类风湿关节炎患者工作能力障碍的影响因素调查分析及对生活质量和心理状态的影响

Investigation and Analysis of the Influencing Factors of Work Ability Disorders in Patients with Rheumatoid Arthritis and Their Impact on Quality of Life and Psychological State

目的:调查类风湿关节炎(RA)患者工作能力障碍状况,分析其影响因素,探讨工作能力障碍对RA患者生活质量和心理状态的影响。方法:本研究调查对象为2022年5月~2023年5月来山东第一医科大学附属聊城二院门诊检查并确诊的RA患者126例,采用问卷调查的方式对患者的相关资料进行收集,评估患者工作能力障碍发生情况。采用单因素及多因素Logistic分析RA患者工作能力障碍的影响因素。同时采用健康调查量表(SF-36)中文版评估患者生活质量,采用抑郁自评量表(SAS)和焦虑自评量表(SDS)分别评价患者抑郁、焦虑情况。结果:126份问卷中120份为回收有效,回收有效率为95.24%,其中出现工作能力障碍80例,所占比例66.67%,无工作能力障碍40例,所占比例33.33%。RA患者工作能力障碍与文化程度、居住地、平均月收入、职业状态、发病年龄、病程、受累关节数有关(P<0.05),而与性别、延误确诊时间、畸形关节数及医疗支付方式无关(P>0.05)。文化程度高中及以下、居住地为农村、平均月收入≤2000元、从事体力劳动、发病年龄≤30岁、病程>2年、受累关节数>10个是RA患者发生工作能力障碍的主要危险因素(P<0.05)。工作能力障碍组生理功能、生理职能、躯体疼痛、总体健康、活力、社会功能、情感职能、精神健康评分均低于无工作能力障碍组(P<0.05)。无工作能力障碍组SAS、SDS评分低于工作能力障碍组(P<0.05)。结论:RA患者工作能力障碍的发生率为66.67%,居住地为农村、平均月收入≤2000元、文化程度高中及以下、从事体力劳动、发病年龄≤30岁、病程>2年、受累关节数>10个是RA患者工作能力障碍的影响因素,且工作能力障碍对患者生活质量以及心理状态有一定影响。

Objective:To investigate the status of work ability disorders in patients with rheumatoid arthritis(RA),analyze their influencing factors,and explore the impact of work ability disorders on the quality of life and psychological state of RA patients.Methods:This study investigated 126 RA patients who underwent outpatient examinations and were diagnosed in The Second Hospital of Liaocheng Affiliated to Shandong First Medical University from May 2022 to May 2023.Collected relevant information about patients through a questionnaire survey to evaluate the occurrence of work ability disorders in patients.Used univariate and multivariate logistic analysis to analyze the influencing factors of work ability disorders in RA patients.At the same time,the Chinese version of the Health Survey Scale(SF-36)was used to evaluate the quality of life of patients,and the Self Rating Depression Scale(SAS)and Self Rating Anxiety Scale(SDS)were used to evaluate the depression and anxiety status of patients,respectively.Results:Out of 126 questionnaires,120 were considered valid for collection,with a recovery effectiveness rate of 95.24%.Among them,80 cases had work ability disorders,accounting for 66.67%,and 40 cases had no work ability disorders,accounting for 33.33%.The work ability disorder of RA patients is related to educational level,place of residence,average monthly income,occupational status,age of onset,course of disease,and number of affected joints(P<0.05),but not to gender,delayed diagnosis time,number of deformed joints,and medical payment method(P>0.05).The main risk factors for work ability disorders in RA patients are education level high school and below,residence in rural areas,average monthly income≤2000 yuan,engaged in manual labor,age of onset≤30 years,disease course>2 years,and number of affected joints>10(P<0.05).The physiological function,physiological function,physical pain,overall health,vitality,social function,emotional function,and mental health scores of the work ability disorder group were lower than those of the non work ability disorder group(P<0.05).The SAS and SDS scores of the non work ability disorder group were lower than those of the work ability disorder group(P<0.05).Conclusion:The incidence of work ability disorders in RA patients is 66.67%,with rural residency,average monthly income≤2000 yuan,high school education or below,physical labor,age of onset≤30 years,disease course>2 years,and number of affected joints>10 being the influencing factors for work ability disorders in RA patients.Work ability disorders have a certain impact on the quality of life and psychological state of patients.