abstract: 'Rationale \& Objective: Although patients with chronic kidney disease

  (CKD) are at risk for work disability and loss of employment, not all

  experience work disruption. We aimed to describe the barriers to and

  facilitators of sustained employment experienced by Dutch patients with

  CKD.

  Study Design: Qualitative study using semi-structured interviews.

  Setting \& Participants: 27 patients with CKD glomerular filtration rate

  categories 3b-5 (G3b-G5) from 4 nephrology outpatient clinics in The

  Netherlands.

  Analytical Approach: Content analyses with constant comparison of

  interview data based on the International Classification of Functioning,

  Disability and Health framework.

  Results: Participants were 6 patients with CKD G3b-G4, 8 patients

  receiving maintenance dialysis, and 13 patients with functioning kidney

  transplants. We identified health-related barriers (symptoms, physical

  toll of dialysis/transplantation, limited work capacity) and

  facilitators (few physical symptoms, successful posttransplantation

  recovery, absence of comorbidities, good physical condition), personal

  barriers (psychological impact, limited work experience) and

  facilitators (positive disposition, job satisfaction, work attitude,

  person-job fit), and environmental barriers and facilitators.

  Environmental barriers were related to nephrology care (waiting time,

  use of a hemodialysis catheter) and work context (reorganization,

  temporary contract, working hours, physical demands); environmental

  facilitators were related to nephrology care (personalized dialysis,

  preemptive transplant), work context (large employer, social climate,

  job requiring mental rather than physical labor, flexible working hours,

  adjustment of work tasks, reduced hours, remote working, support at

  work, peritoneal dialysis exchange facility), and support at home.

  Occupational health services and social security could be barriers or

  facilitators.

  Limitations: The study sample of Dutch patients may limit the

  transferability of these findings to other countries.

  Conclusions: The wide range of barriers and facilitators in all

  International Classification of Functioning, Disability and Health

  components suggests great diversity among patients and their

  circumstances. These findings underline the importance of personalized

  nephrology and occupational health care as well as the importance of

  individually tailored workplace accommodations to promote sustained

  employment for patients with CKD.'
affiliation: 'van der Mei, SF (Corresponding Author), Univ Groningen, Dept Hlth Sci
  Appl Hlth Res, Univ Med Ctr Groningen, Groningen, Netherlands.

  van der Mei, Sijrike F.; Alma, Manna A.; Visser, Annemieke, Univ Groningen, Dept
  Hlth Sci Appl Hlth Res, Univ Med Ctr Groningen, Groningen, Netherlands.

  Brouwer, Sandra, Univ Groningen, Dept Hlth Sci Community \& Occupat Med, Univ Med
  Ctr Groningen, Groningen, Netherlands.

  Gansevoort, Ron T.; Franssen, Casper F. M.; Bakker, Stephan J. L., Univ Groningen,
  Dept Internal Med, Univ Med Ctr Groningen, Groningen, Netherlands.

  Westerhuis, Ralf, Dialysis Ctr Groningen, Groningen, Netherlands.

  de Rijk, Angelique E., Maastricht Univ, Fac Hlth Med \& Life Sci, CAPHRI Care \&
  Publ Hlth Res Inst, Dept Social Med, Maastricht, Netherlands.

  Hemmelder, Marc H., Med Ctr Leeuwarden, Dept Internal Med, Leeuwarden, Netherlands.

  van Buren, Marjolijn, HagaHosp, Dept Internal Med, The Hague, Netherlands.

  van Buren, Marjolijn, Leiden Univ Med Ctr, Dept Nephrol, Leiden, Netherlands.'
author: van der Mei, Sijrike F. and Alma, Manna A. and de Rijk, Angelique E. and Brouwer,
  Sandra and Gansevoort, Ron T. and Franssen, Casper F. M. and Bakker, Stephan J.
  L. and Hemmelder, Marc H. and Westerhuis, Ralf and van Buren, Marjolijn and Visser,
  Annemieke
author-email: s.f.van.der.mei@umcg.nl
author_list:
- family: van der Mei
  given: Sijrike F.
- family: Alma
  given: Manna A.
- family: de Rijk
  given: Angelique E.
- family: Brouwer
  given: Sandra
- family: Gansevoort
  given: Ron T.
- family: Franssen
  given: Casper F. M.
- family: Bakker
  given: Stephan J. L.
- family: Hemmelder
  given: Marc H.
- family: Westerhuis
  given: Ralf
- family: van Buren
  given: Marjolijn
- family: Visser
  given: Annemieke
da: '2023-09-28'
doi: 10.1053/j.ajkd.2021.04.008
earlyaccessdate: NOV 2021
eissn: 1523-6838
files: []
issn: 0272-6386
journal: AMERICAN JOURNAL OF KIDNEY DISEASES
keywords-plus: 'KIDNEY-TRANSPLANTATION; WORK; HEALTH; DIALYSIS; DISEASE; LIFE;

  PARTICIPATION; INTERVENTION; MAINTENANCE; OUTCOMES'
language: English
month: DEC
number: '6'
number-of-cited-references: '45'
orcid-numbers: 'Alma, Manna/0000-0002-8203-2713

  van der Mei, Sijrike/0000-0003-0100-4882

  Franssen, Casper/0000-0003-1004-9994'
pages: 780-792
papis_id: 7e4177aa0a3b2a180fc13f408c2e31bc
ref: Vandermei2021barriersfacilitators
researcherid-numbers: 'Alma, Manna/G-7987-2011

  Hemmelder, Marc/AFQ-0383-2022

  '
times-cited: '8'
title: 'Barriers to and Facilitators of Sustained Employment: A Qualitative Study
  of Experiences in Dutch Patients With CKD'
type: article
unique-id: WOS:000720942500007
usage-count-last-180-days: '2'
usage-count-since-2013: '8'
volume: '78'
web-of-science-categories: Urology \& Nephrology
year: '2021'