157 General discussion be accepted as causes. Clinical tests, functional capacity evaluations, and psychological tests were the most commonly used methods to assess inability to work fulltime, although all countries mentioned different combinations of methods as suitable for this purpose. In all countries, research on this topic was found to be very limited, and only in the Netherlands was a guideline (not evidence-based) available. More evidence on this concept is obviously warranted, considering the huge impact of these assessment outcomes for both society and the individual. Research question 2: What is the prevalence of inability to work fulltime and what are associated socio-demographic and disease-related factors? The research described in Chapters 4 to 6 used different study samples to examine the prevalence of inability to work fulltime and associated sociodemographic and disease-related factors. In Chapter 4, we used registerbased data of a year cohort of 30,177 sick-listed workers applying for longterm work disability benefits according to the Work and Income Act (WIA), including all types of diagnoses. This study showed an almost 40% overall prevalence of inability to work fulltime. Of these applicants unable to work fulltime, the majority could not work more than 4 hours per day. We found that applicants with higher age, female gender, higher educational level (compared to lower level) and multimorbidity had a significantly higher risk of an inability to work fulltime. This risk varied between disease groups, with diseases of the blood, the respiratory system, neoplasms, and diseases of the genitourinary and circulatory system indicating higher odds, and musculoskeletal diseases, the largest group in the sample, indicating lower odds. In Chapters 5 and 6, we used the same dataset, but included only applicants whose primary diagnosis involved a cancer (Chapter 5) or a mental and behavioral disorder (Chapter 6) to further explore inability to work fulltime within these disease groups. For applicants diagnosed with cancer, we found a prevalence of 69.8% inability to work fulltime, and for the group diagnosed with a mental disorder, a prevalence of 41.4%. Different associations between socio-demographic and disease-related factors were identified in both groups. For applicants diagnosed with cancer, age and female gender were significantly associated with higher risk of inability to work fulltime. For applicants diagnosed with a mental disorder, age and female gender were again significantly associated with higher risk of inability to work fulltime. Regarding disease-related factors, for both cancer and mental disorders we found differences between type of diagnoses and inability to work fulltime. Applicants diagnosed with lymphoid and haematopoietic cancers showed higher risks of being assessed as unable to work fulltime, whereas being diagnosed with cancer of the musculoskeletal (locomotor) system indicated 8
RkJQdWJsaXNoZXIy MTk4NDMw