Open AccessThe relationships between adult juvenile idiopathic arthritis and employment
Author(s) -
Malviya Ajay,
Rushton Stephen P.,
Foster Helen E.,
Ferris Calum M.,
Hanson Helen,
Muthumayandi Karthik,
Deehan David J.
Publication year - 2012
Publication title -
arthritis & rheumatism
Language(s) - English
Resource type - Journals
eISSN - 1529-0131
pISSN - 0004-3591
DOI - 10.1002/art.34499
Subject(s) - medicine , gainful employment , physical therapy , educational attainment , arthritis , structural equation modeling , juvenile rheumatoid arthritis , juvenile , disease , gerontology , psychology , job satisfaction , job performance , social psychology , statistics , mathematics , job attitude , biology , economics , genetics , economic growth
Abstract Objective The chronicity of juvenile idiopathic arthritis (JIA) into adulthood and attendant potential disability may adversely influence educational attainment and the ability to secure and maintain gainful employment. We undertook this study to investigate the effects of patient‐ and disease‐specific factors on education and employment outcomes in a group of adult patients with JIA. Methods We performed a cross‐sectional study of 103 consecutive adults attending a JIA continuity clinic, and patients who consented completed questionnaires relating to educational achievement, employment status, and functional disability (the Health Assessment Questionnaire disability index [HAQ DI]), and, for those who were employed, the rheumatoid arthritis Work Instability Scale. We used the structural equation modeling technique to study key patient and disease variables for employment in adults with JIA. Results The median age of patients was 24 years (range 17–71 years) with median disease duration of 19 years (range 7–67 years). Functional disability (the mean HAQ DI score) was significantly lower in patients who were employed ( P = 0.03) and in those with oligoarticular JIA (t = 2.29, P = 0.02). Educational achievement was not influenced by JIA subtype (F = 1.18, P = 0.33). Educational achievement measured by General Certificate of Secondary Education (GCSE) grades had a positive effect on the type of job achieved in later life (F = 11.63, P = 0.001), with greater success leading to more professional or managerial posts. In the complex structural equation model, job stability was influenced positively by educational achievement measured by GCSE grades and negatively by the HAQ DI score (t = 10.94, P = 6.36 × 10 −16 ). Conclusion Educational attainment is key to successful employability and is influenced by functional disability rather than by JIA subtype. These findings have implications for choice of occupation and delivery of career advice to aid decision making by young people with JIA.