McCormack Róisín C, O'Shea Finbar, Doran Michele, Connolly Deirdre
Discipline of Occupational Therapy, Trinity Centre for Health Sciences, St James' Hospital, Dublin, Ireland.
Rheumatology Department, St James' Hospital, Dublin, Ireland.
Musculoskeletal Care. 2018 Sep;16(3):398-404. doi: 10.1002/msc.1237. Epub 2018 Mar 25.
Work disability and job loss are serious consequences of rheumatic diseases (RDs), and fatigue is a symptom of RDs commonly reported to have an impact on work performance. A FAtigue ManagEment in Work (FAME-W) programme was developed to facilitate the self-management of fatigue in work. The present pilot study explored if FAME-W could facilitate individuals with RDs to manage fatigue in work and improve their ability to meet work demands.
Twenty-seven individuals with a variety of rheumatic diagnoses completed a 4-week, 2-h occupational therapy-led self-management programme. Each week focused on fatigue-related topics, including fatigue and activity management, pain management and joint protection, mental well-being, effective communication with employers and work colleagues, and employment legislation. Individual workplace ergonomic assessments were also offered. Study measures (work function, fatigue, pain, mood and self-efficacy) were completed prior to starting FAME-W, immediately post-intervention and 12 weeks post-intervention.
Participants (56% male) had a mean age of 43 years. No significant improvements were observed immediately post-programme. However, at the 12-week follow-up, significant improvements were reported in meeting work demands (scheduling [p = 0.046], output [p = 0.002], physical [p = 0.003], mental [p = 0.016]), fatigue [p = 0.001], pain [p = 0.01], anxiety [p = 0.001], depression [p < 0.001], self-efficacy [p < 0.001] and Arthritis Impact Measurement Scales 2-Short Form (physical: p = 0.005; symptoms: p = 0.010; affect: p = 0.010; social: p = 0.001).
Significant improvements were reported in participants' ability to meet various demands of their work 3 months post-FAME-W. These findings suggest that FAME-W has the potential to assist individuals with RDs to meet the demands of their work, although further research is required to test the effectiveness of this intervention.
工作残疾和失业是风湿性疾病（RDs）的严重后果，疲劳是RDs常见的一种症状，通常被认为会影响工作表现。一项工作中的疲劳管理（FAME-W）计划旨在促进工作中疲劳的自我管理。本试点研究探讨了FAME-W是否能帮助患有RDs的个体管理工作中的疲劳，并提高他们满足工作要求的能力。
27名患有各种风湿性疾病的个体完成了一项为期4周、每周2小时的由职业治疗师主导的自我管理计划。每周聚焦于与疲劳相关的主题，包括疲劳与活动管理、疼痛管理与关节保护、心理健康、与雇主和同事的有效沟通以及就业法规。还提供了个体工作场所的人体工程学评估。研究指标（工作功能、疲劳、疼痛、情绪和自我效能感）在开始FAME-W之前、干预后即刻以及干预后12周时完成。
参与者（56%为男性）的平均年龄为43岁。在计划结束后即刻未观察到显著改善。然而，在12周随访时，报告在满足工作要求方面有显著改善（日程安排[p = 0.046]、产出[p = 0.002]、身体方面[p = 0.003]、心理方面[p = 0.016]）、疲劳[p = 0.001]、疼痛[p = 0.01]、焦虑[p = 0.001]、抑郁[p < 0.001]、自我效能感[p < 0.001]以及关节炎影响测量量表2 - 简表（身体方面：p = 0.005；症状方面：p = 0.010；情感方面：p = 0.010；社会方面：p = 0.001）。
在FAME-W结束3个月后，参与者满足工作各种要求的能力有显著改善。这些发现表明FAME-W有潜力帮助患有RDs的个体满足工作要求，尽管需要进一步研究来检验这种干预措施的有效性。
