Employer perspectives concerning the self-management support needs of workers with long-term health conditions

What do employers need when supporting stroke survivors to return to work?: a mixed-methods study

BACKGROUND

Employers are key in supporting stroke survivors to return to work (RTW) but do not always have knowledge/skills or guidance to do so.

OBJECTIVES

To explore employers' needs for provision of post-stroke RTW support.

METHODS

Mixed-methods study. Participants recruited through voluntary response/purposive sampling. Survey of employers investigated stroke knowledge (maximum score: 7), RTW process knowledge (maximum score: 8), and perceived competency for actions supporting RTW (maximum score: 100%). Regression analyses explored relationships between employers' demographic/contextual characteristics and knowledge and perceived competency scores. Interviews with employers explored factors influencing their post-stroke RTW support. Interview data were analyzed using a framework analysis. Survey/interview findings were synthesized with those from a qualitative systematic review.

RESULTS

Across the survey (n = 50), interviews (n = 7), and review (25 studies), employers' support was influenced by stroke survivors' decisions to disclose stroke-related limitations, employers' knowledge regarding roles/responsibilities, employers' communication skills, and information provided by healthcare. Regression analyses: Human resources/occupational health support was positively associated with stroke knowledge (ß = 2.30, 95% CI 0.36-4.41, p = 0.013) and RTW process knowledge (ß = 5.12, 95% CI 1.80-6.87, p = 0.001). Post-stroke RTW experience was positively associated with stroke knowledge (ß = 1.36, 95% CI 0.46-2.26, p = 0.004) and perceived competency (ß = 31.13, 95% CI 18.40-44.76, p = 0.001). Organization size (i.e. working in a larger organization) was positively associated with RTW process knowledge (ß = 2.96, 95% CI 1.52-4.36, p = <.001).

CONCLUSIONS

Employers' RTW support was influenced by personal and environmental factors; they may benefit from education and guidance on stroke and their roles/responsibilities during the RTW process.

Employer representatives' experiences of supporting employees with cognitive impairments in a digital work environment

BACKGROUND

Digital work poses cognitive demands on all employees, but the impact is greater for employees with cognitive impairments. Digitalization also has significant implications for employer representatives as they are responsible for the work environment. However, knowledge is scarce concerning employer representatives' perspectives on identifying needs and support for employees with cognitive impairments working in a digital work environment.

OBJECTIVE

To describe employer representatives' experiences of work environment management with focus on employees with cognitive impairments working in a digital environment.

METHODS

Focus group methodology was used. Six employer representatives with work environment responsibilities participated.

RESULTS

One overall theme "Mastering the interconnected processes in a transformative digital work environment" as well as three themes "Facilitating good digital work conditions", "Identifying needs and difficulties in work tasks among employees' with cognitive impairments" and "Pursuing knowledge and collaborations to support employees with cognitive impairments" with subthemes were identified. The themes describe employer representatives' challenges and efforts to identify fluctuating needs in employees with cognitive impairments and, also, to organize and reduce cognitive demands in the work environment to support them.

CONCLUSIONS

Managing the challenges of an evolving digital work environment and matching individual work ability of employees with cognitive impairments in relation to cognitive demands is an ongoing process. The participants valued cooperation with employees with cognitive impairments but lacked support from expertise. The need to develop and implement a functioning support system for vocational rehabilitation to ensure a sustainable work in digital work environments is indicated.

Sustaining work ability amongst female professional workers with long COVID

BACKGROUND

Long COVID (LC) compromises work ability (WA). Female worker WA has been more adversely impacted than WA in men. Exploration of lived experiences could elucidate the WA support required.

AIMS

To explore the working conditions and circumstances experienced as affecting sustained WA amongst female workers with LC, to help mitigate worklessness risks.

METHODS

Online semi-structured qualitative interviews were conducted with 10 female workers self-reporting or formally diagnosed with LC who had made some attempt to return to work (RTW). Interviews were analysed using template analysis to map themes informing WA enablers and obstacles onto a biopsychosocial model of rehabilitation.

RESULTS

All participants were professionals working in an employed or self-employed capacity. Key themes reflecting circumstances that afforded sustained WA included the autonomy over where, when and how to work indicated as facilitated by a professional role, rapid health care access, predominantly sedentary work, competent colleagues able to cover for transient reduced WA, a strong interface between specialist health and management support, and accessible organizational policies that steer health management according to equity rather than equality. Highly flexible, iterative, co-produced RTW planning, tolerant of fluctuating symptom expression appears vital. In return for providing such flexibility, participants felt that employers' workforce diversity and competence would be protected and that workers would need to reciprocate flexibility.

CONCLUSIONS

These qualitatively derived findings of workers' lived experiences add to existing guidance on supporting WA for people struggling with LC. Moreover, the same principles seem appropriate for tackling worklessness amongst working-age adults with complex long-term health conditions.

Experiences of workers with post-COVID-19 symptoms can signpost suitable workplace accommodations

Purpose

The prevalence and multi-system nature of post-COVID-19 symptoms warrants clearer understanding of their work ability implications within the working age population. An exploratory survey was undertaken to provide empirical evidence of the work-relevant experiences of workers recovering from COVID-19.

Design/methodology/approach

A bespoke online survey based on a biopsychosocial framework ran between December 2020 and February 2021. It collected quantitative ratings of work ability and return-to-work status, qualitative responses about return-to-work experiences, obstacles and recommendations, along with views on employer benefits for making accommodations. A sample of 145 UK workers recovering from COVID-19 was recruited via social media, professional networks and industry contacts. Qualitative data was subject to thematic analysis. Participants were mainly from health/social care (50%) and educational settings (14%).

Findings

Just over 90% indicated that they had experienced at least some post-COVID-19 symptoms, notably fatigue and cognitive effects. For 55%, symptoms lasted longer than six months. Only 15% had managed a full return-to-work. Of the 88 who provided workability ratings, just 13 and 18% respectively rated their physical and mental workability as good or very good. Difficulties in resuming work were attributed to symptom unpredictability, their interaction with job demands, managing symptoms and demands in parallel, unhelpful attitudes and expectations. Manager and peer support was reported as variable.

Originality/value

Workplace health management characterised by flexible long-term collaborative return-to-work planning, supported by more COVID-centric absence policies and organisational cultures, appear pivotal for sustaining the return-to-work of the large segments of the global workforce affected by post-COVID-19 symptoms.