Socioeconomic differences in working life expectancy: a scoping review.

BACKGROUND: In the last decade, interest in working life expectancy (WLE) and socioeconomic differences in WLE has grown considerably. However, a comprehensive overview of the socioeconomic differences in WLE is lacking. The aim of this review is to systematically map the research literature to improve the insight on differences in WLE and healthy WLE (HWLE) by education, occupational class and income while using different ways of measuring and estimating WLE and to define future research needs. METHODS: A systematic search was carried out in Web of Science, PubMed and EMBASE and complemented by relevant publications derived through screening of reference lists of the identified publications and expert knowledge. Reports on differences in WLE or HWLE by education, occupational class or income, published until November 2022, were included. Information on socioeconomic differences in WLE and HWLE was synthesized in absolute and relative terms. RESULTS: A total of 26 reports from 21 studies on educational and occupational class differences in WLE or HWLE were included. No reports on income differences were found. On average, WLE in persons with low education is 30% (men) and 27% (women) shorter than in those with high education. The corresponding numbers for occupational class difference were 21% (men) and 27% (women). Low-educated persons were expected to lose more working years due to unemployment and disability retirement than high-educated persons. CONCLUSIONS: The identified socioeconomic inequalities are highly relevant for policy makers and pose serious challenges for equitable pension policies. Many policy interventions aimed at increasing the length of working life follow a one-size-fits-all approach which does not take these inequalities into account. More research is needed on socioeconomic differences in HWLE and potential influences of income on working life duration.

Sustainable employability of long-term care staff in self-managing teams: A qualitative study.

AIM: To discover what long-term care (LTC) staff working in self-managing teams consider necessary to remain sustainably employable. DESIGN: Qualitative study with semi-structured interviews. METHODS: In 2020, semi-structured interviews were conducted one-on-one with 25 LTC workers from a medium-large Dutch organization providing long-term care. All interviews were audio-recorded, anonymously transcribed verbatim and analysed with thematic content analysis in the software program Atlas.ti. RESULTS: LTC workers indicated a need for autonomy. They wanted their control and involvement in decisions to be strengthened. Furthermore, LTC workers indicated a need for relatedness, by experiencing support, a feeling of togetherness and more time to have attention for the residents. Lastly, LTC workers expressed a need for (assistance in) further developing their competence. CONCLUSION: In order to remain willing and able to work, LTC workers in self-managing teams want their needs for autonomy, relatedness and competence to be addressed. Working conditions are important to these LTC workers' sustainable employability since they can hinder or promote the satisfaction of their needs. IMPLICATIONS: It is important that management in LTC is aware of the importance of LTC workers' needs for sustainable employability. We recommend that management critically reflect on and invest in addressing these needs by enhancing indicators and limiting inhibitors of the needs. IMPACT: A robust LTC workforce is necessary to provide care to the aging population. In the context of the increasing implementation of self-managing teams in LTC organizations, understanding what workers in self-managing teams need in order to remain sustainably employable is crucial. For sustainable employability (i.e. to remain willing and able to work), interviewees indicated a need for autonomy, relatedness, and competence. Nearly all participants stressed the importance of belonging and feeling connected. Working conditions seemed to relate not only directly to the sustainable employability of LTC staff but also indirectly through their lack of contribution to the satisfaction of workers' psychological needs. The outcomes of this study primarily impact workers and management within LTC organizations with self-managing teams. They benefit from recognizing the significance of addressing workers' needs to ensure their essential and sustainable employability in the sector. REPORTING METHOD: The Standards for Reporting Qualitative Research and the Consolidated Criteria for Reporting Qualitative (COREQ) research were used. PATIENT OR PUBLIC CONTRIBUTION: Two LTC workers provided advice and feedback regarding the materials and set up of the interviews. These two ambassadors additionally helped in reaching our population, by disseminating information about the study.

Cancer survivors and adverse work outcomes: associated factors and supportive interventions.

INTRODUCTION: The number of cancer survivors in a working age is rising. An awareness of factors associated with adverse work outcomes, and of supportive interventions, is needed. SOURCES OF DATA: A narrative review of research obtained via several databases, including Medline and PsycINFO, was conducted. AREAS OF AGREEMENT: A range of factors is associated with adverse work outcomes such as prolonged sick leave, delayed return to work, disability pension and unemployment in cancer survivors. They include the cancer type and treatment, fatigue, cognitive functioning, work factors and elements of health care systems. Effective supportive interventions encompass physical and multicomponent interventions. AREAS OF CONTROVERSY: The role of behaviour determinants and legislative and insurance systems is unclear. It is furthermore uncertain what the optimal timing of delivering supportive interventions is. GROWING POINTS: Further focus on vulnerable groups, including specific cancer types and those with lower income, lower educational level and in precarious employment, is needed. AREAS TIMELY FOR DEVELOPING RESEARCH: Recent developments are tailored and timely interventions.

Effectiveness of Team and Organisational Level Workplace Interventions Aimed at Improving Sustainable Employability of Aged Care Staff: A Systematic Review.

Purpose The sustainable employability of healthcare professionals in aged care is under pressure, but research into the effectiveness of interventions aimed at improving employees' sustainable employability is scarce. This review therefore aimed to investigate the effectiveness of workplace interventions on sustainable employability of healthcare professionals in aged care. Methods A systematic literature search was performed. Studies were included when reporting about the effect of an intervention at work in an aged care setting on outcomes related to one of the three components of sustainable employability (i.e. workability, vitality, employability). The methodological quality of each study was assessed and a rating system was used to determine the level of evidence. Additionally, a sensitivity analysis was performed, accounting for the match between the intervention's focus and the targeted component of sustainable employability. Results Current review includes 32 interventions published between 1996 and 2019. Interventions covered learning and improving skills, changing the workplace, and exercising or resting. The initial analysis showed a strong level of evidence for employability and insufficient evidence for workability and vitality. The sensitivity analysis revealed strong evidence for the effectiveness of interventions addressing either employability or workability, and insufficient evidence for vitality. Conclusions Evidence for workplace interventions on sustainable employability of healthcare professionals in aged care differed. We found strong evidence for effects of workplace interventions on employability and for those directly targeting workability. Evidence for effects of interventions on vitality was insufficient. The alignment of the interventions to the targeted component of sustainable employability is important for effectiveness.

Clinical Work-Integrating Care in Current Practice: A Scoping Review.

PURPOSE: Clinical work-integrating care (CWIC) refers to paying attention to work participation in a clinical setting. Working patients may benefit from CWIC. The purpose of this study is to explore the extent and nature to which medical specialists provide CWIC and what policies and guidelines oblige or recommend specialists to do. METHODS: A scoping review was conducted. The databases MEDLINE, EMBASE, Psychinfo, CINAHL, and Web of Science were searched for studies on the extent and nature of CWIC and supplemented by gray literature on policies and guidelines. Six main categories were defined a priori. Applying a meta-aggregative approach, subcategories were subsequently defined using qualitative data. Next, quantitative findings were integrated into these subcategories. A separate narrative of policies and guidelines using the same main categories was constructed. RESULTS: In total, 70 studies and 55 gray literature documents were included. The main findings per category were as follows: (1) collecting data on the occupation of patients varied widely; (2) most specialists did not routinely discuss work, but recent studies showed an increasing tendency to do so, which corresponds to recent policies and guidelines; (3) work-related advice ranged from general advice to patient-physician collaboration about work-related decisions; (4) CWIC was driven by legislation in many countries; (5) specialists sometimes collaborated in multidisciplinary teams to provide CWIC; and (6) medical guidelines regarding CWIC were generally not available. CONCLUSION: Medical specialists provide a wide variety of CWIC ranging from assessing a patient's occupation to extensive collaboration with patients and other professionals to support work participation. Lack of medical guidelines could explain the variety of these practices.

Implementing Nonoperative Treatment Strategy for Simple Pediatric Appendicitis: A Qualitative Study.

INTRODUCTION: A nonoperative treatment strategy (NOT) with antibiotics for children with simple appendicitis could reduce anesthesia and surgery-related complications. As the implementation of a new treatment in routine clinical practice may take years, this study aims to identify barriers and facilitators for implementation of NOT for children with simple appendicitis. MATERIALS AND METHODS: To identify barriers and facilitators for its implementation, we conducted 14 semistructured interviews and a focus group with health insurance/hospital policymakers, surgical clinicians, and young people-together with their parents-who have been treated surgically or with antibiotics. Transcripts were open coded and categorized as per the framework for healthcare innovations by Fleuren et al. RESULTS: We identified four main themes: (1) Appendicitis is a well-known disease. Children, parents, and clinicians regard appendectomy as routine and safe, making them reluctant toward other treatment options. (2) Clinicians regard uptake of NOT in the national appendicitis guideline necessary for its implementation. (3) For identification of patients best suited for NOT more experience and scientific evidence is needed. (4) Appendectomy and NOT have different risk and benefits making the treatment choice depended on individual patient preferences. CONCLUSIONS: By addressing how NOT and operative treatment are regarded by patients and surgeons could have a substantial impact on the implementation of NOT for children with simple appendicitis. Furthermore, the individual preferences of patients need to be taken into account when choosing between operative and NOT. In other words, offering NOT in a shared decision-making model seems the first appropriate step in its implementation.

Development of the core of an ICF-based instrument for the assessment of work capacity and guidance in return to work of employees on sick leave: a multidisciplinary modified Delphi study.

BACKGROUND: Several occupational health disciplines are involved in return to work guidance, implying that good interdisciplinary collaboration is important. A shared conceptual framework and a common language for the assessment of work capacity and guidance in return to work is expected to be at the benefit of appropriate and sustainable employability of sick employees. The International Classification of Functioning, Disability and Health (ICF) can be considered a shared conceptual framework and is also promising in terms of a common language. The purpose of the current study is to reach multidisciplinary consensus among occupational health professionals on the content of an ICF-based instrument for the assessment of work capacity and guidance in return to work. METHODS: To obtain multidisciplinary consensus we conducted a modified Delphi study among twelve occupational health experts, including four occupational physicians, four insurance physicians and four labour experts. The study included two e-mail rounds and two virtual meetings. In the consecutive rounds the experts assessed ICF items as well as a list of non-ICF-based work-related environmental factors on their relevance for the assessment of the work capacity and guidance in return to work together with their interpretability. RESULTS: The four consecutive Delphi rounds resulted in 20 items that are minimally needed for the assessment of the work capacity and return to work possibilities of employees on sick leave. The final list included six items on personal functioning, seven items on social functioning and seven items on physical functioning. CONCLUSIONS: This set of items forms the core of an ICF-based instrument, which is expected to facilitate interdisciplinary and intradisciplinary communication because of the use of a shared conceptual framework. As such, it should be of help in the guidance in return to work of employees on sick leave and contribute to appropriate and sustainable employability.

Proposal to extend the PROMIS® item bank v2.0 'Ability to Participate in Social Roles and Activities': item generation and content validity.

PURPOSE: Previous research indicated that the Patient-Reported Outcomes Measurement Information System (PROMIS®) item bank v2.0 'Ability to Participate in Social Roles and Activities' may miss subdomains of social participation. The purpose of this study was to generate items for these missing subdomains and to evaluate their content validity. METHODS: A three-step approach was followed: (1) Item generation for 16 International Classification of Functioning Disability and Health subdomains currently not covered by the item bank; (2) Evaluation of content validity of generated items through expert review (n = 20) and think-aloud interviews with a purposeful sample of people with and without (chronic) health conditions (n = 10), to assess item comprehensibility, relevance, and comprehensiveness; and 3) Item revision based on the results of step 2, in a consensus procedure. RESULTS: First, 48 items were generated. Second, overall, content experts indicated that the generated items were relevant. Furthermore, based on experts' responses, items were simplified and 'participation in social media' was identified as an important additional subdomain of social participation. Additionally, 'participating in various social roles simultaneously' was identified as a missing item. Based on the responses of the interviewed adults items were simplified. Third, in total 17 items, covering 17 subdomains, were proposed to be added to the original item bank. DISCUSSION: The relevance, comprehensibility and comprehensiveness of the 17 proposed items were supported. Whether the proposed extension of the item bank leads to better psychometric properties of the item bank should be tested in a large-scale field study.

A qualitative study investigating the meaning of participation to improve the measurement of this construct.

PURPOSE: The purpose of this study was to improve the measurement of participation. Research questions were as follows: (1) What constitutes participation according to adults? (2) Do they mention participation subdomains that are not covered in the Patient-Reported Outcomes Measurement Information System (PROMIS) item bank "Ability to Participate in Social Roles and Activities"? METHODS: Semi-structured interviews were conducted with 46 adults from the general population. Interviews were thematically analysed using the International Classification of Functioning, Disability and Health (ICF) as conceptual framework. Thereafter, assigned codes were compared to PROMIS item bank. RESULTS: Participants mentioned a variety of participation subdomains that were meaningful to them, such as socializing and employment. All subdomains could be classified into the ICF. The following subdomains were not covered by the PROMIS item bank: acquisition of necessities, education life, economic life, community life, and religion and spirituality. Also a distinction between remunerative (i.e. paid) and non-remunerative (i.e. unpaid) employment, and domestic life was missing. Several ICF sub-codes were not mentioned, such as ceremonies. CONCLUSIONS: Many participation subdomains were mentioned to be meaningful. As several of these subdomains are not covered in the PROMIS item bank, it may benefit from extension with new (patient-)reported subdomains of participation.

The role of personal characteristics, work environment and context in working beyond retirement: a mixed-methods study.

OBJECTIVE: To investigate the role of personal characteristics, work environment and context in working beyond retirement. METHODS: In the current study, a mixed-methods design was applied including quantitative survey data and semi-structured telephone interviews. Respondents (N = 568) were selected from the Study on Transitions in Employment, Ability and Motivation (STREAM). Personal characteristics, work characteristics and contextual factors were measured using a questionnaire at baseline. Concurrently, qualitative data of 30 persons aged over 65 years were gathered. Logistic regression analyses were used to identify quantitative associations and thematic analyses were used for qualitative purposes. RESULTS: Quantitative data revealed that being in good physical health (OR = 1.80), developmental proactivity (OR = 1.38), interesting work (OR = 2.02), appreciation (OR = 1.62) and voluntary work (OR = 1.58) were associated with working beyond the statutory retirement age. Additionally, qualitative findings suggested that working beyond retirement was mainly driven by the desire to contribute to society (e.g., mentor younger coworkers), and identified the employers' willingness to hire an older worker despite existing stereotypes as an important precondition. CONCLUSIONS: Working beyond retirement is influenced by physical health and work characteristics, as well as motivational determinants such as the desire to contribute to society. However, to meet the increasing demands for paid jobs by individuals aged over 65 years, the willingness of employers to actually hire them is crucial. Therefore, recognition and utilization of older workers' potentials is of great importance.

Working life expectancy in good and poor self-perceived health among Dutch workers aged 55-65 years with a chronic disease over the period 1992-2016.

OBJECTIVES: Several governments have taken measures to encourage prolonged working. It is therefore likely that older adults with a chronic disease are required to work longer in poor self-perceived health (SPH) than before. This study examines to what extent working life expectancy (WLE) in good and poor SPH changed between 1992 and 2016 in workers with a chronic disease from age 55 years onwards. METHODS: Three cohorts (1992, 2002 and 2012) of workers with a chronic disease aged 55-65 years were selected from the Longitudinal Aging Study Amsterdam with a 3-year follow-up each (n=705). A three-state survival model was estimated, modelling transitions between states 'working with good SPH', 'working with poor SPH' and 'exit from work'. WLEs were estimated using Multistate Modelling and Estimating Life Expectancies using Continuous Time in R. RESULTS: Of the workers with a chronic disease, total WLEs at age 55 years were 5.2, 5.7 and 6.8 years in cohorts 1992, 2002 and 2012, respectively. Workers initially having poor SPH, had total WLE of 4.7 years of which 2.4 years in poor SPH in cohort 1992. These workers had total WLE of 5.2 years of which 3.3 years in poor SPH in cohort 2002, and total WLE of 6.5 years of which 3.6 years in poor SPH in cohort 2012. CONCLUSIONS: Workers with a chronic disease extended their working lives by approximately 18 months from 1992 to 2016. In the first decade, unhealthy WLE increased, whereas in the second decade, healthy WLE increased, among both workers in general and workers initially having poor SPH.

Determinants of working until retirement compared to a transition to early retirement among older workers with and without chronic diseases: Results from a Dutch prospective cohort study.

AIM: The ageing society and recent policy changes may lead to an increase of older workers with chronic diseases in the workforce. To date, it is unclear whether workers with chronic diseases have specific needs while employed. The aim of this study is to explore the differences in determinants of working until retirement compared to a reference group who have transitioned to early retirement among workers with and without chronic diseases. METHODS: Dutch workers aged 57-62 years ( n = 2445) were selected from an existing prospective cohort study, 'STREAM'. The potential determinants were categorized into: individual, health, work-related and social factors. Logistic regression analyses were performed to determine the associations between these determinants and working until retirement - once for workers with and once for those without chronic diseases. To test differences, we included an interaction term between the determinant and the covariate 'having a chronic disease yes/no' in the analyses of the total population. RESULTS: In total, 1652 (68%) persons were employed from 2011 to 2013. The majority of the determinants appeared to be similar for workers with or without a chronic disease; the interaction terms for these determinants and the covariate 'having a chronic disease' showed a p-value higher than 0.05, except for one individual factor (i.e. mastery) and one work-related factor (i.e. autonomy), which showed a p-value below 0.05. Higher mastery and higher autonomy were statistically significantly associated with working until retirement for those with chronic diseases, whereas they were not for those without chronic diseases. CONCLUSIONS: Differences between workers with and without chronic diseases may exist for working until a statutory retirement age. Interventions aimed at encouraging work participation of older workers should make a distinction between the two groups. Autonomy at work and mastery were found to be factors that may promote work participation until higher age, specifically for older workers with chronic diseases.

Predictors of working beyond retirement in older workers with and without a chronic disease - results from data linkage of Dutch questionnaire and registry data.

BACKGROUND: An increasing number of retirees continue to work beyond retirement despite being eligible to retire. As the prevalence of chronic disease increases with age, working beyond retirement may go along with having a chronic disease. Working beyond retirement may be different for retirees with and without chronic disease. We aim to investigate whether demographic, socioeconomic and work characteristics, health and social factors predict working beyond retirement, in workers with and without a chronic disease. METHODS: Employees aged 56-64 years were selected from the Study on Transitions in Employment, Ability and Motivation (N = 1125). Questionnaire data on demographic and work characteristics, health, social factors, and working beyond retirement were linked to registry data from Statistics Netherlands on socioeconomic characteristics. Separate prediction models were built for retirees with and without chronic disease using multivariate logistic regression analyses. RESULTS: Workers without chronic disease were more likely to work beyond retirement compared to workers with chronic disease (27% vs 23%). In retirees with chronic disease, work and health factors predicted working beyond retirement, while in retirees without a chronic disease, work, health and social factors predicted working beyond retirement. In the final model for workers with chronic disease, healthcare work, better physical health, higher body height, lower physical load and no permanent contract were positively predictive of working beyond retirement. In the final model for workers without chronic disease, feeling full of life and being intensively physically active for > = 2 days per week were positively predictive of working beyond retirement; while manual labor, better recovery, and a partner who did not support working until the statutory retirement age, were negatively predictive of working beyond retirement. CONCLUSIONS: Work and health factors independently predicted working beyond retirement in workers with and without chronic disease, whereas social factors only did so among workers without chronic disease. Demographic and socioeconomic characteristics did not independently contribute to prediction of working beyond retirement in any group. As prediction of working beyond retirement was more difficult among workers with a chronic disease, future research is needed in this group.

Do Work Characteristics Predict Health Deterioration Among Employees with Chronic Diseases?

Purpose In our ageing workforce, the increasing numbers of employees with chronic diseases are encouraged to prolong their working lives. It is important to prevent health deterioration in this vulnerable group. This study aims to investigate whether work characteristics predict health deterioration over a 3-year period among employees with (1) chronic diseases, and, more specifically, (2) musculoskeletal and psychological disorders. Methods The study population consisted of 5600 employees aged 45-64 years with a chronic disease, who participated in the Dutch Study on Transitions in Employment, Ability and Motivation (STREAM). Information on work characteristics was derived from the baseline questionnaire. Health deterioration was defined as a decrease in general health (SF-12) between baseline and follow-up (1-3 years). Crude and adjusted logistic regression analyses were performed to investigate prediction of health deterioration by work characteristics. Subgroup analyses were performed for employees with musculoskeletal and psychological disorders. Results At follow-up, 19.2% of the employees reported health deterioration (N = 1075). Higher social support of colleagues or supervisor predicted health deterioration in the crude analyses in the total group, and the groups with either musculoskeletal or psychological disorders (ORs 1.11-1.42). This effect was not found anymore in the adjusted analyses. The other work characteristics did not predict health deterioration in any group. Conclusions This study did not support our hypothesis that work characteristics predict health deterioration among employees with chronic diseases. As our study population succeeded continuing employment to 45 years and beyond, it was probably a relatively healthy selection of employees.

Work characteristics predict the development of multi-site musculoskeletal pain.

PURPOSE: Musculoskeletal pain in more than one body region is common and a barrier to sustaining employment. We aimed to examine whether work characteristics predict the development of multi-site pain (MSP), and to determine differences in work-related predictors between age groups. METHODS: This study is based on 5136 employees from the Study on Transitions in Employment, Ability and Motivation (STREAM) who reported no MSP at baseline. Measures included physical, emotional, mental, and psychological job demands, social support and autonomy. Predictors of MSP were studied by logistic regression analyses. Univariate and multivariate analyses with age stratification (45-49, 50-54, 55-59, and 60-64 years) were done to explore differences between age groups. RESULTS: All work characteristics with the exception of autonomy were predictive of the development of MSP, with odds ratios varying from 1.21 (95% CI 1.04-1.40) for mental job demands to 1.63 (95% CI 1.43-1.86) for physical job demands. No clear pattern of age-related differences in the predictors of MSP emerged, with the exception of social support, which was predictive of MSP developing in all age groups except for the age group 60-64 years. CONCLUSIONS: Adverse physical and psychosocial work characteristics are associated with MSP. Organisations need to comprehensively assess work environments to ensure that all relevant workplace hazards, physical and psychosocial, are identified and then controlled for across all age groups.

Why older workers work beyond the retirement age: a qualitative study.

BACKGROUND: The aims of the present study were to: 1) gain insight into reasons for working beyond the statutory retirement age from older workers' perspectives, and 2) explore how the domains of the research framework Study on Transitions in Employment, Ability and Motivation (STREAM) can be applied to working beyond retirement age. METHODS: A qualitative research design included individual interviews (n = 15) and three focus groups (n = 18 participants) conducted with older workers aged 65 years and older continuing in a paid job or self-employment. Interview participants were recruited from an existing STREAM cohort study. Focus group participants were recruited from companies and employment agencies. The data were subjected to thematic analysis. RESULTS: The most important motives for working beyond retirement age were maintaining daily routines and financial benefit. Good health and flexible work arrangements were mentioned as important preconditions. The themes emerging from the categorization of the motives and preconditions corresponded to the domains of health, work characteristics, skills and knowledge, and social and financial factors from the STREAM research framework. However, our analysis revealed one additional theme-purpose in life. CONCLUSION: This study offers important new insights into the various preconditions and motives that influence working beyond retirement age. In addition, the five domains of the STREAM research framework, including the additional domain of 'purpose in life', seem to be applicable to working beyond retirement age. This knowledge contributes to the development of work-related interventions that enhance older workers' motivation to prolong their working lives.

A life course perspective on working beyond retirement-results from a longitudinal study in the Netherlands.

BACKGROUND: There is a societal need that workers prolong their working lives. By adopting a life course perspective, this study aimed to investigate the influence of work motives and motivation, health, job characteristics, skills, and financial and social situation on working beyond retirement, and differences between 'on time' and 'off time' retirees (retirement age 65 and <65 years, respectively). METHODS: Retirees aged 57 to 67 years (N = 1,054) who participated in the Dutch Study on Transitions in Employment, Ability and Motivation were included in this study. Participants filled out a questionnaire in 2010, 2011, 2012, and 2013. Predictors of working beyond retirement were identified using logistic regression analyses, and stratified analyses were performed to investigate differences between 'off time' and 'on time' retirees. RESULTS: High work engagement (OR = 1.3), good physical health (OR = 1.8), poor financial situation (OR = 2.4), and voluntary work (OR = 1.5) predicted working beyond retirement. For 'off time' retirees, no financial possibility to retire early (OR = 1.8) and not having a partner (OR = 1.9) predicted working beyond retirement. 'On time' retirees reporting more support at work (OR = 0.7) and without the financial possibility to retire early (OR = 0.5), worked beyond retirement less often. CONCLUSIONS: The results indicated that especially the motivation to work, physical health and the financial situation were the most relevant aspects with regard to working beyond retirement, which supports the idea that the principle of 'human agency' of the life course perspective is useful to understand factors that impact working beyond retirement. Most aspects of the life course principles of 'linked lives' and 'timing' seemed to be less relevant.

Company Policies on Working Hours and Night Work in Relation to Older Workers' Work Ability and Work Engagement: Results From a Dutch Longitudinal Study with 2 Year Follow-Up.

Purpose To longitudinally investigate (1) whether lower work ability and work engagement predict the use of company policies on reduced working hours and exemption from evening/night work among older workers, and (2) whether using such policies subsequently contribute to higher work ability and work engagement. Methods In total 6922 employees (45-64 years) participating in the first three waves of the Study on Transitions in Employment, Ability and Motivation were included. Participants yearly filled out an online questionnaires. Regression analyses were applied to study the influence of baseline work ability and work engagement on the incident use of policies during the first year of follow-up, and the incident use of these policies on work ability and work engagement during the second year of follow-up. Results Employees with a higher work ability were less likely to start using the policy 'reduced working hours' [OR 0.91 (95 % CI 0.83-0.98)]. Starting to use this policy was in turn related to lower work ability 1 year later [B -0.28 (95 % CI -0.47 to -0.08)]. Starting to use the policy 'exemption from evening/night work' was related to higher work engagement 1 year later [B 0.23 (95 % CI 0.07-0.39)]. Conclusions Low work ability precedes the use of some company policies aiming to support sustainable employability of older workers. Further research is needed to explore whether company policies result in a (longstanding) improvement, or reduced deterioration, of older workers' employability.

'All those things together made me retire': qualitative study on early retirement among Dutch employees.

BACKGROUND: Due to the aging of the population and subsequent higher pressure on public finances, there is a need for employees in many European countries to extend their working lives. One way in which this can be achieved is by employees refraining from retiring early. Factors predicting early retirement have been identified in quantitative research, but little is known on why and how these factors influence early retirement. The present qualitative study investigated which non-health related factors influence early retirement, and why and how these factors influence early retirement. METHODS: A qualitative study among 30 Dutch employees (60-64 years) who retired early, i.e. before the age of 65, was performed by means of face-to-face interviews. Participants were selected from the cohort Study on Transitions in Employment, Ability and Motivation (STREAM). RESULTS: For most employees, a combination of factors played a role in the transition from work to early retirement, and the specific factors involved differed between individuals. Participants reported various factors that pushed towards early retirement ('push factors'), including organizational changes at work, conflicts at work, high work pressure, high physical job demands, and insufficient use of their skills and knowledge by others in the organization. Employees who reported such push factors towards early retirement often felt unable to find another job. Factors attracting towards early retirement ('pull factors') included the wish to do other things outside of work, enjoy life, have more flexibility, spend more time with a spouse or grandchildren, and care for others. In addition, the financial opportunity to retire early played an important role. Factors influenced early retirement via changes in the motivation, ability and opportunity to continue working or retire early. CONCLUSION: To support the prolongation of working life, it seems important to improve the fit between the physical and psychosocial job characteristics on the one hand, and the abilities and wishes of the employee on the other hand. Alongside improvements in the work environment that enable and motivate employees to prolong their careers, a continuous dialogue between the employer and employee on the (future) person-job fit and tailored interventions might be helpful.