To understand the experiences of persons with non-visible disabilities / illnesses
pertaining to disclosure decision-making and navigating disclosure and concealment
at work while comparing across disability / illness types, gender, age, and geographic
We conducted a qualitative meta-synthesis using Noblit and Hare's seven steps of meta-ethnography.
Comprehensive searches were conducted via MEDLINE, CINAHL, EMBASE, APA PsychInfo,
Scopus, and Sociological Abstracts (date limit: 2000 to July 2020).
Primary, peer-reviewed, qualitative or mixed methods studies (including only qualitative
components), written in English, that explored disclosure decision-making and/or navigation
of disclosure/concealment with participants who had non-visible disabilities/illnesses
in competitive employment settings were included. Three reviewers were involved in
Data were extracted using a standardized charting form that aligned with the research
question and objectives developed by the primary author (VT). VT independently extracted
the data and a lab research assistant double-checked and extracted the data from 53%
(10 articles) of randomly selected articles.
Studies were analyzed to develop conceptual categories, third-order constructs (i.e.,
themes), and a line-of-argument with reflections and comparisons drawn from the Disclosure
Decision Making Model and Disclosure Process Model and consideration of disability/illness
type, gender, age, and geographic location. Twenty-four studies were included involving
489 participants, aged 16 to 81, from nine countries, including non-visible disabilities/illnesses
such as Human Immunodeficiency Virus, Multiple Sclerosis, fibromyalgia, epilepsy,
learning disabilities, Juvenile Idiopathic Arthritis, and mental illnesses. We developed
four themes for the disclosure decision-making process (self- and other-focused, experiential,
and environmental/workplace factors) and two themes for the disclosure/concealment
event (disclosure/concealment logistics and timing) and noted emerging trends across
ages, genders, disability and illness types, and geographic locations.
: Knowledge obtained could be used among professionals who support persons with non-visible
disabilities or illnesses to help them navigate disclosure at work, and to consider
the role of age, genders, disability and illness types, and geographic locations on
No conflicts of interest to report.