title: Effect of job maintenance training program for employees with chronic disease - a randomized controlled trial on self-efficacy, job satisfaction, and fatigue.
abstract: OBJECTIVE
  Employees with a chronic physical condition may be hampered in job performance due to physical or cognitive limitations, pain, fatigue, psychosocial barriers, or because medical treatment interferes with work. This study investigates the effect of a group-training program aimed at job maintenance. Essential elements of the program are exploration of work-related problems, communication at the workplace, and the development and implementation of solutions.
  
  
  METHODS
  Participants with chronic physical diseases were randomly assigned to the intervention (N=64) or the control group (N=58). Participants were eligible for the study if they had a chronic physical disease, paid employment, experienced work-related problems, and were not on long-term 100% sick leave. Primary outcome measures were self-efficacy in solving work- and disease-related problems (14-70), job dissatisfaction (0-100), fatigue (20-140) and job maintenance measured at 4-, 8-, 12- and 24-month follow-up. We used GLM repeated measures for the analysis.
  
  
  RESULTS
  After 24 months, loss to follow-up was 5.7% (7/122). Self-efficacy increased and fatigue decreased significantly more in the experimental than the control group [10 versus 4 points (P=0.000) and 19 versus 8 points (P=0.032), respectively]. Job satisfaction increased more in the experimental group but not significantly [6 versus 0 points (P=0.698)]. Job maintenance was 87% in the experimental and 91% in the control group, which was not a significant difference. Many participants in the control group also undertook actions to solve work-related problems.
  
  
  CONCLUSIONS
  Empowerment training increases self-efficacy and helps to reduce fatigue complaints, which in the long term could lead to more job maintenance. Better understanding of ways to deal with work-related problems is needed to develop more efficient support for employees with a chronic disease.
authors.affiliation: Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands. i.varekamp@amc.nl
authors.forename: Inge
authors.initials: I
authors.lastname: Varekamp
authors.forename: Jos H
authors.initials: JH
authors.lastname: Verbeek
authors.forename: Angela
authors.initials: A
authors.lastname: de Boer
authors.forename: Frank J H
authors.initials: FJ
authors.lastname: van Dijk
mesh_terms: D000328:Adult; D002908:Chronic Disease / Q000523:psychology* / Q000534:rehabilitation; D005221:Fatigue / Q000209:etiology* / Q000523:psychology; D005260:Female; D006801:Humans; D007318:Inservice Training; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D009786:Occupational Health Services / Q000379:methods; D011209:Power, Psychological; D020377:Self Efficacy; D017132:Workplace / Q000523:psychology