Empowering employees with chronic diseases; development of an intervention aimed at job retention and design of a randomised controlled trial

Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, The Netherlands.
BMC Health Services Research (Impact Factor: 1.66). 12/2008; 8:224. DOI: 10.1186/1472-6963-8-224
Source: PubMed

ABSTRACT Persons with a chronic disease are less often employed than healthy persons. If employed, many of them experience problems at work. Therefore, we developed a training programme aimed at job retention. The objective of this paper is to describe this intervention and to present the design of a study to evaluate its effectiveness. DEVELOPMENT AND DESCRIPTION OF INTERVENTION: A systematic review, a needs assessment and discussions with Dutch experts led to a pilot group training, tested in a pilot study. The evaluation resulted in the development of a seven-session group training combined with three individual counselling sessions. The training is based on an empowerment perspective that aims to help individuals enhance knowledge, skills and self-awareness. These advances are deemed necessary for problem solving in three stages: exploration and clarification of work related problems, communication at the workplace, and development and implementation of solutions. Seven themes are discussed and practised in the group sessions: 1) Consequences of a chronic disease in the workplace, 2) Insight into feelings and thoughts about having a chronic disease, 3) Communication in daily work situations, 4) Facilities for disabled employees and work disability legislation, 5) How to stand up for oneself, 6) A plan to solve problems, 7) Follow-up.
Participants are recruited via occupational health services, patient organisations, employers, and a yearly national conference on chronic diseases. They are eligible when they have a chronic physical medical condition, have a paid job, and experience problems at work. Workers on long-term, 100% sick leave that is expected to continue during the training are excluded. After filling in the baseline questionnaire, the participants are randomised to either the control or the intervention group. The control group will receive no care or care as usual. Post-test mail questionnaires will be sent after 4, 8, 12 and 24 months. Primary outcome measures are job retention, self efficacy, fatigue and work pleasure. Secondary outcome measures are work-related problems, sick leave, quality of life, acquired work accommodations, burnout, and several quality of work measures. A process evaluation will be conducted and satisfaction with the training, its components and the training methods will be assessed.
Many employees with a chronic condition experience problems in performing tasks and in managing social relations at work. We developed an innovative intervention that addresses practical as well as psychosocial problems. The results of the study will be relevant for employees, employers, occupational health professionals and human resource professionals (HRM).

Download full-text


Available from: Gabe de Vries, Jun 29, 2015
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To determine whether employees with disabilities were initially assigned to jobs with work demands that matched their work capacities. Forty-six employees with various physical, mental, sensory and multiple disabilities working in a sheltered workshop. Physical and psychosocial work capacities were assessed post-offer and pre-placement using the Ergo-Kit and Melba. Work demands of the jobs were determined by workplace assessments with TRAC and Melba and were compared with the work capacities. Of the 46 employees, 25 employees were not physically overloaded. When physical overload occurred, it was most often due to regular lifting. All employees were physically underloaded on six or more work activities, most often due to finger dexterity and manipulation. Almost all employees (n=43) showed psychosocial overload or underload on one or more psychosocial characteristics. Psychosocial overload was most often due to endurance (long-term work performance), while psychosocial underload was most often due to speaking and writing. Despite the assessment of work capacities at job placement, underload and overload occurred on both physical activities and psychosocial characteristics. Assessing both work capacities and work demands before job placement is recommended. At job placement more attention should be paid to overloading due to lifting and long-term work performance.
    Work 01/2012; 42(2):205-14. DOI:10.3233/WOR-2012-1343 · 0.52 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Employees with a chronic disease may experience work-related problems that contribute to the risk of job loss. We developed a group-based intervention programme aimed at clarifying problems, making these a subject of discussion at work, and realizing solutions. This process evaluation investigates the intervention's feasibility and the satisfaction of 64 participants in eight groups. Data were collected through process evaluation forms and self-report questionnaires. The recruitment of participants was time-consuming. Highly educated women working in the service sector were overrepresented. The programme was administered as planned, although components were sometimes only discussed briefly, due to lack of time. Satisfaction with the overall programme among participants was high; it was perceived as effective and there were only three dropouts. In particular, the focus on feelings and thoughts about having a chronic disease was highly valued, as were the exchange of experiences and role-playing directed at more assertive communication. A vocational rehabilitation programme aimed at job retention is feasible and is perceived to be effective. Such a programme should address psychosocial aspects of working with a chronic disease beside practical problems. The recruitment of participants is time-consuming. Cooperation with outpatient clinics is necessary in order to reach all groups of employees with a chronic disease that might benefit from job retention programmes. Trial registration: ISRCTN77240155.
    International Archives of Occupational and Environmental Health 01/2011; 84(1):35-43. DOI:10.1007/s00420-010-0577-4 · 2.20 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Mensen met een langdurige of chronische ziekte worden vaak belemmerd in hun werk. Zieke werknemers die op een positieve manier in gesprek zijn met hun omgeving hebben een kleinere kans op uitval uit het arbeidsproces. We werken twee voorbeelden uit van begeleiding wanneer werk in de knel komt: (1) empowerment, en (2) participatieve werkmethode. Empowerment training bij een chronische ziekte is bedoeld voor werknemers die door hun ziekte in de problemen komen. De training is opgezet voor een groep van acht deelnemers en één trainer. Er zijn zeven groepsbijeenkomsten en drie individuele gesprekken. De werknemer ontwikkelt inzichten en vaardigheden om in gesprek te komen met de leidinggevende en gezamenlijk oplossingen te zoeken. Zelfreflectie als voorbereiding op de acties is belangrijk; door dit leerproces wordt de werknemer ‘sterker’. De participatieve werkmethode is een programma voor de al dan niet verzuimende werknemer en zijn of haar leidinggevende met begeleiding door een onpartijdige procesbegeleider die zorgt voor een gelijkwaardige inbreng van beide partijen. Hoofddoel is het signaleren van belemmeringen en het bedenken van passende oplossingen op basis van consensus. Tot slot wordt, in geval van ziekteverzuim, een plan van aanpak voor werkhervatting opgesteld. Trainingen gericht op empowerment en de participatieve werkmethode lijken op veel terreinen en in diverse settings toepasbaar.
    Tijdschrift voor Bedrijfs- en Verzekeringsgeneeskunde 10/2010; 18(8):357-362. DOI:10.1007/BF03089128