title: Work participation and arthritis: a systematic overview of challenges, adaptations and opportunities for interventions.
abstract: OBJECTIVE
  Understanding the factors that play a role in maintaining people with inflammatory arthritis in the workforce may aid the design of interventions to support work participation. The objective of this systematic overview is to summarize qualitative studies that explore experiences of patients with inflammatory arthritis to remain employed or return to work.
  
  
  METHODS
  Bibliographic databases including MEDLINE, EMBASE and PsycInfo were searched until December 2011 to identify any qualitative studies that focused on experiences, challenges or adaptations of patients with inflammatory arthritis to remain employed. Thematic analyses were used to identify any first or higher order themes for which all data were entered into MAXQDA software. In addition, methodological quality was assessed using an eight-item checklist.
  
  
  RESULTS
  Of 6338 citations, 10 studies were included. RA was the condition in eight studies. Individual interviews (six studies) were used more frequently than group interviews (four studies). Methodological quality varied from 2 to 8 points and had no effect on the number of themes identified. Thematic analyses showed seven key concepts important to patients, including disease symptoms, management of the disease, socioeconomic issues, work conditions and adaptations, emotional challenges, interpersonal issues affecting work and family life and meaning of work.
  
  
  CONCLUSIONS
  By including studies from different countries and settings, we show a comprehensive overview of themes considered important by patients and strengthen our belief that these factors should be considered in interventions that aim to improve work participation for patients with inflammatory arthritis.
authors.affiliation: Coronel Institute of Occupational Health, Academic Medical Center, PO Box 22700, 1100 DE Amsterdam, The Netherlands. j.l.hoving@amc.uva.nl
authors.forename: Jan L
authors.initials: JL
authors.lastname: Hoving
authors.forename: Myra C B
authors.initials: MC
authors.lastname: van Zwieten
authors.forename: Marrit
authors.initials: M
authors.lastname: van der Meer
authors.forename: Judith K
authors.initials: JK
authors.lastname: Sluiter
authors.forename: Monique H W
authors.initials: MH
authors.lastname: Frings-Dresen
mesh_terms: D000222:Adaptation, Physiological; D001172:Arthritis, Rheumatoid / Q000191:economics / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy; D004651:Employment; D006801:Humans; D036301:Qualitative Research; D062707:Return to Work
keywords: employment; inflammatory arthritis; management; return to work; systematic review; work participation