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Healthy Workplaces, Employment and Chronic Conditions in Europe: Answering the Hidden Emergency with Innovative Strategies

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (28 February 2018) | Viewed by 48428

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Special Issue Editors

Dr. Matilde Leonardi

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Neurological Institute Carlo Besta, Milan, Italy
Interests: burden; disability; functioning; headache; neurological disorders
Special Issues, Collections and Topics in MDPI journals

Priv.-Doz. Dr. Carla Sabariego

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Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Chair for Public Health und Health Services Research, Ludwig-Maximilians-Universität (LMU) München, Marchioninistr. 17, 81377 Munich, Germany
Interests: international classification of functioning, disability and health (icf); public health and public mental health; disability; health and disability surveys; health economics
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Anastasia Vlachou

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Department of Special Education (SED), University of Thessaly, Argonafton and Filellinon Str., 382-21 Volos, Greece

Special Issue Information

Dear Colleagues,

We are organizing a Special Issue in the International Journal of Environmental Research and Public Health on the development of innovative approaches to promote the professional integration and reintegration of people with chronic diseases and improve their employability.

Individuals with chronic diseases, defined by WHO as diseases of long duration and generally slow progression that are not passed from person to person, often experience work-related problems, such as unemployment, absenteeism, reduced productivity and stigmatization in the workplace, leading to negative consequences at individual, national and European level. The rising prevalence of chronic diseases, as well as the current international economic crisis, make this issue even more problematic, requiring action in terms of innovative strategies to improve the participation of these persons in the labor market. Unfortunately, this is hindered by a lack of knowledge of which strategies are available in the different countries and their effectiveness, and a lack of clarity regarding the employment-related needs of these individuals, leading to gaps between what is offered and what is needed.

The question why people with chronic diseases experience difficulties is crucial to plan strategies and interventions to increase their participation in the labor force. This question was addressed in studies showing that employment problems among chronically ill persons are not only impairment-related, but also connected to socio-demographic and psychological factors, attitudes and beliefs, disclosure, job demands, organizational factors and macro-economic factors. Despite the evidence on the substantial negative impact of chronic diseases on employment, the framework of employment needs of people with chronic diseases is not always clear. It is also necessary to highlight the advantages and gains for society to keep ageing workers with NCDs (non-communicable chronic diseases) into the labor sector as long as possible: Expertise is kept in the work sector, pension systems gain, families are less poor. The EU Pathways project has been analyzing European situation and is proposing strategies to overcome the hidden emergency of employment and chronic conditions. The recommendations will be useful for defining implementation strategies in the coming Joint Action Chrodis Plus.

This Special Issue is open to any subject area related to chronic diseases and employment. The listed keywords suggest just a few of the many possibilities.

Dr. Matilde Leonardi
Dr. Carla Sabariego
Prof. Anastasia Vlachou
Guest Editors

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

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Keywords

Chronic diseases
Employment
Prevention
Policies
Systems
Services
Welfare models
Effectiveness of strategies
NCD Patients’ needs
Policy guidelines
Social research
Healthy workplace
Professional integration and reintegration
Work-related problems
Successful employment strategies

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Published Papers (9 papers)

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Editorial

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6 pages, 613 KiB

Open AccessEditorial

Employment and People with Non Communicable Chronic Diseases: PATHWAYS Recommendations and Suggested Actions for Implementing an Inclusive Labour Market for All and Health in All Sectors

by Matilde Leonardi and Chiara Scaratti

Int. J. Environ. Res. Public Health 2018, 15(8), 1674; https://doi.org/10.3390/ijerph15081674 - 7 Aug 2018

Cited by 8 | Viewed by 2827

Abstract

n/a Full article

(This article belongs to the Special Issue Healthy Workplaces, Employment and Chronic Conditions in Europe: Answering the Hidden Emergency with Innovative Strategies)

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Research

Jump to: Editorial, Review

18 pages, 1777 KiB

Open AccessFeature PaperArticle

Research Project Evaluation—Learnings from the PATHWAYS Project Experience

by Aleksander Galas, Aleksandra Pilat, Matilde Leonardi and Beata Tobiasz-Adamczyk

Int. J. Environ. Res. Public Health 2018, 15(6), 1071; https://doi.org/10.3390/ijerph15061071 - 25 May 2018

Cited by 5 | Viewed by 6293

Abstract

Background: Every research project faces challenges regarding how to achieve its goals in a timely and effective manner. The purpose of this paper is to present a project evaluation methodology gathered during the implementation of the Participation to Healthy Workplaces and Inclusive Strategies in the Work Sector (the EU PATHWAYS Project). The PATHWAYS project involved multiple countries and multi-cultural aspects of re/integrating chronically ill patients into labor markets in different countries. This paper describes key project’s evaluation issues including: (1) purposes, (2) advisability, (3) tools, (4) implementation, and (5) possible benefits and presents the advantages of a continuous monitoring. Methods: Project evaluation tool to assess structure and resources, process, management and communication, achievements, and outcomes. The project used a mixed evaluation approach and included Strengths (S), Weaknesses (W), Opportunities (O), and Threats (SWOT) analysis. Results: A methodology for longitudinal EU projects’ evaluation is described. The evaluation process allowed to highlight strengths and weaknesses and highlighted good coordination and communication between project partners as well as some key issues such as: the need for a shared glossary covering areas investigated by the project, problematic issues related to the involvement of stakeholders from outside the project, and issues with timing. Numerical SWOT analysis showed improvement in project performance over time. The proportion of participating project partners in the evaluation varied from 100% to 83.3%. Conclusions: There is a need for the implementation of a structured evaluation process in multidisciplinary projects involving different stakeholders in diverse socio-environmental and political conditions. Based on the PATHWAYS experience, a clear monitoring methodology is suggested as essential in every multidisciplinary research projects. Full article

(This article belongs to the Special Issue Healthy Workplaces, Employment and Chronic Conditions in Europe: Answering the Hidden Emergency with Innovative Strategies)

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28 pages, 736 KiB

Open AccessArticle

Views and Experiences of Persons with Chronic Diseases about Strategies that Aim to Integrate and Re-Integrate Them into Work: A Systematic Review of Qualitative Studies

by Eva Esteban, Michaela Coenen, Elizabeth Ito, Sonja Gruber, Chiara Scaratti, Matilde Leonardi, Olga Roka, Evdokia Vasilou, Amalia Muñoz-Murillo, Carolina C. Ávila, Dare S. Kovačič, Ivana Ivandic and Carla Sabariego

Int. J. Environ. Res. Public Health 2018, 15(5), 1022; https://doi.org/10.3390/ijerph15051022 - 18 May 2018

Cited by 20 | Viewed by 5411

Abstract

The effectiveness of strategies targeting professional integration and reintegration strongly depends on the experiences of participants. The aim of this systematic literature review is to synthesize European qualitative studies exploring views and experiences of persons with chronic conditions regarding strategies for integration and reintegration into work. The systematic search was conducted in Medline, PsycINFO, CDR-HTA, CDR-DARE and Cochrane Systematic Reviews. Overall, 24 studies published in English between January 2011 and April 2016 were included. Most studies were carried out in Nordic countries or in the UK, and most participants were persons with either mental or musculoskeletal disorders. Ten themes emerged: individual and holistic approach, clarity of strategy and processes, timing of rehabilitation processes, experience with professionals, at the workplace and with peer groups, changes in the understanding of health and work, active involvement in the process, competencies development and motivating aspects of work. Findings highlight, among others, the need to actively involve participants in the return to work process and to provide timely and clearly structured processes and interventions. This review provides stakeholders key information to develop, plan, implement and evaluate interventions to integrate and re-integrate persons with chronic conditions into work in Europe. Full article

(This article belongs to the Special Issue Healthy Workplaces, Employment and Chronic Conditions in Europe: Answering the Hidden Emergency with Innovative Strategies)

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20 pages, 374 KiB

Open AccessArticle

Mapping European Welfare Models: State of the Art of Strategies for Professional Integration and Reintegration of Persons with Chronic Diseases

by Chiara Scaratti, Matilde Leonardi, Fabiola Silvaggi, Carolina C. Ávila, Amalia Muñoz-Murillo, Panayiota Stavroussi, Olga Roka, Helena Burger, Klemens Fheodoroff, Beata Tobiasz-Adamczyk, Carla Sabariego, Eva Esteban, Sonja Gruber, Olga Svestkova, Rune Halvorsen, Asel Kadyrbaeva and Sabrina Ferraina

Int. J. Environ. Res. Public Health 2018, 15(4), 781; https://doi.org/10.3390/ijerph15040781 - 17 Apr 2018

Cited by 24 | Viewed by 4860

Abstract

Background: Persons with chronic diseases (PwCDs) often experience work-related problems, and innovative actions to improve their participation in the labor market are needed. In the frame of the European (EU) Pathways Project, the aim of the study is to compare existing strategies (policies, systems, and services) for professional (re-)integration of PwCDs and mental health conditions available at both European and national level between different European welfare models: Scandinavian, Continental, Anglo-Saxon, Mediterranean, and “Post-Communist”. Method: The European strategies were identified by an overview of relevant academic and grey literature searched through Medline and internet searches, while national strategies were explored through questionnaires and in-depth interviews with national relevant stakeholders. Results: The mapping of existing strategies revealed that, both at European and national level, PwCDs are often considered as part of the group of “persons with disabilities” and only in this case they can receive employment support. European countries put in place actions to support greater labor market participation, but these differ from country to country. Conclusion: Strategies targeting “persons with disabilities” do not necessarily address all the needs of persons with chronic diseases. Countries should consider the importance of employment for all to achieve smart, sustainable, and inclusive growth. Full article

(This article belongs to the Special Issue Healthy Workplaces, Employment and Chronic Conditions in Europe: Answering the Hidden Emergency with Innovative Strategies)

21 pages, 673 KiB

Open AccessArticle

by Matilde Leonardi, Davide Guido, Rui Quintas, Fabiola Silvaggi, Erika Guastafierro, Andrea Martinuzzi, Somnath Chatterji, Seppo Koskinen, Beata Tobiasz-Adamczyk, Josep Maria Haro, Maria Cabello and Alberto Raggi

Int. J. Environ. Res. Public Health 2018, 15(4), 722; https://doi.org/10.3390/ijerph15040722 - 11 Apr 2018

Cited by 14 | Viewed by 7090

Abstract

Background: Research addressing the impact of a large number of factors on unemployment is scarce. We aimed to comprehensively identify factors related to unemployment in a sample of persons aged 18–64 from Finland, Poland and Spain. Methods: In this cross-sectional study, factors from different areas were considered: socio-demographic indicators, health habits, chronic conditions, health state markers, vision and hearing indicators, and social networks and built environment scores. Results: Complete data were available for 5003 participants, mean age 48.1 (SD 11.5), 45.4% males. The most important factors connected to unemployment were health status indicators such as physical disability (OR = 2.944), self-rated health (OR = 2.629), inpatient care (OR = 1.980), and difficulties with getting to the toilet (OR = 2.040), while the most relevant factor related to employment were moderate alcohol consumption (OR = 0.732 for non-heavy drinkers; OR = 0.573 for infrequent heavy drinkers), and being married (OR = 0.734), or having been married (OR = 0.584). Other factors that played a significant role included presence of depression (OR = 1.384) and difficulties with near vision (OR = 1.584) and conversation hearing (OR = 1.597). Conclusions: Our results highlight the importance of selected factors related to unemployment, and suggest public health indications that could support concrete actions on modifiable factors, such as those aimed to promote physical activity and healthy behaviors, tackling depression or promoting education, in particular for the younger. Full article

(This article belongs to the Special Issue Healthy Workplaces, Employment and Chronic Conditions in Europe: Answering the Hidden Emergency with Innovative Strategies)

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17 pages, 4899 KiB

Open AccessArticle

What Persons with Chronic Health Conditions Need to Maintain or Return to Work—Results of an Online-Survey in Seven European Countries

by Nicole Foitzek, Carolina C. Ávila, Ivana Ivandic, Črtomir Bitenc, Maria Cabello, Sonja Gruber, Matilde Leonardi, Amalia Muñoz-Murillo, Chiara Scaratti, Beata Tobiasz-Adamczyk, Anastasia Vlachou, Eva Esteban, Carla Sabariego and Michaela Coenen

Int. J. Environ. Res. Public Health 2018, 15(4), 595; https://doi.org/10.3390/ijerph15040595 - 26 Mar 2018

Cited by 17 | Viewed by 5293

Abstract

Chronic health conditions represent the major share of the disease burden in Europe and have a significant impact on work. This study aims to: (1) identify factors that have a negative or positive impact on the work lives of persons with chronic health conditions; (2) explore the needs of these persons to maintain a job or return to work and (3) compare these results with respect to these persons’ occupational status. An online survey was performed in seven European countries. Open-ended survey questions were analyzed using qualitative methods. In total, 487 participants with six chronic health conditions participated. The majority of participants named work-related aspects (such as career development, stress at the workplace, work structure and schedule as well as workload), support of others and attitudes of others as being the factors positively and negatively impact their work lives the most. Our study shed light on the importance of changing the attitudes of supervisors and co-workers to counteract stigmatization of persons with chronic health conditions in the workplace. In conclusion, this study provides a basis for developing new strategies of integration and reintegration at work for persons with chronic health conditions in European countries. Full article

(This article belongs to the Special Issue Healthy Workplaces, Employment and Chronic Conditions in Europe: Answering the Hidden Emergency with Innovative Strategies)

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19 pages, 1557 KiB

Open AccessArticle

Policy Guidelines for Effective Inclusion and Reintegration of People with Chronic Diseases in the Workplace: National and European Perspectives

by Anastasia Vlachou, Panayiota Stavroussi, Olga Roka, Evdokia Vasilou, Dimitra Papadimitriou, Chiara Scaratti, Asel Kadyrbaeva, Klemens Fheodoroff, Valentina Brecelj, Olga Svestkova, Beata Tobiasz-Adamczyk, Jon Erik Finnvold, Sonja Gruber and Matilde Leonardi

Int. J. Environ. Res. Public Health 2018, 15(3), 493; https://doi.org/10.3390/ijerph15030493 - 11 Mar 2018

Cited by 12 | Viewed by 4820

Abstract

The increasing prevalence of chronic diseases among the European working age population, as well as the implications for the individual and societal level, underline the need for policy guidelines targeting the effective inclusion of persons with chronic diseases in the workplace. The aim of the present paper was to explore the perspectives of European and National-level stakeholders on existing strategies for work re-integration of persons with chronic diseases, and to provide policy guidelines. A highly-structured interview protocol was distributed to 58 National level stakeholders (policy makers, professionals and employers) from seven European countries. Additionally, 20 European organizations concerned with health-related issues and employment completed an online survey. The findings reveal that employment-related challenges remain largely unaddressed. Both national and European stakeholders considered the existing legislative frameworks inadequate and appraised the co-ordination for the implementation of employment re-integration policies as ineffective. Policies targeting at work re-integration of persons with chronic diseases at European and national level should focus on consistent cooperation among all key stakeholders, awareness raising to staff and management, dissemination of effective strategies, developing research and evaluation standards and establishing monitoring systems on inclusive labour markets. Full article

(This article belongs to the Special Issue Healthy Workplaces, Employment and Chronic Conditions in Europe: Answering the Hidden Emergency with Innovative Strategies)

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Review

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19 pages, 817 KiB

Open AccessReview

Furthering the Evidence of the Effectiveness of Employment Strategies for People with Mental Disorders in Europe: A Systematic Review

by Amalia Muñoz-Murillo, Eva Esteban, Carolina C. Ávila, Klemens Fheodoroff, Josep Maria Haro, Matilde Leonardi and Beatriz Olaya

Int. J. Environ. Res. Public Health 2018, 15(5), 838; https://doi.org/10.3390/ijerph15050838 - 24 Apr 2018

Cited by 10 | Viewed by 4607

Abstract

(1) Purpose: This systematic review aims to assess the effectiveness of strategies used in the professional (re)integration of persons with mental disorders (MD) in European countries; (2) Methods: We conducted a search for scientific publications available in relevant electronic databases (Medline, PsycINFO, CDR-HTA, CDR-DARE, and Cochrane Library). The present study collected evidence on the effectiveness, from 2011 to 2016, of employment strategies for persons with MDs; (3) Results: A total of 18 studies were included, representing 5216 participants (aged 18–65, mean age of 38.5 years old) from 7 countries. Job access programs demonstrated effectiveness in four out of six studies. Return to work (RTW) interventions showed significant positive results in two studies, while four studies did not refer to effectiveness. There were inconsistent results in another four studies; (4) Conclusions: Our findings highlight the complexities of the implementation of employment strategies (job access and return to work). Job access strategies seem to improve employment outcomes. The effectiveness of return to work strategies remains unclear. The involvement and commitment of physicians, employment specialists, and employers, and employees capacity for self-care seem decisive for employment re-integration success. Further analyses are needed to assess the cost-effectiveness of these interventions and corroborate our results, with longer follow-ups. Full article

(This article belongs to the Special Issue Healthy Workplaces, Employment and Chronic Conditions in Europe: Answering the Hidden Emergency with Innovative Strategies)

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34 pages, 596 KiB

Open AccessReview

Effectiveness of Integration and Re-Integration into Work Strategies for Persons with Chronic Conditions: A Systematic Review of European Strategies

by Carla Sabariego, Michaela Coenen, Elizabeth Ito, Klemens Fheodoroff, Chiara Scaratti, Matilde Leonardi, Anastasia Vlachou, Panayiota Stavroussi, Valentina Brecelj, Dare S. Kovačič and Eva Esteban

Int. J. Environ. Res. Public Health 2018, 15(3), 552; https://doi.org/10.3390/ijerph15030552 - 19 Mar 2018

Cited by 25 | Viewed by 6198

Abstract

Due to low employment rates associated to chronic conditions in Europe, it is essential to foster effective integration and re-integration into work strategies. The objective of this systematic review is to summarize the evidence on the effectiveness of strategies for integration and re-integration to work for persons with chronic diseases or with musculoskeletal disorders, implemented in Europe in the past five years. A systematic search was conducted in MedLine, PsycINFO, CDR-HTA, CDR-DARE and Cochrane Systematic Reviews. Overall, 32 relevant publications were identified. Of these, 21 were considered eligible after a methodological assessment and included. Positive changes in employment status, return to work and sick leave outcomes were achieved with graded sickness-absence certificates, part-time sick leave, early ergonomic interventions for back pain, disability evaluation followed by information and advice, and with multidisciplinary, coordinated and tailored return to work interventions. Additionally, a positive association between the co-existence of active labour market policies to promote employment and passive support measures (e.g., pensions or benefits) and the probability of finding a job was observed. Research on the evaluation of the effectiveness of strategies targeting integration and re-integration into work for persons with chronic health conditions needs, however, to be improved and strengthened. Full article

(This article belongs to the Special Issue Healthy Workplaces, Employment and Chronic Conditions in Europe: Answering the Hidden Emergency with Innovative Strategies)

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