| Popis: |
The Rheumatoid arthritis (RA) causes early retirement and great number of working day losses. According to our investigation, retirement of patient in our country comes even earlier then in other countries. Possible causes for that are limited possibilities of application of contemporary therapy, which result in severer clinical course of the diseases as well as of the different criteria of the physicians for evaluation of the working ability. The aim of this work was to propose the criteria, which would help physicians to evaluate temporary or permanent working ability. For the purpose of forming the proposal of criteria, functional tests, parameters from our own research as well as the suggestions of the top world's institutions OMERACT, EULAR) are used. In order to assess working ability one should need: pain assessment, Ritchie articular index, the number of painful and swollen joints, morning stiffness duration, index of joint motion, functional ability measured by HAQ, ESR, CRP, Disease Activity Score (DAS), and rtg of both hands. Decision of working ability should not be made based on the current status of some parameters; it should be made by the analysis of the disease's progression. If the index of joint motion, functional status and rtg changes are severer every year, the retirement should be considered. The appropriate evaluation of current activity and follow up of its progression with the usage of the proposed criteria should help primary care physicians to evaluate temporary and permanent working disability. |
