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Influence of significant others on work participation of individuals with chronic diseases: a systematic review
  1. Nicole C Snippen1,
  2. Haitze J de Vries1,
  3. Sylvia J van der Burg-Vermeulen2,
  4. Mariët Hagedoorn3,
  5. Sandra Brouwer1
  1. 1 University of Groningen, University Medical Center Groningen, Department of Health Sciences, Community and Occupational Medicine, Groningen, The Netherlands
  2. 2 Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam, The Netherlands
  3. 3 University of Groningen, University Medical Center Groningen, Department of Health Sciences, Health Psychology, Groningen, The Netherlands
  1. Correspondence to Dr Nicole C Snippen; n.c.snippen{at}


Objective It is widely recognised that significant others (SOs), such as a partner, family member or friend, can influence health outcomes of individuals with a chronic disease. However, not much is known about which specific cognitions (ie, illness perceptions and expectation of work ability) and behaviours (eg, emotional and practical support) of SOs influence work participation. Therefore, we aimed to identify cognitions and behaviours of SOs that are related to work participation of individuals with a chronic disease.

Design A systematic review and thematic synthesis.

Data sources PubMed, Embase, PsycINFO, SocINDEX and Web of Science were searched until 28 March 2017.

Eligibility criteria for selecting studies We included studies reporting on cognitions and behaviours of SOs related to work participation in populations with various chronic diseases.

Data extraction and synthesis Two independent reviewers extracted the data and performed a quality assessment using the Quality Assessment Tool for Quantitative Studies from the Effective Public Health Practice Project 2007 and a checklist for assessment of qualitative studies derived from the Cochrane Supplemental Handbook Guidance. Evidence was thematically synthesised.

Results Out of 5168 articles, 18 were included (15 qualitative and 3 quantitative) of moderate to high quality. Studies were on cancer, chronic pain, brain injuries and mental health disorders. After thematic synthesis 27 factors could be distinguished. Consistent evidence was found that SOs’ positive and encouraging attitudes regarding work participation, encouragement and motivating behaviour and open communication with patients are facilitators for work participation. Consistently reported barriers were SOs’ positive attitudes towards sickness absence and advise, encouragement or pressure to refrain from work.

Conclusions Our findings show that several cognitions and behaviours of SOs can facilitate or hinder work participation of individuals with a chronic disease. Intervening on these factors by involving SOs in disability prevention and return to work intervention strategies may be beneficial. More prognostic studies are needed, as the current evidence is mostly based on qualitative studies.

  • public health
  • social medicine

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  • Patient consent for publication Not required.

  • Contributors All authors contributed to the conception and design of the study. NCS developed the search strategy with support from an information specialist (acknowledged); all authors reviewed the search terms. NCS and HJdV performed the literature search, study selection, data extraction and interpretation of the data and drafted the manuscript. NCS, HJdV, SJvdB-V, MH and SB have contributed to revising the article critically for important intellectual content. The final version of this manuscript has been approved by all the authors.

  • Funding This work was supported by Instituut Gak, grant number 2016755.

  • Competing interests NCS, HJdV and SB report grants from Instituut Gak, during the conduct of the study; SJvdB-V and MH have nothing to disclose.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Extra information concerning the methods and results is available by emailing NCS.

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