EMPLOYMENT AND HEALTH STATUS IN WOMEN WITH FIBROMYALGIA

关于类风湿性关节炎妇女的初步数据表明，那些能够进入和离开劳动力队伍的人的健康状况最好；家庭主妇的健康状况最差。这些发现提出了几个新的问题，关于风湿性疾病妇女的有偿工作、无偿家庭工作和健康状况之间的动态关系，以及这些结果是否适用于其他肌肉骨骼疾病。我们建议研究原发性纤维肌痛综合征（FMS）的女性，并前瞻性地描述健康状况、有偿工作状况、无偿家庭工作和日常压力源的同时演变。患有多发性硬化症的女性将与年龄、种族和就业状况相似的对照组进行比较。这项研究的发现将揭示有偿和无偿家庭工作与身心健康状况之间的关系。我们将从年龄、种族和就业状况相似的社区中招募245名诊断为FMS的妇女和250名健康妇女作为样本。总样本将由在家庭以外工作的人和目前没有工作的人组成。患者将从全国风湿病学家样本中招募，这些风湿病学家是ACR的研究员。每年的访谈将与来自ACR研究员的风湿病学家的全国样本的参与者进行。每年将与参与者进行访谈，以收集有关家庭和就业结构以及功能状况的详细数据。收集参与者家庭和就业结构及功能状况的详细数据。参与者还将在基线时完成为期一周的每日日记和每年的年度访谈，以收集关于日常压力源的详细数据，这些压力源可能是工作和家庭结构对功能状态的中介。拟议的研究将提供描述FMS患者和对照组受试者的有偿和无偿家庭工作的自然过程和健康状况的数据，并将解决有关有偿工作、无偿家庭工作结构与FMS患者和对照组妇女身心健康状况之间关系的问题。首先对数据进行分析，使用描述性统计来描述研究中患者和对照组的经历；其次，MANOVA和MANCOVA技术将用于评估基线时各组之间健康状况的差异，并评估经协变量调整后各组之间健康状况随时间的变化。

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.