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Browsing by Author "Gulden, J.W. van der"
Now showing items 1-9 of 9
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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. -
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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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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A LISREL analysis of work-related risk factors and health complaints in the nursing profession. 1998, Article / Letter to editor (International Archives of Occupational and Environmental Health, vol. 71, iss. 8, (1998), pp. 537-542)OBJECTIVES: To fit a model which describes the complex interaction between various work-related factors and both musculoskeletal and psychosomatic complaints of nurses simultaneously and to compare the results with those of two LISREL models, in which the health outcome variables are analyzed separately in terms of their correlation with the same set of work-related factors. MATERIALS AND METHODS: Nurses (n=718) working in four Dutch nursing homes completed a questionnaire about work-related factors and musculoskeletal and psychosomatic complaints (response 81%). LISREL was used to describe and analyse the models. RESULTS: The full model had a reasonable overall fit. The strongest (and statistically significant) correlations were found between work postures and musculoskeletal complaints and between psychosocial work demands and psychosomatic complaints. In the two single models, health outcomes showed statistically significant correlations with the same work-related factors as they did in the full model. The full model could be slightly improved when the variable somatized complaints (e.g., dizzyness, headache) was related both to musculoskeletal complaints and to psychosomatic complaints. CONCLUSIONS: Although a model that simultaneously describes more dependent variables appears to provide a better approximation of the complexity of the actual relationship between work-related factors and health effects, the models in which only one health outcome is studied seem to give a proper description of the data at hand. This is an important finding because these single health outcome models resemble the usual analysis strategy by means of standard regression analysis. The adapted version of the full model suggests that musculoskeletal complaints of nurses can partly be understood as non-specific health complaints.
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A simple method to evaluate the reliability of OWAS observations. 1998, Article / Letter to editor (Applied Ergonomics, vol. 29, iss. 4, (1998), pp. 281-283)Slides showing nurses in different working postures were used to determine the reliability of OWAS observations. Each slide could be looked at for 3 seconds, while a new slide was shown every 30 seconds to resemble the normal practice of observation. Two observers twice scored a series of slides, some of them being identical at both viewings. To reduce effects of recall there was a time interval of 4 weeks or more between the two viewings and the slides were in a different order the second time. Different series were used to evaluate inter- and intra-observer reliability. The OWAS scores of corresponding slides were compared. In almost all comparisons percentages of agreement over 85% and kappa's over 0.6 were found, which is considered as good agreement. The procedure described seems to be a useful and simple technique to determine such reliability.
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The effects of an ergonomic-educational course. Postural load, perceived physical exertion, and biomechanical errors in nursing. 1998, Article / Letter to editor (International Archives of Occupational and Environmental Health, vol. 71, iss. 5, (1998), pp. 336-342)OBJECTIVES: To evaluate the results of an ergonomic-educational course for nurses we assessed the number and percentage of harmful postures and of ergonomic and biomechanical errors made before and after the course. We also studied the perceived physical exertion. MEANS AND METHODS: In all, 12 nurses who had participated in the course (trainees) and 12 who had not (controls) were recorded on video while performing standardized nursing tasks. The wards from which the two groups of nurses came were comparable, as were the patient populations. The nurses were also comparable in some personal characteristics. The tasks they performed included washing, lifting, and repositioning a patient as well as certain tasks other than patient handling. Video recordings were made once before (1-2 weeks) and twice after the course (after 3 months and after 15 months). The harmful postures, the errors made, and the ratings of perceived exertion were measured by means of the Ovako Working-posture Analysis System (OWAS), a checklist, and Borg scores, respectively. RESULTS: When the first and last measurements of all the above tasks taken as a whole were analyzed the trainees showed a significant improvement in the number and percentage of harmful postures and errors, whereas the controls did not. The same could be concluded for lifting alone. After the course the new work routine did not appear to have caused any extra perceived physical exertion. CONCLUSION: It can be concluded that the course was successful, although it should be carefully investigated as to whether nurses remain capable of working safely in daily practice. The work pressure that nurses experience during their normal duties could prevent them from working safely during everyday work.
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Evaluation of the effects of an ergonomic-educational programme. The assessment of "ergonomic errors" made during the performance of nursing tasks. 1997, Article / Letter to editor (International Archives of Occupational and Environmental Health, vol. 69, iss. 6, (1997), pp. 475-481)OBJECTIVES: The objectives of this study were (i) To establish whether it is possible to assess by means of a check-list in a reliable way errors which violated biomechanical and ergonomical principles during nursing tasks, and (ii) to study the effectiveness of an ergonomic-educational course by using this check-list. MATERIALS AND METHODS: Trainees (n = 12) and a control group of nurses (n = 12) who did not attend the course, performed three nursing activities at three points in time under standardized conditions; once before and twice after the course had ended. Their performances were recorded on video. A check-list was developed to assess the number of ergonomic errors made during the test performances. Two observers completed the check-lists after having watched five videotapes, and one of them did this for a second time 3 weeks later, in order to assess inter- and intra-observer reliability. In addition the tapes of all nurses were scored and analysed on differences in the performance of the two groups at the three points in time. Percentage of agreement and kappa (kappa) was used to express inter- and intra-observer reliability. Student's t-test was used to analyse the differences in mean percentages of errors. RESULTS: The inter- and intra-observer reliability were 92% with kappa of 0.84 and 93% with kappa of 0.86, respectively. Further results showed that the mean percentages of errors made by the control group remained the same at the three measurement times. However, in the trainee group a significant decrease in errors was found. The trainees made fewer errors at all three points in time than the controls did. CONCLUSION: It appears feasible to create a check-list to assess ergonomic errors in a reliable way. Trainees make fewer errors after an ergonomic-educational course. It is necessary, however to evaluate whether trained nurses work more safely in their daily duties than during the study.
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Work related risk factors for musculoskeletal complaints in the nursing profession: results of a questionnaire survey. 1996, Article / Letter to editor (Occupational and Environmental Medicine, vol. 53, iss. 9, (1996), pp. 636-641)OBJECTIVES: To determine the prevalence of musculoskeletal complaints of the back, arms or neck, and legs among nurses, and to investigate the relation between these complaints and various work related and personal variables. METHODS: A questionnaire survey was carried out in four nursing homes in The Netherlands. RESULTS: The response was 95% and resulted in 846 completed questionnaires. It was found that a large proportion of the subjects regularly had back complaints (36%) but also had arm or neck (30%) and leg complaints (16%). Almost all respondents (89%) considered nursing work as physically strenuous. Most of them complained of working under time pressure (69%), increased work pressure (70%), and having no opportunity to take a break from the work (70%). The physical variables which seem to trouble the subjects most were lifting (65%), working in awkward postures (47%), and stooping (34%). Moreover, 53% of the subjects responded that the ergonomic lay out of the ward was disagreeable. Most of the work related variables under study seemed to be associated with musculoskeletal complaints. For all types of complaints the strongest associations were found with having to lift heavy loads. Apart from physical stress various aspects of work pressure showed strong associations with the occurrence of musculoskeletal complaints. The variables on the ergonomy of the ward showed less clear associations with musculoskeletal complaints than were found for physical stress and work pressure. CONCLUSIONS: From these results it may be concluded that future research of health risks of nursing work should have a wider focus than the relation between physical workload and low back pain.
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Physical work load and its assessment among the nursing staff in nursing homes. 1994, Article / Letter to editor (Jom. Journal of Occupational Medicine, vol. 36, iss. 3, (1994), pp. 338-345)A study was conducted to investigate the physical work load and the prevalence of musculoskeletal complaints of nurses in nursing homes. Thirty-six female subjects selected from three nursing homes in the Netherlands participated in an observational study. In addition, the total nursing staff (n = 668) was invited to take part in a questionnaire survey (response was 94%). It was noticed that almost 60% of the observed time was spent on nonpatient-related activities. Moreover, activities alternated rapidly and seldom lasted longer than 4 minutes on average. Twenty percent of the observed time was spent in "poor" work postures as defined by the Ovako Working Posture Analyzing System (Action Category 2 to 4). Activities contributing most to these poor work postures were patient care and household and preliminary tasks. Perceived exertion as scored on the Borg-CR10 scale was highest during patient-related activities. This holds also for a relative increase of heart rate. Questionnaire results showed prevalences of 41%, 35%, and 20% respectively, for back, arm/neck, and leg complaints. From this study it can be concluded that not only patient-related activities should be taken into consideration for the improvement of work postures and other potential strenuous aspects of nursing work. Household and preliminary tasks, ergonomic layout of the ward, and work pressure also deserve attention.
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