Objective. To prospectively examine arthritis-related productivity losses, work changes, and leaving employment, the relationships among these work transitions, and the factors associated with them. Methods. Participants with inflammatory arthritis or osteoarthritis were interviewed at 4 time points, 18 months apart, using a structured questionnaire. At baseline (T1), all participants (n ؍ 490; 381 women, 109 men) were employed. At T2, T3, and T4, the sample decreased to 413, 372, and 349 participants, respectively. Respondents were recruited using community advertising and from rheumatology and rehabilitation clinics. Work transitions considered were productivity losses (absenteeism, job disruptions), work changes (reduced hours, changing jobs), and leaving employment. Also measured were demographic, illness, work context, and psychological variables. Generalized estimation equations modeled predictors of work transitions over time. Results. Although 63.1% of respondents remained employed throughout the study, work transitions were common (reported by 76.5% of participants). Productivity losses, especially job disruptions such as being unable to take on extra work, were the most frequently reported. Work transitions were related to subsequently making other work transitions, including leaving employment. Age, sex, education, activity limitations, control, depression, and arthritis-work spillover were also associated with work transitions. Conclusion. This study sheds light on a process of diverse employment changes that may occur in the lives of many individuals with arthritis. It emphasizes the interrelationships among work transitions, as well as other factors in predicting work transitions, and it provides insight into work changes that may signal impending difficulties with remaining employed.
Objective. To examine the type, degree, and episodic nature of arthritis-related work place activity limitations and the consistency of the relationship of activity limitations to job modifications and work place outcomes. Methods. Using an interviewer-administered structured questionnaire, individuals with osteoarthritis (OA) or inflammatory arthritis (IA) were interviewed at 4 time points, 18 months apart. At baseline, all participants (n ؍ 490; 381 women, 109 men) were employed. Respondents were recruited using community advertising and from rheumatology and rehabilitation clinics. The Workplace Activity Limitations Scale (WALS) assessed arthritis-related disability with job tasks. Job modifications/accommodations (e.g., scheduling changes), work place outcomes (e.g., absenteeism), demographics, illness, and work context were also measured. Repeated cross-sectional logistic regressions examined levels of WALS disability with job modifications and outcomes at each time point. Results. Similar levels of activity limitations were found comparing OA and IA with fewer difficulties with global aspects of work (e.g., scheduling) than with specific tasks (e.g., working with hands). Three-quarters of the participants had episodic or intermittent WALS difficulty over time. Medium and high levels of work place activity limitations were significantly associated with job modifications, and high WALS difficulty was consistently related to negative work outcomes. Conclusion. Many individuals with arthritis report some difficulty with work place activities. However, these difficulties are often intermittent and may not result in changes to work productivity until they are consistently high. This is important for designing work place interventions and for employers, insurers, and the government to understand to avoid viewing individuals with arthritis as a permanent drain on work place and health resources.
Little is known about life course differences in social role participation among those with chronic diseases. This study examined role salience (i.e., importance), role limitations, and role satisfaction among middle- and older-aged adults with and without osteoarthritis (OA) and its relationship to depression, stress, role conflict, health care utilization and coping behaviours. Participants were middle- and older-aged adults with OA (n = 177) or no chronic disabling conditions (n = 193), aged ≥40 years. Respondents were recruited through community advertising and clinics in Ontario, Canada (2009-2010). They completed a 45-50 min telephone interview and 20 min self-administered questionnaire assessing demographics (e.g., age, gender); health (e.g., pain, functional limitations, health care utilization); the Social Role Participation Questionnaire (SRPQ) (role salience, limitations, satisfaction in 12 domains), and psychological variables (e.g., depression, stress, role conflict, behavioural coping). Analyses included two-way ANOVAs, correlations, and linear regression. Results indicated that middle-aged adults (40-59 years) reported greater role salience than older-aged adults (60 + years). Middle-aged adults with OA reported significantly greater role limitations and more health care utilization than all other groups. Middle-aged adults and those with OA also reported greater depression, stress, role conflict, and behavioural coping efforts than older adults or healthy controls. Controlling for age and OA, those with higher role salience and greater role limitations reported more health care utilization. Those with greater role limitations and lower role satisfaction reported greater depression, stress, role conflict, and behavioural coping. This study has implications for research and interventions, highlighting the need to characterize role participation as multidimensional. It points to the importance of taking into account the meaning of roles at different ages among those with chronic diseases like OA when developing interventions to help understand the impact of roles on psychological well-being.
ObjectiveTo examine the availability, need, and use of workplace policies for workers with osteoarthritis (OA) and inflammatory arthritis (IA) and their association with employment outcomes.MethodsParticipants (n = 219) were employed, ages ≥25 years, and diagnosed with OA or IA. They were recruited through community advertising and rheumatology clinics in 2 Canadian provinces. Respondents completed a 35–45‐minute telephone interview assessing demographics (age, sex), health (diagnosis, pain, activity limitations), work context (job control), employment outcomes (workplace activity limitations, absenteeism, productivity losses, reduced hours), benefits (extended health, short‐term leaves), and accommodations (flexible hours, modified schedules, special equipment/adaptations, work‐at‐home arrangements). Regression analyses examined differences in benefit/accommodation need and use.ResultsMany participants reported that arthritis impacted their work. But with the exception of extended health benefits, ∼50–65% of participants reported not needing each individual benefit/accommodation, although only 7.3% of respondents reported needing no benefits or accommodations at all. Greater job control and education were associated with greater perceived need and use of benefits/accommodations. Need was also associated with greater activity limitations, and disclosure of arthritis was related to use of benefits/accommodations. Participants needing but not using workplace policies often had significantly poorer employment outcomes compared to those using benefits/accommodations.ConclusionFindings are relevant to workers with arthritis and to employers. Results suggest that individuals with arthritis are unlikely to be a drain on workplace resources. Many individuals do not use benefits/accommodations until needed, and among those using them, there were generally positive relationships with diverse employment outcomes.
Objective. To examine arthritis self-disclosure at work, factors associated with disclosure, and prospective relationships of self-disclosure and work place support with changes to work place interactions, work transitions, and work place stress. Methods. Using a structured questionnaire, participants with osteoarthritis or inflammatory arthritis were interviewed at 4 time points, 18 months apart. At time 1, all participants (n ؍ 490; 381 women, 109 men) were employed. Of the entire sample, 71% were retained throughout the study. Respondents were recruited using community advertising and from rheumatology and rehabilitation clinics. Self-disclosure and perceived support from managers and coworkers was assessed, as well as demographic, illness, work-context, and psychological variables. Generalized estimating equations modeled associations of disclosure and support on changes at work (e.g., job disruptions, work place stress). Results. At each time point, 70.6 -76.6% of participants had self-disclosed arthritis to their manager and 85.2-88.1% had told a coworker. Intraindividual variability in disclosure was considerable. Factors associated with self-disclosure were often inconsistent over time, with the exception of variables assessing the need to self-disclose (e.g., activity limitations) and perceived coworker support. Self-disclosure was not associated with changes to work. However, coworker support was related to fewer job disruptions, help with work tasks, and being less likely to reduce hours. Perceived managerial support was associated with less work place stress. Conclusion. Greater awareness is needed about issues related to self-disclosing arthritis at work. This study emphasizes the importance of a supportive work place, especially supportive coworkers, in decisions to discuss arthritis at work and in changes to work that might enable people to remain employed.
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