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PubMed1980

A sequential criterion analysis for assessing coping with chronic illness.

A three-stage sequential criterion analysis based on the Goldfried-D'Zurilla behavior model is presented as a heuristic approach for studying chronic illness. The three interrelated stages consist of: (a) problem identification, (b) response enumeration, and (c) response evaluation. The utility of this systematic approach for understanding the adaptive process, helping to identify patients who might benefit from intervention, providing content for actual intervention, and reducing the myth of homogeneity among chronic patient populations for both clinicians and researches, is discussed. Examples of the utility of the criterion analysis are provided throughout the paper.

Adaptation, Psychological↗
PubMed2001

[From limitations to possibilities; the advice from the Donner Committee about disability benefits legislation].

In the Netherlands, the number of people declared unfit to work continues to rise: every working day sees more than 100 new benefit claimants. The average age of these claimants is decreasing and the number of women declared unfit for work is showing a disproportionate increase. Against this background, the Dutch government appointed a committee in June 2000 whose task was to examine the functioning of the legislation. The Donner Committee concluded that the claims made under the disability benefits legislation could not be clarified by a worsening of either the public health or the working conditions. The legislation is based on obsolete ideas in which illness effectively excludes employment. This idea fosters a range of social problems in the employment process, which present themselves as medical problems and therefore remain elusive and unsolved. The result is that people are unnecessarily eliminated from society at a time when paid employment is an increasingly important means of social interaction. The Committee proposes a drastic simplification of the legislation so that a disability benefit can only be claimed in the case of complete unfitness for work. Such a claim can only be made in the case of a serious illness which results in permanent and considerable limitations in everyday functioning. For all other cases involving health problems, the employer and employee need to work together to organise appropriate work. The emphasis is on what the employee can do as opposed to what he/she cannot do. If the employer fails to take the necessary measures then he/she will be obliged to continue paying the salary and if the employee fails to cooperate then he/she can be dismissed. If needs be the employee must be prepared to except a salary reduction of 30%. After two years of absence, dismissal is in every case possible. It is anticipated that as a result of the Committee's proposals, more people will remain in employment but that the number of unemployed as well as the number of legal disputes concerning dismissal will increase.

Disability Evaluation↗
PubMed1991

[Methodological procedures in the evaluation of health within the scope of fitness assessment by the public health service in East Germany].

The base of all fitness ratings is the problem of conformity of individual health state and working conditions. The National Health Services in the GDR, Infant and Youth Health Protection, Industrial Medicine, Public Health Service, the Sports medicine Service, Traffic Medicine Service and the Medical Service of the NVA, employ different methods of fitness rating. When comparing the various methods it becomes evident that the methods applied by the Traffic Medicine Service and the Medical Service of the NVA are more valid. The results of the review tire evidence of the possibility of developing a uniform nomenclature.

Adolescent↗
PubMed1990

[Quality and value of expert assessment of disability with reference to evaluation of cardiovascular diseases].

Because of the high frequency of diseases of heart and circulation a great number of physicians is concerned with experts opinions of them. There were 273 experts opinions from the rural and city district of Leipzig analysed in order to estimate quality and assertions force of experts opinions of invalidity with regard to estimation of diseases of heart and circulation. There was often found that data of anamnesis and documents extracts did not satisfy. But the parts about findings and estimates of experts opinions were in most cases well. Often complaints of patients and possibilities of therapy and rehabilitation were considered too less. The code of diagnosis did not always correspond to the International Statistical Classification of Diseases and Death Causes. There was often no sufficient evidence of diagnosis and degree of heaviness in the text of the experts opinions. But clinical findings with function checks were very well documented in many experts opinions.

Coronary Disease↗
PubMed1990

[Relation of occupational demands and stresses, health status and work incapacity of young workers].

A cross-sectional analysis was carried out comprising 620 boys and 294 girls active in their jobs between one and six years after leaving school to examine the influence of physical conditions and job-related stress and exposures on the frequency of their absenteeism from work due to illness. The frequency is rather high in young workers with chronic disorders or people who have to work under adverse hygienic conditions. This can be seen as a result of both psychic and social factors as well as chronic disorders or job-related stress and exposures, the latter influencing heavily the time a worker may be unfit for work. To raise young people's fitness for work it is necessary to elevate the standard of industrial welfare and provide appropriate health care at the workplace.

Absenteeism↗
PubMed1990

[Medical certification of work and occupational disability].

The ability to work does not depend only on medical factors, but also on various other factors, such as professional training, knowledge of languages, manual ability and the state of the job market. Such non-medical matters may fall outside the physician's area of competence. Assessment of inability to work may thus be very difficult, and may be impossible without additional information.

Aptitude↗