Abu Bakar Fakhriah, Sazliyana Shaharir Syahrul, Mohd Rozita, Mohamed Said Mohd Shahrir, Rajalingham Sakthiswary, Wei Yen Kong
Department of Internal Medicine, Rheumatology Unit, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
Department of Internal Medicine, Nephrology Unit, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
Arch Rheumatol. 2020 Feb 7;35(2):205-213. doi: 10.46497/ArchRheumatol.2020.7405. eCollection 2020 Jun.
This study aims to assess the self-reported work productivity and activity daily living (ADL) impairment among Malaysian patients with systemic lupus erythematosus (SLE) and to examine their associated factors.
This cross-sectional study included 167 SLE patients (21 males, 146 females; mean age 38.2±9.8 years; range, 20 to 60 years) recruited from the outpatient Rheumatology and Nephrology clinics. Face-to-face interviews were conducted to record patients' socio- demographics (age, sex, ethnicity, marital status, and occupation) and SLE disease characteristics (system involvement, age onset, and presence of organ damage). Disease activity was assessed using the Systemic Lupus Erythematosus Disease Activity Index-2000 (SLEDAI-2K). Short form 36 (SF-36) was used to determine health-related quality of life (HRQoL) while Work Productivity and Activity Impairment (WPAI) questionnaire was used to assess the four domains of absenteeism, presenteeism, overall work productivity, and non-work related ADL impairment. Univariate analyses and multivariable regression analysis examined the association of demographic variables, SLE disease characteristics, and activity with reduced HRQoL and WPAI scores.
The majority of the patients were Malays (59.3%), followed by Chinese (34.7%) and Indian (3.6%) patients. More than two-thirds of the patients reported some degree of impairment in their work productivity and ADL due to the disease. The absenteeism rate was 10.4% in the past one week and their indirect costs were 2,875.17 Malaysian ringgits (US $701.22) in the past seven days. Significant predictors of higher work productivity and ADL impairment scores were higher disease activity, more frequent SLE flares, lupus nephritis, and hematological involvement of SLE. Patients with higher work productivity and ADL impairment scores were also strongly associated with poor QoL. No ethnic disparities of work productivity and ADL impairment were found.
Systemic lupus erythematosus significantly affected the overall productivity in work and non-work related activity in our Malaysian multi-ethnic cohort and both impairments were significantly associated with poor QoL.
本研究旨在评估马来西亚系统性红斑狼疮（SLE）患者自我报告的工作效率及日常生活活动（ADL）受损情况，并探究其相关因素。
这项横断面研究纳入了167例SLE患者（21例男性，146例女性；平均年龄38.2±9.8岁；年龄范围20至60岁），这些患者来自门诊风湿病科和肾病科。通过面对面访谈记录患者的社会人口统计学特征（年龄、性别、种族、婚姻状况和职业）以及SLE疾病特征（系统受累情况、发病年龄和器官损害情况）。使用系统性红斑狼疮疾病活动指数2000（SLEDAI - 2K）评估疾病活动度。采用简短健康调查问卷36（SF - 36）来确定健康相关生活质量（HRQoL），同时使用工作效率和活动受损（WPAI）问卷评估旷工、出勤、总体工作效率以及与工作无关的ADL受损这四个领域。单因素分析和多变量回归分析研究了人口统计学变量、SLE疾病特征及活动度与HRQoL降低和WPAI评分之间的关联。
大多数患者为马来人（59.3%），其次是华人（34.7%）和印度人（3.6%）。超过三分之二的患者报告因疾病导致工作效率和ADL有一定程度的受损。过去一周的旷工率为10.4%，过去七天的间接成本为2875.17马来西亚林吉特（701.22美元）。工作效率和ADL受损评分较高的显著预测因素包括疾病活动度较高、SLE发作更频繁、狼疮性肾炎以及SLE的血液系统受累。工作效率和ADL受损评分较高的患者也与较差的生活质量密切相关。未发现工作效率和ADL受损存在种族差异。
在我们的马来西亚多民族队列中，系统性红斑狼疮显著影响了工作和与工作无关活动的总体效率，且这两种受损情况均与较差的生活质量显著相关。
