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Purpose: To examine men and women's perceptions of inter-role balance/imbalance in work, arthritis, and personal roles and its association with demographic, health and employment factors, including job stress, career satisfaction, job disruptions, absenteeism and perceived productivity losses., Methods: Participants were employed, aged ≥40 years and diagnosed with osteoarthritis or inflammatory arthritis. They were recruited through community advertising and rheumatology clinics in two Canadian provinces. Respondents completed a 35-45 min telephone interview and a 20-min self-administered questionnaire assessing role perceptions [(arthritis negatively impacts work (A → W); work/personal life negatively impact arthritis (W/P → A); work as a positive role (W +))], demographic, health and work context information. Analyses included exploratory factor analysis and multivariate regressions., Results: Findings revealed similarities between men (n = 104) and women (n = 248) in health, work and role perceptions, although women reported more benefits of working with arthritis (W+) than men. Some gender differences were found in factors associated with inter-role perceptions highlighting the importance of children, fatigue, unpredictable work hours, job control, and workplace activity limitations. Role perceptions were associated with work outcomes but only one perception, W/P → A, interacted with gender. Among men, greater perceptions that work and personal demands interfered with managing arthritis were associated with more job disruptions., Conclusions: This study revealed negative and positive inter-role perceptions related to working with a chronic illness and associations with work outcomes. It highlights potentially modifiable factors that could assess risk and inform interventions to improve role balance and working experiences.

Objective: Research points to many potential benefits of physical activity (PA) for those with arthritis. However, PA has not typically been examined within the context of other life roles. This study examined the perceptions of PA among individuals managing arthritis in addition to employment and other role demands., Methods: Eight focus groups were conducted with 24 women and 16 men (age range 29-72 years) who were currently or recently employed (within 2 years) and had osteoarthritis or inflammatory arthritis. Participants were recruited from community newspaper advertisements, rheumatology clinics, and arthritis groups. Discussions were audiotaped and transcribed. Transcripts were analyzed using qualitative content analysis., Results: All groups discussed the impact of arthritis on a range of PAs. Overall, participants discussed PA as positively influencing their health and well-being. Yet, several overarching themes highlighted the complexity of PA, including 1) PA as a potential cause of arthritis; 2) the reciprocal impact of arthritis on PA and PA on arthritis; 3) physical and psychological benefits and harms of PA, such as difficulty making PA decisions when living in pain or when faced with episodic symptoms; 4) perceived choices about engagement in PA (e.g., role overload); and 5) social support., Conclusion: The relationships among work, health, and other roles were complex. Competing demands, pain, energy, episodic symptoms, support, and decisions to disclose one's illness at work influenced PA. Changes to PA not only affected physical health but also people's self-identity. PA interventions may be improved by taking into account the demands of multiple life roles., (Copyright © 2013 by the American College of Rheumatology.)

Background: Back problems and arthritis are common chronic conditions, while having back problems is a frequent reason for lost work time. The objective of this study was to investigate employment status amongst individuals who report having both back problems and arthritis, compared to having either condition alone., Methods: We analyzed data from the 2007/2008 Canadian Community Health Survey (ages 25-64, n = 79,719). Respondents who reported neither having worked in the past 12 months nor the past week were coded as not currently employed. Those reported being permanently unable to work were considered to be out of the labor force. Log-Poisson regressions, adjusting for socio-demographic and lifestyle factors, were used to estimate risks for being not currently employed or being out of the labor force for 5 mutually exclusive groups of chronic conditions: arthritis and back problems, back problems, arthritis, any other chronic conditions, and no chronic conditions., Results: 12.7% of respondents reported being not currently employed and 2.9% being out of the labor force. 5.8% of respondents reported both arthritis and back problems, while 16.1% reported back problems and 7.3% arthritis. The back problems and arthritis group had the highest risk of not being currently employed. The risk was higher for men (PR = 1.90; 95% CI = 1.58, 2.29) than for women (PR = 1.31; 95% CI = 1.18, 1.46). Risks of being permanently unable to work were also the greatest for those with comorbid back problems and arthritis., Conclusions: There is a need for a reappraisal of back problems as a cause of work disability to account for the possibility of co-occurring arthritis.

Because of its substantial personal social and economic costs, workforce participation among individuals with rheumatic diseases has received considerable research attention. This chapter reviews non-pharmacological employment interventions for people with rheumatic diseases, focussing on the comprehensiveness of interventions, whether they have been targeted to those groups identified as most at risk, and intervention outcomes and effectiveness. Findings highlight that early diagnosis and treatment of rheumatic diseases may not be enough to keep individuals employed and that comprehensive work interventions may have positive psychological effects, as well as result in increased work participation. However, we lack data addressing the optimum time to intervene and subgroup analyses to determine whether some groups are at increased risk for poor work outcomes. Consistent inclusion of behavioural and psychological outcomes to evaluate interventions and compare studies is also needed, along with cost-benefit studies, to determine the long-term feasibility of work interventions., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Objective: To examine inter-relationships among arthritis (A), work (W) and personal life (P) roles and their reciprocal influences, especially experiences of role balance/imbalance among individuals with inflammatory arthritis (IA) and OA., Methods: Eight focus groups were conducted with 24 women and 16 men (aged 29-72 years). A purposive sample was recruited from community advertising. Eligibility included current employment or having been employed within the previous year. Participants were asked about ways arthritis, work and personal life roles intersected and their impact. A standardized questionnaire collected demographic, symptom and employment data for descriptive purposes., Results: Participants noted that having arthritis affected their identity and intersected with work and personal roles, creating role overload, role conflict, role strain and role facilitation. Role overload highlighted that arthritis both affected and was impacted by work and personal life (A → W; A → P; W → A; P → A). Role conflict focused on A → W and A → P difficulties, whereas role facilitation emphasized the positive impact of work and personal life roles on arthritis (W → A; P → A). Role strain was pervasive and arose from numerous sources. Personal strategies (e.g. positive framing) and contextual factors (e.g. support) were important in contributing to or ameliorating role balance/imbalance., Conclusions: By comprehensively examining multiple types of role balance/imbalance and the context within which it occurs, this study identifies gaps in patient-oriented measurement of the impact of arthritis and areas of need in the development of arthritis intervention.

Objective: To develop a measure of job strain related to differing aspects of working with arthritis and to examine the demographic, illness, work context, and psychosocial variables associated with it., Methods: Study participants were 292 employed individuals with osteoarthritis or inflammatory arthritis. Participants were from wave 3 of a 4-wave longitudinal study examining coping and adaptation efforts used to remain employed. Participants completed an interview-administered structured questionnaire, including a Chronic Illness Job Strain Scale (CIJSS) and questions on demographic (e.g., age, sex), illness and disability (e.g., disease type, pain, activity limitations), work context (e.g., job type, job control), and psychosocial variables (e.g., arthritis-work spillover, coworker/managerial support, job perceptions). Principal component analysis and multiple linear regression were used to analyze the data., Results: A single factor solution emerged for the CIJSS. The scale had an internal reliability of 0.95. Greater job strain was reported for future uncertainty, balancing multiple roles, and difficulties accepting the disease than for current workplace conditions. Participants with inflammatory arthritis, more frequent severe pain, greater workplace activity limitations, fewer hours of work, less coworker support, and greater arthritis-work spillover reported greater job strain., Conclusion: The findings underscore the diverse areas that contribute to perceptions of job strain and suggest that existing models of job strain do not adequately capture the stress experienced by individuals working with chronic illnesses or the factors associated with job strain. Measures similar to the CIJSS can enhance the tools researchers and clinicians have available to examine the impact of arthritis in individuals' lives.

Objective: To examine employed individuals' perceptions of arthritis-work spillover (AWS), the reciprocal influence of arthritis on work and work on arthritis, and the demographic, illness, and work context factors associated with AWS., Methods: The study group comprised 492 employed individuals with osteoarthritis or inflammatory arthritis. Participants completed an interview-administered, structured questionnaire assessing AWS, demographic (e.g., age, sex), illness (e.g., disease type, pain, activity limitations), and work context (e.g., workplace control, hours of work) variables. Principal components analysis, reliability analysis, and multiple linear regression were used to analyze the data., Results: A single factor solution emerged for AWS. The scale had an internal reliability of 0.88. Respondents were more likely to report that work interfered with caring for their arthritis than they were to report that their disease affected their work performance. Younger respondents, those with more fatigue and workplace activity limitations, and those working in trades and transportation reported more AWS. Individuals with more control over their work schedules reported less AWS., Conclusion: The results of this study extend research on arthritis by reexamining the interface between arthritis and employment. This study introduces a new measure of AWS that enhances the range of tools available to researchers and clinicians examining the impact of arthritis in individuals' lives.

Objective: To understand arthritis-related workplace changes, including occasional work loss and changes to the type and hours of work, and the factors associated with them using theories of adaptation and behavior change as a framework., Methods: Participants were 492 employed individuals with rheumatoid arthritis or osteoarthritis. They completed an interview-administered, structured questionnaire assessing demographic, workplace, and psychosocial variables, as well as such work transitions as changes to the hours, type, and nature of work. Hypotheses were examined using multiple linear regression., Results: Seventy percent of respondents made at least 1 work change. Younger participants and those with greater workplace activity limitations reported more changes. Work changes were associated with greater depression. A hypothesized 3-way interaction among people's perceptions of their capacity, their future job expectations, and whether they had told their employer about their arthritis was significant., Conclusion: This study extends arthritis employment research by examining a range of work changes. It highlights the dynamic interplay among arthritis, workplace, and psychosocial variables to understand adaptation to arthritis disability.

Symptoms and functional limitations are commonly reported primary outcome measures in ankylosing spondylitis (AS); however, participation has not been widely evaluated, as reflected by the scarcity of literature on the subject. People with AS suggest that participation in social roles (e.g. employment, leisure, and relationships with others) is a critical outcome that is often adversely affected by the sequelae of the disease and by the demands of managing them. Confusion surrounding the concept of `social role participation' has presented difficulties in defining, developing and using participation as an outcome measure. Specifically, distinguishing participation in a social role from the performance of activities that might be associated with that role is critical for measuring participation, as the repertoire of associated activities will vary between individuals. Furthermore, considering which roles are important to individuals and evaluating their satisfaction with participating in a role at the times and in the ways they would like are also key elements of this measurement. Participation as an outcome measure takes on increased importance in diseases such as AS where, in the absence of a cure, the benefits of interventions often arise from improvements to patients' quality of life. Participation is a predictor of quality of life in diseases other than AS; therefore, evaluating social role participation, understanding the factors that affect it, and intervening to prevent or alleviate participation restrictions will be critical for people with AS. [ABSTRACT FROM AUTHOR]