Gignac Monique A M, Cao Xingshan
Arthritis Community Research & Evaluation Unit, University of Toronto, Toronto, Ontario, Canada.
Arthritis Rheum. 2009 Dec 15;61(12):1753-61. doi: 10.1002/art.24889.
To examine arthritis self-disclosure at work, factors associated with disclosure, and prospective relationships of self-disclosure and work place support with changes to work place interactions, work transitions, and work place stress.
Using a structured questionnaire, participants with osteoarthritis or inflammatory arthritis were interviewed at 4 time points, 18 months apart. At time 1, all participants (n = 490; 381 women, 109 men) were employed. Of the entire sample, 71% were retained throughout the study. Respondents were recruited using community advertising and from rheumatology and rehabilitation clinics. Self-disclosure and perceived support from managers and coworkers was assessed, as well as demographic, illness, work-context, and psychological variables. Generalized estimating equations modeled associations of disclosure and support on changes at work (e.g., job disruptions, work place stress).
At each time point, 70.6-76.6% of participants had self-disclosed arthritis to their manager and 85.2-88.1% had told a coworker. Intraindividual variability in disclosure was considerable. Factors associated with self-disclosure were often inconsistent over time, with the exception of variables assessing the need to self-disclose (e.g., activity limitations) and perceived coworker support. Self-disclosure was not associated with changes to work. However, coworker support was related to fewer job disruptions, help with work tasks, and being less likely to reduce hours. Perceived managerial support was associated with less work place stress.
Greater awareness is needed about issues related to self-disclosing arthritis at work. This study emphasizes the importance of a supportive work place, especially supportive coworkers, in decisions to discuss arthritis at work and in changes to work that might enable people to remain employed.
研究工作中关节炎的自我披露情况、与披露相关的因素，以及自我披露和工作场所支持与工作场所互动变化、工作转换和工作场所压力之间的前瞻性关系。
采用结构化问卷，对患有骨关节炎或炎性关节炎的参与者进行访谈，时间间隔为18个月，共4个时间点。在时间点1时，所有参与者（n = 490；381名女性，109名男性）均有工作。在整个样本中，71%的人在整个研究过程中被保留。通过社区广告以及从风湿病学和康复诊所招募受访者。评估了自我披露情况以及来自经理和同事的感知支持，同时还评估了人口统计学、疾病、工作环境和心理变量。广义估计方程对披露和支持与工作变化（如工作中断、工作场所压力）之间的关联进行了建模。
在每个时间点，70.6 - 76.6%的参与者向经理自我披露了关节炎，85.2 - 88.1%的参与者告知了同事。披露情况的个体内差异相当大。与自我披露相关的因素通常随时间不一致，但评估自我披露需求的变量（如活动受限）和感知到的同事支持除外。自我披露与工作变化无关。然而，同事的支持与较少的工作中断、工作任务帮助以及减少工作时间的可能性降低有关。感知到的管理支持与较少的工作场所压力相关。
需要提高对工作中自我披露关节炎相关问题的认识。本研究强调了支持性工作场所的重要性，特别是支持性的同事，在工作中讨论关节炎的决策以及可能使人们能够继续就业的工作变化方面。
