Sick leave in asthma and COPD; the role of the disease, adaptation, work, psychosocial factors and knowledge.

Contains fulltext : 58719.pdf (publisher's version ) (Open Access)Asthma and Chronic Obstructive Pulmonary Disease (COPD) have negative consequences for work performance. Sick leave and work disability not only lead to high costs for society, but also for a loss of social fulfilment in life through work, which may reduce quality of life. The objective of this thesis was to investigate associations between a broad array of different factors and sick leave in workers with asthma and COPD. Factors we investigated were disease characteristics, health complaints, functional limitations, work characteristics, psychosocial variables, and workers? knowledge about the management of the disease and about their diagnosis. We especially focused on adaptation to functional limitations regarding sick leave. Adaptation is considered as an active way of coping in which an individual adapts to the chronic disorder he is suffering from. This involves a behavioural change, in which he accepts the consequences of the chronic disorder and adapts to this situation. We conducted three studies. First, a qualitative study was conducted using focusgroup interviews (2001). For the second study, a cohort of 189 workers with asthma and COPD underwent a pulmonary function test and completed questionnaires (2002). In the third study, 165 participants completed questionnaires again after one year. The main finding of this study was that inadequate adaptation was associated with sick leave in workers with asthma and COPD. Secondly, within a population of workers with asthma and COPD, parameters expressing the severity of the disease, such as level of pulmonary obstruction (FEV1), were not associated with sick leave. Thirdly, more perceived control over health complaints was associated with less sick leave. The last conclusion was that more knowledge about the disease was associated with more adequate adaptation to functional limitations.KUN Katholieke Universiteit Nijmegen, 1 december 2004Promotores : Folgering, H.T.M., Weel, C. van Co-promotores : Gulden, J.W.J. van der, Vercoulen, J.H.M.M