Role conflict, strain and overload among challenges facing workers with arthritis

The impact of arthritis on the working and personal lives of those with the chronic illness is more profound than one may presume, says new research that examines the intersecting roles of those with the disease and suggests ways to identify those at risk of negative workplace outcomes.

Published: February 12, 2013

Myriam’s arthritis was becoming more and more debilitating. She kept working, but this came at a cost. I haven’t visited with a friend in five years, she says. That was something I had to drop because there are only so many hours in the day. And yet, most of her co-workers were unaware that her work affected her personal life so profoundly because she did not talk about it. I only tell people that I’m friends with … I don’t want to be seen as weak, she says.

This is an amalgam of the real-life stories of those with arthritis that came to light through new research led by Institute for Work & Health Senior Scientist Dr. Monique Gignac, also affiliated with the Arthritis Community Research and Evaluation Unit at the Toronto Western Research Institute.

This study examined inter-relationships among arthritis, work and personal life roles in individuals with arthritis and found that role conflict, overload and strain were the most common challenges among study participants.  Gaps exist in the measurement of the impact of arthritis, as do shortcomings in programs designed to help those with the disease. But these impediments may be addressed through early identification of those at risk of negative workplace outcomes.

Through this qualitative study, Gignac captures what it’s very often like living and working with arthritis: It’s a balancing act. You have work to deal with, but on top of that, you have to take care of your health and meet your other responsibilities, she says.

On the other hand, I think that our previous research tells only part of the story. It may give employers the wrong impression, she says. There’s a lot of data on people with chronic diseases showing they often have to give up work due to their health. But what we found was that many of the study participants with arthritis really want to work, they value their jobs, and they’re making adaptations and accommodations so they can work.

Gignac’s study engaged eight focus groups with 24 women and 16 men (29 to 72 years of age).  Participants (working people with arthritis) were asked about ways arthritis, work and personal life roles intersected, and the impact of this intersection on their health and well-being.

Other areas in life taking a hit

The study revealed role intersection, where living with arthritis, work or the two roles in combination, interfered with personal life activities.  Role conflict—where requirements in one area of life are at odds with other roles—was also common. Participants said:

  • arthritis interfered with job tasks because of symptoms or medication side effects;
  • the unpredictability of symptoms made it hard to plan work activities;
  • fatigue interfered with concentration and productivity; and
  • reduced motivation arose from difficulty accepting the disease’s impact, leaving respondents feeling unable to overcome difficulties.

Role strain—the stress created by conflicting role demands—was pervasive, as was role overload—too few hours to perform all roles adequately. As a result, plans with family and friends were often abandoned. This led the researchers to conclude that people protected their work, often at the expense of other activities in their lives.

In realizing the negative effects of arthritis on work, researchers also discovered the opposite: work interfered with treatment, this could result in participants being too tired to take good care of their health.

Work became particularly stressful for those with physical signs of arthritis (e.g. swollen joints). These people were concerned about not appearing professional or that arthritis would result in discriminatory practices.

Most frequently noted were interpersonal problems that created stress, which, in turn, had a negative impact on the disease and led to poor workplace outcomes, such as absenteeism and leaving work. Many of the study’s participants (25.6 per cent) had changed jobs because of arthritis.

However, not all comments were negative. Role facilitation—positive aspects of a role that enhances other roles—was evident. Overwhelmingly, respondents said that employment had a positive impact on living with arthritis, says Gignac.

Early warning indicators may help

So how can we keep those with arthritis in the workforce? This research suggests that role conflict and overload may act as early warning indicators of workplace difficulties. Existing wellness interventions may  help. What we have in place to deal with a range of work and personal life issues, such as flex time, often work for people with chronic diseases, Gignac says. She also suggests that supervisors could play a key role in helping workers with arthritis.  

This research, supported by a grant from the Canadian Arthritis Network, was published in the February 2012 issue of Rheumatology (vol. 51, no. 2, pp. 324-332, see doi:10.1093/rheumatology/ker317).