A. de Rijk

An insider's point of view: : how a system of flexible working hours helps employees to strike a proper balance between work and personal life

Increasing numbers of organisations offer flexible working hours to help employees balance work and personal life. However, studies about the effects of flexible working hours on work–life balance and organisational outcomes are ambiguous. The aim of this study is to gain greater insights into how employees experience the influence of flexible working hours on their work–life balance. A qualitative research was performed by in-depth interviews with a variant sample of 15 employees and thematic analysis of the data. The more family responsibilities the respondents have, the more they tend to perceive flexible working hours as a necessity rather than an extra benefit. According to the interviewees, the system creates a situation which is advantageous for both employer and employee. The extent to which this is achieved though depends on how organisations apply and implement it. It is concluded that when flexible working hours are supported by management and fit the work culture, they are highly appreciated both for private and work-related reasons. Moreover, its meaning for the private life varies according to life stage. Findings are important for policy makers and human resources managers alike in order to implement and deal with flexible working hours effectively. Consequently, this will help employees strike a proper balance between work and personal life generating beneficial organisational outcomes.

Perceived employer-related barriers and facilitators for work participation of cancer survivors: A systematic review of employers' and survivors' perspectives

To identify employer‐related barriers and facilitators for work participation of cancer survivors from the perspective of both employers and cancer survivors, and to synthesise these perceived barriers and facilitators to understand their perceived consequences.

Patient Factors Related to the Presentation of Fatigue Complaints: Results from a Women's General Health Care Practice

ABSTRACT The aim of this study was to examine which patient-related factors predicted: (1) fatigue, (2) the intention to discuss fatigue and (3) the actual discussion of fatigue during consultation with a GP in a womens general health care practice. Patients were asked to complete two questionnaires: one before and one after consultation. The patient-related factors included: social-demographic characteristics; fatigue characteristics; absence of cognitive representations of fatigue; nature of the requests for consultation; and other complaints. Some 74% of the 155 respondents reported fatigue. Compared to the patients that were not fatigued, the fatigued patients were more frequently employed outside the home, had higher levels of general fatigue, and a higher need for emotional support from their doctor. A minority (12%) intended to discuss fatigue during consultation. Of the respondents returning the second questionnaire (n = 107), 22% reported actually discussing their fatigue with the GP while only 11% had intended to do so. In addition to the intention to discuss fatigue during consultation, the following variables related to actually discussing fatigue: living alone, caring for young children, higher levels of general fatigue, absence of cognitions with regard to the duration of the fatigue, and greater psychological, neurological, digestive, and/or musculoskeletal problems as the reason for consultation. Fatigue was found to be the single reason for consultation in only one case. It is concluded that fatigue does not constitute a serious problem for most patients and that discussion of fatigue with the GP tends to depend on the occurrence of other psychological or physical problems and the patients social context.

Employers' experience of employees with cancer: trajectories of complex communication

PurposeRemaining in paid work is of great importance for cancer survivors, and employers play a crucial role in achieving this. Return to work (RTW) is best seen as a process. This study aims to provide insight into (1) Dutch employers’ experiences with RTW of employees with cancer and (2) the employers’ needs for support regarding this process.MethodsThirty employer representatives of medium and large for-profit and non-profit organizations were interviewed to investigate their experiences and needs in relation to employees with cancer. A Grounded Theory approach was used.ResultsWe revealed a trajectory of complex communication and decision-making during different stages, from the moment the employee disclosed that they had been diagnosed to the period after RTW, permanent disability, or the employee’s passing away. Employers found this process demanding due to various dilemmas. Dealing with an unfavorable diagnosis and balancing both the employer’s and the employee’s interests were found to be challenging. Two types of approach to support RTW of employees with cancer were distinguished: (1) a business-oriented approach and (2) a care-oriented approach. Differences in approach were related to differences in organizational structure and employer and employee characteristics. Employers expressed a need for communication skills, information, and decision-making skills to support employees with cancer.ConclusionsThe employers interviewed stated that dealing with an employee with cancer is demanding and that the extensive Dutch legislation on RTW did not offer all the support needed. We recommend providing them with easily accessible information on communication and leadership training to better support employees with cancer.Implications for cancer survivors• Supporting employers by training communication and decision-making skills and providing information on cancer will contribute to improving RTW support for employees with cancer.• Knowing that the employer will usually be empathic when an employee reveals that they have been diagnosed with cancer, and that the employer also experiences difficulties and dilemmas, might lower the threshold to discuss wishes regarding disclosure, communication, and work issues.• The interests of employer and employee in relation to RTW are interrelated; both have responsibility and a role to play, and are in need of support.

Clinical Interventions to Reduce Work Disability in Workers with Musculoskeletal Disorders or Mental Health Problems

This chapter presents an overview of the effects of clinical interventions to improve work disability in employees with musculoskeletal disorders and mental disorders. Low back pain is the most common musculoskeletal disorder followed by neck/shoulder disorders and/or upper extremity disorders. Targeting at (physical) activity and return to work has positive health implications in employees with low back pain resulting in reduced costs and productivity losses. Some effects of patient education on return to work have been reported in low back pain patients. Physical exercise interventions generally seem effective in reducing work disability in subacute and chronic low back pain populations. For behavioral treatments no effects on work disability were found. A promising multidisciplinary intervention for low back pain is integrated care, which consists of the integration of clinical and occupational healthcare. Positive effects have also been found for physical exercises in workers with neck and/or upper extremity disorders although mostly for pain and self-reported disability whereas many studies surprisingly ignored work disability outcomes.

Economic Evaluation of a New Organizational RTW Intervention to Improve Cooperation Between Sick-Listed Employees and Their Supervisors: A Field Study

Objective: The purpose of this study is to assess the cost-effectiveness, -utility, and -benefit of a new organizational return-to-work intervention to improve COoperation between Sick-listed employees and their Supervisors (COSS). Methods: A field study with 6 months follow-up comparing COSS with common practice randomized participants aged 18 to 60, working at least 12 hours/week and absent for at least 2 weeks. Outcomes were initial return-to-work, quality-adjusted life years, and productivity gains. Results: After 6 months, COSS generated less costs when compared with common practice. Participants in the COSS group returned to work earlier, improvement in quality-adjusted life years were uncertain. Net benefits of COSS versus common practice yielded a productivity gain of &OV0556;395.89. Conclusions: Implementing COSS for sick-listed employees has potentials to reduce costs and improve productivity, and potentially quality of life. Longitudinal research might detect whether COSS also has the potential reaching sustainable return-to-work.

What Employer Actions Are Considered Most Important for the Return to Work of Employees with Cancer? A Delphi Study Among Employees and Employers

Purpose Employers are important stakeholders in the return to work (RTW) of employees with cancer. However, it is unclear what employer actions are most important to that process. The objective, therefore, was to reach consensus on what employer actions are considered most important for the RTW of employees with cancer, by employers and employees separately. Methods A two-round online Delphi study was conducted with two expert panels: one with 23 employers and one with 29 employees with cancer. The results from each panel were analysed separately. Out of 24 suggested employer actions, participants selected the 10 they considered most important for RTW in each of the following RTW phases: (1) disclosure, (2) treatment, (3) RTW plan, and (4) actual RTW. The consensus threshold was set at ≥ 80% during the second round. Results The employer and employee expert panels both reached consensus on the importance of ‘emotional support’, ‘practical support’, ‘allow sufficient sick leave’, ‘plan return to work’, ‘adjust expectations’, ‘assess work ability’, and ‘show appreciation’. Employers also reached consensus on ‘communicate’ and ‘treat normally’, and employees on ‘handle unpredictability’. All these employer actions were considered to be specific for one to three RTW phases. Conclusions Employers reached consensus on the importance of nine employer actions, employees on eight. Both stakeholder perspectives showed great similarities, but did vary regarding important employer actions during the employee’s treatment. We recommend developing interventions targeting the employer, meeting both employer and employee needs in each RTW phase, to enhance RTW support for employees with cancer.

Primary health Centres’ performance assessment measures in developing countries: review of the empirical literature

BackgroundIt is universally accepted that primary healthcare is essential for achieving public health and that assessment of its performance is critical for continuous improvement. The World Health Organization’s (WHO’s) framework for performance assessment is a comprehensive global standard, but difficult to apply in developing countries because of financial and data constraints. This study aims to review the empirical literature on measures for Primary Health Centre (PHC) performance assessment in developing countries, and compare them for comprehensiveness with the aspects described by the WHO Framework.MethodsResearch articles published in English scientific journals between January 1979 and October 2016 were reviewed systematically. The reporting quality of the article and the quality of the measures were assessed with instruments adapted for the purpose of this study. Data was categorized and described.ResultsFifteen articles were included in the study out of 4359 articles reviewed. Nine articles used quantitative methods, one article used qualitative methods exclusively and five used mixed methods. Fourteen articles had a good description of the measurement properties. None of the articles presented validity tests of the measures but eleven articles presented measures that were well established. Mostly studies included components of personnel competencies (skilled/ non-skilled) and centre performance (patient satisfaction/cost /efficiency).ConclusionsIn comparison to the WHO framework, the measures in the articles were limited in scope as they did not represent all service components of PHCs. Hence, PHC performance assessment should include system components along with relevant measures of personnel performance beyond knowledge of protocols. Existing measures for PHC performance assessment in developing countries need to be validated and concise measures for neglected aspects need to be developed.