The dimensional structure of the functional abilities in cases of long-term sickness absence

<p>Abstract</p> <p>Background</p> <p>The health problems that working people suffer can affect their functional abilities and, consequently, can cause a mismatch between those abilities and the demands of the work, leading to sickness absence. A lasting decrease in functional abilities can lead to long-term sickness absence and work disability, with negative consequences for both the worker and the larger society. The objective of this study was to identify common disability characteristics among large groups of long-term sick-listed and disabled employees.</p> <p>Methods</p> <p>As part of the disability benefit entitlement procedure in the Netherlands, an insurance physician assesses the functional abilities of the claimant in a standardised form, known as the List of Functional Abilities (LFA), which consists of six sections containing a total of 106 items. For the purposes of this study, we compiled data from 50,931 assessments. These data were used in an exploratory factor analyses, and the results were then used to construct scales. The stability of dimensional structure of the LFA and of the internal consistency of the scales was studied using data from 80,968 assessments carried out earlier, under a slightly different legislation.</p> <p>Results</p> <p>Three separate factor analyses carried out on the functional abilities of five sections of the LFA resulted in 14 scale variables, and one extra scale variable was based on the items from the sixth section. The resulting scale variables showed Cronbach's Alphas ranging from 0.59 to 0.97, with the exception of one of 0.54. The dimensional structure of the LFA in the verification population differed in some aspects. The Cronbach's Alphas of the verification population ranged from 0.58 to 0.97, again with the exception of the same scale: Alpha = 0.49.</p> <p>Conclusion</p> <p>The differences between the dimensional structures of the primary data and the earlier data we found in this study restrict the possibilities to generalise the results. The scales we constructed can be utilised to produce a compact description of the functional abilities of groups of claimants in the Netherlands. Moreover, the matching work demands can be used to identify jobs low on those demands as being the most accessible for the specific type of disabled employees, particularly severely disabled individuals.</p

The development of instruments to measure the work disability assessment behaviour of insurance physicians

<p>Abstract</p> <p>Background</p> <p>Variation in assessments is a universal given, and work disability assessments by insurance physicians are no exception. Little is known about the considerations and views of insurance physicians that may partly explain such variation. On the basis of the Attitude - Social norm - self Efficacy (ASE) model, we have developed measurement instruments for assessment behaviour and its determinants.</p> <p>Methods</p> <p>Based on theory and interviews with insurance physicians the questionnaire included blocks of items concerning background variables, intentions, attitudes, social norms, self-efficacy, knowledge, barriers and behaviour of the insurance physicians in relation to work disability assessment issues. The responses of 231 insurance physicians were suitable for further analysis. Factor analysis and reliability analysis were used to form scale variables and homogeneity analysis was used to form dimension variables. Thus, we included 169 of the 177 original items.</p> <p>Results</p> <p>Factor analysis and reliability analysis yielded 29 scales with sufficient reliability. Homogeneity analysis yielded 19 dimensions. Scales and dimensions fitted with the concepts of the ASE model. We slightly modified the ASE model by dividing behaviour into two blocks: behaviour that reflects the assessment process and behaviour that reflects assessment behaviour.</p> <p>The picture that emerged from the descriptive results was of a group of physicians who were motivated in their job and positive about the Dutch social security system in general. However, only half of them had a positive opinion about the Dutch Work and Income (Capacity for Work) Act (WIA). They also reported serious barriers, the most common of which was work pressure. Finally, 73% of the insurance physicians described the majority of their cases as 'difficult'.</p> <p>Conclusions</p> <p>The scales and dimensions developed appear to be valid and offer a promising basis for future research. The results suggest that the underlying ASE model, in modified form, is suitable for describing the assessment behaviour of insurance physicians and the determinants of this behaviour. The next step in this line of research should be to validate the model using structural equation modelling. Finally, the predictive value should be tested in relation to outcome measurements of work disability assessments.</p

Disabilities at work

People with disabilities have more problems in finding adequate employment than people without disabilities. In most countries, the law requires that people with disabilities have equal rights and opportunities to find a job. However, in the various stages of finding a job— selection and recruitment, hiring, and employment—there are hindrances that place people with disabilities in a disadvantaged position. There are various options in the application process (i.e. ‘open hiring’), or offering accommodations in the workplace that can help to overcome the barriers people with disabilities face. Making changes to the work processes and job design is a form of ‘workplace accommodations’ that can help to create a better fit between requirements of the job and the capabilities and competences of applicants with a disability. This generally works best if the focus is on human resources related problems and needs in organizations, and it is explored to what extent people with disabilities or chronic diseases can be part of the solution to these organizational human resources-related problems

Inclusive organizations

De invoering van de participatiewet dwingt organisaties na te denken over mogelijkheden om mensen met arbeidsbeperkingen in de organisatie op te nemen. De sociale partners hebben hierover met de minister van sociale zaken en werkgelegenheid de afspraak gemaakt dat er de komende jaren 100.000 extra banen worden gecreëerd voor mensen uit de doelgroep in bedrijven en tevens is de afspraak gemaakt dat er 25.000 banen gecreëerd worden bij de overheid. Nu is dat geen eenvoudige opgave want een aanzienlijk deel van de mensen met arbeidsbeperkingen is niet in staat om gangbare arbeid uit te voeren. Dat is namelijk precies de reden dat zij tot regelingen als wajong, sw, wij zijn toegelaten. Indien de participatie van deze groep bevorderd moet worden, vraagt dat niet alleen om maatregelen voor mensen met een uitkering, maar vooral ook om aanpassingen van de arbeid die op de arbeidsmarkt wordt aangeboden. Het werk moet worden aangepast aan de mogelijkheden van deze groep