Type of participants
This review will consist of studies that include women and men who are of working age (typically 16 to 65 years), have one or more chronic physical illness, have experience with disability policy, and live in any community worldwide. The studies may involve only individuals with chronic physical illness or may include other individuals also, as long as data can be extracted on the individuals with chronic physical illness. The following definition of chronic physical illness will be used to identify studies conducted on the participants of interest:
Chronic physical illness is any physical disease of “long duration and generally slow progression”6(para 1) which can be treated by health interventions but not cured and which can impair daily activities through disability and negatively impact quality of life.40 Among the most common chronic physical illnesses are cardiovascular disease (e.g. coronary artery disease), cerebrovascular disease (e.g. stroke), chronic obstructive pulmonary disease, asthma, diabetes, cancer, arthritis, HIV/AIDS, and such neurological conditions as epilepsy, multiple sclerosis and Parkinson's disease.6,40,41 Excluded from this definition are dementia, mental illness, sensory impairment (hearing and vision loss), developmental conditions (e.g. cerebral palsy, autism) and injuries.
Phenomena of interest
The phenomena of interest for this review are perceived barriers and facilitators in disability policy with respect to labor market engagement. Therefore studies about experiences with disability policy and in which one or both of these phenomena have been examined will be considered for inclusion in this review.
The context of interest for this review is individuals with chronic physical illness living in any community worldwide.
Types of studies
The studies that will be considered for this review are those in which qualitative data have been gathered and analyzed on the phenomena of interest and include, but are not limited to, the following designs: phenomenology, grounded theory, ethnography, qualitative description, action research, feminist research and mixed methods research.
A three-step search strategy will be employed in this review to find both published and unpublished studies. An initial limited search of PubMed and CINAHL will be undertaken followed by an analysis of text words contained in the title and abstract and of the index terms used to describe the article. A second search using all identified keywords and index terms will then be undertaken across all included databases. Thirdly, the reference list of all identified reports and articles will be searched for additional studies. Language limits will not be applied in the search strategies. However, only studies published in the English language will be considered for inclusion in this review. Any published non-English studies will be documented and reported in the review. Date limitations will not be imposed on search strategies.
The databases that will be searched consist of the following: PubMed, CINAHL, PsycInfo, Ageline, Sociological Abstracts, SocINDEX, Social Services Abstracts and Social Work Abstracts. Unpublished studies will be sought through direct contact with authors and through searching ProQuest Dissertations and Theses, MEDNAR, Google Scholar, OpenGrey, OAIster, Google and websites for relevant research institutions, government agencies and non-government organizations.
Initial keywords for the search will consist of the following:
chronic disease, chronic illness, chronic condition, disability, and specific chronic illnesses and classes of illnesses, namely arthritis, asthma, cancer, cardiovascular disease, cerebrovascular disease, coronary artery disease, chronic kidney disease, chronic fatigue syndrome, chronic obstructive pulmonary disease, Crohn's disease, diabetes, epilepsy, fibromyalgia, hepatitis, HIV/AIDS, stroke, systemic lupus erythematosus, Lou Gehrig's disease (amyotrophic lateral sclerosis), multiple sclerosis, Parkinson's disease, ulcerative colitis
work, employment, labor/labour market, job market, job accommodation, job re-entry, disability insurance, benefits, sick leave, policy, legislation, public assistance, social security, social welfare
experience, perception, perspective, narrative, interview, field study, focus group, audio-recording, observational method, qualitative, phenomenology, grounded theory, ethnography, mixed methods, content analysis
The search strategy will be implemented by the health sciences librarian on this review in consultation and collaboration with the other reviewers.
Assessment of methodological quality
Papers selected for retrieval will be independently assessed by the primary and secondary reviewers, that is, the first and second authors, for methodological validity prior to inclusion in the review. A standardized critical appraisal instrument, the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI), will be used (Appendix I). The reviewers will be blinded to each other's assessments of the studies. Once the assessments are completed, the primary reviewer will compare the two assessments for each study. Any discrepancies between the assessments will be resolved through discussion between the first two reviewers and in consultation with the third reviewer and a decision will be made to include the study or not include it in the review.
Data will be extracted from papers included in the review using the standardized Joanna Briggs Institute Data Extraction Instrument (JBI-QARI) (Appendix II). The data extracted will include specific details about the phenomena of interest, populations, study methods and outcomes relevant to addressing the review questions. Authors of studies will be contacted to clarify or seek additional data as necessary. The data will be extracted from each study by the primary reviewer in collaboration with the secondary reviewer. The third reviewer will be consulted should questions arise concerning the data.
Qualitative research findings will, where possible, be pooled using JBI-QARI. This will involve the aggregation or synthesis of findings to generate a set of statements that represent that aggregation, through assembling the findings rated according to their quality and categorizing these findings on the basis of similarity in meaning. These categories will then be subjected to a meta-synthesis in order to produce a single comprehensive set of synthesized findings that can be used as a basis for informing evidence-based practice. Where textual pooling is not possible the findings will be presented in narrative form. The data synthesis will be conducted by the primary reviewer in collaboration with the secondary reviewer. The third reviewer will be consulted for input and the findings will be confirmed through team discussion.
Conflicts of interest
The authors declare no conflicts of interest.
1 World Health Organization. World Report on Disability. Geneva; 2011.
3 The Organisation for Economic Co-operation and Development (OECD). 2015. [Internet]. [Cited July 29, 2015]. Available from: http://www.oecd.org/about/
4 Jones MK. Disability and the labour market: a review of the empirical evidence. J Econ Stud. 2008;35(5):405-424.
5 Donavan R, Dawson B. Fifth Quadrant Analytics: The Return on Disability Company. 2012. [Internet]. [Cited July 29, 2015]. Available from: http://returnondisability.com/
7 Koch LC, Rumrill PD, Conyers L, Wohlford S. A narrative literature review regarding job retention strategies for people with chronic illnesses. Work. 2013;46(1):125-134.
8 Turcotte M. Insights on Canadian Society: Persons with disabilities and employment. Ottawa: Ministry of Industry; 2014. Statistics Canada Catalogue no. 75-006-X.
9 Crooks VA. Women's experiences of developing musculoskeletal diseases: employment challenges and policy recommendations. Disabil Rehabil. 2007;29(14):1107-1116.
10 De Vroome EMM, Uegaki K, van der Ploeg CPB, et al. Burden of Sickness Absence Due to Chronic Disease in the Dutch Workforce from 2007 to 2011. J Occup Rehabil. 2015;25(4):675-84.
11 De Graaf R, Tuithof M, van Dorsselaer S, ten Have M. Comparing the effects on work performance of mental and physical disorders. Soc Psychiatry Psychiatr Epidemiol. 2012;47(11):1873-1883.
12 Dooley D, Fielding J, Levi L. Health and Unemployment. Annu Rev Public Health. 1996;17:449-465.
13 Vick A, Lightman E. Barriers to Employment Among Women With Complex Episodic Disabilities. J Disabil Policy Stud. 2010;21(2):70-80.
14 Anema JR, Prinz C, Prins R. Sickness and Disability Policy Interventions. In: Loisel P, Anema JR, eds. Handbook of Work Disability: Prevention and Management. New York: Springer; 2013:357-371.
15 The Organization for Economic Co-operation and Development. Transforming Disability into Ability: Polices to Promote Work and Income Security for Disabled People. Paris; 2003.
16 The Organization for Economic Co-operation and Development. Sickness, Disability and Work: Breaking Barriers - A Synthesis of Findings across OECD Countries. Paris; 2010.
17 O'Leary P, Dean D. International Research Project on Job Retention and Return to Work Strategies for Disabled Workers: Study Report, USA. Cornell University: GLADNET Collection; 1998. [Internet]. [Cited June 1, 2015]. Available from: http://digitalcommons.ilr.cornell.edu/gladnetcollect/159
18 Jongbloed L. Disability Policy in Canada: An Overview. J Disabil Policy Stud. 2003;13(4):203-209.
19 Kopnina H, Haafkens JA. Disability management: Organizational diversity and dutch employment policy. J Occup Rehabil. 2010;20(2):247-255.
20 Nevala N, Pehkonen I, Koskela I, Ruusuvuori J, Anttila H. Workplace Accommodation Among Persons with Disabilities: A Systematic Review of Its Effectiveness and Barriers or Facilitators. J Occup Rehabil. 2015; 25(2):432-448.
21 Lindsay S, Goodfellow A, Stergiou-Kita M, Kirsh B, Lero D. Improving the Participation of Under-Utilized Talent of People with Physical Disabilities in the Canadian Labour Market: A Scoping Review. 2013.
22 Tripney J, Roulstone A, Vigurs C, Schmidt E, Stewart R. Protocol for a Systematic Review: Interventions to Improve the Labour Market Situation of Adults with Physical and / or Sensory Disabilities in Low- and Middle- Income Countries. Campbell Collab. 2015;11(20):1-65.
23 Antao L, Shaw L, Ollson K, et al. Chronic pain in episodic illness and its influence on work occupations: A scoping review. Work. 2013;44(1):11-36.
24 Saunders SL, Nedelec B. What work means to people with work disability: A scoping review. J Occup Rehabil. 2014;24(1):100-110.
25 Nastasia I, Coutu M-F, Tcaciuc R. Topics and trends in research on non-clinical interventions aimed at preventing prolonged work disability in workers compensated for work-related musculoskeletal disorders (WRMSDs): a systematic, comprehensive literature review. Disabil Rehabil. 2014;36(22):1841-1856.
26 Varekamp I, Verbeek JAM, van Dijk FJH. How can we help employees with chronic diseases to stay at work? A review of interventions aimed at job retention and based on an empowerment perspective. Int Arch Occup Environ Health. 2006;80(2):87-97.
27 Schandelmaier S, Ebrahim S, Burkhardt SCA, de Boer WEL, Zumbrunn T, et al. Return to Work Coordination Programmes for Work Disability: A Meta-Analysis of Randomised Controlled Trials. PLoS One. 2012;7(11):e49760.
28 Gensby U, Labriola M, Irvin E, Amick BC, Lund T. A classification of components of workplace disability management programs: Results from a systematic review. J Occup Rehabil. 2014;24(2):220-241.
29 Bambra C, Whitehead M, Hamilton V. Does "welfare-to-work" work? A systematic review of the effectiveness of the UK's welfare-to-work programmes for people with a disability or chronic illness. Soc Sci Med. 2005;60(9):1905-1918.
30 Clayton S, Bambra C, Gosling R, Povall S, Misso K, Whitehead M. Assembling the evidence jigsaw: insights from a systematic review of UK studies of individual-focused return to work initiatives for disabled and long-term ill people. BMC Public Health. 2011;11(1):170.
31 Patel AS, Farquharson R, Carroll D, Moore A, Phillips CJ, Taylor RS, et al. The Impact and Burden of Chronic Pain in the Workplace: A Qualitative Systematic Review. Pain Pract. 2012;12(7):578-589.
32 De Jong M, de Boer AGEM, Tamminga SJ, Frings-Dresen MHW. Quality of Working Life Issues of Employees with a Chronic Physical Disease: A Systematic Review. J Occup Rehabil. 2015;25(1):182-196.
33 De Vries HJ, Reneman MF, Groothoff JW, Geertzen JHB, Brouwer S. Factors promoting staying at work in people with chronic nonspecific musculoskeletal pain: A systematic review. Disabil Rehabil. 2012;34(6):443-458.
34 Hand CL, Wilkins S, Letts LJ, Law MC. Renegotiating environments to achieve participation: A metasynthesis of qualitative chronic disease research. Can J Occup Ther Can D Ergotherapie. 2013;80(4):251-262.
35 Gewurtz R, Kirsh B. Disruption, disbelief and resistance: A meta-synthesis of disability in the workplace. Work. 2009;34(1):33-44.
36 Banning M. Employment and breast cancer: A meta-ethnography. Eur J Cancer Care (Engl). 2011;20(6):708-719.
37 Hoving JL, van Zwieten MCB, van der Meer M, Sluiter JK, Frings-Dresen MHW. Work participation and arthritis: A systematic overview of challenges, adaptations and opportunities for interventions. Rheumatol (United Kingdom). 2013;52(7):1254-1264.
38 Wells M, Williams B, Firnigl D, et al. Supporting "work-related goals" rather than "return to work" after cancer? A systematic review and meta-synthesis of 25 qualitative studies. Psychooncology. 2013;22(6):1208-1219.
39 MacEachen E, Clarke J, Franche RL, et al. Systematic review of the qualitative literature on return to work after injury. Scand J Work Environ Heal. 2006;32(4):257-269.
Appendix I: Appraisal instruments
QARI appraisal instrument
Appendix II: Data extraction instruments
QARI data extraction instrument