PurposeThe purpose of this review was to search systematically for disease-generic factors associated with either work retention (WR) or return to work (RTW) in people of working age with a chronic disease.MethodsAn extensive search was performed in PubMed, EMBASE, PsycINFO and CINAHL for English-, Dutch- and German-language studies searching on synonyms of the terms chronic disease, WR and RTW. Studies were selected if they described factors related to WR or RTW and included participants with a chronic disease of working age (15–67 years old).ResultsFrom 2597 hits in the electronic databases, we identified six studies reporting 23 factors associated with work participation. Categorized according to the International Classification of Functioning, Disability and Health, health-related factors (comorbidity, duration of symptoms and less dysfunction), environmental factors (work environment and duration of absence) and personal factors (age, gender, education and own prediction of RTW) were identified.ConclusionsVarious disease-generic factors are associated with work participation, of which most of the reported factors are independent of diagnosis. Evidence of the retrieved factors is restricted due to the limited availability of studies focusing on disease-generic factors and overall low quality of the retrieved studies.

The aim of this systematic review was to provide an overview of the available effective interventions that enhance work participation of people with a chronic disease, irrespective of their diagnosis. A search was conducted in PubMed, EMBASE, PsycINFO, CINAHL and the Cochrane Library, searching for systematic reviews published between 2004 and February 2015. Systematic reviews were eligible for inclusion if they described an intervention aimed at enhancing work participation and included participants of working age (18-65 years) with a chronic disease. Reviews had to include populations having different chronic diseases. The quality of the included reviews was evaluated using the quality instrument AMSTAR. Results of reviews of medium and high quality were described in this review. The search resulted in 9 reviews, 5 of which were of medium quality. No high quality reviews were retrieved. 1 review reported inconclusive evidence for policy-based return to work initiatives. The 4 other reviews described interventions focused on changes at work, such as changes in work organisation, working conditions and work environment. Of these 4 reviews, 3 reported beneficial effects of the intervention on work participation. Interventions examined in populations having different chronic diseases were mainly focused on changes at work. The majority of the included interventions were reported to be effective in enhancing work participation of people with a chronic disease, indicating that interventions directed at work could be considered for a generic approach in order to enhance work participation in various chronic diseases.

Purpose To explore solutions that people with a chronic disease use to overcome difficulties they experience regarding participating in work, and the support they require to identify or implement these solutions. Methods Focus groups were held to explore solutions and support requirements of people with a chronic disease. Participants were recruited through a research institution’s patient panel, a patient federation and personal networks. Analysis was conducted by means of open and selective coding, using the MAXQDA software package. Results Five focus groups were held with 19 participants with different chronic diseases. Solutions that were identified included learning to accept and cope with the disease, which is frequently supported by family and friends. Disclosing the disease to employers and colleagues, identifying active ways to help with duties, and implementing adaptations to the work environment were all effective solutions with the help, empathy and understanding of people in the work environment. Solutions mostly supported by patient associations included providing sufficient information about the disease, relevant help and protective legal regulations regarding work participation. Finally, health professionals could support solutions such as incorporating periods of rest, promoting self-efficacy and gaining insight into an individual’s ability to participate in work. Conclusions People with a chronic disease suggested various solutions that can help overcome difficulties surrounding participating in work. Support from friends and family, patient associations, employers, colleagues and occupational health professionals is needed to help identify and implement suitable solutions.