Work functioning of Dutch workers with a chronic disease in early, mid and late working life: Cross-sectional findings from 38,470 participants in the Lifelines Cohort Study.

Insight into the work functioning of workers with chronic diseases may help to improve their sustainable employability. This study examines the work functioning of workers with cardiovascular disease (CVD), diabetes mellitus type 2 (DM2), chronic obstructive pulmonary disease (COPD), rheumatoid arthritis and depression across early, mid, and late working life. This cross-sectional study used data from 38,470 participants of the Dutch Lifelines study. Chronic diseases were classified based on clinical measures, self-reports, and medication. Work functioning was measured with the Work Role Functioning Questionnaire (WRFQ), covering work scheduling and output demands, physical demands, mental and social demands, and flexibility demands. Multivariable linear and logistic regression analyses were used to examine associations between chronic diseases and work functioning (continuous) and low work functioning (dichotomous). Depression was associated with lower work functioning across all subscales and working life stages, with the lowest score in the work scheduling and output demands subscale in late working life (B:-9.51;95%CI:-11.4,-7.65). Rheumatoid arthritis was most strongly associated with lower work functioning in the physical demands subscale, with the lowest score in early working life (B:-9.97;95%CI:-19.0,-0.89). Associations between CVD and DM2 and work functioning were absent in early working life but present in mid and late working life. Associations between COPD and work functioning were absent in mid working life but present in late working life. Occupational health professionals could use the WRFQ to identify workers' perceived difficulties in meeting specific work demands, pointing out directions for interventions to mitigate perceived difficulties and thereby improve sustainable employability.

The Associations Between Illness Perceptions and Expectations About Return to Work of Workers With Chronic Diseases and Their Significant Others: A Dyadic Analysis.

Purpose To examine the associations between illness perceptions and expectations about full return to work (RTW) of workers with chronic diseases and their significant others. Methods This study used cross-sectional data of 94 dyads consisting of workers with chronic diseases and their significant others. We performed dyadic analyses based on the Actor-Partner Interdependence Model (APIM), estimating associations of illness perceptions of the two members of the dyad with their own expectations about the worker's full RTW within six months (actor effect) as well as with the other dyad member's expectations about the worker's RTW (partner effect). Results Illness perceptions of one dyad member were significantly associated with his or her own RTW expectations (actor effect composite illness perceptions score; B = -0.05, p < .001; rd = .37) and with the other dyad member's RTW expectations (partner effect composite illness perceptions score; B = -0.04, p < .001; rd = .35). That is, more negative illness perceptions of one member of the dyad were associated with more negative RTW expectations in both dyad members. For most illness perception domains, we found small to moderate actor and partner effects on RTW expectations (rd range: .23-.44). Conclusions This study suggests that illness perceptions and RTW expectations should be considered at a dyadic level as workers and their significant others influence each other's beliefs. When trying to facilitate adaptive illness perceptions and RTW expectations, involving significant others may be more effective than an individualistic approach targeted at the worker only.

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

OBJECTIVE: 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. METHODS: This study used data from the 18-month longitudinal "Work Life after Cancer" cohort. The Cognitive Symptom Checklist-Work Dutch Version (CSC-W DV) was used to measure work-specific cognitive symptoms. Linear mixed models were performed to examine the course of work-specific cognitive symptoms during 18-month follow-up; linear regression analyses with generalized estimating equations were used to examine associations over time. RESULTS: Working cancer patients examined with different cancer types were included (n = 378). Work-specific cognitive symptoms were stable over 18 months. At baseline, cancer patients reported more working memory symptoms (M = 32.0; CI, 30.0-34.0) compared with executive function symptoms (M = 19.3; CI, 17.6-20.9). Cancer patients holding a job with both manual and nonmanual tasks reported less work-specific cognitive symptoms (unstandardized regression coefficient b = -4.80; CI, -7.76 to -1.83) over time, compared with cancer patients with a nonmanual job. Over time, higher depressive symptoms were related to experiencing more overall work-specific cognitive symptoms (b = 1.27; CI, 1.00-1.55) and a higher fatigue score was related to more working memory symptoms (b = 0.13; CI, 0.04-0.23). CONCLUSIONS: Job type should be considered when looking at work-specific cognitive symptoms over time in working cancer patients. To reduce work-specific cognitive symptoms, interventions targeted at fatigue and depressive symptoms might be promising.

Fatigue and depressive symptoms improve but remain negatively related to work functioning over 18 months after return to work in cancer patients.

PURPOSE: The aims of this study are to investigate the course of work functioning, health status, and work-related factors among cancer patients during 18 months after return to work (RTW) and to examine the associations between these variables and work functioning over time. METHODS: Data were used from the 18-month longitudinal "Work Life after Cancer" (WOLICA) cohort, among 384 cancer patients who resumed work. Linear mixed models were performed to examine the different courses during 18-month follow-up. Linear regression analyses with generalized estimating equations (GEE) were used to examine the associations and interactions. RESULTS: Cancer patients reported an increase of work functioning and a decrease of fatigue and depressive symptoms in the first 12 months, followed by a stable course between 12 and 18 months. Cognitive symptoms were stable during the first 18 months. Working hours increased and social support decreased during the first 6 months; both remained stable between 6 and 18 months. Fatigue, depressive, and cognitive symptoms were negatively associated with work functioning over time; working hours and supervisor social support were positively associated. CONCLUSIONS: Interventions to improve cancer patients' work functioning over time might be promising if they are aimed at reducing fatigue, depressive symptoms, cognitive symptoms, and encouraging supervisor social support. IMPLICATIONS FOR CANCER SURVIVORS: It is important to monitor cancer patients not only in the period directly after RTW but up to 18 months after RTW, allowing for timely interventions when needed.

Multicentre validation of frequent sickness absence predictions.

BACKGROUND: A prediction model including age, self-rated health (SRH) and prior sickness absence (SA) has previously been found to predict frequent SA. AIMS: To further validate the model and develop it for clinical use. METHODS: A multicentre study of care of the elderly workers employed at one of 14 centres in Aarhus (Denmark). SA episodes recorded in the year prior to baseline and both age and SRH at baseline were included in a prediction model for frequent (three or more) SA episodes during a 1-year follow-up period. The prediction model was developed in the largest centre. Risk predictions and discrimination between high- and low-risk workers were investigated in the other centres. The prediction rule 'SRH-prior SA' was derived from the prediction model and prognostic properties of the prediction rule were investigated for each centre, using score <0 as cut-off. RESULTS: Of 2562 workers, 1930 had complete data for analysis. Predictions were accurate in 4 of 13 centres; discrimination was good in five and fair in another five centres. Prediction rule scores <0 identified workers at risk of frequent SA with sensitivities of 0.17-0.54, specificities of 0.86-0.96 and positive predictive values of 0.54-0.87 across centres. CONCLUSIONS: The prediction model discriminated between workers at high and low risk of frequent SA in the majority of centres. The prediction rule 'SRH-prior SA' can be used in clinical practice specifically to identify workers at high risk of frequent SA.

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

PURPOSE: Cancer 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. METHODS: Three 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. RESULTS: Long-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. CONCLUSIONS: Not 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.

The Cognitive Symptom Checklist-Work in cancer patients is related with work functioning, fatigue and depressive symptoms: a validation study.

PURPOSE: The study objectives are to translate the 21-item Cognitive Symptom Checklist-Work (CSC-W21) to Dutch (CSC-W DV) and to validate the CSC-W DV in working cancer patients. METHODS: The CSC-W21 was cross-culturally translated and adapted to a Dutch version. In this 19-item version, the dichotomous response option was changed to an ordinal five-point scale. A validation study of the CSC-W DV was conducted among cancer patients who had returned to work during or following cancer treatment. Internal consistency (Cronbach's α), structural validity (exploratory factor analysis) and construct validity (hypothesis testing) were evaluated. RESULTS: In a cohort of 364 cancer patients, 341 (94 %) completed the CSC-W DV (aged 50.6 ± 8.6 years, 60 % women). Exploratory factor analysis revealed two subscales 'working memory' and 'executive function'. The internal consistency of the total scale and subscales was high (Cronbach's α = 0.93-0.95). Hypothesis testing showed that self-reported cognitive limitations at work were related to work functioning (P < 0.001), fatigue (P = 0.001) and depressive symptoms (P < 0.001), but not to self-rated health (P = 0.14). CONCLUSIONS: The CSC-W DV showed high internal consistency and reasonable construct validity for measuring work-specific cognitive symptoms in cancer patients. The CSC-W DV was associated in expected ways with work functioning, fatigue and depressive symptoms. IMPLICATIONS FOR CANCER SURVIVORS: It is important to enhance knowledge about cognitive symptoms at work in cancer patients, to guide and support cancer patients as good as possible when they are back at work and to improve their work functioning over time.

Time to recurrence of mental health-related absence from work.

BACKGROUND: It is unclear when occupational health providers should re-evaluate workers after mental health-related absences from work. AIMS: To investigate the time to recurrence of mental health-related absences, stratified by International Classification of Diseases-Tenth Revision (ICD-10) diagnostic categories. METHODS: A 10-year observational study of workers employed at a steel mill. Sickness absence data were retrieved from an occupational health register. Mental health-related absences were defined as absence due to emotional disturbance or mental and behavioural disorders. The first mental health-related absence since baseline was called the index episode. Recurrences were defined as mental health-related absences occurring >28 days after recovery from the index episode. The frequency of recurrent mental health-related absence was assessed by the recurrence density (RD) per 1000 person-years. The time to recurrent mental health-related absence was investigated by Kaplan-Meier survival analysis. RESULTS: Of 15461 workers, 391 had recurrent mental health-related absences. RD was 30.5, 34.3, 29.9 and 37.7 per 1000 person-years after index episodes due to emotional disturbance, mood disorders, neurotic disorders and other psychiatric disorders, respectively. RDs did not differ across ICD-10 diagnostic categories. The median time to recurrent mental health-related absence was 15.2 months [95% confidence interval (CI) 12.6-17.7] and was shortest for mood disorders (5.2, 95% CI 1.4-8.9 months) and specific psychiatric disorders (5.3, 95% CI 1.0-13.1 months). CONCLUSIONS: Based on this observational study, we suggest that occupational and primary health care providers consider reviewing the mental health status of workers 6 months after recovery from mental health-related absence.

Associations of work ability with frequent and long-term sickness absence.

BACKGROUND: Reduced work ability is related to long-term sickness absence. The relationship between work ability and frequent sickness absence has not previously been investigated. It is important to distinguish between frequent and long-term sickness absence as they are outcomes of different processes. AIMS: To investigate the associations of work ability with frequent short-term (three or more episodes lasting <2 weeks in the past year), long-term (one or more episodes lasting at least 2 weeks in the past year) and combined (frequent and long-term) sickness absence. METHODS: In 2010-12, we invited employees working in different economic sectors to complete a postal questionnaire measuring work ability using the work ability index (WAI). We compared the WAI scores in employees with frequent, long-term and combined sickness absence with the scores in employees without such sickness absence by multinomial regression analysis. RESULTS: Of 6682 invited employees, 3660 (55%) completed the questionnaire. Mean (standard deviation) WAI scores were 41.2 (3.4), 39.4 (3.9), 37.2 (5.2) and 43.2 (2.7) in employees with frequent, long-term, combined sickness absence and neither frequent nor long-term sickness absence, respectively. WAI scores were negatively related to frequent (odds ratio [OR] = 0.85; 95% confidence interval [CI] 0.82-0.88), long-term (OR = 0.79; 95% CI 0.75-0.82) and combined sickness absence (OR = 0.74; 95% CI 0.71-0.77). CONCLUSIONS: Self-reported reduced work ability is associated with both frequent and long-term sickness absence, suggesting that frequent sickness absence is not only driven by motivational processes.

Can the Maslach Burnout Inventory and Utrecht Work Engagement Scale be used to screen for risk of long-term sickness absence?

OBJECTIVES: To investigate the Maslach Burnout Inventory-General Survey (MBI-GS) and the Utrecht Work Engagement Scale (UWES) for their ability to identify non-sicklisted employees at increased risk of long-term sickness absence (LTSA). METHODS: One-year prospective cohort study including 4,921 employees participating in occupational health surveys in the period 2008-2010. The MBI-GS and UWES were part of the health survey questionnaire and LTSA in the year following the health survey was retrieved from an occupational health register. Associations of baseline MBI-GS and UWES scores with LTSA during 1-year follow-up were stratified by the cause (mental, musculoskeletal, and other somatic illness) of LTSA. Discrimination was assessed by the area (AUC) under the receiver operating characteristic curve and considered practically useful for AUC ≥0.75. RESULTS: During 1-year follow-up, 103 employees (2%) had LTSA due to mental (N = 43), musculoskeletal (N = 31), or other somatic (N = 29) illness. MBI-GS scores were positively and UWES scores negatively associated with mental LTSA, but not musculoskeletal or other somatic LTSA. Discrimination between employees at high and low risk of mental LTSA was moderate: AUC = 0.68 for the MBI-GS and AUC = 0.70 for the UWES. Discrimination did not improve when the MBI-GS and UWES were used simultaneously. CONCLUSION: The MBI-GS and UWES predicted future mental LTSA in non-sicklisted employees, but discrimination was not practically useful for identifying employees at high risk of LTSA. However, both instruments could be used to select employees for further assessment of mental LTSA risk.

Updating and prospective validation of a prognostic model for high sickness absence.

OBJECTIVES: To further develop and validate a Dutch prognostic model for high sickness absence (SA). METHODS: Three-wave longitudinal cohort study of 2,059 Norwegian nurses. The Dutch prognostic model was used to predict high SA among Norwegian nurses at wave 2. Subsequently, the model was updated by adding person-related (age, gender, marital status, children at home, and coping strategies), health-related (BMI, physical activity, smoking, and caffeine and alcohol intake), and work-related (job satisfaction, job demands, decision latitude, social support at work, and both work-to-family and family-to-work spillover) variables. The updated model was then prospectively validated for predictions at wave 3. RESULTS: 1,557 (77 %) nurses had complete data at wave 2 and 1,342 (65 %) at wave 3. The risk of high SA was under-estimated by the Dutch model, but discrimination between high-risk and low-risk nurses was fair after re-calibration to the Norwegian data. Gender, marital status, BMI, physical activity, smoking, alcohol intake, job satisfaction, job demands, decision latitude, support at the workplace, and work-to-family spillover were identified as potential predictors of high SA. However, these predictors did not improve the model's discriminative ability, which remained fair at wave 3. CONCLUSIONS: The prognostic model correctly identifies 73 % of Norwegian nurses at risk of high SA, although additional predictors are needed before the model can be used to screen working populations for risk of high SA.

Fatigue as prognostic risk marker of mental sickness absence in white collar employees.

PURPOSE: To investigate fatigue as prognostic risk marker for identifying working employees at risk of long-term sickness absence (SA). METHODS: At baseline, fatigue was measured in 633 white collar employees with the checklist individual strength (CIS) including scales for fatigue severity, reduced concentration, reduced motivation, and reduced physical activity. SA was medically certified by an occupational physician in the 3rd or 4th SA week with diagnostic codes according to the 10th version of the International Classification of Diseases. Medically certified SA was retrieved at the individual level from an occupational health register after 1-year follow-up. CIS scores were investigated as prognostic risk markers predicting medically certified SA and particularly SA certified as mental SA. RESULTS: 614 employees (N = 378 men and N = 236 women) had complete data and were eligible for analysis; 63 (10 %) had medically certified SA of whom 39 (6 %) had mental SA. Fatigue severity and total CIS scores were associated with medically certified SA in men, but poorly discriminated between men with and without medically certified SA. Fatigue severity, reduced concentration, reduced motivation, and total CIS scores were also associated with mental SA in men. CIS and its reduced concentration scale were valid prognostic risk markers of mental SA. CONCLUSION Fatigue was a prognostic risk marker of mental SA in white collar men. The CIS should be further validated as a screening tool for the risk of mental SA in white collar working populations.

Characteristics of zero-absenteeism in hospital care.

BACKGROUND: Literature on sickness presenteeism is emerging, but still little is known about employees who are never absent from work due to injuries or illness. Insight into the determinants and characteristics of such zero-absentees may provide clues for preventing sickness absence. AIMS: To investigate the characteristics of zero-absentees, defined as employees without sickness absence over a period of 5 years. METHODS: A mixed-method qualitative study comprising semi-structured interviews and focus groups for which Azjen and Fishbein's theory of planned behaviour was used as a framework. Zero-absentees working in hospital care were invited for semi-structured interviews until saturation was reached. The results of semi-structured interviews were validated in two focus groups. RESULTS: Of 1053 hospital employees, 47 were zero-absentees of whom 31 (66%) agreed to participate in the study. After 16 semi-structured interviews, no new insights or information were gathered from the interviews. The remaining 15 employees were invited to two (n = 8 and n = 7) focus groups. Personal attitudes and self-efficacy were more important in zero-absenteeism than social pressures of managers, colleagues or patients. Zero-absentees were found to be intrinsically motivated to try attending work when ill. CONCLUSIONS: In the present study population of hospital employees, we found indications that zero-absenteeism and sickness presenteeism might be different types of work attendance. Managers should realize that zero-absentees are driven by intrinsic motivation rather than social pressures to attend work.

Low job satisfaction does not identify nurses at risk of future sickness absence: results from a Norwegian cohort study.

BACKGROUND: Sickness absence is high in healthcare and contributes to nursing staff shortages reducing the efficiency and quality of patient care. Assessing the risk of sickness absence in working nurses opens opportunities for preventive strategies. Job satisfaction has attracted much attention in healthcare research and has been associated with sickness absence among nurses. OBJECTIVES: To investigate if job satisfaction scores are useful to identify working nurses at risk of future sickness absence. DESIGN: Prospective cohort study with a baseline period from November 2008 to March 2009 and 1-year follow-up. SETTINGS: Hospitals, nursing homes, and ambulant care settings in Norway. PARTICIPANTS: 2059 Norwegian nurses, of whom 1582 (77%) could be followed-up. METHODS: Nurses received a questionnaire at baseline and after 1-year follow-up. The questionnaire contained the Job Satisfaction Index (JSI), a 5-item scale measuring overall job satisfaction, and asked for sickness absence in the last 12 months. Baseline JSI scores were included in a logistic regression model with self-rated sickness absence at 1-year follow-up as outcome variable. Predictions of sickness absence were calibrated by the Hosmer-Lemeshow goodness-of-fit test. The ability of JSI scores to discriminate between nurses with and without sickness absence was examined by receiver operating characteristic analysis and expressed as area under the curve (AUC). RESULTS: Low job satisfaction was associated with higher odds of sickness absence (odds ratio [OR]=1.05; 95% confidence interval [CI] 1.01-1.09) and high (≥ 31 days) sickness absence (OR=1.10; 95% CI 1.06-1.14). Calibration was acceptable, but job satisfaction neither discriminated between nurses with and without sickness absence (AUC=0.54; 95% CI 0.51-0.58) nor between nurses with and without high (≥ 31 days) sickness absence (AUC=0.58; 95% CI 0.54-0.63). CONCLUSIONS: The results of this study indicated that job satisfaction was associated with sickness absence, though job satisfaction scores as measured with the JSI did not identify working nurses at risk of sickness absence.

Leadership effectiveness: a supervisor's approach to manage return to work.

PURPOSE: To investigate adaptive leadership in relation to personnel sickness absence (SA). In situational leadership, supervisors are effective if they adapt their leadership style appropriately to a given situation. METHODS: A managerial reorganization in a Dutch hospital with reassignment of supervisors provided the opportunity to compare SA in the same wards while under the leadership of different supervisors. Leadership effectiveness was measured with the Leader Effectiveness and Adaptability Description (LEAD). Personnel SA was retrieved from employer's records and cumulated at the individual level, distinguishing between short-term (1-7 day) and long-term (>7 days) SA. Cumulated SA days and mean SA lengths before and after managerial reorganization were compared at the individual level by using non-parametric paired statistical analyses. Employer's costs to compensate sick-listed employees' salaries before and after reorganization were cumulated and compared at ward level by using non-parametric statistics. RESULTS: 6 wards (N = 403) retained the same supervisor, 6 wards (N = 504) were assigned more effective supervisors, and 4 wards (N = 184) got less effective supervisors than the ones before reorganization. Cumulated short-term SA days and lengths did not change with leadership effectiveness. Employees who got more effective supervisors had fewer long-term SA days and shorter long-term SA lengths than before reorganization. More effective supervisors saved an average of 21,368 Euros per ward, particularly due to less long-term SA. CONCLUSIONS: Long-term SA was shorter after employees got more effective supervisors. Adaptive supervisors can facilitate return to work and save SA costs by providing the right type of support to sick-listed employees.

Sickness absence due to mental health disorders--a societal perspective.

BACKGROUND: Sickness absence (SA) is affected by societal factors. Increasing socioeconomic stress may cause or worsen mental health disorders, which are among the most frequent causes of SA. Employees may also be more cautious about being absent, for example in times of poor economy. AIMS: To monitor the incidence of SA due to mental health disorders in the Netherlands from 2001 to 2010. METHODS: Descriptive observational study of long-term (> 3 weeks) SA available from an occupational health service register. The incidence of both total and mental health long-term SA in each year was calculated and evaluated alongside the changes in SA compensation policies, gross national product and national unemployment statistics. The incidence of mental health SA was stratified based on the economic (agricultural, industrial, private, public) sector. RESULTS: The incidence of both total and mental health SA decreased gradually since 2004, and fell during the economic recession in 2009 in all economic sectors, particularly the agricultural and industrial sectors. The incidence of mental health SA increased with preliminary economic recovery in 2010 in the private and public sectors, but not in the agricultural and industrial sectors. CONCLUSIONS: Long-term SA due to mental health disorders has decreased since 2004, but further studies across countries are required to confirm and explain this trend.

Employees sick-listed with mental disorders: who returns to work and when?

PURPOSE: To investigate return to work (RTW) in employees sick-listed with mental disorders classified according to the International Classification of Diseases (ICD). METHODS: Sickness absences (SA) medically certified as emotional disturbance (ICD-10 R45) or mental and behavioral disorders (ICD-10 F00-F99) were retrieved from an occupational health service register. RTW was associated with age, gender, and socioeconomic position (SEP) by parametric survival analysis. RESULTS: Emotional, neurotic, somatoform, stress-related, and mood disorders encompassed 94 % of all mental SA. Employees with emotional disturbance had the highest RTW rates: after 1 year 95 % had resumed work and after 2 years 98 % compared to 89 and 96 % of employees with neurotic, somatoform and stress-related disorders, and 70 and 86 % of employees with mood disorders. The probability of RTW decreased after 1 month of SA due to emotional disturbance, 2 months of SA with neurotic, somatoform and stress-related disorders, and 3 months of SA with mood disorders. Women resumed their work later than men. Young employees presenting with emotional disturbance, neurotic, somatoform, and stress-related disorders had earlier RTW than older employees and low-SEP employees had earlier RTW than high-SEP employees. CONCLUSIONS: RTW rates and probabilities differed across categories of mental disorders. Age and SEP were associated with RTW of employees with emotional, neurotic, somatoform, and stress-related disorders, but not with RTW of employees experiencing mood disorders. To maximize the likelihood of RTW, a focus on RTW is important in the first months after reporting sick with mental disorders.

Return to work after cancer diagnosed in 2002, 2005 and 2008.

INTRODUCTION: Improvements in diagnosis and treatment of cancer have increased cancer survival. This study investigated the trends in return to work (RTW) after cancer. METHODS: All employees absent from work due to cancer diagnosed in 2002 (N = 1209), 2005 (N = 1522), and 2008 (N = 1556) were selected from an occupational health service register. Partial RTW was defined as resuming work with 50% of earnings and full RTW as resuming work with 100% of earnings. The percentages of partial and full RTW were determined 2 years after reporting sick and compared with percentages of partial and full RTW after cardiovascular disorders. The time to partial and full RTW after cancer in 2005 and 2008 was compared with the time to RTW in 2002. RESULTS: Partial RTW decreased from 85% 2 years after cancer diagnosis in 2002 to 80% in 2005 and 69% in 2008. Full RTW decreased from 80% 2 years after cancer diagnosis in 2002 to 74% in 2005 and 60% in 2008. RTW after cardiovascular disorders showed similar changes. The time to partial RTW in 2008 was longer than in 2002 after gastrointestinal cancer and lung cancer. The time to full RTW in 2008 was longer than in 2002 after breast cancer, gastrointestinal cancer and lung cancer. CONCLUSIONS: In the past decade, the percentages of employees who resumed work after cancer have decreased in The Netherlands, while the time to RTW increased. Possible explanations include changes in disability policy, economic decline, and resulting decreases in work latitude and workplace accommodations.

Trends in return to work of breast cancer survivors.

Most women interrupt their work activities during the treatment of cancer. This study investigated return to work (RTW) after treatment of breast cancer in the period from January 2002 to December 2008. ArboNed Occupational Health Service records the sickness absence and RTW data of more than one million workers of whom approximately 40% are women. Incident cases of sickness absence due to breast cancer (ICD-10 code C50) were selected from the ArboNed register. Proportions of partial RTW, with 50% of the earnings before sickness absence, and full RTW were determined 1 year after diagnosis. Trends in partial RTW and full RTW were examined by Chi-square trend analysis. The time to partial RTW and full RTW was analysed by Cox regression and stratified by age (<40 years, 40-50 years and >50 years). The proportion of partial RTW was stable around 70% from 2002 to 2008. The proportion of full RTW decreased from 52% in 2002 to 43% in 2008 and showed a linear decline in women of all ages. The time to partial RTW and full RTW in the years 2003-2008 did not change significantly compared with 2002. In the Netherlands, the proportion of employed women who fully resumed working after breast cancer within 1 year of diagnosis has decreased since 2002. These results warrant more epidemiological research to examine the trends in RTW of breast cancer survivors across countries.

Self-rated coping styles and registered sickness absence among nurses working in hospital care: a prospective 1-year cohort study.

BACKGROUND: Sickness absence is an important problem in healthcare that affects the quality of care. Sickness absence has been related to coping strategies. Problem-focused coping was shown to be associated with low sickness absence and emotion-focused coping with high sickness absence among postal workers. OBJECTIVES: This study investigated the relationship between coping styles and sickness absence in healthcare. DESIGN: Prospective study linking self-rated coping styles at baseline with the number of episodes of sickness absence during one year of follow-up. SETTING: Somatic hospital employing 1,153 persons. PARTICIPANTS: Convenience sample of 566 female nurses working in the hospital's clinical wards and outpatient clinic. Of these, 386 (68%) nurses had complete data for analysis. METHODS: The nurses completed a questionnaire at baseline with items on health, work, and coping styles. Three styles of coping were defined: problem-solving coping (i.e., looking for opportunities to solve a problem), social coping (i.e., seeking social support in solving a problem), and palliative avoidant coping (i.e., seeking distraction and avoiding problems). Sickness absence data were retrieved from the hospital's register in the following year. The association between the coping styles and the number of both short (1-7 days) and long (>7 days) episodes of sickness absence was assessed by Poisson regression analyses with age, work hours per week, general health, mental health, and effort-reward [ER] ratio as covariates. RESULTS: Problem-solving coping was negatively associated with the number of long episodes of sickness absence (rate ratio [RR] = 0.78, 95% confidence interval [CI] = 0.64-0.95). Social coping was negatively associated with the number of both short episodes (RR = 0.88, 95% CI = 0.79-0.97) and long episodes (RR = 0.79, 95% CI = 0.64-0.97) of sickness absence. After adjustment for the ER-ratio, the associations of coping with short episodes of sickness absence strengthened and associations with long episodes weakened, however, significance was lost for both types of sickness absence. Palliative avoidant coping was not associated with sickness absence among female hospital nurses. CONCLUSION: Problem-solving coping and social coping styles were associated with less sickness absence among female nurses working in hospital care. Nurse managers may use this knowledge and reduce sickness absence and understaffing by stimulating problem-solving strategies and social support within nursing teams.