Introduction:
Over 30 million Americans have a diagnosis of diabetes. The estimated cost of diagnosed diabetes in 2012 was $245 billion, including $69 billion in reduced productivity. Although many adults with diabetes are productive members of the workforce, loss of work productivity has been associated with the presence of diabetes.
Hypothesis:
We tested the hypothesis that work-related factors were associated with work ability in a sample of working adults with diabetes.
Methods:
This was a cross-sectional mixed methods descriptive design used to study a national convenience sample of 101 working adults with diabetes. Subjects were recruited through the online tool ResearchMatch, and completed surveys using the secure web application REDCap. Valid surveys assessed job content, work-life balance, work limitations and work ability, followed by qualitative telephone interviews in a sub-sample of 30 adults. Adjusting for hemoglobin A1c and diabetes duration, factors significant in the bivariate statistics were included in the stepwise logistic regression with the outcome of excellent work ability. Lastly, quantitative and qualitative data were integrated for analysis.
Results:
The sample was 65% female with mean age 54.1±10.5. The majority were White (74%), non-Hispanic (93%), married (51%), worked full-time (65%) and had type 2 diabetes (87%) with a mean duration of 12.4±9.5 years. Less than half (42%) reported their most recent hemoglobin A1c was <7%. They worked 36±14 hours per week and the majority rated their current work ability as either good (42%) or excellent (33%). Factors associated with work ability included co-worker support (p=.007), work-life balance (p<.0001), skill discretion (p=.02), psychological demands (p=.006), and supervisor support (p=.03). Two factors were independently associated with self-reported excellent work ability: increasing co-worker support improved the odds of excellent work ability (OR: 1.4; 95% CI: 1.04-1.9; p=0.025) and poorer work-life balance decreased the odds or excellent work ability (OR: 0.77; 95% CI: 0.67-0.89; p <.0001).
Qualitative:
Several themes emerged from the data. Most reported no impact of work on keeping medical appointments or managing diabetes at work, and diabetes management was better during a work day since they were on a schedule. Very few report wellness programs at work, and if they exist (e.g. exercise or weight loss program), most do not engage in them.
Data integration:
Those who reported an excellent work ability also expressed less stress and more control over their daily routine.
Conclusions:
The majority of the sample reported good or excellent work ability which was related to less stress and more job control. Workers may benefit from wellness programs that address not only diabetes self-management but also job stress, ways to improve co-worker support, and maintaining optimal work-life balance.