title: Transitioning to employment with a rheumatic disease: the role of independence, overprotection, and social support.
abstract: OBJECTIVE
  To examine perceived independence, overprotection, and support, and their association with the employment participation of young adults with rheumatic disease.
  
  
  METHODS
  One hundred and forty-three young adults, ages 18 to 30 years, with systemic lupus erythematosus (54.5%) and juvenile arthritis (45.5%) completed a 30-min online questionnaire of their work and education experiences. Information collected was demographic, health (e.g., pain, fatigue, disease activity), work context (e.g., career satisfaction, helpfulness of job accommodation/benefits, and workplace activity limitations), and psychosocial (e.g., independence, social support, and overprotection). Log-Poisson regression analysis examined factors associated with employment status.
  
  
  RESULTS
  Over half of respondents were employed (59%) and 26% were enrolled in school. Respondents reported moderate to high perceptions of independence and social support. However, 27% reported that "quite a bit" to "a great deal" of overprotection characterized their relationships with those closest to them. At the bivariate level, employed participants and those indicating greater perceived independence reported greater social support and less overprotection. Multivariable analysis revealed that being employed was associated with older age, more job accommodations/benefits perceived as being helpful, and greater perceived independence.
  
  
  CONCLUSIONS
  This is one of the first studies examining the employment of young adults with rheumatic diseases. Findings highlight the importance of psychosocial perceptions such as independence and overprotection, in addition to support related to working. Additional research is needed to better understand the role of those close to young adults with rheumatic diseases in supporting independence and encouraging employment.
authors.affiliation: From the Dalla Lana School of Public Health, University of Toronto; Arthritis Community Research and Evaluation Unit, Toronto Western Research Institute; Institute for Work and Health; Mobility Program, Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario; Division of Rheumatology, Centre de recherche du Centre Hospitalier Universitaire de Québec, Faculté de Médecine de L'Université Laval, Quebec City, Quebec; Department of Pediatrics, University of Saskatchewan, Saskatoon, Saskatchewan; Division of Pediatric Rheumatology, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia; Division of Rheumatology, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada.A. Jetha, PhD; E. Badley, PhD, Dalla Lana School of Public Health, University of Toronto, and Arthritis Community Research and Evaluation Unit, Toronto Western Research Institute; M.A.M. Gignac, PhD, Dalla Lana School of Public Health, University of Toronto, and Arthritis Community Research and Evaluation Unit, Toronto Western Research Institute, and Institute for Work and Health; D. Beaton, PhD, Institute for Work and Health, and Mobility Program, Clinical Research Unit, St. Michael's Hospital; P.R. Fortin, MD, MPH, Division of Rheumatology, Centre de recherche du Centre Hospitalier Universitaire de Québec, Faculté de Médecine de L'Université Laval; A.M. Rosenberg, MD, Department of Pediatrics; N.J. Shiff, MD, MHSc, University of Saskatchewan; L.B. Tucker, MD, Division of Pediatric Rheumatology, BC Children's Hospital, University of British Columbia; D.P. Mosher, MD, Division of Rheumatology, Faculty of Medicine, University of Calgary. Arif.Jetha@LibertyMutual.com.
authors.forename: Arif
authors.initials: A
authors.lastname: Jetha
authors.affiliation: From the Dalla Lana School of Public Health, University of Toronto; Arthritis Community Research and Evaluation Unit, Toronto Western Research Institute; Institute for Work and Health; Mobility Program, Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario; Division of Rheumatology, Centre de recherche du Centre Hospitalier Universitaire de Québec, Faculté de Médecine de L'Université Laval, Quebec City, Quebec; Department of Pediatrics, University of Saskatchewan, Saskatoon, Saskatchewan; Division of Pediatric Rheumatology, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia; Division of Rheumatology, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada.A. Jetha, PhD; E. Badley, PhD, Dalla Lana School of Public Health, University of Toronto, and Arthritis Community Research and Evaluation Unit, Toronto Western Research Institute; M.A.M. Gignac, PhD, Dalla Lana School of Public Health, University of Toronto, and Arthritis Community Research and Evaluation Unit, Toronto Western Research Institute, and Institute for Work and Health; D. Beaton, PhD, Institute for Work and Health, and Mobility Program, Clinical Research Unit, St. Michael's Hospital; P.R. Fortin, MD, MPH, Division of Rheumatology, Centre de recherche du Centre Hospitalier Universitaire de Québec, Faculté de Médecine de L'Université Laval; A.M. Rosenberg, MD, Department of Pediatrics; N.J. Shiff, MD, MHSc, University of Saskatchewan; L.B. Tucker, MD, Division of Pediatric Rheumatology, BC Children's Hospital, University of British Columbia; D.P. Mosher, MD, Division of Rheumatology, Faculty of Medicine, University of Calgary.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Badley
authors.affiliation: From the Dalla Lana School of Public Health, University of Toronto; Arthritis Community Research and Evaluation Unit, Toronto Western Research Institute; Institute for Work and Health; Mobility Program, Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario; Division of Rheumatology, Centre de recherche du Centre Hospitalier Universitaire de Québec, Faculté de Médecine de L'Université Laval, Quebec City, Quebec; Department of Pediatrics, University of Saskatchewan, Saskatoon, Saskatchewan; Division of Pediatric Rheumatology, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia; Division of Rheumatology, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada.A. Jetha, PhD; E. Badley, PhD, Dalla Lana School of Public Health, University of Toronto, and Arthritis Community Research and Evaluation Unit, Toronto Western Research Institute; M.A.M. Gignac, PhD, Dalla Lana School of Public Health, University of Toronto, and Arthritis Community Research and Evaluation Unit, Toronto Western Research Institute, and Institute for Work and Health; D. Beaton, PhD, Institute for Work and Health, and Mobility Program, Clinical Research Unit, St. Michael's Hospital; P.R. Fortin, MD, MPH, Division of Rheumatology, Centre de recherche du Centre Hospitalier Universitaire de Québec, Faculté de Médecine de L'Université Laval; A.M. Rosenberg, MD, Department of Pediatrics; N.J. Shiff, MD, MHSc, University of Saskatchewan; L.B. Tucker, MD, Division of Pediatric Rheumatology, BC Children's Hospital, University of British Columbia; D.P. Mosher, MD, Division of Rheumatology, Faculty of Medicine, University of Calgary.
authors.forename: Dorcas
authors.initials: D
authors.lastname: Beaton
authors.affiliation: From the Dalla Lana School of Public Health, University of Toronto; Arthritis Community Research and Evaluation Unit, Toronto Western Research Institute; Institute for Work and Health; Mobility Program, Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario; Division of Rheumatology, Centre de recherche du Centre Hospitalier Universitaire de Québec, Faculté de Médecine de L'Université Laval, Quebec City, Quebec; Department of Pediatrics, University of Saskatchewan, Saskatoon, Saskatchewan; Division of Pediatric Rheumatology, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia; Division of Rheumatology, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada.A. Jetha, PhD; E. Badley, PhD, Dalla Lana School of Public Health, University of Toronto, and Arthritis Community Research and Evaluation Unit, Toronto Western Research Institute; M.A.M. Gignac, PhD, Dalla Lana School of Public Health, University of Toronto, and Arthritis Community Research and Evaluation Unit, Toronto Western Research Institute, and Institute for Work and Health; D. Beaton, PhD, Institute for Work and Health, and Mobility Program, Clinical Research Unit, St. Michael's Hospital; P.R. Fortin, MD, MPH, Division of Rheumatology, Centre de recherche du Centre Hospitalier Universitaire de Québec, Faculté de Médecine de L'Université Laval; A.M. Rosenberg, MD, Department of Pediatrics; N.J. Shiff, MD, MHSc, University of Saskatchewan; L.B. Tucker, MD, Division of Pediatric Rheumatology, BC Children's Hospital, University of British Columbia; D.P. Mosher, MD, Division of Rheumatology, Faculty of Medicine, University of Calgary.
authors.forename: Paul R
authors.initials: PR
authors.lastname: Fortin
authors.affiliation: From the Dalla Lana School of Public Health, University of Toronto; Arthritis Community Research and Evaluation Unit, Toronto Western Research Institute; Institute for Work and Health; Mobility Program, Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario; Division of Rheumatology, Centre de recherche du Centre Hospitalier Universitaire de Québec, Faculté de Médecine de L'Université Laval, Quebec City, Quebec; Department of Pediatrics, University of Saskatchewan, Saskatoon, Saskatchewan; Division of Pediatric Rheumatology, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia; Division of Rheumatology, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada.A. Jetha, PhD; E. Badley, PhD, Dalla Lana School of Public Health, University of Toronto, and Arthritis Community Research and Evaluation Unit, Toronto Western Research Institute; M.A.M. Gignac, PhD, Dalla Lana School of Public Health, University of Toronto, and Arthritis Community Research and Evaluation Unit, Toronto Western Research Institute, and Institute for Work and Health; D. Beaton, PhD, Institute for Work and Health, and Mobility Program, Clinical Research Unit, St. Michael's Hospital; P.R. Fortin, MD, MPH, Division of Rheumatology, Centre de recherche du Centre Hospitalier Universitaire de Québec, Faculté de Médecine de L'Université Laval; A.M. Rosenberg, MD, Department of Pediatrics; N.J. Shiff, MD, MHSc, University of Saskatchewan; L.B. Tucker, MD, Division of Pediatric Rheumatology, BC Children's Hospital, University of British Columbia; D.P. Mosher, MD, Division of Rheumatology, Faculty of Medicine, University of Calgary.
authors.forename: Natalie J
authors.initials: NJ
authors.lastname: Shiff
authors.affiliation: From the Dalla Lana School of Public Health, University of Toronto; Arthritis Community Research and Evaluation Unit, Toronto Western Research Institute; Institute for Work and Health; Mobility Program, Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario; Division of Rheumatology, Centre de recherche du Centre Hospitalier Universitaire de Québec, Faculté de Médecine de L'Université Laval, Quebec City, Quebec; Department of Pediatrics, University of Saskatchewan, Saskatoon, Saskatchewan; Division of Pediatric Rheumatology, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia; Division of Rheumatology, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada.A. Jetha, PhD; E. Badley, PhD, Dalla Lana School of Public Health, University of Toronto, and Arthritis Community Research and Evaluation Unit, Toronto Western Research Institute; M.A.M. Gignac, PhD, Dalla Lana School of Public Health, University of Toronto, and Arthritis Community Research and Evaluation Unit, Toronto Western Research Institute, and Institute for Work and Health; D. Beaton, PhD, Institute for Work and Health, and Mobility Program, Clinical Research Unit, St. Michael's Hospital; P.R. Fortin, MD, MPH, Division of Rheumatology, Centre de recherche du Centre Hospitalier Universitaire de Québec, Faculté de Médecine de L'Université Laval; A.M. Rosenberg, MD, Department of Pediatrics; N.J. Shiff, MD, MHSc, University of Saskatchewan; L.B. Tucker, MD, Division of Pediatric Rheumatology, BC Children's Hospital, University of British Columbia; D.P. Mosher, MD, Division of Rheumatology, Faculty of Medicine, University of Calgary.
authors.forename: Alan M
authors.initials: AM
authors.lastname: Rosenberg
authors.affiliation: From the Dalla Lana School of Public Health, University of Toronto; Arthritis Community Research and Evaluation Unit, Toronto Western Research Institute; Institute for Work and Health; Mobility Program, Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario; Division of Rheumatology, Centre de recherche du Centre Hospitalier Universitaire de Québec, Faculté de Médecine de L'Université Laval, Quebec City, Quebec; Department of Pediatrics, University of Saskatchewan, Saskatoon, Saskatchewan; Division of Pediatric Rheumatology, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia; Division of Rheumatology, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada.A. Jetha, PhD; E. Badley, PhD, Dalla Lana School of Public Health, University of Toronto, and Arthritis Community Research and Evaluation Unit, Toronto Western Research Institute; M.A.M. Gignac, PhD, Dalla Lana School of Public Health, University of Toronto, and Arthritis Community Research and Evaluation Unit, Toronto Western Research Institute, and Institute for Work and Health; D. Beaton, PhD, Institute for Work and Health, and Mobility Program, Clinical Research Unit, St. Michael's Hospital; P.R. Fortin, MD, MPH, Division of Rheumatology, Centre de recherche du Centre Hospitalier Universitaire de Québec, Faculté de Médecine de L'Université Laval; A.M. Rosenberg, MD, Department of Pediatrics; N.J. Shiff, MD, MHSc, University of Saskatchewan; L.B. Tucker, MD, Division of Pediatric Rheumatology, BC Children's Hospital, University of British Columbia; D.P. Mosher, MD, Division of Rheumatology, Faculty of Medicine, University of Calgary.
authors.forename: Lori B
authors.initials: LB
authors.lastname: Tucker
authors.affiliation: From the Dalla Lana School of Public Health, University of Toronto; Arthritis Community Research and Evaluation Unit, Toronto Western Research Institute; Institute for Work and Health; Mobility Program, Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario; Division of Rheumatology, Centre de recherche du Centre Hospitalier Universitaire de Québec, Faculté de Médecine de L'Université Laval, Quebec City, Quebec; Department of Pediatrics, University of Saskatchewan, Saskatoon, Saskatchewan; Division of Pediatric Rheumatology, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia; Division of Rheumatology, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada.A. Jetha, PhD; E. Badley, PhD, Dalla Lana School of Public Health, University of Toronto, and Arthritis Community Research and Evaluation Unit, Toronto Western Research Institute; M.A.M. Gignac, PhD, Dalla Lana School of Public Health, University of Toronto, and Arthritis Community Research and Evaluation Unit, Toronto Western Research Institute, and Institute for Work and Health; D. Beaton, PhD, Institute for Work and Health, and Mobility Program, Clinical Research Unit, St. Michael's Hospital; P.R. Fortin, MD, MPH, Division of Rheumatology, Centre de recherche du Centre Hospitalier Universitaire de Québec, Faculté de Médecine de L'Université Laval; A.M. Rosenberg, MD, Department of Pediatrics; N.J. Shiff, MD, MHSc, University of Saskatchewan; L.B. Tucker, MD, Division of Pediatric Rheumatology, BC Children's Hospital, University of British Columbia; D.P. Mosher, MD, Division of Rheumatology, Faculty of Medicine, University of Calgary.
authors.forename: Dianne P
authors.initials: DP
authors.lastname: Mosher
authors.affiliation: From the Dalla Lana School of Public Health, University of Toronto; Arthritis Community Research and Evaluation Unit, Toronto Western Research Institute; Institute for Work and Health; Mobility Program, Clinical Research Unit, St. Michael's Hospital, Toronto, Ontario; Division of Rheumatology, Centre de recherche du Centre Hospitalier Universitaire de Québec, Faculté de Médecine de L'Université Laval, Quebec City, Quebec; Department of Pediatrics, University of Saskatchewan, Saskatoon, Saskatchewan; Division of Pediatric Rheumatology, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia; Division of Rheumatology, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada.A. Jetha, PhD; E. Badley, PhD, Dalla Lana School of Public Health, University of Toronto, and Arthritis Community Research and Evaluation Unit, Toronto Western Research Institute; M.A.M. Gignac, PhD, Dalla Lana School of Public Health, University of Toronto, and Arthritis Community Research and Evaluation Unit, Toronto Western Research Institute, and Institute for Work and Health; D. Beaton, PhD, Institute for Work and Health, and Mobility Program, Clinical Research Unit, St. Michael's Hospital; P.R. Fortin, MD, MPH, Division of Rheumatology, Centre de recherche du Centre Hospitalier Universitaire de Québec, Faculté de Médecine de L'Université Laval; A.M. Rosenberg, MD, Department of Pediatrics; N.J. Shiff, MD, MHSc, University of Saskatchewan; L.B. Tucker, MD, Division of Pediatric Rheumatology, BC Children's Hospital, University of British Columbia; D.P. Mosher, MD, Division of Rheumatology, Faculty of Medicine, University of Calgary.
authors.forename: Monique A M
authors.initials: MA
authors.lastname: Gignac
mesh_terms: D000328:Adult; D001171:Arthritis, Juvenile / Q000523:psychology*; D003625:Data Collection; D004651:Employment / Q000523:psychology*; D005260:Female; D006801:Humans; D057187:Independent Living / Q000523:psychology*; D008180:Lupus Erythematosus, Systemic / Q000523:psychology*; D008297:Male; D010290:Parents / Q000523:psychology; D065840:Protective Factors; D011584:Psychology; D012044:Regression Analysis; D012216:Rheumatic Diseases / Q000523:psychology*; D012938:Social Perception; D012944:Social Support; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: EMPLOYMENT; INDEPENDENCE; JUVENILE ARTHRITIS; SOCIAL SUPPORT; SYSTEMIC LUPUS ERYTHEMATOSUS; YOUNG ADULTHOOD