Background: Work disability is prevalent among people with rheumatoid arthritis (RA), and preventing work disability has been recognized as preferable to rehabilitation. However, literature reviews have not focused on predictive factors of work disability.
Objectives: To identify predictive factors of work disability by systematically reviewing studies on work disability prevention research.
Search Strategy: A search for studies published between 1988 and 2004 was conducted on the following databases: Cinahl, Embase, and Medline. The following key words were used in combination: (a) rheumatoid arthritis, (b) a cluster of synonyms of work and their different format (e.g., working, worker, occupation, job, employ, etc.), and (c) a cluster of synonyms and antonyms of ability (e.g. able, abilities, unable, capable, incapable, etc.).
Selection criteria: Studies were selected based on two inclusion criteria: (1) individual(s) with RA as participants, and (2) study with the outcome of work ability (or disability) or related concepts.
Data collection and analysis: Once the first reviewer selected the identified papers, the second reviewer repeated the selection process in a random sample of the identified papers for reliability. Selected studies were categorized according to the methodological quality as evaluated by the authors on eight criteria. The authors rated the level of evidence for predictive factors based on the number of studies that are consistent with each other.
Main results: A total of 17 studies were included in the study. The authors reported the following predictive factors of work disabilities: (a) factors that directly reflect RA, including rheumatoid factor positivity and disease duration; (b) impairment of body function or body structure, including variables of disease activity, pain and emotional function, and structural damage; (c) activity limitations; (d) environmental factors; and (e) personal factors. Overall the findings suggest that biomedical variables were not consistent predictors of work disability.
Authors? conclusion: Biomedical variables are not sufficient to explain work disability. Intervention for work disability prevention needs to focus on reducing physical job demands for which job accommodation may be necessarily.