Factors influencing work retention for people with multiple sclerosis -: Cross-sectional studies using qualitative and quantitative methods
Factors influencing work retention for people with multiple sclerosis -: Cross-sectional studies using qualitative and quantitative methods
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DOI：
10.1007/s00415-005-0765-4
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发表时间：
2005-08-01
影响因子：
6
通讯作者：
Playford, ED
中科院分区：
文献类型：
--
作者：
O'Connor, R;Cano, SJ;Playford, ED
目的探讨影响多发性硬化（MS）患者工作能力的因素，为今后的临床管理提供建议。方法横断面研究采用定性（第一阶段）和定量（第二阶段）的方法。在第一阶段，采访了62名患者并完成了一份关于多发性硬化症对就业影响的探索性问卷。在第二阶段，100名参加MS门诊的患者完成了对工作的影响问卷，自我报告的Barthel指数和一般健康问卷（GHQ-28）。结果在第一阶段，17个领域被确定为影响MS患者继续工作的能力，无论是与MS或环境。在第二阶段，MS相关因素和环境因素据报告对工作能力有重大影响。只有20%的患者接受过关于保留工作的建议。失业患者（N = 64）在Barthel指数上的残疾程度高于就业患者（差异5.1; p < 0.001），但在GHQ-28上的心理健康状况相似。结论阻止MS患者工作的问题往往与疾病有关，也与工作有关。许多病人被孤立，因为他们不知道帮助的来源。医疗保健专业人员的有效管理在帮助多发性硬化症患者保持就业方面具有潜在的重要作用。
Objective To identify factors that impact on the ability of patients with multiple sclerosis (MS) to remain in work in order to make recommendations for future clinical management. Methods Cross-sectional studies using qualitative (phase one) and quantitative (phase two) methods. In phase one, 62 patients were interviewed and completed an exploratory questionnaire regarding the impact of MS on employment. In phase two, 100 patients attending an MS outpatient clinic completed an impact on work questionnaire, the self-report Barthel index, and the General Health Questionnaire (GHQ-28). Results In phase one, 17 areas were identified as impacting on MS patients' ability to remain in work, either relating to MS or environment. In phase two, both MS related factors and environmental factors were reported to have a major impact on ability to work. Only 20% of patients had received any advice about work retention. Unemployed patients (N = 64) had greater disability than employed patients on the Barthel index (difference 5.1; p < 0.001), but similar psychological wellbeing on the GHQ-28. Conclusion The issues that prevent people with MS from working tend to be disease-related, as well as work-related. Many patients are isolated, as they are unaware of sources of help. Effective management by healthcare professionals has a potentially important role in helping people with multiple sclerosis to remain employed.