Background/Purpose: Participating in employment is an important milestone in the transition to adulthood for young people living with rheumatic disease and can be influenced by relationships with those closest to them including parents, spouses or friends. To date, little research has looked at social relationships and their impact on the work experiences of young adults living with rheumatic disease.

This study aims at examining the nature of social relationships and their influence on perceived independence and participation in employment in young adults (18 to 30 years of age) living with systemic lupus erythematosus (SLE) and juvenile arthritis (JA).  

Methods: 143 young adults (Mean age = 23.3, SD = 3.5,) with SLE (n = 78) and JA (n = 65) completed an online survey. In addition to collecting information on demographics, health (e.g. pain, fatigue, disease activity, activity limitations) and employment status, the Lubben Social Network Scale was administered to measure social contacts and perceptions of support using eight items (e.g. “How many relatives do you see or hear from at least once a month?”). Responses to items were provided on a 5-point scale (0 = none; 5 = nine or more) and a total score was produced. Participants were also asked about perceived overprotection that characterized their relationships with those closest to them (1 = not at all; 5 = a great deal). Seven items assessing independence were developed for the study and administered to participants (1 = not at all; 5 = a great deal). Bivariate analyses were conducted to examine the interrelationships between variables and multivariable log-Poisson analysis examined factors associated with employment. 

Results: More than half of participants (59.4%) were employed at the time of the survey. 26% were students and the remaining were not working. Respondents indicated having a well-managed health condition with low average pain, fatigue, disease activity and HAQ-PROMIS scores. Participants reported moderate to high perceptions of independence (Mean = 3.6, SD = .60) and social support (Mean = 22.1, SD = 7.3) as well as low overprotection (Mean = 2.8, SD = 1.4). Despite low average scores, over one quarter (27.1%) reported ‘quite a bit’ to ‘a great deal’ of overprotection. At the bivariate level, perceived independence was related to greater social support and less overprotection (p< .05). At the multivariable level greater perceptions of independence were significantly associated with a greater likelihood of participating in employment (PR = 1.3, 95%CI 1.0-1.6). When controlling for psychosocial variables, health factors were not significantly related to being employed. 

Conclusion: For young adults with rheumatic disease perceptions of independence play an important role in determining one’s likelihood of participating in paid work and should be promoted. This study also showed that the role of others is more complex than simply providing support. Young adults experiencing less overprotection may have more opportunities for independence that may in turn foster employment. Future research needs to unpack the relationship between psychosocial factors and employment in greater detail.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-role-of-social-relationships-and-perceived-independence-in-the-employment-participation-of-young-adults-with-rheumatic-disease/