Love over gold and mind over matter? Identifying capabilities that preserve medical assistants' sustainable employability.

BACKGROUND: Medical assistants (MAs) are crucial for affordable, high-quality primary care, but what motivates this low-wage occupational group to stay in their job remains underexplored. This paper identifies the work aspects that MAs value ("capabilities"), and how they affect sustainable employability, which refers to employees' long-term ability to function and remain in their job. METHODS: We used structural equation modelling to assess how capabilities relate to four outcomes among MAs: burnout, job satisfaction, intention to quit, and experiencing work as meaningful. RESULTS: We find that earning a good income, developing knowledge and skills, and having meaningful relationships at work relate to the outcomes. Meaningful relationships represent a stronger predictor than salary for one's intention to quit. CONCLUSIONS: Competitive salaries are necessary but not sufficient to motivate low-wage health care workers like MAs to stay in their job. Health care leaders and managers should also structure work so that MAs can foster meaningful relationships with others as well as develop competencies.

What's up doc? Physicians' reflections on their sustainable employability throughout careers: a narrative inquiry.

BACKGROUND: Physicians have complex and demanding jobs that may negatively affect their sustainable employability (SE) and quality of care. Despite its societal and occupational relevance, empirical research on physicians' SE is scarce. To further advance our understanding of physicians' SE, this study explores how physicians perceive their employment context to affect their SE, how physicians self-regulate with the intent to sustain their employability, and how self-regulations affect physicians' SE and their employment context. METHODS: Twenty Dutch physicians from different specialisms were narratively interviewed between March and September 2021 by a researcher with a similar background (surgeon) to allow participants to speak in their own jargon. The interviews were analyzed collaboratively by the research team in accordance with theory-led thematic analysis. RESULTS: According to the interviewees, group dynamics, whether positive or negative, and (mis)matches between personal professional standards and group norms on professionalism, affect their SE in the long run. Interviewees self-regulate with the intent to sustain their employability by (I) influencing work; (II) influencing themselves; and (III) influencing others. Interviewees also reflect on long-term, unintended, and dysfunctional consequences of their self-regulations. CONCLUSIONS: We conclude that physicians' SE develops from the interplay between the employment context in which they function and their self-regulations intended to sustain employability. As self-regulations may unintentionally contribute to dysfunctional work practices in the employment context, there is a potential for a vicious cycle. Insights from this study can be used to understand and appraise how physicians self-regulate to face complex challenges at work and to prevent both dysfunctional work practices that incite self-regulation and dysfunctional consequences resulting from self-regulations.

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.

Sustainable Employability of People with Limited Capability for Work: The Participatory Development and Validation of a Questionnaire.

PURPOSE: Understanding sustainable employability (SE) of people with limited capability for work (LCW) due to physical or mental disability is crucial for the sustainable participation of this target group. Therefore, adequate measurement instruments for SE are needed. This study aims to validate a questionnaire to measure SE among people with LCW using a participatory approach, including person-job fit (PJ fit) and work-related sense of coherence (Work-SoC). METHODS: Existing scales for the main concepts were tested and adapted for face validity via cognitive interviews (n = 6), with the involvement of a co-researcher with LCW in the research team. Next, the questionnaire was administered among people with LCW (n = 248) to assess its factor structure (Confirmatory Factor Analysis) and reliability (Cronbach's alpha). RESULTS: Analysis of the cognitive interviews identified problems with clarity and readability of items, instructions and response categories of used (existing) scales. The main adjustments concerned the shortening of text length, the usage of familiar language and examples, and the addition of an introduction game. Most of the adapted SE indicator scales showed an overall good fit and acceptable-to-good internal reliability. The overall SE model had an overall good fit, and excluding 'internal employability' further improved this fit. PJ fit and Work-SoC had an acceptable/good model fit and internal consistency. CONCLUSION: The participatory validation process resulted in a validated and comprehensive questionnaire to measure SE, PJ fit and Work-SoC among people with LCW, which enables research into the development of their SE. This questionnaire can be utilised to contribute to a more inclusive labour market.

"I noticed that when I have a good supervisor, it can make a Lot of difference." A Qualitative Study on Guidance of Employees with a Work Disability to Improve Sustainable Employability.

PURPOSE: For employees with a work disability adequate daily guidance from supervisors is key for sustainable employability. Supervisors often lack expertise to guide this group of employees. Mentorwijs (literal translation: Mentorwise) is a training for supervisors to improve the guidance of employees with a work disability. The aim of this study was to investigate the experiences of employees with a work disability regarding: (1) the guidance from their supervisors (who followed the Mentorwijs training), (2) which differences they notice in the guidance due to the Mentorwijs training, and (3) what kind of aspects they consider important in their guidance to achieve sustainable employability. METHODS: A qualitative study was performed with semi-structured (group) interviews among twenty-one employees with a work disability. Thematic analysis was performed to analyze the data. RESULTS: Themes that followed from the interviews were: (1) work tasks and conditions can facilitate or hinder sustainable employability: (2) relationships among employees and with supervisors can affect sustainable employability; (3) a desire for new opportunities and challenges; and (4) a need for supervisor skills to facilitate sustainable employability, i.e. appreciation, availability of help, dealing with problems, listening, attitude and communication. According to employees, changes were mainly noticed in supervisor skills. CONCLUSIONS: Employees with a work disability were very satisfied with the guidance of supervisors who followed the Mentorwijs training. To improve sustainable employability, training of supervisors should focus more on adequate work conditions, providing employees opportunities to learn new work tasks and improving supervisors' skills regarding appreciation, attitude and communication.

Workplace Mental Health Disclosure, Sustainable Employability and Well-Being at Work: A Cross-Sectional Study Among Military Personnel with Mental Illness.

Purpose Disclosure of mental illness to a supervisor can have positive (e.g. supervisor support) and negative consequences (e.g. stigma). However, research on the association between disclosure and sustainable employability and well-being at work is scarce. The aim of this study was to investigate the association between the disclosure decision (yes/no), experiences with the decision (positive/negative) and sustainable employment and well-being at work among military personnel with mental illness (N = 323). Methods A cross-sectional questionnaire study was conducted. Descriptive and regression (linear and ordinal) analyses were performed. Comparisons were made between those with positive and negative disclosure experiences. Results Disclosure decision (yes/no) was not significantly associated with any of the measures of sustainable employability and well-being at work. However, positive disclosure experiences were significantly associated with higher scores on almost all measures of sustainable employability and well-being at work. Those with negative disclosure experiences reported significantly more shame (Mpos = 2.42, Mneg = 2.78, p < .05) and discrimination (Mpos = 1.70, Mneg = 2.84, p < .001). Those with a positive disclosure experience, reported significantly more supervisor support (Mpos = 3.20, Mneg = 1.94, p < .001). Conclusion We did not find evidence that the disclosure decision itself is related to measures of sustainable employment and well-being at work. In contrast, how participants had experienced their (non-)disclosure decision was significantly related to almost all measures. This emphasizes the importance of the work environments reactions to disclosure and mental illness in the workplace. Future research and interventions should focus on increasing the likelihood of positive disclosure experiences through creating a more inclusive work environment, with more supervisor support and less stigma.

How a steeper organisational hierarchy prevents change-adoption and implementation of a sustainable employability intervention for employees in low-skilled jobs: a qualitative study.

BACKGROUND: Adoption and implementation are prerequisites for the effectiveness of organisational interventions, but successful implementation is not self-evident. This article provides insights into the implementation of the organisational intervention 'Healthy Human Resources' (HHR). HHR is developed with Intervention Mapping and aims at improving sustainable employability (SE) of employees in low-skilled jobs. METHODS: Qualitative data on adoption and implementation were collected by interviews with three employees and seven middle managers in five Dutch organisations and by extensive notes of observations and conversations in a logbook. Data triangulation was applied and all data were transcribed and analysed thematically using the qualitative analysis guide of Leuven (QUAGOL). RESULTS: All organisations adopted HHR, but three failed during the transition from adoption to implementation, and two implemented HHR only partially. The steepness of the organisational hierarchy emerged as an overarching barrier: steeper hierarchical organisations faced more difficulties with implementing HHR than flatter ones. This was reflected in middle managers' lack of decision-making authority and being overruled by senior management. Middle managers felt incapable of remedying the lack of employees' voice. Subsequently, 'us-versus-them' thinking patterns emerged. These power imbalances and 'us-versus-them' thinking reinforced each other, further strengthening the hierarchical steepness. Both processes could be the result of wider socio-political forces. CONCLUSIONS: This study improved the understanding of the difficulties to adopt and implement such organisational intervention to contribute to the sustainable employability of employees in low-skilled jobs. Practical implications are given for future implementation of organisational interventions.

Measuring sustainable employability: psychometric properties of the capability set for work questionnaire.

BACKGROUND: The capability set for work questionnaire (CSWQ) is being used to measure the new model of sustainable employability building on the capability approach. However, previous studies on the psychometric properties of the instrument are limited and cross-sectional. This two-way study aimed to (1) evaluate the convergent validity of the CSWQ with the theoretically related constructs person-job fit, strengths use, and opportunity to craft and (2) test the predictive and incremental validity of the questionnaire for the well-established work outcomes, including work ability, work engagement, job satisfaction, and task performance. METHODS: A representative sample of 303 Dutch workers, chosen with probably random sampling, were surveyed using a one-month follow-up, cross-lagged design via the Longitudinal Internet Studies for the Social Sciences panel. The convergent validity was assessed by exploring the strength of associations between the capability set for work questionnaire and the theoretically related constructs using Pearson's correlations. The predictive and incremental validity was evaluated by performing a series of linear hierarchical regression analyses. RESULTS: We found evidence of the convergent validity of the capability set score by moderate correlations with person-job fit, strengths use, and opportunity to craft (r = 0.51-0.52). A series of multiple regression analyses showed that Time 1 capability set score and its constituents (i.e., importance, ability, and enablement) generally had predictive and incremental validity for work ability, work engagement, job satisfaction, and task performance measured at Time 2. However, the incremental power of the CSWQ over and above conceptually related constructs was modest. CONCLUSIONS: The findings support the convergent, predictive, and incremental validity of the capability set for work questionnaire with not previously investigated work constructs. This provided further evidence to support its utility for assessing a worker's sustainable employability for future research and practical interventions.

The MAastricht Instrument for Sustainable Employability - Italian version (MAISE-IT): a validation study.

BACKGROUND: Governments and employers aim to promote sustainable employability (SE) in aging societies. In the Netherlands, an instrument for capturing the employee perspective on SE, the MAastricht Instrument for Sustainable Employability (MAISE-NL), has recently been developed. This study seeks to validate the Italian version of the MAISE (MAISE-IT). METHODS: The MAISE-IT (a translated and culturally adapted version of the MAISE for the Italian population), the Work-Health Balance questionnaire and a demographic survey (age, gender, education, and occupational activity) were completed online by 455 respondents (328 public administration workers and 127 respondents recruited from social networks). Construct and criterion validity were tested by CFA; reliability, correlational analyses and subgroup differences with ANOVAs. RESULTS: The CFA analysis revealed that the MAISE-IT consists of 12 scales distributed in four areas: (1) Meaning of SE; (2) Level and Factors affecting SE; (3) Overall responsibility for SE; and (4) Responsibility for factors affecting SE. Construct and criterion validity and reliability were good. Italian workers reported a moderately high level of SE. They regarded employers to be somewhat more responsible for SE than employees. CONCLUSIONS: This study showed the validity of the MAISE-IT in the Italian context. The MAISE-IT is valuable for tapping employees' needs in order to develop SE interventions tailored to the employee perspective.

Sustainable employability of teachers with hearing loss.

OBJECTIVE: In many countries the retirement age is rising. Consequently, age-related hearing loss is an increasing occupational health problem. This study examined the association between hearing loss and sustainable employability of teachers. DESIGN: For this cross-sectional study a survey and an online hearing screening test were used. Sustainable employability was measured with the Capability Set for Work Questionnaire (CSWQ), examining seven work values. CSWQ-scores of teachers with poor, insufficient, and good hearing were investigated with ordinal regression analyses. Work values and discrepancies between the importance and achievement of the values were examined by chi-square tests. STUDY SAMPLE: Dutch teachers (N = 737) of whom 146 (20%) had insufficient and 86 (12%) poor hearing. RESULTS: Teachers with insufficient (OR = 0.64; 95% CI 0.46-0.89) and poor (OR = 0.55; 95% CI 0.36-0.83) hearing had lower CSWQ-scores compared with good hearing teachers. Adjustment for covariates, in particular for self-rated health, attenuated the associations. Compared with good hearing teachers, teachers with poor hearing reported more discrepancies in using their knowledge and skills and setting their own goals at work. CONCLUSIONS: Hearing loss was negatively associated with sustainable employability of teachers. This emphasises the importance of assessing the hearing status of teachers.

Dementia, Work and Employability: Using the Capability Approach to Understand the Employability Potential for People Living with Dementia.

The importance of remaining in, or re-entering, the labour market is emphasised by governments internationally. While this may bring benefits, progressive disabilities such as dementia affect an individual's employability. Although employers have legal obligations to support employees with disabilities, research suggests that employers are not providing this support to employees living with dementia and are undermining their capabilities. Drawing on interview data from 38 key informants collected over two studies, we explore the potential for supporting and promoting the employability of people living with dementia. A model of sustainable employability based on the Capability Approach is used as a lens to explore this issue. The findings demonstrate the implications of progressive disabilities for employability when the worker and their family are faced with dealing with a disability in a period of uncertainty with a lack of public and workplace understanding.

How can wellbeing at work and sustainable employability of gifted workers be enhanced? A qualitative study from a capability approach perspective.

BACKGROUND: Being gifted with a very high IQ (> 98 percentile) can provide an advantage in the occupational context but can also come with its` own specific challenges. Where some studies found higher than average levels of wellbeing at work and successful careers amongst the gifted, other studies report boredom and less job satisfaction. This poses the question what gifted people value in work, and which factors are associated with the achievement of valued work related outcomes, wellbeing and sustainable employability. In this study these questions were explored using the value driven capability approach as a theoretical framework. METHOD: A qualitative approach was chosen and 16 in-depth semi-structured interviews with gifted workers (IQ > 130) were conducted. The transcripts were analysed using a reflexive thematic analysis aimed at identifying the work related outcomes participants aspired to achieve and the contextual and personal factors that affected the actualisation of these outcomes. RESULTS: Participants placed great value on the opportunity to learn, to use their knowledge and skills, and tended to have high ethical standards. If realized, these values contributed to wellbeing whereas if not fulfilled, this often resulted in frustration and sadness. The most important personal factors associated with wellbeing at work and sustainable employability were the level of organizational awareness, self-knowledge, a willingness to compromise, and fear of stigmatisation. Contextually a facilitating leadership style of managers was important, allowing the worker autonomy and decision latitude. Socially, participants enjoyed others as sparring partners but often had an aversion to small talk which could lead to social avoidance and loneliness. CONCLUSIONS: If gifted workers managed (to get) what they valued in work, this was associated with wellbeing and sustainable employment Coaching aimed at improving organizational awareness, specific social skills (e.g. small talk, adaptability) and understanding their own cognitive processes could be valuable. The application of an autonomy supporting facilitative leadership style by supervisors would be beneficial. Further research should try to confirm the findings using quantitative methods and needs to examine more closely the impact of stigmatisation and leadership styles.

Using intervention mapping to develop 'Healthy HR' aimed at improving sustainable employability of low-educated employees.

BACKGROUND: The perspectives of low-educated employees are often neglected when designing sustainable employability (SE) interventions. As a result, the interventions offered by the employer do often not align with the needs of low-educated employees. This particular group should therefore be actively involved in the process of developing and implementing SE interventions in their work organizations. The current paper describes the development process of a web-based intervention for HR managers and direct supervisors aimed at improving the SE of low-educated employees. This intervention is specifically designed to involve low-educated employees. METHODS: The first four steps of the Intervention Mapping (IM) approach were used to systematically develop the intervention with the active involvement of stakeholders. Step 1 comprised a needs assessment including a literature review, empirical evidence, scoping search and several focus group interviews with employees and with representatives of employers. Step 2 formulated the intervention objective. During step 3, suitable theoretical methods were selected and translated to practical applications. Step 4 involved the development of a web-based intervention by integrating all information from the preceding steps. RESULTS: The needs assessment indicated that the employees' active involvement and employees-employer genuine dialogue should be essential characteristics of an SE intervention for low-educated employees. The online toolkit 'Healthy HR' (HHR) was developed, which contains eight steps. Each step consists of one or more tasks helping the employer and employees with developing and implementing SE interventions themselves. One or more dialogue-based tools support each task. The leading principle providing structure within HHR was Adapted Intervention Mapping. CONCLUSION: Principles of IM appeared to be useful to develop the intervention HHR systematically. This development process resulted in a practical online toolkit that supports employers in the development and implementation of local SE interventions tailored to the needs of low-educated employees. These employees should be actively involved in the process through a dialogue-based approach. By using IM principles, HHR is expected to increase the effectiveness in bettering the health and well-being of low-educated employees.

Physical workload and obesity have a synergistic effect on work ability among construction workers.

PURPOSE: Obesity and high physical workload are both associated with poor work ability, but the interaction between obesity and high physical workload on work ability is not yet fully understood. Obesity and high physical workload may share a common mechanical pathway, possibly leading to a synergistic negative effect on work ability. The purpose of this study was to investigate the effect of obesity on work ability in workers with high versus low physical work load. METHODS: A longitudinal study was conducted among 36,435 Dutch construction workers who participated in at least two periodic medical examinations during the years 2008-2015. Logistic regression analyses were used to investigate the effect of manual material handling and strenuous work postures in sports on the association between obesity and work ability. Work ability was measured using the self-reported Work Ability Index consisting of seven dimensions. Confounding effects were tested for age, educational level, smoking, vigorous physical activity, psychosocial work demands, and working hours. Additive interaction between obesity and physical workload on work ability was tested using the relative excess risk due to interaction (RERI). RESULTS: Construction workers with overweight (OR = 1.09; 95% CI 1.02-1.16) or obesity (OR = 1.27; 95% CI 1.17-1.38) had an increased risk of poor/moderate work ability. Exposure to manual material handling (OR = 1.58; 95% CI 1.49-1.68) or strenuous work postures (OR = 1.80; 95% CI 1.70-1.90) also increased the risk of poor/moderate work ability. The effect of the combination of obesity with high physical workload was greater than the sum of the individual effects (strenuous work postures: RERI = 0.39; 95% CI 0.10-0.67; manual material handling: RERI = 0.26; 95% CI 0.02-0.51). CONCLUSIONS: Obesity and high physical workload were associated with poor work ability and had a synergistic, negative effect on work ability. Interventions that prevent obesity and high physical workload might have a beneficial effect on work ability.

Implementing sensor technology applications for workplace health promotion: a needs assessment among workers with physically demanding work.

BACKGROUND: Workers with physically demanding work may be at risk for injury, illness or other adverse health outcomes due to exposure to different occupational hazards, especially at higher age. Sensor technology applications may be useful in the workplace to unobtrusively measure and monitor work exposures and provide workers with real-time feedback or access to data on demand. Many aspects might impede the implementation of sensor technology applications in the workplace, which should be taken into consideration for a successful implementation. Moreover, needs and preferences of workers regarding the use of sensor technology applications during work performance need to be identified. Therefore, the aim of this study was to identify worker needs and preferences regarding the use of sensor technology applications in the workplace. METHODS: Four on-site focus group sessions were conducted in four different companies among workers with physically demanding work (n = 30). Semi-structured interview schedules were used to identify which work exposures should be measured, by which kind of sensor technology applications, under which (pre)conditions, how to motivate long-term use of sensor technology applications, and which type of feedback is preferred. For data analysis, a content-analysis with an inductive approach was performed. RESULTS: Participants mentioned that they want to use wearable sensor technology applications to measure and monitor physical job demands, occupational heat stress, noise and fatigue. Factors associated with quality, comfort and perceived ease of use were identified as potential barriers for implementation in the workplace. Long-term motivation was attributed to the ability to manage and monitor work exposures, positive feedback and data ownership. Participants indicated a need to both receive real-time feedback and access to data on demand. CONCLUSIONS: Sensor technology applications may support workers with physically demanding work to measure and monitor their work exposures. Potential barriers for implementation such as privacy aspects and quality, comfort and perceived ease of use of sensor technology applications need to be well considered to ensure successful implementation of sensor technology applications in the workplace.

The capability set for work - correlates of sustainable employability in workers with multiple sclerosis.

BACKGROUND: The aim of this study was to examine whether work capabilities differ between workers with Multiple Sclerosis (MS) and workers from the general population. The second aim was to investigate whether the capability set was related to work and health outcomes. METHODS: A total of 163 workers with MS from the MS@Work study and 163 workers from the general population were matched for gender, age, educational level and working hours. All participants completed online questionnaires on demographics, health and work functioning. The Capability Set for Work Questionnaire was used to explore whether a set of seven work values is considered valuable (A), is enabled in the work context (B), and can be achieved by the individual (C). When all three criteria are met a work value can be considered part of the individual's 'capability set'. RESULTS: Group differences and relationships with work and health outcomes were examined. Despite lower physical work functioning (U = 4250, p = 0.001), lower work ability (U = 10591, p = 0.006) and worse self-reported health (U = 9091, p ≤ 0.001) workers with MS had a larger capability set (U = 9649, p ≤ 0.001) than the general population. In workers with MS, a larger capability set was associated with better flexible work functioning (r = 0.30), work ability (r = 0.25), self-rated health (r = 0.25); and with less absenteeism (r = - 0.26), presenteeism (r = - 0.31), cognitive/neuropsychiatric impairment (r = - 0.35), depression (r = - 0.43), anxiety (r = - 0.31) and fatigue (r = - 0.34). CONCLUSIONS: Workers with MS have a larger capability set than workers from the general population. In workers with MS a larger capability set was associated with better work and health outcomes. TRIAL REGISTRATION: This observational study is registered under NL43098.008.12: 'Voorspellers van arbeidsparticipatie bij mensen met relapsing-remitting Multiple Sclerose'. The study is registered at the Dutch CCMO register ( https://www.toetsingonline.nl ). This study is approved by the METC Brabant, 12 February 2014. First participants are enrolled 1st of March 2014.

Experiences with multiple job holding: a qualitative study among Dutch older workers.

BACKGROUND: Multiple job holding (MJH) is a common and growing phenomenon in many countries. Little is known about experiences with MJH among older workers. The objective of the present study is to gain insight in experiences with MJH among Dutch workers aged 45 years and older. METHODS: Multiple job holders were selected from the Study on Transitions in Employment, Ability, and Motivation (STREAM), a Dutch cohort study among persons aged 45 years and older. Purposive sampling was applied to assure heterogeneity regarding gender, educational level, health, financial situation, willingness to continue MJH, and type of MJH (only jobs as employee or also being self-employed). Interviews were conducted until data saturation occurred. Fifteen multiple job holders participated in this study (eight men, seven women). Interviews were digitally recorded, transcribed verbatim and analyzed, along with field notes, using thematic content analysis. The data were openly coded, after which codes were aggregated into themes, which formed a thematic map. In each phase of the analysis at least two researchers were involved to increase reliability. RESULTS: Experiences with MJH varied from positive to negative. They were influenced by characteristics of individual jobs, e.g. social support at work, as well as characteristics of the combination of jobs, e.g. positive spill-over effects, and conflicts between work schedules. The personal context of multiple job holders, e.g. their age, or reason for MJH, affected how work characteristics influenced experiences. Negative experiences with one job often coincided with negative experience in the other job(s), and problems in the personal context. Some multiple job holders were able to make changes to their situation when desired. For some, this was not possible, which augmented their negative experience. CONCLUSIONS: This study adds to existing knowledge that experiences with MJH are not only influenced by work characteristics but also by the personal context of multiple job holders, and that some workers are able to change their situation when desired, while others are not. Future research should study how different combinations of work and personal characteristics influence sustainable employability of multiple job holders. Policies facilitating life-long learning could increase opportunities to change the MJH situation when desired.

Process Evaluation of a Workers' Health Surveillance Program for Meat Processing Workers.

Objective To evaluate the implementation process of a workers' health surveillance (WHS) program in a Dutch meat processing company. Methods Workers from five plants were eligible to participate in the WHS program. The program consisted of four evaluative components and an intervention component. Qualitative and quantitative methods were used to evaluate seven process aspects. Data were gathered by interviews with stakeholders, participant questionnaires, and from registries of the company and occupational health service. Results Two recruitment strategies were used: open invitation or automatic participation. Of the 986 eligible workers, 305 participated in the program. Average reach was 53 %. Two out of five program components could not be assessed on dose delivered, dose received and fidelity. If components were assessable, 85-100 % of the components was delivered, 66-100 % of the components was received by participants, and fidelity was 100 %. Participants were satisfied with the WHS program (mean score 7.6). Contextual factors that facilitated implementation were among others societal developments and management support. Factors that formed barriers were program novelty and delayed follow-up. Conclusion The WHS program was well received by participants. Not all participants were offered the same number of program components, and not all components were performed according to protocol. Deviation from protocol is an indication of program failure and may affect program effectiveness.

Sustainable employability in shiftwork: related to types of work schedule rather than age.

PURPOSE: There is scarce research on age and sustainable employability of nurses working in various types of work schedules. Earlier research showed that nurses working in work schedules differ regarding age. Different operationalisations of age might explain variations in sustainable employability. Therefore, the aim of this study was to investigate how nurses working in various types of work schedule differ regarding sustainable employability, and the role that age plays in these differences. Age was defined as chronological age, organisational age, life-span age, and functional age. METHOD: Questionnaires were distributed to 974 Dutch nurses in residential elder care (response rate 51 %) with questions about the type of work schedule, aspects of sustainable employability, various operationalisations of age, and registered sickness absence data were used. RESULTS: Nurses working in various types of work schedules differed regarding aspects of sustainable employability, also when operationalisations of age were added. The 'life-span age' was directly related to aspects of sustainable employability. Statistically, work ability and job satisfaction were only explained by varying operationalisations of age. CONCLUSIONS: Nurses' sustainable employability appeared to be mainly related to differences between the types of work schedule rather than age. Fixed early shifts are characterised by the most positive aspects of sustainable employability, and three rotating schedules score worst. To improve sustainable employability, organisations should implement a system in which nurses with different types of work schedule are monitored in combination with their life-span perspective.

A Workplace Health Promotion Program for a Predominantly Military Population: Associations with General Health, Mental Well-Being and Sustainable Employability.

Due to the globally increasing life expectancies, many countries are raising their official retirement age to prevent labor shortages and sustain retirement systems. This trend emphasizes the need for sustainable employability. Unhealthy lifestyles pose a risk to sustainable employability as they contribute to chronic diseases and decreased productivity. Workplace Health Promotion (WHP) programs have gained attention as a strategy to enhance employee health and well-being. The Netherlands Armed Forces, a unique employer with demanding psychological and physical requirements, was used as a case study to investigate the associations of a WHP Program with workers health and sustainable employability. The program offered tailor-made guidance to participants (N = 341) through individual coaching trajectories. The program's impact was evaluated by measuring self-reported health, mental well-being, and sustainable employability over a 6-month period. Results indicated significant improvements across all these dimensions after participation in the program. This study provides valuable insights into the benefits of tailor-made WHP programs. While this was an observational study without a control group, this study supports the importance of incorporating individualized approaches in WHP initiatives to foster positive outcomes in health and sustainable employability.