Residual work capacity and (in)ability to work fulltime among a year cohort of cancer survivors who claim a disability benefit

PURPOSE: Residual work capacity (RWC) and inability to work fulltime (IWF) are important outcomes in disability benefit assessments for workers diagnosed with cancer. The aim of this study is to gain insight into the prevalence of both outcomes, the associations of disease-related and socio-demographic factors and if these differ across cancer diagnosis groups.METHODS: A year cohort of anonymized register data of cancer survivors who claim a disability benefit after 2 years of sick leave (n = 3690, age 53.3 ± 8.8, 60.4% female) was used. Having no RWC was defined as having no possibilities to perform any work at all, whereas IWF was defined as being able to work less than 8 h per day.RESULTS: The prevalence of being assessed with no RWC was 42.6%. Of the applicants with RWC (57.4%), 69.8% were assessed with IWF. Cancers of the respiratory organs showed the highest odds for having no RWC, whereas lymphoid and haematopoietic cancers showed the highest odds for IWF. Within specific cancer diagnosis groups, different associations were identified for both outcomes.CONCLUSION: The prevalence of no RWC and IWF in applicants of work disability benefits diagnosed with cancer is high compared to the prevalence in other diagnoses. The odds for no RWC, IWF, and associated factors differ per cancer diagnosis group.IMPLICATIONS FOR CANCER SURVIVORS: Being diagnosed with cancer has an enormous impact on work (dis)ability. Our results show that 2 years after being diagnosed with cancer, the majority of the disability benefit applicants are assessed with RWC; however, only 15% of all applicants with cancer had a normal ability to work fulltime, and therefore, it is of great importance to accompany them in their return to work.</p

Validation of the Work Role Functioning Questionnaire 2.0 in cancer patients

Objective The Work Role Functioning Questionnaire 2.0 (WRFQ), measuring the percentage of time a worker has difficulties in meeting the work demands for a given health state, has shown strong reliability and validity in various populations with different chronic conditions. The present study aims to validate the WRFQ in working cancer patients. Methods A validation study of the WRFQ 2.0 was conducted, using baseline data from the longitudinal Work Life after Cancer study. Structural validity (Confirmatory Factor Analysis, CFA), internal consistency (Cronbach's alpha) and discriminant validity (hypothesis testing) were evaluated. Results 352 working cancer patients, most of them diagnosed with breast cancer (48%) and 58% in a job with mainly non-manual tasks, showed a mean WRFQ score of 78.6 (SD = 17.1), which means that they had on average difficulties for 78.6% of the time they spent working. Good internal consistency (alpha = 0.96) and acceptable to good fit for both the four and five-factor model (CFA) was found. The WRFQ distinguished between cancer patients reporting good vs. poor health (80.3 vs. 73.0, p = 0.001), low vs. high fatigue (82.0 vs. 72.2, p <0.001), no vs. clinical depression (80.4 vs. 58.8, p <0.001) and low vs. high cognitive symptoms (86.1 vs. 64.7, p <0.001). Conclusions The WRFQ 2.0 is a reliable and valid instrument to measure work functioning in working cancer patients. Further psychometric research on responsiveness is needed to support its use in health practice

Content Validation of a Practice-Based Work Capacity Assessment Instrument Using ICF Core Sets

PURPOSE: A shift from providing long-term disability benefits to promoting work reintegration of people with remaining work capacity in many countries requires new instruments for work capacity assessments. Recently, a practice-based instrument addressing biopsychosocial aspects of functioning, the Social Medical Work Capacity instrument (SMWC), was developed. Our aim was to examine the content validity of the SMWC using ICF core sets. METHODS: First, we conducted a systematic search to identify relevant ICF core sets for the working age population. Second the content of these core sets were mapped to assess the relevance and comprehensiveness of the SMWC. Next, we compared the content of the SMWC with the ICF-core sets. RESULTS: Two work-related core sets and 31 disease-specific core sets were identified. The SMWC and the two work-related core sets overlap on 47 categories. Compared to the work-related core sets, the Body Functions and Activities and Participation are well represented in the new instrument, while the component Environmental factors is under-represented. Compared to the disease-specific core sets, items related to the social and domestic environmental factors are under-represented, while the SMWC included work-related factors complementary to the ICF. CONCLUSION: The SMWC content seems relevant, but could be more comprehensive for the purpose of individual work capacity assessments. To improve assessing relevant biopsychosocial aspects, it is recommended to extend the instrument by adding personal and environmental (work- and social-related) factors as well as a more tailored use of the SMWC for assessing work capacity of persons with specific diseases or underlying illness. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s10926-020-09918-7) contains supplementary material, which is available to authorized users

Sustainable employability of teachers with hearing loss

Objective In many countries the retirement age is rising. Consequently, age-related hearing loss is an increasing occupational health problem. This study examined the association between hearing loss and sustainable employability of teachers. Design For this cross-sectional study a survey and an online hearing screening test were used. Sustainable employability was measured with the Capability Set for Work Questionnaire (CSWQ), examining seven work values. CSWQ-scores of teachers with poor, insufficient, and good hearing were investigated with ordinal regression analyses. Work values and discrepancies between the importance and achievement of the values were examined by chi-square tests. Study sample Dutch teachers (N = 737) of whom 146 (20%) had insufficient and 86 (12%) poor hearing. Results Teachers with insufficient (OR = 0.64; 95% CI 0.46–0.89) and poor (OR = 0.55; 95% CI 0.36–0.83) hearing had lower CSWQ-scores compared with good hearing teachers. Adjustment for covariates, in particular for self-rated health, attenuated the associations. Compared with good hearing teachers, teachers with poor hearing reported more discrepancies in using their knowledge and skills and setting their own goals at work. Conclusions Hearing loss was negatively associated with sustainable employability of teachers. This emphasises the importance of assessing the hearing status of teachers

Employment Status and Work Functioning among Kidney Transplant Recipients

Background and objectives: To date, employment figures of kidney transplant recipients in Europe are inconsistent. Additionally, little is known about work functioning of employed kidney transplant recipients and work functioning trajectories before and after transplantation. Design, setting, participants, & measurements: Data from the ongoing TransplantLines Biobank and Cohort study and from community-dwelling employed adults were used. Health-related work functioning of kidney transplant recipients was assessed with the Work Role Functioning Questionnaire 2.0 and compared with potential kidney donors and community-dwelling employed adults. Results: We included 668 kidney transplant recipients of working age (59% men, age 51±11 years) at median 3 (interquartile range, 2–10) years after transplantation, 246 potential kidney donors of working age (43% men, age 53±9 years), and 553 community-dwelling employed adults (70% men, age 45±11 years). The proportion of employed kidney transplant recipients was lower compared with potential kidney donors (56% versus 79%). If employed, the work functioning score of kidney transplant recipients was slightly lower compared with employed potential kidney donors yet higher compared with community-dwelling employed adults (medians 91 [interquartile range, 76–98], 94 [interquartile range, 85–99], and 88 [interquartile range, 79–95], respectively). Backward linear regression analyses revealed that lower educational level, having a kidney from a deceased donor, presence of tingling or numbness of hands or feet, presence of concentration/memory problems, presence of anxiety, and presence of severe fatigue were independently associated with lower work functioning among kidney transplant recipients. Additional subgroup analyses showed that work functioning scores were lower before transplantation than at 12 months after transplantation (83 [interquartile range, 66–93] versus 92 [interquartile range, 88–98], respectively; P=0.002). Conclusions: Stable employed kidney transplant recipients report to function well at work. In addition, this study shows that self-reported work functioning is higher after successful kidney transplantation compared with before transplantation. Clinical Trial registry name and registration number: TransplantLines Biobank and Cohort study, NCT0327284

Sustainable employability - definition, conceptualization, and implications: A perspective based on the capability approach

Contains fulltext : 168167.pdf (publisher's version ) (Open Access)OBJECTIVES: The aim of this paper is to propose a new model of sustainable employability based on the capability approach, encompassing the complexity of contemporary work, and placing particular emphasis on work-related values. METHODS: Having evaluated existing conceptual models of work, health, and employability, we concluded that prevailing models lack an emphasis on important work-related values. Amartya Sen's capability approach (CA) provides a framework that incorporates a focus on values and reflects the complexity of sustainable employability. RESULTS: We developed a model of sustainable employability based on the CA. This model can be used as starting point for developing an assessment tool to investigate sustainable employability. CONCLUSIONS: A fundamental premise of the CA is that work should create value for the organization as well as for the worker. This approach challenges researchers, policy-makers, and practitioners to investigate what people find important and valuable - what they would like to achieve in a given (work) context - and moreover to ascertain whether people are able and enabled to do so. According to this approach, it is not only the individual who is responsible for achieving this; the work context is also important. Rather than merely describing relationships between variables, as existing descriptive models often do, the CA depicts a valuable goal: a set of capabilities that constitute valuable work. Moreover, the CA fits well with recent conceptions of health and modern insights into work, in which the individual works towards his or her own goals that s/he has to achieve within the broader goals of the organization

Work capacity assessments and efforts to achieve a job match for claimants in a social security setting: an international inventory

Purpose: Many high-income countries are witnessing a shift of focus on eligibility for disability benefits towards promotion of work reintegration. However, little is known about how countries assess work capacity, and how a job match is then obtained. The current study aims to compare work capacity assessments and available efforts to achieve a job match in eight high-income OECD countries. Methods: A survey was conducted among key stakeholders concerning organization of work capacity assessments in social security settings, and efforts made to obtain a job, across eight OECD countries: Australia, Denmark, Finland, Iceland, Sweden, the Netherlands, the United Kingdom and the United States. Results: In most countries, work capacity is assessed at several time points, with variations in moments and in information used for job matching. In countries obtaining information on personal and work levels, the search to find a job match usually begins with the persons who have disabilities. Conclusion: Although a shift towards a holistic focus in work capacity assessment has been recognized, medical factors still prevail. Limited emphasis is placed on the implications of functional limitations for the possibilities of work. A holistic approach to assessment needs to be coupled with holistic support measures through provision of coordinated and high quality job matching services.IMPLICATIONS FOR REHABILITATION Besides determining eligibility for benefits the outcome of the work capacity assessment can also be used for other purposes such as reintegration and should not result in a static description of work capacity but also deliver insight in support needs. Involving multiple institutions and disciplines in work capacity assessments may result in a broader overview of the claimants’ capacities, however this places high demands on cooperation and data sharing of all those involved. Incorporating the claimants own perspective on work capacity and possibilities to work might improve the legitimacy of the process and reasonably also the achievement of a good and sustainable job match. This can be achieved by using self reported questionnaires and interviews in the assessments

Workers with health problems:three perspectives on functioning at work

<p>Purpose: Our aims were (i) to explore why it is that one worker with a health problem is able to stay at work while the other is not, (ii) to identify signals for decreased functioning at work, and (iii) to explore if and how this can be measured. Method: We conducted three focus groups: with workers with a health problem, occupational physicians, and human resources managers/supervisors. Results: Individual differences in coping strategies, motivation, believes, attitudes, and values were mentioned. All three groups reported that the supervisor is the key figure in the functioning at work of workers with health problems. The supervisor can facilitate the work accommodation of workers and help optimizing functioning at work. The identified signals might contribute to the development of an instrument. Conditions for use were suggested, i.e. a "safe" setting. Conclusions: This focus group study provided insight in why it is that one worker is able to stay at work while the other is not, according to the opinions of three different groups. Although all three groups reported that the supervisor is the key figure in the functioning at work of workers with health problems, there are differences between how the three stakeholders perceive the situation.</p>

Prognostic Factors for Successful Work Functioning in the General Working Population

<p>Purpose To help workers to stay at work in a healthy productive and sustainable way and for the development of interventions to improve work functioning, it is important to have insight in prognostic factors for successful work functioning. The aim of this study is to identify prognostic factors for successful work functioning in a general working population. Methods A longitudinal study (3 months follow-up) was conducted among the working population (N = 98). Work functioning was assessed with the Work Role Functioning Questionnaire 2.0 (WRFQ). The total score was categorized as follows: 0-90; > 90 a parts per thousand currency sign95; and > 95-100 (defined as 'successful work functioning'). Ordinal logistic regression analyses were performed to examine bivariate relationships between potential prognostic factors and the dependent variable (successful work functioning) to identify potential prognostic factors for the multivariate models (p <0.10). A stepwise approach was used to introduce the variables in the multiple ordinal regression analyses. Results Baseline work functioning and work ability were significant prognostic factors for successful work functioning at 3 months follow-up. No prospective associations were identified for psychological job demands and supervisor social support with successful work functioning. Conclusion To our knowledge this is the first longitudinal study to identify prognostic factors for successful work functioning in the general working population. High work ability is predictive for future successful work functioning, independent of baseline work functioning.</p>