Article

Employment and health status changes among women with fibromyalgia: a five-year study.

Department of Oral Health and Diagnostic Science and Division of Behavioral Sciences and Community Health, University of Connecticut, Farmington, CT 06030-3910, USA.
Arthritis & Rheumatism (impact factor: 7.87). 12/2008; 59(12):1735-41. DOI:10.1002/art.24309 pp.1735-41
Source: PubMed

ABSTRACT To assess changes in health status of women with fibromyalgia (FM) over 5 years and determine whether baseline employment status influences health outcomes adjusting for other baseline factors.
Two hundred eighty-seven women with FM were recruited from a national sample of rheumatologists and interviewed by phone at baseline and annually for 4 years. Data were collected on pain, fatigue, Center for Epidemiologic Studies Depression Scale and Modified Health Assessment Questionnaire (M-HAQ) scores, demographic characteristics, and employment status. At the end of the study, 211 participants remained. Data were analyzed using multilevel modeling techniques. Bootstrap methods adjusted for the cluster sampling.
The participants' mean +/- SD age was 47 +/- 11 years, their mean +/- SD education level was 14 +/- 2 years, 90% were white, 50% employed, 64% married, and their median household income was >or=$50,000. Mean +/- SD scores at baseline were 57.2 +/- 24 for pain, 75.4 +/- 22 for fatigue, 22.9 +/- 13 for depression, and 0.73 +/- 0.5 for the M-HAQ. Multilevel modeling indicated that all health status measures declined significantly over time except for pain. Rates of change varied from -1.22 for fatigue to -0.03 for the M-HAQ. Except for pain, patients who were employed at baseline had better health status over time. The employment and time interaction was not significant, indicating that health status changed at the same rate regardless of employment status. Other significant factors were age and income.
Employed women with FM have better health status at baseline and maintain that advantage over time. Employment does not seem to provide a protective health benefit.

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Keywords

+/- SD age
 
211 participants
 
5 years
 
baseline factors
 
change varied
 
cluster sampling
 
demographic characteristics
 
employment status
 
Epidemiologic Studies Depression Scale
 
health status
 
health status measures
 
mean +/- SD education level
 
Mean +/- SD scores
 
median household income
 
Modified Health Assessment Questionnaire
 
Multilevel modeling
 
multilevel modeling techniques
 
protective health benefit
 
Rates
 
significant factors
 

Susan Reisine