Brown Tamara, Hammond Alison, Ching Angela, Parker Jennifer
Centre for Human Movement and Rehabilitation Research, School of Health and Society, University of Salford, Salford, Greater Manchester, UK.
King's Clinical Trials Unit, Institute of Psychiatry, Kings College London, London, UK.
Musculoskeletal Care. 2023 Sep;21(3):827-844. doi: 10.1002/msc.1760. Epub 2023 Mar 28.
Rheumatic and musculoskeletal diseases (RMD) impact on work participation. The aims of this study were to: examine work limitations of working people with: rheumatoid arthritis, axial spondyloarthritis (axSpA), osteoarthritis, or fibromyalgia using the Workplace Activity Limitations Scale (WALS, a measure of presenteeism); and identify personal, functioning and disability, and work contextual factors associated with presenteeism.
Secondary analysis was conducted of a cross-sectional survey including work outcome measures (WORK-PROM study). A literature review identified variables (coded to ICF) to include in multivariable regressions examining factors associated with presenteeism.
Moderate to high WALS scores were identified in: 93.60% with FM; 69.90% OA; 65.20% RA; and 46.80% axSpA (n = 822). Similarities in work limitations were noted across conditions, although some more problematic in specific RMD. Participants received help with about a quarter of activities (27%RA; 25%FM; 23%OA; 17%axSpA) and work adaptations for less than a fifth causing difficulty (18%FM; 14%RA; 14%OA; 9%axSpA). Literature review identified 33 variables in the WORK-PROM dataset to include in multivariable regressions. Factors associated with higher WALS scores were worse: functional limitations, job strain, pain, difficulties with mental-interpersonal job demands, perceived health status, work-life balance, greater need for work accommodations and lack of perceived work support.
This study extends understanding of work limitations of working people with these four RMD, the extent of help and adaptations received, need for more work accommodation support, and focus on work support, work rehabilitation, and healthy workplace practices to help keep people working.
风湿性和肌肉骨骼疾病(RMD)会影响工作参与度。本研究的目的是:使用工作场所活动受限量表(WALS,一种衡量出勤主义的指标),检查患有类风湿性关节炎、轴性脊柱关节炎(axSpA)、骨关节炎或纤维肌痛的在职人员的工作限制;并确定与出勤主义相关的个人、功能和残疾以及工作环境因素。
对一项横断面调查进行二次分析,该调查包括工作结果测量(WORK-PROM研究)。文献综述确定了要纳入多变量回归的变量(编码为国际功能、残疾和健康分类 [ICF]),以检查与出勤主义相关的因素。
在以下人群中发现了中度至高度的WALS分数:纤维肌痛患者中占93.60%;骨关节炎患者中占69.90%;类风湿性关节炎患者中占65.20%;轴性脊柱关节炎患者中占46.80%(n = 822)。尽管某些特定的RMD问题更多,但在各种疾病中都注意到了工作限制方面的相似之处。参与者约四分之一的活动得到了帮助(类风湿性关节炎患者为27%;纤维肌痛患者为25%;骨关节炎患者为23%;轴性脊柱关节炎患者为17%),不到五分之一造成困难的工作调整得到了帮助(纤维肌痛患者为18%;类风湿性关节炎患者为14%;骨关节炎患者为14%;轴性脊柱关节炎患者为9%)。文献综述在WORK-PROM数据集中确定了33个变量,以纳入多变量回归。与较高WALS分数相关的因素更差的有:功能限制、工作压力、疼痛、心理人际工作需求方面的困难、感知健康状况、工作与生活平衡、对工作调整的更大需求以及缺乏感知到的工作支持。
本研究扩展了对患有这四种RMD的在职人员工作限制、所获得的帮助和调整程度、对更多工作调整支持的需求的理解,并强调了工作支持、工作康复和健康的工作场所实践,以帮助人们继续工作。