Use it or lose it? Identifying reasons for the low use of psychosocial support by hospital staff.

BACKGROUND: Psychosocial support programs are a way for hospitals to support the mental health of their staff. However, while support is needed, utilization of support by hospital staff remains low. This study aims to identify reasons for non-use and elements that are important to consider when offering psychosocial support. METHODS: This mixed-method, multiple case study used survey data and in-depth interviews to assess the extent of psychosocial support use, reasons for non-use and perceived important elements regarding the offering of psychosocial support among Dutch hospital staff. The study focused on a time of especially high need, namely the COVID-19 pandemic. Descriptive statistics were used to assess frequency of use among 1514 staff. The constant comparative method was used to analyze answers provided to two open-ended survey questions (n = 274 respondents) and in-depth interviews (n = 37 interviewees). RESULTS: The use of psychosocial support decreased from 8.4% in December 2020 to 3.6% by September 2021. We identified four main reasons for non-use of support: deeming support unnecessary, deeming support unsuitable, being unaware of the availability, or feeling undeserving of support. Furthermore, we uncovered four important elements: offer support structurally after the crisis, adjust support to diverse needs, ensure accessibility and awareness, and an active role for supervisors. CONCLUSIONS: Our results show that the low use of psychosocial support by hospital staff is shaped by individual, organizational, and support-specific factors. These factors can be targeted to increase use of psychosocial support, whereby it is important to also focus on the wider hospital workforce in addition to frontline staff.

Predicting and Assessing Work Performance of People with Limited Work Capacity (LWC): A Multi-Wave, Multi-Source Study.

Purpose Occupational integration is vital for the health of all people, also for people with Limited Work Capacity (LWC). Therefore, participation in regular work is a legal right for people that are restricted in their work capacity due to a disability and/or lack sufficient education. Full and effective integration is dependent on the person-job fit, and adequate vocational support should focus on meeting performance standards, as is common practice in traditional personnel selection and development programmes. Despite the huge amount of valid instruments for personnel selection and development, these tests are not suitable people with LWC. Recently, an instrument was developed for assessment and development purposes specifically for this target group. That study provided evidence for reliability and dimensionality this instrument. In our study, we add criterion-related measures to this instrument to demonstrate that assessment at T1 predict performance at T2, thus validating the instrument. Method We conducted a four-source data study, two sources for independent and two for outcome variables, to test the predictive validity of this instrument in a multi-wave setup. Results This study largely supports the validity of the instrument in predicting work behaviour and task performance of people with LWC. More specific, when measures are tailored to this target group, this group is able to predict their work behaviour and task performance accurately just like the general population. Conclusion We conclude that this instrument contributes to science, vocational support practices, and the personal and professional development of people with LWC, which is required for sustainable work.

The Development of an Instrument to Measure the Work Capability of People with Limited Work Capacity (LWC).

Purpose Participation in regular paid jobs positively affects mental and physical health of all people, including people with limited work capacities (LWC), people that are limited in their work capacity as a consequence of their disability, such as chronic mental illness, psychological or developmental disorder. For successful participation, a good fit between on one hand persons' capacities and on the other hand well-suited individual support and a suitable work environment is necessary in order to meet the demands of work. However, to date there is a striking paucity of validated measures that indicate the capability to work of people with LWC and that outline directions for support that facilitate the fit. Goal of the present study was therefore to develop such an instrument. Specifically, we adjusted measures of mental ability, conscientiousness, self-efficacy, and coping by simplifying the language level of these measures to make the scales accessible for people with low literacy. In order to validate these adjusted self-report and observer measures we conducted two studies, using multi-source, longitudinal data. Method Study 1 was a longitudinal multi-source study in which the newly developed instrument was administered twice to people with LWC and their significant other. We statistically tested the psychometric properties with respect to dimensionality and reliability. In Study 2, we collected new multi-source data and conducted a confirmatory factor analysis (CFA). Results Studies yielded a congruous factor structure in both samples, internally consistent measures with adequate content validity of scales and subscales, and high test-retest reliability. The CFA confirmed the factorial validity of the scales. Conclusion The adjusted self-report and the observer scales of mental ability, conscientiousness, self-efficacy, and coping are reliable measures that are well-suited to assess the work capability of people with LWC. Further research is needed to examine criterion-related validity with respect to the work demands such as work-behaviour and task performance.

Lending a Helping Hand at Work: A Multilevel Investigation of Prosocial Motivation, Inclusive Climate and Inclusive Behavior.

Purpose People with disabilities often encounter difficulties at the workplace such as exclusion or unfair treatment. Researchers have therefore pointed to the need to focus on behavior that fosters inclusion as well as variables that are antecedents of such 'inclusive behavior'. Therefore the purpose of this study was to research the relationship between prosocial motivation, team inclusive climate and employee inclusive behavior. Method A survey was conducted among a sample of 282 paired employees and colleagues, which were nested in 84 teams. Employees self-rated prosocial motivation and team inclusive climate, their inclusive behavior was assessed by colleagues. Hypotheses were tested using multilevel random coefficient modeling. Results Employees who are prosocially motivated will display more inclusive behavior towards people with disabilities, and this relationship is moderated by team inclusive climate in such a way that the relationship is stronger when the inclusive climate is high. Conclusion This study shows that inclusive organizations, which value a diverse workforce, need to be aware of not only individual employee characteristics, but also team level climate to ensure the smooth integrations of people with disabilities into regular work teams.

Exploring the path to corruption-An informed grounded theory study on the decision-making process underlying corruption.

Past corruption research at the individual level has mainly focused on demographics, personality, attitudes, or morality related variables. Until now, only a few studies have focused on the intra-individual psychological mechanisms of corruption. Building on normative decision-making theory, the present study attempts to shed further light on the internal mechanisms that lead to the decision that corruption is a viable path. Following an informed grounded theory approach, we conducted semi-structured interviews with 38 Indonesian prisoners who have been convicted of corruption. Guided by a multi-step decision-making process, including problem recognition, information search, and evaluation of the information, our results revealed unique insights into individuals' considerations that led to corruption. We elaborate on interrelations between these stages and explore new forms of corrupt decision-making elements within this process. Theoretical implications for corruption research and the practical implications for anti-corruption programs of these findings are discussed.

Sweet dreams are made of this: A person-centered approach toward understanding the role of sleep in chronic fatigue.

Previous studies show that sleep is essential in preventing symptoms related to chronic levels of fatigue. In the present study, we move beyond the traditional variable-centered approach and adopt a person-centered approach by considering antecedents and outcomes of sleep profiles. Specifically, we consider job characteristics (i.e., workload, job control, and their interaction) as predictors of sleep profiles and indicators of chronic fatigue (i.e., prolonged fatigue and burnout) as outcomes. In establishing sleep profiles, we consider levels as well as the variability of the sleep dimensions across a week. Based on daily diary data from 296 Indonesian employees, the present article uses latent profile analysis to identify sleep profiles based on both weekly averages of several sleep dimensions (i.e., sleep quality, fragmentation, duration, bedtime, and wake-up time) and their intraindividual variability. Moreover, it explores the relationship between the identified profiles to prolonged fatigue and burnout 2 weeks later as outcomes, as well as to baseline workload, job control, and their interaction as predictors. We find four different profiles ("Average Sleepers," "Deep Owls," "Short Sleep Compensators," and "Restless Erratic Sleepers"). While workload, job control, and their interaction could not predict profile membership, these profiles relate differently to prolonged fatigue and burnout. As such, our study shows the importance of understanding the combination of sleep levels and variability across a week through sleep profiles, and how they differentially relate to symptoms of chronic fatigue. Our findings also highlight the need to study indicators of sleep variability alongside sleep levels. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Toward More Inclusive Work Organizations by Redesigning Work.

Inclusive Work Redesign (IWR) is an innovative strategy to create feasible job opportunities for job seekers from vulnerable groups at the labor market, in particular people with disabilities, in such a way that it contributes to sustainable employment for all staff and to the organization's performance. As an element of active labor market policies (ALMP), in the Netherlands, IWR is used as an instrument for Public Employment Services (PES) and professionals in occupational rehabilitation to support employers, using a demand-oriented approach. IWR is also a potential valuable asset for strategic human resource management (SHRM) aimed at inclusion and sustainable employment. The article describes IWR in the context of social security and staffing problems of organizations, and the application of IWR in the Netherlands and Germany.

Blue Monday, yellow Friday? Investigating work anticipation as an explanatory mechanism and boundary conditions of weekly affect trajectories.

Affective well-being of employees is a key outcome in the occupational health literature. Yet, researchers of emotions and affect have long called for a better understanding of the dynamic nature of such experiences. Directly addressing this call, we have built on temporal schema theories and the notion of temporal depth to develop and test the anticipation of work account as a theoretical explanation of systematic weekly change patterns in positive and negative affect. Using a 7-day experience-sampling design and latent growth curve modeling, we hypothesized and found that anticipation of work linearly decreased over the course of the workweek, so did negative affect. Supporting our hypothesis that change patterns in work anticipation drive change patterns in evening affect, the linear change trajectory of anticipation was significantly related to change trajectories in positive and negative affect. Furthermore, we identified the structure of the workweek and chronic workload as boundary conditions that interact in shaping weekly change patterns in anticipation. Specifically, patterns of decreasing anticipation were most pronounced for employees with a regular Monday-Friday workweek and high chronic levels of workload, while they were weakest for employees with a regular workweek but low levels of chronic workload. Taken together, our results highlight the role of work itself and working conditions in dynamic aspects of affect. They yield theoretical and practical implications for the study of affect and its work-related experiential and behavioral consequences. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

To Uncertainty and Beyond: Identifying the Capabilities Needed by Hospitals to Function in Dynamic Environments.

Hospitals operate in increasingly complex and dynamically uncertain environments. To understand how hospital organizations can cope with such profound uncertainty, this article presents a multiple case study of five hospitals during the COVID-19 crisis in a heavily hit region of the Netherlands. We find that hospitals make adaptations in five key categories, namely: reorganization, decision-making, human resources, material resources, and planning. These adaptations offer insights into the core capabilities needed by hospitals to cope with dynamic uncertainty. Our findings highlight the need for hospitals to become more flexible without sacrificing efficiency. Organizations can accomplish this by building in more sensing and seizing capabilities to be better prepared for and respond to environmental change. Furthermore, transforming capabilities allow organizations to be more resilient and responsive in the face of ongoing uncertainty. We make recommendations on how hospitals can build these capabilities and address the core challenges they face in this pursuit.

There and back again. Examining the development of employee commitment during a prolonged crisis.

To effectively function and adapt in crises, healthcare organizations rely on the skills and commitment of their workforce. Yet, our current understanding of how employees' workplace commitment is affected by and evolves throughout the course of a crisis remains limited. In this paper, we explore the commitment of hospital staff to an important workplace target, the COVID-19 crisis response, and show how this commitment develops over time. We report on an exploratory case study of hospital staff in a heavily hit region of the Netherlands. We conducted interviews with hospital executives, management, medical and support staff to uncover the issues hospitals faced in recruiting staff to provide COVID-19 care throughout the first and second wave of the crisis. Our findings suggest that while staff initially exhibited high levels of commitment to aiding in the crisis effort, staff were perceived to exhibit lower levels of commitment in the second wave, complicating the provision of COVID-19 care. We unveil three contributing factors to this shift, namely: competing demands, energy depletion and a lack of support and appreciation. Our findings suggest that while staff were initially willing to dedicate themselves and take responsibility for the crisis effort, as their other more stable commitments became more salient in the second wave, their willingness to dedicate limited resources to the crisis effort decreased. In our discussion, we examine the implications of our findings for the literature on workplace commitment, and advance our understanding of employee workplace commitment during crises.

We're Not Gonna Fall: Depressive Complaints, Personal Resilience, Team Social Climate, and Worries about Infections among Hospital Workers during a Pandemic.

Maintaining hospital workers' psychological health is essential for hospitals' capacities to sustain organizational functioning during the COVID-19 pandemic. Workers' personal resilience can be an important factor in preserving psychological health, but how this exactly works in high stakes situations, such as the COVID-19 pandemic, requires further exploration. Similarly, the role of team social climate as contributor to individual psychological health seems obvious, but how it exactly prevents workers from developing depressive complaints in prolonged crises remains under investigated. The present paper therefore applies conservation of resources theory to study the relationships between resilience, team social climate, and depressive complaints, specifically focusing on worries about infections as an important explanatory mechanism. Based on questionnaire data of 1126 workers from five hospitals in the Netherlands during the second peak of the pandemic, this paper estimates a moderated-mediation model. This model shows that personal resilience negatively relates to depressive complaints (ß = -0.99, p < 0.001, 95%CI = -1.45--0.53), partially as personal resilience is negatively associated with worries about infections (ß = -0.42, p < 0.001, 95%CI = -0.50--0.33) which in turn are positively related to depressive complaints (ß = 0.75, p < 0.001, 95% CI = 0.31-1.19). Additionally, team social climate is associated with a lower effect of worries about being infected and infecting others on depressive complaints (ß = -0.88, p = 0.03, 95% CI = -1.68--0.09). These findings suggest that resilience can be an important individual level resource in preventing depressive complaints. Moreover, the findings imply that hospitals have an important responsibility to maintain a good team social climate to shield workers from infection related worries building up to depressive complaints.

More than one strategy: A closer examination of the relationship between deep acting and key employee outcomes.

The relationship between emotional labor strategies (i.e., deep acting and surface acting) and employee outcomes has been often studied. Yet, although the impact of surface acting on employee well-being is clear, findings regarding deep acting have been inconsistent. In the present study, we propose that this may be explained by the multidimensional nature of deep acting, which subsumes different specific emotion regulation strategies. With a 5-day diary study, we investigated the links between subtypes of deep acting (i.e., cognitive change and attentional deployment) and key employee outcomes (i.e., mental fatigue, self-authenticity, and rewarding interactions) in a sample of 244 employees. Multilevel analyses confirmed that different emotion regulation strategies underlying deep acting were differentially related to employee outcomes, which may explain the mixed results of previous research examining deep acting as a uniform construct. Theoretical and practical implications of considering specific emotion regulation strategies underlying deep acting are discussed. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Corruption, Fast or Slow? Ethical Leadership Interacts With Machiavellianism to Influence Intuitive Thinking and Corruption.

Ethical leadership has been suggested as an organizational factor that could reduce unethical behaviors in an organization. We extend this research by examining how and when ethical leadership could reduce followers' corruption. We examined the moderating role of followers' Machiavellianism and the mediating role of intuitive thinking style in the negative effect of ethical leadership on corruption. Across two different studies (field study and experiment), we found that ethical leadership decreases followers' corruption (Studies 1 and 2) and that this negative effect is mediated by followers' intuitive thinking style (Study 2). Furthermore, followers' Machiavellianism moderated the direct negative effect of ethical leadership on corruption. However, the pattern of this moderation was not consistent. In Study 1, we found that ethical leadership has the strongest direct negative impact on corruption when followers' Machiavellianism is high, whereas in Study 2, we found that ethical leadership has the strongest direct negative effect on corruption when followers' Machiavellianism is low. The theoretical implications for corruption, ethical leadership, and information processing research, as well as practical implications for corruption prevention, will be discussed.

Feeling the force: Changes in a left-lateralized network of brain areas under simulated workday conditions are reflected in subjective mental effort investment.

Investing mental effort is costly, and the investment has to be matched by a reward to make a person engage in task performance. However, the neural structures underlying the continued management of mental effort are not known. Previous work has identified left-lateralized structures, most prominently the left anterior Insular Cortex (aIC) as regions implied in post-hoc evaluation and also anticipation of mental effort investment. We present a study aimed at identifying neural structures that are sensitive to changes in both task load and fatigue-induced state load. Sixteen healthy participants performed an n-back task before and after a fatigue-inducing day in a helicopter simulator or a free day. Subjective mental effort ratings showed an interaction of the effects of both task and state load changes, with a reduced effect of task load during the fatigued state. Testing for the same interaction effect in a whole-brain functional MRI data, we found a left-lateralized group of clusters in aIC, the anterior cingulate cortex, the dorsal striatum and frontal eye field and M1. We discuss the possible role of these areas and also the relevance of our findings in the light of the proposed opportunity cost model of mental effort.

Should you switch off or stay engaged? The consequences of thinking about work on the trajectory of psychological well-being over time.

This study examined how 2 different ways of being mentally engaged with work-related issues during evenings (affective rumination and problem-solving pondering) cause changes in psychological well-being over a 1-year period. We conducted a 3-wave longitudinal study with a time lag of 6 months between each wave. At the first measurement moment, participants filled out a survey over 5 consecutive working days assessing work-related affective rumination and problem-solving pondering during evenings. Exhaustion and health complaints were assessed at the first measurement moment as well as after 6 and 12 months. The 3 waves of data obtained from a total of 123 participants with full-time and primarily mentally demanding jobs were analyzed using latent growth curve modeling (LGM). The results showed that affective rumination is a significant predictor of increase in exhaustion over time. Problem-solving pondering was not found to be a significant predictor of change in psychological well-being over time. These findings demonstrate that work-related rumination during evenings may lead to health problems over time depending on the type of rumination. It suggests that unlike affective rumination, problem-solving pondering during evenings has no influence on psychological well-being over time. (PsycINFO Database Record

Handling the reflective-formative measurement conundrum: a practical illustration based on sustainable employability.

OBJECTIVES: Constructs capturing health or functioning can have reflective and/or formative measurement models. Although a construct's measurement model has extensive implications on the construction, validation, and use of a measurement instrument, measurement models are frequently wrongly or not explicitly specified. As this is likely due to a lack of guidelines, this study uses sustainable employability as an example to demonstrate a) the applicability of an adapted checklist for establishing a construct's measurement model; and b) the use of structural equation modeling to handle formative constructs. STUDY DESIGN AND SETTING: First, the checklist is applied to sustainable employability to establish its measurement model. Second, using observational self-report data from 2,544 employees, structural equation models are estimated to evaluate the structural and criterion validity of sustainable employability as a formative construct. RESULTS: The checklist demonstrates strong applicability, identifying sustainable employability as a formative construct. Model fit indices (Comparative fit indices ≥ 0.932, Tucker-Lewis indices ≥ 0.925, root mean square errors of approximation ≤ 0.034) suggest the formative measurement model for sustainable employability is valid. CONCLUSION: The checklist and structural equation modeling facilitate handling formative constructs. By establishing sustainable employability as a formative construct, individuals' long term ability to function at work can be more adequately studied and intervened upon.

Time takes us all? A two-wave observational study of age and time effects on sustainable employability.

Objectives Various cognitive and physical abilities decline with age. Consequently, sustainable employability research has focused on the labor market participation of older employees. However, it remains unclear whether age actually affects employees' work and labor-market functioning. A major complicating factor is that age effects can be distorted by time effects. That is, changes over time may not be due to aging but to some structural difference between the times of measurement. The present article aims to provide clarity by estimating age effects on sustainable employability while controlling for potential time effects. Methods Based on two-wave survey data from a sample of 2672 employees (ages 35‒65 years) multilevel regressions are estimated to analyze the effects of age and time on sustainable employability. Here, sustainable employability is operationalized as a formative construct consisting of nine dimensions, each capturing a different facet of an individual's ability to function at work and in the labor market. Results The analyses reveal that age has small effects on only two dimensions (employability and perceived health) while time affects three dimensions (fatigue, job performance, and skill gap) of sustainable employability. Moreover, for all dimensions of sustainable employability most variance exists between (61.43-84.96%) rather than within (15.04-38.57%) subjects. Conclusions These findings suggest that the process of aging has a limited effect on working individuals' capacities to function in their job and the labor market. Consequently, the focus on age in the context of sustainable employability policies and research may require reconsideration.

Job characteristics and off-job activities as predictors of need for recovery, well-being, and fatigue.

Two empirical studies examined need for recovery (i.e., a person's desire to be temporarily relieved from demands in order to restore his or her resources) as a mediator in the relationship between poor job characteristics (high job demands, low job control) and high off-job demands, on the one hand, and fatigue and poor individual well-being, on the other hand. Multilevel data from a daily survey study in the health service sector (Study 1) showed that high job demands, low job control, and unfavorable off-job activities predicted a high need for recovery. Need for recovery in turn was negatively related to individual well-being. A large-scale survey with a representative sample of the Dutch working population (Study 2) confirmed these findings for fatigue. In both studies, need for recovery mediated the effects of job characteristics and off-job activities on fatigue and poor well-being, respectively.

Is Work-Related Rumination Associated with Deficits in Executive Functioning?

Work-related rumination, that is, perseverative thinking about work during leisure time, has been associated with a range of negative health and wellbeing issues. The present paper examined the association between work-related rumination and cognitive processes centerd around the theoretical construct of executive functioning. Executive functioning is an umbrella term for high level cognitive processes such as planning, working memory, inhibition, mental flexibility; and it underlies how people manage and regulate their goal directed behavior. Three studies are reported. Study I, reports the results of a cross-sectional study of 240 employees, and demonstrates significant correlations between work-related rumination and three proxy measures of executive functioning: cognitive failures (0.33), cognitive flexibility (-0.24), and situational awareness at work (-0.28). Study II (n = 939), expands on the findings from study 1 and demonstrates that workers reporting medium and high work-related rumination were 2.8 and 5 times, respectively, more likely to report cognitive failures relative to low ruminators. High ruminators also demonstrated greater difficulties with 'lapses of attention' (OR = 4.8), 'lack of focus of attention' (OR = 3.4), and 'absent mindedness' (OR = 4.3). The final study, examined the association between work-related rumination and executive functioning using interview data from 2460 full time workers. Workers were divided into tertiles low, medium, and high. The findings showed that high work-related rumination was associated with deficits in starting (OR = 2.3) and finishing projects (OR = 2.4), fidgeting (OR = 1.9), memory (OR = 2.2), pursuing tasks in order (OR = 1.8), and feeling compelled to do things (OR = 2.0). It was argued that work-related rumination may not be related to work demands per se, but appears to be an executive functioning/control issue. Such findings are important for the design and delivery of intervention programes aimed at helping people to switch off and unwind from work.

Critical reflections on the currently leading definition of sustainable employability.

Sustainable employability (SE) is an important topic as it deals with employees' abilities to function adequately at work and in the labor market throughout their working lives. However, until now there has been only one attempt to define SE in the international literature (1). This first definition is a valuable contribution to the field as it rightfully describes SE as a multidimensional concept, recognizes the importance of both employee and work characteristics, and acknowledges the inherently longitudinal nature of SE. Despite these merits, we argue that this definition of SE has some serious omissions that are important in capturing SE comprehensively. Specifically, we argue that the definition could be improved in various ways, namely, it should: (i) clarify which aspects of employment constitute someone's SE; (ii) not counterintuitively treat SE as a characteristic of both the job and the employee simultaneously; (iii) not be based on the insufficiently tested assumption that achieving value in work inherently leads to SE; (iv) be formulated in a way that SE can also apply to unemployed individuals; and (v) adequately specify how the inherently longitudinal dimension of SE should be addressed. We would like to contribute to the discussion by providing guidelines for a new adjusted definition of SE that could facilitate further research on this important concept and its determinants. Introduction SE is a topic of vital importance to individual employees, organizations and society alike. It generally refers to employees' capacities to function in work throughout their working life. As participation in work is important for individuals, organizations, and society as a whole, individuals' ability to function in work is essential. For individuals, work provides meaning, financial security as well as social contacts. Organizations need productive employees to survive. Also from a societal perspective, it is important that as many people as possible participate in the labor market to maintain economic welfare (1). Moreover, as a consequence of population aging (2-6), longevity, rapid changes in technology (7, 8) and changes in the nature of work (1), both the need to promote sustainable employability of individuals in society and the complexity to succeed in doing so increase even further. Only recently, van der Klink et al provided the first definition of the concept in the international scientific literature (1, p74): "Sustainable employability means that throughout their working lives, workers can achieve tangible opportunities in the form of a set of capabilities. They also enjoy the necessary conditions that allow them to make a valuable contribution through their work, now and in the future, while safeguarding their health and welfare. This requires, on the one hand, a work context that facilitates this for them and, on the other, the attitude and motivation to exploit these opportunities." This definition is accompanied by an equally recent operationalization of SE as a set of capabilities (9). Moreover, the definition itself also appeared in an earlier Dutch publication (10), which other international publications about SE most commonly refer to [ie, in comparison with other definitions in the non-international (eg, Dutch) literature] (11-13). As mentioned, the present paper provides a critical reflection on van der Klink et al's aforementioned definition of SE (1). Merits Van der Klink et al's definition of SE (1) has three important merits. First, SE is seen as a multidimensional construct. It is presented as consisting of a broad set of opportunities for employees to create value for themselves and for their employer that cover various aspects of working. Moreover, the individual's health and well-being as well as attitudinal and motivational aspects are included in the definition as well. This acknowledgement of the multidimensionality of SE is favorable, as it illustrates the complexity of the construct and of what constitutes functioning in work. This is in accordance with the International Classification of Functioning, Disability and Health (ICF) (14), in which functioning is seen from three different perspectives (body, activities, and participation). The ICF underlines the multifaceted and complex nature of functioning in which disease, environmental factors, and personal factors play a role. Similarly, the multifaceted nature of functioning is also illustrated by the fact that different disciplines focus on different aspects to understand functioning at work (15, 16). Second, SE is (partially) defined as the degree to which (i) employees are able to work throughout their entire working lives, and (ii) their work context enables them to do so. This suggests that SE is a set of interacting characteristics of the employee and the work context that codetermine the opportunities and conditions affecting employees' capacity to participate in the labor market throughout their working lives. As such, the definition describes an equal responsibility for employee and employer to maintain the employee's ability to work. This could be considered as a great merit, as research shows how strongly an employee's ability to function is influenced by both the individual, work and work-contextual factors (17). Third, van der Klink et al's definition recognizes that SE is an inherently longitudinal construct as clearly embedded in the words "throughout their working lives". This is essential as "sustainable" necessarily implies a time dimension. Need for further development Despite the aforementioned merits, there are important needs for improvement of van der Klink et al's definition of SE. First, it is not immediately clear from the definition what particular element(s) of the work situation constitute(s) SE. The paper provides some clarity by equating SE with the capability set it propagates, as evidenced by these statements: "… in an accompanying paper also published in this issue, we report on the development and validation of a questionnaire that allows for the assessment of sustainable employability based on the concept of capability" (1, p72) and "This [capability] set, in our view, represents the best possible operationalization of sustainable employability" (1, p74). However, in the paper, SE is also referred to as being determined by a worker's capability: "this model holds that an individual's sustainable employability is determined by how he or she succeeds in converting resources into capabilities, and subsequently into work functioning, in such a way that values such as security, recognition and meaning are met"(1, p72). As it is not feasible that SE is predicted by itself in the form of a capability set, perhaps the capability set does not actually refer to SE itself but rather to a favorable employment situation that may cause SE. More clarity on this issue is needed. Second, the definition seems to treat SE as a characteristic of both the job and the individual at the same time. This is counterintuitive and problematic as the job and work context may predict an individual's ability to be sustainably employed, but they can never be aspects that are part of SE. Instead, employability is a characteristic of the individual alone. Of course the individual's ability to be employed does depend on work and work-contextual factors, but these should be predictors and not be embedded in the construct itself. For an adequate definition of SE, it is essential to disentangle these relationships between causes (employment) and effects (employability). Moreover, future approaches should treat SE as an individual characteristic that is an outcome of the complex interaction between other individual, work, and work-contextual characteristics. Third, the definition and operationalization of SE assume that achieving value in work inherently predicts SE and that, therefore, SE can be conceptualized as achieving value in work. This is problematic, as before such claims can be made, such relationships need to be tested with SE as criterion. This is, however, impossible within the approach van der Klink et al provides. (1), as SE is equated with its predictor(s). Therefore, similar to the first conceptual issue, it seems unlikely that the capability set adequately reflects SE. Fourth, the definition by van der Klink et al (1) suggests that SE only applies to individuals who are employed. In the Abma et al publication (9), which accompanies van der Klink's definition paper as a validation paper, this is shown by the way in which capabilities are measured. Moreover, the definition also suggests this because individuals can only be considered to be sustainably employable if their work context enables them to achieve tangible opportunities. However, individuals who are not currently working can still be highly employable and even sustainably so, but just be between jobs. It is therefore not required for individuals to be enabled by their employer to be sustainably employable. Consequently, in line with our aforementioned points on improving the definition, being enabled by an employer to achieve value may be an important predictor of SE, but it is not necessarily part of SE itself. Moreover, future approaches to SE should define the concept in such a way that it is applicable to every individual regardless of employment status. Finally, the definition and operationalization of SE in the form of a capability set do not include any specification on how the longitudinal aspect of SE should be captured. The definition rightfully acknowledges the longitudinal dimension of SE, but its operationalization focuses solely on achieving value. Although achieving value at work may be an important predictor of SE, a complete operationalization and definition should include its longitudinal nature as well. Outlook In conclusion, while van der Klink et al's definition of SE (1) does have strong merits, it requires further improvement. The approach's main drawback is that capabilities seem more apt at describing a potentially important set of predictor(s) of SE than at capturing the construct itself. Either way, future developments in conceptualizing SE should build on the aforementioned merits, but also define SE in a way that (i) clearly labels which aspects of the employment situation constitute SE; (ii) explicitly separates causes and effects; (iii) treats SE as an individual characteristic that may be affected by other employment characteristics at the individual, work, and work-contextual levels; (iv) makes the concept applicable to any individual regardless of their employment status; and (v) clearly addresses the longitudinal nature of SE as embedded in the word "sustainable". These guidelines should not only enable the development of an appropriate definition of SE but also a conceptually sound way of measuring the construct.