Work Interventions to Improve Employment Outcomes for Persons With Rheumatoid Arthritis and Osteoarthritis

Worksite Vocational Rehabilitation Intervention to Improve Employment Outcomes for Persons With Arthritis?

To determine if worksite based functional evaluation/intervention provided by occupational therapists improves employment outcomes for persons with arthritis.

Arthritis is second only to heart disease as a cause of work-related disability with significant financial costs associated with the loss of work for persons with arthritis. Many persons with arthritis have physical impairments which affect their ability to work, with 50% of persons with rheumatoid arthritis leaving employment within 10 years of diagnosis. Risk factors predicting employability, length of employment and worksite accommodations for workers with arthritis have been well documented. Variables predicting work cessation include blue collar jobs and more physically demanding jobs, an older age of the worker, lower education, perceived job strain, social support of co-workers and supervisors, job satisfaction, and self-efficacy. Recent studies of self-report by persons with arthritis identified the use of worksite accommodations such as others providing assistance at work, job autonomy, time flexibility, and use of special equipment. Unknown is the effect of on-site work interventions. The need exists to determine if the provision of strategies for physical accommodations, worksite modifications, and assistive technologies at the individual's job site improves the ability of persons with arthritis to continue working.

This is a randomized clinical trial to investigate the efficacy of a worksite based intervention to improve the employment outcomes of persons with rheumatoid (RA) or osteoarthritis (OA). Persons with RA or OA who have arthritis related work difficulties will have an occupational therapist provide a worksite evaluation and subsequent training in strategies to accommodate arthritis related physical impairments and improve job performance and satisfaction. Participants in control group will be provided with educational printed materials related for a self-initiated worksite evaluation of musculoskeletal and environmental risks at the worksite for persons with arthritis.

Inclusion Criteria:

• Rheumatoid arthritis or osteoarthritis diagnosed by a rheumatologist
• Competitively employed; full or part time
• Reporting arthritis-related employment difficulties
• Agree to participate in a work site evaluation

Exclusion Criteria:

• Systemic complications of RA (e.g., vasculitis)
• Organic Brain Syndrome
• Uncontrolled psychiatric disorders
• Uncontrolled medical conditions (e.g., active cancer)