Benner Joyce L, Hilberink Sander R, Veenis Thessa, van der Slot Wilma M A, Roebroeck Marij E
Department of Rehabilitation Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands.
Sophia Rehabilitation Center, The Hague, the Netherlands.
Dev Med Child Neurol. 2017 Jul;59(7):762-768. doi: 10.1111/dmcn.13423. Epub 2017 Mar 17.
To explore the course of employment in adults with cerebral palsy (CP) over 14 years, and to identify subgroups at risk for unemployment.
Sixty-five adults with CP (33 males, 32 females; baseline age 25y 8mo, standard deviation [SD] 3y 2mo; intellectual impairment 25%; bilateral CP 65%) participated in a prospective cohort study. Self-reports of employment and work hours per week in 1996, 2000, and 2010 were documented. The course of employment (including sheltered work) and work hours per week were analysed, using generalized estimating equations (GEE).
Overall, employment rate was stable over time (38-45%, p=0.413), but lower than in the general population (75-86%, p<0.001). Employment rates were specifically low in adults with intellectual impairment, bilateral CP, and in adults with Gross Motor Function Classification System (GMFCS) levels IV and V. Work hours per week declined (35.0 [SD 7.9] to 31.2 [SD 10.3], p=0.033), especially among females (32.3 [SD 6.4] to 23.4 [SD 7.4], p<0.001). Similar to the general population, females often worked part-time.
Employment was low compared with the general population, but remained stable in the long term; however, work hours per week decreased. Adults with intellectual impairment, bilateral CP, and GMFCS levels IV and V are subgroups at risk for unemployment.
探讨14年间成年脑瘫患者的就业历程，并确定存在失业风险的亚组。
65名成年脑瘫患者（33名男性，32名女性；基线年龄25岁8个月，标准差[SD]3岁2个月；智力障碍25%；双侧脑瘫65%）参与了一项前瞻性队列研究。记录了1996年、2000年和2010年的就业自我报告及每周工作时长。使用广义估计方程（GEE）分析就业历程（包括庇护性工作）和每周工作时长。
总体而言，就业率随时间保持稳定（38 - 45%，p = 0.413），但低于一般人群（75 - 86%，p < 0.001）。智力障碍、双侧脑瘫的成年患者以及粗大运动功能分类系统（GMFCS）为IV级和V级的成年患者就业率尤其低。每周工作时长下降（从35.0[SD 7.9]降至31.2[SD 10.3]，p = 0.033），尤其是女性（从32.3[SD 6.4]降至23.4[SD 7.4]，p < 0.001）。与一般人群类似，女性常从事兼职工作。
与一般人群相比，就业率较低，但长期保持稳定；然而，每周工作时长减少。智力障碍、双侧脑瘫以及GMFCS为IV级和V级的成年患者是存在失业风险的亚组。
