Cognitions and perceptions of workers with a chronic disease: Development and evaluation of a training program for occupational health professionals

The number of people in the working age with a chronic disease is rising. Occupational physicians and insurance physicians are occupational health professionals (OHPs) with a key role to increase work participation of people with a chronic disease by intervening on factors that can limit work participation. Important factors in this are cognitions and perceptions of workers, such as motivation or expectations regarding return to work. The main objective of this thesis is to gain more knowledge on how OHPs can involve cognitions and perceptions in the occupational health management and work disability assessment of workers with a chronic disease.
Part I of this thesis describes two literature reviews, a survey study among OHPs and a focus group study among workers in which knowledge was acquired regarding ten cognitions and perceptions associated with work participation, how OHPs can obtain information about these factors and how they can intervene on these factors when necessary. With the outcome of these studies a training program on cognitions and perceptions for OHPs was developed and evaluated, which is described in Part II of this thesis. In addition, the effects of the training were studied in a randomized controlled trial.
Participation in the training program increased the ability of OHPs to identify cognitions and perceptions of workers and to recommend evidence-based interventions. OHPs were very satisfied about the training program. They thought it was useful for practice and were more aware of cognitions and perceptions during consultations after following the training. However, lack of time was perceived as a barrier when implementing the learned skills into practice.
The thesis concludes with recommendations for OHPs to identify cognitions and perceptions, to discuss cognitions and perceptions during consultations, and to advice about interventions to change these factors. Participation of OHPs in the new developed training program is recommended.