Striking a Balance WorkHealthPersonal Life Conf

Authors: Monique A M Gignac Diane Lacaille Dorcas E Beaton Catherine L Backman Xingshan Cao Elizabeth M Badley

Publish Date: 2013/12/27

Volume: 24, Issue: 3, Pages: 573-584

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Abstract

Purpose To examine men and women’s perceptions of interrole balance/imbalance in work arthritis and personal roles and its association with demographic health and employment factors including job stress career satisfaction job disruptions absenteeism and perceived productivity losses Methods Participants were employed aged ≥40 years and diagnosed with osteoarthritis or inflammatory arthritis They were recruited through community advertising and rheumatology clinics in two Canadian provinces Respondents completed a 35–45 min telephone interview and a 20min selfadministered questionnaire assessing role perceptions arthritis negatively impacts work A → W work/personal life negatively impact arthritis W/P → A work as a positive role W + demographic health and work context information Analyses included exploratory factor analysis and multivariate regressions Results Findings revealed similarities between men n = 104 and women n = 248 in health work and role perceptions although women reported more benefits of working with arthritis W+ than men Some gender differences were found in factors associated with interrole perceptions highlighting the importance of children fatigue unpredictable work hours job control and workplace activity limitations Role perceptions were associated with work outcomes but only one perception W/P → A interacted with gender Among men greater perceptions that work and personal demands interfered with managing arthritis were associated with more job disruptions Conclusions This study revealed negative and positive interrole perceptions related to working with a chronic illness and associations with work outcomes It highlights potentially modifiable factors that could assess risk and inform interventions to improve role balance and working experiencesFor most workers employment occurs in conjunction with other role demands related to family and personal relationships household tasks and social and leisure activities To date a considerable number of studies have examined workpersonal life balance Findings indicate that perceptions of interrole conflict and role overload are common among employed women and men and are associated with work and health outcomes like reduced job satisfaction and lower work performance as well as increased work absenteeism job turnover depression and burnout 1 2 3 4 5 6 7 8 9 However few studies have examined role balance in the context of chronic disease This oversight is important as chronic conditions often affect individuals in their prime working years when they have multiple role demands 10 Many chronic conditions also increase in prevalence with age and will gain in importance with the greying of the workforce that is underway in many developed countries 11 12 13 14 15 A better understanding of the nexus among work chronic disease and personal life can help identify individuals at risk for difficulties sustaining employment and inform ways to manage chronic diseases in the workplaceAmong the most prevalent chronic health conditions affecting employment are rheumatic diseases like arthritis 16 17 18 19 20 Arthritis is associated with giving up work increased sick leave absenteeism and atwork productivity loss presenteeism 19 21 22 23 24 25 26 27 28 29 30 Challenges in working with arthritis include dealing with ongoing or intermittent disease symptoms like pain and fatigue as well as activity limitations with work tasks 31 32 33 34 35 Work context factors such as physically demanding work a high work pace low job control and commuting also can make working problematic for people with the disease 33 35 36 37 38 39 40 41In addition to the potentially negative impact of arthritis on work a small number of studies have examined whether individuals perceive that their job or their personal life affects their health or management of their disease 35 38 42 For example a qualitative study of individuals with inflammatory arthritis eg rheumatoid arthritis and osteoarthritis found that many individuals reported both negative and positive aspects of working with arthritis Negative comments highlighted that arthritis symptoms or their treatment sometimes interfered with performance of job tasks But the opposite direction was also true with individuals noting that work and personal demands could interfere with health care appointments or was exhausting making it difficult to find time and energy to optimize care of their disease 42 Despite these difficulties individuals also reported positive aspects of working with arthritis Maintaining employment was highly valued This was not only because of financial resources and access to benefits that jobs provided eg medication extended health benefits like physiotherapy but also because work was often central to an individual’s identity provided purpose to activities opportunities to be productive social interactions a distraction from health problems and even the chance for regular physical activity that helped minimize symptoms 42 43These findings suggest that to help individuals sustain employment while living with arthritis it is critical to better understand the perceived balance individuals with chronic diseases have across their work health and personal life roles the factors associated with role balance or conflict and the relationship of interrole perceptions to employment outcomes This study addresses these issues by examining three types of interrole relationships that emerged from previous qualitative research a the extent to which arthritis is perceived as negatively impacting work b the extent to which work and personal life is perceived as negatively impacting arthritis symptoms and care and c the extent to which work is perceived as a positive role when living with arthritis Additionally we examine how demographic health and work contextual factors are associated with different interrole perceptions Specifically drawing on previous research we examined the degree to which arthritis was perceived as leaving too little time or energy to fulfill work demands ways that work or personal demands conflicted with ways to effectively attend to or manage arthritis and whether or not work was perceived as beneficial by contributing to one’s sense of identity and enjoyment or by keeping individuals active in society potentially overcoming some of the effects of chronic arthritis symptoms For example greater pain and fatigue may be associated with perceptions that arthritis has a negative impact on work whereas working unpredictable hours eg shift work or having children at home may make it difficult to manage arthritis and be associated with perceptions that work and personal demands interfere with managing one’s health Having control over one’s work schedule or flexible work hours may mitigate the negative impact of arthritis on work and be associated with more positive perceptions of working with arthritisWe also examine the degree to which these three interrole perceptions arthritis affecting work work/personal life affecting arthritis employment as a positive role are associated with job stress career satisfaction job disruptions eg arriving late leaving early extended breaks absenteeism and work productivity Poorer work outcomes are expected to be associated with greater workhealthpersonal life conflict whereas the perception of work as a positive role is expected to be associated with greater career satisfaction and better work outcomesInterrole perceptions are examined separately for women and men Reviews of the workpersonal life balance literature find mixed evidence for gender differences 2 4 9 Some studies find that women report poorer workfamily fit than men especially in families with children while other studies find small or no significant gender effects 2 4 9 Some authors have noted that while early studies often found that women experienced more employment and family stressors than men later research finds few differences which may reflect changes in gender roles over time 2 9 In studies of individuals with arthritis there are also mixed findings for gender and work Some research finds no differences in employment while others find that women with arthritis are less likely to be working or more likely to need workplace accommodations 19 40 44 Although men with arthritis were more likely to remain working compared to women research has found that they reported more negative job experiences like being passed over for a promotion 19 By examining women and men separately we can compare similarities and differences in their perceptions of workhealthpersonal life balance and better understand whether arthritis is associated with unique issues related to employmentIndividuals 40 years of age or older with osteoarthritis OA or inflammatory arthritis IA residing in Ontario or British Columbia Canada were recruited to study their employment experiences Participants were recruited mainly using community advertising Additional participants especially those with inflammatory rheumatic diseases which are less common were recruited from rheumatology clinics and The Arthritis Society TAS website The sample was purposive to ensure diversity across occupations and so that individuals receiving fewer health care services were not systematically excluded To be eligible participants had to report that they had received a physician diagnosis of OA or IA eg rheumatoid arthritis psoriatic arthritis ankylosing spondylitis have an arthritis duration of at least 1 year paid employment no comorbid conditions or injuries within the previous year causing disability eg multiple sclerosis migraine stroke and fluency in English

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