Supplementary Material for: Overcoming Workplace Disability in IBD Patients: An Observational Study

<b><i>Background:</i></b> Inflammatory Bowel Disease (IBD) can have considerable effects on employment outcomes because of its disabling character. <b><i>Goals:</i></b> We aimed to investigate the impact of IBD in the workplace and to better understand the need for accommodations and adaptations. <b><i>Study:</i></b> Between November 2017 and March 2018, IBD patients were recruited from outpatient clinics in Christchurch Hospital, New Zealand. The survey assessed employment, the need for workplace accommodations and the difficulty arranging it, insurance, and disability using the item-reduced Inflammatory Bowel Disease Disability Index for self-report (IBD-DI-SR). Data were analyzed using descriptive statistics and multivariate logistic regression modeling. <b><i>Results:</i></b> One hundred twenty-three patients were included (response rate 64%), 112 of whom reported that they experienced symptoms while working (60% female, 71% Crohn’s disease, mean age 41.9 years). Ninety-one percent needed at least 1 workplace accommodation when symptoms were most severe. Almost half of the patients who needed an accommodation had difficulty arranging it. The most needed accommodations were time to go to medical appointments (71%) and easy access to a suitable toilet (71%). Being female, having less effective medication, and being distressed were associated with the need for 2 or more accommodations, difficulty in arranging accommodations, and not asking for needed accommodation. <b><i>Conclusions:</i></b> Many IBD patients need accommodations at work while symptomatic in order to overcome workplace disability, which can be difficult to arrange. Improved resources are needed to inform employees and employers about the disease, the possibilities for workplace accommodations, and practical strategies to request them.

**背景**：炎症性肠病（Inflammatory Bowel Disease, IBD）具有致残性，可对患者的就业结局产生显著影响。
**目标**：本研究旨在探讨炎症性肠病对职场的影响，并深入了解患者对工作场所适配调整的需求。
**研究方法**：2017年11月至2018年3月，研究人员从新西兰克赖斯特彻奇医院的门诊诊所招募炎症性肠病患者。本调研采用经条目精简的炎症性肠病残疾自评量表（item-reduced Inflammatory Bowel Disease Disability Index for self-report, IBD-DI-SR），对患者的就业情况、工作场所适配调整需求及申请难度、保险状况与残疾情况进行评估。研究采用描述性统计与多因素logistic回归模型对采集数据进行分析。
**结果**：本研究共纳入123例患者，应答率为64%；其中112例报告在工作期间出现症状，受试者中女性占60%、克罗恩病（Crohn’s disease）患者占71%，平均年龄41.9岁。91%的患者在症状最严重时，至少需要1项工作场所适配调整。在需要适配调整的患者中，近半数表示申请调整存在困难。最常见的适配需求为就医请假时间（71%）与便捷使用合适卫生间（71%）。女性、药物治疗效果不佳以及存在心理痛苦，与患者需要2项及以上适配调整、申请调整困难以及未主动申请所需适配调整均存在相关性。
**结论**：多数炎症性肠病患者在出现症状时，需通过工作场所适配调整来克服职场残疾障碍，但此类调整往往难以申请落实。因此亟需完善相关资源，向在职患者与雇主普及炎症性肠病相关知识、工作场所适配调整的可行方案，以及申请适配调整的实操策略。