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The needs of persons with chronic health conditions to maintain or return to work 30 years after transformation from socialism into capitalism – a preliminary report from the Polish part of the PATHWAYS project

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Gałaś A., Piłat A., Tobiasz–Adamczyk B., Leonardi M.
International Journal of Occupational Medicine and Environmental Health
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2020
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vol. 33
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issue 4
427-444
EN
ObjectivesAn increased burden of chronic diseases in the working age population is observed across high income countries. Persons with chronic diseases (PwCDs) are less likely to maintain or return to work due to several constraints they experience. The purpose of the study was to assess the preferences and needs of PwCDs regarding 6 areas of flexibility at the workplace. It was assessed whether there were any personal characteristics associated with higher or lower expectations and needs.Material and MethodsThis was a part of a large multicenter international project, i.e., the PArticipation To Healthy Workplaces And inclusive Strategies in the Work Sector (PATHWAYS) project, aimed to contribute to the development of innovative approaches to promote professional integration and reintegration of PwCDs into the work sector. In Poland, 59 respondents diagnosed with different chronic diseases were identified through advocacy groups. An on-line survey was conducted to collect information on their needs and expectations. A cluster analysis was performed to reveal some expectation types which differentiated individuals across 6 analyzed domains, along with a multivariable logistic regression to identify some characteristics associated with a special expectation type.ResultsWorkplace facilitator items were generally scored as needed (“rather conductive” and “very conductive” groups identified). The factors positively associated with higher needs in this domain were education, and a hindering type of the disease. Unrestricted working hours were very conductive or indifferent, and were positively associated with education. Legal solutions were more conductive for older people. Medical support, access to training, and supervisors’ knowledge were needed in general, with no associations with the personal characteristics identified.ConclusionsPersons with chronic diseases report several facilitators which are needed for them to maintain or return to work, but they are not satisfied with the existing economy in Poland. These needs should be taken into consideration in the effective policy development.
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Factors affecting work ability and influencing early retirement decisions of older employees: an attempt to integrate the existing approaches

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Woźniak B., Brzyska M., Piłat A., Tobiasz–Adamczyk B.
International Journal of Occupational Medicine and Environmental Health
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2022
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vol. 35
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issue 5
509-526
EN
The article has several objectives. First, it aims to discuss, based on the international literature analysis, theoretical models and factors influencing early retirement decisions, and limiting work ability and employability of older people. Second, the concept of (and the factors related to) work ability as well as the role of age management in improving employability and sustaining work activity of older adults are analyzed against the backdrop of the Polish context. Cultural (ageism) and organizational (e.g., a lack of appropriate age management in companies) factors influencing work activity in the oldest age groups are taken into account. Third, the authors present some solutions and recommendations coming from the international Participation To Healthy Workplaces And inclusive Strategies in the Work Sector (PATHWAYS) project. Finally, theoretical models, concepts and solutions are integrated into a model elucidating the conditions (cultural, social, organizational, individual) influencing work ability of older adults. The model aims to take into account theories and factors identified in the literature review and grouped into several categories. The analysis highlights the role of appropriate age management in companies in the process of sustaining work ability of older employees.
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Challenges for the labor market: 2 complementary approaches to premature cessation of occupational activity

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Piłat A., Wilga M., Leonardi M., Vlachou A., Tobiasz-Adamczyk B.
International Journal of Occupational Medicine and Environmental Health
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2019
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vol. 32
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issue 5
695-721
EN
Objectives Current demographic trends, such as society aging, the spreading of chronic diseases, as well as early retirement choices, lead to the dwindling labor market population. Taking into consideration the foregoing tendencies and their consequences, the issue of the shrinking labor force resources seems to be the most important challenge for the labor market. In response to it, this paper identifies individual and institutional causes of withdrawal from the labor market, and explores the views of Polish stakeholders on existing strategies for the occupational re-integration of persons with chronic diseases (PwCDs). Material and Methods Polish results of 2 European projects: “Participation to Healthy Workplaces and Inclusive Strategies in the Work Sector” (the PATHWAYS project) and “The Collaborative Research on Aging in Europe” (COURAGE in Europe) complemented each other. The cross-sectional population data and data from stakeholders’ interviews were used. Results The authors identified several causes which could encourage people to withdraw from the labor market before attaining the official retirement age at 3 different levels: individual, occupational, and institutional. Although research has shown that the macro-level situation is crucial to staying occupationally active, in Poland stakeholders have reported the lack of effective coordination in the implementation of policies for the occupational re-integration of PwCDs. Conclusions A decision to cease work prematurely reflects a combination of many different factors, such as individual determinates, work characteristics, personal convictions, and systemic solutions. The study demonstrated that, despite the awareness of the dwindling resources of labor force, the employment-related challenges faced by PwCDs as well as people who are close to the retirement age remain unaddressed. Int J Occup Med Environ Health. 2019;32(5):695–721
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Difficult entry and return to the labor market: on the professional (re)integration of people with disabilities and chronic health conditions in Poland (The PATHWAYS research project)

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Piłat A., Woźniak B., Tobiasz–Adamczyk B., Brzyska M., Leonardi M., Ferraina S., Kadyrbaeva A.
International Journal of Occupational Medicine and Environmental Health
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2019
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vol. 32
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issue 4
475-488
EN
Objectives The objective of this study is to present the barriers existing in Poland to professional integration and reintegration of people with chronic diseases, including mental health conditions, and discuss them on the basis of expert opinions and in comparison with the situation in other European countries. Material and Methods The research methodology was based on a mixed-methods approach, including literature review, in-depth expert interviews, and a survey (based on a structured questionnaire) performed with experts. Results The mapping of policies, systems and services facilitating the integration and reintegration of people with chronic diseases in Poland, as well as expert opinions, made it possible to identify many barriers regarding access to support, such as an obligation to have a certificate of disability, and a system of certification by 2 institutions. There are also barriers regarding the support itself, including problems with subsidies and with professional (re)integration services. Conclusions Poland has a multi-level and multi-sector system of public institutions, which should provide support for people with disabilities and chronic diseases. Nevertheless, the research conducted in Poland indicates an insufficient implementation of the existing solutions. Int J Occup Med Environ Health. 2019;32(4):475–88
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Gender perspective in the analysis of the relationship between health and work cessation, and how to deal with it

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Piłat A., Galaś A., Wilga M., Cabello M., Koskinen S., Haro J. M., Leonardi M., Tobiasz–Adamczyk B.
International Journal of Occupational Medicine and Environmental Health
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2020
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vol. 33
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issue 3
365-384
EN
ObjectivesThe main objective of this study is to examine the relationship between health and an early exit from paid employment in the Finnish, Polish, and Spanish populations. The authors have addressed the following 3 issues: who chooses not to work according to gender patterns, whether the health status is a determinant of being non-employed, and what diseases are associated with being non-employed.Material and MethodsThe studied material consists of data from the Collaborative Research on Ageing in Europe (COURAGE in Europe) project. The analysis was based on a sample of 5868 individuals, including 1214 from Finland, 2152 from Poland and 2532 from Spain. In the paper, these data were complemented with the results of the PArticipation To Healthy Workplaces And inclusive Strategies in the Work Sector (PATHWAYS) project. Results: The results of the study revealed that self-rated health was a strong predictor of being non-employed for different reasons. Chronic diseases, such as arthritis, angina, diabetes, chronic obstructive pulmonary disease, depression and hypertension, were typically associated with an increased risk of being non-employed due to health problems and early retirement. Women more frequently reported arthritis and depression, while a higher proportion of men suffered from angina and diabetes.ConclusionsThe results obtained by the authors highlight the importance of evaluating gender patterns in work cessation and, at the same time, the importance of gender-focused actions in terms of preventing withdrawal from the labor market. In principle, all chronic diseases have some impact on participation in the labor market. It is worth noting, however, that each of them affects workforce participation in a different manner, depending on the specific disease, country and gender. For this reason, tailored support to every individual’s needs is highly recommended.
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