Current practices, needs, and expectations of discussing work with a medical specialist from a patient’s perspective: a qualitative study

Figures & data

Table 1. Demographics and treatment-related factors.

Demographic Categories	Frequency	%
Sex
Male	14	42
Female	19	58
Age
30–39 years	2	6
40–49 years	8	24
50–59 years	16	49
60–67 years	7	21
Highest educational level
General secondary education	2	6
Lower vocational education	8	24
Higher vocational or college education	19	58
University education	4	12
Treating medical specialist^a
Cardiologist	7	21
Dermatologist	4	12
Oncologist	3	9
Orthopedic surgeon	9	27
Pulmonologist	10	30
Rehabilitation physician	8	24
Other^b	15	46
Duration since start of first treatment
<1 year	4	12
1–4 years	12	36
5–9 years	8	24
10–19 years	4	12
>20 years	4	12
Missing	1	3
Employment status
Full time employment^c	13	39
Sick-listed^d	6	43
Part time employment^c	9	27
Sick-listed^d	4	50
Partial work-disability – employed	2	6
Partial work-disability – unemployed	1	3
Permanent work-disability	7	21
Unemployed	1	3

^aPercentages do not count up to 100%, because several participants were under treatment by more than one medical specialists.

^bOther medical specialists were (n of participants): Gastroenterologists (4), Internists (5), Neurologists (2), Ophthalmologists (2), Otolaryngologists (3), Rheumatologists (4), Surgeons other than orthopedic (3), and Urologists (3).

^cFull time employment was defined as working ≥36 h per week.

^dSubgroup from employed participants (i.e., full time and part time employment).

Table 2. Themes and subthemes.

Theme 1: The process of becoming a patient while wanting to continue working

The medical specialist as a first contact for continuing daily life as normal (which includes working)

The exchange between patient and medical specialist

Theme 2: Different needs for different patients

Three categories of work concerns

The role of the medical specialist in relation to differing work concerns

Work participation does not always need to be a topic of conversation

Theme 3: Patients’ expectations of CWIC during interaction with a medical specialist

Why medical specialists did not always discuss work participation

Unmet needs fulfilled by other health care professionals

The role of the patient himself or herself

Preconditions for providing CWIC

Figure 1. Three-layered model of work-related concerns from a patients’ perspective with exemplary questions and the expected role of a medical specialist. (A) Influence of work on disease (both positive and negative); (B) influence of diagnosis or treatment on work ability (mostly about the negative influence); and (C) work ability will remain decreased, which has to be accepted and gives rise to questions about sick leave and social security. The expected role of the medical specialist is larger for questions in category A and decreases toward category C.

Diagram showing the relation between three different categories of concerns regarding work, disease, treatment/diagnoses, work ability, acceptance of work ability loss, sick leave and social security, and the expected role of a medical specialist to deal with these questions.

Read the detailed description of this figure

The relation between three different categories of concerns regarding work are represented by three icons of humans with a question mark (A, B, and C). Next to icon A an arrow indicates these concerns are about work influencing disease with a box of example questions (e.g., “Does work cause my disease?”). Next to icon B an arrow indicates these concerns are about diagnosis/treatment influencing work ability with a box of example questions (e.g., “How to balance work and health?”). Next to icon C one arrow indicates that these concerns are about decrease work ability raising questions to acceptance with a box of examples (e.g., “I must keep working, what can I do?”) and another arrow indicates that these concerns can also be about sick leave followed by social security with a boxes of example questions (e.g., “My occupational health physician wants information, can you provide this?” and “What are my rights and obligations?” respectively). A dotted arrow points from disease (icon A) to diagnosis/treatment (icon B). A second dotted arrow points from work ability (icon B) to decrease work ability (icon C). These dotted arrows indicate the natural course of a patients journey which may not always be applicable. Right to each box of example questions is a box with descriptions of the expected role of the medical specialist. Right to the boxes with the role description is a triangle depicted pointing downwards emphasizing the role of the medical specialist is larger for work-related concerns in category A compared to category C.

Data availability statement

The data is not available for others at this point in time. If an individual is interested in the data, however, they can send a request to the corresponding author.