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The relationships between adult juvenile idiopathic arthritis and employment
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Professor Stephen Rushton
Professor Helen Foster
Professor David Deehan
Malviya A, Rushton SP, Foster HE, Ferris CM, Hanson H, Muthumayandi K, Deehan DJ
Arthritis & Rheumatism
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Objectives: 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 investigated the impact of patient and disease specific factors on education and employment outcomes in patient group of adults with JIA. Methods A cross-sectional study of 103 consecutive adults attending a JIA continuity clinic was performed and consented patients completed questionnaires relating to educational achievement, employment status, functional disability (Health Assessment Questionnaire (HAQ score)) and for those who were in employment, a Work Instability Score(RA-WIS). Results: The median age of patients was 24 years(range:17-71) with median disease duration of 19 years(range:7-67). Functional disability was significantly lower (mean HAQ score) in patients who were in employment (p=0.03) and those with oligoarticular JIA (t=2.28,p=0.02). Educational achievement was not influenced by JIA subtype (F=1.18,p=0.33). Educational achievement at General Certificate of Secondary Education (GCSE)(F=11.63,p=0.001) had a positive impact on the type of job achieved in later life, with higher success leading to more professional or managerial posts. Job stability was influenced positively by educational achievement at GCSE and negatively by the disability score (t=10.94,p=6.36
). Conclusion: We have used structural equation modelling technique to study key patient and disease variables for employment in adults with JIA. Educational attainment is key to successful employability and is influenced by functional disability rather than JIA subtype. This work has implications for choice of occupation and delivery of careers advice and decision making for young people with JIA.
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