title: Employment and health status changes among women with fibromyalgia: a five-year study.
abstract: OBJECTIVE
  To assess changes in health status of women with fibromyalgia (FM) over 5 years and determine whether baseline employment status influences health outcomes adjusting for other baseline factors.
  
  
  METHODS
  Two hundred eighty-seven women with FM were recruited from a national sample of rheumatologists and interviewed by phone at baseline and annually for 4 years. Data were collected on pain, fatigue, Center for Epidemiologic Studies Depression Scale and Modified Health Assessment Questionnaire (M-HAQ) scores, demographic characteristics, and employment status. At the end of the study, 211 participants remained. Data were analyzed using multilevel modeling techniques. Bootstrap methods adjusted for the cluster sampling.
  
  
  RESULTS
  The participants' mean +/- SD age was 47 +/- 11 years, their mean +/- SD education level was 14 +/- 2 years, 90% were white, 50% employed, 64% married, and their median household income was >or=$50,000. Mean +/- SD scores at baseline were 57.2 +/- 24 for pain, 75.4 +/- 22 for fatigue, 22.9 +/- 13 for depression, and 0.73 +/- 0.5 for the M-HAQ. Multilevel modeling indicated that all health status measures declined significantly over time except for pain. Rates of change varied from -1.22 for fatigue to -0.03 for the M-HAQ. Except for pain, patients who were employed at baseline had better health status over time. The employment and time interaction was not significant, indicating that health status changed at the same rate regardless of employment status. Other significant factors were age and income.
  
  
  CONCLUSIONS
  Employed women with FM have better health status at baseline and maintain that advantage over time. Employment does not seem to provide a protective health benefit.
authors.affiliation: Department of Oral Health and Diagnostic Science and Division of Behavioral Sciences and Community Health, University of Connecticut, Farmington, CT 06030-3910, USA. reisine@nso1.uchc.edu
authors.forename: Susan
authors.initials: S
authors.lastname: Reisine
authors.forename: Judith
authors.initials: J
authors.lastname: Fifield
authors.forename: Stephen
authors.initials: S
authors.lastname: Walsh
authors.forename: Deborah Dauser
authors.initials: DD
authors.lastname: Forrest
mesh_terms: D000367:Age Factors; D004522:Educational Status; D004651:Employment; D005221:Fatigue / Q000503:physiopathology; D005260:Female; D005356:Fibromyalgia / Q000503:physiopathology*; D006304:Health Status; D006801:Humans; D007182:Income; D017533:Marital Status; D008875:Middle Aged; D010146:Pain / Q000503:physiopathology