Systemic Lupus Erythematosus and Functional Work Disability: A Qualitative Perspective Using a Work Disability Prevention Approach

Aaron Howe¹, Anson Li², Kevon Jules², Jeremy Tan², Malek Sadek², Mahta Kakvan³, Vijay Chattu¹, Ali Bani-Fatemi¹, Dennisse Bonilla⁴, Wils Nielsen⁵, Nicole Anderson⁶, J. Antonio Avina-Zubieta⁷, Mary Fox⁸, William Shaw⁹, Derek Haaland¹⁰, Janet Pope¹¹, Paul R. Fortin¹², Kathleen Bingham⁴, Nathalie Rozenbojm⁴, Christine Peschken¹³, Jiandong Su⁴, Jennifer Reynolds¹⁴, Catherine Ivory¹⁵, Dafna Gladman¹⁶, Murray Urowitz¹⁷, Francisco Sanchez-Guerrero¹⁸, Lily Lim¹³, Stephanie Keeling¹⁹, Ana Soberanis¹, Patti Katz²⁰, Zahi Touma¹ and Behdin Nowrouzi-Kia¹, ¹University of Toronto, Toronto, ON, Canada, ²University of Toronto, Restore Lab, Toronto, ON, Canada, ³University Health Network, University of Toronto, Toronto, ON, Canada, ⁴University Health Network, Toronto, ON, Canada, ⁵University of Toronto, Markham, ON, Canada, ⁶Schroeder Arthritis Institute, Krembil Research Institute, University Health Network and University of Toronto, Toronto, ON, Canada, ⁷Arthritis Research Canada, Vancouver, BC, Canada, ⁸York University, Toronto, ON, Canada, ⁹University of Connecticut School of Medicine, Farmington, CT, ¹⁰The Waterside Clinic, Oro Medonte, ON, Canada, ¹¹University of Western Ontario, London, ON, Canada, ¹²Centre ARThrite - CHU de Québec - Université Laval, Quebec City, QC, Canada, ¹³University of Manitoba, Winnipeg, MB, Canada, ¹⁴University of British Columbia, Vancouver, BC, Canada, ¹⁵The Ottawa Hospital Research Institute, Ottawa, ON, Canada, ¹⁶Schroeder Arthritis Institute, Krembil Research Institute, Toronto Western Hospital, Department of Medicine, University of Toronto, Toronto, ON, Canada, ¹⁷Schroeder Arthritis Institute, Krembil Research Institute; University of Toronto Lupus Clinic; Division of Rheumatology, Toronto, ON, Canada, ¹⁸University Health Network/Sinai Health system, Toronto, ON, Canada, ¹⁹University of Alberta, Edmonton, AB, Canada, ²⁰University of California San Francisco, San Rafael, CA

Meeting: ACR Convergence 2023

Keywords: Qualitative Research, Systemic lupus erythematosus (SLE), work

Session Information

Date: Tuesday, November 14, 2023

Title: (2257–2325) SLE – Diagnosis, Manifestations, & Outcomes Poster III

Session Type: Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose: Work participation meaningfully influences mental wellbeing, health-related quality of life, and disease-related outcomes in individuals with systematic lupus erythematosus (SLE). Previous studies estimate that 20-50% of SLE patients experience some form of work disability (WD) yet there is limited understanding of the integrative effects of the psychosocial and workplace factors associated with WD. The objective of this study was to identify psychosocial and workplace factors associated with WD to create an SLE-related functional profile that is grounded in a WD prevention framework.

Methods: SLE patients (n=28) were purposively recruited from multiple medical centers across Canada. Guided by the WD prevention framework, semi-structured interviews were conducted with patients to explore their perspectives of factors associated with WD. The guide contained questions corresponding to the framework’s proposition that disability in the workplace is not only due to the workers’ characteristics but also due to environmental factors. Interview data were transcribed verbatim. Thematic analysis was utilized to analyze the data.

Results: Four themes emerged from the data: a) modifiable workplace factors, b) workplace expectations and stigma with work performance, c) availability of workplace support and accommodations, d) physical limitations and feelings of safety at work (Figure 1). Neurocognitive symptoms, fatigue, and physical limitations were frequently reported as factors associated with WD in SLE. Participants reported that participation in work increased their personal control, and reduced their physical and mental demands were more desirable and which in turn, subjectively prevented WD (Figure 2).

Conclusion: WD in SLE necessitates the recognition of the dynamic symptom fluctuations and multidimensionality of the disease, in the context of its relationship to work. Future studies should examine the psychosocial and workplace factors identified to establish a goal-oriented preventative framework that could improve WD outcomes in individuals with SLE.

Figure 1. Thematic analysis diagram

Figure 2. Word frequency diagram

Disclosures: A. Howe: None; A. Li: None; K. Jules: None; J. Tan: None; M. Sadek: None; M. Kakvan: None; V. Chattu: None; A. Bani-Fatemi: None; D. Bonilla: None; W. Nielsen: None; N. Anderson: None; J. Avina-Zubieta: None; M. Fox: None; W. Shaw: None; D. Haaland: None; J. Pope: AbbVie, 1, 2; P. Fortin: AbbVie, 1, AstraZeneca, 1, 6, GlaxoSmithKlein(GSK), 1, 6, Roche-Genentech, 1; K. Bingham: None; N. Rozenbojm: None; C. Peschken: AstraZeneca, 2, 5, GSK, 2, 5, Roche, 1, 2; J. Su: None; J. Reynolds: AbbVie/Abbott, 6, AstraZeneca, 6, GlaxoSmithKlein(GSK), 6, sandoz, 6; C. Ivory: None; D. Gladman: AbbVie, 2, 5, Amgen, 2, 5, Bristol Myers Squibb, 2, Celgene, 2, 5, Eli Lilly, 2, 5, Galapagos, 2, Gilead Sciences, 2, Janssen, 2, 5, Novartis, 2, 5, Pfizer Inc, 2, 5, UCB, 2, 5; M. Urowitz: None; F. Sanchez-Guerrero: None; L. Lim: Pfizer, 6; S. Keeling: AbbVie/Abbott, 1, 6, AstraZeneca, 1, 6, Bristol-Myers Squibb(BMS), 1, 6, GlaxoSmithKlein(GSK), 1, 6, Roche, 1, 6, UCB, 1, 6; A. Soberanis: None; P. Katz: None; Z. Touma: AstraZeneca, 2, GSK, 2; B. Nowrouzi-Kia: None.

To cite this abstract in AMA style:

Howe A, Li A, Jules K, Tan J, Sadek M, Kakvan M, Chattu V, Bani-Fatemi A, Bonilla D, Nielsen W, Anderson N, Avina-Zubieta J, Fox M, Shaw W, Haaland D, Pope J, Fortin P, Bingham K, Rozenbojm N, Peschken C, Su J, Reynolds J, Ivory C, Gladman D, Urowitz M, Sanchez-Guerrero F, Lim L, Keeling S, Soberanis A, Katz P, Touma Z, Nowrouzi-Kia B. Systemic Lupus Erythematosus and Functional Work Disability: A Qualitative Perspective Using a Work Disability Prevention Approach [abstract]. Arthritis Rheumatol. 2023; 75 (suppl 9). https://acrabstracts.org/abstract/systemic-lupus-erythematosus-and-functional-work-disability-a-qualitative-perspective-using-a-work-disability-prevention-approach/. Accessed .

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