Associations between depressive complaints and indicators of labour participation among older Dutch employees: a prospective cohort study.

PURPOSE: European policy measures have led to an increased net labour participation of older employees. Yet, via different routes (for instance disability schemes) employees still often leave the labour market early. Mental health may be an important factor hindering labour participation. Aims of this study are twofold: first, to examine the relationship between mental health-particularly depressive complaints-and indicators of labour participation among older employees over a 2-year follow-up period and second, to explore the impact of different work contexts when studying this relation. METHODS: A subsample of older employees (aged > 45 years; n = 1253) from the Maastricht Cohort Study was studied. Depressive complaints were assessed using the Hospital Anxiety and Depression scale. Logistic and Cox regression analyses covered 2 years of follow-up and were also stratified for relevant work-related factors. RESULTS: Employees with mild depressive complaints showed statistically significantly higher risks for poor mental workability (HR 2.60, 95% CI 1.14-5.92) and high psychological disengagement levels (HR 2.35, 95% CI 1.21-4.57) over time compared to employees without depressive complaints. Within various work contexts, for instance in which employees perform physically demanding work or have high psychological job demands, significantly stronger associations were found between depressive complaints and poor mental workability over time. CONCLUSIONS: This study shows strong longitudinal associations between depressive complaints and indicators of labour participation, also within different work contexts over time. Results provide valuable input for developing preventive measure aiming to enhance sustainable labour participation of older employees.

fMRI network correlates of predisposing risk factors for delirium: A cross-sectional study.

Delirium, the clinical expression of acute encephalopathy, is a common neuropsychiatric syndrome that is related to poor outcomes, such as long-term cognitive impairment. Disturbances of functional brain networks are hypothesized to predispose for delirium. The aim of this study in non-delirious elderly individuals was to investigate whether predisposing risk factors for delirium are associated with fMRI network characteristics that have been observed during delirium. As predisposing risk factors, we studied age, alcohol misuse, cognitive impairment, depression, functional impairment, history of transient ischemic attack or stroke, and physical status. In this multicenter study, we included 554 subjects and analyzed resting-state fMRI data from 222 elderly subjects (63% male, age range: 65-85 year) after rigorous motion correction. Functional network characteristics were analyzed and based on the minimum spanning tree (MST). Global functional connectivity strength, network efficiency (MST diameter) and network integration (MST leaf fraction) were analyzed, as these measures were altered during delirium in previous studies. Linear regression analyses were used to investigate the relation between predisposing delirium risk factors and delirium-related fMRI characteristics, adjusted for confounding and multiple testing. Predisposing risk factors for delirium were not associated with delirium-related fMRI network characteristics. Older age within our elderly cohort was related to global functional connectivity strength (ß = 0.182, p < 0.05), but in the opposite direction than hypothesized. Delirium-related functional network impairments can therefore not be considered as the common mechanism for predisposition for delirium.

Longitudinal associations of light-intensity physical activity with quality of life, functioning and fatigue after colorectal cancer.

PURPOSE: Evidence from cross-sectional studies suggests that higher levels of light-intensity physical activity (LPA) are associated with better health-related quality of life (HRQoL) in colorectal cancer (CRC) survivors. However, these associations have not been investigated in longitudinal studies that provide the opportunity to analyse how within-individual changes in LPA affect HRQoL. We investigated longitudinal associations of LPA with HRQoL outcomes in CRC survivors, from 6 weeks to 2 years post-treatment. METHODS: Data were used of a prospective cohort study among 325 stage I-III CRC survivors (67% men, mean age: 67 years), recruited between 2012 and 2016. Validated questionnaires were used to assess hours/week of LPA (SQUASH) and HRQoL outcomes (EORTC QLQ-C30, Checklist Individual Strength) at 6 weeks, and 6, 12 and 24 months post-treatment. We applied linear mixed regression to analyse longitudinal confounder-adjusted associations of LPA with HRQoL. RESULTS: We observed statistically significant longitudinal associations between more LPA and better global quality of life and physical, role and social functioning, and less fatigue over time. Intra-individual analysis showed that within-person increases in LPA (per 8 h/week) were related to improved HRQoL, including better global quality of life (ß = 1.67, 95% CI 0.71; 2.63; total range scale: 0-100) and less fatigue (ß = - 1.22, 95% CI - 2.37; - 0.07; scale: 20-140). Stratified analyses indicated stronger associations among participants below the median of moderate-to-vigorous physical activity (MVPA) at diagnosis. CONCLUSION: Higher levels of LPA were longitudinally associated with better HRQoL and less fatigue in CRC survivors up to two years post-treatment. Further prospective studies using accelerometer data are necessary to inform development of interventions targeting LPA.

Predisposition for delirium and EEG characteristics.

OBJECTIVE: Delirium is associated with increased electroencephalography (EEG) delta activity, decreased connectivity strength and decreased network integration. To improve our understanding of development of delirium, we studied whether non-delirious individuals with a predisposition for delirium also show these EEG abnormalities. METHODS: Elderly subjects (N = 206) underwent resting-state EEG measurements and were assessed on predisposing delirium risk factors, i.e. older age, alcohol misuse, cognitive impairment, depression, functional impairment, history of stroke and physical status. Delirium-related EEG characteristics of interest were relative delta power, alpha connectivity strength (phase lag index) and network integration (minimum spanning tree leaf fraction). Linear regression analyses were used to investigate the relation between predisposing delirium risk factors and EEG characteristics that are associated with delirium, adjusting for confounding and multiple testing. RESULTS: Functional impairment was related to a decrease in connectivity strength (adjusted R2 = 0.071, ß = 0.201, p < 0.05). None of the other risk factors had significant influence on EEG delta power, connectivity strength or network integration. CONCLUSIONS: Functional impairment seems to be associated with decreased alpha connectivity strength. Other predisposing risk factors for delirium had no effect on the studied EEG characteristics. SIGNIFICANCE: Predisposition for delirium is not consistently related to EEG characteristics that can be found during delirium.

Development and internal validation of prediction models for colorectal cancer survivors to estimate the 1-year risk of low health-related quality of life in multiple domains.

BACKGROUND: Many colorectal cancer (CRC) survivors experience persisting health problems post-treatment that compromise their health-related quality of life (HRQoL). Prediction models are useful tools for identifying survivors at risk of low HRQoL in the future and for taking preventive action. Therefore, we developed prediction models for CRC survivors to estimate the 1-year risk of low HRQoL in multiple domains. METHODS: In 1458 CRC survivors, seven HRQoL domains (EORTC QLQ-C30: global QoL; cognitive, emotional, physical, role, social functioning; fatigue) were measured prospectively at study baseline and 1 year later. For each HRQoL domain, scores at 1-year follow-up were dichotomized into low versus normal/high. Separate multivariable logistic prediction models including biopsychosocial predictors measured at baseline were developed for the seven HRQoL domains, and internally validated using bootstrapping. RESULTS: Average time since diagnosis was 5 years at study baseline. Prediction models included both non-modifiable predictors (age, sex, socio-economic status, time since diagnosis, tumor stage, chemotherapy, radiotherapy, stoma, micturition, chemotherapy-related, stoma-related and gastrointestinal complaints, comorbidities, social inhibition/negative affectivity, and working status) and modifiable predictors (body mass index, physical activity, smoking, meat consumption, anxiety/depression, pain, and baseline fatigue and HRQoL scores). Internally validated models showed good calibration and discrimination (AUCs: 0.83-0.93). CONCLUSIONS: The prediction models performed well for estimating 1-year risk of low HRQoL in seven domains. External validation is needed before models can be applied in practice.

Need for recovery and different types of early labour force exit: a prospective cohort study among older workers.

PURPOSE: This study examines the relationship between need for recovery (NFR) and labour force exit (LFE) among older workers. Different types of LFE (early retirement, work disability and unemployment) are considered, and the role of potential confounding and modifying factors, including the availability of early LFE schemes, is examined. Also, associations between NFR and the intention and ability to prolong one's working life, which are known determinants of LFE, are assessed. METHODS: A subsample of older workers from the Maastricht Cohort Study was examined (n = 2312). The relationship between NFR and LFE was investigated by means of Cox regression analyses. Logistic regression analyses were performed to investigate cross-sectional associations between NFR and the intention and ability to prolong working life. RESULTS: Elevated NFR was associated with a higher risk of overall LFE during a 4-year follow-up period (HR 1.39, 95% CI 1.09-1.78), and specifically with a higher risk of leaving the labour force through early retirement and work disability. When early retirement schemes were available, strong and significant associations between NFR and LFE were observed (HR 2.79, 95% CI 1.29-6.02), whereas no significant associations were found when such schemes were unavailable. Older workers with a higher NFR also had earlier retirement intentions and lower self-assessed abilities (both physical and mental) to prolong their working life until the mandatory retirement age. CONCLUSIONS: Because this study shows that NFR is a precursor of LFE among older workers, monitoring NFR is important for timely interventions aimed at reducing NFR to facilitate extended labour participation.

Personalized risk prediction of postoperative cognitive impairment - rationale for the EU-funded BioCog project.

Postoperative cognitive impairment is among the most common medical complications associated with surgical interventions - particularly in elderly patients. In our aging society, it is an urgent medical need to determine preoperative individual risk prediction to allow more accurate cost-benefit decisions prior to elective surgeries. So far, risk prediction is mainly based on clinical parameters. However, these parameters only give a rough estimate of the individual risk. At present, there are no molecular or neuroimaging biomarkers available to improve risk prediction and little is known about the etiology and pathophysiology of this clinical condition. In this short review, we summarize the current state of knowledge and briefly present the recently started BioCog project (Biomarker Development for Postoperative Cognitive Impairment in the Elderly), which is funded by the European Union. It is the goal of this research and development (R&D) project, which involves academic and industry partners throughout Europe, to deliver a multivariate algorithm based on clinical assessments as well as molecular and neuroimaging biomarkers to overcome the currently unsatisfying situation.

The trait and occasion components of fatigue and their association with sickness absence.

OBJECTIVE: Fatigue is an important health outcome in public and occupational health care. To correctly understand and treat high levels of (prolonged) fatigue it is important to disentangle the state of fatigue into a time-varying (occasion) and -invarying (trait) component. Not only for understanding of the construct itself over time but also for its relation with (health) outcomes such as sickness absence. METHODS: Longitudinal data (n=2316) from the Maastricht Cohort Study (MCS) study was used, which assessed fatigue across 4-month intervals using the Checklist Individual Strength (CIS). RESULTS: It was found that the occasion component explains 27.60% (95%-CI [25.80%; 29.40%]) of the variance of fatigue and the trait component 71.00% (95%-CI [69.00%; 72.90%]). The trait component was, furthermore, found to be a significant predictor of sickness absence. CONCLUSION: Fatigue has a considerable time-invariant component. As this component is also related with other adverse health outcomes, preventive measures and interventions should take the difference between the occasion and trait component of fatigue into account.

Monitoring of need for recovery and prolonged fatigue within the working population: Evaluation of reliability and agreement over time.

BACKGROUND: Need for recovery (NFR) and prolonged fatigue are two important concepts for monitoring short- and long-term outcomes of psychological job demands within employees. For effective monitoring it is, however, important to gain insight in the reproducibility of the instruments that are used. OBJECTIVE: The objective was to assess reproducibility of the NFR scale and Checklist Individual Strength (CIS), measuring NFR and prolonged fatigue respectively, in the working population. METHODS: Longitudinal data from the Maastricht Cohort Study (MCS) study was used, capturing 12,140 employees from 45 different companies at baseline. A 'working' and 'returning to work' sample was conceived for different intervals; 4-month, 1-year, and 2-year. RESULTS: Reliability, assessed with the interclass correlation, was high within employees with a stable work environment for the NFR scale (0.78) and CIS (0.75). The smallest detectable change, assessing the agreement, was 41.20 for the NFR scale and 31.10 for the CIS. CONCLUSIONS: Reliability was satisfactory for both the NFR scale and CIS. The agreement of both scales to detect a changes within employees was, however, less optimal. It is, therefore, suggested that, ideally, both instruments are placed within a broader range of instruments to effectively monitor the outcomes of psychological job demands.

The Impact of Physical Work Demands on Need for Recovery, Employment Status, Retirement Intentions, and Ability to Extend Working Careers: A Longitudinal Study Among Older Workers.

OBJECTIVE: Prospectively investigating whether different approaches of physical work demands are associated with need for recovery (NFR), employment status, retirement intentions, and ability to prolong working life among older employees from the industry and health care sector. METHODS: A subsample from the Maastricht Cohort Study was studied (n = 1126). Poisson, Cox, and logistic regression analyses were performed to investigate outcomes. RESULTS: Perceiving physical work demands as strenuous was associated with higher NFR. Continuous physical strain was associated with being out of employment 4 years later. Employees with the highest amount of physical work demands perceived they were less able to prolong working life, although no significant associations between physical work demands and retirement intentions were found. CONCLUSIONS: Overall, physical work demands were associated with adverse outcomes, with divergent insights for the different approaches of physical work demands.

Low-dose CT angiography of the abdominal aorta and reduced contrast medium volume: Assessment of image quality and radiation dose.

AIM: To determine the effect of using 80 kV tube voltage and a reduced amount of contrast medium on the image quality and radiation dose of computed tomography angiography (CTA) of the abdominal aorta. MATERIALS AND METHODS: Patients who were referred for a CTA examination of the abdominal aorta were included in this technical efficacy study. Thirty patients were divided randomly into two groups. Fifteen patients underwent a dual-energy CT (DECT) protocol (Group A). Fifteen patients were scanned with the use of an automated tube potential selection algorithm tool (Group B). In both protocols, a test bolus injection of 10 ml ioversol (350 mg iodine/ml) was used, followed by 20 ml of 1:1 saline-diluted contrast medium. Quantitative analysis comprised determination of the mean attenuation and contrast-to-noise ratio. Qualitative image analysis was performed independently by five radiologists. The estimated radiation dose in terms of CT dose index and effective dose was recorded and compared with a standard 120 kV protocol. RESULTS: In Group B, six patients underwent CTA at 80 kV, seven patients underwent CTA at 100 kV and two patients underwent CTA at 120 kV. The mean contrast-enhancement values of Group A (80 kV) and the 80 kV subgroup of Group B were 16.5% and 27.6% higher compared to the 100 kV subgroup of Group B, these differences were, however, not significant. There were no significant differences in mean image quality between groups. In patients undergoing CTA at 80 kV the effective dose decreased by up to 51.3% compared to a conventional 120 kV CTA protocol. CONCLUSIONS: The findings of this study support the hypothesis that 80 kV in CTA of the abdominal aorta can reliably be used with only 30 ml contrast medium in total and a 50% reduction in radiation dose. The overall image quality was diagnostically adequate; however, it appeared to be suboptimal in patients with a BMI above 28 kg/m(2).

The impact of depression and diabetes mellitus on older workers' functioning.

OBJECTIVE: Using the International Classification of Functioning, Disability and Health as a framework, this study investigates the impact of depression and diabetes mellitus on older workers' functioning (problems with concentration, physical functioning, need for recovery and work and social participation restrictions). The study focuses on how these chronic conditions, in their interaction with the work context, affect older workers' functioning, which may be an important precursor of early retirement. METHODS: Older workers (≥ 45years) with depression (n=127) or diabetes mellitus (n=107) enrolled in the prospective Maastricht Cohort Study (MCS) were followed between October 2008 and October 2012. Linear, logistic and Cox regression analyses were performed to investigate the effect of these health conditions on workers' functioning compared to a reference group of older workers without a chronic condition (n=1612). The interaction with participants' working conditions (psychological job demands, decision latitude and strenuous work) was also analysed. RESULTS: Compared to the reference group, depression and diabetes mellitus were (over time) positively related with need for recovery caseness and restrictions in social participation but not with restrictions in work participation. Depression was positively related with concentration problems and need for recovery, whereas diabetes mellitus was negatively related with physical functioning. Finally, the relationship between functioning and depression and diabetes mellitus depends on working conditions. CONCLUSION: Older workers with depression or diabetes mellitus are vulnerable to losses in specific domains of functioning. The impact on functioning varies across working conditions, providing insight for disease-tailored preventive measures.

Cardiovascular Morbidity and Mortality Among Working Individuals With Rheumatic Disease: Results From a Large Prospective Cohort Study.

BACKGROUND: Cardiovascular comorbidities are common in rheumatic diseases and are associated with an increased mortality risk but have not been studied in a working population, with less severe disease. Also, the impact of premature cardiovascular mortality on work participation has been neglected until now. OBJECTIVES: The objectives of this study were to evaluate the cardiovascular risk in working individuals with inflammatory rheumatic diseases and to explore whether cardiovascular morbidity and mortality are associated with decreased work participation in this population. METHODS: Employees from 45 companies in The Netherlands (n = 12,140) were prospectively followed up from 1998 onward by annual questionnaires. Data covering 10 years of follow-up was available (1998-2008) for rheumatic and cardiovascular morbidities. Self-reported rheumatic and cardiovascular diseases were verified by clinical review in hospital records in a subsample living in 1 specific region of The Netherlands. Information on the vital status was obtained by linking our records to national registries. Cox proportional hazards models were used to determine the contribution of cardiovascular comorbidity on mortality, with adjustment for confounders. RESULTS: In the sample verified by clinical review, the 10-year risk of developing cardiovascular diseases tended to be increased in workers with inflammatory rheumatic diseases (n = 17) at baseline (relative risk, 2.30; 95% confidence interval [CI], 0.91-5.81) and was significantly increased in those with gout (n = 18) at baseline (relative risk, 3.64; 95% CI, 1.64-8.09) as compared with those without inflammatory rheumatic diseases or gout, respectively. Gout (n = 31; hazard ratio, 4.19; 95% CI, 1.33-13.25) and cardiovascular diseases (n = 206; hazard ratio, 2.19; 95% CI, 1.24-3.84) were significantly related to 10-year mortality. No deaths had occurred in individuals with inflammatory rheumatic diseases during follow-up. CONCLUSIONS: In this study, gout was significantly associated with cardiovascular comorbidity and mortality, but inflammatory rheumatic diseases were not. Decreased work participation in workers with gout and potentially inflammatory rheumatic diseases can be expected because of an increased morbidity but not mortality risk.

The context dependency of the self-report version of the Strength and Difficulties Questionnaire (SDQ): a cross-sectional study between two administration settings.

BACKGROUND: The Strength and Difficulties Questionnaire (SDQ) is a screening instrument for psychosocial problems in children and adolescents, which is applied in "individual" and "collective" settings. Assessment in the individual setting is confidential for clinical applications, such as preventive child healthcare, while assessment in the collective setting is anonymous and applied in (epidemiological) research. Due to administration differences between the settings it remains unclear whether results and conclusions actually can be used interchangeably. This study therefore aims to investigate whether the SDQ is invariant across settings. METHODS: Two independent samples were retrieved (mean age = 14.07 years), one from an individual setting (N = 6,594) and one from a collective setting (N = 4,613). The SDQ was administered in the second year of secondary school in both settings. Samples come from the same socio-geographic population in the Netherlands. RESULTS: Confirmatory factor analysis showed that the SDQ was measurement invariant/equivalent across settings and gender. On average, children in the individual setting scored lower on total difficulties (mean difference = 2.05) and the psychosocial problems subscales compared to those in the collective setting. This was also reflected in the cut-off points for caseness, defined by the 90th percentiles, which were lower in the individual setting. Using cut-off points from the collective in the individual setting therefore resulted in a small number of cases, 2 to 3%, while ∼10% is expected. CONCLUSION: The SDQ has the same connotation across the individual and collective setting. The observed structural differences regarding the mean scores, however, undermine the validity of the cross-use of absolute SDQ-scores between these settings. Applying cut-off scores from the collective setting in the individual setting could, therefore, result in invalid conclusions and potential misuse of the instrument. To correctly apply cut-off scores these should be retrieved from the applied setting.

The applicability of the international classification of functioning, disability, and health to study lifestyle and quality of life of colorectal cancer survivors.

BACKGROUND: Well-designed studies on lifestyle and health-related quality of life (HRQoL) in colorectal cancer survivors based on a biopsychosocial instead of a traditional biomedical approach are warranted. We report on the applicability of the International Classification of Functioning, Disability, and Health (ICF) as useful biopsychosocial framework to improve research on how lifestyle influences colorectal cancer survivors' HRQoL, using the Energy for life after ColoRectal cancer (EnCoRe) study as an example. METHODS: The ICF was used to develop a conceptual model for studying lifestyle and colorectal cancer survivors' HRQoL, by identifying relevant factors from literature and mapping them within the ICF. Subsequently, this model was used for selection of measurement instruments and biomarkers. By linking meaningful concepts within selected measures to the ICF, we could assess the ICF coverage of our developed conceptual model. RESULTS: Within selected measures, 450 meaningful concepts were identified, of which 88% were linked to the ICF. The linking process resulted in 132 distinctive ICF categories assigned (38% within "Body Functions," 2% within "Body Structures," 46% within "Activities and Participation," and 14% within "Environmental Factors"). CONCLUSIONS: The selected EnCoRe study measures broadly cover ICF domains relevant to colorectal cancer survivors, stressing the relevance of using a biopsychosocial approach for studying this population's HRQoL. IMPACT: The developed conceptual model will guide data analyses and interpretation, and facilitate early transfer of results for development, evaluation, and implementation of personalized multidisciplinary lifestyle interventions. We recommend the ICF as an invaluable framework for improving the quality and scope of HRQoL studies.

Different approaches to estimate exposure to work stressors, using repeated measurements, and the association with cardiovascular disease.

OBJECTIVE: To explore the stability of exposure to work stressors over time and to examine the impact of different approaches of estimating exposure on the cardiovascular disease (CVD) risk estimation. METHODS: The Maastricht Cohort Study-Work Stressor Score was used to assess work stressors at three consecutive time points among 6154 employees participating in the Maastricht Cohort Study. Incident CVD was assessed with questionnaires. Five approaches were used to estimate exposure as, for example, cumulative exposure above a cutoff point, total exposure, and average exposure. RESULTS: The correlation between the work stressor scores assessed at the first and third time point was 0.58. Employees with a stable exposure above the highest quartile had a fully adjusted hazard ratio of 1.58 (95% confidence interval, 0.93 to 2.72). CONCLUSION: Employees with a stable exposure above the highest quartile score during a minimum of 2 years might have the highest relative CVD risk.

Prediction of long-term sickness absence among employees with depressive complaints.

INTRODUCTION: To study the properties of a screening instrument in predicting long-term sickness absence among employees with depressive complaints. METHODS: Employees at high risk of future sickness absence were selected by the screening instrument Balansmeter (BM). Depressive complaints were assessed with the depression scale of the Hospital Anxiety and Depression Scale. The total study population consisted of 7,401 employees. Sickness absence was assessed objectively and analyzed at 12 and 18 months of follow-up using company registers on certified sick leave. RESULTS: The relative risk (RR) for long-term sickness absence, for employees at high risk versus not at high risk, was 3.26 (95% CI 2.54-4.22) in men and 2.55 (1.98-3.35) in women, when the BM was applied in the total study population. The RR of long-term sickness absence of employees with depressive complaints compared with employees without depressive complaints was 3.13 (2.41-4.09) in men and 2.45 (2.00-3.00) in women. The RR of long-term sickness absence for the BM applied in employees with depressive complaints was 5.23 in men and 3.87 in women. When the BM with a cut-off point with a higher sensitivity was applied in employees with depressive complaints, the RR for long-term sickness absence was 4.88 in men and 3.80 in women. CONCLUSIONS: The screening instrument Balansmeter is able to predict long-term sickness absence within employees with depressive complaints. The total prediction of long-term sickness absence proved better in employees with depressive complaints compared with employees of a general working population.

Integrating a family-focused approach into child obesity prevention: rationale and design for the My Parenting SOS study randomized control trial.

BACKGROUND: More than 20% of US children ages 2-5 yrs are classified as overweight or obese. Parents greatly influence the behaviors their children adopt, including those which impact weight (e.g., diet and physical activity). Unfortunately, parents often fail to recognize the risk for excess weight gain in young children, and may not be motivated to modify behavior. Research is needed to explore intervention strategies that engage families with young children and motivate parents to adopt behaviors that will foster healthy weight development. METHODS: This study tests the efficacy of the 35-week My Parenting SOS intervention. The intervention consists of 12 sessions: initial sessions focus on general parenting skills (stress management, effective parenting styles, child behavior management, coparenting, and time management) and later sessions apply these skills to promote healthier eating and physical activity habits. The primary outcome is change in child percent body fat. Secondary measures assess parent and child dietary intake (three 24-hr recalls) and physical activity (accelerometry), general parenting style and practices, nutrition- and activity-related parenting practices, and parent motivation to adopt healthier practices. DISCUSSION: Testing of these new approaches contributes to our understanding of how general and weight-specific parenting practices influence child weight, and whether or not they can be changed to promote healthy weight trajectories. TRIAL REGISTRATION: ClinicalTrials.gov: NCT00998348.

Screening questionnaire Balansmeter proved successful in predicting future long-term sickness absence in office workers.

OBJECTIVE: To develop and validate a screening instrument to identify employees at high risk for future long-term sickness absence. STUDY DESIGN AND SETTING: The instrument was developed (n=5,601) and internally validated (n=3,383) through data analyses of the Maastricht Cohort Study, among a group of office workers not absent from work. External validation was performed in a cohort of 3,895 bank employees. RESULTS: The screening instrument, Balansmeter, captures 34 questions on demographics, work environment, private situation, (mental) health, and sickness absence history. The Balansmeter showed good predictive values for future sickness absence (>28 days) in men (internal validation relative risk [RR] 4.69 [95% confidence interval (CI): 2.74, 8.02]; external validation RR 3.90 [95% CI: 2.35, 6.45]) and women (internal validation RR 4.16 [95% CI: 2.05, 8.43]; external validation RR 2.62 [95% CI: 1.44, 4.77]). CONCLUSION: It is possible to predict future sickness absence. The Balansmeter can be considered a valuable screening instrument.

Interpersonal conflicts at work as a predictor of self-reported health outcomes and occupational mobility.

OBJECTIVES: The aim of this prospective study was to examine the relationship between interpersonal conflicts at work and subsequent self-reported health outcomes (self-reported general health, need for recovery, and prolonged fatigue) and occupational mobility (internal mobility ie, changing job function, and external mobility ie, changing employers). METHODS: Data from the Maastricht Cohort Study on fatigue at work (n = 5582 for co-worker conflict; n = 5530 for supervisor conflict) were used. Interpersonal conflict with either co-workers or supervisors was assessed between baseline and 1-year follow-up. Outcomes were studied every 4 months between 1-year and 2-year follow-up. Logistic regression analyses using generalised estimating equations were conducted for each of the dichotomous outcomes, while controlling for demographic factors, the presence of a long-term illness, other workplace stressors, coping, and outcome at baseline. Analyses were conducted for men only. RESULTS: At baseline, conflicts with co-workers occurred in 7.2% of the study population, while conflicts with supervisors occurred in 9.5% of the study population. In general, this study showed that co-worker conflict was a statistically significant risk factor for the onset of an elevated need for recovery, prolonged fatigue, poor general health and external occupational mobility. Supervisor conflict was a significant risk factor for the onset of an elevated need for recovery, prolonged fatigue, external occupational mobility, and internal occupational mobility. CONCLUSIONS: The results of this study indicate a possible causal relationship between interpersonal conflicts at work and self-reported health and occupational mobility. Given the considerable impact of interpersonal conflicts at work on the individual worker and on the organisation, and the fact that interpersonal conflicts at work are highly prevalent, these findings underline the need for interventions aimed at preventing the occurrence of interpersonal conflicts at work, or at least reducing the harmful effects on both the employee and the organisation.