Ankilozan spondilitte iş engelliliği ve iş verimliliği kaybı ile ilişkili faktörler

Abstract

Amaç: Ankilozan spondilitte (AS) çalışma durumunu ve iş verimliliği kaybıyla ilişkili faktörleri değerlendirmek. Gereç ve Yöntem: Bu kesitsel çalışmaya 70 AS tanılı hasta dahil edildi.Yorgunluk, sabah tutukluğu ve ağrı visual analog skala (VAS) kullanılarak değerlendirildi. Hastalık aktivitesi, fiziksel fonksiyon, yaşam kalitesi, anksiyete ve depresyon sırasıyla Bath Ankilozan Spondilit Hastalık Aktivite İndeksi (BASDAI), Bath Ankilozan Spondilit Fonksiyonel İndeksi (BASFI), Ankilozan Spondilit Yaşam Kalitesi (ASQoL), Hastane Anksiyete ve Depresyonu (HAD) ölçeği kullanılarak değerlendirildi. AS’nin iş verimliliği üzerindeki etkisini belirlemek için İş Verimliliği ve Faaliyet Bozulması Anketini (WPAI) kullanıldı. Çalışan ve çalışmayan hastaların klinik ve demografik özellikleri karşılaştırıldı. Absenteeism ve presenteeism ile ilişkili faktörler, sırasıyla univariable lojistik ve doğrusal regresyon analizi kullanılarak değerlendirildi. Bulgular: AS’li 70 hastanın (24 kadın, 46 erkek) yaş ortalaması 42,96 ± 7,83 yıl idi. Çalışan hasta oranı %65,7 idi. Presenteeism ve absenteeism oranları sırasıyla %60,21 ve %37’dir. Çalışan ve çalışmayan hastaların klinik ve demografik özellikleri farklı değildi (p>0.05). Absenteeism, düşük eğitim seviyesi (odds ratio [OR]=7,636; 95% confidence interval [CI]=1,782-32,723; p=0,006), sabah tutukluğu (OR=1,545; 95% CI=1,118-2,134; p=0,008), BASDAI (OR=1,645; 95% CI=1,088-2,489; p=0,018), ve ASQoL (OR=1,392; 95% CI=1,094-1,772; p=0,007) ile ilişkiliydi. Univariable linear regression modelinde, presenteeism BASDAI (β=8,394; 95% CI=5,570-11,217; p<0,001), yorgunluk (β=6,656; 95% CI=3,015-10,298; p=0,001), ağrı (β=6,011; 95% CI=2,669-9,352; p=0,001), sabah tutukluğu (β=6,108; 95% CI=3,949-8,268; p<0,001), BASFI (β=5,703; 95% CI=2,701-8,705; p< 0,001), ASQoL (β=3,209; 95% CI=1,781-4,637; p<0,001), ve anksiyete (β=2,095; 95% CI=0,243-3,947; p=0,027) ile ilişkili bulundu. Sonuç: Çalışan AS hastalarında absenteeism ve presenteeism yüzdesi yüksekti. Absenteeism, düşük eğitim düzeyi, sabah tutukluğu, hastalık aktivitesi ile ilişkiliydi. Presenteeism, yorgunluk, ağrı, sabah tutukluğu, fonksiyon, anksiyete, yaşam kalitesi ve hastalık aktivitesi dahil olmak üzere hasta tarafından bildirilen sonuçlarla ilişkiliydi.

Keywords

• Ankilozan spondilit
• absenteeism
• presenteeism

Work disability and factors associated with work productivity loss in ankylosing spondylitis

Abstract

Objective: To assess the rate of employment and factors associated with work productivity loss in Ankylosing spondylitis (AS). Material and Method: This study was designed as a cross-sectional study that included 70 patients with AS. Fatigue, morning stiffness, and pain were assessed on a visual analogue scale (VAS). Disease activity, physical function, quality of life, anxiety and depression were assessed using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Ankylosing Spondylitis Quality of Life (ASQoL), and Hospital Anxiety and Depression Scale (HAD), respectively. We used the Work Productivity and Activity Impairment Questionnaire (WPAI) to determine the impact of AS on work productivity. The clinical and demographic characteristics of working and not working patients were compared. Factors associated with absenteeism and presenteeism were assessed using univariable logistic and linear regression analysis, respectively. Results: Mean age of 70 patients (24 women, 46 men) with AS was 42.96 ± 7.83 years. The percentages of working patients was 65.7%. The percentages of presenteeism and absenteeism were 60.21% and 37%, respectively. The clinical and demographic characteristics of working and not working patients were not different (p>0.05). Absenteeism was associated with low educational level (odds ratio [OR]=7.636; 95% confidence interval [CI]=1.782-32.723; p=0.006), morning stiffness (OR=1.545; 95% CI=1.118-2.134; p=0.008), BASDAI (OR=1.645; 95% CI=1.088-2.489; p=0.018), and ASQoL (OR=1.392; 95% CI=1.094-1.772; p=0.007). In the linear regression model, BASDAI (β=8.394; 95% CI=5.570-11.217; p<0.001), fatigue (β=6.656; 95% CI=3.015-10.298; p=0.001), pain (β=6.011; 95% CI=2.669-9.352; p=0.001), morning stiffness (β=6.108; 95% CI=3.949-8.268; p<0.001), BASFI (β=5.703; 95% CI=2.701-8.705; p< 0.001), ASQoL (β=3.209; 95% CI=1.781-4.637; p<0.001), and HAD-A (β=2.095; 95% CI=0.243-3.947; p=0.027) were significantly associated with presenteeism. Conclusion: The percentage of absenteeism and presenteeism were high in working AS patients. Absenteeism was associated with low educational level, morning stiffness, and disease activity. Presenteeism was associated with patient-reported outcomes, including fatigue, pain, morning stiffness, function, anxiety, quality of life, and disease activity.

Keywords

• Ankylosing spondylitis
• absenteeism
• presenteeism
• patient-reported outcomes

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