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Abstract
Background: Over the past decade, the need to measure work-related impairment of individuals with chronic fatigue syndrome (CFS) and develop rehabilitation programs focusing directly on employment has become increasingly clear.
Aims: Evidence in the scientific literature was sought to determine the extent of work-related impairment and the efficacy of rehabilitation programs that specifically focus on issues of work-related impairment and employment.
Methods: Three evidence-based medical review sources and five specialist databases were searched. English-language studies of adults with CFS published between 1 January 1966 and 15 July 2004 were included if functional or work-related impairment and employment were primary variables measured in the study.
Results: Few studies of work-related impairment and work-focused rehabilitation in CFS exist. Rates of unemployment ranged from 35 – 69% and rates of job loss ranged from 26 – 89%. Work-related impairment encompassed getting out of bed, transportation to work, communication at work, difficulties with energy and cognition at work, errors at work, falling asleep, lost work hours, and excessive dependence on coworkers. Most rehabilitation programs have not focused directly on employment outcomes but findings for improvement in work status following these programs offer promise for future research.
Conclusions: CFS is associated with considerable work-related disability. Preliminary findings support the need for the development of comprehensive rehabilitative programs that focus on volitional, functional, social, and environmental aspects of re-employment.
Declaration of interest: Financial support for this review was provided by the National Institutes of Health Grant #5R01HD43301.
