Introduction Kidney failure negatively affects opportunities for work participation. Little is known about work functioning of employed CKD patients. This study investigates work-related outcomes,... Show moreIntroduction Kidney failure negatively affects opportunities for work participation. Little is known about work functioning of employed CKD patients. This study investigates work-related outcomes, and examines associations between patient characteristics and employment status. Methods We performed a cross-sectional survey study in nine nephrology outpatient clinics in the Netherlands among working age (18-67 years) CKD Stage G3b-G5, dialysis and transplant patients (n = 634; mean age 53.4 years (SD 10); 53% male; 47% Stage G3b-G5, 9% dialysis, 44% transplantation). We assessed employment status, work disability, work-related characteristics (i.e., work situation, working hours, job demands), work functioning (i.e., perceived ability to work, productivity loss, limitations in work), work environment (i.e., work accommodations, psychosocial work environment), as well as health status and fatigue. Results Sixty-five percent were employed reporting moderate work ability. Of those, 21% received supplementary work disability benefits, 37% were severely fatigued, 7% expected to drop out of the workforce, and 49% experienced CKD-related work limitations. Work accommodations included reduced working hours, working at a slower pace, adjustment of work tasks or work schedule, and working from home. Multivariable analysis of sustained employment showed associations with younger age, male gender, higher level of education, better general and physical health and pre-emptive transplantation. Transplant patients had the highest work ability and highest expectation to maintain work. Dialysis patients had the highest productivity loss and perceived the most limitations regarding functioning in work. Stage G3b-G5 patients reported the lowest social support from colleagues and highest conflict in work and private life. Conclusions Employed CKD patients experience difficulties regarding functioning in work requiring adjustment of work or partial work disability. In addition to dialysis patients, stage G3b-G5 patients are vulnerable concerning sustained employment and work functioning. Show less
Gorp, D.A.M. van; Hiele, K. van der; Middelkoop, H.A.M.; Visser, L.H. 2019
Background: Cognitive dysfunction is increasingly being recognized as an important limiting factor in work participation in patients with multiple sclerosis. This literature review provides a... Show moreBackground: Cognitive dysfunction is increasingly being recognized as an important limiting factor in work participation in patients with multiple sclerosis. This literature review provides a description, synthesis and interpretation of the existing literature and identifies gaps in current knowledge.Methods: Papers published between 1970 and April 2017 were included. Clinical trials, randomized controlled trials or observational quantitative studies in which data on cognitive factors associated with employment, work functioning or work-related problems were reported. Papers were manually double checked by two blinded reviewers.Results: A total of 41 papers were included of which 4 described prospective, longitudinal studies. The majority of studies reported positive associations between cognitive functioning and work outcomes (38/41 studies; 93%). Positive associations were found between work outcomes and global cognitive functioning (8/9 studies; 89%), language (8/17 studies; 47%), processing speed/ working memory (23/26 studies; 88%),new learning and memory (12/22 studies; 55%), executive functioning (10/17; 59%), intelligence (1/6; 17%) and self-reported cognitive functioning (14/15; 93%). None of the reviewed studies found a relation between visuospatial processing and work outcomes (0/8; 0%). Models including cognitive measures as well as demographic (age, education), neurological (disability, fine motor coordination, disease course), and psychological variables (depression, personality, fatigue) best predicted work outcomes.Conclusion: By conducting this review we found ample evidence that objective cognitive functioning (specifically processing speed/ working memory and executive functioning) and self-reported cognitive functioning are important independent associates of work outcomes and these factors should be addressed by healthcare professionals. Future research could benefit from a focus on longitudinal changes in cognition and its relation to work outcomes. Show less
Boeft, M. den; Twisk, J.W.R.; Hoekstra, T.; Terluin, B.; Penninx, B.W.J.H.; Wouden, J.C. van der; ... ; Horst, H.E. van der 2016
