Femke Abma

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

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 Sens 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.

Factors influencing work functioning after cancer diagnosis: a focus group study with cancer survivors and occupational health professionals

PurposeCancer survivors (CSs) frequently return to work, but little is known about work functioning after return to work (RTW). We aimed to identify barriers and facilitators of work functioning among CSs.MethodsThree focus groups were conducted with CSs (n = 6, n = 8 and n = 8) and one focus group with occupational health professionals (n = 7). Concepts were identified by thematic analysis, using the Cancer and Work model as theoretical framework to structure the results.ResultsLong-lasting symptoms (e.g. fatigue), poor adaptation, high work ethics, negative attitude to work, ambiguous communication, lack of support and changes in the work environment were mentioned as barriers of work functioning. In contrast, staying at work during treatment, open dialogue, high social support, appropriate work accommodations and high work autonomy facilitated work functioning.ConclusionsNot only cancer-related symptoms affect work functioning of CSs after RTW but also psychosocial and work-related factors. The barriers and facilitators of work functioning should be further investigated in studies with a longitudinal design to examine work functioning over time.

Workers with health problems: three perspectives on functioning at work

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. Implications for Rehabilitation The supervisor is a key figure in the work functioning of workers with health problems; he/she can facilitate work accommodation of workers and help to optimize functioning at work. The three stakeholders show differences in how they perceive functioning at work; e.g. workers tend to focus on their health and working conditions, while the human resources managers/supervisors and occupational physicians also take the workers’ motivation, the attributed value of work, and the organizational culture into account. An instrument to measure work functioning might be beneficial to help workers with health problems to stay at work. These results can help in decision making for use of an existing work functioning instrument.

Cross-national comparisons of sickness absence systems and statistics: towards common indicators

We aimed to identify common elements in work sickness absence (SA) in Spain, Sweden and The Netherlands. We estimated basic statistics on benefits eligibility, SA incidence and duration and distribution by major diagnostics. The three countries offer SA benefits for at least 12 months and wage replacement, differing in who and when the payer assumes responsibility; the national health systems provide health care with participation from occupational health services. Episodes per 1000 salaried workers and episode duration varied by country; their distribution by diagnostic was similar. Basic and useful SA indicators can be constructed to facilitate cross-country comparisons.

The capability set for work: development and validation of a new questionnaire

OBJECTIVES The aim of this study was to develop a questionnaire to measure work capabilities based on Amartya Sens capability approach and evaluate its validity. METHODS The development of the questionnaire was based on a combination of qualitative and quantitative methods: interviews, literature study, and an expert meeting. Additionally, in a survey, the validity was evaluated by means of hypotheses testing (using correlations and regression analyses). RESULTS The questionnaire consists of a set of seven capability aspects for work. For each aspect, it is determined whether it is part of a workers capability set, ie, when the aspect is considered valuable, is enabled in work, and is realized. The capability set was significantly correlated with work role functioning-flexibility demands (-0,187), work ability (-0.304), work performance (-0.282), worked hours (-0.073), sickness absence (yes/no) (0.098), and sickness absence days (0.105). The capability set and the overall capability item are significantly associated with all work outcomes (P<0.010). CONCLUSIONS The new capability set for work questionnaire appears to be a valid instrument to measure work capabilities. The questionnaire is unique because the items include the valued aspects of work and incorporate whether a worker is able to achieve what (s)he values in his/her work. The questionnaire can be used to evaluate the capability set of workers in organizations to identify aspects that need to be addressed in interventions.

Responsiveness of the Work Role Functioning Questionnaire ( Spanish Version) in a General Working Population

Objective: To examine the responsiveness of the Work Role Functioning Questionnaire (Spanish version) (WRFQ-SpV) so that it could be used in evaluative studies. Methods: A longitudinal survey was performed. Combinations of distribution- and anchor-based approaches were used. Five hypotheses were tested, examining validity of change scores. The consensus-based standards for the selection of health status measurement instruments (COSMIN) guided the study design. Results: One hundred two participants (mean age, 47.3 years; SD = 10.3 years) completed the WRFQ-SpV twice, within a mean interval of 3.7 (SD = 1.8) months. Four hypotheses were confirmed and one was rejected. It was verified that the WRFQ-SpV was able to detect (true) changes over time. Conclusion: Suggestive evidence about the possible use of the WRFQ-SpV with evaluative purposes was provided. More research is needed to examine the instrument responsiveness for groups whose health is stable or deteriorates.

Work functioning trajectories in cancer patients: Results from the longitudinal Work Life after Cancer (WOLICA) study

More than 60% of cancer patients are able to work after cancer diagnosis. However, little is known about their functioning at work. Therefore, the aims of this study were to (1) identify work functioning trajectories in the year following return to work (RTW) in cancer patients and (2) examine baseline sociodemographic, health‐related and work‐related variables associated with work functioning trajectories. This longitudinal cohort study included 384 cancer patients who have returned to work after cancer diagnosis. Work functioning was measured at baseline, 3, 6, 9 and 12 months follow‐up. Latent class growth modeling (LCGM) was used to identify work functioning trajectories. Associations of baseline variables with work functioning trajectories were examined using univariate and multivariate analyses. LCGM analyses with cancer patients who completed on at least three time points the Work Role Functioning Questionnaire (n = 324) identified three work functioning trajectories: “persistently high” (16% of the sample), “moderate to high” (54%) and “persistently low” work functioning (32%). Cancer patients with persistently high work functioning had less time between diagnosis and RTW and had less often a changed meaning of work, while cancer patients with persistently low work functioning reported more baseline cognitive symptoms compared to cancer patients in the other trajectories. This knowledge has implications for cancer care and guidance of cancer patients at work.

The Work Role Functioning Questionnaire v2.0 Showed Consistent Factor Structure Across Six Working Samples

Objective The Work Role Functioning Questionnaire v2.0 (WRFQ) is an outcome measure linking a persons’ health to the ability to meet work demands in the twenty-first century. We aimed to examine the construct validity of the WRFQ in a heterogeneous set of working samples in the Netherlands with mixed clinical conditions and job types to evaluate the comparability of the scale structure. Methods Confirmatory factor and multi-group analyses were conducted in six cross-sectional working samples (total N = 2433) to evaluate and compare a five-factor model structure of the WRFQ (work scheduling demands, output demands, physical demands, mental and social demands, and flexibility demands). Model fit indices were calculated based on RMSEA ≤ 0.08 and CFI ≥ 0.95. After fitting the five-factor model, the multidimensional structure of the instrument was evaluated across samples using a second order factor model. Results The factor structure was robust across samples and a multi-group model had adequate fit (RMSEA = 0.63, CFI = 0.972). In sample specific analyses, minor modifications were necessary in three samples (final RMSEA 0.055–0.080, final CFI between 0.955 and 0.989). Applying the previous first order specifications, a second order factor model had adequate fit in all samples. Conclusion A five-factor model of the WRFQ showed consistent structural validity across samples. A second order factor model showed adequate fit, but the second order factor loadings varied across samples. Therefore subscale scores are recommended to compare across different clinical and working samples.

The assessment by insurance physicians of functional limitations related to mental disorders among disability benefit claimants

SamenvattingWe investigated under- and over-recognition of functional limitations related to mental disorders by insurance physicians (IPs) in disability benefit claimants with and without mental disorders. The sample consisted of 247 persons claiming disability after two years of sickness absence. All respondents were interviewed using the Composite International Diagnostic Interview (CIDI) generating mental disorders listed in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) present in the past thirty days. Functional limitations related to mental disorders as reported by IPs were extracted from registry. Under-recognition of functional limitations related to mental disorders for any mental disorder was found in 15.7%, for mood disorders in 7.1% and for anxiety disorders in 16.4%. Over-recognition of functional limitations related to mental disorders for any mental disorder was found in 41.2%, for mood disorders in 48.4% and for anxiety disorders in 44.8%. Under-recognition of functional limitations related to mental disorders is limited. Apparently IPs primarily focus on functional limitations and impairments, and not on the causal illness. Over-recognition of functional limitations related to mental disorders is more pronounced.

Work-specific cognitive symptoms and the role of work characteristics, fatigue and depressive symptoms in cancer patients during 18 months post return to work

Cancer patients can experience work‐specific cognitive symptoms post return to work. The study aims to (1) describe the course of work‐specific cognitive symptoms in the first 18 months post return to work and (2) examine the associations of work characteristics, fatigue and depressive symptoms with work‐specific cognitive symptoms over time.