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Matić I, Musil V. Subjective Well-Being and Self-Assessed Health of Adolescents: A Longitudinal Cohort Study. Eur J Investig Health Psychol Educ 2023; 13:2853-2862. [PMID: 38131896 PMCID: PMC10742589 DOI: 10.3390/ejihpe13120197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 11/23/2023] [Accepted: 11/30/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND The aim of this study was to investigate the stability and predictors of subjective well-being and self-perceived health in adolescents over a two-year period, focusing on the importance of mental health in overall well-being. METHODS Participants in this longitudinal cohort study were surveyed at the ages of 15 (n = 441) and 17 (n = 354) through questionnaires. The data were analyzed using both descriptive and inferential statistical methods. Hierarchical regression was employed to investigate significant predictors of subjective well-being. The subjective well-being and self-perceived health dimensions showed a consistent level of stability throughout the two-year period of secondary education. Additionally, there was a significant correlation between well-being at the beginning and end of this education period. Furthermore, self-perceived health dimensions, particularly general health, vitality, and mental health, were positively associated with well-being at the end of secondary education, highlighting their role in overall subjective well-being. The regression analysis revealed that self-perceived health factors, notably "General health" and "Mental health", significantly predicted overall subjective well-being, enhancing the model's explanatory power beyond gender and economic status. Nevertheless, baseline subjective well-being has the strongest predictive effect on final well-being. CONCLUSIONS This study highlights the importance of psychological and health factors, particularly mental health, that affect the overall well-being of adolescents and emphasizes the need to focus on and improve these factors in order to improve subjective well-being.
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Affiliation(s)
- Ivica Matić
- Department of Nursing, Catholic University of Croatia, 10000 Zagreb, Croatia
| | - Vera Musil
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia;
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2
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Lyttelton T, Zang E. Occupations and Sickness-Related Absences during the COVID-19 Pandemic. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2022. [PMID: 35100514 DOI: 10.1177/002214652110536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Pandemic frontline occupations consist of disproportionately low socioeconomic status and racial minority workers. Documenting occupational health disparities is therefore crucial for understanding COVID-19-related health inequalities in the United States. This study uses Current Population Survey microdata to estimate occupational differences in sickness-related absences (SAs) from work in March through June 2020 and their contribution to educational, racial-ethnic, and nativity health disparities. We find that there has been an unprecedented rise in SAs concentrated in transportation, food-related, and personal care and service occupations. SA rates were 6 times higher in these occupations than in non-health-care professions. The greatest increases were in occupations that are unsuitable for remote work, require workers to work close to others, pay low wages, and rarely provide health insurance. Workers in these occupations are disproportionately Black, Hispanic, indigenous, and immigrants. Occupation contributes 41% of the total of Black/white differences and 54% of educational differences in SAs.
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Lyttelton T, Zang E. Occupations and Sickness-Related Absences during the COVID-19 Pandemic. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2022; 63:19-36. [PMID: 35100514 PMCID: PMC9013443 DOI: 10.1177/00221465211053615] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Pandemic frontline occupations consist of disproportionately low socioeconomic status and racial minority workers. Documenting occupational health disparities is therefore crucial for understanding COVID-19-related health inequalities in the United States. This study uses Current Population Survey microdata to estimate occupational differences in sickness-related absences (SAs) from work in March through June 2020 and their contribution to educational, racial-ethnic, and nativity health disparities. We find that there has been an unprecedented rise in SAs concentrated in transportation, food-related, and personal care and service occupations. SA rates were 6 times higher in these occupations than in non-health-care professions. The greatest increases were in occupations that are unsuitable for remote work, require workers to work close to others, pay low wages, and rarely provide health insurance. Workers in these occupations are disproportionately Black, Hispanic, indigenous, and immigrants. Occupation contributes 41% of the total of Black/white differences and 54% of educational differences in SAs.
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4
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Grubman-Nowak M, DĘbska-ŚlizieŃ A, Renke M. Employment after renal transplantation vs. the health locus of control and the quality of life. Int J Occup Med Environ Health 2022; 35:53-62. [PMID: 34533137 PMCID: PMC10464777 DOI: 10.13075/ijomeh.1896.01765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 05/12/2021] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVES The aim of the presented study was to compare the health locus of control (HLC) between employed and unemployed patients after kidney transplantation (KT), and to investigate the relationship between HLC and the quality of life (QoL). MATERIAL AND METHODS The study group consisted of 101 KT patients and the control group of 60 hemodialysis (HD) patients. The applied methods were: the Multidimensional Health Locus of Control Questionnaire (MHLC), the WHO Quality of Life Questionnaire (WHOQoL-BREF), and a survey collecting information on the socio-demographic status and work experience. RESULTS Overall, 57.5% of KT patients were employed and 42.5% were unemployed. In the HD group, 25% were employed and 71% were unemployed, while 4% did not disclose their employment status. The unemployed KT patients, in comparison with the employed ones, presented a higher feeling of the impact of chance on their health (unemployed M±SD 23.68±6.59; employed M±SD 21.02±4.57) and a lower level of QoL on the Somatic Scale (unemployed Me = 14.00, IQR = 3.00; employed Me = 1450, IQR = 3.00) and the Environmental Scale (unemployed M±SD 15.39±2.83; employed M±SD 16.85±3.24). In the employed KT group, the Internal Control Scale (MHLC) correlated with all QoL scales (the Somatic Scale: r = 0.292, p = 0.036; the Psychological Scale: r = 0.455, p = 0.001; the Social Scale: r = 0.304, p = 0.029; and the Environmental Scale: r = 0.307, p = 0.027). In the unemployed KT group, the Internal Control Scale (MHLC) correlated significantly with the Somatic Scale (r = 0.396, p = 0.013) and the Psychological Scale (r = 0.374, p = 0.019). CONCLUSIONS The employed KT patients have a higher level of independence, with results indicating a strong internal type. Additionally, the working patients assess their QoL better, both in terms of their health condition and the organization of satisfying environment. The obtained knowledge about the psychological characteristics of KT patients may be useful for the occupational activation programs and psycho-education for those with weaker predispositions. Int J Occup Med Environ Health. 2022;35(1):53-62.
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Affiliation(s)
- Marta Grubman-Nowak
- Medical University of Gdańsk, Clinic of Occupational, Metabolic and Internal Diseases, Gdańsk, Poland
| | - Alicja DĘbska-ŚlizieŃ
- Medical University of Gdańsk, Department of Nephrology, Transplantology and Internal Diseases, Gdańsk, Poland
| | - Marcin Renke
- Medical University of Gdańsk, Clinic of Occupational, Metabolic and Internal Diseases, Gdańsk, Poland
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5
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Verhoef JAC, Bal MI, Roelofs PDDM, Borghouts JAJ, Roebroeck ME, Miedema HS. Effectiveness and characteristics of interventions to improve work participation in adults with chronic physical conditions: a systematic review. Disabil Rehabil 2020; 44:1007-1022. [PMID: 32686963 DOI: 10.1080/09638288.2020.1788180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE Chronic physical conditions often negatively affect work participation. The objective of this systematic review is to investigate the effectiveness and characteristics of vocational rehabilitation interventions for people with a chronic physical condition. METHODS Searches in five databases up to April 2020 identified 30 studies meeting our inclusion criteria. Two reviewers independently assessed and extracted data. The Grading of Recommendation, Assessment, Development and Evaluation (GRADE) framework was used to evaluate quality of evidence for three outcome measures related to work participation. RESULTS All vocational rehabilitation interventions consisted of multiple components, but their characteristics varied widely. Analysis of 22 trials yielded a moderate positive effect with moderate certainty of interventions on work status; analysis of five trials with low risk of bias showed a large positive effect with moderate certainty (risk ratio 1.33 and 1.57, respectively). In addition, in eight studies we found a moderate to small positive effect with low certainty on work attitude (standardized mean difference = 0.59 or 0.38, respectively). We found no effect on work productivity in nine studies. CONCLUSION The systematic review of the literature showed positive effects of vocational rehabilitation interventions on work status and on work attitude; we found no effect on work productivity.Implications for rehabilitationIn rehabilitation, addressing work participation of persons with a chronic physical condition using targeted interventions is beneficial to improve or sustain work participation, irrespective of the intervention characteristics and diagnosis.Interventions that include multiple components and offer individual support, whether or not combined with group sessions, are likely to be more effective in improving work participation in persons with a chronic physical condition.The overview of vocational interventions in this systematic review may assist healthcare professionals in making informed decisions as to which intervention to provide.Vocational rehabilitation, as well as studies on work participation in chronic disease, should include a long follow-up period to explore if work participation is sustainable and contributes to health and wellbeing.
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Affiliation(s)
- Joan A C Verhoef
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands.,Department of Rehabilitation Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Marjolijn I Bal
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands.,Department of Rehabilitation Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Pepijn D D M Roelofs
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
| | - Jeroen A J Borghouts
- Research Centre Caring Society, Avans University of Applied Sciences, Breda, The Netherlands
| | - Marij E Roebroeck
- Department of Rehabilitation Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.,Rijndam Rehabilitation Institute, Rotterdam, The Netherlands
| | - Harald S Miedema
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
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6
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Eguchi H, Tsutsumi A, Inoue A, Kachi Y. Organizational justice and illness reporting among Japanese employees with chronic diseases. PLoS One 2019; 14:e0223595. [PMID: 31634347 PMCID: PMC6802873 DOI: 10.1371/journal.pone.0223595] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 09/24/2019] [Indexed: 12/05/2022] Open
Abstract
Purpose This study examined the association between perceived organizational justice (i.e., procedural justice and interactional justice) and reporting of illness to one's company (illness reporting) among Japanese employees with chronic diseases. Methods This online cross-sectional survey included 1,134 employees (aged 18–65 years) who required workplace support to combine work with disease treatment. Participants were classified into tertiles of perceived organizational justice (low, moderate, and high). Multiple logistic regression analyses were conducted to examine sex differences in the associations between perceived justice and illness reporting. Results Males reporting perceived high levels of procedural and interactional justice had significantly higher odds of illness reporting than those with perceived low levels of procedural (odds ratio [OR] 2.62, 95% confidence interval [CI]: 1.47–4.66) and interactional justice (OR 4.34, 95% CI: 2.28–8.27). Females with perceived high levels of interactional justice had significantly higher odds of illness reporting than those with perceived low levels of interactional justice (OR 1.74, 95% CI: 1.08–2.80). There was no significant association between procedural justice and illness reporting among females. Conclusion The findings indicate that high perceived organizational justice is positively associated with illness reporting among Japanese employees who require workplace support to combine work and disease treatment.
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Affiliation(s)
- Hisashi Eguchi
- Department of Public Health, Kitazato University School of Medicine, Minami-ku, Sagamihara, Kanagawa, Japan
- * E-mail:
| | - Akizumi Tsutsumi
- Department of Public Health, Kitazato University School of Medicine, Minami-ku, Sagamihara, Kanagawa, Japan
| | - Akiomi Inoue
- Department of Public Health, Kitazato University School of Medicine, Minami-ku, Sagamihara, Kanagawa, Japan
| | - Yuko Kachi
- Department of Public Health, Kitazato University School of Medicine, Minami-ku, Sagamihara, Kanagawa, Japan
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7
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Brekke I, Richardsen KR, Jenum AK. Sickness absence in pregnancy and sedentary behavior: a population-based cohort study from Norway. BMC Public Health 2019; 19:71. [PMID: 30651106 PMCID: PMC6334424 DOI: 10.1186/s12889-018-6379-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 12/27/2018] [Indexed: 11/21/2022] Open
Abstract
Background Sickness absence in pregnancy accounts for a large part of sickness-related absenteeism among women. Exercise in pregnancy is associated with a lower level of sickness absence, however little is known about how sedentary behaviour is related to sickness absence in pregnancy. In the current study, we hypothesize a positive association between sedentary hours/day and the risk of long-term sickness absence. Methods Population-based cohort study of pregnant women attending three Child Health Clinics in Groruddalen, Oslo, 823 Women (74% of those eligible) were included between 2008 and 2010. Questionnaire data were collected at gestational weeks 10–20 (visit 1) and 28 (visit 2). Sedentary time and physical activity were objectively recorded at visit 1 with the multi-sensor SenseWear™ Pro3 Armband (SWA). Long-term sickness absence was self-reported at visit 2. We explored the association between sedentary time and long-term sickness absence in pregnancy using multiple logistic regression analysis. Results The odds of long-term sickness absence was significantly increased per one-hour increase in daily sedentary time (odds ratio 1.45 [95% confidence interval 1.13–1.84]), providing support for our hypothesis that sedentary time is positively associated with long-term sickness absence. Conclusions Pregnant women with a sedentary lifestyle have a higher risk of long-term sickness absence from work. Reducing sedentary time in pregnancy may improve health, and may, in turn reduce sickness absence in pregnancy.
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Affiliation(s)
- Idunn Brekke
- Centre for Welfare and Labour Research - Norwegian Social Research, OsloMet - Oslo Metropolitan University, Post box 4 St. Olavs plass, N-0130, Oslo, Norway. .,Faculty of Health Sciences - Department of Nursing and Health promotion, OsloMet - Oslo Metropolitan University, Post box 4 St. Olavs plass, N-0130, Oslo, Norway.
| | - Kåre Rønn Richardsen
- Faculty of Health Sciences - Department of Physiotherapy, OsloMet - Oslo Metropolitan University, Post box 4 St. Olavs plass, N-0130, Oslo, Norway
| | - Anne Karen Jenum
- General Practice Research Unit (AFE), Department of General Practice, University of Oslo, Institute of Health and Society, Post Box 1130 Blindern, 0318, Oslo, Norway
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8
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de Wind A, Boot CRL, Sewdas R, Scharn M, van den Heuvel SG, van der Beek AJ. Do Work Characteristics Predict Health Deterioration Among Employees with Chronic Diseases? JOURNAL OF OCCUPATIONAL REHABILITATION 2018; 28:289-297. [PMID: 28660365 PMCID: PMC5978827 DOI: 10.1007/s10926-017-9716-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Purpose In our ageing workforce, the increasing numbers of employees with chronic diseases are encouraged to prolong their working lives. It is important to prevent health deterioration in this vulnerable group. This study aims to investigate whether work characteristics predict health deterioration over a 3-year period among employees with (1) chronic diseases, and, more specifically, (2) musculoskeletal and psychological disorders. Methods The study population consisted of 5600 employees aged 45-64 years with a chronic disease, who participated in the Dutch Study on Transitions in Employment, Ability and Motivation (STREAM). Information on work characteristics was derived from the baseline questionnaire. Health deterioration was defined as a decrease in general health (SF-12) between baseline and follow-up (1-3 years). Crude and adjusted logistic regression analyses were performed to investigate prediction of health deterioration by work characteristics. Subgroup analyses were performed for employees with musculoskeletal and psychological disorders. Results At follow-up, 19.2% of the employees reported health deterioration (N = 1075). Higher social support of colleagues or supervisor predicted health deterioration in the crude analyses in the total group, and the groups with either musculoskeletal or psychological disorders (ORs 1.11-1.42). This effect was not found anymore in the adjusted analyses. The other work characteristics did not predict health deterioration in any group. Conclusions This study did not support our hypothesis that work characteristics predict health deterioration among employees with chronic diseases. As our study population succeeded continuing employment to 45 years and beyond, it was probably a relatively healthy selection of employees.
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Affiliation(s)
- Astrid de Wind
- Department of Public and Occupational Health, Amsterdam Public Health research institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
- Body@Work, Research Center on Physical Activity, Work and Health, TNO-VU/VUmc, Amsterdam, The Netherlands.
| | - Cécile R L Boot
- Department of Public and Occupational Health, Amsterdam Public Health research institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
- Body@Work, Research Center on Physical Activity, Work and Health, TNO-VU/VUmc, Amsterdam, The Netherlands
| | - Ranu Sewdas
- Department of Public and Occupational Health, Amsterdam Public Health research institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - Micky Scharn
- Department of Public and Occupational Health, Amsterdam Public Health research institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - Swenne G van den Heuvel
- Body@Work, Research Center on Physical Activity, Work and Health, TNO-VU/VUmc, Amsterdam, The Netherlands
- Work Health Technology, Netherlands Organisation for Applied Scientific Research TNO, Schipholweg 77-89, 2316 ZL, Leiden, The Netherlands
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam Public Health research institute, VU University Medical Center, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
- Body@Work, Research Center on Physical Activity, Work and Health, TNO-VU/VUmc, Amsterdam, The Netherlands
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de Wit M, Wind H, Hulshof CTJ, Frings-Dresen MHW. Person-related factors associated with work participation in employees with health problems: a systematic review. Int Arch Occup Environ Health 2018; 91:497-512. [PMID: 29700608 PMCID: PMC6002456 DOI: 10.1007/s00420-018-1308-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 04/18/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE The objective of this systematic review was to explore and provide systematically assessed information about the association between person-related factors and work participation of people with health problems. The research question was: what is the association between selected person-related factors and work participation of workers with health problems? METHODS A systematic review was carried out in PubMed and PsycINFO to search for original papers published between January 2007 and February 2017. The risk of bias of the studies included was assessed using quality assessment tools from the Joanna Briggs Institute. The quality of evidence was assessed using the GRADE framework for prognostic studies. RESULTS In total, 113 studies were included, all of which addressed the association between person-related factors and work participation. The factors positively associated with work participation were positive expectations regarding recovery or return to work, optimism, self-efficacy, motivation, feelings of control, and perceived health. The factors negatively associated with work participation were fear-avoidance beliefs, perceived work-relatedness of the health problem, and catastrophizing. Different coping strategies had a negative or a positive relationship with work participation. CONCLUSIONS The results of this review provide more insight into the associations between different cognitions and perceptions and work participation. The results of this study suggest that person-related factors should be considered by occupational- and insurance physicians when they diagnose, evaluate or provide treatment to employees. Further research is required to determine how these physicians could obtain and apply such information and whether its application leads to a better quality of care.
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Affiliation(s)
- Mariska de Wit
- Department Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health research institute, PO Box 22700, 1100 DE, Amsterdam, The Netherlands.
| | - Haije Wind
- Department Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health research institute, PO Box 22700, 1100 DE, Amsterdam, The Netherlands
| | - Carel T J Hulshof
- Department Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health research institute, PO Box 22700, 1100 DE, Amsterdam, The Netherlands
| | - Monique H W Frings-Dresen
- Department Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam Public Health research institute, PO Box 22700, 1100 DE, Amsterdam, The Netherlands
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10
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Ubalde-Lopez M, Delclos GL, Benavides FG, Calvo-Bonacho E, Gimeno D. The effect of multimorbidity on sickness absence by specific diagnoses. Occup Med (Lond) 2017; 67:93-100. [PMID: 27496547 DOI: 10.1093/occmed/kqw092] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND As the world's population ages, the prevalence of multiple chronic and non-chronic health-related conditions is increasing. Research on multimorbidity, the co-occurrence of two or more health-related conditions, has mainly involved patient and older populations. Its effect in working populations, presumably younger and healthier, is not well known but could conceivably affect sickness absence (SA) and ability to return to work. AIMS To examine the effect of multimorbidity on the incidence and duration of SA episodes by frequent diagnostic groups. METHODS A prospective study (in 2006-2008) of workers in Spain. Information on health-related conditions was gathered with a standardized questionnaire and used to construct a sex-specific multidimensional multimorbidity score (MDMS). In order to estimate the effect of MDMS on incidence and duration of SA episodes due to cardiovascular diseases (CVD), musculoskeletal disorders (MSD) and mental health disorders (MHD), we fitted Cox models adjusted by age, occupational social class and number of prior SA episodes for both sexes. RESULTS The study population was 372370. Men with high MDMS showed a trend towards higher incidence risk for SA due to CVD and MSD [adjusted hazard ratio (aHR) = 2.03; 95% confidence interval (CI) 1.48-2.78 and aHR = 1.20; 95% CI 1.01-1.43, respectively]. Women showed a similar trend for MSD, but MHD had the strongest association (aHR = 4.78; 95% CI 1.97-11.62) for high MDMS. In both sexes, the effect of MDMS was strongest among those without a prior SA. No consistent associations with SA duration were observed. CONCLUSIONS Multimorbidity increased the risk of incident musculoskeletal, mental and cardiovascular SA episodes but not their duration.
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Affiliation(s)
- M Ubalde-Lopez
- CISAL-Center for Research in Occupational Health, University Pompeu Fabra, Barcelona 08003, Spain.,CIBERESP, CIBER in Epidemiology and Public Health, Madrid 28029, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona 08003, Spain
| | - G L Delclos
- CISAL-Center for Research in Occupational Health, University Pompeu Fabra, Barcelona 08003, Spain.,CIBERESP, CIBER in Epidemiology and Public Health, Madrid 28029, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona 08003, Spain.,Southwest Center for Occupational and Environmental Health, Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas School of Public Health, Houston, TX 77225, USA
| | - F G Benavides
- CISAL-Center for Research in Occupational Health, University Pompeu Fabra, Barcelona 08003, Spain.,CIBERESP, CIBER in Epidemiology and Public Health, Madrid 28029, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona 08003, Spain
| | - E Calvo-Bonacho
- Ibermutuamur (Mutua de Accidentes de Trabajo y Enfermedades Profesionales de la Seguridad Social 274), Madrid 28043, Spain
| | - D Gimeno
- CISAL-Center for Research in Occupational Health, University Pompeu Fabra, Barcelona 08003, Spain.,CIBERESP, CIBER in Epidemiology and Public Health, Madrid 28029, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona 08003, Spain.,Southwest Center for Occupational and Environmental Health, Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas School of Public Health, San Antonio Campus, San Antonio, TX 78229, USA
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11
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Loef B, de Hollander EL, Boot CR, Proper KI. Physical activity of workers with and without chronic diseases. Prev Med Rep 2016; 3:30-5. [PMID: 26844183 PMCID: PMC4733060 DOI: 10.1016/j.pmedr.2015.11.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To contribute to the development of measures that increase physical activity (PA) levels in workers with and without chronic diseases, insight into workers' PA level is needed. Therefore, this study examined the association between the number of chronic diseases and PA in a Dutch working population. METHODS Data of 131,032 workers from the Dutch Public Health Monitor 2012 were used in this cross-sectional study conducted in 2015 in the Netherlands. PA was operationalized as adherence (yes/no) to three PA guidelines. One of these was the American College of Sports Medicine (ACSM) guideline (≥ 3 days/week, ≥ 20 min/day of vigorous-intensity activities). Also, the amount of moderate- and vigorous-intensity PA in min/week for those who were physically active for > 0 min/week was calculated. Associations between chronic diseases (0, 1, ≥ 2 chronic diseases) and PA were examined using logistic regression and Generalized Estimating Equations stratified for age (19-54 years/55-64 years). RESULTS Workers aged 19-54 years with one (OR = 0.90 (99% CI = 0.84-0.95)) and multiple chronic diseases (OR = 0.76 (99% CI = 0.69-0.83)) had lower odds of adhering to the ACSM-guideline than workers without chronic diseases. Similar patterns were found for older workers. Younger workers with one (B = 24.44 (99% CI = 8.59-40.30)) and multiple chronic diseases (B = 49.11 (99% CI = 26.61-71.61)) had a higher amount of moderate PA than workers without chronic diseases. CONCLUSION Workers with chronic diseases adhered less often to the ACSM-guideline, but among workers aged 19-54 years who were physically active for > 0 min/week, those with chronic diseases spent more time in moderate-intensity PA than those without chronic diseases.
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Affiliation(s)
- Bette Loef
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center Amsterdam, The Netherlands
| | - Ellen L. de Hollander
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Cécile R.L. Boot
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center Amsterdam, The Netherlands
| | - Karin I. Proper
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center Amsterdam, The Netherlands
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12
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Åberg F. From prolonging life to prolonging working life: Tackling unemployment among liver-transplant recipients. World J Gastroenterol 2016; 22:3701-3711. [PMID: 27076755 PMCID: PMC4814733 DOI: 10.3748/wjg.v22.i14.3701] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 02/19/2016] [Accepted: 03/02/2016] [Indexed: 02/06/2023] Open
Abstract
Return to active and productive life is a key goal of modern liver transplantation (LT). Despite marked improvements in quality of life and functional status, a substantial proportion of LT recipients are unable to resume gainful employment. Unemployment forms a threat to physical and psychosocial health, and impairs LT cost-utility through lost productivity. In studies published after year 2000, the average post-LT employment rate is 37%, ranging from 22% to 55% by study. Significant heterogeneity exists among studies. Nonetheless, these employment rates are lower than in the general population and kidney-transplant population. Most consistent employment predictors include pre-LT employment status, male gender, functional/health status, and subjective work ability. Work ability is impaired by physical fatigue and depression, but affected also by working conditions and society. Promotion of post-LT employment is hampered by a lack of interventional studies. Prevention of pre-LT disability by effective treatment of (minimal) hepatic encephalopathy, maintaining mobility, and planning work adjustments early in the course of chronic liver disease, as well as timely post-LT physical rehabilitation, continuous encouragement, self-efficacy improvements, and depression management are key elements of successful employment-promoting strategies. Prolonging LT recipients’ working life would further strengthen the success of transplantation, and this is likely best achieved through multidisciplinary efforts ideally starting even before LT candidacy.
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Nour N, Heck CS, Ross H. Factors related to participation in paid work after organ transplantation: perceptions of kidney transplant recipients. JOURNAL OF OCCUPATIONAL REHABILITATION 2015; 25:38-51. [PMID: 24871373 DOI: 10.1007/s10926-014-9519-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE Following kidney transplantation, recipients often have difficulty returning to meaningful occupations, including paid employment. The purpose of the current study was to describe the sociodemographic profile of kidney transplant recipients at a major Canadian Transplant Centre and to identify factors perceived to affect participation in paid work post-transplant. METHODS Of the 530 kidney recipients who had received a kidney transplant at our facility between 2003 and 2008, 144 recipients were randomly selected, and mailed a questionnaire. RESULTS There were 60 returned questionnaires (41.7 % response rate). The average age of responders was 49.4 years and the majority were male (68.3 %). While the rate of employment decreased significantly (p = 0.00) from 68.3 % pre- to 38.3 % post-transplant, retirement rates increased significantly (p = 0.00) from 8.3 % pre- to 18.3 % post-transplant. The responders, who were not working post-transplant, more likely lived alone (p = 0.05), had a lower level of education (p = 0.02), and had lower perceived emotional (p = 0.00) and physical (p = 0.00) health status compared to those who returned to work post-transplant. Gender, donor type, age, and post-transplant complications did not differ (p > 0.05) between the working and not working groups. Both person- and work-related factors impacted on return to paid work post-transplant. Most responders (working and not working) reported feeling emotionally and physically ready to work after their transplant. Work-related enablers included positive employer attitude towards medical history and employer agreement that recipients could take time off for medical appointments. Of those returning to work, the nature of their jobs changed from heavy physical demands to sedentary work. There was a 20.0 % increase in reliance on government disability insurance post-transplant. Responders recommended the development of a rehabilitation program focused on working and consulting with transplant recipients' employers to further enable successful reintegration into the workplace after transplantation. CONCLUSIONS The ability to return to paid work after kidney transplant is a complex phenomenon, likely impacted by a combination of person- and work-related factors, which contributed to how individuals perceived their abilities to attain or return to paid work. It is important that in facilitating renal transplant recipients to resume valued life occupations such as paid work, the dynamic interactions between personals values, perception of one's abilities, skills, job requirements and employer characteristics be considered.
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Affiliation(s)
- Nazanin Nour
- Toronto General Hospital, University Health Network, 4EB-316-200 Elizabeth Street, Toronto, ON, M2G 2C4, Canada,
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O'Neil A, Jacka FN, Quirk SE, Cocker F, Taylor CB, Oldenburg B, Berk M. A shared framework for the common mental disorders and Non-Communicable Disease: key considerations for disease prevention and control. BMC Psychiatry 2015; 15:15. [PMID: 25652365 PMCID: PMC4342822 DOI: 10.1186/s12888-015-0394-0] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 01/15/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Historically, the focus of Non Communicable Disease (NCD) prevention and control has been cardiovascular disease (CVD), type 2 diabetes mellitus (T2DM), cancer and chronic respiratory diseases. Collectively, these account for more deaths than any other NCDs. Despite recent calls to include the common mental disorders (CMDs) of depression and anxiety under the NCD umbrella, prevention and control of these CMDs remain largely separate and independent. DISCUSSION In order to address this gap, we apply a framework recently proposed by the Centers for Disease Control with three overarching objectives: (1) to obtain better scientific information through surveillance, epidemiology, and prevention research; (2) to disseminate this information to appropriate audiences through communication and education; and (3) to translate this information into action through programs, policies, and systems. We conclude that a shared framework of this type is warranted, but also identify opportunities within each objective to advance this agenda and consider the potential benefits of this approach that may exist beyond the health care system.
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Affiliation(s)
- Adrienne O'Neil
- IMPACT Strategic Research Centre, Deakin University and Barwon Health, Po Box 281, Geelong, VIC, 3220, Australia.
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
- Department of Psychiatry and Behavioral Medicine, Stanford University, Palo Alto, USA.
| | - Felice N Jacka
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia.
- Department of Psychiatry, University of Melbourne, Parkville, Australia.
- Black Dog Institute, Sydney, Australia.
| | - Shae E Quirk
- IMPACT Strategic Research Centre, Deakin University and Barwon Health, Po Box 281, Geelong, VIC, 3220, Australia.
| | - Fiona Cocker
- Melbourne School of Population & Global Health, University of Melbourne, Melbourne, Australia.
| | - C Barr Taylor
- Department of Psychiatry and Behavioral Medicine, Stanford University, Palo Alto, USA.
| | - Brian Oldenburg
- Melbourne School of Population & Global Health, University of Melbourne, Melbourne, Australia.
| | - Michael Berk
- IMPACT Strategic Research Centre, Deakin University and Barwon Health, Po Box 281, Geelong, VIC, 3220, Australia.
- Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Melbourne, Australia.
- Florey Institute for Neuroscience and Mental Health, Melbourne, Australia.
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Boot CRL, Deeg DJH, Abma T, Rijs KJ, van der Pas S, van Tilburg TG, van der Beek AJ. Predictors of having paid work in older workers with and without chronic disease: a 3-year prospective cohort study. JOURNAL OF OCCUPATIONAL REHABILITATION 2014; 24:563-572. [PMID: 24322825 DOI: 10.1007/s10926-013-9489-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND As the prevalence of chronic disease amongst older workers is high and increasing, it is important to know if the large subgroup of older workers with chronic disease has specific needs when it comes to prolonging participation in paid work. OBJECTIVES To investigate differences and similarities in predictors of having paid work in workers aged 55+ with and without chronic disease. METHODS Workers aged 55-62 years were selected from the 2002-2003 cohort of the Longitudinal Aging Study Amsterdam (n = 333). Potential predictors were: health, personality, work characteristics, and demographics. Per potential predictor, a logistic regression coefficient for 'having paid work in 2005-2006' was calculated for workers with and without chronic disease. A pooled estimate was computed and differences between the pooled estimate and the coefficients were tested. Results Follow-up data were available for 95 %, of whom 67 % still had paid work. Predictors of having paid work were similar for workers with and without chronic diseases, except for physical workload (χ(2) = 5.37; DF = 1) and psychosocial resources at work (χ(2) = 5.94; DF = 1). Having more psychosocial resources (OR = 3.57; 95 %CI 1.33-10.0) was predictive for having paid work in workers with chronic disease and not in workers without chronic disease. Lower age, more weekly working hours, no functional limitations, fewer depressive symptoms, lower neuroticism scores, and more sense of mastery were significantly associated with having paid work in all workers. CONCLUSIONS Differences between predictors of having paid work between workers with and without chronic disease should be taken into account when aiming to prevent exit from the workforce. In particular the vulnerable subgroup of older workers with chronic disease and low psychosocial resources at work is more likely to quit working.
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Affiliation(s)
- Cécile R L Boot
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Van Der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands,
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Shaw WS, Besen E, Pransky G, Boot CRL, Nicholas MK, McLellan RK, Tveito TH. Manage at work: a randomized, controlled trial of a self-management group intervention to overcome workplace challenges associated with chronic physical health conditions. BMC Public Health 2014; 14:515. [PMID: 24885844 PMCID: PMC4051380 DOI: 10.1186/1471-2458-14-515] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Accepted: 05/23/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The percentage of older and chronically ill workers is increasing rapidly in the US and in many other countries, but few interventions are available to help employees overcome the workplace challenges of chronic pain and other physical health conditions. While most workers are eligible for job accommodation and disability compensation benefits, other workplace strategies might improve individual-level coping and problem solving to prevent work disability. In this study, we hypothesize that an employer-sponsored group intervention program employing self-management principles may improve worker engagement and reduce functional limitation associated with chronic disorders. METHODS In a randomized controlled trial (RCT), workers participating in an employer-sponsored self-management group intervention will be compared with a no-treatment (wait list) control condition. Volunteer employees (n = 300) will be recruited from five participating employers and randomly assigned to intervention or control. Participants in the intervention arm will attend facilitated group workshop sessions at work (10 hours total) to explore methods for improving comfort, adjusting work habits, communicating needs effectively, applying systematic problem solving, and dealing with negative thoughts and emotions about work. Work engagement and work limitation are the principal outcomes. Secondary outcomes include fatigue, job satisfaction, self-efficacy, turnover intention, sickness absence, and health care utilization. Measurements will be taken at baseline, 6-, and 12-month follow-up. A process evaluation will be performed alongside the randomized trial. DISCUSSION This study will be most relevant for organizations and occupational settings where some degree of job flexibility, leeway, and decision-making autonomy can be afforded to affected workers. The study design will provide initial assessment of a novel workplace approach and to understand factors affecting its feasibility and effectiveness. TRIAL REGISTRATION Clinicaltrials.gov: NCT01978392 (Issued November 6, 2013).
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Affiliation(s)
- William S Shaw
- Liberty Mutual Research Institute for Safety, 71 Frankland Rd,, Hopkinton, MA 01748, USA.
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Differences in predictors for return to work following musculoskeletal injury between workers with and without somatic comorbidities. Int Arch Occup Environ Health 2014; 87:871-9. [PMID: 24504627 DOI: 10.1007/s00420-014-0928-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2013] [Accepted: 01/24/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE In workers with musculoskeletal injuries, comorbidity is associated with worse return to work (RTW) outcomes. In the context of RTW, it is unclear whether associations between predictors and RTW are similar or different for workers with and without comorbidity. This study aims to investigate differences and similarities between workers with and without comorbidity in 12-month predictors for RTW in workers who are absent from work due to a musculoskeletal injury. METHODS All workers with lost-time claims who were off work at baseline were selected from the Early Claimant Cohort (Canada) (n = 1,566). Follow-up data on RTW were available of 810 workers after 12 months. Predictors included demographic, health-related, and work-related factors. Differences between coefficients of the groups with and without comorbidity were tested. RESULTS Low household income was a predictor for RTW in workers without comorbidity only. Better mental health was a predictor for RTW in workers with comorbidity only. Higher education, less pain intensity, better general health, less bodily pain, better physical health, and a positive supervisor response were predictors for RTW in the total group. CONCLUSIONS Injured workers with and without comorbidity should be considered as two distinct groups when focusing on mental health or household income.
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Alonso J, Vilagut G, Adroher ND, Chatterji S, He Y, Andrade LH, Bromet E, Bruffaerts R, Fayyad J, Florescu S, de Girolamo G, Gureje O, Haro JM, Hinkov H, Hu C, Iwata N, Lee S, Levinson D, Lépine JP, Matschinger H, Medina-Mora ME, O'Neill S, Ormel JH, Posada-Villa JA, Ismet Taib N, Xavier M, Kessler RC. Disability mediates the impact of common conditions on perceived health. PLoS One 2013; 8:e65858. [PMID: 23762442 PMCID: PMC3675077 DOI: 10.1371/journal.pone.0065858] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2012] [Accepted: 05/02/2013] [Indexed: 02/05/2023] Open
Abstract
Background We examined the extent to which disability mediates the observed associations of common mental and physical conditions with perceived health. Methods and Findings WHO World Mental Health (WMH) Surveys carried out in 22 countries worldwide (n = 51,344 respondents, 72.0% response rate). We assessed nine common mental conditions with the WHO Composite International Diagnostic Interview (CIDI), and ten chronic physical with a checklist. A visual analog scale (VAS) score (0, worst to 100, best) measured perceived health in the previous 30 days. Disability was assessed using a modified WHO Disability Assessment Schedule (WHODAS), including: cognition, mobility, self-care, getting along, role functioning (life activities), family burden, stigma, and discrimination. Path analysis was used to estimate total effects of conditions on perceived health VAS and their separate direct and indirect (through the WHODAS dimensions) effects. Twelve-month prevalence was 14.4% for any mental and 51.4% for any physical condition. 31.7% of respondents reported difficulties in role functioning, 11.4% in mobility, 8.3% in stigma, 8.1% in family burden and 6.9% in cognition. Other difficulties were much less common. Mean VAS score was 81.0 (SD = 0.1). Decrements in VAS scores were highest for neurological conditions (9.8), depression (8.2) and bipolar disorder (8.1). Across conditions, 36.8% (IQR: 31.2–51.5%) of the total decrement in perceived health associated with the condition were mediated by WHODAS disabilities (significant for 17 of 19 conditions). Role functioning was the dominant mediator for both mental and physical conditions. Stigma and family burden were also important mediators for mental conditions, and mobility for physical conditions. Conclusions More than a third of the decrement in perceived health associated with common conditions is mediated by disability. Although the decrement is similar for physical and mental conditions, the pattern of mediation is different. Research is needed on the benefits for perceived health of targeted interventions aimed at particular disability dimensions.
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Affiliation(s)
- Jordi Alonso
- IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain ; Pompeu Fabra University, Barcelona, Spain.
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Boot CRL, van den Heuvel SG, Bültmann U, de Boer AGEM, Koppes LLJ, van der Beek AJ. Work adjustments in a representative sample of employees with a chronic disease in the Netherlands. JOURNAL OF OCCUPATIONAL REHABILITATION 2013; 23:200-8. [PMID: 23592014 DOI: 10.1007/s10926-013-9444-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
PURPOSE The aims of this study are: (1) to describe the prevalence of needed and implemented work adjustments in a representative sample of Dutch employees with a chronic disease; and (2) to assess the effects of needed and implemented work adjustments on sick leave. METHODS The prevalence of work adjustments was assessed in employees with a chronic disease, aged between 15 and 65 years (n = 7,687) from the 2007 Netherlands Working Conditions Survey (NWCS). Of these, N = 2,631 employees participated in the Netherlands Working Conditions Cohort Study (NWCCS) measurements in 2008 and 2009. The NWCCS data were used to investigate the effects of work adjustments on sick leave. All data were self-reported. A repeated measures ANOVA was performed to analyse differences in sick leave in 2007, 2008 and 2009 between employees with and without a need for work adjustments, for those who reported an implemented work adjustment and those who did not. RESULTS In 2007, the prevalence of implemented work adjustments among Dutch employees with a chronic disease was 22 %, while 30 % reported the need of a work adjustment. In employees with and without a need for work adjustments in 2007, a work adjustment in 2008 was significantly associated with a decrease in sick leave from 2007 to 2009. CONCLUSION The need for work adjustments is higher than the implementation of work adjustments. Work adjustments should be considered more often for employees with chronic diseases, because implementation of a work adjustment is associated with a decrease in sick leave.
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Affiliation(s)
- Cécile R L Boot
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.
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Mehnert A, de Boer A, Feuerstein M. Employment challenges for cancer survivors. Cancer 2013; 119 Suppl 11:2151-9. [DOI: 10.1002/cncr.28067] [Citation(s) in RCA: 193] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Revised: 11/29/2012] [Accepted: 12/03/2012] [Indexed: 11/10/2022]
Affiliation(s)
- Anja Mehnert
- Section of Psychosocial Oncology, Department of Medical Psychology and Medical Sociology; University Medical Center Leipzig; Leipzig Germany
- Department of Medical Psychology; University Medical Center Hamburg-Eppendorf; Hamburg Germany
| | - Angela de Boer
- Coronel Institute of Occupational Health; Academic Medical Center; Amsterdam the Netherlands
| | - Michael Feuerstein
- Department of Medical and Clinical Psychology; Uniformed Services University of the Health Sciences; Bethesda Maryland
- Department of Preventive Medicine and Biometrics; Uniformed Services University of the Health Sciences; Bethesda Maryland
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Proper KI, Koppes LLJ, van Zwieten MHJ, Bemelmans WJE. The prevalence of chronic psychological complaints and emotional exhaustion among overweight and obese workers. Int Arch Occup Environ Health 2011; 85:537-45. [DOI: 10.1007/s00420-011-0703-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2011] [Accepted: 09/12/2011] [Indexed: 01/09/2023]
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