Background Work disability (WD) is the final stage of work problems and may be prevented by effective treatment and ergonomic interventions in earlier stage of work productivity loss and work instability. Contextual factors, disease related factors and local social security systems may also affect WD.
Objectives We aimed to determine the predictive factors of work productivity and work stability in Turkish patients with ankylosing spondylitis
Methods One-hundred patients with ankylosing spondylitis (31 females and 69 males) were included into this study. Demographics, working state, Bath scores of disease activity, functional and radiologic state, quality of life, cardiopulmonary functions (echocardiography, exercise stress test and pulmonary function test) and general work impairments (work productivity impairment and work instability) were recorded. WPAI and AS-WIS were selected as work outcomes. The most predictive factors were analyzed in work productivity and work instability. SPSS 14.0 statistics (descriptives, pearson correlation, and stepwise regressions were used for statistical analyses.
Results Thirty-two patients (mean age: 42,6±11.7) were unemployed. Unemployed patients showed more female, less educated, low disease activity, and low fitness profile. The percentages of absenteeism (WPAI-1), presenteeism (WPAI-2), regular activity impairment (WPAI-3) and overall work impairment (WPAI-4) were determined as 8, 44, % 47, and % 37, respectively, in employee group. When affecting factors assessed with multiple stepwise linear regression analysed; the only determinant for absenteeism (WPAI-1) was the working day loss due to ilness at last year. Chest mobility, annual income level, AS quality of life (ASQoL), work change and co-morbid diseases were the determinants of presenteeism (WPAI-2), regular activity impairment (WPAI-3) and overall work impairment (WPAI-4). The score of mean work instability (AS-WIS) was 11.5±5.8, and 42.6% of patients had low and 57,4% of patients had moderate-high work instability. Multiple stepwise linear regression analysis showed that most predictive factors for work instability were regular activity impairment (WPAI-3) and AS-QoL. The factors affecting non-work status were older age, female sex and low annual income level in stepwise logistic regression.
Conclusions The common predictive factor of work productivity and work stability was quality of life. For evaluation of work productivity; socioeconomic factors such as annual income level and frequent work change were determinative as well as clinical datas (chest expansion and comorbid diseases). We suggested both pharmacologic and nonpharmacologic interventions to improve quality of life should be enabled in early period to improve work productivity.
Disclosure of Interest None declared