EMPLOYMENT AND HEALTH STATUS IN WOMEN WITH FIBROMYALGIA

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Preliminary data on women with rheumatoid arthritis (RA) indicate that those who are able to enter and leave the work force experience the best health outcomes; homemakers report the worst health. These findings raise several new questions about the dynamic relationship among paid work, unpaid family work and health status among women with rheumatic diseases and whether these results hold for other musculoskeletal conditions. We propose to study women with primary fibromyalgia syndrome (FMS) and to describe prospectively the simultaneous evolution of health status, paid work status, unpaid family work, and daily stressors. Women with MS will be compared to a control group similar in age, race, and employment status. Finding from the study will shed light on the relationships among paid and unpaid family work and physical and psychological health status. We will recruit a sample of 245 women diagnosed with FMS and 250 healthy women from the community similar in age, race, and employment status. The total sample will consist of equal groups of those who are employed outside the home and those who are not currently employed. Patients will be recruited from a national sample of rheumatologists who are fellows in the ACR. Annual interviews will be conducted with participants from a national sample of rheumatologists who are fellows in the ACR. Annual interviews will be conducted with participants to collect detailed data on family and employment structure and functional status. Participants to collect detailed data on family and employment structure and functional status. Participants also will complete a daily diary for one week at the time of the baseline and annual interviews each year to collect detailed data on daily stressors as possible mediator of work and family structure on functional status. The proposed study will provide data describing the natural course of paid and unpaid family work and health status among FMS patients and control subjects and will address questions about the relationship between paid work, unpaid family work structure and the physical and psychological health status of women with FMS and controls. The data will be analyzed first, using descriptive statistics in order to describe the experiences of the patients and controls in the study; second, MANOVA and MANCOVA techniques will be used to assess differences in health status between groups at baseline and to assess changes over time in health status between groups adjusting for covariates.