Training for Supervisors to Improve Sustainable Employment of Employees with a work Disability: A Longitudinal Effect and Process Evaluation from an Intervention Study with Matched Controls.

PURPOSE: Supervisors play a crucial role in sustainable employment of employees with a work disability. The 'Mentorwijs' (literal translation: Mentorwise) training was developed to train supervisors in knowledge, attitudes and skills needed to guide these employees. This study evaluated the effect of 'Mentorwijs' on employees' employment and supervisors' behavioral outcomes. METHODS: Register- and questionnaire data were obtained from 73 employees and 1,526 matched controls to measure employment (≥ 1/month, ≥ 12 h/week and ≥ 3 consecutive months (≥ 1 h/month)) during a 12-month follow-up period. Questionnaire data were obtained from 127 supervisors who followed the 'Mentorwijs' training, to assess their knowledge, self-efficacy, intention to adopt and applied behaviors. RESULTS: Employment for ≥ 1 h/month did not significantly improve after 3 (ß = 0.05; CI=-0.07-0.16), 6 (ß = 0.07; CI=-0.04-0.18), 9 (ß = 0.08; CI=-0.02-0.18) and 12 (ß = 0.01; CI=-0.08-0.10) months among employees whose supervisors followed 'Mentorwijs' compared to those who did not. Significant effects were found after 8 months (ß = 0.11; CI = 0.01-0.21). Comparable effects were found for employment ≥ 12 hour/week and ≥ 3 consecutive months (≥ 1 hour/month). Supervisors' knowledge and self-efficacy significantly improved as a result of 'Mentorwijs', but no effects were found for intention to adopt and applied behaviors. CONCLUSIONS: 'Mentorwijs' is a promising training to improve the guidance of employees with a work disability. Further research is needed to examine how long-term effects of 'Mentorwijs' on employment can be sustained.

A qualitative study into the perspectives of clients on shared decision-making as a method to support return to work.

BACKGROUND: Being able to participate in work is an important determinant of health. Therefore, reintegration professionals provide support to clients to return to work (RTW). Since RTW has a significant impact on a client's life, it is preferred that clients are involved in the decision-making process of RTW. A method to do so, is shared decision-making (SDM), involving the following steps: collaborating as a team, explaining to clients that they can be part of the decision-making process, setting a shared goal, presenting and discussing choice options, and making a shared decision. OBJECTIVE: We explored how clients experience and prefer these SDM steps in their current and ideal interaction with professionals. METHODS: We performed semi-structured interviews with fourteen clients receiving support in their RTW process from four different municipalities. RESULTS: Clients emphasised the importance of collaborating as team. None of the clients reported having been told that they could be part of the decision-making process, or discussed a shared goal with a professional, which they would prefer. Some clients were presented choice options. When choice options were discussed, frequently only the negative aspects of choice options were explained by the professional. A great number of clients experienced that shared decisions were made, but based this on the shared effort made by the client and professional to RTW. CONCLUSIONS: Clients generally wish to cooperate and participate in the decision-making process, but their ability to do so is limited due to not being fully involved in the SDM steps.

Shared decision making from reintegration professionals' perspectives to support return to work: a qualitative study.

BACKGROUND: Work participation is an important determinant of public health; being unemployed leads to a decrease in an individual's health. In the Netherlands, people with a work disability can apply for disability benefits, in which people also receive support to return to work (RTW). A method, currently used in the medical sector, that can include both the perspective of the reintegration professional and of the individual in the process of RTW, is shared decision making (SDM). In this article we explore to what extent reintegration professionals currently use SDM, and to what extent they prefer to use SDM in their ideal interaction with clients. METHODS: We performed semi-structured interviews with fourteen reintegration professionals from four different municipalities. The transcripts were coded according to content analysis, applying open and axial coding. RESULTS: Reintegration professionals emphasised the importance of having a good relationship with clients, of building trust and collaborating as a team. They did not inform their clients that they could be part of the decision-making process, or discussed a shared goal. Although professionals did emphasise the importance of aligning their approach with the preferences of the client and though they tried to offer some choice options, they did not mention available options, discussed the pros and cons of these options or evaluated decisions with their clients. Furthermore, they did not mention any of these aspects in their ideal interaction with clients. CONCLUSIONS: SDM has a potential value, because all professionals underline the importance of having an alliance with clients, collaborating as a team, and striving to align their approach with the preferences of the client. However, professionals currently perform a limited set of SDM steps. Additional knowledge and skills are needed for both reintegration professionals and municipalities so that professionals can consider and reflect on the value of using SDM, or SDM steps, in supporting RTW. Providing clients with knowledge and skills seems necessary to facilitate both self-management and SDM.