Published online 2020 Feb 7
ABSTRACT
Background
Working
with a chronic condition can be challenging. Providing support to
workers with a chronic condition can help them to stay at work and
prevent work-related problems. Workers with a chronic condition who
successfully stay at work can provide valuable input for the development
of effective supportive interventions to prevent exit from work and
facilitate sustainable employment. The aim of this study is to explore
the lived experiences of workers with a chronic condition and identify
existing barriers, facilitators and possible support needs for staying
at work.
with a chronic condition can be challenging. Providing support to
workers with a chronic condition can help them to stay at work and
prevent work-related problems. Workers with a chronic condition who
successfully stay at work can provide valuable input for the development
of effective supportive interventions to prevent exit from work and
facilitate sustainable employment. The aim of this study is to explore
the lived experiences of workers with a chronic condition and identify
existing barriers, facilitators and possible support needs for staying
at work.
Methods
Four focus groups were conducted between August and December 2017 with workers with one or more chronic conditions (n = 30).
Participants included employees and (partially) self-employed workers.
All focus group data were transcribed verbatim and thematically
analyzed.
Participants included employees and (partially) self-employed workers.
All focus group data were transcribed verbatim and thematically
analyzed.
Results
Disclosure
and expressing one’s needs were considered important personal
facilitators for staying at work. Environmental facilitators included
receiving practical information on working with a chronic condition and
social and employer support. Environmental barriers were identified in
the work environment, the health care system and service provision,
e.g., manager and co-worker’s lack of knowledge about working with a
chronic condition, a lack of focus on work in the course of treatment
for a chronic condition, dissatisfaction with occupational physician
support, and the absence of support for self-employed workers. Provided
support should be available to all workers, and be proactive and
tailored to the workers’ specific support needs.
and expressing one’s needs were considered important personal
facilitators for staying at work. Environmental facilitators included
receiving practical information on working with a chronic condition and
social and employer support. Environmental barriers were identified in
the work environment, the health care system and service provision,
e.g., manager and co-worker’s lack of knowledge about working with a
chronic condition, a lack of focus on work in the course of treatment
for a chronic condition, dissatisfaction with occupational physician
support, and the absence of support for self-employed workers. Provided
support should be available to all workers, and be proactive and
tailored to the workers’ specific support needs.
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Conclusions
A
variety of facilitators, barriers and support needs were identified in
various domains. By addressing environmental barriers (e.g., by
integrating work in the course of treatment and creating supportive work
environments), sustainable employment by workers with a chronic
condition can be promoted.
variety of facilitators, barriers and support needs were identified in
various domains. By addressing environmental barriers (e.g., by
integrating work in the course of treatment and creating supportive work
environments), sustainable employment by workers with a chronic
condition can be promoted.
Keywords: Work, Chronic conditions, Support, Barriers and facilitators, Sustainable employment
Background
Working
with a chronic condition can be a struggle, since physical or
psychological challenges can hamper work performance, potentially
resulting in a loss of productivity, extended or frequent sick leave, or
job loss [1–3].
The number of people in the working population with one or more chronic
conditions will continue to rise due to a variety of reasons, amongst
others an aging population, unhealthy lifestyles and unfavorable working
conditions [4, 5].
Although a large percentage of the working population with a chronic
condition is able to work, work participation rates among these workers
lag behind the general population [6].
Staying at work and prevention of work-related problems among workers
with a chronic condition is of significant importance, since return to
work after reporting being ill has proven to be difficult [5, 7].
with a chronic condition can be a struggle, since physical or
psychological challenges can hamper work performance, potentially
resulting in a loss of productivity, extended or frequent sick leave, or
job loss [1–3].
The number of people in the working population with one or more chronic
conditions will continue to rise due to a variety of reasons, amongst
others an aging population, unhealthy lifestyles and unfavorable working
conditions [4, 5].
Although a large percentage of the working population with a chronic
condition is able to work, work participation rates among these workers
lag behind the general population [6].
Staying at work and prevention of work-related problems among workers
with a chronic condition is of significant importance, since return to
work after reporting being ill has proven to be difficult [5, 7].
Participation
in the workforce positively influences well being and improves quality
of life, as it brings purpose to life and fosters socials contacts [8, 9].
Relevant factors enabling workers with a chronic condition to stay at
work have been well investigated, and demonstrate that in addition to
disease-related factors, personal and environmental factors are critical
for sustainable employment [10–12].
A wide variety of interventions have been developed to facilitate
sustainable employment for these workers, and are aimed at the work
environment (e.g. facilitating work accommodations) or directed at the
individual worker (e.g. increasing empowerment and self-management
skills) [13–15].
in the workforce positively influences well being and improves quality
of life, as it brings purpose to life and fosters socials contacts [8, 9].
Relevant factors enabling workers with a chronic condition to stay at
work have been well investigated, and demonstrate that in addition to
disease-related factors, personal and environmental factors are critical
for sustainable employment [10–12].
A wide variety of interventions have been developed to facilitate
sustainable employment for these workers, and are aimed at the work
environment (e.g. facilitating work accommodations) or directed at the
individual worker (e.g. increasing empowerment and self-management
skills) [13–15].
In
addition to self-management and empowerment, self-control is a relevant
factor for staying at work. Empowerment, self-management and
self-control are all concepts that relate to one’s ability to master a
life with a chronic condition and maintain quality of life [16–19].
However, some differences between these concepts can be identified.
Self-management can, in a broader sense, be defined as the daily
management of a chronic condition over the course of the illness,
thereby focusing more on managing symptoms, treatments, and the physical
and psychosocial consequences of the condition [20].
Although both empowerment and self-control link to gaining control over
decisions and actions, empowerment can be considered either a social,
cultural, psychological or political process [19].
Whereas self-control seems more an internal process, with self-control
being defined as ‘the capacity for altering one’s own responses,
especially to bring them into line with standards such as ideals,
values, morals, and social expectations, and to support the pursuit of
long-term goals’ (p.351) [21]. This also relates to someone’s ability to adapt to new situations [22, 23].
addition to self-management and empowerment, self-control is a relevant
factor for staying at work. Empowerment, self-management and
self-control are all concepts that relate to one’s ability to master a
life with a chronic condition and maintain quality of life [16–19].
However, some differences between these concepts can be identified.
Self-management can, in a broader sense, be defined as the daily
management of a chronic condition over the course of the illness,
thereby focusing more on managing symptoms, treatments, and the physical
and psychosocial consequences of the condition [20].
Although both empowerment and self-control link to gaining control over
decisions and actions, empowerment can be considered either a social,
cultural, psychological or political process [19].
Whereas self-control seems more an internal process, with self-control
being defined as ‘the capacity for altering one’s own responses,
especially to bring them into line with standards such as ideals,
values, morals, and social expectations, and to support the pursuit of
long-term goals’ (p.351) [21]. This also relates to someone’s ability to adapt to new situations [22, 23].
Proceeding from the new definition of health from Huber, ‘having the ability to adapt and self-manage’ (p. 2) [24],
having higher levels of self-control at work and the possibility of
exerting self-control can improve well being and health. This then
facilitates sustainable employment for workers with a chronic condition.
Encouraging people with a chronic condition to take control over their
lives and their work has been a focal point of the Dutch government and
society for a long time [25].
In a qualitative synthesis on self-control of workers with a chronic
condition, we specified the desired behaviors that are important to
staying at work and the influence of these behaviors and their
interaction with the environment. The study findings also showed the
importance of support for exerting self-control [26].
having higher levels of self-control at work and the possibility of
exerting self-control can improve well being and health. This then
facilitates sustainable employment for workers with a chronic condition.
Encouraging people with a chronic condition to take control over their
lives and their work has been a focal point of the Dutch government and
society for a long time [25].
In a qualitative synthesis on self-control of workers with a chronic
condition, we specified the desired behaviors that are important to
staying at work and the influence of these behaviors and their
interaction with the environment. The study findings also showed the
importance of support for exerting self-control [26].
Exerting
desired self-control behaviors is often not enough to stay at work for
workers with a chronic condition. Adequate support is also critical, as
stated by the European Chronic Disease Alliance [5]. Research has already shown the positive effects of a supportive work environments for workers with a chronic condition [27].
However, other domains, such as occupational health services and
medical health care have an important supportive role as well [28, 29]. National policies can also have an important influence on sustainable employment of workers with a chronic condition [5].
Effective supportive interventions can help workers with a chronic
condition to stay at work and achieve sustainable employment. However,
workers’ specific support needs must first be identified. Workers with a
chronic condition who are successful in staying at work can provide
valuable input for these supportive interventions. Therefore, the aim of
this study is to explore the lived experiences of Dutch workers with a
chronic condition who are successful in staying at work, and identify
facilitating factors, existing barriers and possible support needs for
staying at work.
desired self-control behaviors is often not enough to stay at work for
workers with a chronic condition. Adequate support is also critical, as
stated by the European Chronic Disease Alliance [5]. Research has already shown the positive effects of a supportive work environments for workers with a chronic condition [27].
However, other domains, such as occupational health services and
medical health care have an important supportive role as well [28, 29]. National policies can also have an important influence on sustainable employment of workers with a chronic condition [5].
Effective supportive interventions can help workers with a chronic
condition to stay at work and achieve sustainable employment. However,
workers’ specific support needs must first be identified. Workers with a
chronic condition who are successful in staying at work can provide
valuable input for these supportive interventions. Therefore, the aim of
this study is to explore the lived experiences of Dutch workers with a
chronic condition who are successful in staying at work, and identify
facilitating factors, existing barriers and possible support needs for
staying at work.
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