Unmet workplace support needs and lost productivity of workers with systemic sclerosis: a path analysis study

OBJECTIVE: Few studies have examined how workplace support can address work productivity loss among individuals with systemic sclerosis (SSc). We examined: 1) the relationship between unmet workplace support needs and work productivity loss among workers with SSc; and 2) whether SSc symptom severity, fatigue, active disease periods and workplace activity limitations mediate the relationship between unmet workplace support and work productivity loss. METHOD: A cross-sectional survey was conducted of employed individuals with SSc who were recruited through rheumatology clinics. Information on work productivity loss (i.e., absenteeism, presenteeism, job disruptions), and the need, availability and use of workplace supports were collected. SSc symptom severity (e.g., workplace activity limitations, active disease periods, fatigue and overall SSc symptom severity), demographic, health and work context characteristics were collected. Three Bayesian path models examined the association between unmet workplace support needs and each work productivity loss outcome. SSc symptom severity variables were examined as mediators in each model. RESULTS: 110 employed participants were recruited (mean age=49 years +/- 12.9). Over three quarters of participants were female (77%) and worked full-time (77%). Most needed workplace supports included extended health benefits (84%), special equipment (63%) and flex-time (59%). Additionally, 61% reported unmet workplace support needs. Path models indicated that indirect relationships between unmet workplace support needs and work productivity loss were significant. For all models, workplace activity limitations mediated the relationship between unmet workplace support need and productivity loss. CONCLUSION: To foster productive employment of people with SSc, interventions need to address symptom severity and meet workplace support needs