Participation in paid and unpaid work by adults with rheumatoid arthritis

To define determinants of participation in paid and unpaid work by adults with rheumatoid arthritis (RA).

A survey was designed in consultation with working age (< 65 yrs) adults with RA and sent to 269 patients recruited through 5 rheumatology practices. Hours worked "last week" was the measure of participation in employment and unpaid work (household, home maintenance, caregiving, studying, and volunteering). Potential determinants, conceptually organized as attributes of the person, environment, or occupation, were ascertained.

Recruitment response rate was 40% of patients invited, and 89% of those recruited submitted complete surveys. The 239 respondents were mostly women (81%), with mean age 50 years and duration of RA 13 years. Respondents reported an average of 47 hours of work: 19 paid and 28 unpaid hours. Regression analyses indicated more hours of paid work were associated with psychologically demanding work, higher social function, less pain, being male, managerial job type, and lower ratings of occupational balance. More hours of unpaid work were associated with more children in the household, greater perceived physical and psychological demand of the work, social support from family, and having a post-secondary education. Work limitations, reported by 73 respondents, were associated with lower functional status, more pain, and less psychologically demanding work.

Factors associated with greater participation in paid work differed from those associated with unpaid work. Work limitation affects both paid and unpaid workers. Work-related rehabilitation and education programs may be enhanced by addressing factors identified by this sample of paid and unpaid workers.