Use of prescribed medication at work in employees with chronic illness

Background: This study examined factors associated with the use of prescribed medication at work. Methods: Questionnaire survey of employees with diagnosed chronic illnesses from four UK organisations. Data was collected on type of chronic illness, health status, health beliefs, work limitations, occupational health support, GP and line manager support. Data was analysed using Univariate logistic regression. Results: 1474 employees with chronic illness participated. Medication use at work (yes v no) was predicted by age, pain, diagnosis of heart disease, medication use at home, benefit of prescribed medication to health, ease of using medication at work, practical support from families and practical and emotional support from GP and line manager. In a multivariate logistic regression model, medication use at work was predicted by medication use at home and ease of using medication at work only. Conclusions: The ease of taking medication at work was found to be a key predictor of medication use at work, suggesting occupational health may play a vital role in findings ways to support employees in their usage of medication. This may be for example by providing help and guidance in storing medication at work and encouraging employees to disclose medication use to employers and managers where necessary. Occupational health services can help create a workplace culture that places a high value on health, educating staff on the value of looking after their health and the benefits of following advice

Sickness absence management: encouraging attendance or 'risk-taking' presenteeism in employees with chronic illness?

Purpose: To investigate the organisational perspectives on the effectiveness of their attendance management policies for chronically ill employees. Methods: A mixed-method approach was employed involving questionnaire survey with employees and in-depth interviews with key stakeholders of the organisational policies. Results: Participants reported that attendance management polices and the point at which systems were triggered, posed problems for employees managing chronic illness. These systems presented risk to health: employees were more likely to turn up for work despite feeling unwell (presenteeism) to avoid a disciplinary situation but absence-related support was only provided once illness progressed to long-term sick leave. Attendance management polices also raised ethical concerns for ‘forced’ illness disclosure and immense pressures on line managers to manage attendance. Conclusions: Participants felt their current attendance management polices were unfavourable toward those managing a chronic illness. The policies heavily focused on attendance despite illness and on providing return to work support following long-term sick leave. Drawing on the results, the authors conclude that attendance management should promote job retention rather than merely prevent absence per se. They outline areas of improvement in the attendance management of employees with chronic illness

Work factors related to psychological and health-related distress among employees with chronic illnesses

Objective: This study examined specific psychosocial factors associated with psychological and health-related distress amongst employees reporting different chronic illnesses. Methods: The sample consisted of 1029 employees managing either musculoskeletal pain (n=324), arthritis and rheumatism (n=192), asthma (n=174), depression and anxiety (n=152), heart disease (n=96) or diabetes (n=91). Information on psychological distress, work limitations, illness management, disclosure, absence, presenteeism, support and demographic factors were obtained through self-administered questionnaires. Results: Both low psychological well-being and high health-related distress were associated with an increase in work limitations (β=0.20, SE=.03; and β=0.19, SE=.01, respectively), poorer management of illness symptoms at work (β=−0.17, SE=.12; and β=−0.13, SE=.02), high presentieesm (β=0.19, SE=.25; and β=0.14, SE=.05) and low workplace support (β=−0.05, SE=.22; and β=−0.12, SE=.05). Health-related distress was additionally associated with disclosure of illness at work (β=0.18, SE=.08) and long-term sickness absence (β=0.10, SE=.06). Conclusions: To enable individuals to effectively manage both their illness and their work without serious repercussions, it is important for both healthcare professionals and employers alike, to improve the well-being of workers with chronic illness by supporting and facilitating their efforts to over-come health-related limitations at work

Employment and the common cancers; correlates of workability during or following cancer treatment

To provide an in-depth review of the impact of cancer and cancer-related issues on work ability for those working during or following cancer treatment. Of total, 19 papers published between 1999 and 2008 on cancer and work ability were reviewed. Studies have shown that most types of cancers result in decreased work ability compared to healthy controls or those with other chronic conditions. Some cancer types have more decreased work ability than other types. Decreased work ability is associated with type of treatment (chemotherapy), treatment-related side-effects (e.g. fatigue) and co-morbidity with other health conditions. For most cancers, work ability improves over time irrespective of age. More longitudinal research is required to fully determine the impact of cancer and its treatment on work ability, occupational health services can help such employees make a full recovery and maintain employment by regularly assessing work ability and working hours so that work adjustment and support can be appropriately tailored

Returning employees back to work: developing a measure for supervisors to Support Return to Work (SSRW)

Introduction Evidence suggests that supervisors' behaviors have a strong influence on employees' health and well-being outcomes. Few have examined the specific behaviors associated with managing an employee back to work following long-term sick leave. This study describes the development of a behavior measure for Supervisors to Support Return to Work (SSRW) using qualitative and quantitative research methods. Methods Qualitative data were collected between 2008 and 2010 from a UK population of organisational stakeholders (N = 142), line managers (N = 20) and employees (N = 26). Data from these samples were used to develop a 42 item questionnaire and to validate it using a further sample of line managers (N = 186) and employees (N = 359). Results Based on a factor structure and reliability results, four scales emerged. The measure demonstrated good internal reliability, construct and concurrent validity. Longitudinal data analyses demonstrated test-retest reliability and promising predictive validity. Conclusions This is a potentially valuable tool in research and in organisational settings, both during long-term sick leave and after employees have returned to work

Meta-synthesis of qualitative research on the barriers and facilitators to implementing workplace mental health interventions

Purpose There has been a rapid increase in the number of mental health interventions implemented in the workplace. The efficacy of these interventions has been mixed. The factors influencing implementation may offer insights to why some interventions fail to be effective. Method We conducted a meta-synthesis of qualitative research on the barriers and facilitators to implementing workplace mental health interventions. We evaluated the quality of evidence using CASP and CERQual and synthesized our data using thematic analysis. Results 33 studies were included in the review. A broad range of interventions were reflected in the studies, a majority of which were implemented at the individual level and in health care settings. Facilitators included positive disclosure by line managers, completion of intervention in work time, scheduling flexibility and trainer credibility. Barriers included managers not prioritising interventions, lack of suitable training of facilitators, competing priorities, workload issues and staff shortages. No findings were judged to be very well supported (i.e., high confidence). Conclusion Evidence surrounding the implementation of mental health interventions in the workplace is weak, and studies are limited to high income countries, with a bias towards healthcare and public sector settings. We call for a taxonomy of implementation issues specifically for workplace mental health to advance knowledge and practice.</p

Back, but not better: ongoing mental health hampers return to work outcomes

Research commissioned by the Mental Health Foundation suggests that employees off sick with depression or anxiety may be returning to work with ongoing symptoms, and that follow-up support is often lacking

Returning to work. The role of depression

This study was carried out by Loughborough University and funded by the Foundation's grants programme. It examines the role of depression in returning to work after a period of sickness absence across four types of chronic illnesses: depression and anxiety, back pain, heart disease and cancer. The report shows that almost half (45%) of those with a physical condition experienced mild to moderate depression, but were more worried about telling their employer about their mental health issues than their cancer or heart disease. Despite the fact that depression impacted on their well-being and ability to function at work, most felt unable to tell their line managers about the difficulties they were facing

Self-management of health-behaviors among older and younger workers with chronic illness

Objective: To examine the self-management of health behaviors carried out by older (aged 50-69 years) and younger workers (aged 20-49 years) with a chronic illness. Methods: Questionnaire data was collected from 759 employees with a diagnosed chronic illness. Four categories of self-managing health behaviors were examined: using prescribed medication, monitoring and responding to symptoms. managing an appropriate diet and exercising. Results: The majority of participants (56-97%) reported being advised to carry out health behaviors at home and at work. Controlling for confounding factors, medication use was associated with younger and older workers. Managing an appropriate diet was associated with younger workers with asthma, musculoskeletal pain or diabetes. Exercising was associated with younger workers with asthma and with older workers with heart disease, arthritis and rheumatism or diabetes. Conclusions: The findings indicate that there are differences in diet and exercise activities among younger and older workers.Practice implications: To increase self-management in health behaviors at work, improved communication and understanding between the different health professions and the patient/employee is required so that different tailored approaches can be effectively targeted both by age and within the context of the working environment, to those managing asthma, heart disease, diabetes and arthritis and rheumatism

Evaluation of a natural workspace intervention with active design features on movement, interaction and health

Background: There is increasing focus on designing workspaces that promote less sitting, more movement and interaction to improve physical and mental health. Objective: This study evaluates a natural intervention of a new workplace with active design features and its relocation to a greener and open space. Methods: An ecological model was used to understand how organisations implement change. Pre and post survey data from 221 matched cases of workers and accelerometery data (n=50) were analysed. Results: Results show a decrease in occupational sitting (-20.65 mins/workday, p=.001) and an increase in workplace walking (+5.61 mins/workday, p=.001) using survey data, and accelerometery data (occupational sitting time: -31.0 mins/workday, p=.035, standing time: +22.0 mins/workday, p=.022, stepping time: +11.0 mins/workday, p=.001). Improvements in interaction, musculoskeletal pain and mental health were reported. Conclusions: Application of the ecological model shows that the organisation understands how to target the built environment and social/cultural environment but not how to target behaviour change at the individual level