Varekamp, I. , de Vries, G. , Heutink, A. & van Dijk, F. J. H. Empowering employees with chronic diseases; development of an intervention aimed at job retention and design of a randomised controlled trial. BMC Health Serv. Res. 8, 224

Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, The Netherlands.
BMC Health Services Research (Impact Factor: 1.71). 12/2008; 8(1):224. DOI: 10.1186/1472-6963-8-224
Source: PubMed


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).

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    • "The lower HRQOL regarding school/work functioning might be explained by the typically higher rates of absences for individuals with chronic health conditions compared to healthy populations [34]. It has been found that YAs with chronic health conditions are less able to work than their healthy peers and have paid jobs less often [35,36]. Surprisingly, the differences described above seem not to apply for men ages 26–30. "
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    ABSTRACT: The purpose of this study is to provide Dutch norm data and to assess internal consistency and construct validity for the Pediatric Quality of Life Inventory Young Adult Generic Core Scales (PedsQL_YA) in Dutch young adults aged 18-30 years. A sample of 649 young adults from the general Dutch population aged 18-30 years, stratified by age, sex, marital status and education, completed a socio-demographic questionnaire and the Dutch version of the PedsQL_YA online. Internal consistency of the PedsQL_YA scales was determined with Cronbach's alphas. Norm scores were obtained by calculating the mean PedsQL scale scores by gender, age and health status. Differences in scale scores were analyzed for gender, age and health status (construct validity) using two-sample t-tests and effect sizes were calculated. Construct validity was determined by testing differences in PedsQL scores between healthy young adults and young adults with chronic health conditions. All scales of the PedsQL_YA showed satisfactory to excellent internal consistency, with Cronbach's alphas between .77 and .94. Men reported higher scores (indicating better HRQOL) than women on all scales (p < .01), except for school/work functioning. No age differences were found. Young adults with chronic health conditions scored lower on all scales (p < .001) than healthy young adults, indicating good construct validity. Effect sizes varied from medium to large. The Dutch version of the PedsQL_YA has adequate psychometric properties. With the availability of reliable norm data, the PedsQL_YA can be used as a tool in the evaluation of health related quality of life in healthy young adults and those with a chronic health condition.
    Health and Quality of Life Outcomes 01/2014; 12(1):9. DOI:10.1186/1477-7525-12-9 · 2.12 Impact Factor
    • "vocational rehabilitation for patients entering or re-entering in the workforce exist, on the other, the issue of maintaining the current employment is not evaluated systematically in research (Townsend, 2008; Varekamp et al., 2008). "
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    ABSTRACT: We assess the knowledge available on the difficulties experienced by multiple sclerosis (MS) patients in work-related activities. A literature review was carried out using the keywords 'multiple sclerosis' and 'employment' or 'work' through PubMed and EMBASE. Papers reporting patient-derived data on difficulties at work as primary or secondary outcome measures and published in the period 2002-December 2011 were searched. A total of 26 papers were selected, for a total of 32 507 patients (mean age 46.2 years; 42.1% with relapsing-remitting MS). Most papers reported observational studies or cross-sectional surveys focused on health-related quality of life and MS costs. Symptoms more frequently addressed are fatigue, mobility and cognitive impairments. Limited research has been carried out on the working environment. We found a relatively small number of papers published in the last 10 years on the difficulties that patients with MS can experience at work, and this kind of information always appeared as a secondary outcome. In general, it is possible to affirm that MS has a strong impact on patients' employment status, as the mean unemployment rate was 59%. Research on factors promoting maintenance of remunerative employment is required.
    International journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation 12/2012; 36(2). DOI:10.1097/MRR.0b013e32835c79ea · 1.28 Impact Factor
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    • "From a societal viewpoint, encouraging employees to work whenever possible is an economic and social imperative [2]. For the past several decades, social policy in many countries has been focused on helping individuals with a chronic disease or disability that restricts participation in work roles, to enter or re-enter the labor market [38]. "
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    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.
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