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

Impact of employment contract changes on workers' quality of working life, job insecurity, health and work-related attitudes

Contains fulltext : 102606.pdf (publisher's version ) (Open Access)Impact of Employment Contract Changes on Workers' Quality of Working Life, Job Insecurity, Health and Work-related Attitudes: Alfred F. WAGENAAR, et al. Behavioural Science Institute, Department of Work and Organizational Psychology, Radboud University Nijmegen, The Netherlands-Objectives: Changes in employment contracts may impact the quality of working life, job insecurity, health and work-related attitudes. We examined the validity of two partly competing theoretical approaches. Based upon a segmentation approach, we expected no change in scores among stable trajectories, whereas upward trajectories were expected to be for the better and downward trajectories to be for the worse (Hypothesis 1). As turnover theories suggest that this hypothesis may only apply to workers who do not change employer, we also examined these contract trajectories stratified for a change of employer (Hypothesis 2). Methods and Results: Drawing on the 2007 and 2008 waves of the Netherlands Working Conditions Cohort Study (N=9,688), repeated measures analysis of covariance showed little across-time change in the criterion variables, thus largely disconfirming our first hypothesis. These results could (at least partly) be explained by employer change; this was generally associated with improved scores among all contract trajectories (Hypothesis 2). However, workers receiving a less stable contract from the same employer were found to be at risk for health and well-being problems. Conclusions: Segmentation theory-based assumptions on contract trajectories primarily apply to stable and downward contract trajectories at the same employer, whereas assumptions from turnover theories better apply to contract trajectories combined with a change of employer. Future research should focus more closely on factors predicting "involuntary" downward trajectories into precarious temporary employment or unemployment.11 p