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Young adults with SLE experience 20% to 40% work loss rate
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FORT WORTH, Texas — Young adults with systemic lupus erythematosus have a work loss incidence rate of 20% to 40%, right at a time when they are experiencing multiple transitions in their personal and professional lives, according to Carole Dodge, OTRL, CHT, of Michigan Medicine.
“Due to all of the symptoms they face, and the difficulties it causes for school, mobility, housework, paid work and other aspects of their lives, young adults start limiting their activity,” Dodge told attendees at the Rheumatology Nurses Society Annual Meeting. “Not surprisingly, there is a higher incident of work loss due to SLE among this age group.”
According to Dodge, SLE-related issues that may cause a reduction of work include musculoskeletal or cognitive impairment, pain, fatigue, anxiety or increased disease activity.
“Maybe, due to musculoskeletal impairment, they cannot work an 8-hour day,” she said. “Or, concerning cognitive involvement, if they have a job that involves numbers or requires attention to detail, maybe they make lots of errors and this comes to their employer’s attention, and they may be let go. In addition, knowing they have pain or fatigue may lead to increased anxiety, which can impair their performance on the job.”
In addition, increased disease activity may require patients to miss work due to physician appointments, which could also lead to the patient to be fired or let go, Dodge said.
For young adults, this all occurs during a period in their life when lupus is also creating increased challenges regarding school, leisure and social activities, parenting and their identity, she added.
To help these patients better transition into their adult lives, and to develop strategies for healthy disease management, Dodge recommended occupational therapy, including physical activity and exercise. According to Dodge, occupational therapy can improve cognitive deficits, fatigue, pain and anxiety.
In addition, Dodge said that young adult patients with SLE who performed supervised aerobic training on a treadmill have experienced improvements in depression, function, exercise tolerance and aerobic capacity, as well as less fatigue, with no increase in disease severity.
Education and self-management may also help young adult patients with SLE, she said.
According to Dodge, patients with lupus who completed a 6-week arthritis management program for SLE experienced significant improvements in fatigue, depression, coping skills and self-efficacy. In addition, those who completed an education self-management program demonstrated significant improvements in depression, anxiety, overall mental burden and quality of life, although there was no improvement in disease activity.
In addition to physical activity and self-management, Dodge stressed the importance of listening to patients.
“We all have time constraints in the office, but therapists have a little bit more time to talk with the patient, and sit down with them,” Dodge said. “When I have a patient in my clinic, I do a lot of time just listening. I will ask them questions, but then I will just sit back. I ask them what their biggest challenges are, and I ask them what activities they are avoiding, and what is the most important change they would make. This is important because, although they are most likely doing what they can to get by, avoiding activities that are important to them can affect their quality of life. Getting those activities back is an important aspect to focus on.” – by Jason Laday
Reference:
Dodge C. Navigating life’s transitions with SLE: School, relationships, work and career. Presented at: Rheumatology Nurses Society Annual Conference; Aug. 8-11, 2018; Fort Worth, Texas.
Disclosure: Dodge reports no relevant financial disclosures.