Unravelling the Complexities Of Disclosure For Employees With Non-Visible Disabilities / Illnesses At Work: A Qualitative Meta-Synthesis

Abstract

Objective(s) To understand the experiences of persons with non-visible disabilities / illnesses pertaining to disclosure decision-making and navigating disclosure and concealment at work while comparing across disability / illness types, gender, age, and geographic location. Data Sources We conducted a qualitative meta-synthesis using Noblit and Hare's seven steps of meta-ethnography. Comprehensive searches were conducted via MEDLINE, CINAHL, EMBASE, APA PsychInfo, Scopus, and Sociological Abstracts (date limit: 2000 to July 2020). Study Selection Primary, peer-reviewed, qualitative or mixed methods studies (including only qualitative components), written in English, that explored disclosure decision-making and/or navigation of disclosure/concealment with participants who had non-visible disabilities/illnesses in competitive employment settings were included. Three reviewers were involved in screening. Data Extraction Data were extracted using a standardized charting form that aligned with the research question and objectives developed by the primary author (VT). VT independently extracted the data and a lab research assistant double-checked and extracted the data from 53% (10 articles) of randomly selected articles. Data Synthesis Studies were analyzed to develop conceptual categories, third-order constructs (i.e., themes), and a line-of-argument with reflections and comparisons drawn from the Disclosure Decision Making Model and Disclosure Process Model and consideration of disability/illness type, gender, age, and geographic location. Twenty-four studies were included involving 489 participants, aged 16 to 81, from nine countries, including non-visible disabilities/illnesses such as Human Immunodeficiency Virus, Multiple Sclerosis, fibromyalgia, epilepsy, learning disabilities, Juvenile Idiopathic Arthritis, and mental illnesses. We developed four themes for the disclosure decision-making process (self- and other-focused, experiential, and environmental/workplace factors) and two themes for the disclosure/concealment event (disclosure/concealment logistics and timing) and noted emerging trends across ages, genders, disability and illness types, and geographic locations. Conclusions : Knowledge obtained could be used among professionals who support persons with non-visible disabilities or illnesses to help them navigate disclosure at work, and to consider the role of age, genders, disability and illness types, and geographic locations on disclosure. Author(s) Disclosures No conflicts of interest to report. To understand the experiences of persons with non-visible disabilities / illnesses pertaining to disclosure decision-making and navigating disclosure and concealment at work while comparing across disability / illness types, gender, age, and geographic location. We conducted a qualitative meta-synthesis using Noblit and Hare's seven steps of meta-ethnography. Comprehensive searches were conducted via MEDLINE, CINAHL, EMBASE, APA PsychInfo, Scopus, and Sociological Abstracts (date limit: 2000 to July 2020). Primary, peer-reviewed, qualitative or mixed methods studies (including only qualitative components), written in English, that explored disclosure decision-making and/or navigation of disclosure/concealment with participants who had non-visible disabilities/illnesses in competitive employment settings were included. Three reviewers were involved in screening. Data were extracted using a standardized charting form that aligned with the research question and objectives developed by the primary author (VT). VT independently extracted the data and a lab research assistant double-checked and extracted the data from 53% (10 articles) of randomly selected articles. Studies were analyzed to develop conceptual categories, third-order constructs (i.e., themes), and a line-of-argument with reflections and comparisons drawn from the Disclosure Decision Making Model and Disclosure Process Model and consideration of disability/illness type, gender, age, and geographic location. Twenty-four studies were included involving 489 participants, aged 16 to 81, from nine countries, including non-visible disabilities/illnesses such as Human Immunodeficiency Virus, Multiple Sclerosis, fibromyalgia, epilepsy, learning disabilities, Juvenile Idiopathic Arthritis, and mental illnesses. We developed four themes for the disclosure decision-making process (self- and other-focused, experiential, and environmental/workplace factors) and two themes for the disclosure/concealment event (disclosure/concealment logistics and timing) and noted emerging trends across ages, genders, disability and illness types, and geographic locations. : Knowledge obtained could be used among professionals who support persons with non-visible disabilities or illnesses to help them navigate disclosure at work, and to consider the role of age, genders, disability and illness types, and geographic locations on disclosure.