2012, Article / Letter to editor (Health Care Analysis, vol. 20, iss. 3, (2012), pp. 213-230)In vocational rehabilitation, empowerment is understood as the notion that people should make an active, autonomous choice to find their way back to the labour process. Following this line of reasoning, the concept of empowerment implicitly points to a specific kind of activation strategy, namely labour participation. This activation approach has received criticism for being paternalistic, disciplining and having a one-sided orientation on labour participation. Although we share this theoretical criticism, we want to go beyond it by paying attention to the practical consequences of understanding empowerment as an activation strategy. Inspired by the field of Science and Technology Studies, we will explore the meaning of empowerment and activation in concrete practices of vocational rehabilitation in the Netherlands. Our analysis is based on the narratives of people with a work disability about their lives and the vocational rehabilitation programmes they participated in. We present five illustrative cases that how empowerment is 'done' in the practice of vocational rehabilitation and its unintended effects. Our analysis demonstrates that activation strategies seem to be caught in a paradox: instead of including people in society, they have excluding consequences. Vocational rehabilitation professionals can go beyond this paradox by learning from the ways in which empowerment is 'done' by clients in vocational rehabilitation programmes.
2010, 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.
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.
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.
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.
2009, 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.
2015, Dissertation Werkgerelateerde musculoskeletale aandoeningen vormen een groot probleem en leiden vaak tot menselijk lijden, ziekteverzuim en een verminderde werkproductiviteit. Werkgerelateerde musculoskeletale aandoeningen zijn chronische musculoskeletale aandoeningen die veroorzaakt of verergerd worden door de arbeidsinhoud, (fysieke) arbeidsomstandigheden en/of werkgerela- teerde psychosociale factoren, ofschoon andere activiteiten zoals huishoudelijke taken of sport en persoonlijke factoren ook een rol kunnen spelen. Zelfmanagement wordt meer en meer gebruikt om de eigen-e!ectiviteit en het gezondheidsgedrag bij mensen met chronische aandoeningen te verbeteren.
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.
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.
2013, Article / Letter to editor (Social Science & Medicine, vol. 96, (2013), pp. 9-16)In 'active welfare states', labour participation is regarded essential for being part of and contributing to society. In the striving for an increase in labour participation of people who were considered (partly) disabled for work, not 'disabilities', but 'abilities' are put centre stage in vocational rehabilitation programmes. In this article we explore what this change in focus means in practice. We do this by investigating tensions experienced by participants of vocational rehabilitation practices that aim at facilitating return-to-work for people with disabilities. Our analysis derives from stories that clients and professionals told about daily experiences with disability, vocational rehabilitation and (labour) participation. These stories illustrate the logic embedded in vocational rehabilitation practices. Our analysis demonstrates that this logic, that focuses on will power, stable abilities and employability, hampers the realization of labour participation for a part of the population. We conclude that a logic of embodiment in which lived experiences of clients are acknowledged and in which it is explored what clients are concretely able to do in a specific context may be better equipped to facilitate return-to-work. (C) 2013 Elsevier Ltd. All rights reserved.
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.
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.
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.
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.
2012, Article / Letter to editor (Wetenschappelijk Tijdschrift voor Ergotherapie, vol. 5, iss. 4, (2012), pp. 53-58)De herziene ergotherapierichtlijn CVA (Cerebraal Vasculair Accident) is volop in ontwikkeling en wordt in maart 2013 gepresenteerd. De herziene richtlijn is vanzelfsprekend nóg meer evidence-based, cliëntgecentreerd, op het handelen gericht en in de context gesitueerd. Deze column heeft een informatief karakter en geeft een voorproefje van de vernieuwingen die in de herziene ergotherapierichtlijn CVA worden opgenomen. Deze herzieningen sluiten aan bij de Zorgstandaard CVA/TIA die in november 2012 gepresenteerd is aan het werkveld (1). In de zorgstandaard wordt beschreven wat zorgverleners, cliënten en familie mogen verwachten van de zorg aan CVA-cliënten in alle fases van zorg na het CVA en dit is gebaseerd op de wensen en verwachtingen van cliënten en hun naasten. Ontwikkelingen waar de ergotherapierichtlijn CVA naadloos bij aansluit zijn de wens dat zorg goed aansluit op het functioneren thuis en het hebben van meer regie door cliënten en naasten tijdens het zorgproces.
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.
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.
2021, Article / Letter to editor (Tijdschrift voor Arbeidsvraagstukken, vol. 37, iss. 2, (2021), pp. 205-232)In dit artikel onderzoeken we de relatie tussen sociaaleconomische status (SES), psychische gezondheid en arbeid. Via een systematische literatuurreview hebben we onderzocht in hoeverre er een verband is tussen enerzijds SES, en anderzijds blijven werken en werkfunctioneren bij veelvoorkomende psychische klachten. Ook hebben we middels een kwalitatieve studie onder arboprofessionals, leidinggevenden en werknemers onderzocht welke factoren het blijven werken met psychische klachten voor werknemers met een lage SES belemmeren dan wel bevorderen. Op basis van de literatuurreview blijken SES-groepen niet te verschillen in hun werkfunctioneren bij psychische klachten. Wel vinden we enig bewijs dat een hoog inkomen en hoge beroepsklasse het blijven werken bevorderen. Daarnaast blijken uit de kwalitatieve studie factoren om te blijven werken met psychische klachten en een lage SES een samenspel te zijn van kenmerken van de werknemer, het werk en de leidinggevende. Waar financiële stress het blijven werken van werknemers met een lage SES belemmert, zijn potentiële bevorderende factoren: zelfinzicht, regelmogelijkheden in arbeidsinhoud, arbeidsomstandigheden en arbeidsvoorwaarden, en een steunende leidinggevende. In de praktijk zijn er bij medewerkers met een lage SES echter minder mogelijkheden om deze gunstige voorwaarden te realiseren.
2011, Article / Letter to editor (Journal Orthopaedic Sports and Physical Therapy, vol. 42, iss. 4, (2011), pp. 371-378)To investigate whether oxygen consumption and blood flow at rest and after exercise are lower in the affected arm of patients with repetitive strain injury (RSI) compared to controls, and lower in the healthy nonaffected forearm within patients with unilateral RSI. RSI is considered an upper extremity overuse injury. Despite the local presentation of complaints, RSI may be represented by systemic adaptations. Insight into the pathophysiology of RSI is important to better understand the development of RSI complaints and to develop effective treatment and prevention strategies. Twenty patients with unilateral RSI and 20 gender-matched control subjects participated in this study. Forearm muscle blood flow and oxygen consumption were measured using near-infrared spectroscopy at baseline and immediately after isometric handgrip exercises at 10%, 20%, and 40% of the individual maximal voluntary contraction. Unilateral RSI resulted in a lower oxygen consumption and blood flow in the affected forearm at baseline and lower oxygen consumption after incremental handgrip exercises compared to controls (P<.05). In addition, exercise-induced blood flow and oxygen consumption in the nonaffected forearm in patients with RSI were similarly reduced. Blood flow and oxygen consumption after exercise are similarly attenuated in the affected and nonaffected arms of patients with unilateral RSI. Our findings suggest that, despite the unilateral character in clinical symptoms, RSI demonstrates systemic adaptations in forearm blood flow and oxygen consumption at rest and after exercise.
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.
2011, Book (monograph) 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 cliënten 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 cliënten 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.
2022, Article in monograph or in proceedings (Psychological determinants of participation in worksite health promotion programs by blue collar workers within the Transport & Logistics sector)