Work status and work ability of patients receiving kidney replacement therapy: Results from a European survey

BACKGROUND

Employment is important for the quality of life and financial security of patients of working age receiving kidney replacement therapy (KRT). We aimed to examine self-reported work status and general, physical and mental work ability, and to determine associations between demographic, disease-related, work-related, and macro-economic factors and employment. .

METHODS

Europeans from 37 countries, aged 19-65 years, treated with dialysis or kidney transplantation, filled out the web-based or paper-based cross-sectional EDITH kidney patient survey between November 2017 and January 2019. We performed descriptive analyses and multivariable generalized logistic mixed models.

RESULTS

Of the 3 544 patients, 36.5% were employed and working (25.8% of dialysis patients, 53.9% of kidney transplant recipients [KTRs]). Mean general work ability was 5.5 out of 10 (dialysis: 4.8, KTRs: 6.5). Non-working patients (all: 4.1, dialysis: 3.9, KTRs: 4.7) scored lower than working patients (all: 7.7, dialysis 7.3, KTRs: 8.0). Working dialysis patients scored lower on physical and mental work ability (7.1 and 8.1) than working KTRs (8.0 and 8.4, p < 0.001). Impaired physical work ability (42.7%) was more prevalent than impaired mental work ability (26.7%). Male sex, age 40-49 years, higher education, home dialysis or kidney transplantation as current treatment, treatment history including kidney transplantation, absence of diabetes mellitus, better general work ability, and higher country GDP were positively associated with employment (p < 0.05).

CONCLUSIONS

Low employment rates and impaired work ability were prevalent among European patients receiving KRT. Demographic, disease-related, work-related, and macro-economic factors were associated with employment.

Family involvement on nursing wards and the role conflicts experienced by surgical nurses: A multicentre cross-sectional study

OBJECTIVE

To examine among surgical nurses whether work-role conflict, work-role ambiguity, respect, distress and trust in collaboration due to interactions with family caregivers in the nursing ward are associated with the quality of contact with patients and their families.

METHODS

A multicentre cross-sectional study was conducted between January and March 2020. Surgical nurses completed a questionnaire recording work-role conflict, work-role ambiguity, sense of respect, distress, trust in collaboration and quality of contact with patients and their families. Data were analysed using correlation analysis, multiple linear regression analysis and mediation regression analysis.

RESULTS

A total of 135 nurses completed the questionnaire. The correlation analysis showed significant correlations between nurses' impaired quality of contact with patients and their families and nurses' work-role conflicts, work-role ambiguity, trust in collaboration and distress (p < 0.05). The multiple regression analyses corroborated that work-role conflict and distress were significantly and positively associated with impaired quality of contact. Furthermore, mediation regression analysis showed that work-role conflict was associated indirectly and significantly with quality of contact through distress.

CONCLUSION

Work-role conflict due to having family caregivers involved in the care of hospitalised patients is significantly associated with nurses' distress and quality of contact with patients and their families.

SICQ coping and the health-related quality of life and recovery of critically ill ICU patients: A prospective cohort study

Background

The coping styles of the Sickness Insight in Coping Questionnaire (SICQ; positivism, redefinition, toughness, fighting spirit, nonacceptance) may affect the health and recovery of hospitalized critically ill patients.

Research Question

Do the SICQ coping styles of hospitalized critically ill patients relate to the patients health-related quality of life (HRQoL) and recovery?

Study Design and Methods

A prospective cohort study was conducted in a single university-affiliated Dutch hospital. Participants were critically ill adult patients admitted to a mixed medical-surgical ICU (start: n = 417; pre-ICU: n = 391; hospital discharge: n = 350; 3-month follow-up: n = 318; 6-month follow-up: n = 308; 12-month follow-up: n = 285). Coping was recorded with the SICQ pre-ICU and at discharge. HRQoL was measured with the SF-12 pre-ICU, at discharge, and 3, 6, and 12 months after discharge. Indicators of recovery were ICU and hospital length of stay, discharge disposition, and mortality. Correlation and regression analyses were used for data analysis.

Results

Positivism (r = 0.28-0.51), fighting spirit (r = 0.14-0.35), and redefinition (r = 0.12-0.23) associated significantly (P < .05) with mental HRQoL after discharge. Furthermore, positivism associated positively (P < .01) with physical HRQoL (r = 0.17-0.26) after discharge. Increase in positivism (r = 0.13), redefinition (r = 0.13), and toughness (r = 0.13) across the period of hospitalization associated positively (P ≤ .05) with mental HRQoL at discharge. Pre-ICU positivism associated with hospital length of stay (ρ = −.21, P ≤ .05) and hazard for death (HR = 0.57, P < .01) and had a unidirectional effect on mental HRQoL (β = .30, P < .001).

Interpretation

SICQ coping is associated with long-term mental HRQoL, hospital length of stay, and hazard for death among hospitalized critically ill patients.

Proposal to extend the PROMIS® item bank v2.0 'Ability to Participate in Social Roles and Activities': item generation and content validity

PURPOSE

Previous research indicated that the Patient-Reported Outcomes Measurement Information System (PROMIS®) item bank v2.0 'Ability to Participate in Social Roles and Activities' may miss subdomains of social participation. The purpose of this study was to generate items for these missing subdomains and to evaluate their content validity.

METHODS

A three-step approach was followed: (1) Item generation for 16 International Classification of Functioning Disability and Health subdomains currently not covered by the item bank; (2) Evaluation of content validity of generated items through expert review (n = 20) and think-aloud interviews with a purposeful sample of people with and without (chronic) health conditions (n = 10), to assess item comprehensibility, relevance, and comprehensiveness; and 3) Item revision based on the results of step 2, in a consensus procedure.

RESULTS

First, 48 items were generated. Second, overall, content experts indicated that the generated items were relevant. Furthermore, based on experts' responses, items were simplified and 'participation in social media' was identified as an important additional subdomain of social participation. Additionally, 'participating in various social roles simultaneously' was identified as a missing item. Based on the responses of the interviewed adults items were simplified. Third, in total 17 items, covering 17 subdomains, were proposed to be added to the original item bank.

DISCUSSION

The relevance, comprehensibility and comprehensiveness of the 17 proposed items were supported. Whether the proposed extension of the item bank leads to better psychometric properties of the item bank should be tested in a large-scale field study.

The association of subjective fit perceptions, distress, emotional exhaustion, and work engagement, with work functioning problems: A cross-sectional study conducted among young construction project management professionals

OBJECTIVES

To investigate the association of subjective fit perceptions, distress, emotional exhaustion, and work engagement, with work functioning, among young construction project management professionals (CPMPs).

METHODS

The research had a cross-sectional design. Dutch young CPMPs (142 participants, age range: 20 to 30 years of age) completed a questionnaire containing general questions recording their demographic characteristics, and instruments recording the following concepts: perceived person-organization fit, perceived person-job fit (including demands-abilities fit and needs-supplies fit), distress, emotional exhaustion, work engagement, and work functioning. Correlation analysis and multiple regression analysis were used to examine the association of fit perceptions, distress, emotional exhaustion, and work engagement, with work functioning.

RESULTS

The correlation analysis indicated that person-organization fit, needs-supplies fit, distress, emotional exhaustion, and work engagement correlated significantly with work functioning problems of young CPMPs. The multiple regression analyses corroborated that needs-supplies fit, distress, and emotional exhaustion related significantly to the work functioning problems of young CPMPs, with the standardized regression coefficients (β) of -0.28, 0.52, and 0.38 (P < .01), respectively. Other than would be expected, the multiple regression analyses also made clear that work engagement does not significantly relate to work functioning problems beyond distress and emotional exhaustion.

CONCLUSIONS

Incongruence between personal needs and job supplies, psychological distress, and emotional exhaustion are central correlates of the work functioning problems of young CPMPs. Occupational health professionals can use these insights to help young CPMPs at work.

A qualitative study investigating the meaning of participation to improve the measurement of this construct

PURPOSE

The purpose of this study was to improve the measurement of participation. Research questions were as follows: (1) What constitutes participation according to adults? (2) Do they mention participation subdomains that are not covered in the Patient-Reported Outcomes Measurement Information System (PROMIS) item bank "Ability to Participate in Social Roles and Activities"?

METHODS

Semi-structured interviews were conducted with 46 adults from the general population. Interviews were thematically analysed using the International Classification of Functioning, Disability and Health (ICF) as conceptual framework. Thereafter, assigned codes were compared to PROMIS item bank.

RESULTS

Participants mentioned a variety of participation subdomains that were meaningful to them, such as socializing and employment. All subdomains could be classified into the ICF. The following subdomains were not covered by the PROMIS item bank: acquisition of necessities, education life, economic life, community life, and religion and spirituality. Also a distinction between remunerative (i.e. paid) and non-remunerative (i.e. unpaid) employment, and domestic life was missing. Several ICF sub-codes were not mentioned, such as ceremonies.

CONCLUSIONS

Many participation subdomains were mentioned to be meaningful. As several of these subdomains are not covered in the PROMIS item bank, it may benefit from extension with new (patient-)reported subdomains of participation.

Looking Beyond Our Similarities: How Perceived (In)Visible Dissimilarity Relates to Feelings of Inclusion at Work

We investigated how the perception of being dissimilar to others at work relates to employees' felt inclusion, distinguishing between surface-level and deep-level dissimilarity. In addition, we tested the indirect relationships between surface-level and deep-level dissimilarity and work-related outcomes, through social inclusion. Furthermore, we tested the moderating role of a climate for inclusion in the relationship between perceived dissimilarity and felt inclusion. We analyzed survey data from 887 employees of a public service organization. An ANOVA showed that felt inclusion was lower for individuals who perceived themselves as deep-level dissimilar compared to individuals who perceived themselves as similar, while felt inclusion did not differ among individuals who perceived themselves as surface-level similar or dissimilar. Furthermore, a moderated mediation analysis showed a negative conditional indirect relationship between deep-level dissimilarity and work-related outcomes through felt inclusion. Interestingly, while the moderation showed that a positive climate for inclusion buffered the negative relationship between deep-level dissimilarity and felt inclusion, it also positively related to feelings of inclusion among all employees, regardless of their perceived (dis)similarity. This research significantly improves our understanding of how perceived dissimilarity affects employees by distinguishing between surface-level and deep-level dissimilarity and by demonstrating the importance of a climate for inclusion.

An intervention that reduces stress in people who combine work with informal care: randomized controlled trial results

Background

The aim of the research was to examine whether a role-focused self-help course intervention would decrease caregiver stress and distress, and functioning problems, among people who suffer stress because they combine paid work with informal care.

Methods

A pre-registered (NTR 5528) randomized controlled design was applied (intervention vs. wait list control). Participants (n = 128) were people who had paid work and were suffering stress due to their involvement in informal care activities. Participants allocated to the intervention group (n = 65) received the role-focused self-help course. Control group members (n = 63) received this intervention after all measurements. Prior to the random allocation (pre-test), and 1 month (post-test 1) and 2 months (post-test 2) after allocation, all participants completed a questionnaire that measured their caregiver stress (primary outcome), distress, work functioning, negative care-to-work interference and negative care-to-social and personal life interference. Mixed model ANOVAs were used to test the effectiveness of the intervention.

Results

Two months after allocation, the intervention group participants had lower levels of caregiver stress and distress compared with the control group participants. The intervention did not directly resolve impaired work functioning or interference of care with work and social/personal life.

Conclusion

The intervention decreases caregiver stress and distress in people who suffer stress because they combine paid work with informal caring. The intervention (Dutch version) can be downloaded at no cost from www.amc.nl/mantelzorgstress.

Predictive value and construct validity of the work functioning screener-healthcare (WFS-H)

Objectives:

To test the predictive value and convergent construct validity of a 6-item work functioning screener (WFS-H).

Methods:

Healthcare workers (249 nurses) completed a questionnaire containing the work functioning screener (WFS-H) and a work functioning instrument (NWFQ) measuring the following: cognitive aspects of task execution and general incidents, avoidance behavior, conflicts and irritation with colleagues, impaired contact with patients and their family, and level of energy and motivation. Productivity and mental health were also measured. Negative and positive predictive values, AUC values, and sensitivity and specificity were calculated to examine the predictive value of the screener. Correlation analysis was used to examine the construct validity.

Results:

The screener had good predictive value, since the results showed that a negative screener score is a strong indicator of work functioning not hindered by mental health problems (negative predictive values: 94%-98%; positive predictive values: 21%-36%; AUC:.64-.82; sensitivity: 42%-76%; and specificity 85%-87%). The screener has good construct validity due to moderate, but significant (p<.001), associations with productivity (r=.51), mental health (r=.48), and distress (r=.47).

Conclusions:

The screener (WFS-H) had good predictive value and good construct validity. Its score offers occupational health professionals a helpful preliminary insight into the work functioning of healthcare workers.

Measuring Work Functioning: Validity of a Weighted Composite Work Functioning Approach

PURPOSE

To examine the construct validity of a weighted composite work functioning measurement approach.

METHODS

Workers (health-impaired/healthy) (n = 117) completed a composite measure survey that recorded four central work functioning aspects with existing scales: capacity to work, quality of work performance, quantity of work, and recovery from work. Previous derived weights reflecting the relative importance of these aspects of work functioning were used to calculate the composite weighted work functioning score of the workers. Work role functioning, productivity, and quality of life were used for validation. Correlations were calculated and norms applied to examine convergent and divergent construct validity. A t test was conducted and a norm applied to examine discriminative construct validity.

RESULTS

Overall the weighted composite work functioning measure demonstrated construct validity. As predicted, the weighted composite score correlated (p < .001) strongly (r > .60) with work role functioning and productivity (convergent construct validity), and moderately (.30 < r < .60) with physical quality of life and less strongly than work role functioning and productivity with mental quality of life (divergent validity). Further, the weighted composite measure detected that health-impaired workers show with a large effect size (Cohen's d > .80) significantly worse work functioning than healthy workers (discriminative validity).

CONCLUSION

The weighted composite work functioning measurement approach takes into account the relative importance of the different work functioning aspects and demonstrated good convergent, fair divergent, and good discriminative construct validity.

Volunteer leadership: The role of pride and respect in organizational identification and leadership satisfaction

We introduce and test with structural equation modeling an identity-based model of volunteer leadership (Study 1: N = 109 volunteers; Study 2: N = 183 volunteers). Volunteers take pride in the organization, due to leader communication about the effectiveness of the volunteer work and leader prototypicality. Volunteers feel respected by their leaders due to supportive leadership and leader encouragements for expressing ideas within the non-profit organization. These aspects of volunteer leadership relate to identification with the non-profit organization and the satisfaction with the leadership among volunteers, via respectively pride in the non-profit organization and respect from the leadership of the non-profit organization. Implications for leadership and avenues for further research are discussed.

Volunteer recruitment: the role of organizational support and anticipated respect in non-volunteers' attraction to charitable volunteer organizations

In 3 experiments the authors examined how specific characteristics of charitable volunteer organizations contribute to the recruitment of new volunteers. In line with predictions, Study 1 revealed that providing non-volunteers with information about organizational support induced anticipated feelings of respect, which subsequently enhanced their attraction to the volunteer organization. However, information about the current success of the volunteer organization did not affect anticipated pride (as among those who seek paid employment) and in fact caused potential volunteers to perceive the organization as being in less need for additional volunteers. Study 2 further showed that information about support from the volunteer organization is a more relevant source of anticipated respect and organizational attraction than support from co-volunteers. Study 3 finally showed that information about task and emotional support for volunteers contributes to anticipated respect and organizational attractiveness and that this increases the actual willingness of non-volunteers to participate in the volunteer organization. Interventions aimed at attracting volunteers and avenues for further research are discussed.

Volunteering for charity: Pride, respect, and the commitment of volunteers

This study builds upon and extends the social-identity-based model of cooperation with the organization (T. R. Tyler, 1999; T. R. Tyler & S. L. Blader, 2000) to examine commitment and cooperative intent among fundraising volunteers. In Study 1, structural equation modeling indicated that pride and respect related to the intent to remain a volunteer with an organization, and that this relation was mediated primarily by normative organizational commitment. In Study 2, structural equation modeling indicated that the perceived importance of volunteer work was related to pride, that perceived organizational support related to the experience of respect, and that pride and respect mediated the relation between perceived importance and support on the one hand and organizational commitment on the other. Overall, the results suggest that volunteer organizations may do well to implement pride and respect in their volunteer policy, for instance to address the reliability problem (J. L. Pearce, 1993).