Department of Internal Medicine, 4th Military Teaching Hospital, R. Weigla 5, 50-981 Wrocław, Poland.
Department of Transport Systems, Faculty of Mechanical Engineering, University of Technology, 50-370 Wrocław, Poland.
Int J Environ Res Public Health. 2022 Oct 14;19(20):13260. doi: 10.3390/ijerph192013260.
Reduced work participation has social implications (sickness absence, economic impact) and consequences for the individual patient (impoverishment, depression, limited social interaction). As patients with rheumatoid arthritis (RA) are more likely to experience job loss and/or at-work productivity loss and are at higher risk of sickness absence and, ultimately, permanent work productivity, consideration should be given to the association between work productivity or partial work capacity and quality of life (QoL). The aim of the study was to assess the relationship between QoL and the risk of work disability, as well as to estimate the risk of a future event and identify factors affecting the risk of work disability in RA inpatients.
This cross-sectional study included 142 inpatients (65 male) aged 47 (38-58) years, who met the established criteria for a diagnosis of RA and treatment with biologic drugs. Only standardized tools were used to examine the patients: WHOQOL-BREF, MFIS and AS-WIS.
An analysis of the QoL scores on the WHOQOL-BREF demonstrated that the patients' QoL was lowest in the physical health domain and highest in the social relationships domain. The median WHOQOL-BREF total score in the group studied was 62.8, which indicates a moderate QoL. The median total score for the risk of work disability (AS-WIS) was 10.1, which indicates that the level of risk of work disability in the patients was higher than the average level reported in the literature. A multivariate analysis showed that the following were significant independent determinants of a higher risk of work disability: low QoL in the WHOQOL-BREF physical health (β = 0.961; = 0.029) and psychological health (β = 1.752; = 0.002) domains, being in a relationship (β = 0.043; = 0.005) and the use of opioids for pain (β = 3.054; = 0.012).
RA patients presented with moderate QoL, moderate fatigue (MFIS) and high risk of disability (AS-WIS). There is an association between a high risk of work disability and lower QoL, especially in the physical and psychological health domains. The lower the QoL in those domains, the higher the risk of work disability. The identification of factors increasing the risk of work disability will help in planning tailored interventions to improve at-work productivity loss and thus prevent work disability.
工作参与度降低会带来社会影响（病假、经济影响）和对个体患者的影响（贫困、抑郁、社交互动受限）。由于类风湿关节炎（RA）患者更有可能失业和/或工作生产力下降，病假和永久性工作生产力丧失的风险更高，因此应考虑工作生产力或部分工作能力与生活质量（QoL）之间的关系。本研究的目的是评估 QoL 与工作残疾风险之间的关系，并估计未来事件的风险，以及确定影响 RA 住院患者工作残疾风险的因素。
这是一项横断面研究，纳入了 142 名符合 RA 诊断标准且接受生物药物治疗的住院患者（65 名男性，年龄 47[38-58]岁）。仅使用标准化工具对患者进行检查：WHOQOL-BREF、MFIS 和 AS-WIS。
WHOQOL-BREF 得分的 QoL 分析表明，患者的生理健康领域的 QoL 最低，社会关系领域的 QoL 最高。研究组的 WHOQOL-BREF 总分中位数为 62.8，表明 QoL 处于中等水平。工作残疾风险（AS-WIS）的总分中位数为 10.1，表明患者的工作残疾风险水平高于文献报道的平均水平。多变量分析显示，以下是工作残疾风险较高的独立显著决定因素：WHOQOL-BREF 生理健康（β=0.961；P=0.029）和心理健康（β=1.752；P=0.002）领域的 QoL 较低、处于恋爱关系中（β=0.043；P=0.005）和使用阿片类药物缓解疼痛（β=3.054；P=0.012）。
RA 患者表现出中等水平的 QoL、中等程度的疲劳（MFIS）和高残疾风险（AS-WIS）。工作残疾风险较高与 QoL 较低之间存在关联，尤其是在生理和心理健康领域。这些领域的 QoL 越低，工作残疾的风险就越高。确定增加工作残疾风险的因素将有助于制定有针对性的干预措施，以提高工作生产力丧失的治疗效果，从而预防工作残疾。
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