Background/Purpose: To understand the challenges that people with osteoarthritis (OA) experience at work due to their condition, for the purpose of adapting to OA the content of Making It Work™, an online self-management program supporting workers with inflammatory arthritis (IA) to remain employed and lead healthy and productive lives at work.

Methods:

Eight focus groups were conducted with 34 workers with OA (1 group with hand OA, 1 hip, 2 knee, and 4 multi-joint OA). Patients were recruited through arthritis consumer organizations, a teacher’s benefit plan, and outpatient arthritis clinics. Eligibility criteria included, being currently employed, age 18–70 years, having been diagnosed with OA by a physician and reporting being affected by OA at work. Focus group were conducted using a standardized interview guide, led by an experienced facilitator and transcribed verbatim. Transcripts were analyzed independently by 2 researchers. A thematic analysis followed a general inductive approach to identify problems and organize them into topics and broad categories.

Results:

The sample included 34 patients (mean age 55 years; OA duration: 8.2 yrs), working in education (n=23); health care (n=6); business (n=2); office/ clerical (n=3). Analysis revealed 4 main categories of problems or challenges:

1. Impact of OA : current symptoms (pain, psychological symptoms, fatigue due to constant pain and need for planning), impact of OA (functional limitations, interpersonal relationships, e.g., lack of understanding or fear of annoying others, reduced self-confidence, reduced social participation) and evolution of symptoms (variability, unpredictability).
2. Barriers to cope with OA: physical environment, lack of effective treatment, difficulty adapting having OA, other impacts (financial consequences, comorbidity).
3. Difficulties at work: impact of OA at work, e.g., safety issues, barriers at work [job characteristics (e.g., time constraints), job environment (e.g., limited work space or poor equipment), lack of support, reluctance to disclose (due to fear of stigmatization), difficulty commuting].
4. Adaptations to work done by patients without requesting job accommodations: modifying movement, activities or position, and planning work differently to avoid pain, addressing mobility and commuting issues (e.g finding parking close to work).

Conclusion:

The study identified challenging issues meaningful to individuals working with OA. Though issues are similar to those described by IA patients, they are described differently, and their respective importance differs. Findings will be useful to vocational counsellors and other health professionals helping people with OA deal with employment issues related to their arthritis, and to people developing employment health services for arthritis.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/challenges-and-barriers-to-employment-that-persons-with-osteoarthritis-face-at-work-due-to-their-condition/