From the Guidelines
Improving employment and non-employment outcomes for individuals with chronic illness requires a multifaceted approach that addresses social determinants of health, including interventions to promote flexible back-to-work policies and mitigate risk factors for cardiovascular disease. This approach is crucial as individuals with chronic illness, such as heart failure, face significant challenges in maintaining employment, with factors like heavy alcohol consumption, smoking, depression, and chronic pain exacerbating the risk of unemployment 1.
Key Interventions
- Policy-based interventions that promote more flexible back-to-work policies to mitigate the incidence of disability and joblessness are essential 1.
- Clinician sensitivity to the effects of poverty on an individual's self-care ability can lead to effective tailoring of the care plan to help patients compensate, with the involvement of community health workers being a particularly successful intervention 1.
- Addressing mental health issues, such as depression, through evidence-based treatments can also improve employment outcomes, as these conditions are often comorbid with chronic illnesses and significantly impact an individual's ability to work.
Comprehensive Support
Improving quality of life for individuals with chronic illness involves not only medical treatment but also supportive services that address the social determinants of health. This includes vocational rehabilitation services, such as job coaching and skills training, to help individuals return to work or find suitable employment matching their abilities. Additionally, lifestyle modifications, including regular physical activity tailored to ability levels, proper nutrition, and adequate sleep hygiene, can significantly improve overall functioning and quality of life.
Employment and Non-Employment Outcomes
The relationship between unemployment and increased risk of cardiovascular disease is well described 1, highlighting the need for interventions that not only support employment but also mitigate the health risks associated with unemployment. By addressing these factors and providing comprehensive support, individuals with chronic illness can experience improvements in both employment and non-employment outcomes, leading to better morbidity, mortality, and quality of life outcomes.
From the Research
Employment Outcomes
- Individuals with chronic illness can expect improvements in employment outcomes through supported employment interventions, such as the Individual Placement and Support (IPS) model 2, 3, 4, 5.
- The IPS model has been shown to be effective in increasing competitive employment rates, job stability, and overall employment outcomes for individuals with severe mental illnesses 2, 4, 5.
- Supported employment interventions have also been found to be beneficial for individuals with conditions other than severe mental illness, such as affective disorders, mental disorders and justice involvement, and substance abuse 3.
Non-Employment Outcomes
- Improvements in non-employment outcomes, such as global state, social functioning, mental state, quality of life, and satisfaction, have also been reported in individuals with chronic illness who participate in supported employment interventions 3, 4.
- However, the evidence for non-employment outcomes is limited, and more research is needed to fully understand the effects of supported employment on these outcomes 3, 4.
Key Factors
- Strong collaborations between vocational rehabilitation (VR) and IPS programs are essential for improving employment outcomes, and features of strong collaborations include expertise, consistency, accessibility, and integration 2.
- Fidelity to the IPS model and the addition of other interventions can also enhance the effectiveness of supported employment 4.
- Defining competitive employment and increasing the measurement of non-vocational outcomes can help improve research in this area 3.