15 General introduction Outline of the thesis This first chapter (Chapter 1) is a general introduction, describing the societal background of the concept of inability to work fulltime, placing this concept in the setting of work disability benefits, and laying out the research gaps and aims of the thesis. Chapter 2 presents the findings of an interview study involving perspectives of both patients and physicians, to provide a conceptualization and operationalization of the concept inability to work fulltime as well as an inventory of assessment methods. Chapter 3 presents findings from a survey across experts from 19 countries, through the European Union of Medicine in Assurance and Social Security (EUMASS), to explore the characteristics and the assessment of inability to work fulltime across European countries. Chapter 4 presents descriptive data on various aspects of (the assessment of) inability to work fulltime. It also provides information about the prevalence and degree of inability to work fulltime in the Netherlands, and describes relevant socio-demographic and diseaserelated factors. For this study we used a cross-sectional register-based cohort of applicants for long-term work disability benefits, according to the Work and Income Act (WIA) [13]. Chapters 5 and 6 explore the prevalence, and associations with our subject, in applicants diagnosed with cancer (Chapter 5) and mental health problems (Chapter 6), using the same cohort. Again, using the same cohort, Chapter 7 presents results of a study to explore the association of inability to work fulltime with having paid employment one year after the assessment, using follow-up register data on work participation. Chapter 8, the general discussion, presents an overview of the main findings and discusses the results. It also provides implications for policy and practice, and recommendations for future research. 1
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