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Hagendijk ME, Zipfel N, Melles M, van der Wees PJ, Hulshof CTJ, Çölkesen EB, Hoving JL, van der Burg-Vermeulen SJ. Towards person-centred work-focused healthcare for people with cardiovascular disease: a qualitative exploration of patients' experiences and needs. Disabil Rehabil 2024:1-13. [PMID: 38676465 DOI: 10.1080/09638288.2024.2344653] [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: 07/29/2023] [Accepted: 04/13/2024] [Indexed: 04/29/2024]
Abstract
PURPOSE To explore the experiences and needs concerning work-focused healthcare of patients experiencing problems with work participation due to cardiovascular disease based on all facets of person-centred care. METHODS Nineteen patients who experienced or continue to experience problems with work participation due to cardiovascular disease participated in semi-structured interviews preceded by preparatory written assignments. The transcripts were analysed by means of directed qualitative content analysis. Adapted principles of the Picker Institute for Person-Centred Care provided a template for the analysis. RESULTS 28 experiences and needs emerged and were grouped into the eight principles for person-centred work-focused healthcare. Randomly presenting one theme for each of the eight principles, the themes included: (1) frequent encounters with occupational healthcare professionals; (2) substantive work-related advice; (3) transparency in communication; (4) support for family; (5) information provision on the work-focused healthcare process; (6) personal control during the process; (7) empathy for the personal situation; and (8) tailored work-focused support. CONCLUSIONS The identified experiences and needs for work-focused healthcare of patients experiencing problems with work participation due to cardiovascular disease clearly indicate the need to improve the delivery of person-centred work-focused healthcare to better meet the individual needs of patients.
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Affiliation(s)
- Marije E Hagendijk
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Nina Zipfel
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Marijke Melles
- Department of Human-Centred Design, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands
| | - Philip J van der Wees
- Scientific Institute for Quality of Healthcare (IQ Healthcare), Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Carel T J Hulshof
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Ersen B Çölkesen
- Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - Jan L Hoving
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Research Centre for Insurance Medicine, Amsterdam, The Netherlands
| | - Sylvia J van der Burg-Vermeulen
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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Bernt Jørgensen SM, Johnsen NF, Maribo T, Brøndum S, Gislason G, Kristiansen M. Factors shaping return to work: a qualitative study among heart failure patients in Denmark. Disabil Rehabil 2023:1-11. [PMID: 37818938 DOI: 10.1080/09638288.2023.2266998] [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: 02/05/2023] [Accepted: 09/30/2023] [Indexed: 10/13/2023]
Abstract
PURPOSE For people of working-age diagnosed with heart failure, return to work (RTW) is often a significant rehabilitation goal. To inform vocational rehabilitation strategies, we conducted a qualitative study aiming at exploring patient experienced support needs, and barriers and facilitators to RTW. MATERIALS AND METHODS Ten men and eight women with heart failure (48-60 years) were interviewed in Denmark during 2022. A thematic analysis was conducted using the Sherbrooke model as framework. RESULTS Multiple factors operating at different levels shaped participants' RTW processes. Personal factors included motivation, mental and physical health, social relations, and financial concerns. Factors in the health care system shaping RTW included access to medical treatment, mental health care, and cardiac rehabilitation. Factors in workplace system shaping RTW included job type, employer support, and social relations. Factors in the legislative and insurance system shaping RTW included authorities' administration of sickness benefits, professional assistance, vocational counselling, and interdisciplinary cooperation. CONCLUSION Findings illustrate a need to include vocational rehabilitation within comprehensive cardiac rehabilitation programmes, to identify people in need of support, to improve the coordination of care across the health and social care sectors, and to involve employers, health care professionals, and social workers in individualised RTW strategies.IMPLICATIONS FOR REHABILITATIONVocational re-integration is shaped by multiple factors operating at different levels (including personal factors, work-related factors, factors in the health care system, and factors in the legislative and insurance system).To improve return to work following heart failure, there is a need for multi-level initiatives, including policy measures and efforts to enhance continuity and coordination of care.People with heart failure in need of vocational support should be identified early within comprehensive cardiac rehabilitation programmes.Health care professionals should address work-related issues and provide individualised information and clear advice regarding timely and safe return to work.Individualised return-to-work plans should be developed within interdisciplinary teams across health and social care sectors and involve employers to ensure that they are aware of relevant work accommodations.
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Affiliation(s)
- Sidsel Marie Bernt Jørgensen
- The Danish Heart Foundation, Section of Cardiovascular Research, Copenhagen, Denmark
- Department of Public Health & Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - Nina Føns Johnsen
- The Danish Heart Foundation, Section of Cardiovascular Research, Copenhagen, Denmark
| | - Thomas Maribo
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Central Denmark Region, DEFACTUM, Aarhus, Denmark
| | - Stig Brøndum
- The Danish Heart Foundation, Section of Cardiovascular Research, Copenhagen, Denmark
| | - Gunnar Gislason
- The Danish Heart Foundation, Section of Cardiovascular Research, Copenhagen, Denmark
- Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Maria Kristiansen
- Department of Public Health & Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
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Andersen EB, Kristiansen M, Bernt Jørgensen SM. Barriers and facilitators to return to work following cardiovascular disease: a systematic review and meta-synthesis of qualitative research. BMJ Open 2023; 13:e069091. [PMID: 36707117 PMCID: PMC9884880 DOI: 10.1136/bmjopen-2022-069091] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES Return to work is a key rehabilitation goal, however, people recovering from cardiovascular disease (CVD) often struggle with returning to work. The aim of this study was to conduct a systematic review and meta-synthesis of the existing qualitative evidence on barriers and facilitators to return to work experienced by people with CVD. METHODS A systematic literature search was conducted in PubMed, Embase, Web of Science, PsycINFO, Scopus and CINAHL in August 2022. The reference lists of the included articles were searched. The Critical Appraisal Skills Programme was used for quality appraisal and a meta-synthesis was employed. FINDINGS This review includes 15 studies of overall high methodological quality. Barriers covered four themes: physical limitations, psychological and relational factors, the working context and support within health and social care systems. Facilitators were related to five themes: return to normality, enhancing well-being, financial concerns, the working context and support within health and social care systems. CONCLUSION Our findings highlight that return to work following CVD is a complex process influenced by individual factors, as well as work-related factors, factors in the health and social care systems and social security policies and regulations. To improve return to work, this review illustrates a need for individualised, multidisciplinary and coordinated vocational rehabilitation programmes that accommodate potential barriers to re-employment. Similarly, this review highlights how vocational rehabilitation programmes should ensure individualised information and support early in the rehabilitation process, as well as the importance of engaging relevant stakeholders, such as employers, in making individualised return-to-work plans.
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Affiliation(s)
- Emma Borre Andersen
- Section of Cardiovascular Research, The Danish Heart Foundation, Copenhagen, Denmark
| | - Maria Kristiansen
- Department of Public Health & Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - Sidsel Marie Bernt Jørgensen
- Section of Cardiovascular Research, The Danish Heart Foundation, Copenhagen, Denmark
- Department of Public Health & Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
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Rinsky-Halivni L, Hovav B, Christiani DC, Brammli-Greenberg S. Aging workforce with reduced work capacity: From organizational challenges to successful accommodations sustaining productivity and well-being. Soc Sci Med 2022; 312:115369. [PMID: 36162364 DOI: 10.1016/j.socscimed.2022.115369] [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: 06/02/2022] [Revised: 08/29/2022] [Accepted: 09/09/2022] [Indexed: 10/31/2022]
Abstract
Israel is experiencing accelerated workforce aging and increasing retirement age that began in the last two decades. Aging workers suffer from increased illness and impairment rates, challenging employing organizations with reduced work capacity. Occupational health practitioners often assist employers in accommodating these challenges. However, insufficient evidence on prognostic factors, organizational practices, and age management tools hamper successful accommodation. Research on the organizational perceptions of aging workers is also limited. Our study aims to (1) identify the domains in which the aging workforce challenges Israeli organizations according to a multi-level theoretical model we developed, and (2) assess the practices employed by organizations to address the declines in work capacity from employers' and workers' perspectives. Our qualitative study employed semi-structured interviews of 26 employers and workers' representatives from eight Israeli organizations sampled by maximum variation according to organizational characteristics. Thematic framework analysis of organizational perceptions on challenges, facilitators, and practices in use, via aging workers' cases was utilized. We identified organizational challenges on five levels: individual worker, work environment, interpersonal team relationships, organization, and community relationships, stemming from the aging workers' reduced capacity to meet job demands and conditions. Time adjustments, work environment changes, and job task changes were common accommodations practices used by the organizations. Successful accommodations from the employers' perspective preserved workers' and teams' productivity, and from the workers' perspective, those that lowered demand and improved job control without damaging earnings or job status. Taken together, organizations from all economic sectors should prepare for the increasing need to accommodate work conditions for aging workers with limitations to preserve their health and safety. Balancing employers' and workers' perspectives when accommodating workers with reduced work capacity is imperative to promote healthy aging at the workplace. Government intervention is advised to encourage continued job participation to reduce employment termination.
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Affiliation(s)
- Lilah Rinsky-Halivni
- Takemi Program in International Health, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, USA; Braun School of Public Health, Faculty of Medicine, The Hebrew University, Jerusalem, Israel.
| | - Boaz Hovav
- Health Systems Management Department, Max Stern Yezreel Valley College, Afula, Israel.
| | - David C Christiani
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, USA.
| | - Shuli Brammli-Greenberg
- Braun School of Public Health, Faculty of Medicine, The Hebrew University, Jerusalem, Israel.
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Perceived return-to-work pressure following cardiovascular disease is associated with age, sex, and diagnosis: a nationwide combined survey- and register-based cohort study. BMC Public Health 2022; 22:1059. [PMID: 35624504 PMCID: PMC9135990 DOI: 10.1186/s12889-022-13494-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 05/17/2022] [Indexed: 11/24/2022] Open
Abstract
Background Return to work is a key rehabilitation goal for people with cardiovascular disease (CVD) because employment matters to individuals and societies. However, people recovering from CVD often struggle with returning to work and maintaining employment. To identify people in need of vocational counselling, we examined the probability of feeling under pressure to return to work following CVD. Methods We conducted a combined survey- and register-based study in a randomly selected, population-based cohort of 10,000 people diagnosed with atrial fibrillation, heart failure, heart valve disease, or ischaemic heart disease in 2018. The questionnaire covered return-to-work items, and we reported the probabilities of feeling under pressure to return to work with 95% confidence intervals (CIs) in categories defined by sex, age, and CVD diagnosis. Results The survey response rate was 51.1%. In this study, we included 842 respondents (79.7% men) aged 32–85 years, who had returned to work following a sick leave. Overall, 249 (29.7%) had felt pressure to return to work. The probability of feeling under pressure to return to work ranged from 18.3% (95% CI: 13.1–24.6) among men aged > 55 years with atrial fibrillation to 51.7% (95% CI: 32.5–70.6) among women aged ≤ 55 years with atrial fibrillation. In addition, 66.0% of all respondents had not been offered vocational rehabilitation, and 48.6% of those who reported a need for vocational counselling had unmet needs. Survey responses also indicated that many respondents had returned to work before feeling mentally and physically ready. Conclusion A substantial proportion of people with cardiovascular disease feel under pressure to return to work, and this pressure is associated with age, sex, and diagnosis. The results show that vocational rehabilitation must be improved and emphasize the importance of ensuring that cardiac rehabilitation programmes include all core rehabilitation components.
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de Breij S, Huisman M, Boot CRL, Deeg DJH. Sex and gender differences in depressive symptoms in older workers: the role of working conditions. BMC Public Health 2022; 22:1023. [PMID: 35597949 PMCID: PMC9123290 DOI: 10.1186/s12889-022-13416-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 05/11/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Female older workers generally leave the work force earlier than men. Depressive symptoms are a risk factor of early work exit and are more common in women. To extend working lives, pathways leading to these sex inequalities need to be identified. The aim of this study was to investigate the association of sex and gender with depressive symptoms in older workers, and the role of working conditions in this association. METHODS We used data from the Longitudinal Aging Study Amsterdam (2012-2013/2015-2016, n = 313). Our outcome was depressive symptoms, measured by the Center for Epidemiologic Studies Depression Scale. We included biological sex, a gender index ranging from masculine to feminine (consisting of six items measuring gender roles: working hours, income, occupation segregation, education, informal caregiving, time spent on household chores), and working conditions (physical demands, psychosocial demands, cognitive demands, autonomy, task variation, social support) in our models. We examined the differential vulnerability hypothesis, i.e., sex/gender moderates the association between working conditions and depressive symptoms, and the differential exposure hypothesis, i.e., working conditions mediate the association between sex/gender and depressive symptoms. RESULTS Female sex and feminine gender were both associated with more depressive symptoms. The differential vulnerability hypothesis was not supported by our results. We did find that femininity was negatively associated with autonomy and task variation. In turn, these working conditions were associated with fewer depressive symptoms. Thus, autonomy and task variation partially mediated the association between gender and depressive symptoms, supporting the differential exposure hypothesis. Mediation effects for sex inequalities were not significant. CONCLUSIONS Older female workers and older feminine workers have more depressive symptoms than their male/masculine counterparts. Autonomy and task variation appeared to be important in - partially - explaining gender differences in depressive symptoms rather than sex differences. By improving these conditions, gender inequality in mental health among older workers can be reduced, so that both genders have similar chances to reach the retirement age in good mental health.
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Affiliation(s)
- Sascha de Breij
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan 1089A, 1081, Amsterdam, the Netherlands
| | - Martijn Huisman
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan 1089A, 1081, Amsterdam, the Netherlands.,Department of Sociology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Cécile R L Boot
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Dorly J H Deeg
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, De Boelelaan 1089A, 1081, Amsterdam, the Netherlands.
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Durand MJ, Coutu MF, Tremblay D, Sylvain C, Gouin MM, Bilodeau K, Kirouac L, Paquette MA, Nastasia I, Coté D. Insights into the Sustainable Return to Work of Aging Workers with a Work Disability: An Interpretative Description Study. JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:92-106. [PMID: 32347441 DOI: 10.1007/s10926-020-09894-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose A sustainable return to work (S-RTW) following prolonged work disability poses particular challenges as workers age. This article provides a synthesis of the factors and issues involved in a S-RTW process for aging workers following such a disability. Methods Using interpretive description methods, a critical review was conducted of the literature specifying return-to-work factors and issues for aging workers with regard to four major causes of work disability (musculoskeletal disorders, common mental disorders, cancer or other chronic diseases). The initial review concerned the 2000-2016 literature, and was subsequently updated for November 2016-December 2018. To further explore and contextualise the results of this literature review, four focus groups were held with stakeholders, representing the workplace, insurance, and healthcare systems and workers. Qualitative thematic analysis was performed. Results Fifty-five articles were reviewed and 35 stakeholders participated in the focus groups. Returning to work and staying at work appear to be particularly challenging for aging workers, who face notable issues and stigma concerning their ability to meet work demands, as well as their mobilisation and engagement in these processes. Such findings echo in many ways the main assertions of the literature on aging at work, except those regarding the transformation of capacities with aging, which is not mentioned in relation to workers with a work disability. The influence of healthcare and compensation systems on the S-RTW of aging work-disabled workers has also received little attention to date. Conclusions The results underscore that aging workers with a disability are frequently vulnerable in terms of their health or their jobs. Intersectoral efforts are needed to remedy this situation to keep them at work.
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Affiliation(s)
- Marie-José Durand
- Centre d'action en prévention et réadaptation des incapacités au travail (CAPRIT), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada.
- Centre de recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada.
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada.
| | - Marie-France Coutu
- Centre d'action en prévention et réadaptation des incapacités au travail (CAPRIT), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- Centre de recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
| | - Dominique Tremblay
- Centre de recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- School of Nursing, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles-Le Moyne, Longueuil, QC, J4K 0A8, Canada
| | - Chantal Sylvain
- Centre d'action en prévention et réadaptation des incapacités au travail (CAPRIT), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- Centre de recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
| | - Marie-Michelle Gouin
- Department of Management and Human Resource Management, School of Management, Université de Sherbrooke, 2500 Boulevard de l'Université, Sherbrooke, QC, J1K 2R1, Canada
| | - Karine Bilodeau
- Faculty of Nursing, Université de Montréal, Station Centre-ville, PO Box 6128, Montreal, QC, H3C 3J7, Canada
| | - Laurie Kirouac
- Department of Industrial Relations, Université Laval, 1025 avenue des Sciences-Humaines, Québec, QC, G1V 0A6, Canada
| | - Marie-Andrée Paquette
- Centre d'action en prévention et réadaptation des incapacités au travail (CAPRIT), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- Centre de recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
| | - Iuliana Nastasia
- Institut de Recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), 505 Boulevard De Maisonneuve West, Montreal, QC, H3A 3C2, Canada
| | - Daniel Coté
- Institut de Recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), 505 Boulevard De Maisonneuve West, Montreal, QC, H3A 3C2, Canada
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Boot CR, Bosma AR. How qualitative studies can strengthen occupational health research. Scand J Work Environ Health 2021; 47:91-93. [PMID: 33306131 PMCID: PMC8114569 DOI: 10.5271/sjweh.3943] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Cécile Rl Boot
- Amsterdam UMC, VU University, Amsterdam Public Health Research Institute, Department of Public and Occupational Health, Amsterdam, The Netherlands.
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Castro CMS, Costa MFL, Cesar CC, Neves JAB, Sampaio RF. [Influence of education and health conditions on paid work of elderly Brazilians]. CIENCIA & SAUDE COLETIVA 2019; 24:4153-4162. [PMID: 31664388 DOI: 10.1590/1413-812320182411.05762018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 04/10/2018] [Indexed: 11/22/2022] Open
Abstract
The objective of this study was to determine associations between socio-demographic and health characteristics with paid work among elderly Brazilians. The analysis included 11,177 subjects aged 60 years and over from the National Health Survey conducted in 2013. The multivariate analysis was based on prevalence ratios and their respective 95% confidence intervals estimated by Poisson regression. The participation of men in paid work was significantly higher (32.9%) than women (14.4%). For men and women, this participation decreased with increasing age and was higher among those with better schooling and good self-rated health. Among men, good self-rated health was associated with paid work (PR = 1.63, 95% CI, 1.23-2.15) only for those with less schooling (< 9 years). Among women, good self-rated health revealed a positive association with paid work (PR = 1.94, 95% CI 1.32-2.84) for those with less schooling, and a negative association for those with better schooling (RP = 0.54, 95% CI 0.38-0.77). The results suggest that investments in schooling and improvements in health conditions can contribute to an increase in the longevity of the elderly in the labor market.
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Affiliation(s)
- Camila Menezes Sabino Castro
- Programa de Pós-Graduação em Saúde Coletiva, Instituto René Rachou, Fiocruz. Av. Augusto de Lima 911, Barro Preto. 30190-002 Belo Horizonte MG Brasil.
| | - Maria Fernanda Lima Costa
- Programa de Pós-Graduação em Saúde Coletiva, Instituto René Rachou, Fiocruz. Av. Augusto de Lima 911, Barro Preto. 30190-002 Belo Horizonte MG Brasil.
| | - Cibele Comini Cesar
- Centro de Desenvolvimento e Planejamento Regional, Faculdade de Ciências Econômicas, Universidade Federal de Minas Gerais (UFMG). Belo Horizonte MG Brasil
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Steinmetz-Wood M, Pluye P, Ross NA. The planning and reporting of mixed methods studies on the built environment and health. Prev Med 2019; 126:105752. [PMID: 31226344 DOI: 10.1016/j.ypmed.2019.105752] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 06/05/2019] [Accepted: 06/16/2019] [Indexed: 01/17/2023]
Abstract
Researchers examining the influence of the built environment on health are increasingly using mixed methods approaches. The use of more than one type of methodology to address a single research question is compelling in this field because researchers investigating the impact of the built environment on health have been faced with proposing solutions to a complex societal problem involving interacting systems and social uncertainties. Mixed methods studies can help researchers to gain a better understanding of the relationships that exist between humans and their environment by drawing on qualitative and quantitative methods. Mixed methods studies could also be instrumental for providing effective policy solutions. This is because they allow researchers to identify built environment determinants of health in a population of interest and to understand the social and cultural factors that might influence the uptake of an intervention by this population. The objective of this paper is to assist those conducting research on the built environment and health who may have little background in mixed methods. We provide an overview of mixed methods research designs and provide concrete techniques for the integration of diverse methods. We also discuss the recommendations for mixed methods research in the field of built environment - health research, drawing on specific examples from published studies. Reporting a research design and an integration strategy in mixed methods studies could help to strengthen our ability to gain new insights into the multidimensional nature of the relationship between the built environment and health.
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Affiliation(s)
- Madeleine Steinmetz-Wood
- Department of Geography, McGill University, 805 Sherbrooke Street West, Montreal, Quebec, Canada.
| | - Pierre Pluye
- Department of Family Medicine, McGill University, 5858, chemin de la Côte-des-Neiges, Montreal, Quebec, Canada
| | - Nancy A Ross
- Department of Geography, McGill University, 805 Sherbrooke Street West, Montreal, Quebec, Canada
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11
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Finger ME, Escorpizo R, Tennant A. Measuring Work-Related Functioning Using the Work Rehabilitation Questionnaire (WORQ). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2795. [PMID: 31387320 PMCID: PMC6696256 DOI: 10.3390/ijerph16152795] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 07/16/2019] [Accepted: 07/22/2019] [Indexed: 12/23/2022]
Abstract
The assessment of work-related functioning is a key process in vocational rehabilitation to identify specific domains of disability that can be considered within return to work strategies. The Work Rehabilitation Questionnaire (WORQ) was developed to evaluate work-related functioning based on the International Classification of Functioning, Disability, and Health (ICF) framework and is available in different languages. The aim of this study was to assess the French version of the WORQ using item response theory to further validate the scale. Rasch analysis of WORQ and the WORQ-BRIEF (a brief version of the WORQ) was performed using a calibration sample of 221 persons with musculoskeletal injuries. A four-testlet solution indicated the unidimensionality of WORQ, with no differential item functioning for age, education, physical job demands, and injury severity. Reliability was 0.969 and 0.918 for WORQ and WORQ-BRIEF, respectively. The minimal detectable change was calculated to be 4.2% of its operational range for WORQ and 8.5% for WORQ-BRIEF. Consequently, the French version of WORQ can be considered a good measure of work-related functioning in musculoskeletal conditions. WORQ can be used in rehabilitation practice to comprehensively identify the disability and guide clinical decision making and intervention planning. Further studies are needed to evaluate the psychometric properties of WORQ in other health conditions.
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Affiliation(s)
- Monika E Finger
- Participation, Integration & Social Epidemiology Group, Swiss Paraplegic Research, 6207 Nottwil, Switzerland.
- ICF Research Branch, WHO FIC CC Germany (DIMDI) at SPF, 6207 Nottwil, Switzerland.
| | - Reuben Escorpizo
- Participation, Integration & Social Epidemiology Group, Swiss Paraplegic Research, 6207 Nottwil, Switzerland
- ICF Research Branch, WHO FIC CC Germany (DIMDI) at SPF, 6207 Nottwil, Switzerland
- Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT 05452, USA
| | - Alan Tennant
- ICF Research Branch, WHO FIC CC Germany (DIMDI) at SPF, 6207 Nottwil, Switzerland
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12
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Vooijs M, Leensen MCJ, Hoving JL, Wind H, Frings-Dresen MHW. Value of work for employees with a chronic disease. Occup Med (Lond) 2019; 68:26-31. [PMID: 29301005 DOI: 10.1093/occmed/kqx178] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Most people with a chronic disease value participation in work. Knowledge is limited, however, as to what extent employees with a chronic disease value participating in work, and the main reasons for this. Limited research is available on which specific factors contribute to the perceived value of work. Aims To evaluate main reasons for, and the extent to which employees with a chronic disease value participation in work, and factors which motivate or demotivate employees in work. Methods A survey of members of three large patient federations was performed. Respondents had a chronic disease and were of working age. The extent and reasons for valuing work were analysed using descriptive statistics; (de)motivating aspects were qualitatively analysed using specific software. Results The 1683 respondents valued work with an average of 8 on a scale from 1 to 10 (1: 'work is not at all important to me' and 10: 'work is extremely important to me'). Most frequent reported reasons for valuing work were the provision of income, social contact and the ability to contribute to society. Motivational aspects for work were being financially independent, having positive social contact with colleagues or clients and having the ability to contribute to society. In contrast, negative social contact, performing useless work and having little autonomy demotivated people. Conclusions Employed people with a chronic disease generally value work, mainly because it makes them financially independent, provides social contact and enables them to contribute to society.
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Affiliation(s)
- M Vooijs
- Coronel Institute of Occupational Health, Academic Medical Center, Amsterdam Public Health research institute, DE Amsterdam, The Netherlands
| | - M C J Leensen
- Coronel Institute of Occupational Health, Academic Medical Center, Amsterdam Public Health research institute, DE Amsterdam, The Netherlands
| | - J L Hoving
- Coronel Institute of Occupational Health, Academic Medical Center, Amsterdam Public Health research institute, DE Amsterdam, The Netherlands
| | - H Wind
- Coronel Institute of Occupational Health, Academic Medical Center, Amsterdam Public Health research institute, DE Amsterdam, The Netherlands
| | - M H W Frings-Dresen
- Coronel Institute of Occupational Health, Academic Medical Center, Amsterdam Public Health research institute, DE Amsterdam, The Netherlands
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13
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van Egmond MP, Duijts SFA, van Muijen P, van der Beek AJ, Anema JR. Therapeutic Work as a Facilitator for Return to Paid Work in Cancer Survivors. JOURNAL OF OCCUPATIONAL REHABILITATION 2017; 27:148-155. [PMID: 27118124 PMCID: PMC5306222 DOI: 10.1007/s10926-016-9641-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Purpose The increase of flexible employment in European labour markets has contributed to workers' risk of job loss. For sick-listed workers with chronic illnesses, such as cancer, and especially those without an employment contract, participation in therapeutic work may be an important step towards paid employment. The purpose of this study was to determine the role of therapeutic employment as facilitator for return to paid work, in a cohort of sick-listed cancer survivors (CSs) with and without an employment contract. Methods In this longitudinal study, data were used from a cohort of Dutch CSs (N = 192), who applied for disability benefits after 2 years of sick leave. The primary outcome measure was return to paid work after 1 year. Logistic regression analysis was applied. Results Of the participating CSs (mean age 50.7 years, 33 % male), 69 % had an employment contract at baseline. CSs without an employment contract participated significantly less in therapeutic work (p < 0.001) and were less likely to return to paid work after 1 year (p = 0.001), than those with a contract. Participation in therapeutic work significantly increased the chance of return to paid work after 1 year (OR 6.97; 95 % CI 2.94-16.51), adjusted for age, gender, level of work disability and having an employment contract. Conclusions Participation in therapeutic work could be an important facilitator for return to paid work in sick-listed CSs. The effectiveness of therapeutic work as a means to return to paid employment for sick-listed workers should be studied in an experimental setting.
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Affiliation(s)
- M P van Egmond
- Department of Public and Occupational Health, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
- Dutch Research Center for Insurance Medicine, AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands
| | - S F A Duijts
- Department of Public and Occupational Health, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - P van Muijen
- Department of Public and Occupational Health, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
- Dutch Research Center for Insurance Medicine, AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands
- Dutch Social Security Agency, Amsterdam, The Netherlands
| | - A J van der Beek
- Department of Public and Occupational Health, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
- Dutch Research Center for Insurance Medicine, AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands
| | - J R Anema
- Department of Public and Occupational Health, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
- Dutch Research Center for Insurance Medicine, AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands.
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14
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Pransky GS, Fassier JB, Besen E, Blanck P, Ekberg K, Feuerstein M, Munir F. Sustaining Work Participation Across the Life Course. JOURNAL OF OCCUPATIONAL REHABILITATION 2016; 26:465-479. [PMID: 27704342 PMCID: PMC5104763 DOI: 10.1007/s10926-016-9670-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Introduction Many disability prevention strategies are focused on acute injuries and brief illness episodes, but there will be growing challenges for employers to manage circumstances of recurrent, chronic, or fluctuating symptoms in an aging workforce. The goal of this article is to summarize existing peer-review research in this area, compare this with employer discourse in the grey literature, and recommend future research priorities. Methods The authors participated in a year-long sponsored collaboration that ultimately led to an invited 3-day conference, "Improving Research of Employer Practices to Prevent Disability", held October 14-16, 2015, in Hopkinton, Massachusetts, USA. The collaboration included a topical review of the scientific and industry literature, group discussion to identify key areas and challenges, drafting of initial documents, and feedback from peer researchers and a special panel of experts with employer experience. Results Cancer and mental illness were chosen as examples of chronic or recurring conditions that might challenge conventional workplace return-to-work practices. Workplace problems identified in the literature included fatigue, emotional exhaustion, poor supervisor and co-worker support, stigma, discrimination, and difficulties finding appropriate accommodations. Workplace intervention research is generally lacking, but there is preliminary support for improving workplace self-management strategies, collaborative problem-solving, and providing checklists and other tools for job accommodation, ideas echoed in the literature directed toward employers. Research might be improved by following workers from an earlier stage of developing workplace concerns. Conclusions Future research of work disability should focus on earlier identification of at-risk workers with chronic conditions, the use of more innovative and flexible accommodation strategies matched to specific functional losses, stronger integration of the workplace into on-going rehabilitation efforts, and a better understanding of stigma and other social factors at work.
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Affiliation(s)
- Glenn S Pransky
- Liberty Mutual Research Institute for Safety, 71 Frankland Road, Hopkinton, MA, 01748, USA.
- University of Massachusetts Medical School, Worcester, MA, USA.
| | | | - Elyssa Besen
- Liberty Mutual Research Institute for Safety, 71 Frankland Road, Hopkinton, MA, 01748, USA
| | - Peter Blanck
- Burton Blatt Institute, Syracuse University, Syracuse, NY, USA
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15
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Hoogendijk EO, Deeg DJH, Poppelaars J, van der Horst M, Broese van Groenou MI, Comijs HC, Pasman HRW, van Schoor NM, Suanet B, Thomése F, van Tilburg TG, Visser M, Huisman M. The Longitudinal Aging Study Amsterdam: cohort update 2016 and major findings. Eur J Epidemiol 2016; 31:927-45. [PMID: 27544533 PMCID: PMC5010587 DOI: 10.1007/s10654-016-0192-0] [Citation(s) in RCA: 147] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 08/13/2016] [Indexed: 12/14/2022]
Abstract
The Longitudinal Aging Study Amsterdam (LASA) is an ongoing longitudinal study of older adults in the Netherlands, which started in 1992. LASA is focused on the determinants, trajectories and consequences of physical, cognitive, emotional and social functioning. The study is based on a nationally representative sample of older adults aged 55 years and over. The findings of the LASA study have been reported in over 450 publications so far (see www.lasa-vu.nl ). In this article we describe the background and the design of the LASA study, and provide an update of the methods. In addition, we provide a summary of the major findings from the period 2011-2015.
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Affiliation(s)
- Emiel O Hoogendijk
- Department of Epidemiology and Biostatistics, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
| | - Dorly J H Deeg
- Department of Epidemiology and Biostatistics, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Jan Poppelaars
- Department of Epidemiology and Biostatistics, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
- Department of Sociology, VU University, Amsterdam, The Netherlands
| | - Marleen van der Horst
- Department of Epidemiology and Biostatistics, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | | | - Hannie C Comijs
- Department of Psychiatry, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - H Roeline W Pasman
- Department of Public and Occupational Health, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Natasja M van Schoor
- Department of Epidemiology and Biostatistics, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Bianca Suanet
- Department of Sociology, VU University, Amsterdam, The Netherlands
| | - Fleur Thomése
- Department of Sociology, VU University, Amsterdam, The Netherlands
| | | | - Marjolein Visser
- Department of Health Sciences, Faculty of Earth and Life Sciences, EMGO + Institute for Health and Care Research, VU University, Amsterdam, The Netherlands
- Department of Internal Medicine, Nutrition and Dietetics, VU University Medical Center, Amsterdam, The Netherlands
| | - Martijn Huisman
- Department of Epidemiology and Biostatistics, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
- Department of Sociology, VU University, Amsterdam, The Netherlands
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