Dr. Foster has received honoraria and educational bursaries from Genzyme, Biomarin, and Pfizer (less than $10,000 each).
The relationships between adult juvenile idiopathic arthritis and employment
Version of Record online: 27 AUG 2012
Copyright © 2012 by the American College of Rheumatology
Arthritis & Rheumatism
Volume 64, Issue 9, pages 3016–3024, September 2012
How to Cite
Malviya, A., Rushton, S. P., Foster, H. E., Ferris, C. M., Hanson, H., Muthumayandi, K. and Deehan, D. J. (2012), The relationships between adult juvenile idiopathic arthritis and employment. Arthritis & Rheumatism, 64: 3016–3024. doi: 10.1002/art.34499
- Issue online: 27 AUG 2012
- Version of Record online: 27 AUG 2012
- Accepted manuscript online: 31 MAY 2012 11:49AM EST
- Manuscript Accepted: 3 APR 2012
- Manuscript Received: 13 NOV 2011
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.
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.
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).
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.