Ostuzzi S M T, Aiello E N, Ingegnoli F, Pistarini C, Poletti B, Silani V, Fiabane E
ALOMAR ODV - Lombard Association for Rheumatic Diseases, Milan.
Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan.
Reumatismo. 2024 Oct 1;76(4). doi: 10.4081/reumatismo.2024.1689.
Rheumatic musculoskeletal diseases (RMDs) are the causes of frequent absence from work and loss of productivity. As (in)visible diseases, it is up to the individuals to decide if disclosing their diagnosis, with important repercussions also within the workplace. Still little is known about disease disclosure in the workplace (DD-W) in patients with RMDs. This study aimed to investigate socio-demographic, clinical, and psychological predictors of DD-W among working patients with RMDs.
A cross-sectional Italian national study captured DD-W in people with RMDs. An online survey was developed using ad-hoc questions and scientific questionnaires to explore demographics and work-related, clinical, and psychological factors. Stepwise logistic regressions were run to identify significant predictors of DD-W.
A total of 250 working rheumatic patients completed the survey; 81.2% of the participants enacted DD-W. DD-W behaviors were predicted by perceived visibility of the RMD (p=0.008), work type (p=0.022), general DD behaviors (p<0.001), and perceived family support (p=0.023). Among RMD patients, psoriatic arthritis participants had higher probabilities of DD-W (p=0.02), whereas lower probabilities were detected in fibromyalgia patients (p=0.003). Lower disease duration corresponded in the sample to higher probabilities of DD-W (p=0.036).
The majority of RMD patients in this study enacted DD-W. DD-W was associated with medical, occupational, and psychological factors, supporting the multidimensionality of the process. Further research on the subject might help foster better DD-W decision-making processes for RMD patients while promoting intervention strategies in education, policy, and culture.
风湿性肌肉骨骼疾病（RMDs）是导致频繁缺勤和生产力损失的原因。作为（不可）见疾病，是否披露其诊断由个人决定，这在工作场所也会产生重要影响。关于RMD患者在工作场所的疾病披露情况（DD-W）仍知之甚少。本研究旨在调查患有RMD的在职患者中DD-W的社会人口统计学、临床和心理预测因素。
一项横断面的意大利全国性研究对患有RMD的人群的DD-W情况进行了调查。使用专门设计的问题和科学问卷开展了一项在线调查，以探究人口统计学以及与工作相关、临床和心理因素。进行逐步逻辑回归以确定DD-W的显著预测因素。
共有250名患有风湿性疾病的在职患者完成了调查；81.2%的参与者进行了DD-W。RMD的可见性感知（p = 0.008）、工作类型（p = 0.022）、一般的DD行为（p < 0.001）和感知到的家庭支持（p = 0.023）可预测DD-W行为。在RMD患者中，银屑病关节炎患者进行DD-W的可能性较高（p = 0.02），而纤维肌痛患者的可能性较低（p = 0.003）。在样本中，疾病持续时间较短对应着较高的DD-W可能性（p = 0.036）。
本研究中的大多数RMD患者进行了DD-W。DD-W与医学、职业和心理因素相关，支持了该过程的多维度性。对此主题的进一步研究可能有助于为RMD患者促进更好的DD-W决策过程，同时推动教育、政策和文化方面的干预策略。
