Curtin R B, Oberley E T, Sacksteder P, Friedman A
Medical Education Institute, University Research Park, Madison, WI, USA.
Am J Kidney Dis. 1996 Apr;27(4):533-40. doi: 10.1016/s0272-6386(96)90164-x.
Three hundred fifty-nine chronic dialysis patients (85 employed and 274 nonemployed) were surveyed to identify/verify those characteristics which differentiate between employed versus nonemployed status. Education emerged as a significant correlate of employment, as noted by previous investigators, whereas, unlike previous research, neither mode of dialysis, length of time on dialysis, number of comorbid conditions, nor cause of renal failure (eg, diabetes) were associated with employment status. Measures of functional status (MOS SF-20 and Karnofsky) were positively associated with employment. Furthermore, patients' perceptions that their health limited the type and amount of work that they could do were negatively associated with employment. In addition, using a series of de novo items, we found subjects' beliefs about dialysis patients' ability to work to be a "self-fulfilling prophecy" with regard to employment status. That is, patients who themselves believed that dialysis patients should work and had this notion reinforced by significant others were more likely to be employed. Interestingly, 21 percent of unemployed patients reported that they were both able to work and wanted to return to work. Because it is consistently reported that only a small percentage of dialysis patients are employed, targeting the patients who are both willing and able to work for vocational rehabilitation might significantly increase the numbers of employed dialysis patients.
对359名慢性透析患者（85名就业者和274名非就业者）进行了调查，以确定/核实那些区分就业与非就业状态的特征。正如之前的研究者所指出的，教育程度是就业的一个显著相关因素，然而，与之前的研究不同，透析方式、透析时间长短、合并症数量以及肾衰竭原因（如糖尿病）均与就业状态无关。功能状态指标（MOS SF - 20和卡诺夫斯基量表）与就业呈正相关。此外，患者认为自身健康状况限制了其能够从事的工作类型和工作量的看法与就业呈负相关。另外，通过一系列全新的项目，我们发现受试者对透析患者工作能力的信念对于就业状态而言是一种“自我实现的预言”。也就是说，那些自己认为透析患者应该工作且这种观念得到重要他人强化的患者更有可能就业。有趣的是，21%的失业患者报告称他们既能工作又想重返工作岗位。鉴于一直有报告称只有一小部分透析患者就业，针对那些既有意愿又有能力工作的患者进行职业康复治疗可能会显著增加就业透析患者的数量。
