Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands.
BMC Public Health. 2012 Mar 6;12:156. doi: 10.1186/1471-2458-12-156.
Work disability is a major problem for both the worker and society. To explore the work opportunities in regular jobs of persons low in functional abilities, we tried to identify occupations low in task demands. Because of the variety of functional abilities and of the corresponding work demands, the disabled persons need to be classified by type of disability in a limited number of subgroups. Within each subgroup, occupations judged suitable for the most seriously disabled will be selected as having a very low level of the corresponding task demands. These occupations can be applied as reference occupations to assess the presence or absence of work capacity of sick-listed employees in regular jobs, and as job opportunities for people with a specific type of functional disability.
Registered data from 50,931 disability assessments within the Dutch social security system were used in a second order factor analysis to identify types of disabilities in claimants for a disability pension. Threshold values were chosen to classify claimants according to the severity of the disability. In the disability assessment procedure, a labour expert needs to select jobs with task demands not exceeding the functional abilities of the claimant. For each type of disability, the accessible jobs for the subgroup of the most severely disabled claimants were identified as lowest in the corresponding demand.
The factor analysis resulted in four types of disabilities: general physical ability; autonomy; psychological ability; and manual skills. For each of these types of disablement, a set of four to six occupations low in task demands were selected for the subgroup of most severely disabled claimants. Because of an overlap of the sets of occupations, 13 occupations were selected in total. The percentage of claimants with at least one of the occupations of the corresponding set (the coverage), ranged from 84% to 93%. An alternative selection of six occupations for all subgroups with even less overlap had a coverage ranging from 84% to 89% per subgroup.
This study resulted in two proposals for a set of reference occupations. Further research will be needed to compare the results of the new method of disability assessment to the results of the method presently used in practice.
工作残疾是工人和社会的主要问题。为了探索低功能能力人群在常规工作中的工作机会，我们试图确定低任务需求的职业。由于功能能力和相应工作需求的多样性，残疾人需要按残疾类型分类到有限的少数亚组中。在每个亚组中，选择被判断为适合最严重残疾的职业，作为具有非常低水平的相应任务需求的职业。这些职业可以作为参考职业，评估在常规工作中请病假的员工是否有工作能力，也可以作为特定类型功能残疾人士的工作机会。
使用荷兰社会保障系统的 50931 份残疾评估登记数据进行二阶因子分析，以确定残疾养恤金申请人的残疾类型。选择阈值根据残疾的严重程度对申请人进行分类。在残疾评估程序中，劳动专家需要选择任务需求不超过申请人功能能力的工作。对于每种残疾类型，为最严重残疾的亚组申请人确定了可及的工作，这些工作在相应的需求中处于最低水平。
因子分析产生了四种残疾类型：一般身体能力；自主性；心理能力；和手工技能。对于每种类型的残疾，为最严重残疾的亚组申请人选择了四到六种任务需求低的职业。由于职业集的重叠，总共选择了 13 种职业。至少有一种相应职业集（覆盖率）的申请人比例从 84%到 93%不等。对于所有亚组的另一种选择，即六个职业的选择，甚至更少的重叠，每个亚组的覆盖率从 84%到 89%不等。
本研究提出了两组参考职业的建议。需要进一步研究，将新的残疾评估方法的结果与目前实践中使用的方法的结果进行比较。
