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炎症性肠病患者的工作生活质量受损。

Impaired Quality of Working Life in Inflammatory Bowel Disease Patients.

机构信息

Department of Gastroenterology and Hepatology, Amsterdam UMC, Amsterdam Gastroenterology and Metabolism Research Institute, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.

Department of Gastroenterology and Hepatology, Amstelland Ziekenhuis, Amstelveen, The Netherlands.

出版信息

Dig Dis Sci. 2021 Sep;66(9):2916-2924. doi: 10.1007/s10620-020-06647-y. Epub 2020 Oct 16.

Abstract

BACKGROUND

Work-related aspects are important determinants of health for inflammatory bowel disease (IBD) patients.

AIMS

We aimed to describe quality of working life (QWL) in IBD patients and to assess variables that are associated with QWL.

METHODS

Employed IBD patients of two tertiary and two secondary referral hospitals were included. QWL (range 0-100) was measured using the Quality of Working Life Questionnaire (QWLQ). Work productivity (WP), fatigue, and health-related quality of life (HRQL) were assessed using the Work Productivity and Activity Impairment questionnaire, Multidimensional Fatigue Inventory, and Short Inflammatory Bowel Disease Questionnaire, respectively. Active disease was defined as a score > 4 for the patient-reported Harvey-Bradshaw index in Crohn's disease (CD) or Simple Clinical Colitis Activity Index in ulcerative colitis patients.

RESULTS

In total, 510 IBD patients were included (59% female, 53% CD, mean age 43 (SD 12) years). The mean QWLQ score was 78 (SD 11). The lowest subscore (54 (SD 26)) was observed for "problems due to the health situation": 63% reported fatigue-related problems at work, 48% agreed being hampered at work, 46% had limited confidence in their body, and 48% felt insecure about the future due to their health situation. Intermediate/strong associations were found between QWL and fatigue (r = - 0.543, p < 0.001), HRQL (r = 0.527, p < 0.001), WP loss (r = - 0.453, p < 0.001) and disease activity (r = - 0.331, p < 0.001). Independent predictors of impaired QWL in hierarchical regression analyses were fatigue (B = - 0.204, p < 0.001), WP loss (B = - 0.070, p < 0.001), and impaired HRQL (B = 0.248, p = 0.001).

CONCLUSIONS

IBD-related problems at work negatively influence QWL. Fatigue, reduced HRQL, and WP loss were independent predictors of impaired QWL in IBD.

摘要

背景

与工作相关的因素是炎症性肠病(IBD)患者健康的重要决定因素。

目的

我们旨在描述 IBD 患者的工作生活质量(QWL),并评估与 QWL 相关的变量。

方法

纳入两家三级和两家二级转诊医院的在职 IBD 患者。使用工作生活质量问卷(QWLQ)测量 QWL(范围 0-100)。使用工作生产力和活动障碍问卷、多维疲劳量表和简短的炎症性肠病问卷分别评估工作生产力(WP)、疲劳和健康相关生活质量(HRQL)。在克罗恩病(CD)患者中,活动疾病定义为患者报告的 Harvey-Bradshaw 指数评分>4;在溃疡性结肠炎患者中,活动疾病定义为简单临床结肠炎活动指数评分>4。

结果

共纳入 510 例 IBD 患者(59%为女性,53%为 CD,平均年龄 43[12]岁)。QWLQ 评分的平均值为 78(11)。最低的子分数(54[26])是“由于健康状况引起的问题”:63%的患者报告工作中存在与疲劳相关的问题,48%的患者同意在工作中受到阻碍,46%的患者对自己的身体缺乏信心,48%的患者对自己的健康状况感到不安。在 QWL 与疲劳(r=-0.543,p<0.001)、HRQL(r=0.527,p<0.001)、WP 损失(r=-0.453,p<0.001)和疾病活动(r=-0.331,p<0.001)之间发现了中度/强相关性。在分层回归分析中,疲劳(B=-0.204,p<0.001)、WP 损失(B=-0.070,p<0.001)和 HRQL 受损(B=0.248,p=0.001)是 QWL 受损的独立预测因素。

结论

与 IBD 相关的工作问题会对 QWL 产生负面影响。疲劳、HRQL 降低和 WP 损失是 IBD 患者 QWL 受损的独立预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3415/8379106/b8783cf91a62/10620_2020_6647_Fig1_HTML.jpg

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