Rheumatic disease disclosure at the early career phase and its impact on the relationship between workplace supports and presenteeism

BACKGROUND: Young adults with rheumatic disease face challenges communicating health needs, accessing workplace support and sustaining productivity. We examine whether disclosure modifies the relationship between workplace support and presenteeism. METHODS: An online survey was administered to Canadian young adults with rheumatic disease and asked about presenteeism (0=health had no effect on work; 10=health completely prevented working), workplace support need, availability and use and whether health details were disclosed to an immediate supervisor. A multivariable robust linear regression model was conducted and stratified by those who did and did not disclose the details of their health to their supervisor. RESULTS: 306 participants completed the survey with a mean presenteeism score of 4.9 (SD = 2.3). Over 70% disclosed health details to their supervisor; those who disclosed reported greater presenteeism (mean=5.2; SD=2.5) when compared to those who did not disclose (mean=4.2; SD=2.61). Greater disease severity was associated with disclosure. Half of participants reported unmet workplace support needs (53%), 32% reported that their workplace support needs were met and 15% reported exceeded workplace support needs. The relationship between presenteeism and workplace support needs were modified by disclosure. For participants who disclosed, unmet (ß= 1.59, 95% CI 0.75, 2.43) and met workplace support needs (ß= 1.25, 95% CI 0.39, 2.11) were associated with greater presenteeism when compared to those with exceeded workplace support needs. CONCLUSION: To address presenteeism, strategies should be developed for young adults with rheumatic disease to foster access to available workplace supports and navigate disclosure decisions