Background/Purpose:

Work-related behavior and experiences are discussed to be either risk factors or resources for individual‘s health. Diseases and related changing working conditions and/or experiences might have additional effects. The objective of the study was to describe work-related attitudes and to examine their relationship to clinical data and health in patients (pts) with rheumatoid arthritis (RA).

Methods:

Self-reported (outcome) questionnaires were applied to RA pts and controls (c) not suffering from rheumatic diseases, both groups were capable for work. The ‘AVEM’ questionnaire assesses eleven health relevant dimensions via 66 items and thus determines the personal attitude towards work, see Table 1. The dimensions (d) are attributable to three areas: work engagement (d 1-5), resistance to stress (again d 5; 6-8) and emotions accompanying occupation (d 9-11). Pts self-reported clinical data. Ethics committee approval had been obtained.

Results:

267 pts (85.0% female (f)) and 177 c (90.3% f) contributed data. Pts’ mean age was 47.7±10.0 (c 42.8±9.8) years, mean disease duration 9.0±8.0 years, and the mean HAQ 1.1±0.5 (c 0.4±0.1). 85.5% of the pts self-reported at least one comorbidity (range 0-8, c 45.2%, range 0-4). In pts 81.7% received at least one immunosuppressive medication (range 0-6), 43.8% steroids ≤7.5mg, 9.0% steroids >7.5mg and 61.4% NSAIDS.

AVEM scales are depicted in Table 1, RA pts scored significantly different to c in six dimensions. Pts scored similar to c in work engagement scales and resignation tendencies, but showed less capability for emotional distancing, lower balance and mental stability, lower satisfaction with work & life and lower experiences of social support. OR indicate whether pts of the T- group (see table 1) have an increased risk for lower self-rated health status compared to T+.

Table 1 AVEM dimensions in c and RA pts, *mean±standarddeviation (SD), T+ and T- Percentage of pts deviating > 1 SD from mean of c, + Wilcoxon test, # Fisher’s exact test

Conclusion:

This is the first study applying AVEM to RA pts. Results detected domains that are potentially modifiable and should be considered in clinical management. Resistance to stress and emotional issues should be predominantly targeted. Further study analyzes will address correlations to other study parameters and confounding factors. Thus, appropriate strategies that promote healthy personal attitudes and equip pts with adequate supporting coping skills that prepare them for the challenges at their daily work might and should be developed.

Unrestricted grants: Ministry of Innovation, Science, Research and Technology of the German State North Rhine-Westphalia, Deutsche Rheuma-Liga e.V., supported by German LE Self-Help Community, Abbvie Germany, Hiller Foundation