Work factors and behavioural coping in relation to withdrawal from the labour force in patients with rheumatoid arthritis

Objective-To assess separate and combined effects of work factors and behavioural coping in relation to withdrawal from the labour force among patients with rheumatoid arthritis (RA). Methods-A cross sectional study was conducted in a Dutch nationwide random sample of 720 patients with RA. Information about work factors and behavioural coping was collected by a self-administered postal questionnaire. A broad variety of work factors and coping styles were evaluated separately and in combination using multivariate logistic regression analyses, controlling for sociodemographic and disease related variables. Attributable and preventable fractions were calculated from the combined analyses to assess the relative importance of the contributing factors. Results-Additional job training, equal career opportunities, letting the disease influence the choice of the current job position, and informing colleagues about having the disease were negatively associated with withdrawal from the labour force. The most relevant factor in terms of decreasing the risk was adjusting job demands which accounted for 63% of the patients still in the labour force. Decreasing activities and diverting attention in order to cope with pain, and pacing in order to cope with limitations were the coping styles which were positively associated with withdrawal from the labour force. The most relevant factor in terms of increasing the risk of withdrawal was pacing which accounted for 67% of the withdrawals. Conclusion-Work factors are potentially important modifiable risk factors for withdrawal from the labour force in patients with RA. Behavioural coping is also relevant.