Impromptu everyday disclosure dances: how women with fibromyalgia respond to disclosure risks at work

Disabil Rehabil. 2016 Jul;38(15):1442-53. doi: 10.3109/09638288.2015.1103794. Epub 2015 Nov 27.

Abstract

Purpose: Findings from a study examining how women with fibromyalgia remain employed are used to explicate a conceptualization that adds to literature on workplace disclosure of stigmatized illnesses and impairments: disclosure dances that employees improvise in response to workplace-relationships needs and disclosure risks.

Methods: Critical-discourse-analysis (CDA) methodology framed the study. Data were collected through 26 semi-structured, individual interviews with participant triads or dyads comprising women with fibromyalgia, family members and supervisors or co-workers. Interviews with managers who supervised disabled employees other than the women supplemented these data. Following coding, data were compared within and across triads/dyads through code-dimension summaries, narrative summaries and relational diagrams.

Results: Women with fibromyalgia and other stigmatized illnesses improvised everyday disclosures when they needed to explain fluctuating work ability, when others needed reminding about invisible impairments, and when workplace relationships changed. These impromptu disclosures comprised three dimensions: exposing oneself to scrutiny by disclosing both illness and impairments, divulging stigmatized illness, and revealing invisible impairments selectively.

Conclusion: Through impromptu disclosure dances, women tailored disclosure to changing immediate circumstances. While assumptions from psychological theories of risk underlie current conceptualizations of disclosure as planned in advance, this article examines disclosure through a different lens: social theories of everyday risk. Implications for rehabilitation For women with fibromyalgia, disclosing illness and impairments at work may entail risks to their jobs and workplace relationships. Rehabilitation professionals need to consider these risks when advising women with fibromyalgia about disclosing their illness and impairments at work. Professionals may first want to learn from clients about their workplace cultures and relationships, and their perceptions of disclosure risk. Professionals can then suggest a range of disclosure responses, depending on the relationship and risk.

Keywords: Chronic illness; disclosure risks; everyday risk; fibromyalgia; workplace disclosure; workplace relationships.

MeSH terms

  • Adult
  • Female
  • Fibromyalgia* / physiopathology
  • Fibromyalgia* / psychology
  • Fibromyalgia* / rehabilitation
  • Humans
  • Occupational Stress / psychology
  • Rehabilitation / methods
  • Rehabilitation / psychology*
  • Risk Reduction Behavior
  • Self Disclosure*
  • Social Adjustment*
  • Social Stigma
  • Work Performance*