At last.... I have finished my research report!

 Like I wrote in my last post my phd-traject had been ended at a rather rude way. While trying to finish the writing my supervisors decided to stop supporting me. They had decided this together, the day for our appointment. It was presented as a fait à complit. The main reason to stop their guidance was that they didn't expect me to finish the report in time. 😲😲 It was a  rather strange argument because I was at that time the only one who was putting time in the writing (in my own spare time)!😀 In a split second I was considering to search for new supervisors, but a the same time a great fatigue overtook me. 

Considering the care for my mother and the impact at my energy level it was rather clear that I had to decide to stop with this project for health reasons. Having the findings of my research already, I decided to adjust my goals and start writing my report in a short and more accessible way for my colleagues. Luckily I got support of two colleagues who were very enthusiastic over my research. They reckoned my findings interesting enough for my colleagues. In their eyes the findings will contribute to the evidence based work which is so propagated by Vocational Expert Knowledge Center (AKC), one of my former sponsors. 

With the help of these colleagues - Yvette and Natasha - I did finish my report recently. They were very enthusiastic and so inspiring that I retrieved my own pleasure and drive to finish the job. I know for sure that without their support I wouldn't have succeeded and therefore I' am very grateful for their support. At last finished 😃, just one day before my retirement!

The report will be included in the AKC library. In that way it will be easily accessible for all vocational experts in the field of Work and Health. 

It's also therefore an easily to read document for the people who I have interviewed in my research over their experiences with the phenomenon of the second opinion.

Over time I will provide a webinar, because corona makes it impossible till now to organize a workshop with many people. In the webinar I will give more information over the background of subject of the research and the decisions we have made in the approach on the investigation. Of course there will be room for questions. As soon as the date is known I will publish it in my blog and on LinkedIn. 

Of course I will continue on this blog with specific findings in my report. Hopefully it will give you as reader, more inspiration to react on my post. And maybe we could come to some exchange of new insights and research knowledge.

Sickness is not a choice

So here I 'am back again, just being busy with writing my last PhD reports. You could say it's more wrestling than writing and time slips through my fingers while thinking and rethinking my words at paper, sorry... at the screen. But nonetheless every time as I did some work, how little it may be at the end of the day, I feel still somehow satisfied  about starting this adventure. It gave me a lot of pleasures and new insights. But since last weeks this adventure has been stopped rather in a rough way and unexpected. But I want first come  back on  last theme: my health!

Those who have read some of my earlier blogs know that I wrote some time about how I have experienced being sick for a long time, and that I felt some uneasiness about my health while I officially had recovered. Now I realize it is my condition that did worry me, more precisely the actual state of my condition. And with that condition I mean my total state of mind and physical performance. Before getting ill I ran three times a week for one and half hour, easily. I felt rather strong and sure about the things I did in my work, my research and in private life. But now for a long time I had these strange varying  moods: sometimes not being capable to concentrate on one object, or I started with (too) many different things at one time. Because my memory wasn't at his best I needed more time to do the things I had to do. To compensate this I spent more time to my work and my research, making long days and weeks. Looking back now I was rather on my way to a nice big burnout. In the meanwhile I saw my extra work time of my sponsor slipping away.

And so it went on for another year and September 2016 my free time was over. I got back in my old job of vocational expert during four days a week. From that time on I had to do my PhD writing in my own free time. But fate had other plans with me. At the end of that September month my mother in law died at the age of 89. Not totally unexpected because of her state of health and her age. But after the alarming call of the physician she died in two days. So the shock was rather big. In November my own mother was diagnosed with the beginning of the Alzheimer disease. So now I landed in the land of care and bureaucracy. Not a very successful combination I can tell.  And in between these tragic moments we had a serious renovation in our house.

So I planned a stop until January to resume then my research activities... fighting against some underlying tiredness. But fate had again other plans: in June 2017 my mother was suddenly taken to hospital. She did loss a lot of blood and had a cardiac arrhythmia. She recovered rather soon despite her age of 92 years, but my brother and I were from that moment in a constant alarm state of mind. My mother is now 94 years of age and we are very busy with caring for her while Alzheimer more and more power gets over her.

  

Time flies.... when you're doing some training!

Time flies.... when you're doing some training!

In my latest blog I wrote about my sudden illness in 2014 and the rather major influences of this on my daily life. More than a year passed by and I can not say with doing nothing. On the contrary. But somehow it feels like a short time, like when you're having fun. And sure I did have fun but I did some hard working also.
Like I wrote last time around the end of 2013 I was used to run 3 times a week for 1,5 h at ease. In January 2015 I could run for 13 minutes without a break, and two months later I did successfully run for 10 kilometer in 1h 7m. I was very proud at my self! In the meanwhile I started also a Natural Fit training for once or twice times weekly under the careful guidance of my trainer Jacky Ledeboer (www.fysioenzo.nl).

Nevertheless I had to give way somewhere in July because of a new injury. Not so serious but major enough for a short pause and a restart on a lower level. After this intermission I succeeded in finishing a run of 15 kilometer in 1h 26m in November. So there I was... very proud again .

But I was of course also busy with my research: writing articles, trying to submit them to relevant journals and analyzing continuously the data of my survey and case study. The process of submitting my articles I experienced as a rather frustrating activity. So I have decided to stop with that for the time being and to concentrate now at finishing my thesis at first after consulting my professor.  And so I' am now in the middle of all my data, literature and memo's trying to write clearly and understandable about the main findings of my research. As you all will probably understand at this moment I cannot publish anything yet. But I think the findings will be quite interesting for many people especially for those who are working in the field of social security and human resource management!

But first things first: now at the 6th of march 2016 I will do the City-Pier-City run in my hometown The Hague (www.nncpcloopdenhaag.nl). It will be my first half-marathon in two years!

Absent, present or both, or a new perspective seen from the inner side?

My last blog (january 2014)  I'have written one day before a  rather unexpected but major event changed my plans rather deeply. It was on a Tuesday and I remember that I felt somewhat tired and not satisfied with the results that day of my research work. And for a while I was deliberating with myself if I should take some rest or do some running. Running is for me an important way to renew my energy and concentration level. But I decided to take some rest, and laid myself down at the couch to have a nice and sound nap in the afternoon.

And then it happened........ within a few minutes I felt cold and my limps were shaking! So I took a blanket, but that didn't stop the shaking. And as soon as I laid down at bed, the shivering stopped, what felt like a great releave. But that was just for a short time: my temperature was rising fast. In two hours I had a temperature of 40.2 degree (Celsius = 104,36 F) and another two hours later I was in the hospital with 40.8 C/ 105,44 F at the suspicion of a pneumonia!!! So they checked everything: longs, blood, urine, BUT not my body. And because they couldn't find anything they gave me antibiotica (broad spectrum). This helped tot get the fever down and within the hour I had only 38 C/ 100,4 F. The nurse who brought me to my room told me I did come probably just in time!
The next morning they found the cause of all this: a bacterial infection in my left leg! And so I got a more precise shot of antibiotica and within two days I was back home with a receipt for another 8 days of antibiotica.
Soon the bacteria was declared to be dead and gone and my family doctor gave me the advice to behave myself more according to my age (59), because my condition was in bad shape: my condition was now at level zero because my physiological systeem had collapsed. My body had to do the rest of the fysical recovery.
At first I didn't understand this message at all, because before all this had happend I ran three times a week for one hour and a half. And sure I would need some time to recover,... that's no big deal!? 

But it appeared to be a huge deal: at first my walking (no running) and biking was at a very slow speed and for less than half an hour! My concentration was away. I could read the newspaper for a maximum of 10 minutes before falling asleep etc. I couldn't do  anything but being a patient and keep my rest. This happend in the beginning of the year, and now I'am writing this, just a year later! I'am back to work (even in another, more responsible job) and back to my research. I can do everything again. But my running is still strongly limited. I ran now for 13 minutes at most for the next intermission. I'am very happy about that and I see the light again. But, yeah....... it's been a long time to get at this point. I cannot remember being that ill for such a long time.

So while still wondering about the theme of the last message, I ask myself: if the bacteria is dead, and I'am at work again, and I'am only in my running limited, how would one call this situation. I'am not sick and I'am not absent or sick present at my work.
But I'am still not physically the same person as before I fell ill. So there appears to be even an other category, namely: being 100% healthy but with a (hopefully) temporary disability. So I'am disabled at work?
 

Absent, present or both?

At the moment I 'am very busy with the data analysis of the survey and doing my interviews. In the meanwhile I will write about  interesting findings in relevant literature. Hopefully you'll appreciate this sharing in knowledge.

Three fascinating articles I read lately about the subject of 'sickness presenteeism'. As the opposite of sickness absence this concept describes the behaviour of employees who are going to work while feeling ill. And where sickness absence in general is seen as an interesting subject for research, one may ask oneself: 'what's the relevance of the first concept? These employees are at work, so leave them alone...what's the hush?' 
 

But the authors of these articles explain in a few sentences the relevance of this phenomenon. The first article, written by G. Bergström et al., 2009 (DOI 10.1007/s00420-009-0433-6) and is called 'Does sickness presenteeism have an impact on future general health?' The answer is quite clear: yes! The respondents were questioned in a survey and were followed in a longitudinal study at three moments: at the start, after 18 months and after 3 years. The survey was held  under employees working in the public sector and in the private sector. The results did show that 'at the baseline sickness presenteeism is consistently found to heighten the risk of fair/ poor health at both moments (18 months and 3 years)'. 
The second article 'Sick but yet at work' (Aronsson et al., 2000,) is about a study under 3,8001 Swedish employees. One-third out of this sample did go to their work despite being ill at two or more times in one year. Especially employees working in the educational or welfare sectors reported a heightened risk of sickness presenteeism. This was interpreted as indicating that individuals are more likely to keep on working with illness in occupations which involve caring for others where basic human needs are to be met, implying a strong demand on the employee to be present. Furthermore, sickness presenteeism was also more prevalent among employees having to catch up on work after being absent for a period. Symptoms related to presenteeism involved pain and distress, such as musculoskeletal pain, disturbed sleep, fatigue and minor depression. A positive correlation was found between sickness absence and sickness presenteeism, i.e. individuals reporting more absenteeism also tended to report more presenteeism'.

Important conclusions are: members of occupational groups whose everyday tasks are to provide care or welfare services, or teach or instruct, have a substantially increased risk of being at work when sick. The link between difficulties in replacement or finding a stand in and sickness presenteeism is confirmed by the study results. The
categories with high sickness presenteeism experience symptoms more often than those without presenteeism. The most common combination is low monthly income, high sickness absenteeism and high sick presenteeism.

In the third article (Anne Grinyer & Vicky Singleton, 2000) with the challenging title 'Sickness absence as risk-taking behavior' the authors refer to the fact that as well in their research as in the research of McKevitt et al. (1997) under doctors were found the following outcomes. Cultural and organizational factors such as perceived pressures from colleagues, not to let them down and to cause them more work, were playing a crucial role in the decision to stay at work. 'Disapprovement of taking sick leave’ and `pressure of work’ (McKevitt et al., 1997) are the risks one has to take when one is reporting oneself ill. An additional organizational factor as the trigger point system, specifically designed to reduce sickness absence had also an unintended effect, and paradoxically, may did increase the absence rate. 



An other risk-taking situation had been the introduction of teamwork. While teamwork was intended by management to be empowering, the effect was to leave the staff the feeling that they had little choice but to attend work, even when unwell, as they would be `letting the team down’, thus risking personal and professional relationships in the process.
The main issue here is, maybe that in organizations to much attention is given to absence policy instead to the prevention of absence namely sickness presenteeism!
   

 

 

 

The proces of progress and something called inspiration

Well... it's been a long time since I have written on my blog. The main reason is that I have been very busy with my research, so that's the good part of the excuse. To write something of interest is akward when inspiration is far away and that's the nasty part.
But now after one and a half year of hard work I did refind  my inspiration to write in my blog again, and hopefully you will enjoy it (again).

About the hard work part: I did, at last, finish my research design and proposal in the spring of 2012. Both supervisors were very pleased with the content. After this important milestone I have been very busy with drawing up a good and validated questionnaire for the survey. And after testing this questionnaire, the next challenge was the making of a random sample for the survey to start with that at the end of 2012. Lucky, the response was good: we did receive more than expected. Out of the casegroup we had a response of 27% and out of the controlgroup even a nice 42%. So all the effords I made in creating an understandable and accessible questionnaire in coöperation with my supervisors, were repaid !

With a treasure filled up with information, the next step was importing the obtained data in SPSS. Unlucky there were some setbacks in doing this, and so we did lose some valuable time. That's why the data-analysis didn't take place earlier than now. In the meanwhile I have written the second concept of my first article. A really exciting experience  which I have enjoyed very much. The content of the article is about my research proposal and research design. Ít's interesting to read because it sheds light at my search for a clear cut but scientific approach. So hopefully we will get one of the so many scientific journals interested for publishing the article. Before that time I cannot reveal anything of the content. When it's accepted I can tell everything about  it without any reserve.

And at the very moment I'am preparing myself for doing the interviews as part of the qualitative research.

The norm of reciprocity

One of the central problems of sociological theory is accounting for stability and instability in social systems. In my search in literature about the existence and origins of conflict I came across an interesting article written by Gouldner, already in 1960*!

I read it with great interest, and while I can't using it at the moment, I don't want to withhold it from you. And I'am rather interested in your reaction on the statements in this articel. Maybe you can help me to connect it with my research-topic.
The author claims that there is some general norm of reciprocity that explains why people are not breaking off existing relations or began to quarrel even when the other party is not fully repaying his debt.
He explains that for example an employer not only pays his workers because he has contracted to do so; he may also feel that the workman has earned his wages. This latter is based on a general norm of reciprocity: if others have been fulfilling their status duties to you, you in turn have an additional or second order obligation (repayment) to fulfill your status duties to them.
If  people refuse to do their duty, those demanding compliance maybe required to justify their claims: "if you won't do this simply because it is your duty, then remember all that I have done for you in the past and do it to repay your debt to me."

"When internalized in both parties, the norm obliges the one who has first received a benefit to repay it at some time; it thus provides some realistic grounds for confidence. Consequently there may be less hesitancy in being the first ."
For my research I'am interested in why - if these statements are true - people are not acting conform this general norm. And then Gouldner ends his article with the following: "clearly the norm of reciprocity cannot apply with full force in relations with children, old people, or those who are mentally or physically handicapped."

*Alvin W. Gouldner, The norm of reciprocity: a preliminary statement, American Sociological Review, april 1960, Volume 25, Number 2