‘You don’t want to be seen as a burden’ experiences of working with early inflammatory arthritis: a qualitative study

Abstract

Purpose

To describe the impact of early inflammatory arthritis on work participation.

Materials and Methods

Thirty individuals (24 women) of working age (age 18–69 years) with inflammatory arthritis (<2 years duration) who were in paid employment or fulltime education were interviewed using qualitative description methodology. Data was analysed using thematic analysis.

Results

Half of participants (n = 15) reported work disability within the first two-years of diagnosis. Five descriptive themes were identified that explained the early impact of IA on participation in paid employment. These themes were: (i) altered capacity for work; (ii) work comes first; (iii) the invisible burden; (iv) the disclosure effect; and (v) a reconstructed work future.

Conclusion

The scale of early work disability appears to be higher than previously understood. Although early medical intervention has improved disease management, significant work-based restrictions requiring intervention remain. Internalised and invisible work-related anxieties present early in the disease and need to be acknowledged and addressed by healthcare providers.

IMPLICATIONS FOR REHABILITATION

• Early inflammatory arthritis causes significant challenges in work ability, and early work-based participation restrictions are present despite early use of drug therapy.

• Assessment of the client’s subjective experience, including understanding the invisible burden, is an important aspect in determining the types of work interventions required.

• Disclosure of diagnosis in the work environment is associated with anxiety and fear, however, disclosure is influential in supporting capacity to retain work participation and should be included in work interventions.

• Routine healthcare should include early interventions to address work-based restrictions and supporting work retention to avoid work disability.

Keywords:

• Early inflammatory arthritis
• new diagnosis
• client-identified participation restrictions
• client priorities
• paid employment
• work disability
• healthcare delivery
• qualitative description

Acknowledgements

Thank you to those who shared their personal experiences of early inflammatory arthritis.

Disclosure statement

No potential conflict of interest was reported by the author(s).