I27. BEHAVIOURAL COPING EFFORTS TO MANAGE WORKPLACE ACTIVITY LIMITATIONS

Background: Despite improved treatment, many individuals with inflammatory arthritis (IA) report difficulties working, reduced productivity and elevated absenteeism. Although interventions have begun to address workplace issues facing individuals with IA, few studies have examined existing workplace policies and whether their use is associated with better health and employment outcomes. This research) examined behavioural coping efforts used by individuals to manage health and work difficulties; the availability, need and use of diverse workplace policies, comparing those with arthritis to healthy controls and factors associated with coping efforts, including the intermittent nature of arthritis symptoms, the decision whether to disclose one’s arthritis at work and work–health–life balance. Methods: Data are drawn from three studies of participants living with IA, osteoarthritis (OA) and healthy controls. Two community surveys (total n = 1772) and one qualitative study (n = 40) collected data. Study 1 participants were administered questionnaires on four separate occasions spanning ∼5 years using in-person interviews; study 2 participants were administered on-line questionnaires or surveyed by telephone; qualitative participants participated in one of eight focus groups. All studies assessed demographic (e.g., age, gender), health (e.g., pain, fatigue, workplace activity limitations) and work context (e.g., job sector, hours, physical work) information. Surveys also assessed workplace practices and accommodations (e.g., flexible hours, special equipment, modified duties), psychosocial perceptions (e.g. work–health balance, job stress) and job outcomes (e.g. absenteeism, productivity loss, job disruptions). Results: Respondents working with arthritis reported significantly poorer health (pain, fatigue) than healthy controls. To manage workplace activity limitations, respondents reported a range of coping efforts, including giving up or modifying job activities, anticipating and avoiding problems and getting assistance from colleagues. Approximately, 20% of respondents changed jobs over the course of ∼5 years and 24–45% had not told their employer about their arthritis. Yet, there were few differences in reports of needing or using workplace policies compared to healthy controls and many individuals delayed using workplace accommodations until symptoms were consistently severe. Participants with arthritis who had unmet accommodation needs reported greater work stress, fatigue, workplace activity limitations, health variability, productivity loss and job disruptions. Respondents who drew upon workplace policies in advance of a problem or crisis had the lowest levels of fatigue, activity limitations, productivity loss and job disruptions. Conclusion: Despite poorer health, respondents with arthritis often did not take advantage of available workplace policies and many were reluctant to disclose activity limitations at work. Yet using accommodations, even when not needed, was associated with better health and work outcomes. These results need to be replicated. They point to potential benefits of more proactive use of work policies to manage arthritis and employment. Disclosure statement: M.G.: Grants/research support: Canadian Institutes of Health Research.

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