Facilitators, barriers and support needs for staying at work with a chronic condition: a focus group study

Abstract

Background: Working with a chronic condition can be challenging. Providing support to workers with a chronic condition can help them to stay at work and prevent work-related problems. Workers with a chronic condition who successfully stay at work can provide valuable input for the development of effective supportive interventions to prevent exit from work and facilitate sustainable employment. The aim of this study is to explore the lived experiences of workers with a chronic condition and identify existing barriers, facilitators and possible support needs for staying at work. Methods: Four focus groups were conducted between August and December 2017 with workers with one or more chronic conditions (n = 30). Participants included employees and (partially) self-employed workers. All focus group data were transcribed verbatim and thematically analyzed. Results: Disclosure and expressing one's needs were considered important personal facilitators for staying at work. Environmental facilitators included receiving practical information on working with a chronic condition and social and employer support. Environmental barriers were identified in the work environment, the health care system and service provision, e.g., manager and co-worker's lack of knowledge about working with a chronic condition, a lack of focus on work in the course of treatment for a chronic condition, dissatisfaction with occupational physician support, and the absence of support for self-employed workers. Provided support should be available to all workers, and be proactive and tailored to the workers' specific support needs. Conclusions: A variety of facilitators, barriers and support needs were identified in various domains. By addressing environmental barriers (e.g., by integrating work in the course of treatment and creating supportive work environments), sustainable employment by workers with a chronic condition can be promoted.

Supporting employees with chronic conditions to stay at work: perspectives of occupational health professionals and organizational representatives

“…This endorses the need for creating supportive work environments as found in this study, which is in line with other studies [ 32 – 34 ]. A more pronounced role of the health care sector in preventing work-related problems, as identified in this study, was also mentioned by employees with chronic conditions, and reflects the importance of making work an essential part in the course of treatment [ 6 , 31 ].…”

“…This correlates to two of our earlier studies among employees, which identified disclosure as an important facilitator for staying at work. However, whether employees disclose their chronic condition is very much dependent on the context, being more likely to disclose in a supportive work environment [ 6 , 9 ]. This endorses the need for creating supportive work environments as found in this study, which is in line with other studies [ 32 – 34 ].…”

“…The desire of employees and employers to solve problems on their own, was seen as one of the reasons for this. However, our study among employees also showed dissatisfaction with support offered by OPs, which could also be a contributing factor, as this kept employees from seeking additional support from OPs [ 6 ]. We also found that some organizational representatives appeared ambivalent to refer employees preventively to OPs, which is in line with a study by Paulsson et al, that also showed a lack of use of suggested expertise of occupational health professionals [ 35 ].…”

“…Prior research has identified various factors that facilitate sustainable employment for employees with chronic conditions, including work-related, disease-related and personal factors. Our earlier studies among employees with chronic conditions already showed the importance of disclosure and employees expressing their needs to enable them to stay at work [ 6 ]. Furthermore, various aspects of the work environment contribute to sustainable employment, such as organizational culture, employee-employer relations, company policies and organizational support [ 7 , 8 ].…”

“…Furthermore, various aspects of the work environment contribute to sustainable employment, such as organizational culture, employee-employer relations, company policies and organizational support [ 7 , 8 ]. Organizational support and a supportive work environment enable employees with chronic conditions to talk about their condition and ask for support or accommodations if needed, thereby creating the right circumstances for them to stay at work [ 6 , 9 ]. Therefore, aside from employees with chronic conditions, other stakeholders both within occupational health care and within organizations, can play a role in sustainable employment by providing support to these employees.…”