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Workers with a chronic disease and work disability

Problems and solutions
Leitthema

Abstract

The prevalence of chronic diseases in the age group 18–65 years is high. Cardiometabolic conditions and musculoskeletal diseases are the most frequent chronic diseases. Depending on disease and comorbidity, the employment rates are considerably lower than for healthy individuals. Chronically ill workers may have problems in meeting job demands, they may experience physical, cognitive or sensory limitations, have fatigue or pain complaints or other disease symptoms. Psychological distress, depressive feelings, feelings of shame or guilt, lack of coping or communicative skills, and non-supportive colleagues and supervisors may add to work-related problems. The ICF Model (International Classification of Functioning, Disability and Health) of the WHO offers a framework for understanding and considering health-related problems at work and finding solutions. Interventions to prevent problems in functioning, sickness absence and work disability may focus on the worker, the workplace, or health care. Multidisciplinary vocational rehabilitation, exercise therapy, cognitive behavioural interventions, workplace interventions and empowerment are interventions with at least some evidence of effectiveness. Future policy could focus more on promotion of workers’ health and future research should include the interests and motivations of employers concerning disability management, skills of line managers, the feasibility of interventions to prevent work disability and the context sensitivity of study outcomes.

Keywords

Chronic disease Work-related problems Work disability Vocational rehabilitation Occupational health 

Chronisch Kranke im Erwerbsleben

Probleme und Lösungen

Zusammenfassung

Die Prävalenz chronischer Erkrankungen in der Altersgruppe der 18- bis 65-Jährigen ist hoch. Am häufigsten treten kardiometabolische Störungen und muskuloskeletale Krankheiten auf. In Abhängigkeit von der Erkrankung und Komorbidität liegen die Beschäftigungsraten verglichen mit gesunden Personen wesentlich niedriger. Chronisch kranken Beschäftigten kann es schwer fallen, den beruflichen Anforderungen gerecht zu werden. Sie können physisch, kognitiv und sensorisch eingeschränkt sein sowie an Erschöpfung, Schmerzen oder anderen Krankheitssymptomen leiden. Psychische Belastung, depressive Verstimmungen, Scham- und Schuldgefühle, fehlende Coping- und Kommunikationsfähigkeiten wie auch mangelnde Unterstützung durch Kollegen und Vorgesetzte können die Arbeitsprobleme noch verstärken. Die International Classification of Functioning, Disability and Health (ICF) der Weltgesundheitsorganisation (WHO) bietet einen Rahmen für das Verständnis, die Berücksichtigung und die Lösung gesundheitsbedingter Probleme am Arbeitsplatz. Maßnahmen zur Prävention von Beeinträchtigungen der Funktionsfähigkeit, krankheitsbedingten Fehlzeiten und Arbeitsunfähigkeit können auf den Beschäftigten, den Arbeitsplatz oder die Gesundheitsversorgung zielen. Multidisziplinäre berufliche Rehabilitation, Bewegungstherapie, kognitive Verhaltenstherapie, Interventionen am Arbeitsplatz und Empowerment sind Maßnahmen, für deren Wirksamkeit es zumindest einige Anhaltspunkte gibt. Zukünftige Strategien könnten schwerpunktmäßig die Gesundheit der Beschäftigten fördern. In kommende Untersuchungen sollten die Belange und Motivationen von Arbeitgebern hinsichtlich der betrieblichen Wiedereingliederung („disability management“) einbezogen werden. Auch die Fähigkeiten der Vorgesetzten, die Machbarkeit von Maßnahmen zur Prävention der Arbeitsunfähigkeit und die Kontextsensitivität der Studienergebnisse gilt es zu berücksichtigen.

Schlüsselwörter

Chronische Erkrankungen Arbeitsprobleme Arbeitsunfähigkeit Berufliche Rehabilitation Arbeitsmedizin 

Notes

Conflict of interest

On behalf of all authors, the corresponding author states that there are no conflicts of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.Varekamp Onderzoek & AdviesAmsterdamThe Netherlands
  2. 2.Coronel Institute of Occupational Health, Academic Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands
  3. 3.Robert Koch InstituteBerlinGermany

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