疲劳导致中轴型脊柱关节炎患者工作效率受损:一项英国横断面研究。

Fatigue contributes to work productivity impairment in patients with axial spondyloarthritis: a cross-sectional UK study.

作者信息

Espahbodi Shima, Bassett Paul, Cavill Charlotte, Freeth Mandy, Hole John, Sengupta Raj

机构信息

Royal National Hospital for Rheumatic Diseases (RNHRD), Bath, UK.

StatsConsultancy Ltd., Buckinghamshire, UK.

出版信息

Clin Exp Rheumatol. 2017 Jul-Aug;35(4):571-578. Epub 2017 Feb 24.

DOI:
Abstract

OBJECTIVES

To determine factors associated with absenteeism, presenteeism, work productivity loss (WPL), and daily activity impairment in UK patients with AxSpA using standardised measures.

METHODS

490 patients with AxSpA completed (1) Work Productivity and Impairment questionnaire (WPAI), providing measures for absenteeism, presenteeism, WPL and daily activity impairment, and (2) BASDAI, BASFI, BASMI, Jenkins Sleep scale, Patient Global Assessment disease activity (PGA), back pain night and anytime, EQ-5D for mobility, self-care, daily activities, pain/discomfort, anxiety/depression, EQ-VAS Health State Today, FACIT fatigue, for health-related disease factors. Multivariate linear and logistic regression determined associations between WPAI measures and health-related factors.

RESULTS

301(61%) patients provided WPAI measurements, 76% were male, 87% HLA-B27+. Mean (SD) WPAI scores for absenteeism were 5.1%(19.2), presenteeism 22%(24.3), WPL 23.2%(25.7), activity impairment 34.8%(27.3). Absenteeism was associated with higher fatigue levels and more likely in patients with nrAxSpA. Presenteeism and WPL were both associated higher fatigue levels, BASDAI, and BASFI respectively. Daily activity impairment was associated with higher fatigue levels, BASFI, PGA, EQ-VAS, and smoking.

CONCLUSIONS

Work productivity and impairment are associated with fatigue, disease activity, and functional ability in UK patients with AxSpA. The strong association of fatigue with all work measures as well as with daily activity impairment emphasises the need to better understand the impact of fatigue on patients' quality of life. Improving fatigue may help to optimise work status.

摘要

目的

采用标准化测量方法,确定英国轴性脊柱关节炎(AxSpA)患者旷工、出勤但工作效率低下、工作效率损失(WPL)和日常活动受损的相关因素。

方法

490例AxSpA患者完成了(1)工作效率与受损情况问卷(WPAI),提供旷工、出勤但工作效率低下、WPL和日常活动受损的测量数据,以及(2)巴斯强直性脊柱炎疾病活动指数(BASDAI)、巴斯强直性脊柱炎功能指数(BASFI)、巴斯强直性脊柱炎脊柱活动指数(BASMI)、詹金斯睡眠量表、患者整体疾病活动评估(PGA)、夜间及任何时间的背痛情况、用于评估活动能力、自我护理、日常活动、疼痛/不适、焦虑/抑郁的EQ-5D、今日EQ-VAS健康状况、功能性评估癌症治疗疲劳量表(FACIT疲劳量表),以获取与健康相关的疾病因素。多变量线性和逻辑回归分析确定了WPAI测量值与健康相关因素之间的关联。

结果

301例(61%)患者提供了WPAI测量数据,其中76%为男性,87%为HLA-B27阳性。旷工的WPAI平均(标准差)得分为5.1%(19.2),出勤但工作效率低下为22%(24.3),WPL为23.2%(25.7),活动受损为34.8%(27.3)。旷工与更高的疲劳水平相关,且非放射学轴性脊柱关节炎(nrAxSpA)患者旷工的可能性更大。出勤但工作效率低下和WPL分别与更高的疲劳水平、BASDAI和BASFI相关。日常活动受损与更高的疲劳水平、BASFI、PGA、EQ-VAS以及吸烟相关。

结论

在英国AxSpA患者中,工作效率和受损情况与疲劳、疾病活动及功能能力相关。疲劳与所有工作指标以及日常活动受损之间的紧密关联强调了有必要更好地了解疲劳对患者生活质量的影响。改善疲劳状况可能有助于优化工作状态。

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