Department of Neurosurgery, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.
Division of Endocrinology and Center for Endocrine Tumors, Department of Medicine, Leiden University Medical Center, Leiden, The Netherlands.
Pituitary. 2018 Dec;21(6):593-604. doi: 10.1007/s11102-018-0913-3.
Pituitary tumors may have a considerable impact on patients' functional status, including paid employment, yet research in this area is sparse.
To describe work disability and its determinants in patients treated for a pituitary tumor.
Cross-sectional study including patients treated for a pituitary tumor in the working age (18-65 years), who completed five validated questionnaires assessing work disability [Short Form-Health and Labour Questionnaire, Work Role Functioning Questionnaire 2.0 (WRFQ)], health-related quality of life (HRQoL) and utility (Short Form-36, EuroQoL) and disease burden (Leiden Bother and Needs Questionnaire-Pituitary). Additional data were extracted from the medical records (age, gender, tumor type, treatment, date of diagnosis) and self-reports (marital status, education, endocrine status). Associations of disease-specific and sociodemographic characteristics, HRQoL, and disease burden with (not) having a paid job were examined through multivariate logistic regression.
We included 241 patients (61% female, median age 53 years, median time since diagnosis 11 years), of whom 68 (28%) were without a paid job. Patients who had acromegaly, Cushing's disease, (pan)hypopituitarism, radiotherapy, were single, less educated, lower HRQoL, and increased disease burden were more often without a paid job (p < 0.05). Among those with paid jobs, 41% reported health-related absenteeism in the previous year. The three work incapacitating problems reported by the largest proportion of patients were within the mental and social domain (WRFQ).
Work disability among patients treated for a pituitary tumor is substantial. As impact on social functioning is high, it is strongly advised to incorporate work disability during clinical guidance of patients.
垂体肿瘤可能会对患者的功能状态产生重大影响，包括有薪就业，但该领域的研究却很少。
描述接受垂体肿瘤治疗的患者的工作障碍及其决定因素。
这是一项横断面研究，纳入了处于工作年龄（18-65 岁）的接受垂体肿瘤治疗的患者，这些患者完成了五项经过验证的问卷，评估工作障碍[健康和劳动简表、工作角色功能问卷 2.0（WRFQ）]、健康相关生活质量（HRQoL）和效用（健康状况 36 项简表、EuroQoL）和疾病负担（莱顿困扰和需求问卷-垂体）。从病历（年龄、性别、肿瘤类型、治疗、诊断日期）和自我报告（婚姻状况、教育程度、内分泌状况）中提取了其他数据。通过多变量逻辑回归分析，研究了疾病特异性和社会人口学特征、HRQoL 和疾病负担与（无）有薪工作之间的关系。
我们纳入了 241 名患者（61%为女性，中位年龄 53 岁，中位诊断后时间 11 年），其中 68 名（28%）没有带薪工作。患有肢端肥大症、库欣病、（全）垂体功能减退症、放疗、单身、受教育程度较低、HRQoL 较低和疾病负担较高的患者更有可能没有带薪工作（p<0.05）。在有带薪工作的患者中，41%报告在过去一年中因健康原因缺勤。报告工作能力丧失问题最多的是精神和社会领域（WRFQ）。
接受垂体肿瘤治疗的患者的工作障碍相当大。由于对社会功能的影响很高，强烈建议在为患者提供临床指导时纳入工作障碍。
