Psychosocial working conditions as determinants of asthma self-management at work: A systematic review

Objective: Asthma exerts a considerable impact on patients and their employers. While adequate self-management is able to improve patients' prognosis, its actual implementation in everyday life may depend on contextual factors. We aimed to review the literature on the potential determinants of asthma self-management at the workplace. Data Sources: We systematically searched Medline and PsycINFO using terms related to the key concepts of interest (i.e., adult asthma, working conditions, and self-management). Study Selection: We included original studies published in peer-reviewed journals in English or German since 1992 addressing any type of asthma self-management behavior as the outcome and any type of working condition as the determinant. Results: Upon implementation of a multi-stage selection process, seven articles were included. As those studies showed considerable methodological heterogeneity, a qualitative analysis was applied. A first study identified three different adaptation profiles among employees with asthma with implications for self-management behavior. Another study suggested that concerns about taking time off from work may be associated with the utilization of emergency ambulance services for asthma. Five studies among workers with various chronic illnesses addressed determinants of self-disclosure, coping with acute symptoms (e.g., medication use at work), and the potential effect of practical and emotional support from line managers or colleagues on self-management. Conclusion: Our review indicates that the evidence for a potential link of occupational factors with asthma self-management at work is relatively sparse. Future research should take a more comprehensive approach by considering multiple types of working conditions and asthma self-management behaviors simultaneously.