Biomedical subjects

Ijmert Kant

Publications and source records attributed to Ijmert Kant.

At least 19 recordsLinked to original sources

PubMed2006

Long-term predictors of outcome in fatigued employees on sick leave: a 4-year follow-up study.

BACKGROUND: Persistent fatigue is strongly associated with functional status and can lead to absenteeism and work disability. Despite several prognostic studies on chronic fatigue, little attention has been paid to occupational outcomes. METHOD: A total of 127 fatigued employees on sick leave were followed-up after 4 years to determine long-term predictors of work disability, fatigue caseness and chronic fatigue syndrome (CFS)-like caseness. Measures included fatigue, physical functioning, illness attributions, psychological problems and emotional exhaustion. RESULTS: Thirty-three participants (26%) were receiving work disability benefits at the 4-year follow-up. Older age and lower levels of physical functioning predicted work disability. Weaker psychological attributions and lower levels of physical functioning were predictors of fatigue caseness. CFS-like caseness was predicted by female gender and lower levels of physical functioning. Self-reported physical functioning remained a strong and statistically significant determinant of work disability [odds ratio (OR) 0.45, 95% confidence interval (CI) 0.24-0.87] and CFS-like caseness (OR 0.20, 95% CI 0.09-0.43) after controlling for confounders. CONCLUSIONS: This study suggests that physical functioning plays an important role in the persistence of fatigue complaints and work disability in employees on sick leave. The course of fatigue is a complex process, and exploring temporal relationships between fatigue, functional status and work status in future research could provide valuable information for the improvement of fatigue management.

Adult↗

PubMed2006

Long-term efficacy of cognitive-behavioral therapy by general practitioners for fatigue: a 4-year follow-up study.

OBJECTIVE: In an earlier study, we found that cognitive-behavioral therapy (CBT) delivered by general practitioners (GPs) for fatigue among employees on sick leave was not effective after 12 months. In this study we aim to assess the long-term efficacy of CBT by GPs for fatigue. It was hypothesized that the intervention could prevent deterioration as well as relapse of fatigue complaints and relapse into absenteeism in the long term. METHODS: Patients who participated in the original randomized controlled trial were followed up 4 years later. Fatigue and absenteeism were the main outcomes. RESULTS: Fatigue and absenteeism were high in the intervention and control groups at the 4-year follow-up. There was no significant difference between the intervention group and the control group on fatigue and absenteeism. The intervention group however tended toward less-favorable outcomes as compared with the control group. CONCLUSIONS: Like that of chronic fatigue syndrome, the prognosis of less-advanced fatigue is rather poor. CBT delivered by GPs is not effective in the long term.

Absenteeism↗

PubMed2006

Smoking among shift workers: More than a confounding factor.

In studies on the cardiovascular disease risk among shift workers, smoking is considered to be a confounding factor. In a study of 239 shift and 157 daytime workers, it was found that shift work was prospectively related to increased cigarette consumption, indicating that smoking might be in the causative pathway; however, the number of study subjects was too low to warrant sound conclusions. Therefore, data from the Maastricht Cohort study were used to investigate the longitudinal relation between smoking and shift work in a much larger population. In this study, a total of 12,140 employees were followed for two years by means of self-administered questionnaires. The authors compared workers who normally worked during daytime hours only (74%) with those who worked other than day shifts (26%). Logistic regression analyses were performed, adjusting for demographic factors of age, gender, and educational level to evaluate the risk of starting to smoke (n = 25) in the group of non-smoking workers and the risk of quitting (n = 318) in the group of smoking workers. Logistic regression analysis showed a significant association between shift work and taking up smoking during the two-year follow-up (odds ratio: 1.46, p = 0.03). The risk to stop smoking was somewhat lower in shift workers (odds ratio: 0.91) but not statistically significant (p = 0.5). To conclude, this study showed that, independent of educational level, shift workers are more prone to start smoking. This finding might have important implications for studies on the health effects of shift workers and for possible interventions aimed at the reduction of the excess health risk among shift workers.

Adult↗

PubMed2006

Leisure time physical activity and sickness absenteeism; a prospective study.

AIM: To establish whether workers with frequent leisure time physical activities are at higher or lower risk of sickness absence compared to inactive workers. METHOD: Self reported and company recorded sickness absence data were collected during 18 months of follow-up for 8902 workers. Frequency of leisure time physical activities was queried at baseline. RESULTS: Overall, we found that workers active in their leisure time twice or more each week reported significantly less sickness absence compared to inactive workers (14.8 versus 19.5 days/year), mainly due to a decrease in sick leave because of musculoskeletal disorders. CONCLUSION: Demotivating sports participation by making workers liable for workdays lost due to sporting injuries might be counter-productive in decreasing absenteeism and its related costs. Promoting worker participation in sport might lead to reduced absenteeism.

Absenteeism↗

PubMed2005

Psychological distress, fatigue and long-term sickness absence: prospective results from the Maastricht Cohort Study.

OBJECTIVE: Little is known about psychological distress as a risk factor for the onset of long-term sickness absence and even less about the influence of fatigue in this relationship. METHODS: We examined the relationship between psychological distress and the onset of long-term sickness absence during 18 months of follow-up while considering fatigue. Analyses were based on 6403 employees participating in the Maastricht Cohort Study. RESULTS: Psychological distress was related to the onset of long-term sickness absence (women relative risk 1.45, 95% confidence interval = 1.23-1.72; men 1.33, 1.21-1.46). Adjustment for fatigue weakened the associations, particularly in women. Caseness analyses revealed different effects of psychological distress and fatigue in the onset of long-term sickness absence in men and women. CONCLUSION: The findings underline the need for interventions aiming at psychological distress and, depending on the gender, also at fatigue, to reduce the risk of long-term sickness absence.

Absenteeism↗

PubMed2005

Fatigue and job stress as predictors for sickness absence during common infections.

The objective of this study was to investigate the effect of health and work-related factors as predictors of subsequent sickness absence when experiencing common infections (common cold, flu-like illness, and gastroenteritis). Self-administered questionnaire data were used (baseline n = 12,140). To perform the analysis, employees reporting common infections in the final questionnaire were selected. Employees reporting sickness absence due to common infections were compared with a group who stayed at work during an infection. Multivariate survival analysis revealed no significant effects of job demands, decision latitude, or job strain on absence in workers experiencing common infections. Low levels of commitment (risk [RR] 1.22; confidence interval [CI] 1.03-1.44) and low job satisfaction (RR 1.36; CI 1.13-1.164) increased the chance of being absent during a common cold. Also, having a long-standing disease (RR 1.22; CI 1.05-1.41) and fatigue (RR 1.20; CI 1.05-1.37) increased the chance of being absent during a common infection. Having an executive function decreased the chance of being absent. We conclude that absence during a common cold is partly influenced by motivational factors in work, in contrast to more severe common infections which are more health related. Insight in factors related to absenteeism are important as a start for preventive measures to reduce sickness absence.

Adult↗

PubMed2004

The effect of non-random loss to follow-up on group mean estimates in a longitudinal study.

Bias due to selective non-response is often neglected in large-scale epidemiological studies. And, although some recent techniques enable adjustment for selective non-response, these are rarely applied. The Maastricht Cohort Study, a study on fatigue at work among 12140 respondents at baseline, enabled us to estimate the degree of bias in a real life data set. After seven subsequent measurements, spanning a 2-year period, 8070 respondents remained in the cohort. Two traditional ways of presenting longitudinal mean levels (means using all data, and means using only complete cases) are compared with adjusted mean levels, using mixed models. The difference between the complete case and overall mean levels and the adjusted means were about 2% for the continuous fatigue score and 6% for the proportion of fatigued cases. For the company mean scores the observed bias due to selective non-response might be as much as 30% for some of the company means for the continuous fatigue score and up to 160% for the estimated number of fatigued cases. We therefore conclude that bias due to selective non-response needs serious attention. Next to making vigorous attempts to minimize longitudinal non-response, the use of statistical adjustment is also recommended.

Bias↗

PubMed2004

Psychological distress and depressed mood in employees with asthma, chronic bronchitis or emphysema: a population-based observational study on prevalence and the relationship with smoking cigarettes.

OBJECTIVES: To evaluate if employees with asthma, chronic bronchitis or emphysema can be characterized as a population of patients with a high prevalence of psychological distress and/or depressed mood. Above all, we wanted to examine the influence of smoking status on the relationship between chronic disease and psychological distress/depressed mood. METHODS: A postal survey was conducted among 12,103 employees participating in the Maastricht Cohort Study. RESULTS: Smoking employees, who reported having asthma, chronic bronchitis or emphysema were more likely to report suffering from depressed mood compared to smokers with no long-lasting disease (prevalence rate, PR: 29.3 and 9.0%, respectively; OR for depressed mood = 4.04; 95% CI: 2.56-6.39) and when compared to smoking employees with a history of heart disease, hypertension or myocardial infarction (PR: 18.1%; OR: 1.99; 95% CI: 1.07-3.68), or rheumatoid arthritis (PR: 20.1%; OR: 1.73; 95% CI: 0.96-3.11). CONCLUSION: These findings provide health care professionals with additional evidence regarding the importance for including the assessment of psychological distress and depressed mood in the routine evaluation of the patient with asthma, chronic bronchitis or emphysema, especially with regard to smoking cessation.

Age Distribution↗

PubMed2004

Effects of job insecurity from a workplace closure threat on fatigue and psychological distress.

The aim of this study was to prospectively investigate the effect of potential workplace closure, an externally attributed form of job insecurity, on fatigue and psychological distress. In April 1999, the minister responsible announced that a governmental agency would close down one of its two locations. Baseline data from the employees were available before the closure announcement (n = 574) because they were enrolled in the Maastricht Cohort Study on "Fatigue at Work." In the closure group, the relative risk for becoming a psychological distress case was 1.61 (95% confidence interval [CI] = 1.27-2.05) during 13 months after the closure threat. Within the closure group, a difference in relative risk for psychological distress was observed between employees who self reported an increase in job insecurity (relative risk = 1.85; 95% CI = 1.41-2.42) and employees who did not report an increase in job insecurity (relative risk 1.14; 95% CI = 0.58-2.24)

Comorbidity↗

PubMed2004

Diabetes, employment and fatigue-related complaints: a comparison between diabetic employees, "healthy" employees, and employees with other chronic diseases.

The work situation and fatigue-related complaints of employees with diabetes (N = 141) were compared with "healthy" employees (N = 8946) and employees with other chronic diseases (N = 1883). Baseline data from a Dutch Cohort Study on Fatigue at Work were used to test differences in background variables, work characteristics, lifestyle factors, and fatigue-related complaints. Odds ratios were calculated for prolonged fatigue, the need for recovery, burnout, and psychological distress. Results showed that employees with diabetes work more daytime hours and work less overtime than the other groups. If they have no comorbidity, they are no more likely to report fatigue-related complaints than "healthy" employees, except for a depressed mood. Comorbidity (the presence of one or more additional chronic diseases) is associated with increased fatigue-related complaints. Therefore, this group will need special attention from professionals.

Adolescent↗

PubMed2004

Predicting the two-year course of unexplained fatigue and the onset of long-term sickness absence in fatigued employees: results from the Maastricht Cohort Study.

Because of the serious adverse consequences of unexplained fatigue, it is important to identify factors that determine the prognosis of unexplained fatigue and the onset of long-term sickness absence in fatigued employees. Analyses were based on the Maastricht Cohort Study, a prospective population-based cohort study among more than 12,000 employees. Severely fatigued employees who were not on sick leave (n = 2108) were selected at baseline and followed up at six time points during the course of 2 years. Point prevalences of severe fatigue (59% to 63%) and long-term sickness absence (1.8% to 3.1%) among participants were fairly stable at all consecutive time points. Lower levels of fatigue severity, work-related exhaustion and anxious mood, absence of conflicts with colleagues, and good self-rated health at baseline were predictors of the onset of recovery from fatigue in survival analyses. Older age, low decision authority, female sex, working in nightshift, a physical attribution of fatigue, and a history of absenteeism were predictors of the onset of long-term absenteeism. The course of unexplained fatigue in employees is characterized by remission and relapse in time while the absolute risk of long-term absenteeism is small. Given the broad range of predictors, it appears that fatigue and long-term sickness absence entangle different underlying processes. Our findings underscore the notion that prevention and treatment of fatigue should be aimed at health perception and emotional well-being.

Adult↗

PubMed2004

Impact of worktime arrangements on work-home interference among Dutch employees.

OBJECTIVES: This study examined the effects of different worktime arrangements on work-home interference while taking into account other work-related factors, private situation and health status, explored gender differences in this relation, and examined reciprocal effects between workhours and work-home interference. METHODS: Data from the Maastricht cohort study on fatigue at work were used with 8 months of follow-up (N=6947 at baseline). RESULTS: Worktime arrangements were related to work-home interference among the men and women, even after control for confounding. As compared with daywork, baseline shiftwork was associated with higher work-home interference over time. Within daywork, full-time work was prospectively related to higher work-home interference than part-time work was. For full-timers, baseline overtime work, hours of overtime work, change in number of workhours, and commuting time were related to higher work-home interference over time, whereas compensation for overtime work, familiarity with work roster, ability to take a day off, and a decrease in workhours at own request were associated with less work-home interference. For the part-timers, baseline overtime work and commuting time were related to higher work-home interference over time, whereas compensation for overtime, flexible workhours, and ability to take a day off were protective against work-home interference. Reciprocal relations between work-home interference and workhours were also found. CONCLUSIONS: Worktime arrangements are clearly related to work-home interference. Because reciprocal effects exist as well, important selection processes may exist. Nevertheless, specific characteristics of worktime arrangements could constitute useful tools for reducing work-home interference.

Adult↗

PubMed2004

Direction of shift rotation among three-shift workers in relation to psychological health and work-family conflict.

OBJECTIVES: The aim of the present study was to investigate whether the direction of shift rotation was related to the need for recovery, fatigue, sleep quality, work-family conflict, and leisure time among three-shift workers. METHODS: Data of 95 workers in forward-rotating three-shift work and 681 workers in backward-rotating three-shift work, with 32 months of follow-up, in the Maastricht cohort study (N=12,095) were used. Both cross-sectional and longitudinal analyses were carried out. RESULTS: A backward rotation schedule was prospectively related to an increased need for recovery [relative risk (RR) 2.88, 95% confidence interval (95% CI) 1.06-7.81] and poor general health (RR 3.21, 95% CI 1.32-7.83), as compared with a forward rotation schedule. Adjustment for demographic and health variables and the characteristics of the work environment did not alter these relations considerably. Furthermore, a forward rotation schedule was prospectively related to less work-family conflict and better sleep quality over the 32 months of follow-up. Finally, high levels of fatigue, need for recovery, poor sleep quality, poor general health, insufficient leisure time, and work-family conflict at first measurement were associated with an increased risk of leaving shiftwork during the follow-up. CONCLUSIONS: Optimization of shiftwork schedules, in terms of shift rotation, seems a promising method for decreasing the negative impact accompanying shiftwork. Future studies should investigate whether these findings for three-shift workers are applicable to other shiftwork schedules as well. Furthermore, this study clearly illustrates the existence of secondary selection processes among shiftworkers and thereby emphasizes the complexity of valid shiftwork research.

Adult↗

PubMed2003

Need for recovery from work: evaluating short-term effects of working hours, patterns and schedules.

In this paper working hours, patterns and work schedules of employees were evaluated in terms of need for recovery from work. Self-administered questionnaire data from employees of the Maastricht Cohort Study on Fatigue at Work (n = 12,095) were used. Poisson regression analyses and multivariate logistic regression analyses revealed that higher working hours a day and working hours a week generally went together with more need for recovery from work. Overtime work was particularly associated with higher need for recovery from work in both genders. Both male and female three-shift or irregular shift workers had higher odds of elevated need for recovery compared to day workers. When additionally controlling for work-related factors, need for recovery levels among shift workers substantially lowered. This study clearly showed that working hours and schedules are associated with need for recovery from work, with different associations for men and women. Especially the associations between work schedules and need for recovery from work were very interrelated with other work-related factors. Future studies could further investigate the possibility that shift work might function as a proxy of other work-related factors that explain the different levels in need for recovery from work, or that job demands are perceived higher among shift workers and may therefore lead to more need for recovery from work.

Adult↗

PubMed2003

The association between chronic diseases and fatigue in the working population.

OBJECTIVE: The aims of this study were to examine (a) whether employees with a chronic disease report more fatigue than employees without a chronic disease, (b) whether number or type of chronic disease is related to fatigue, and (c) whether differences in fatigue level in various types of chronic diseases are related to psychological distress. METHODS: Data were taken from 12,137 employees. Fatigue was measured with the Checklist Individual Strength (CIS). RESULTS: Employees with a chronic disease reported more fatigue (OR=2.9, 95% CI=2.7-3.2). Small differences were observed in the level of fatigue in various types of diseases. A strong linear association between the number of chronic diseases and fatigue was found. Psychological distress explained the higher level of fatigue in some chronic diseases (gastrointestinal diseases and migraine). CONCLUSIONS: Fatigue is more common in employees with a chronic disease. A strong association between number of chronic diseases and fatigue exists. Fatigue in employees with a chronic disease can partly be explained by psychological distress. Some chronic diseases show a stronger association between psychological distress and fatigue.

Adolescent↗

PubMed2003

Antecedents and consequences of work-family conflict: a prospective cohort study.

This study examined both risk factors for the onset of work-family conflict and consequences in terms of need for recovery and prolonged fatigue for men and women separately. Two-year follow-up data from the Maastricht Cohort Study on "Fatigue at Work" (n = 12,095) were used. At baseline, the prevalence of work-family conflict was 10.8% (9.0% in women; 11.1% in men), the cumulative incidence at 1 year follow-up was 5.1%. For men, several work-related demands, shift work, job insecurity, conflicts with coworkers or supervisor, having full responsibility for housekeeping, and having to care for a chronically ill child or other family member at home were risk factors for the onset of work-family conflict, whereas decision latitude and coworker and supervisor social support protected against work-family conflict. In women, physical demands, overtime work, commuting time to work, and having dependent children were risk factors for work-family conflict, whereas domestic help protected against work-family conflict at 1 year follow-up. Work-family conflict was further shown to be a strong risk factor for the onset of elevated need for recovery from work and fatigue.

Adult↗

PubMed2002

Fatigue and psychological distress in the working population: psychometrics, prevalence, and correlates.

OBJECTIVE: The purposes of this study were: (1) to explore the relationship between fatigue and psychological distress in the working population; (2) to examine associations with demographic and health factors; and (3) to determine the prevalence of fatigue and psychological distress. METHODS: Data were taken from 12,095 employees. Fatigue was measured with the Checklist Individual Strength, and the General Health Questionnaire (GHQ) was used to measure psychological distress. RESULTS: Fatigue was fairly well associated with psychological distress. A separation between fatigue items and GHQ items was shown. No clear, distinct pattern of associations was found for fatigue vs. psychological distress with respect to demographic factors. The prevalence was 22% for fatigue and 23% for psychological distress. Of the employees reporting fatigue, 43% had fatigue only, whereas 57% had fatigue and psychological distress. CONCLUSIONS: The results indicate that fatigue and psychological distress are common in the working population. Although closely associated, there is some evidence suggesting that fatigue and psychological distress are different conditions, which can be measured independently.

Adolescent↗

PubMedDate not supplied

Risk of depression and anxiety in employees with chronic bronchitis: the modifying effect of cigarette smoking.

OBJECTIVE: The present study evaluates whether smoking status modifies the association between chronic bronchitis and depression or anxiety in a population-based sample. Furthermore, we tested whether these associations are different in people without any respiratory complaints and those with asthma. METHODS: For this study, we used cross-sectional data form the Maastricht Cohort Study, a population-based cohort study among Dutch employees. RESULTS: In total, 7482 employees completed and returned the questionnaire (92.7%). In employees with chronic bronchitis, the prevalence of depression and anxiety was significantly higher compared with healthy employees and employees with asthma. Results indicate that the odds of having comorbid depression or anxiety for employees with chronic bronchitis compared with healthy employees is highest in current and past smokers, indicating that smoking status modifies this association. CONCLUSION: Chronic bronchitis is strongly associated with depression and anxiety. Because depression and/or anxiety may not only interfere with an attempt to stop smoking but also contribute significantly to experiencing low quality of life, it is important to consider these disorders and chronic bronchitis as different disease entities. Prospective longitudinal studies are needed to elucidate the mechanisms underlying the association among chronic bronchitis, psychiatric disorders, and cigarette smoking.

Absenteeism↗