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BACKGROUND AND AIMS: Data on the prevalence of work disability in patients with inflammatory bowel disease (IBD) are heterogeneous. As most studies have been performed in selected, often severe, IBD patients, the true prevalence of disability in the community remains controversial. The aim of this cross-sectional study was to evaluate the prevalence and severity of disability and its predictive factors in a community-based IBD population. PATIENTS AND METHODS: Patients recorded in the community-based IBD register at the Hospital Universitario de Burgos were contacted. After informed consent they completed a set of questionnaires including demographic, clinical, disability and quality of life data. The statistical study was performed using SPSS 21. RESULTS: A total of 293 patients were included - 151 Crohn's disease (CD), 142 ulcerative colitis (UC), 137 female, mean age: 45 ± 11 years, mean time since diagnosis: 10.6 ± 11 years. Twelve patients (4.1%) had a work-disability pension. In addition, 93 (32%) of all patients had an officially recognized disability degree, which was generally moderate (n = 73, 25%) or severe (N = 16, 5%). Age, time since IBD diagnosis, CD, perianal disease, incontinence, active disease, the need for anti-TNF or psychological treatment, previous surgeries and the number of diagnostic tests and medical visits in the previous year were predictors of disability. Major predictors of qualifying for a disability pension were age, IBD activity, incontinence, need for biological drugs and ostomy. CONCLUSION: Mild to moderate work disability is frequent in IBD. However, only a minority of patients develop severe disability qualifying them for a pension.
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The present article revises practical aspects on the format and content of the clinical reports used for the evaluation of disability for the Spanish Disability Grants System. As a framework for understanding how these clinical reports should be, the review includes also a short overview of the different types of disability grants and the administrative and court mechanisms for granting.
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Avaliação da Deficiência , Prontuários Médicos , Redação/normas , Humanos , Guias de Prática Clínica como AssuntoRESUMO
BACKGROUND: No validated instruments have been developed to measure work disability in Crohn's disease (CD). The aim of our study was to develop and validate a CD perceived work disability questionnaire (CPWDQ). METHODS: Development phase: an initial questionnaire containing 52 items was obtained from patients' interviews plus additional sources; it was completed by 106 patients and the 16 most significant items were selected using a psychometric method in order to create the CPWDQ. Validation phase: The validation assessed the questionnaire's convergent validity, discriminant validity, test-retest reproducibility, and internal consistency in 108 patients. Spearman rank correlation, t-test, intraclass correlation, and Cronbach's alpha were used for the analysis. RESULTS: Convergent validity was confirmed by good correlations between the CPWDQ and: clinical activity (r = 0.59, P < 0.01), the Short Inflammatory Bowel Disease Questionnaire, IBDQ-9, (r = 0.76, P < 0.001), Euroqol-5D (r = 0.53, P < 0.01), and overall work impairment (WPAI_CD) r = 0.66 (P < 0.01). Discriminant validity: CPWQ scores were higher in patients expected to have more severe disability, that is, in patients with active disease (n = 38) 32.3 ± 7.3 versus inactive (n = 70) 22.6 ± 5.9 (P < 0.001), in those requiring previous sick leave 30.7 ± 7.5 (n = 45) versus no sick leave 22.6 ± 6.6 (n = 63) (P < 0.01), and in those requiring hospitalization 32.2 ± 8.6 (n = 18) versus no hospitalization 24.7 ± 7.1 (n = 90) (P < 0.01). Internal consistency was also good (Cronbach's alpha = 0.89). Reproducibility: CPWDQ measures obtained 2 weeks apart showed an excellent intraclass correlation coefficient: 0.89 (95% CI: 0.83-0.93). CONCLUSIONS: The CPWDQ seems to be a valid, reliable tool for measuring subjective work disability in CD.
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Doença de Crohn/diagnóstico , Doença de Crohn/psicologia , Pessoas com Deficiência/psicologia , Percepção , Psicometria , Qualidade de Vida , Trabalho , Atividades Cotidianas , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Licença Médica/estatística & dados numéricos , Inquéritos e Questionários , Adulto JovemRESUMO
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