Abstract

Background:People with inflammatory arthritis (IA), i.e. rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis, often experience low work ability and up to 38% lose their job during the first years after being diagnosed with IA (1). As a result, people with IA have a higher risk of job loss and permanent exclusion from the labor market than people without IA (1, 2). Work-related rehabilitation is complex and encompass a variety of interventions which aim to reduce barriers to maintain work and improve work ability. Unfortunately, positive results from work-related rehabilitation is scarce (3), why a better understanding of the challenges people at risk for job loss experience is needed to develop relevant interventions.Objectives:To explore perceived challenges and need for support to remain at work among people with IA who are at risk of job loss.Methods:A qualitative explorative design based on a hermeneutic approach was applied. Outpatients with IA who considered themselves at risk for long-term job loss, were recruited at the Danish Hospital for Rheumatic Diseases. An interview guide was developed based on earlier results from a systematic review and qualitative studies in close cooperation with three patient research partners. Individual semi-structured interviews were performed from December 2019 to May 2020.Results:Eleven women and four men with IA (aged 36-68 years) were interviewed. The participants were employed full time, part time or on sick leave. From the analysis, a main theme ‘Balancing work as a part of everyday life’ and four sub-themes emerged: 1) Working despite challenges, 2) Prioritizing energy for work, 3) Fatigue affects everything and 4) Need for support. To be able to work was very important to all participants. In general, they were stretching their limits, had concerns about maintaining their job and they used different strategies to deal with the challenges they met at work. Flexibility at work in every possible way and support from employers and co-workers were the main needs to be able to remain at work.Conclusion:Overall, patients with IA prioritized to keep working, but experienced challenges with balancing their work and energy in everyday life. They need support and flexibility at work to be able to remain at work.

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