title: Do employment and family work affect the health status of women with fibromyalgia?
abstract: OBJECTIVE
  To assess health status differences of women with fibromyalgia syndrome (FM) who are employed and not employed, and to evaluate whether employment and family work influence the health status of women with FM as it does for women in community studies.
  
  
  METHODS
  Participants were 287 women recruited from 118 randomly selected rheumatology practices. They completed telephone interviews that collected data on demographic characteristics, health status, symptoms, family work, and social support. One hundred thirty-seven were employed and 150 were not employed. Formal statistical analysis, including estimation and testing, focused on the relationship between employment and 4 health status measures: Modified Health Assessment Questionnaire (MHAQ), visual analog scale (VAS) for pain on the interview day, number of painful areas, and VAS for fatigue on the interview day. The relationship between employment and these measures was evaluated using analysis of variance, chi-square, linear regression, and ordinal logistic regression.
  
  
  RESULTS
  The majority of participants reported high levels of symptoms and poor health status. In the bivariate analyses, employed women reported significantly less pain, less fatigue, and better functional status than those who were not employed. In the multivariate analyses, employment remained a significant factor in explaining number of painful areas, functional status (MHAQ), and fatigue, with employed women reporting better health status than those not employed. Employment was not associated with pain on the day of the interview when other factors were considered in the analysis. The psychological demands of family work were consistently related to all dependent measures of health status, as those with greater psychological demands reported worse health status.
  
  
  CONCLUSIONS
  As in community studies, employed women with FM report better health status than women who are not employed. The demands of family work exert a serious and significant effect on every dimension of health status and should be the focus of greater clinical attention. Further followup will assess whether employment has a protective effect for women with FM as in community studies or whether women with less severe FM tend to remain in the workforce.
authors.affiliation: Department of Behavioral Sciences and Community Health, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT 06030, USA. Reisine@nsol.uchc.edu
authors.forename: Susan
authors.initials: S
authors.lastname: Reisine
authors.forename: Judith
authors.initials: J
authors.lastname: Fifield
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Walsh
authors.forename: Richard
authors.initials: R
authors.lastname: Feinn
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D016022:Case-Control Studies; D004651:Employment; D005190:Family; D005260:Female; D005356:Fibromyalgia / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D006304:Health Status; D006796:Household Work; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D011788:Quality of Life; D018570:Risk Assessment; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D012944:Social Support; D011795:Surveys and Questionnaires; D014481:United States; D014931:Women, Working