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Women with fibromyalgia: Employment and daily life
Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
2004 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Introduction: The major symptoms of fibromyalgia have been shown to severely impact everyday activities. As a consequence, many women have problems remaining in a work role. Not being able to fulfil valued roles influences quality of life. Moreover, consequences in terms of high costs in compensation for reduced work ability are also of importance for society. Today, the number of young women diagnosed with fibromyalgia is increasing.

Objectives: The general aim of this thesis was to increase and deepen knowledge of the life situation of women with fibromyalgia; to examine how to manage a work role when in constant pain, and especially the situation for newly-diagnosed women.

Subjects and Methods: 278 women with longstanding pain were included. The thesis includes five different studies, two of them with a focus on the work situation, two with focus on young, newly-diagnosed women’s life situation, and one investigating time-use and activity patterns in working and non-working women with fibromyalgia. Methods used are a postal questionnaire, instruments commonly used in fibromyalgia, a diary, and interviews.

Results: Despite limitations in physical capacity, 48% of the women are working, full-time or part-time. However, most job loss is associated with the fibromyalgia symptoms, and the women report that the symptoms influence their daily activities during most of their waking time. There is a rapid increase in sickness absence in the newly-diagnosed women, and the young women in particular do not return to the labour market during the first year after receiving their diagnosis. The non-working women have a more demanding family situation, and are also less satisfied with their present situation than working women.

Conclusion: When individual adjustments of the work situation are made and the women participate to a level that matches their ability, they are able to continue in a work role. In evaluating the women’s work capacity, the total life situation of the women should be considered.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2004. , 47 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 845
Keyword [en]
work role, newly-diagnosed, time-use, activity pattern, family work
National Category
Clinical Science
Identifiers
URN: urn:nbn:se:liu:diva-5184ISBN: 91-7373-818-2 (print)OAI: oai:DiVA.org:liu-5184DiVA: diva2:21099
Public defence
2004-04-21, Victoriasalen, Campus US, Linköpings universitet, Linköping, 09:00 (English)
Opponent
Supervisors
Note
On the day of the public defence of the doctoral thesis, the status of article III and IV was Submitted.Available from: 2004-05-21 Created: 2004-05-21 Last updated: 2012-01-25Bibliographically approved
List of papers
1. Factors of Importance for Work Disability in Women with Fibromyalgia
Open this publication in new window or tab >>Factors of Importance for Work Disability in Women with Fibromyalgia
2000 (English)In: Journal of Rheumatology, ISSN 0315-162X, Vol. 27, no 5, 1271-1276 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To identify factors of importance for women with fibromyalgia (FM) to continue working despite the limitations imposed by the symptoms.

METHODS: A mail questionnaire with questions regarding social background, symptoms, sickness benefits, work situation, work conditions and adjustments, opinions regarding own work ability, and satisfaction with the situation was sent to 218 consecutive women seen at a university pain or rheumatology clinic. Answers were obtained from 176 women.

RESULTS: Pain, poor quality sleep, abnormal tiredness, muscle stiffness, and increased pain after muscle exertion were frequently reported symptoms. Fifty percent of the women were employed, 15% full-time. Twenty-three percent reported FM as the reason for not working. The work situation had been changed for 58% of the working women, and 80% counted on being able to continue working.

CONCLUSION: Work disability is a serious concern in FM, and the majority of women with FM have limitations in their ability to work. Our results indicate that individual adjustments in the work situation need to be made and that women who have found a level matching their ability may continue to work and find it satisfactory. Early intervention in the work situation is recommended.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-13639 (URN)
Available from: 2004-05-21 Created: 2004-05-21 Last updated: 2009-05-18
2. Factors of Importance for Work Disability in Women with Fibromyalgia: An Interview Study
Open this publication in new window or tab >>Factors of Importance for Work Disability in Women with Fibromyalgia: An Interview Study
2002 (English)In: Arthritis Care and Research, ISSN 1529-0131, Vol. 47, no 3, 266-274 p.Article in journal (Refereed) Published
Abstract [en]

Objective: Fibromyalgia symptoms such as continuous pain, tiredness, hyperalgesia, and allodynia limit gainful employment. The present study examines which factors influence the decision to remain in a work role for women with fibromyalgia. This information is important for the individual and for public finances.

Methods: Qualitative interviews were performed with 39 women, 19 of whom were gainfully employed and 20 who had stopped working. The transcribed interviews were analyzed and divided into categories and subcategories.

Results: Four categories appear, at societal and individual levels, that were regarded as important by the women for remaining in a work role.

Conclusions: The ability to remain at work depends not only on limitations in work capacity, but also on the capacity of society to adjust work environments and work tasks. More individual solutions are needed to allow women with fibromyalgia to maintain work roles.

Keyword
Work role, Employment, Work disability, Qualitative method
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-13640 (URN)
Available from: 2004-05-21 Created: 2004-05-21 Last updated: 2009-05-18
3. The Impact of Fibromyalgia on Employment Status of Newly-Diagnosed Young Women
Open this publication in new window or tab >>The Impact of Fibromyalgia on Employment Status of Newly-Diagnosed Young Women
2005 (English)In: Journal of Musculoskeletal Pain, ISSN 1058-2452, Vol. 13, no 2, 31-41 p.Article in journal (Refereed) Published
Abstract [en]

Objectives: To describe employment loss in young women with newly diagnosed fibromyalgia syndrome [FMS] and to identify variables that may explain early loss of employment.

Methods: In this pilot studsy, 94 young women [18-39 years old] in the United States [USA] and Sweden completed demographics, global rating scales, and standardized questionnaires, including the Fibromyalgia Impact Questionnaire, SF-36 General Health Subscale, Beck Depression Inventory, Beck Anxiety Inventory, Arthritis Self-Efficacy Scale, Arthritis Impact Measurement Scales II Social Support Subscale, and Job Flexibility Scale, three times during the first 12 to 15 months after diagnosis.

Results: At the time of diagnosis, 60 percent were in paid employment [USA 71 percent, Sweden 49 percent]. When the participants entered the study, within three months of diagnosis, only 46 percent were working [USA 56 percent, Sweden 37 percent]. Twelve months later, 41 percent were working [USA 55 percent, Sweden 28 percent]. Younger age, poorer physical functioning, and lower self-efficacy for pain management along with higher symptom interference with ability to do any work, and pain severity predicted unemployment with 75 percent accuracy.

Conclusions: An early and notable decrease in the percentage of young women diagnosed with FMS and working in paid employment was seen in this pilot study. Because most of the job loss was associated with FMS symptoms, a larger study of strategies to control or ameliorate these symptoms in the work setting should be undertaken.

Keyword
Fibromyalgia; women; employment; disability; outcomes
National Category
Social Sciences
Identifiers
urn:nbn:se:liu:diva-13641 (URN)10.1300/J094v13n02_05 (DOI)
Available from: 2004-05-21 Created: 2004-05-21 Last updated: 2009-05-07
4. Young women with fibromyalgia in the United States and Sweden: Perceived difficulties during the first year after diagnosis
Open this publication in new window or tab >>Young women with fibromyalgia in the United States and Sweden: Perceived difficulties during the first year after diagnosis
2006 (English)In: Disability and Rehabilitation, ISSN 0963-8288, Vol. 28, no 19, 1177-1185 p.Article in journal (Refereed) Published
Abstract [en]

Purpose. The major symptoms of fibromyalgia (FM) - pain, tiredness, disrupted sleep, and muscle weakness - severely impact everyday activities, including the paid work role of women who have had FM for a long time. There are no prospective studies on young and newly diagnosed women with FM. The aim of the present study was to describe and compare difficulties young and newly diagnosed women in Sweden and the United States experienced during their first year after diagnosis.

Method. Three interviews, 6 months apart, were conducted, with 49 Swedish and 45 US women between the ages of 18 and 39. Five open-ended questions were asked concerning physical, psychological and social difficulties and limitations, and factors that increased or decreased their difficulties and limitations. At interviews 2 and 3 the women were also asked about ways of preventing their difficulties. The answers were written down and analysed by a content analysis approach.

Results. Consistent categories of difficulties were reported: symptoms, movements, activities, moods, social network, external factors and coping strategies. More US women were working outside their homes than were their Swedish counterparts and they expressed more difficulties compared with the Swedish women.

Conclusions. In general, difficulties decreased and coping strategies increased over the 1-year period in both groups of newly diagnosed, young women.

Keyword
Activities of daily living; qualitative method; content analysis; physical; psychological; social
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-13642 (URN)10.1080/09638280600551534 (DOI)
Available from: 2004-05-21 Created: 2004-05-21
5. Time Use and Activity Patterns in Women with Long-term Pain
Open this publication in new window or tab >>Time Use and Activity Patterns in Women with Long-term Pain
2004 (English)In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, Vol. 11, no 1, 26-35 p.Article in journal (Refereed) Published
Abstract [en]

Earlier studies of people with fibromyalgia have shown that pain, tiredness, and sleep disruption seriously affect their daily performance and their ability to maintain life roles. A time-geographic diary method was used to study activities and time use in the daily lives of women with long-term pain. The results of the diaries were also used to evaluate activity changes over time. Sixteen women wrote diaries over seven days, and after three months for another four days. The diaries were analysed in a computer program. After considering the results of the first diary, the women formulated goals to be met in the following three months. The results showed that working women spent significantly less time on “Care for others”, “Care for oneself”, Rest, and “Procure and prepare food” compared with non-working women. Further, working women used time in a manner similar to that of the Swedish female population. The diary method gave a clear picture of the women's daily lives. Visualized in graphs and tables, it will serve as an educational tool in rehabilitation and can be used as a framework for discussing adjustment and coping strategies.

Keyword
activities of daily living, fibromyalgia, occupational therapy, qualitative research, rehabilitation, work
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-13643 (URN)10.1080/11038120410019081 (DOI)
Available from: 2004-05-21 Created: 2004-05-21 Last updated: 2009-08-19

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