Why are Disclosure Decisions so Difficult? Understanding Factors that Encourage and Discourage Workers with a Chronic Disabling Condition from Disclosing Health Information at Work.

IF 2.5 3区 医学 Q1 REHABILITATION
Monique A M Gignac, Julie Bowring, Ron Saunders, Lahmea Navaratnerajah, Peter M Smith, Arif Jetha, Aaron Thompson, Renee-Louise Franche, William S Shaw, Marta Pienkowski
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Abstract

Purpose: The decision whether to disclose a disability at work is complex. Drawing on communication theories, we examined disclosure decision-making and how workers with disabling health conditions prioritized information that could simultaneously encourage and discourage disclosure.

Methods: An online, cross-sectional survey asked workers with physical and mental health/cognitive conditions creating job limitations (i.e., disability) at work about the health impacts on their employment, their disclosure goals, preferences, support availability, workplace culture, work context, and demographic information. Descriptive, multivariate, and latent profile analyses were used.

Results: Participants were 591 workers (51% men, 48% women, 1% non-binary) with physical (41%), mental health/cognitive (24%), or both groups of conditions (35%). Forty-two percent of participants had not disclosed health information or needs to their supervisor. Six profiles of decision patterns were identified: (1) little health impact, supports available; (2) some health impacts, positive support appraisals; (3) some health impacts, uncertain what to do; (4) some health impacts, considerable personal concerns; (5) little health impact, few concerns, few supports available; and (6) considerable health impacts but perceives many risks to sharing. Disclosure decisions often prioritized personal goals, preferences, and workplace culture over health impacts and support availability. Profiles were differentiated by health condition type and work context.

Conclusion: Understanding how workers prioritize information when considering disclosing a disability at work has implications for organizational support practices and clinical efforts to support workers. It underscores that worker decisions go beyond health impacts and highlights the need for support resources to help workers address decision uncertainty and stress.

为何披露决策如此困难?了解鼓励和阻止患有慢性残疾的工人在工作中披露健康信息的因素。
目的:是否在工作中披露残疾的决定是复杂的。根据传播理论,我们研究了披露决策,以及患有残疾健康状况的工人如何优先考虑可能同时鼓励和阻止披露的信息。方法:一项在线横断面调查,询问在工作中有身体和心理健康/认知状况造成工作限制(即残疾)的员工对其就业的健康影响,他们的披露目标、偏好、可获得的支持、工作场所文化、工作环境和人口统计信息。使用了描述性、多变量和潜在剖面分析。结果:参与者为591名工人(51%男性,48%女性,1%非二元),身体(41%),心理健康/认知(24%)或两组条件(35%)。42%的参与者没有向他们的主管透露健康信息或需求。确定了六种决策模式概况:(1)健康影响小,有支持;(2)部分健康影响、积极支持评价;(3)一些健康影响,不确定如何处理;(4)对健康有一定影响,对个人有相当大的影响;(5)健康影响小,关注少,支持少;(6)相当大的健康影响,但认为许多风险共享。披露决策通常优先考虑个人目标、偏好和工作场所文化,而不是健康影响和支持的可用性。概况根据健康状况类型和工作环境进行区分。结论:了解员工在考虑在工作中披露残疾时如何优先考虑信息,对组织支持实践和临床支持员工的努力具有重要意义。报告强调,工人的决定超出了对健康的影响,并强调需要提供支助资源,帮助工人应对决策的不确定性和压力。
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来源期刊
CiteScore
5.80
自引率
12.10%
发文量
64
期刊介绍: The Journal of Occupational Rehabilitation is an international forum for the publication of peer-reviewed original papers on the rehabilitation, reintegration, and prevention of disability in workers. The journal offers investigations involving original data collection and research synthesis (i.e., scoping reviews, systematic reviews, and meta-analyses). Papers derive from a broad array of fields including rehabilitation medicine, physical and occupational therapy, health psychology and psychiatry, orthopedics, oncology, occupational and insurance medicine, neurology, social work, ergonomics, biomedical engineering, health economics, rehabilitation engineering, business administration and management, and law.  A single interdisciplinary source for information on work disability rehabilitation, the Journal of Occupational Rehabilitation helps to advance the scientific understanding, management, and prevention of work disability.
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