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

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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_at_amc.uva.nl

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Background RSI

• known since 1700 in Bernardino Ramazzinis
• 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

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Objective

• 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

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Methods

• 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

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Methods dependent and independent variables

• 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)

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Results (1) demographics
p-values lt0,01 (Sluiter Frings-Dresen,
submitted)
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Main cause RSI complaints?RSI working (n745),
sick-listed (n376)
p-values gt 0,05
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Location of complaints? 8 regionsChronic
RSI-patients (n1121)
58
53
61
27
53
70
33
58
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Duration, extent and severity of complaintsRSI
working (n745), sick-listed (n376)
p-values lt0,01 (Sluiter Frings-Dresen,
submitted) Clinical relevant differences in
extent and severity of complaints
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QoL(1) SF-36 domains (higher scores are better
QoL)
pp physical functioning prp physical role p
pain vtvitality sfsocial functioning erpemotion
al role mhmental health
Clinical relevant differences
All plt0,01 except for Social functioning (p0,44)
(Sluiter Frings-Dresen, submitted)
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QoL (2) current estimated work-ability compared
to best ever(10)
P0,000 and clinically relevant (Sluiter
Frings-Dresen, submitted)
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Decrease in QoL because of RSI complaints
Percentual decrease Working 31 Sick-listed
49
plt0,01 between groups and clinically relevant
present difference (Sluiter Frings-Dresen,
submitted)
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Clinically relevant differences in illness
representation

• 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)

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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