Background Working life factors influence patients’ (life) satisfaction and well being. Effort at work is part of a social contract that reciprocates effort by adequate reward. Components of work-related rewards matter for health. Research on effort-reward imbalance (ERI) might contribute to the understanding of factors related to the well-being of patients (pts) with systemic lupus erythematosus (SLE). We studied the ERI model in SLE with respect to gender-specific aspects.
Objectives We studied the ERI model in SLE with respect to gender-specific aspects.
Methods A cross-sectional study applied a set of standardized self-reported questionnaires to SLE pts capable for work. Effort- reward ratio (ERR) > 1 reflects ERI, overcommitment scores (OCS) in the upper tertile (UT) indicate relevant values. Data were compared to controls (c) not suffering from rheumatic diseases. Ethical approval was obtained.
Results 252 pts (95.6% female (f)) and 177 c (90.3% f) contributed data. Pts mean age was 40.1±9.4 (c 42.8±9.8) years, mean disease duration 10.5±7.3 years, mean HAQ 0.8±0.4 (c 0.4±0.1). In pts 86.0% self-reported at least one comorbidity (range 0-10), c 45.2% (range 0-4). 77.4% took at least one immunosuppressive drug (DMARD, range 0-3). 40.5% steroids ≤7.5mg, 16.3% steroids >7.5mg, 34.0% NSAIDS.
For (gender-specific) ERI and OCS results see table 1. 13.8% showed relevant effort-reward imbalance (ERR>1). ERR>1 pts scored significantly worse in all ERI subscales (p-values<0.01). Except marital status the above mentioned personal and disease related factors did not differ significantly in ERR>1 and ERR≤1 pts, none of the factors differed significantly in pts with OCS in the lower tertiles compared to pts with OCS in UT.
Compared to c pts differed significantly in the OCS, effort, reward and esteem scale as well as in ERR>1 and proportions of OCS in UT. Although the same was found for female pts, male (m) pts did not differ significantly to male c.
Conclusions In this first study investigating the ERI in SLE pts a high proportion had effort reward imbalance (ERR>1). ERI values and OCS were significantly different between female pts and c. Further study analysis will address pts satisfaction with their family situation and other (gender) specific factors to develop appropriate support strategies.
Acknowledgements Unrestricted grants Ministry of Innovation, Science, Research and Technology of the German State North Rhine-Westphalia, Deutsche Rheuma-Liga e.V., German LE Self-Help Community, Abbott Immunology Germany, Hiller Foundation.
Disclosure of Interest None Declared