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

Abstract

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.

Exploring self-control of workers with a chronic condition: a qualitative synthesis

“…Co-workers assuming tasks and talking about living and working with the chronic condition are both valuable forms of support for a worker with a chronic condition. Much research has been done on workplace accommodations for specific conditions and chronic conditions in general including consideration of the need and use of accommodations and subsequent impact on work outcomes (Al Dhanhani, Gignac, Beaton, Su, & Fortin, 2015;Chhibba et al, 2017;Chow, Cichocki, & Croft, 2014;Gifford & Zong, 2017;Gignac, Cao, & McAlpine, 2015;Leslie, Kinyanjui, Bishop, Rumrill, & Roessler, 2015;Nevala, Pehkonen, Koskela, Ruusuvuori, & Anttila, 2015). Depending on the condition, accommodations can be permanent or temporary, as for example for conditions with an episodic course.…”

Excess Productivity Costs of Systemic Lupus Erythematosus, Systemic Sclerosis, and Sjögren's Syndrome: A General Population–Based Study

“…Thus, with encouragement from clinicians, modifications in these factors may attenuate future productivity losses, especially among newly diagnosed individuals, as may educational supports. Although some patients do not wish to disclose their diagnosis at work, having increased access to, and uptake of, accommodations such as flexibility in work hours/location (5,44), pacing tasks (4), training for a different position (44), or software to reduce time spent keyboarding (5), may help ameliorate these factors and preserve individuals' productivity and ability to work. Their long term effectiveness and cost effectiveness are still being evaluated, but some efficacy has been demon strated (42,43).…”

“…In addition to health status, evidence suggests that work context factors such as increased job strain and psy chosocial demands, and decreased control, are also key de terminants of work limitations (4) and work loss (33). Although some patients do not wish to disclose their diagnosis at work, having increased access to, and uptake of, accommodations such as flexibility in work hours/location (5,44), pacing tasks (4), training for a different position (44), or software to reduce time spent keyboarding (5), may help ameliorate these factors and preserve individuals' productivity and ability to work. Pres ervation of individuals' productivity and ability to work, in turn, could reduce costs to patients, employers, disability insurers, and society.…”

Are There Differences in Workplace Accommodation Needs, Use and Unmet Needs Among Older Workers With Arthritis, Diabetes and No Chronic Conditions? Examining the Role of Health and Work Context

“…Respondents were asked about the following workplace practices and policies that could act as accommodations: (a) flexible hours (i.e., have some flexibility in the times when work starts or finishes); (b) special equipment/adaptations (e.g., built-up keyboard); (c) modified job duties (e.g., reduced lifting); (d) altered work schedules (e.g., compressed work week); (e) more breaks and rest periods; (f) work-at-home arrangements; (g) extended health benefits (paid for by employers and not covered by provincial health insurance, e.g., some medications, physical therapy, dental); (h) paid or unpaid short-term leave (i.e., an extended absence due to health of more than 1 week and less than 3 months); (i) wellness programs (e.g., nutritional information; Dhanhani et al, 2015 ; Gignac et al, 2015 ). For each accommodation, participants were asked whether they needed the accommodation (Yes/No) and whether it was available (Yes/No/Don’t know).…”

“…Research examining workplace accommodations among individuals with arthritis or diabetes is uncommon. A small number of studies exist in samples of individuals with arthritis and find that accommodation use is relatively low, despite individuals reporting pain, fatigue, and functional limitations at work ( Dhanhani, Gignac, Beaton, Su, & Fortin, 2015 ; Chen et al, 2007 ; Gignac, Cao, & McAlpine, 2015 ; Yelin, Sonneborn, & Trupin, 2000 ). Research has not examined whether the absence of accommodation use reflects a lack of accommodation availability or need.…”