The Influence of Employer Support on Employee Management of Chronic Health Conditions at Work Fehmidah Munir Raymond Randall Joanna Yarker Karina Nielsen Ó Springer Science+Business Media, LLC 2009 Abstract Introduction This study examined the relation- ship between employer support, self-efficacy and self-man- agement of chronic illness at work. Method 772 employees reporting musculoskeletal pain (n = 230), arthritis and rheumatism (n = 132), asthma (n = 129), depression and anxiety (n = 121), heart disease (n = 80) and diabetes (n = 80) completed a questionnaire distributed across four large organizations. A modified version of the Self-Efficacy to Manage Symptoms Scale and the Self-Management Behaviors Scale were used. Support from line manager and occupational health were assessed. Results Structural equa- tion modelling analyses revealed that line managers support was directly related to employees’ self-management of symptoms and medication at work. All three self-efficacy measures (beliefs about the ability to make adjustments, take medication and manage symptoms at work) partially mediated the relationship between line manager support and the use of medication at work. Self-efficacy beliefs in taking medication and making work adjustments also partially mediated the relationship between line manager support and self-management of symptoms at work. In contrast, there were no direct relationship between occupational health support and two self-management behaviors. Self-efficacy beliefs about making adjustments at work fully mediated the relationship between support from occupational health and self-management behaviors. Conclusions Employer support in developing both symptom-related and work-related self- efficacy for medication adherence and symptom manage- ment is important for those working with a chronic illness. Keywords Self-efficacy Á Self-management behaviors Á Employer support Á Chronic health conditions Á Line managers Á Presenteeism Introduction It is well-recognised that employees with chronic health conditions such as poor mental health and musculoskeletal pain have increased sickness absence and presenteeism compared with healthy employees [1, 2]. Employers and Governments in industrialised countries are keen to reduce the costs associated with both sickness absence and pre- senteeism associated with chronic health conditions, and there is now recognition that in order to reduce these costs, organizations must invest in health management as a way to reduce symptom burden for the employee and optimise work productivity for those employees with a chronic health condition [3]. Although a number of strategies can be introduced at the organizational level to improve employee health and well- F. Munir (&) Work and Health Research Centre, School of Sport, Exercise and Health Sciences, Brockington Building, Loughborough University, Loughborough, Leicestershire LE11 3TU, UK e-mail: F.Munir@lboro.ac.uk R. Randall School of Psychology, Leicester University, Lancaster Road, Leicester LE1 9HN, UK e-mail: rjr15@leicester.ac.uk J. Yarker Goldsmiths College, University of London, New Cross, London SE14 7NW, UK e-mail: j.yarker@gold.ac.uk K. Nielsen National Research Centre for the Working Environment, Lersoe Park Alle 105, 2100 Copenhagen, Denmark e-mail: kmn@ami.dk 123 J Occup Rehabil DOI 10.1007/s10926-009-9199-7