Arthritis symptoms, the work environment, and the future: measuring perceived job strain among employed persons with arthritis

Objective. To investigate, in a cohort of patients with ankylosing spondylitis (AS) adequately treated with infliximab, changes over time in presenteeism and the role of presenteeism relative to that of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Bath Ankylosing Spondylitis Functional Index (BASFI) in predicting sick leave. Methods. Data were analyzed from 71 patients with paid work and taking a stable dose of infliximab participating in a 96-week study with 5 assessment points. Covariates included presenteeism, sick leave, time, sex, age, BASDAI, BASFI, Bath Ankylosing Spondylitis Metrology Index, and part-or full-time work. Presenteeism represented the AS impact on productivity (by visual analog scale, range 0-10, where 10 5 completely unproductive). Sick leave represented the number of days absent from work due to AS in the last 6 months. A linear mixed-effects model for presenteeism, and hurdle and zero-inflated count models for sick leave were explored. Results. Mean 6 SD presenteeism ranged from 2.2 6 2.2 to 3.8 6 7.8, and sick leave occurred in 8-17% of the patients during the 6-month period. Presenteeism positively correlated with BASDAI and BASFI, but was not significantly influenced by time. The chance of incurring sick leave was affected by presenteeism but not by BASDAI and BASFI. Conditional on being absent from work, the effect of presenteeism on the length of sick leave (in days) was much stronger than BASDAI and BASFI. For presenteeism ‡5, an increase of 1 unit in presenteeism yielded an increase by 36-40% (or 2-12 days) in the length of sick leave during the following 6 months. Conclusion. Presenteeism, even measured by a simple visual analog scale, was an important factor to explain future sick leave.

Section: Discussionsupporting

confidence: 89%

Longitudinal Analyses of Presenteeism and Its Role as a Predictor of Sick Leave in Patients With Ankylosing Spondylitis

Tran‐Duy

Nguyen

Thijs

et al. 2015

“…This is a 12-item scale that measures difficulties related to different work activities (e.g., difficulties related to upper and lower extremity mobility) (36,38,39). Responses range from 0 (no difficulty) to 3 (not able to do).…”

Section: Significance and Innovationsmentioning

confidence: 99%

“…This validated 15-item scale of job strain assesses a person's appraisal of the stressfulness of the working environment when living and working with a chronic disease (38). Questions ask about stress related to work and having a chronic disease (e.g., the extent of the stress related to job demands combined with having lupus).…”

Section: Significance and Innovationsmentioning

confidence: 99%

Job Accommodations Availability and Utilization Among People With Lupus: An Examination of Workplace Activity Limitations and Work Context Factors

Dhanhani

Gignac

Beaton

et al. 2015

Self Cite

Objective. The aim of this study was to examine the availability of diverse job accommodations (or flexible working arrangements) and to describe their use among people with systemic lupus erythematosus (lupus), as well as to examine factors associated with the use of job accommodations. Methods. A mail survey was sent to adult lupus patients receiving care from a lupus clinic based in Toronto, Canada. The survey assessed demographic information, self-reported disease activity, work history, workplace activity limitations, job strain, and the availability and use of job accommodations. Standard multivariable linear regression analysis was used to examine factors associated with the use of job accommodations. Results. We received 362 responses of 604 mailed surveys (60% response rate). Participants who were employed within the last 5 years, but who were not currently working, were less likely than currently employed participants to report having had job accommodations available to them at their last place of employment. The use of job accommodations was reported by 70% of currently employed respondents and by 72% of those not currently employed. The most common job accommodation used was sick leave days. Factors positively associated with the use of job accommodations among those who were employed included higher levels of education, being diagnosed with fibromyalgia, at least 1 episode of short-term work disability, not belonging to a union, greater workplace activity limitations, and greater job strain. Conclusion. The use of job accommodations among people with lupus is common. Work context factors, such as workplace activity limitations and job strain, are the main factors associated with the use of job accommodations.

“…Studies suggest that, despite improvements in treatment for rheumatic diseases, many individuals continue to report difficulties working, have elevated absenteeism rates, and report reduced productivity (1)(2)(3)(4). In addition to the physical symptoms of the disease creating difficulties for people in remaining employed, factors like job stress, symptom unpredictability, disruptions to work because of time needed for treatment, and employment factors like a lack of job control and absence of workplace support can create barriers to working (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20).…”

Section: Introductionmentioning

confidence: 99%

Availability, Need for, and Use of Work Accommodations and Benefits: Are They Related to Employment Outcomes in People With Arthritis?

Gignac

Cao

McAlpine

2015

Self Cite

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.