Abstract
Abstract Background Inflammatory bowel disease(IBD) is a chronic disease usually diagnosed in early adulthood and characterized by unpredictable flare-ups and debilitating symptoms that can interfere with the patient's ability to work and perform daily activities. In fact, since work disability is difficult to quantify, several scores have been developed for this purpose. The Work Ability Index(WAI) is a validated practical tool to measure the work capacity of patients. The objective of this study was to assess work performance in patients followed for IBD using the WAI psychometric tool, and to identify predictive factors of work disability. Methods We conducted a cross-sectional study including working patients followed for IBD, over a 9-months period. We collected sociodemographic, clinico-biological and evolutionary data. Quality of life was assessed by the IBDQ questionnairy. Work capacity was assessed using the WAI, a short 7-item questionnairy, which classified work performance into four categories: poor (score between 7-27), moderate(28-36), good(37-43) and excellent(44-49). Results We included 45 patients: 80% Crohn disease and 20% ulcerative colitis. The mean age was 44 years[20-72], the sex-ratio M/F was 0.7, and the mean of follow-up time was 9 years[1-18]. The average number of working hours per week was 38.84 [9-60]. The mean absenteeism during the last twelve months was 49.6 days [0-240] and the average number of hospitalization days was 30.7 [0-150]. The mean WAI value was 32.58, which corresponds to a moderate work performance. Assessment of work performance according to the WAI questionnaire showed that 38% of patients (N=17) had poor work ability, 24% (N=11) moderate work ability, 33% (N=15) good work ability and only two patients had an excellent work ability. In univariate and multivariate study, predictive factors of disability at work in IBD patients were: Furthermore, the assessment of health-related quality of life by the IBDQ questionnairy showed a mean IBDQ value of 160.78 which corresponds to a moderate score relating a quality of life; 224 being the maximum score obtainable reflecting an optimal quality of life. In the analytical study and using Spearman's test, a statistically significant correlation was found between the WAI and IBDQ with a p-value <0.0001 and a correlation coefficient r=0.7, reflecting the impact of work life on quality of life. Conclusion In our study, one third of patients had poor work capacity. Risk factors for poor performance were disease severity, presence of osteoarticular extraintestinal manifestation, and patients with children. The only protective factor identified was a high level of education. Thus, the Work Ability Index can be used as a screening tool to identify the need for rehabilitation.
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