, Bergen, Norway.

出版信息

Mult Scler. 2017 Jun;23(7):1008-1017. doi: 10.1177/1352458516667240. Epub 2016 Sep 6.

Abstract

BACKGROUND

The aim was to investigate predictive values of coping styles, clinical and demographic factors on time to unemployment in patients diagnosed with multiple sclerosis (MS) during 1998-2002 in Norway.

METHOD

All patients ( N = 108) diagnosed with MS 1998-2002 in Hordaland and Rogaland counties, Western Norway, were invited to participate in the long-term follow-up study in 2002. Baseline recordings included disability scoring (Expanded Disability Status Scale (EDSS)), fatigue (Fatigue Severity Scale (FSS)), depression (Beck Depression Inventory (BDI)), and questionnaire assessing coping (the Dispositional Coping Styles Scale (COPE)). Logistic regression analysis was used to identify factors associated with unemployed at baseline, and Cox regression analysis to identify factors at baseline associated with time to unemployment during follow-up.

RESULTS

In all, 41 (44%) were employed at baseline. After 13 years follow-up in 2015, mean disease duration of 22 years, 16 (17%) were still employed. Median time from baseline to unemployment was 6 years (±5). Older age at diagnosis, female gender, and depression were associated with patients being unemployed at baseline. Female gender, long disease duration, and denial as avoidant coping strategy at baseline predicted shorter time to unemployment.

CONCLUSION

Avoidant coping style, female gender, and longer disease duration were associated with shorter time to unemployment. These factors should be considered when advising patients on MS and future employment.

摘要

背景

本研究旨在调查应对方式、临床和人口统计学因素对 1998-2002 年期间在挪威被诊断为多发性硬化症(MS)的患者失业时间的预测价值。

方法

所有在 1998-2002 年期间在挪威西部霍达兰和罗加兰郡被诊断为 MS 的患者(n=108)均被邀请参加 2002 年的长期随访研究。基线记录包括残疾评分(扩展残疾状况量表(EDSS))、疲劳(疲劳严重程度量表(FSS))、抑郁(贝克抑郁量表(BDI))和评估应对方式的问卷(性格应对方式量表(COPE))。使用逻辑回归分析确定与基线时失业相关的因素,使用 Cox 回归分析确定与随访期间失业时间相关的基线时因素。

结果

共有 41 名(44%)患者在基线时就业。在 2015 年进行了 13 年的随访后,平均疾病持续时间为 22 年,仍有 16 名(17%)患者就业。从基线到失业的中位时间为 6 年(±5)。诊断时年龄较大、女性和抑郁与基线时患者失业相关。女性、较长的疾病持续时间和基线时否认作为回避应对策略预测了失业时间较短。

结论

回避应对方式、女性和较长的疾病持续时间与失业时间较短相关。在为 MS 患者及其未来就业提供建议时,应考虑这些因素。

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