Cognitive deficits are associated with unemployment in adults with sickle cell anemia
Cognitive deficits are associated with unemployment in adults with sickle cell anemia
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DOI：
10.1080/13803395.2016.1149153
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发表时间：
2016-01-01
影响因子：
2.2
通讯作者：
Kassim, Adetola
中科院分区：
文献类型：
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作者：
Sanger, Maureen;Jordan, Lori;Kassim, Adetola
据估计，患有镰状细胞病（SCD）的成年人中有25-60%失业。对造成这一人群高失业率的因素没有进行充分研究。由于已知SCD相关的认知缺陷风险，我们检验了失业与智力功能减退相关的假设。我们对50名成年镰状细胞性贫血患者进行了回顾性图表分析，这些患者完成了认知测试，包括韦氏成人智力量表-IV，作为标准护理的一部分。在测试时记录就业状况。作为可能的失业风险因素的医学变量包括疾病表型、脑梗死和疼痛频率。样本的平均年龄为30.7岁（范围= 19-59岁）; 56%为女性。几乎一半的人（44%）失业。在多变量logistic回归模型中，较低的智商分数（比值比= 0.88; p = 0.002，95%置信区间，CI [0.82，0.96]）和较低的教育程度（比值比= 0.13; p = 0.012，95% CI [0.03，0.65]）与失业几率增加相关。研究结果表明，镰状细胞性贫血成年人的认知障碍可能会导致失业的风险。帮助这些人获得职业康复服务可能是多学科护理的一个重要组成部分。
An estimated 25-60% of adults with sickle cell disease (SCD) are unemployed. Factors contributing to the high unemployment rate in this population are not well studied. With the known risk of cognitive deficits associated with SCD, we tested the hypothesis that unemployment is related to decrements in intellectual functioning. We conducted a retrospective chart review of 50 adults with sickle cell anemia who completed cognitive testing, including the Wechsler Adult Intelligence Scale-IV, as part of standard care. Employment status was recorded at the time of testing. Medical variables examined as possible risk factors for unemployment included disease phenotype, cerebral infarction, and pain frequency. The mean age of the sample was 30.7 years (range = 19-59); 56% were women. Almost half of the cohort (44%) were unemployed. In a multivariate logistic regression model, lower IQ scores (odds ratio = 0.88; p = .002, 95% confidence interval, CI [0.82, 0.96]) and lower educational attainment (odds ratio = 0.13; p = .012, 95% CI [0.03, 0.65]) were associated with increasing odds of unemployment. The results suggest that cognitive impairment in adults with sickle cell anemia may contribute to the risk of unemployment. Helping these individuals access vocational rehabilitation services may be an important component of multidisciplinary care.