Langbrandtner Jana, Steimann Gero, Reichel Christoph, Bokemeyer Bernd, Hüppe Angelika
Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck, Lübeck.
Reha-Zentrum Mölln, Klinik Föhrenkamp, Mölln.
Rehabilitation (Stuttg). 2022 Apr;61(2):97-106. doi: 10.1055/a-1581-6497. Epub 2021 Sep 20.
Patients with inflammatory bowel diseases (IBD) are often impaired in their ability to be employed due to IBD symptoms. The aim of this study was to explore work-related problems and support requested by IBD patients and develop rehabilitation programs meeting their needs.
A total of 235 IBD patients (97 rehabilitants, 138 outpatients) completed a questionnaire assessing disease-specific impairments, work-related concerns and the need for support services. Subjective work disability was determined with the SPE scale.
Participants were on average 46 years old, 60% were women, 45% suffered from Crohn's disease and 67% worked full-time; 72% (n=170) had a negative subjective prognosis of gainful employment. Participants reported an average of 12 disease-specific and 22 work-related problems. About 50% of the participants reported disease-specific problems, namely fatigue (66%), weakness (55%) and urge to pass stool (55%). The three most common work-related problems affecting more than 50% of the respondents almost every day were reduced work ability (56%), worrying about not being fully efficient (55%) and stress at work (53%). Support services requested were counselling for information on the disease (91%), treatment options (88%), social law benefits (85%) and exercises to increase physical fitness (84%).
The wide range of work-related physical and psychosocial impairments affecting IBD patients reveals a need to extend current rehabilitation services, with a stronger occupational focus and to implement a standardized screening for work-related problems. Disease-specific support services can be developed and addressed in a multimodal and interdisciplinary setting such as the rehabilitation sector.
炎症性肠病（IBD）患者常因IBD症状而就业能力受损。本研究旨在探讨IBD患者与工作相关的问题及所需支持，并制定满足其需求的康复计划。
共有235名IBD患者（97名康复患者，138名门诊患者）完成了一份问卷，评估特定疾病损伤、与工作相关的担忧以及对支持服务的需求。用SPE量表确定主观工作残疾情况。
参与者平均年龄46岁，60%为女性，45%患有克罗恩病，67%全职工作；72%（n = 170）对有酬就业的主观预后为负面。参与者平均报告了12个特定疾病问题和22个与工作相关的问题。约50%的参与者报告了特定疾病问题，即疲劳（66%）、虚弱（55%）和便意（55%）。几乎每天影响超过50%受访者的三个最常见的与工作相关的问题是工作能力下降（56%）、担心工作效率不高（55%）和工作压力（53%）。所要求的支持服务包括疾病信息咨询（91%）、治疗选择（88%）、社会法律福利（85%）和增强体质锻炼（84%）。
影响IBD患者的与工作相关的身体和心理社会损伤范围广泛，这表明需要扩展当前的康复服务，加强职业重点，并对与工作相关的问题进行标准化筛查。可以在多模式和跨学科环境（如康复部门）中开发和提供特定疾病支持服务。
