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Quality of Life and illness representation in chronic RSI patients: does work status matter?

Quality of Life and illness representation in chronic RSI patients: does work status matter?. Dr. Judith K. Sluiter, PhD, Associate Prof. Prof.dr Monique H.W. Frings-Dresen Coronel Institute of Occupational Health, Academic Medical Center, Amsterdam, Netherlands j.sluiter@amc.uva.nl.

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Quality of Life and illness representation in chronic RSI patients: does work status matter?

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  1. Quality of Life and illness representation in chronic RSI patients: does work status matter? Dr. Judith K. Sluiter, PhD, Associate Prof. Prof.dr Monique H.W. Frings-Dresen Coronel Institute of Occupational Health, Academic Medical Center, Amsterdam, Netherlands j.sluiter@amc.uva.nl

  2. known since 1700 in Bernardino Ramazzini’s “De Morbis Artificum Diatriba” most registred occupational disease in The Netherlands lot of studies: focus on short-term complaints somewhere in upper extremity in working populations lack of studies in larger groups of chronic RSI patients lack of knowledge about what may be important for the ability to work with these complaints RSI Dutch patient association: 1700 members in 1999, 3250 members in 2005 Background: RSI

  3. to study differences between the perspectives of working and sick-listed Dutch chronic RSI patients’ with respect to indices of quality of life and illness representation Objective

  4. data from questionnaire study 2005 N= 1121; members of the RSI patient association demographics work-status (working or presently sick-listed) complaint-related variables: type, severity, duration, extent cause of RSI Methods

  5. quality of life (QoL): SF-36 subscales current work-ability compared to best ever (0-10) percentual complaint-related QoL deterioration calculated through two VAS-scales that asked to rate QoL with respect to current general health (0-100) and general health before the RSI-complaints existed (0-100) illness representation: brief illness perception questionnaire (B-IPQ) (Broadbent et al., 2006) comparison between working and sick-listed patients (statistical and in terms of clinically relevant differences) Methods: dependent and independent variables

  6. Results (1): demographics *= p-values <0,01 (Sluiter & Frings-Dresen, submitted)

  7. Main cause RSI complaints?RSI working (n=745), sick-listed (n=376) * = p-values > 0,05

  8. Location of complaints? 8 regionsChronic RSI-patients (n=1121) 58% 53% 61% 27% 53% 70% 33% 58%

  9. Duration, extent and severity of complaintsRSI working (n=745), sick-listed (n=376) *= p-values <0,01 (Sluiter & Frings-Dresen, submitted); Clinical relevant differences in extent and severity of complaints

  10. QoL(1): SF-36 domains (higher scores are better QoL) pp= physical functioning prp= physical role p= pain vt=vitality sf=social functioning erp=emotional role mh=mental health = Clinical relevant differences All p<0,01 except for Social functioning (p=0,44) (Sluiter & Frings-Dresen, submitted)

  11. QoL (2): current estimated work-ability compared to best ever(10) P=0,000 and clinically relevant (Sluiter & Frings-Dresen, submitted)

  12. Decrease in QoL because of RSI complaints Percentual decrease: Working: 31% Sick-listed: 49% p<0,01 between groups and clinically relevant present difference (Sluiter & Frings-Dresen, submitted)

  13. Consequences: how much does your illness affect your life (not at all, to severely) Treatment control: how much do you think your treatment can help your illness? (not at all, to extremely helpful) Identity: how much do you experience symptoms from your illness? (no symptoms at all, to many severe symptoms) Clinically relevant differences in illness representation

  14. Conclusions • sick-listed RSI patients reported a greater number and more severe complaints than working RSI patients; severity and extent of complaints may be usable as prognostic factors to decide on timely interventions for work resumption • quality of life deterioration due to the RSI complaints is greater for sick-listed compared to working RSI patients • illness representation differs with work status at almost all dimensions, but clinically relevant on consequences, treatment control, and identity ; this could be used in informational treatment strategies

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