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Browsing by Author "Engels, J.A."
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Effects of mindfulness-based stress reduction and an organizational health intervention on Dutch teachers’ mental health Janssen, M.H.M.G. ; Heerkens, Y.F. ; Heijden, Beatrice van der ; Korzilius, Hubert ; Peters, P. ; Engels, J.A.2022, Article / Letter to editor (Health Promotion International, (2022), pp. 1-15) -
Corrigendum: Supporting Double Duty Caregiving and Good Employment Practices in Health Care Within an Aging Society. Detaille, S.I. ; Lange, A.H. de ; Engels, J.A. ; Pijnappels, M. ; Hutting, N. ; Osagie, E.R. ; Reig-Botella, A.2021, Article / Letter to editor (Frontiers in Psychology, vol. 12, (2021), pp. 666611)[This corrects the article DOI: 10.3389/fpsyg.2020.535353.]. -
PHYSIOTHERAPY WORKS: RCT ON THE (COST-)EFFECTIVENESS OF A PHYSICAL THERAPIST-LED, WORK-ORIENTED INTERVENTION IN PEOPLE WITH AXIAL SPONDYLOARTHRITIS AND RHEUMATOID ARTHRITIS Bakker, NF ; Knoop, J. ; Hutting, N. ; Heerkens, Y.F. ; Engels, J.A. ; Staal, J.B. ; Leeden, M van der ; Boonen, A ; Vlieland, TPMV ; Weely, SFE van2021, Article / Letter to editor (Clinical and Experimental Rheumatology, vol. 39, iss. 5, (2021), pp. 1240)
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O-61 Barriers and Facilitators for Participation in Workplace Health Promotion Programs: Peer-to-Peer Interviews Among Employees 2021, Article / Letter to editor (Occupational and Environmental Medicine, vol. 78, iss. A25, (2021))Abstract Introduction Workplace health promotion (WHP) programs have shown to be effective in the reduction of body weight, increased psychological wellbeing and perceived health of employees. Despite the potential benefits for employees, participation rates of WHP programs are often low (10–64%). Objectives To get more insight into reasons for (non)participation, the objective of this study was to identify the barriers and facilitators for participation in WHP programs from the employee perspective. Methods Peer-to-peer interviewing, a method derived from citizen science, was used to actively involve the target group of employees. In total 14 employees working in the cleaning-, ICT- and facility- sector were trained to conduct interviews themselves with co-workers. All interviews were recorded and transcribed verbatim. The Consolidated Framework for Implementation Research (CFIR) was used to create an initial codebook, complemented with the constructs ‘interpersonal’ and ‘intrapersonal factors’ from the Social Ecological Model. Data were coded both deductively and inductively, and ranked by two researchers independently. Results In total, 62 peer-to-peer interviews were conducted by the 14 peer-interviewers. Preliminary findings show that main barriers for participation in WHP interventions are a lack of knowledge about the programs and a negative attitude towards WHP (e.g. no belief that their employer can help them with improving their lifestyle). Facilitating factors identified were fit of the WHP activities to the employees’ needs and available (working) time to participate. Conclusion Our findings on the main barriers and facilitators for participation in WHP according to employees may contribute to more successful implementation and higher participation rates in future WHP programs.
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Supporting Double Duty Caregiving and Good Employment Practices in Health Care Within an Aging Society Detaille, S.I. ; Lange, A.H. de ; Engels, J.A. ; Pijnappels, M.C.M. ; Hutting, N. ; Osagie, E.R. ; Reig-Botella, A.2020, Article / Letter to editor (Frontiers in Psychology, vol. 11, (2020)) -
A study protocol for a cluster randomised controlled trial on mindfulness-based stress reduction: studying effects of mindfulness-based stress reduction and an additional organisational health intervention on mental health and work-related perceptions of teachers in Dutch secondary vocational schools. Janssen, M.H.M.G. ; Heerkens, Y.F. ; Heijden, Beatrice van der ; Korzilius, Hubert ; Peters, P. ; Engels, J.A.2020, Article / Letter to editor (Trials, vol. 21, iss. 1, (2020), pp. 376)
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Effects of Mindfulness-Based Stress Reduction Training on Healthcare Professionals' Mental Health: Results from a Pilot Study Testing Its Predictive Validity in a Specialized Hospital Setting. Janssen, M.H.M.G. ; Heijden, Beatrice van der ; Engels, J.A. ; Korzilius, Hubert ; Peters, P. ; Heerkens, Y.F.2020, Article / Letter to editor (International Journal of Environmental Research and Public Health, vol. 17, iss. 24, (2020), pp. 9420)
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Verpleegkundige én mantelzorger 2019, Article / Letter to editor (TVZ : verpleegkunde in praktijk en wetenschap, vol. 129, (2019), pp. 25-26)
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Hoofdstuk 4: Het veld Arbeid & Gezondheid: de spelers en het beroepsmatig handelen 2019, Part of book or chapter of book (Heerkens, Y.F.; Bieleman, A.; Miedema, H. (ed.), Handboek Arbeid & Gezondheid)
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Hoofdstuk 5: (Meer) aan het werk 2019, Part of book or chapter of book (Heerkens, Y.F.; Bieleman, A.; Miedema, H. (ed.), Handboek Arbeid & Gezondheid)
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Hoofdstuk 7: Re-integratie 2019, Part of book or chapter of book (Heerkens, Y.F.; Bieleman, A.; Miedema, H. (ed.), Handboek Arbeid & Gezondheid)
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Effects of Mindfulness-Based Stress Reduction on employees' mental health: A systematic review. 2018, Article / Letter to editor (PLoS One, vol. 13, iss. 1, (2018), pp. e0191332)OBJECTIVES: The purpose of this exploratory study was to obtain greater insight into the effects of Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) on the mental health of employees. METHODS: Using PsycINFO, PubMed, and CINAHL, we performed a systematic review in October 2015 of studies investigating the effects of MBSR and MBCT on various aspects of employees' mental health. Studies with a pre-post design (i.e. without a control group) were excluded. RESULTS: 24 articles were identified, describing 23 studies: 22 on the effects of MBSR and 1 on the effects of MBSR in combination with some aspects of MBCT. Since no study focused exclusively on MBCT, its effects are not described in this systematic review. Of the 23 studies, 2 were of high methodological quality, 15 were of medium quality and 6 were of low quality. A meta-analysis was not performed due to the emergent and relatively uncharted nature of the topic of investigation, the exploratory character of this study, and the diversity of outcomes in the studies reviewed. Based on our analysis, the strongest outcomes were reduced levels of emotional exhaustion (a dimension of burnout), stress, psychological distress, depression, anxiety, and occupational stress. Improvements were found in terms of mindfulness, personal accomplishment (a dimension of burnout), (occupational) self-compassion, quality of sleep, and relaxation. CONCLUSION: The results of this systematic review suggest that MBSR may help to improve psychological functioning in employees.
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Sickness Absence of Nurses Working in Residential Elder Care: The Essential Role of Psychosocial Job Resources and Home Demands. 2018, Article / Letter to editor (Journal of Occupational and Environmental Medicine, vol. 60, iss. 9, (2018), pp. e445-e454)OBJECTIVES: To elucidate the role and pathways of psychosocial home demands, psychosocial home resources, and psychosocial job resources in relation to sickness absence among nurses working in residential elder care. METHODS: Longitudinal (SEM) analyses with bootstrapping with a 1 year follow-up among 365 nurses were performed. Survey data and registered sickness absence data were used. RESULTS: A complete mediation model showed the best fit. More psychosocial job resources (β= -1.50) like "work schedule fit with private life" predicted less and more psychosocial home demands (β= 0.62) predicted more psychosomatic health complaints. The job resources and home demands predicted sickness absence duration and episodes 1-year later mediated through nurses' health. CONCLUSIONS: More attention is needed for nurses' work schedule fit with private life and their home demands to potentially reduce health-related sickness absence among nurses working in residential elder care.
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Elaboration of the contextual factors of the ICF for Occupational Health Care. 2017, Article / Letter to editor (Work: A Journal of Prevention, Assessment and Rehabilitation, vol. 57, iss. 2, (2017), pp. 187-204)BACKGROUND: Many work-related items are not included in the current classification of environmental factors from the International Classification of Functioning, Disability and Health (ICF). Furthermore, personal factors are not classified and the ICF only provides a very limited list of examples. These facts make the ICF less useful for occupational health care and for research in the field of occupation and health. OBJECTIVE: The objective of this discussion paper is to introduce an elaboration of contextual factors, focussing on factors that influence work participation. METHODS: During the last 12 years, we developed two concept lists from the bottom up. These lists are based on our experiences in teaching and research, suggestions from students and other researchers, and factors found in the literature. In the fall of 2015 a scoping literature review was done to check for missing factors in these two concept lists. RESULTS: An elaboration of contextual factors, consisting of a list of work-related environmental factors and a list of personal factors. CONCLUSIONS: Important contextual factors that influence work participation are identified. Researchers, teachers, students, occupational and insurance physicians, allied health care professionals, employers, employees, and policy makers are invited to use the elaboration and to make suggestions for improvement. The elaboration and the suggestions received can be used in the ICF revision process. The development of an ICF ontology must be given priority, to give room to this elaboration, which will increase the applicability of the ICF and enable mapping with other terminologies and classifications.
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Informal care, employment and quality of life: Barriers and facilitators to combining informal care and work participation for healthcare professionals. 2017, Article / Letter to editor (Work: A Journal of Prevention, Assessment and Rehabilitation, vol. 58, iss. 2, (2017), pp. 215-231)BACKGROUND: In The Netherlands, one out of six Dutch employees has informal care tasks; in the hospital and healthcare sector, this ratio is one out of four workers. Informal carers experience problems with the combination of work and informal care. In particular, they have problems with the burden of responsibility, a lack of independence and their health. These problems can reveal themselves in a variety of mental and physical symptoms that can result in absenteeism, reduction or loss of (work) participation, reduction of income, and even social isolation. OBJECTIVE: The aim of the study was to describe the factors that informal carers who are employed in healthcare organizations identify as affecting their quality of life, labour participation and health. METHODS: We conducted an exploratory study in 2013-2014 that included desk research and a qualitative study. Sixteen semi-structured interviews were conducted with healthcare employees who combine work and informal care. Data were analyzed with Atlas-TI. RESULTS: We identified five themes: 1. Fear and responsibility; 2. Sense that one's own needs are not being met; 3. Work as an escape from home; 4. Health: a lack of balance; and 5. The role of colleagues and managers: giving support and understanding. CONCLUSIONS: Respondents combine work and informal care because they have no other solution. The top three reasons for working are: income, escape from home and satisfaction. The biggest problems informal carers experience are a lack of time and energy. They are all tired and are often or always exhausted at the end of the day. They give up activities for themselves, their social networks become smaller and they have less interest in social activities. Their managers are usually aware of the situation, but informal care is not a topic of informal conversation or in performance appraisals. Respondents solve their problems with colleagues and expect little from the organization.
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Work participation of patients with musculoskeletal disorders: is this addressed in physical therapy practice? Oswald, W. ; Hutting, N. ; Engels, J.A. ; Staal, J.B. ; Nijhuis-van der Sanden, M.W.G. ; Heerkens, Y.F.2017, Article / Letter to editor (Journal of Occupational Medicine and Toxicology, vol. 12, (2017), pp. 27)BACKGROUND: Musculoskeletal disorders are the main complaints for visiting a physical therapist (PT) in primary health care; they have a negative effect on an individual's quality of life and result in a major cost to society. Qualitative research has shown that physical therapists (PTs) treating patients with these disorders experience barriers in the integration of occupational factors within their practice, and also revealed a lack of cooperation between PTs and (other) occupational healthcare providers. The aim of this study is to quantitatively investigate how generalist PTs in the Netherlands, who treat patients with musculoskeletal disorders, currently integrate occupational factors within their practice, and to identify their opinions and needs with regard to enhancing the integration of the patient's work within physical therapy practice. METHODS: A cross-sectional survey was conducted among generalist PTs who treat working-age (18-67 years) patients with musculoskeletal disorders. Generalist PTs were contacted for participation via digital news-mails and asked to fill out an online survey which was developed based on the results of a recent qualitative study. The survey consisted of: i) demographics of the participants, ii) questions on how generalist PTs currently integrate occupational factors within their practice, and iii) asked their opinion about the integration of occupational factors within physical therapy. The PTs were also asked about their needs with regard to the integration of occupational factors and with regard to cooperation with other (occupational) health professionals. All answers (using Likert scales) are presented as the number and percentage of the respondents reporting those specific answers, whereas all other answers are presented as means and standard deviations. RESULTS: Of the 142 respondents, 64% indicated that occupational factors should be addressed to a greater extent within physical therapy. To have the possibility to bill for a workplace assessment (60.6%) and more knowledge about laws and regulations (50%) were identified as needs of the respondents. Only 14.8% of the respondents indicated that they communicate with or consult a PT specialized in occupational health. Only 12.7% of the participants who do not have a specialized PT within their practice sometimes/regularly refer patients to a specialized PT. CONCLUSIONS: Although generalist PTs address occupational factors within their practice, there is room for improvement. This study also identified a lack of cooperation between generalist PTs and PTs specialized in occupational health.
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Physical therapists and importance of work participation in patients with musculoskeletal disorders: a focus group study. Hutting, N. ; Oswald, W. ; Staal, J.B. ; Engels, J.A. ; Nouwens, E ; Nijhuis-van der Sanden, M.W.G. ; Heerkens, Y.F.2017, Article / Letter to editor (BMC Musculoskeletal Disorders, vol. 18, iss. 1, (2017), pp. 196)BACKGROUND: Musculoskeletal disorders are a major health problem resulting in negative effects on wellbeing and substantial costs to society. Work participation is associated with positive benefits for both mental and physical health. Potentially, generalist physical therapists (GPTs) can play an important role in reducing absenteeism, presenteeism and associated costs in patients with musculoskeletal disorders. However, work participation is often insufficiently addressed within generalist physical therapy practice (GPTP). Therefore, this study evaluates whether GPTs take work participation into account as a determining factor in patients with musculoskeletal disorders, and how this might be improved. METHODS: This qualitative study consisted of seven focus groups involving 30 participants: 21 GPTs and 9 occupational physical therapists (OPTs). Based on an interview guide, participants were asked how they integrate work participation within their practice, how they collaborate with other professionals, and how GPTs can improve integration of the patient's work within their practice. RESULTS: Although participants recognized the importance of work participation, they mentioned that the integration of this item in their GPTP could be improved. Generally, GPTs place insufficient priority on work participation. Moreover, there is a lack of cooperation between the generalist physical therapist and (other) occupational healthcare providers (including OPTs), and the borderlines/differences between generalist physcial therapy and occupational health physcial therapy were sometimes unclear. GPTs showed a lack of knowledge and a need for additional information about several important work-related factors (e.g. work content, physical and psychosocial working conditions, terms of employment). CONCLUSIONS: Although a patient's work is important, GPTs take insufficient account of work participation as a determining factor in the treatment of patients with musculoskeletal disorders. GPTs often lack specific knowledge about work-related factors, and there is insufficient cooperation between OPTs and other occupational healthcare providers. The integration of work participation within GPTP, and the cooperation between GPTs and other occupational healthcare providers, show room for improvement.
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Experiences of Participants in a Self-Management Program for Employees with Complaints of the Arm, Neck or Shoulder (CANS): A Mixed Methods Study Hutting, N. ; Detaille, S.I. ; Heerkens, Y.F. ; Engels, J.A. ; Staal, J.B. ; Nijhuis-van der Sanden, M.W.G.2017, Article / Letter to editor (Journal of Occupational Rehabilitation, vol. 27, (2017), pp. 35-48)
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Which resources moderate the effects of demanding work schedules on nurses working in residential elder care? A longitudinal study. 2016, Article / Letter to editor (International Journal of Nursing Studies, vol. 58, (2016), pp. 31-46)BACKGROUND: Shiftwork is a major job demand for nurses and has been related to various negative consequences. Research suggests that personal and job resources moderate the impact of work schedules on stress, health and well-being. OBJECTIVES: This longitudinal study examined whether the interactions of personal and job resources with work schedule demands predicted work engagement and emotional exhaustion in nursing. DESIGN: This longitudinal study included two waves of data collection with a one year follow-up using self-report questionnaires among 247 nurses working shifts or irregular working hours in residential care for the elderly in the Netherlands. METHODS: Moderated structural equation modelling was conducted to examine the interactions between personal and job resources and work schedule demands. Two work schedule demands were assessed: type of work schedule (demanding vs. less demanding) and average weekly working hours. Two personal resources, active coping and healthy lifestyle, and two job resources, work schedule control and the work schedule fit with nurses' private life, were assessed. RESULTS: Results showed that the work schedule fit with nurses' private life buffered the relationship between work schedule demands and emotional exhaustion one year later. Furthermore, the work schedule fit with nurses' private life increased work engagement one year later when work schedule demands were high. Work schedule control strengthened the positive relationship between work schedule demands and emotional exhaustion one year later. The personal resources, active coping and healthy lifestyle were no moderators in this model. CONCLUSION: Nurses suffer less from decreasing work engagement and emotional exhaustion due to work schedule demands when their work schedules fit with their private lives. Work schedule control did not buffer, but strengthened the positive relationship between weekly working hours and emotional exhaustion one year later. Job resources appeared to be more important for nurses' well-being than personal resources. These findings highlight the importance of the fit of a work schedule with nurse's private life, if the work schedule is demanding.
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A new typology of work schedules: Evidence from a cross-sectional study among nurses working in residential elder care 2016, Article / Letter to editor (Work: A Journal of Prevention, Assessment and Rehabilitation, vol. 54, iss. 1, (2016), pp. 21-33)BACKGROUND: Work schedules contribute substantially to the health and well-being of nurses. Too broad typologies are used in research that do not meet the current variety in work schedules. OBJECTIVE: To develop a newtypology for nurses' work schedules based on five requirements and to validate the typology. METHODS: This study is based on a questionnaire returned by 498 nurses (response 51%) including questions regarding nurses' work schedule, socio-demographic, and family characteristics and their appraisal of the work schedule. Frequencies of the different schedules were computed to determine the typology. To validate the typology, differences between the types were tested with ANOVAs, Chi(2) and Kruskal-Wallis tests. RESULTS: Five main types can be distinguished based on predetermined requirements and frequencies, namely: (1) fixed early shift, (2) rotating two shift pattern without night shift, (3) rotating three shift pattern, (4) fixed and rotating two shift pattern including night shift, and (5) fixed normal day or afternoon shifts. Nurses in these types of work schedule differed significantly with respect to hours worked, days off between shifts, age, education, years in the job, commuting time, contribution to household income, satisfaction with work schedule and work schedule control. Especially nurses with type 3 schedules differed from other types. CONCLUSIONS: A typology of five main types of work schedules is proposed. Content validity of the typology is sufficient and the new typology seems useful for research on work-related aspects of nursing.
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Hoe zien bedrijven de rol van de diëtist bij leefstijlbevordering op de werkvloer? Een onderzoek naar de wensen en behoeften van bedrijven over de inzet van de diëtist bij leefstijlbevordering op de werkvloer. 2016, Article / Letter to editor (Nederlands Tijdschrift voor Voeding & Diëtetiek, vol. 71, iss. 4, (2016), pp. S1-S8)
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Development of a self-management intervention for employees with complaints of the arm, neck and/or shoulder (CANS): a focus group study with experts. 2015, Article / Letter to editor (Journal of Occupational Medicine and Toxicology, vol. 10, (2015), pp. 9)BACKGROUND: Many people suffer from complaints of the arm, neck and/or shoulder (CANS). The complaints are persistent and there is a need for intervention programs for those with longstanding CANS. Studies suggest that a behavioural change is needed in employees with CANS. A self-management program with an add-on eHealth module might be an effective option to achieve the behavioural change needed to manage the complaints in employees with CANS. The aim of this study was to determine the content and strategies of the intervention and to gain insight into possible barriers and facilitators for implementation. Therefore, we examined the views of experts on the problems and characteristics associated with employees with CANS as well as their opinion on a self-management program consisting of self-management sessions and an eHealth module. METHODS: A qualitative study was performed consisting of three focus groups involving a total of 17 experts (with experience with CANS, self-management and/or eHealth interventions). Experts were asked their opinion about the content and requirements of a self-management program for employees with CANS, including an eHealth module. Data were analysed using qualitative data analysis. After coding, the emergent themes were used to organise the data into main categories, expressing the ideas and opinions of experts on CANS, self-management and/or eHealth interventions. RESULTS: The experts pointed out that the intervention should focus on increasing employees' self-efficacy and empowerment, and address topics related to the possible risk factors for CANS, symptoms, work environment, social environment and personal factors. The eHealth module should be self-explanatory and attractive, and the information provided should be brief, clear and concise. CONCLUSIONS: Experts appeared to see a role for a self-management program for employees with CANS. They indicated that the combination of group sessions and eHealth can work well. Experts provided valuable information with regard to the content of the self-management intervention and the design of the eHealth module.
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Sustainable employability in shiftwork: related to types of work schedule rather than age. 2015, Article / Letter to editor (International Archives of Occupational and Environmental Health, vol. 88, iss. 7, (2015), pp. 881-893)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.
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Effect evaluation of a self-management programme for employees with complaints of the arm, neck or shoulder: a randomised controlled trial. Hutting, N. ; Staal, J.B. ; Engels, J.A. ; Heerkens, Y.F. ; Detaille, S.I. ; Nijhuis-van der Sanden, M.W.G.2015, Article / Letter to editor (Occupational and Environmental Medicine, vol. 72, iss. 12, (2015), pp. 852-861)OBJECTIVE: To evaluate the effectiveness of a self-management intervention (including an eHealth module), compared with usual care, in employees with chronic non-specific complaints of the arm, neck or shoulder (persisting >3 months). METHODS: Participants were randomised into the self-management group (SG) or usual care group (UCG). The SG participated in 6 self-management sessions and could use an eHealth module; the UCG could use all available usual care. The primary outcome of the study was score on the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH). Secondary outcomes included: absenteeism, pain in the previous week, quality of life, pain catastrophising, self-efficacy, work style, presenteeism, fatigue, and limitations experienced during work. Data were analysed using generalised estimating equations (GEE) linear regression and Mann-Whitney U tests, and were collected at baseline, 3-month, 6-month, and 12-month follow-up. RESULTS: On the general module of the DASH, no significant difference between SG and the UCG was detected. On most of the other outcome measures, there were no significant between-group differences. In the DASH work module, the between-group effect was -3.82 (95% CI -7.46 to -0.19, p=0.04). For limitations experienced in job-related activities the between-group effect was -1.01 (95% CI -1.97 to -0.04, p=0.04). The mean hours of sport activities in the past 3 months, measured at 12 months, was 1.00 h (95% CI -1.90 to -0.12 h, p=0.03) less in the SG compared with the UCG. CONCLUSIONS: The self-management intervention improved the participants' perceived disability during work. Since no significant between-group differences were found on most outcome measures, the results of this study should be interpreted with caution. TRIAL REGISTRATION NUMBER: Dutch Trial Registration number NTR 3816.
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Development of a Vitality Scan related to workers' sustainable employability: a study assessing its internal consistency and construct validity. 2015, Article / Letter to editor (BMC Public Health, vol. 15, (2015), pp. 551)BACKGROUND: Most validated sustainable employability questionnaires are extensive and difficult to obtain. Our objective was to develop a usable and valid tool, a Vitality Scan, to determine possible signs of stagnation in one's functioning related to sustainable employability and to establish the instrument's internal consistency and construct validity. METHODS: A literature review was performed and expert input was obtained to develop an online survey of 31 items. A sample of 1722 Dutch employees was recruited. Internal consistency was assessed by Cronbach's alpha. The underlying theoretical concepts were extracted by factor analysis using a principal component method. For construct validity, a priori hypotheses were defined for expected differences between known subgroups: 1) older workers would report more stagnation than younger workers, and 2) less educated workers would report more problems than the highly educated ones. Both hypotheses were statistically tested using ANOVA. RESULTS: Internal consistency measures and factor analysis resulted in five subscales with acceptable to good reliability (Cronbach's alpha 0.72-0.87). These subscales included: balance and competence, motivation and involvement, resilience, mental and physical health, and social support at work. Three items were removed following these analyses. In accordance with our a priori hypothesis 1, the ANOVA showed that older workers reported the most problems, while younger workers reported the least problems. However, hypothesis 2 was not confirmed: no significant differences were found for education level. CONCLUSIONS: The developed Vitality Scan - with the 28 remaining items - showed good measurement properties. It is applicable as a user-friendly, evaluative instrument for worker's sustainable employability. The scan's value for determining whether or not the employee is at risk for a decrease in functioning during present and future work, should be further tested.
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Development of a self-management program for employees with complaints of the arm, neck, and/or shoulder: an intervention mapping approach Hutting, N. ; Detaille, S.I. ; Engels, J.A. ; Heerkens, Y.F. ; Staal, J.B. ; Nijhuis-van der Sanden, M.W.G.2015, Article / Letter to editor (Journal of Multidisciplinary Healthcare, vol. 2015, iss. 8, (2015), pp. 307-320)To develop a self-management program with an additional eHealth module, using the six steps of the intervention mapping (IM) protocol, to help employees with complaints of the arm, neck, and/or shoulder (CANS) cope with their problems. In Step 1 of the IM protocol, a needs assessment was performed consisting of a review of the Dutch multidisciplinary guidelines on CANS, and of focus group sessions with employees with CANS (n=15) and with relevant experts (n=17). After the needs assessment, the objectives of the intervention and the determinants of self-management at work were formulated (Step 2). Furthermore, theory-based intervention methods and practical strategies were selected (Step 3), and an intervention program (including the eHealth module) was developed (Step 4). Finally, plans for implementation and evaluation of the program were developed (Steps 5 and 6). Step 1 of the IM protocol revealed that employees with CANS should be stimulated to search for information about the cause of their complaints, about how to deal with their complaints, and in which manner they can influence their complaints themselves. In Step 2, the overall goal of the intervention was defined as "self-management behavior at work" with the aim to alleviate the perceived disability of the participants. Step 3 described how the intervention methods were translated into practical strategies, and goal setting was introduced as an important method for increasing self-efficacy. The product of Step 4 was the final program plan, consisting of 6-weekly group sessions of 2.5 hours each and an eHealth module. In Step 5, a recruitment plan and course materials were developed, a steering committee was set up, trainers were recruited, and the final program was tested. In Step 6, an evaluation plan was developed, which consists of a randomized controlled trial with a 12-month follow-up period and a qualitative evaluation (interviews) with some of the participants.
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Development and measurement properties of the Dutch version of the Stanford Presenteeism Scale (SPS-6). 2014, Article / Letter to editor (Journal of Occupational Rehabilitation, vol. 24, iss. 2, (2014), pp. 268-277)OBJECTIVE: To develop a Dutch version of the Stanford Presenteeism Scale (SPS-6) and examine the reliability and discriminant, discriminative and structural validity of the Dutch SPS-6 (DSPS-6). METHODS: The original SPS-6 (English-language) was translated and adapted to the Dutch culture. Thirty participants filled in the DSPS-6 at baseline (T0) and after 5 days (T1). Internal consistency (Cronbach's alpha), test-retest reliability (Spearman's correlation coefficient, Spearman's rho), item-to-total correlations, discriminant validity (association with job stress and job satisfaction), discriminative validity (patients reporting a (work) disability compared with those indicating that they had no disability; Spearman's rho, t tests), structural validity (Varimax rotation with Kaiser Normalization) and floor and ceiling effects were examined. RESULTS: Cronbach's alpha for the DSPS-6 was 0.89. Test-retest Spearman's rho was 0.82 (p < 0.01). Item-to-total correlations ranged from 0.60 to 0.82. Subjects reporting a work disability had significantly lower DSPS scores (discriminative validity). Spearman's rho for the DSPS-6 score and job satisfaction were 0.38 (p = 0.05; at T0) and 0.27 (at T1), respectively. Spearman's rho for the association between the DSPS-6 and job stress were -0.52 (p = 0.01; at T0) and -0.42 (p = 0.05; at T1), respectively (discriminant validity). The two factors derived from the principal components analysis account for 77.5 % of the variance of responses (structural validity). A ceiling effect was present. CONCLUSIONS: The DSPS-6 showed good reliability and structural validity. The discriminative validity of the DSPS-6 is partly supported. The concept of presenteeism is not sufficiently distinct from the constructs of job stress and job satisfaction (discriminant validity). The results of the present study show that the adaptation of the SPS-6 into Dutch was successful. Further research on the reliability, validity and responsiveness of the DSPS-6 in a larger group of participants is recommended.
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Experiences of employees with arm, neck or shoulder complaints: a focus group study. 2014, Article / Letter to editor (BMC Musculoskeletal Disorders, vol. 15, (2014), pp. 141)BACKGROUND: Many people suffer from complaints of the arm, neck or shoulder (CANS). CANS causes significant work problems, including absenteeism (sickness absence), presenteeism (decreased work productivity) and, ultimately, job loss. There is a need for intervention programs for people suffering from CANS. Management of symptoms and workload, and improving the workstyle, could be important factors in the strategy to deal with CANS. The objective of this study is to evaluate the experienced problems of employees with CANS, as a first step in an intervention mapping process aimed at adaptation of an existing self-management program to the characteristics of employees suffering from CANS. METHODS: A qualitative study comprising three focus group meetings with 15 employees suffering from CANS. Based on a question guide, participants were asked about experiences in relation to continuing work despite their complaints. Data were analysed using content analysis with an open-coding system. During selective coding, general themes and patterns were identified and relationships between the codes were examined. RESULTS: Participants suffering from CANS often have to deal with pain, disability, fatigue, misunderstanding and stress at work. Some needs of the participants were identified, i.e. disease-specific information, exercises, muscle relaxation, working with pain, influence of the work and/or social environment, and personal factors (including workstyle). CONCLUSIONS: Employees suffering from CANS search for ways to deal with their complaints in daily life and at work. This study reveals several recurring problems and the results endorse the multi-factorial origin of CANS. Participants generally experience problems similar to those of employees with other types of complaints or chronic diseases, e.g. related to their illness, insufficient communication, working together with healthcare professionals, colleagues and management, and workplace adaptations. These topics will be addressed in the adaptation of an existing self-management program to the characteristics of employees suffering from CANS.
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Factors influencing work participation of adults with developmental dyslexia: a systematic review. 2014, Article / Letter to editor (BMC Public Health, vol. 14, (2014), pp. 77)BACKGROUND: Evidence has been synthesized to determine hindering and facilitating factors associated with the work participation of adults with developmental dyslexia (DD), classified according to the International Classification of Functioning, Disability and Health (ICF). METHODS: A systematic literature review has been performed. Two search strings were used to determine the population and the context of work. The ICF was expanded with two subdivisions: one that made the environmental factors more work-related and a subdivision of personal factors. For data extraction the method known as qualitative metasummary was used and the manifest frequency effect size (MFES) for each category in the ICF was calculated. RESULTS: From 33 included studies 318 factors have been extracted and classified in the ICF. In the classification the frequency of occurrences and the consistency in direction (i.e., hindering or facilitating) have been made visible. The ICF categories with the highest MFES were mental functions with factors like feelings and emotions about dyslexia; activities like reading or writing/spelling; participation with factors like acquiring and keeping a job; social relationships at work where the attitudes and support of the employer and co-workers are important; working conditions with factors like the availability of assistive technology and accommodations on the job; and personal factors like self-disclosure and coping strategies. CONCLUSIONS: In the context of work DD affects nearly all domains of functioning, mostly in a negative way. Within each domain the impact of DD increases over the course of life. To overcome that negative influence, many forms of adaptation, compensation, or coping are mentioned. Also notable is the lack of positive attitudes toward DD of the participants with DD-with the exception of the attitudes of teachers with DD-as well as on the part of colleagues, supervisors, and employers.
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How Persons with a Neuromuscular Disease Perceive Employment Participation : A Qualitative Study Minis, Marie-Antoinett van ; Satink, T. ; Kinébanian, Astrid ; Engels, J.A. ; Heerkens, Y.F. ; Engelen, B.G.M. van ; Nijhuis-van der Sanden, M.W.G.2014, Article / Letter to editor (Journal of Occupational Rehabilitation, vol. 24, iss. 1, (2014), pp. 52-67)Introduction A qualitative study was carried out to understand how people with a slow progressive adult type neuromuscular disease (NMD) perceive employment participation. Methods 16 paid employed persons with NMD were interviewed in open, in-depth interviews. Data were analyzed using the constant comparison method. Results Four themes were identified in the analyses: (1) Experiences regarding the meaning of work; (2) Solving problems oneself; (3) Reaching a turning point; and (4) Taking into account environmental aspects. Persons with NMD highlighted benefits of staying at work as well as the tension they felt how to shape decisions to handle progressive physical hindrances in job retention. This study shows how participants at work with NMD were challenged to keep up appearances at work and at home, the tension felt around when and if to disclose, the effect of their condition on colleagues and work reorganization challenges. Participants experienced that disclosure did not always make things better. With increasing disability participants’ focus shifted from the importance of assistive products towards considerate colleague, in particular superior’s willingness in supporting job retention.
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A self-management program for employees with complaints of the arm, neck, or shoulder (CANS): study protocol for a randomized controlled trial. 2013, Article / Letter to editor (Trials, vol. 14, (2013), pp. 258)BACKGROUND: Complaints of the arm, neck, or shoulder (CANS) have a multifactorial origin and cause considerable work problems, including decreased work productivity, sickness absence, and, ultimately, job loss. There is a need for intervention programs for people with CANS. Self-management is an approach used in chronic disease care to improve self-efficacy and wellness behaviors to facilitate participants to make informed choices and carry them out. This study will evaluate the effectiveness of a self-management program (including ehealth) and compare it to usual care among employees with chronic CANS (lasting >3 months). METHODS/DESIGN: This is a randomized controlled trial in which 142 participants will be recruited and randomized (with pre-stratification) to either the intervention group (IG) or control group (CG). The IG will participate in a self-management program consisting of six group sessions and an ehealth module. The CG is allowed to use all usual care available. The primary outcome of the study is the self-reported disability of arm, shoulder, and hand, measured with the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH). Secondary outcomes include: absenteeism, pain in the previous week, quality of life, catastrophizing pain, self-efficacy, workstyle, presenteeism, fatigue, the use of usual care, and limitations experienced on the job. Data are collected at baseline and at 3, 6, and 12 months follow-up. DISCUSSION: Following the process of intervention mapping we developed a self-management program to suit and alleviate the problems and needs of employees with CANS. A strength of the study is that our intervention is specifically tailored to match the needs of employees with CANS. The study also has some potential weaknesses (for example, use of co-interventions, combination of group sessions and ehealth, self-reporting of data and possible contamination, Hawthorne effect, and recall or information bias) which are discussed. TRIAL REGISTRATION: The trial is registered with the Dutch Trial Register (http://www.trialregister.nlNTR3816): (January 2013). The first participant was randomized in September 2012.
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Effect Evaluation of a Self-Management Program for Dutch Workers with a Chronic Somatic Disease: A Randomized Controlled Trial 2013, Article / Letter to editor (Journal of Occupational Rehabilitation, vol. 2013, iss. 23, (2013), pp. 189-199)Purpose: The objective of this study is to investigate the effect of a Self-Management Program for workers with a chronic disease. This program is based on the Chronic Disease Self-Management Program of Stanford University, modified for workers with a chronic somatic disease. Methods: In a randomized controlled trial, the effectiveness of a Self-Management Program was evaluated. Participants were randomly assigned to the experimental group (n = 57) and the control group (n = 47). The experimental group received an intervention, the control group received care as usual. Primary outcome measures were self-efficacy at work and the attitude towards self-management at work. Secondary outcomes were the SF-12 health survey questionnaire, job satisfaction and intention to change job. The results were measured at baseline, after the intervention and 8 months after the intervention. Results: The attitude towards self-management at work (enjoyment) improved after 8 months for the intervention group (p = 0.030). No other outcome variable differed significantly. As an interaction effect, it was found that low educated workers developed a better physical health quality (SF-12) in the intervention group compared with the control group. The attitude towards self-management at work (importance) improved in the intervention group for older and female workers and the attitude toward enjoying self-management at work improved for female workers only. Conclusion: The results show that low educated workers, older workers and women benefit significantly more from the training than higher educated workers, younger workers and men.
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Exploring employment in consultation reports of patients with neuromuscular diseases Minis, Marie-Antoinett van ; Cup, Edith ; Heerkens, Y.F. ; Engels, J.A. ; Engelen, B.G.M. van ; Oostendorp, Rob2012, Article / Letter to editor (Archives of Physical Medicine and Rehabilitation, vol. 93, iss. 12, (2012), pp. 2276-2280)To explore consultation reports for patient and employment characteristics and recommendations on employment regarding patients with neuromuscular diseases (NMDs). Eighty percent of the included consultation reports contained information on employment. Less than half the patients with NMD were employed, most in office-related jobs, using some kind of adaptations. Nineteen of 20 patients who agreed to recommendations regarding therapy were adequately referred by occupational therapists and physical therapists for treatment of employment problems.
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Bespreekbaar maken van overgewicht op de werkplek; kan dat en wie moet het doen? 2011, Article / Letter to editor (Tijdschrift voor Gezondheidswetenschap, vol. 2011, iss. 89, (2011), pp. 114-121)Overgewicht is momenteel het snelst groeiende volksgezondheidsprobleem in Nederland. Uit eerder onderzoek blijkt dat werknemers met overgewicht twee maal zo vaak verzuimen en minder productief zijn dan collegas zonder overgewicht. Om overgewicht bij werknemers aan te pakken, of liever nog te voorkómen, is van belang om te weten hoe leidinggevenden, medewerkers en professionals aankijken tegen het bespreekbaar maken en aanpakken van overgewicht en eventuele andere leefstijlfactoren op de werkplek. Het in dit artikel beschreven onderzoek richt zich op de verantwoordelijkheden en mogelijkheden van werkgever en werknemer rondom de preventie van overgewicht. Methoden: Met leidinggevenden en werknemers van een groot ziekenhuis, diëtisten, bedrijfsartsen en arbeidsdeskundigen werden semigestructureerde interviews gehouden om te inventariseren hoe men denkt over ‘het bespreken van leefstijl op de werkplek’, met name van overgewicht. Resultaten: Om de onderzoeksvraag te beantwoorden is een schema ontworpen met de belangrijkste uitspraken uit de interviews met de genoemde groepen. Er bleek een redelijke consensus over het feit dat de leidinggevende werknemers mag aanspreken op hun leefstijl. Een faciliterende en motiverende aanpak is dan aan te bevelen, dwang wordt afgeraden. Geadviseerd wordt om behalve aan overgewicht en obesitas ook aandacht te besteden aan andere leefstijlaspecten en aan de balans tussen werk en privé. Conclusie: Er is zeker een draagvlak om ‘op de werkvloer’ aandacht te besteden aan een gezonde leefstijl. Leidinggevenden moeten bijvoorbeeld door training geholpen worden om hun rol hierbij vorm te geven. Het bespreekbaar maken van leefstijlthemas wordt als lastig ervaren. Voorlopig is een optie hier een onafhankelijke leefstijlcoach of diëtist voor in te schakelen.
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Spelers op het veld arbeid en gezondheid : Hoofdstuk 4 2011, Part of book or chapter of book (Arbeid & Gezondheid: Een handboek voor paramedici & arboprofessionals, pp. 91-147)Het bevorderen van duurzame arbeidsparticipatie is een kerntaak voor paramedici en arboprofessionals. In sociaal opzicht is arbeidsparticipatie belangrijk omdat het bijdraagt aan zelfstandigheid en zelfrespect. Maar niet iedereen kan een baan vinden of houden. Bovendien zullen door de stijgende pensioenleeftijd meer werknemers te kampen krijgen met arbeidsbeperkingen. Hoe kunt u als paramedicus of arboprofessional uw clienten ondersteunen in het arbeidsparticipatieproces? Het antwoord op deze vraag vindt u in de tweede editie van Arbeid Gezondheid. De geactualiseerde denkmodellen en onderwerpen in dit handboek dienen als handvatten voor professionals om de arbeidsparticipatie van hun clienten te optimaliseren. Daarbij is kennis vanuit verschillende disciplines noodzakelijk. In de eerste editie lag de nadruk op interventie (preventie, behandeling en reïntegratie). Deze uitgebreide herziening bespreekt de rol van professionals in drie praktische contexten: (meer) aan het werk, aan het werk (blijven) en weer aan het werk. Daarvoor wordt in deel 1 het theoretische kader aangeboden. Deel 2 gaat vervolgens in op de praktische kant en geeft onder andere talloze tips, voorbeelden en nuttige adressen.
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The role of specialized physical therapists in gainful employment of clients 2011, Article / Letter to editor (Physiotherapy, vol. 97, iss. S1, (2011), pp. eS468-eS469)In the Netherlands educational programs exist to train physical therapists (PTs) to treat employees with work-related complaints of the movement system. Contrary to occupational physical therapists working in workplaces, these professional work mainly in primary healthcare. WPT2011 Research Report Abstratcs
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Arbeidsfysiotherapeut als spin in het web? 2011, Article / Letter to editor (Nederlands Tijdschrift voor Fysiotherapie, vol. 121, iss. 2, (2011), pp. 74-84)
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Using intervention mapping (IM) to develop a self-management program for employees with a chronic disease in the Netherlands 2010, Article / Letter to editor (BMC Public Health, vol. 2010, iss. 10, (2010), pp. 353)Employees with a chronic disease often encounter problems at work because of their chronic disease. The current paper describes the development of a self-management programme based on the Chronic Disease Self-Management programme (CDSMP) of Stanford University to help employees with a chronic somatic disease cope with these problems at work. The objective of this article is to present the systematic development and content of this programme. The method of intervention mapping (Bartholomew 2006) was used to tailor the original CDSMP for employees with a chronic somatic disease. This paper describes the process of adjusting the CDSMP for this target group. A needs assessment has been carried out by a literature review and qualitative focus groups with employees with a chronic disease and involved health professionals. On the basis of the needs assessment, the relevant determinants of self-management behaviour at work have been identified for the target population and the objectives of the training have been formulated. Furthermore, techniques have been chosen to influence self-management and the determinants of behaviour and a programme plan has been developed.
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Employment status of patients with neuromuscular diseases in relation to personal factors, fatigue and health status : A secondary analysis Minis, Marie-Antoinett van ; Kalkman, Joke ; Akkermans, Reinier ; Engels, J.A. ; Huijbregts, Peter ; Bleijenberg, Gijs ; Oostendorp, Rob ; Engelen, B.G.M. van2010, Article / Letter to editor (Journal of Rehabilitation Medicine, vol. 42, iss. 1, (2010), pp. 60-65)To determine the number of employed people in a group of patients with neuromuscular diseases and in 3 separate subgroups (facioscapulo-humeral dystrophy, hereditary motor and sensory neuropathy, and myotonic dystrophy) to investigate any differences in employment status between the patient groups, and to identify factors related to employment status. A total of 591 patients with neuromuscular diseases participated in the study, 138 with facioscapulo-humeral dystrophy, 135 with hereditary motor and sensory neuropathy, and 318 with myotonic dystrophy. Self-report questionnaires, the Checklist Individual Strength (CIS) and the Short Form-36 (SF-36). Of the patients with neuromuscular diseases in the study, 56.7% were employed. Younger age, being male, and higher education contributed significantly to employment status of the neuromuscular diseases group and the hereditary motor and sensory neuropathy and myotonic dystrophy subgroups. Significant between-group differences for employed vs not employed subjects were present in the total neuromuscular diseases group on all subscales of the CIS and SF-36. Factors related to employment status differed for the 3 neuromuscular diseases subgroups. More than half of the patients with neuromuscular diseases were employed. Patients with facioscapulo-humeral dystrophy and patients with hereditary motor and sensory neuropathy were more often employed than patients with myotonic dystrophy. Between-group analyses for differences in baseline factors revealed 11 significant factors related to employment. Multivariate logistic analyses revealed 6 factors contributing to employment for the group of patients with neuromuscular diseases.
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Author's reply to Coggon commentary on epidemiological investigation of prognosis. 2009, Article / Letter to editor (Scandinavian Journal of Work, Environment & Health, vol. 35, iss. 6, (2009), pp. 479)
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Classification of employment factors according to the International Classification of Functioning, Disability and Health in patients with neuromuscular diseases: a systematic review. 2009, Article / Letter to editor (Disability and Rehabilitation, vol. 31, iss. 26, (2009), pp. 2150-2163)PURPOSE: A systematic evaluation of the literature to identify health and contextual factors associated with employment in patients with neuromuscular diseases (NMD) and to perform a best evidence synthesis, taking into account the design of studies, methodological quality and the statistical significance of findings. METHOD: Publications were retrieved by a computerised search in medical and psychological databases. Two reviewers assessed titles and abstracts first and assessed the quality of the remaining full text publications independently as well. Of the residual publications, health and contextual factors associated with employment in patients with NMD were extracted. The factors found were included in a recently developed expanded International Classification of Functioning, Disability and Health scheme. RESULTS: Six hundred and sixty-two titles and abstracts were screened. The main reason to exclude a title and/or abstract was the absence of the study population selected: Facioscapulohumeral Muscular Dystrophy (FSHD), Hereditary Motor and Sensory Neuropathy (HMSN) & Myotonic Dystrophy (MD). Of the remaining 20 full-text publications, eight publications fulfilled the inclusion criteria: two repeated survey designs and six cross-sectional studies. Factor extraction resulted in 94 factors related to employment. Ten factors in five publications were indicative for an association with employment status: Disease related factors HMSN, MD & NMD in general), factors related to functions (physical functions, muscle power functions), general personal factors (age, gender and education), work related personal factors (type of occupation, and expressed interest in employment by patients with NMD). CONCLUSION: In the best evidence synthesis ten factors were indicative for an association with employment status in patients with NMD in five publications with good to excellent methodological quality.
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Common prognostic factors of work disability among employees with a chronic somatic disease: a systematic review of cohort studies. 2009, Article / Letter to editor (Scandinavian Journal of Work, Environment & Health, vol. 35, iss. 4, (2009), pp. 261-281)OBJECTIVE: Based on prospective and retrospective disease cohort studies, the aim of this review was to determine common prognostic factors for work disability among employees with rheumatoid arthritis, asthma, chronic obstructive pulmonary disease, diabetes mellitus, and ischemic heart disease (IHD). METHODS: A systematic literature search in Medline (1990-2008) and Embase (1990-2008) was carried out to identify relevant cohort studies using a well-defined list of inclusion and quality criteria. RESULTS: We identified 43 relevant cohort studies with sufficient methodological quality (20 for rheumatoid arthritis, 3 for asthma and 20 for IHD). The common prognostic factors for work disability found in all the diseases were: perceived health complaints, limitation in daily physical activities caused by the disease (high versus low), heavy manual work, and female gender. The common positive prognostic factors for rheumatoid arthritis and IHD were age (high versus low) and sickness absence. The common negative factors for rheumatoid arthritis and IHD were education (high versus low) and ethnic origin (white versus non-white). CONCLUSIONS: As many prognostic factors for work disability are similar for employees with various chronic diseases, it is possible to detect high risk groups. This information supports the development and implementation of a general disability management intervention for employees suffering from a chronic disease to overcome health-related limitations at work.
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Effectiviteit en kosteneffectiviteit ergotherapie aan huis bij ouderen met dementie en hun mantelzorgers. Een gerandomiseerd gecontroleerd onderzoek Schreurs, Victor ; Swart, B.J.M. de ; Engels, J.A. ; Schaafsma, Gertjan ; Steultjens, E.M.J. ; Hullegie, Wim ; Heerkens, Y.F. ; Cingel, Robert van2009, Article / Letter to editor (Fysiotherapie en Ouderenzorg, vol. 23, iss. 3, (2009), pp. 19-30)Ergotherapie wordt in de eerstelijn steeds vaker geïndiceerd. Daarbij is erg belangrijk dat ook de hoeveelheid beschikbare evidence groeit. Dit artikel laat zien dat het dagelijks functioneren van patiënten met dementie verbetert en de draaglast van mantelzorgers neemt af ten gevolge van een gestructureerde aanpak. Bovendien blijkt dat deze verbeteringen behouden blijven na follow-up.
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Hoofdpijn of zere nek? De gerichte aanpak van de arbeidsfysiotherapeut. 2008, Article / Letter to editor (Arbo, iss. 5, (2008), pp. 38-39)
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Een pleidooi voor het gebruik van de International Classification of Functioning, Disability and Health (ICF) in de arbozorg. 2008, Part of book or chapter of book (Naar een betere zorg voor zieke werknemers. Afstemmen van behandeling en werkhervatting.)
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Verpleegkundigen snoepen te veel. Onregelmatige diensten beïnvloeden eetgedrag verpleegkundigen niet. 2007, Article / Letter to editor (Arbo, iss. 10, (2007), pp. 20-23)
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Vitale werknemers, vitale bedrijven (redactioneel) 2007, Article / Letter to editor (Tijdschrift voor Gezondheidswetenschappen, vol. 85, iss. 2, (2007))
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Work related external and personal factors and the ICF (International Classification of Functioning, Disability and Health). 2007, Article in monograph or in proceedings (15th International WCPT Congress)
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