Background/Purpose: Working life factors influence patients’ (life) satisfaction and well being. Effort at work is part of a social contract that reciprocates effort by adequate reward. Components of work-related rewards matter for health. Research on effort-reward imbalance (ERI) might contribute to the understanding of factors related to the well-being of patients (pts) with systemic lupus erythematosus (SLE). We studied pts’ job-tasks-related burdens and stress levels measured by the ERI model.

Methods: In a cross-sectional nationwide study a set of standardized self-administered questionnaires was applied to SLE pts. ERI was assessed by the corresponding questionnaire in pts capable for work. Effort reward ratio (ERR) scores > 1 and upper tertile scores of overcommitment (OCS) reflect relevant values. Based on pts’ reported occupations, occupational physicians categorized tasks-related burden into a developed, standardized coding system that included ‘working environment burden’, ‘physical burden’, ‘mental burden’, and ‘other burden’. Ethical approval was obtained.

Results: 252 pts (95.2% female) contributed data. Mean age was 40.1±9.4 years, mean disease duration 10.5±7.3 years, mean HAQ 0.8±0.4. 86.0% self-reported at least one comorbidity (range 1-10). 77.4% took at least one immunosuppressive drug (DMARD, range 1-3), 40.5% steroids ≤7.5mg, 16.3% steroids >7.5mg, 34.0% NSAIDS.

For ERI results see table 1. 79.5% showed relevant effort-reward imbalance (ERR>1). ERR>1 pts scored significantly lower in the esteem, job security and the job promotion/salary scales (p-values<0.05). Above mentioned personal and disease related factors, pts’ self-categorized occupation groups, working environment burden, physical burden, mental burden and other burden did not differ significantly in ERR>1 and ERR≤1 pts.

39.0% had relevant OCS, see table 1. Except HAQ above mentioned personal and disease related factors, working environment burden, physical burden, mental burden and other burden did not differ significantly in pts with OCS in the lower tertiles compared to pts with relevant OCS.

 

Effort mean±SD	Reward mean±SD	ERR>1 %	Esteem mean±SD	Job Security mean±SD	Job Promotion / Salary mean±SD	Overcommittment mean±SD
15.6±4.9	21.6±9.2	79.5	9.6±4.9	3.9±2.6	8.2±3.7	14.3±4.0

 Table 1: ERI and overcommittment scores

Conclusion: In this first study investigating the ERI in SLE pts a high proportion had effort reward imbalance (ERR>1). Analysis on mechanisms potentially involved in the relation between ERI and SLE showed that job-tasks-related burden scored by occupational physicians and most disease related factors did not differ in ERI and OCS subgroups. Further study data analysis will address pts’ perceptions of their job-related burden to develop appropriate support strategies.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/job-related-burden-and-effort-reward-imbalance-in-patients-with-systemic-lupus-erythematosus/