Rheumatoid arthritis patients' views of a vocational rehabilitation intervention provided by rheumatology occupational therapists

Prior, Yeliz; Bodell, S; Amanna, A; Hammond, A

Abstract

Background: Work disability in RA is common and many are unlikely to return to work once they cease working. Rheumatology occupational therapists (OTs) are well-placed to identify the work problems of people with RA as their role includes evaluating the impact of arthritis on functional ability, work and social roles. This study, nested within a randomized controlled trial (RCT) of a vocational rehabilitation (VR) programme, aimed to explore employed RA patients’ perceptions of the impact of VR or work advice received.

Methods: The VR intervention was modified for use in the UK from an American study. Rheumatology OTs (n = 9) attended three-days training in this VR programme delivered by VR experts. Both the intervention and control group received a work advice pack including written information about job modifications, how to access existing VR support and employment rights forpeople with disabilities s. The intervention group also received on average 3 (S.D.: 1.08) hours of VR delivered by a rheumatology OT. At six month follow-up, semi-structured telephone interviews with participants (n = 32) were conducted to investigate their views of VR and advice received. These were recorded, transcribed and thematically analysed by three researchers to ensure validity.

Results: The majority of participants were still in paid employment. Two different and overarching themes emerged within each group: (i) the intervention group: valued the work advice they received (e.g. pacing, looking after self, changes to work routines, advice on equipment/aids) and highlighted the therapeutic benefit of seeing an OT (ii) the control group: perceived their condition as more debilitating than those in the intervention group, and lacked future aspirations about staying employed. They were unaware of their rights at work, refrained from disclosing their condition to their employers and expressed concerns about taking frequent sick leave, anticipating this might result in job loss. Most participants admitted not to have read the information booklet, which was the only advice received in this study by the control group.

Conclusion: Working people with RA receiving VR delivered by rheumatology OTs in this trial found it helped them learn how to manage their condition at work, and understand their employment rights. Comparing to those who only received a written advice, they were more optimistic about staying employed in the future. This study suggests that a relatively short intervention provided by rheumatology OTs may help working people with RA stay in work for longer, potentially improving work disability.

• Presentation Conference Type: Conference Paper (published)
• Conference Name: British Society for Rheumatology
• Publication Date: Apr 7, 2014
• Deposit Date: Jun 30, 2023
• Print ISSN: 1462-0324
• Electronic ISSN: 1462-0332
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 53
• Pages: 121-122
• DOI: https://doi.org/10.1093/rheumatology/keu106.008
• Publisher URL: https://academic.oup.com/rheumatology/article/53/suppl_1/i121/1795785