369 Swimming against the current: a meta-ethnography examining living with arthritis and being employed
Bibliographic record
Abstract
Introduction Arthritis and related rheumatic conditions are common causes of work disability in Canada and the United States, with job loss ranging between 37%–60% within the first 10 years of diagnosis. As diagnosis commonly occurs between the ages of 30–60 years, the symptoms of pain, limited mobility, and fatigue can seriously disrupt and hinder work lives. While research has examined disability and work loss among persons with arthritis (PwA), little is known about what they do to maintain employment. Our goal was to understand how PwA experience employment and to use this information to build a model describing what they need to sustain employment. Methods We searched published studies on arthritis and employment from six electronic databases (1980–2017) and bibliographical reviews using a combination of keywords related to arthritis, employment, and qualitative research. Our search yielded 748 articles, and after applying the inclusion criteria, 17 studies remained. Two reviewers independently reviewed, critically appraised, and extracted concepts from each study in chronological order. Result Using a meta-ethnographic process, we identified seven themes highlighting the common issues experienced by PwA. Using these themes, we developed a process model that illustrates how individual factors (i.e., physical symptoms, self-awareness, meaning of work) influence work-sustainability strategies that are initially privately managed (i.e., personal adjustments, medical treatment, family support); however, when symptoms become too difficult to conceal, individuals will disclose their condition to their employer so that they can draw upon additional work-sustainability strategies (i.e., work accommodations, supervisor and co-worker support, insurers). Individuals engage in these strategies to maintain a ‘non-ill’ identity and remain in their current job for as long as possible. Discussion Our findings will help rehabilitation specialists, employers, and researchers understand what PwA may need to sustain meaningful employment outcomes. Implications to workplace policies and practices are discussed.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.054 | 0.112 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.006 |
| Bibliometrics | 0.011 | 0.011 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.005 | 0.007 |
| Open science | 0.002 | 0.004 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".