Research Center for Insurance Medicine

Amsterdam, Netherlands

Research Center for Insurance Medicine

Amsterdam, Netherlands
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Vlasveld M.C.,Netherlands Institute of Mental Health and Addiction | Vlasveld M.C.,VU University Amsterdam | Van Der Feltz-Cornelis C.M.,Netherlands Institute of Mental Health and Addiction | Van Der Feltz-Cornelis C.M.,University of Tilburg | And 8 more authors.
British Journal of Psychiatry | Year: 2012

Randomised controlled trial to evaluate the effectiveness of collaborative care in a Dutch occupational healthcare setting: 126 workers on sick leave with major depressive disorder were randomised to usual care (n = 61) or collaborative care (n = 65). After 3 months, collaborative care was more effective on the primary outcome measure of treatment response (i.e. reduction in symptoms of ≥50%) on the Patient Health Questionnaire-9 (PHQ-9). However, the groups did not differ on the PHQ-9 as a continuous outcome measure. Implications of these results are discussed.


Cornelius B.L.R.,Research Center for Insurance Medicine | Cornelius B.L.R.,University of Groningen | Cornelius B.L.R.,Social Security Institute | Groothoff J.W.,University of Groningen | And 4 more authors.
BMC Public Health | Year: 2013

Background: Screening for mental disorders among disability claimants is important, since mental disorders seem to be seriously under-recognized in this population. However, performance of potentially suitable scales is unknown. We aimed to evaluate the psychometric properties of three scales, the 10- and 6-item Kessler Psychological Distress Scale (K10, K6) and the 12-item General Health Questionnaire (GHQ-12), to predict present state mental disorders, classified according to the Diagnostic and Statistical Manual of Mental Disorders, 4 §ssup§ th §esup§ Edition (DSM-IV) among disability claimants. Methods. All scales were completed by a representative sample of persons claiming disability benefit after two years sickness absence (n=293). All diagnoses, both somatic and mental, were included. The gold standard was the Composite International Diagnostic Interview (CIDI 3.0) to diagnose present state DSM-IV disorder. Cronbach's α, sensitivity, specificity, positive (PPV) and negative predictive values (NPV), and the areas under the Receiver Operating Characteristic curve (AUC) were calculated. Results: Cronbach's alpha's were 0.919 (K10), 0.882 (K6) and 0.906 (GHQ-12). The optimal cut-off scores were 24 (K10), 14 (K6) and 20 (GHQ-12). The PPV and the NPV for the optimal cut point of the K10 was 0.53 and 0.89, for the K6 0.51 and 0.87, and for the GHQ-12 0.50 and 0.82. The AUC's for 30-day cases were 0.806 (K10; 95% CI 0.749-0.862), 0.796 (K6; 95% CI 0.737-0.854) and 0.695 (GHQ-12; 95% CI 0.626-0.765). Conclusions: The K10 and K6 are reliable and valid scales to screen for present state DSM-IV mental disorder. The optimal cut-off scores are 24 (K10) and 14 (K6). The GHQ-12 (optimal cut-off score: 20) is outperformed by the K10 and K6, which are to be preferred above the GHQ-12. The scores on separate items of the K10 and K6 can be used in disability assessment settings as an agenda for an in-depth follow-up clinical interview to ascertain the presence of present state mental disorder. © 2013 Cornelius et al.; licensee BioMed Central Ltd.


Vonk Noordegraaf A.,EMGO Institute for Health and Care Research | Huirne J.A.F.,EMGO Institute for Health and Care Research | Brolmann H.A.M.,EMGO Institute for Health and Care Research | Van Mechelen W.,EMGO Institute for Health and Care Research | And 3 more authors.
BJOG: An International Journal of Obstetrics and Gynaecology | Year: 2011

Objective: To generate structured detailed uniform convalescence recommendations after gynaecological surgery by a modified Delphi method amongst experts and a representative group of physicians. Design: Modified Delphi study. Setting: Expert physicians recruited by their respective medical boards and employed at different hospitals, doctor's surgeries and healthcare services. Population: Twelve experts (five gynaecologists, two general practitioners [GPs] and five occupational physicians [OPs]) and a representative sample of 63 medical doctors. Methods: Multidisciplinary detailed recommendations for graded resumption of relevant activities after uncomplicated hysterectomy (laparoscopic supracervical, total laparoscopic/laparoscopic-assisted, vaginal and abdominal hysterectomies) and laparoscopic adnexal surgery were developed. Recommendations were based on a literature review and a modified Delphi procedure among 12 experts, recruited in collaboration with the participating medical boards of gynaecologists, GPs and OPs. Main outcome measures: A multidisciplinary consensus of at least 67% on the relevant detailed convalescence recommendations in relation to hysterectomy and laparoscopic adnexal surgery. Results: Out of initially 65 activities, the expert panel judged 38 activities relevant for convalescence recommendations. Consensus for all activities was achieved after four Delphi rounds and two group discussions. The recommendations were judged as feasible by a representative sample of 26 gynaecologists, 19 GPs and 18 OPs. Conclusions: Consensus between gynaecologists, GPs and OPs was achieved on all relevant convalescence recommendations regarding hysterectomy (abdominal, vaginal and laparoscopic) and laparoscopic adnexal surgery. © 2011 The Authors BJOG An International Journal of Obstetrics and Gynaecology.


Vlasveld M.C.,Netherlands Institute of Mental Health and Addiction | Vlasveld M.C.,VU University Amsterdam | Van Der Feltz-Cornelis C.M.,Netherlands Institute of Mental Health and Addiction | Van Der Feltz-Cornelis C.M.,University of Tilburg | And 8 more authors.
Journal of Occupational Rehabilitation | Year: 2012

Introduction: Long-term sickness absence is a major public health and economic problem. Evidence is lacking for factors that are associated with return to work (RTW) in sick-listed workers. The aim of this study is to examine factors associated with the duration until full RTW in workers sick-listed due to any cause for at least 4 weeks. Methods: In this cohort study, health-related, personal and job-related factors were measured at entry into the study. Workers were followed until 1 year after the start of sickness absence to determine the duration until full RTW. Cox proportional hazards regression analyses were used to calculate hazard ratios (HR). Results: Data were collected from N = 730 workers. During the first year after the start of sickness absence, 71% of the workers had full RTW, 9.1% was censored because they resigned, and 19.9% did not have full RTW. High physical job demands (HR.562, CI.348-.908), contact with medical specialists (HR.691, CI.560-.854), high physical symptoms (HR.744, CI.583-.950), moderate to severe depressive symptoms (HR.748, CI.569-.984) and older age (HR.776, CI.628-.958) were associated with a longer duration until RTW in sick-listed workers. Conclusions: Sick-listed workers with older age, moderate to severe depressive symptoms, high physical symptoms, high physical job demands and contact with medical specialists are at increased risk for a longer duration of sickness absence. OPs need to be aware of these factors to identify workers who will most likely benefit from an early intervention. © The Author(s) 2011.


Van Muijen P.,VU University Amsterdam | Van Muijen P.,Research Center for Insurance Medicine | Weevers N.L.E.C.,Dutch Workers Insurance Authority | Snels I.A.K.,Dutch Workers Insurance Authority | And 8 more authors.
European Journal of Cancer Care | Year: 2013

The objective of this study was to provide an overview of the prognostic factors for return to work and employment of cancer survivors. Cohort studies were selected if the population consisted of cancer patients between 18 and 65 years of age, with return to work, employment or equivalent concepts as main outcome measure, studying at least one prognostic factor. The methodological quality of the included studies and level of evidence for each prognostic factor were assessed. Twenty-eight cohort studies met the inclusion criteria. Heavy work and chemotherapy were negatively associated with return to work. Less invasive surgery was positively associated with return to work. Breast cancer survivors had the greatest chance of return to work. Old age, low education and low income were negatively associated with employment. Moderate evidence was found for extensive disease being negatively associated with both return to work and employment, and for female gender being negatively associated with return to work. The review shows that in cancer survivors, a limited number of prognostic factors of return to work and employment can be identified. Physicians primarily engaged in the process of vocational rehabilitation of cancer survivors should be aware of the potential role these factors exert. © 2012 Blackwell Publishing Ltd.


van Muijen P.,VU University Amsterdam | van Muijen P.,Dutch Social Security Agency | van Muijen P.,Research Center for Insurance Medicine | Duijts S.F.A.,VU University Amsterdam | And 5 more authors.
Journal of Cancer Survivorship | Year: 2013

Purpose: Sick-listed cancer survivors may face lasting side-effects, even after a successful completion of treatment. As a consequence, they are at risk of work disability, which may lead to job loss. Knowledge of prognostic factors of work disability may support cancer survivors in their trajectory of vocational rehabilitation. The purpose of this study was to identify prognostic factors of work disability in sick-listed cancer survivors. Methods: From the first day of sick leave, a cohort of 131 cancer survivors was followed for 24 months. Included participants were aged between 20 and 63 years. Data were collected, using questionnaires, at 10 months after reporting sick. The level of work disability, i.e., entitlement for disability compensation, was assessed by an insurance physician and a labour expert at 24 months. Univariate and multiple logistic regression analyses were performed. Results: In the univariate analysis, 14 variables were found to be associated with the level of work disability at 24 months. These factors were related to socio-demographics, health characteristics, work-related characteristics, and return to work (RTW) expectations. Multiple logistic regression showed that at 10-month sick leave, perception of health care providers on cancer survivors' work ability and experienced influence on RTW, both reported by workers, were significantly associated with the level of work disability at 24 months. Conclusion: It seems in the interest of cancer survivors to take an active role in planning their RTW trajectory and to discuss RTW with their health care providers. Implications for Cancer Survivors: The potential role healthcare providers may play in counselling cancer survivors on RTW must not be underestimated. Cancer survivors may benefit in having control on their RTW trajectory. © 2013 Springer Science+Business Media New York.


Duijts S.F.A.,VU University Amsterdam | Duijts S.F.A.,Research Center for Insurance Medicine | Van Egmond M.P.,VU University Amsterdam | Van Egmond M.P.,Research Center for Insurance Medicine | And 7 more authors.
Psycho-Oncology | Year: 2014

Objective Attention for the expanding group of cancer survivors at work, and the late effects they are confronted with while working, has been limited. The objective of this systematic review is to identify and summarize studies, exploring ongoing physical and/or psychosocial problems related to functioning of employees with a history of cancer, beyond their return to work. Methods Publications were identified through computerized Medline, Psychinfo, Embase, and Cinahl searches (January 2000-March 2013). Studies had to be directed at cancer survivors, who were employed during the study. Both qualitative and quantitative studies were included. Quality assessment of these studies was performed. Two reviewers independently extracted data from each publication, e.g., physical and/or psychosocial problems (e.g., fatigue and cognitive limitations), outcome measures (e.g., work productivity), and qualitative and quantitative results. Results The search identified 8979 articles. After exclusion on title and abstract, 64 were retrieved for full text screening, of which 30 met the inclusion criteria. A total of 20 studies reported quantitative and 10 studies reported qualitative results. The majority of studies assessed psychosocial problems in cancer survivors at work. Cognitive limitations, coping issues, fatigue, depression, and anxiety were reported to influence work ability. Physical problems, such as difficulties with lifting and treatment-induced menopausal symptoms, were frequently described to affect functioning at work. Conclusions Ongoing physical and/or psychosocial problems are present in occupationally active cancer survivors, which may cause serious difficulties at work. The results of this study may be used as input for developing supportive interventions for these survivors. Copyright © 2013 John Wiley & Sons, Ltd. Copyright © 2013 John Wiley & Sons, Ltd.


Lammerts L.,VU University Amsterdam | Lammerts L.,Research Center for Insurance Medicine | Schaafsma F.G.,VU University Amsterdam | Schaafsma F.G.,Research Center for Insurance Medicine | And 3 more authors.
Journal of Occupational Rehabilitation | Year: 2016

Purpose This study aimed to perform a process evaluation of a participatory supportive return to work program for workers without a (permanent) employment contract, sick-listed due to a common mental disorder. The program consisted of a participatory approach, integrated care and direct placement in a competitive job. Our main questions were: were these components realized in practice and in accordance with the protocol? The evaluation took place alongside a randomized controlled trial. Methods The study population consisted of workers who filed a sickness benefit claim at the Dutch Social Security Agency, professionals of this agency and of vocational rehabilitation agencies. We focused on sick-listed workers and professionals who had actually participated in the intervention. Data was collected mainly by questionnaires. Results Only 36 out of 94 intervention group participants started with the program. In half of these cases application of integrated care was reported. Most other steps in the program were completed. However, fidelity to the protocol was low to reasonable. Much delay was observed in the execution of the program and only two sick-listed workers were placed in a competitive job. Still, satisfaction with the participatory approach was good. Conclusions Despite the positive evaluation of the participatory approach, the full program was executed less successfully compared to similar programs evaluated in earlier studies. This will probably affect the outcomes of our trial. Findings from this study will help to interpret these outcomes. Nevertheless, more knowledge is needed about experiences of stakeholders who participated in the program. Trial Registration NTR3563. © 2016 The Author(s)


Berkhof M.,VU University Amsterdam | Berkhof M.,Research Center for Insurance Medicine | van Rijssen H.J.,VU University Amsterdam | van Rijssen H.J.,Research Center for Insurance Medicine | And 6 more authors.
Patient Education and Counseling | Year: 2011

Objective: Physicians need good communication skills to communicate effectively with patients. The objective of this review was to identify effective training strategies for teaching communication skills to qualified physicians. Methods: PubMED, PsycINFO, CINAHL, and COCHRANE were searched in October 2008 and in March 2009. Two authors independently selected relevant reviews and assessed their methodological quality with AMSTAR. Summary tables were constructed for data-synthesis, and results were linked to outcome measures. As a result, conclusions about the effectiveness of communication skills training strategies for physicians could be drawn. Results: Twelve systematic reviews on communication skills training programmes for physicians were identified. Some focused on specific training strategies, whereas others emphasized a more general approach with mixed strategies. Training programmes were effective if they lasted for at least one day, were learner-centred, and focused on practising skills. The best training strategies within the programmes included role-play, feedback, and small group discussions. Conclusion: Training programmes should include active, practice-oriented strategies. Oral presentations on communication skills, modelling, and written information should only be used as supportive strategies. Practice implications: To be able to compare the effectiveness of training programmes more easily in the future, general agreement on outcome measures has to be established. © 2010 Elsevier Ireland Ltd.


Achterberg T.J.,University of Amsterdam | Wind H.,University of Amsterdam | Wind H.,Research Center for Insurance Medicine | Frings-Dresen M.H.W.,University of Amsterdam
Disability and Rehabilitation | Year: 2012

Purpose: To define the most important factors for the work participation of the young disabled according to experts. Method: A Delphi study was conducted with internet questionnaires. Health-related, personal and environmental factors known from literature were presented to insurance physicians and labour experts. The experts assessed whether a factor was important for the work participation of the young disabled. New factors added by the experts in the first round were assessed in the second round. Factors assessed as important by at least 80% of the experts were input for the last round, in which the experts chose the ten most important factors. Results: Participation included 156 experts in the first round and 91 experts in the last round. They selected 44 of 92 factors as important. Severity of limitations, type of limitations and motivation were placed by more than 55% of the experts on their top-ten list to be assessed in a plan to help the young disabled participate in work. Conclusion: Severity and type of limitations and motivation are considered to be the most important factors for the work participation of the young disabled and should be included in a participation plan. Implications for Rehabilitation As young disabled experience barriers when entering the labour market, knowledge of influencing factors is necessary to help them successfully participate in work. According to experts the disease-related severity and type of limitations and the personal factor motivation are the most important factors to know to help these young disabled to participate in work. © 2012 Informa UK, Ltd.

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