-
[show abstract]
[hide abstract]
ABSTRACT: Stelt u zich de volgende aan de werkelijkheid ontleende situaties voor. Een vrouw van 42 jaar (getrouwd, 2 kinderen) is secretaresse
bij een makelaarskantoor als zij gewrichtsklachten krijgt. Enige maanden later wordt de diagnose reumatoïde artritis gesteld.
Haar werkgever weet niet wat dit is en toont weinig begrip. Hij is niet bereid om aanpassingen in bijvoorbeeld werktijden
door te voeren. Op het werk maken collega’s vervelende opmerkingen over haar misvormde handen. Ze voelt zich schuldig als
ze een periode niet kan werken, omdat anderen haar werk dan moeten overnemen. Ze probeert het ziekteverzuim zo veel mogelijk
te beperken, waardoor ze al haar energie in het werk moet steken, wat weer ten koste gaat van haar privé-leven. Ze wil graag
blijven werken, vooral vanwege de sociale contacten. Gaandeweg blijkt ze het werk toch niet vol te kunnen houden en na ongeveer
vier jaar wordt ze volledig afgekeurd.
03/2011: pages 536-575;
-
[show abstract]
[hide abstract]
ABSTRACT: To investigate the relationship between work and quality of life (QOL) in patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS) aged 16-59.
1056 patients with RA and 658 with AS were included in the study. Data were obtained by postal questionnaire, which included several generic and disease related QOL instruments. Separate dimensions and physical and mental summary scores from the SF-36 were compared. Stepwise multiple regression was performed to study the relationship between work and physical and mental health related QOL, including disease related factors, coping, and fatigue.
Physical health related QOL was reported to be worse, and mental health related QOL better, in RA than in AS in people of working age. No differences between RA and AS were found in somatic pain, physical role functioning, social functioning, emotional role functioning, vitality, or general health perception; nor were there any significant differences in fatigue and behavioural coping styles. Work was positively associated with physical health related QOL in both groups and, after disease characteristics, was the most important determinant. No association was found with mental health related QOL.
Although physical health related QOL was worse in patients with RA, the impact on several dimensions of health related QOL in patients with RA and AS of working age under rheumatological care was comparable. Patients with RA and AS experienced similar limitations in physical role functioning, including work. Work is an important independent external determinant of physical health related QOL, but not of mental health related QOL.
Annals of the Rheumatic Diseases 01/2004; 62(12):1178-84. · 8.73 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To assess the labour market position of patients with ankylosing spondylitis (AS) in relation to disease duration and to identify potential factors in relation to withdrawal from the labour force.
A cross sectional mail survey was conducted among 658 patients with AS. Participation in the labour force was defined as having a paid job. The independent effect of duration of disease was examined by an indirect method of standardisation. A broad variety of risk factors were examined separately and in a combined analysis, including sociodemographic factors, disease related variables, coping styles, and work related factors. Attributable and preventable fractions were calculated from the combined analyses to assess the relative importance of the contributing factors.
Probability of participation in the labour force was similarly reduced in patients with AS with different durations of disease. Pacing to cope with limitations was the most relevant factor in increasing the risk of withdrawal from the labour force, accounting for 73% of withdrawals. Coping with limitations by often seeking creative solutions, high disease activity, increased age, and insufficient support from colleagues or management were also positively associated with withdrawal from the labour force. Technical or ergonomic adjustments of the workplace, working in large companies, and coping with dependency style through frequent acceptance were negatively associated. Of these factors, technical or ergonomic adjustment was the most relevant in terms of reducing the risk.
Sociodemographic factors, disease related factors, coping styles, and work related factors contribute simultaneously to withdrawal from the labour force.
Annals of the Rheumatic Diseases 09/2002; 61(8):693-9. · 8.73 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To assess separate and combined effects of work factors and behavioural coping in relation to withdrawal from the labour force among patients with rheumatoid arthritis (RA).
A cross sectional study was conducted in a Dutch nationwide random sample of 720 patients with RA. Information about work factors and behavioural coping was collected by a self-administered postal questionnaire. A broad variety of work factors and coping styles were evaluated separately and in combination using multivariate logistic regression analyses, controlling for sociodemographic and disease related variables. Attributable and preventable fractions were calculated from the combined analyses to assess the relative importance of the contributing factors.
Additional job training, equal career opportunities, letting the disease influence the choice of the current job position, and informing colleagues about having the disease were negatively associated with withdrawal from the labour force. The most relevant factor in terms of decreasing the risk was adjusting job demands which accounted for 63% of the patients still in the labour force. Decreasing activities and diverting attention in order to cope with pain, and pacing in order to cope with limitations were the coping styles which were positively associated with withdrawal from the labour force. The most relevant factor in terms of increasing the risk of withdrawal was pacing which accounted for 67% of the withdrawals.
Work factors are potentially important modifiable risk factors for withdrawal from the labour force in patients with RA. Behavioural coping is also relevant.
Annals of the Rheumatic Diseases 12/2001; 60(11):1025-32. · 8.73 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To assess work history and labour force participation among patients with rheumatoid arthritis (RA) in the Netherlands.
A random sample of 1056 patients with RA aged 16-59 years from 17 rheumatology practices in the Netherlands was examined. Data on disease status and outcome were obtained by a questionnaire including standardised instruments, such as the Rapid Assessment of Disease Activity in Rheumatology (RADAR) and RAND-36 questionnaires. Labour force participation was defined as having a paid job.
Of the study group with a mean disease duration of 12 years, 35.7% held a paid job (men 56.7%; women 27.7%). When standardised for age, sex, and educational level, the labour force participation of patients with RA was 61.2% compared with 65.5% for the general population, which was not statistically significant. Disease duration of six years and more was negatively associated with labour force participation.
After controlling for the confounding effects of age, sex, and education, the labour force participation of patients with RA in the Netherlands is only slightly lower than that of the general population.
Annals of the Rheumatic Diseases 08/2000; 59(7):549-54. · 8.73 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: It was investigated whether radiographic osteoarthritis (ROA) is associated with specific haplotypes of the COL2A1 gene. Radiographs of knees, hips, hands, and spine were scored for the presence of ROA in subjects of 55-70 years from a population-based cohort study, the Rotterdam study. Cases had ROA in 3 or more joint groups; controls, from the same population, had ROA in less than 3 joint groups. Allele frequencies of 3 dimorphisms (HaeIII, HindIII, MaeII) and a VNTR polymorphism of the COL2A1 gene were determined. The VNTR allele 14R2 and the HindIII polymorphism showed a significant association. Haplotype analysis of the HaeIII, HindIII and VNTR polymorphisms showed that a specific haplotype (1-2-14R2) is strongly associated with ROA in 3 or more joint groups (OR = 5.3, 95% CI 2.3-12.7). Our results suggest that a specific haplotype of the COL2A1 locus may predispose to generalised ROA.
Annals of Human Genetics 10/1999; 63(Pt 5):393-400. · 2.57 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: It was investigated whether radiographic osteoarthritis (ROA) is associated with specific
haplotypes of the COL2A1 gene. Radiographs of knees, hips, hands, and spine were scored for the
presence of ROA in subjects of 55–70 years from a population-based cohort study, the Rotterdam
study. Cases had ROA in 3 or more joint groups; controls, from the same population, had ROA in
less than 3 joint groups. Allele frequencies of 3 dimorphisms (HaeIII, HindIII, MaeII) and a VNTR
polymorphism of the COL2A1 gene were determined. The VNTR allele 14R2 and the HindIII
polymorphism showed a significant association. Haplotype analysis of the HaeIII, HindIII and
VNTR polymorphisms showed that a specific haplotype (1-2-14R2) is strongly associated with ROA
in 3 or more joint groups (OR = 5.3, 95% CI 2.3–12.7). Our results suggest that a specific haplotype
of the COL2A1 locus may predispose to generalised ROA.
Annals of Human Genetics 08/1999; 63(05):393 - 400. · 2.57 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: A follow-up study of a cohort of 444 patients aged 16 to 59 years who consulted with their general practitioners (GPs) in 1987-1988 for an incident episode of back pain.
To determine the proportion of patients with back pain in whom chronic back problems develop after a follow-up of 7 years, to compare health outcomes and labor force participation of patients with and without chronic back problems and to identify determinants of chronicity.
The incidence and prevalence of back pain are very high. A large proportion of the costs related to medical consumption, absence from work, and disability are probably caused by chronic back problems. It is unknown what proportion of back problems become chronic, especially after a long follow-up period, and which factors can predict chronicity.
Data on the course of the symptoms and medical consumption from the period between 1987-1988 and 1991 were gathered retrospectively. Data on several health outcomes, including LFP, and data on some work characteristics were collected prospectively in 1991. A more extensive data set on health outcomes including psychologic status and working situation was collected in 1994.
Chronic back problems developed in 28% of the patients. These patients reported more pain, higher levels of medical resource consumption, worse health outcomes, and lower labor force participation. Episodes of back pain before 1987-1988, severe pain in 1991, and disability score in 1991 were positively associated with chronicity in 1994, difficulties with job performance in 1991, and frequent stooping in the subgroup of patients who held a paying job in the follow-up period.
Even after a follow-up of 7 years, the proportion of people with chronic back problems was high. The consequences for quality of life, labor force participation, and consumption of medical resources are clear. Further research is necessary to examine determinants and ways to prevent chronicity.
Spine 10/1998; 23(18):2021-8; discussion 2028-9. · 2.08 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: A genetic association study was performed to investigate whether radiographical osteoarthritis (ROA) was associated with specific genotypes of the insulin-like growth factor I (IGF-1) gene.
Subjects aged 55-65 years were selected from a population-based study of which ROA at the knee, hip, spine, and hand was assessed. Genotypes were determined of a polymorphism in the promoter region of the IGF-1 gene.
The IGF-1 locus was significantly associated with the presence of ROA (over-all adjusted OR for heterozygous subjects = 1.9, 95% CI 1.2, 3.1 and for homozygous subjects 3.6, 95% CI 0.8, 16.2).
These results suggest that variation at the IGF-1 locus is associated with ROA development and may play a part in ROA pathogenesis. To confirm these findings replication in another population-based sample is needed.
Annals of the Rheumatic Diseases 07/1998; 57(6):371-4. · 8.73 Impact Factor
-
British journal of rheumatology 06/1998; 37(5):555-61.
-
I Meulenbelt,
C Bijkerk,
S C de Wildt, H S Miedema,
H A Valkenburg,
F C Breedveld,
H A Pols,
J M Te Koppele,
V F Sloos,
A Hofman,
P E Slagboom,
C M van Duijn
[show abstract]
[hide abstract]
ABSTRACT: To investigate whether radiographically evident osteoarthritis (ROA) in 55-65-year-old men and women is associated with specific alleles or genotypes of the cartilage matrix protein (CRTM) and cartilage link protein (CRTL1) genes.
Cases were selected from a population-based study on the presence of ROA of the knee or hip. Further radiographic analysis included scoring for spine and hand ROA. Controls, selected from the same population, were free of ROA in all joints.
The CRTM locus was significantly associated with hip ROA in men (odds ratio 0.50, 95% confidence interval 0.26-0.95). A significant association between ROA and the CRTL1 gene was not observed.
These results suggest that the CRTM locus may play a role in the sex- and joint site-specific pattern of ROA development.
Arthritis & Rheumatism 11/1997; 40(10):1760-5. · 7.87 Impact Factor
-
Nederlands tijdschrift voor geneeskunde 06/1993; 137(18):928.
