The purpose of the proposed research is to examine in what ways the return to work of persons with a chronic health condition may be influenced by barriers at the workplace, conceptions about the meaning of work, and a changing perspective on life that is a reflection more of social than chronological age. The major hypothesis to be tested is that these non-medical variables will be more important than demographic or medical characteristics in explaining resumption of the work role. The proposed research, thus, will be directed to identifying the interrelationship among values, aging and the work role as they intervene between health and effective functioning. The research design calls for a prospective study of 240 end stage renal disease patients. Subjects will be men and women, 18 years of age or older, who were employed or looking for work in the year prior to beginning dialysis and who have no condition that specifically precludes working. Three kinds of data are to be collected at two points in time. Patients are to be interviewed 3-6 months after beginning dialysis and again, 9-12 months later. Medical record data will be obtained, as well as a clinician assessment of patient functioning. All patients will be ambulatory and the analysis will control for type of maintenance therapy and organ transplant, if any. Thirty informant interviews are to be conducted with employers, not in firms where patients may have worked but in the major types of work settings represented by their jobs, in order to identify factors that lead employers to be supportive, ambivalent or negative about employing a person with end stage renal disease.
