Incapacité et retour au travail
Novembre 2024
Purpose Inpatient rehabilitation therapies can be applied for in Germany by patients of working age to support their return to work. However, there are some problems that impede an easy and uncomplicated application process. An interdisciplinary case management approach for rehabilitation care planning was developed to facilitate the access to rehabilitation. Case conferences (CCs) were held with relevant stakeholders and took place on a digital communication platform. We conducted a qualitative process evaluation to understand the implementation of the intervention and to identify contextual factors as well as mechanisms for a successful implementation in the context of primary care. Methods The process evaluation included interviews with primary care physicians (PCPs), patients and stakeholders involved in the intervention process. Reflexive thematic analysis was used to analyse the data. Emerging themes were structured according to the Donabedian framework of structure, process and outcomes. Results A total of 18 interviews were conducted. Important results included the desire for more patient involvement and case management. Patients especially valued the opportunity to receive support from a social worker. Limitations of the platform related to usability and limited opportunities for stakeholder communication. Despite training for PCPs, several problems arose regarding the clarity of the intervention process. Patients were satisfied with their application process and the treatments offered, while PCPs reported an increase in workload. Conclusions A digitalisation of the application procedure for rehabilitation and further treatment options is acceptable to patients and personal support of a social worker is particularly valued. However, patients should be included in the CC in terms of a shared decision-making process. The digital platform requires sufficient training and adjustments have to be made to enhance usability and to improve the efficiency of the process for PCPs. Overall, the exchange between the various stakeholders in the CC is considered particularly useful in more complex cases.
© Buch K; Hamme V; Becker A; Seifart U; Maulbecker-Armstrong C; Moser K; Seferi P; Keller A; van der Wardt V. BMC Health Services Research. 24(1):1299, 2024 Oct 29.
Purpose Patients with occupational injuries often receive multidisciplinary rehabilitation for a rapid return to work. Rehabilitation aftercare programs give patients the opportunity to help patients apply the progress they have made during the rehabilitation to their everyday activities. Telerehabilitation aftercare programs can help reduce barriers, such as lack of time due to other commitments, because they can be used regardless of time or location. Careful identification of barriers, facilitators, and design requirements with key stakeholders is a critical step in developing a telerehabilitation aftercare program. This study aims to identify barriers, facilitators, and design requirements for a future telerehabilitation aftercare program for patients with occupational injuries from the perspective of the key stakeholders. Methods We used a literature review and expert recommendations to identify key stakeholders. We conducted semistructured interviews in person and via real-time video calls with 27 key stakeholders to collect data. Interviews were transcribed verbatim, and thematic analysis was applied. We selected key stakeholder statements about facilitators and barriers and categorized them as individual, technical, environmental, and organizational facilitators and barriers. We identified expressions that captured aspects that the telerehabilitation aftercare program should fulfill and clustered them into attributes and overarching values. We translated the attributes into one or more requirements and grouped them into content, functional, service, user experience, and work context requirements. Results The key stakeholders identified can be grouped into the following categories: patients, health care professionals, administrative personnel, and members of the telerehabilitation program design and development team. The most frequently reported facilitators of a future telerehabilitation aftercare program were time savings for patients, high motivation of the patients to participate in telerehabilitation aftercare program, high usability of the program, and regular in-person therapy meetings during the telerehabilitation aftercare program. The most frequently reported barriers were low digital affinity and skills of the patients and personnel, patients' lack of trust and acceptance of the telerehabilitation aftercare program, slow internet speed, program functionality problems (eg, application crashes or freezes), and inability of telerehabilitation to deliver certain elements of in-person rehabilitation aftercare such as monitoring exercise performance. In our study, the most common design requirements were reducing barriers and implementing facilitators. The 2 most frequently discussed overarching values were tailoring of telerehabilitation, such as a tailored exercise plan and tailored injury-related information, and social interaction, such as real-time psychotherapy and digital and in-person rehabilitation aftercare in a blended care approach. Conclusions Key stakeholders reported on facilitators, barriers, and design requirements that should be considered throughout the development process. Tailoring telerehabilitation content was the key value for stakeholders to ensure the program could meet the needs of patients with different types of occupational injuries.
© Lange-Drenth L; Schulz H; Suck I; Bleich C. JMIR Formative Research. 8:e51865, 2024 Nov 08.
Purpose Several actions have been taken to improve the sick listing process, patient safety and return to work. One of them is the implementation of the rehabilitation coordinator function, of which the benefits have not yet been fully explored. Neither has the role of the manager, who has significant impact on the implementation and support of a new function. This study aimed to explore how first line managers', who employed a rehabilitation coordinator that had completed a one-year specialized study program, perceived, and experience the function rehabilitation coordinator. Methods This is an interview study using a semi structured interview guide for data collection and thematic analysis was applied to the data. Ten first line managers in health care were interviewed. Results Four themes were identified: The Saviour, A personalized function, Change takes time and Strengthen status and legitimacy. The managers experienced the rehabilitation coordinator as a valuable function who facilitates collaboration in the team and with external stakeholders and perceived them as a much-needed resources, supporting physicians with sick leave issues. The assignment was ambiguous and dependent on the rehabilitation coordinators individual characteristics, which may result in a risk of overload. The managers were engaged in the implementation process, but this required time. They considered it important to strengthen legitimacy for the function which required support and encouragement to take part in specialized education and training. Conclusions The managers experienced the rehabilitation coordinators as playing a crucial role in the return-to-work process. They were willing to support how this new function will improve and develop. The results from this can serve as a guidance for the implementation and support of the function rehabilitation coordinator.
© Strid C; Benner R; Stefansdotter R; Stigmar K. BMC Health Services Research. 24(1):1371, 2024 Nov 09.
Octobre 2024
Purpose In return-to-work (RTW) negotiations after sickness absence, the work ability of an individual employee becomes a shared interest for the multiple stakeholders representing both the healthcare sector and working life. In practice, the employee, employer and occupational health professionals need to reach a shared understanding of the employee's work ability to enable shared decision-making concerning the plans for sustainable RTW. Methods Drawing on 14 video-recorded RTW negotiations, we used conversation analysis-informed membership categorization analysis to examine how the participants of RTW negotiations discuss the work ability of an employee to pursue a shared understanding of the situation. Results Work ability was constructed in a very situational way, using illness categories to both explain the work ability of the employee and argue for or against their ability or inability to work. Conclusions Our study contributes to research on RTW by introducing a new perspective to work ability. We show how work ability is realized during RTW negotiations through interaction, and how participants leverage their cultural understanding of illness and capability when negotiating work ability. We also demonstrate how membership categorization analysis can reveal the situational and consequential aspects of illness and work ability categories.
© Keranen H; Tiitinen S; Juvonen-Posti P; Weiste E; Seppanen S; Ala-Mursula L.Health: an Interdisciplinary Journal for the Social Study of Health, Illness & Medicine. 13634593241290176, 2024 Oct 14.
Purpose Prior research has found evidence that persons who are nonwhite are less likely to receive workplace accommodations than other persons. Objective: To test whether the receipt of workplace accommodations by adults aged 50 and older who had work limitations varies by race/ethnicity in the U.S., controlling for age, gender, education, organizational size, and the physical nature of the occupation. Methods Bivariate and logistic regressions using 2002 to 2018 Health and Retirement Study data on adults aged 50 and older with a work limitation (n= 6,711). Results Receipt of workplace accommodations does not vary by race/ethnicity for U.S. adults aged 50 and older who had a work limitation, with an estimated 34% to 37% of all older adults receiving accommodations across all racial categories. Receipt of accommodations was more likely for persons working at organizations that employed 100 or more people, holding all else constant. Conclusions Smaller employers may benefit from training or other supports to increase the availability of workplace accommodations. Workers with disabilities might also benefit from increased education offered by vocational rehabilitation agencies, workforce development programs, and other similar organizations on how to make requests for and implement reasonable accommodations.
© Brucker DL; Henly M; Houtenville AJ. Journal of Vocational Rehabilitation. Oct 2024
Septembre 2024
Purpose Clinical work-integrating care (CWIC) refers to paying attention to work participation in a clinical setting. Working patients may benefit from CWIC. The purpose of this study is to explore the extent and nature to which medical specialists provide CWIC and what policies and guidelines oblige or recommend specialists to do. Methods A scoping review was conducted. The databases MEDLINE, EMBASE, Psychinfo, CINAHL, and Web of Science were searched for studies on the extent and nature of CWIC and supplemented by gray literature on policies and guidelines. Six main categories were defined a priori. Applying a meta-aggregative approach, subcategories were subsequently defined using qualitative data. Next, quantitative findings were integrated into these subcategories. A separate narrative of policies and guidelines using the same main categories was constructed. Results In total, 70 studies and 55 gray literature documents were included. The main findings per category were as follows: (1) collecting data on the occupation of patients varied widely; (2) most specialists did not routinely discuss work, but recent studies showed an increasing tendency to do so, which corresponds to recent policies and guidelines; (3) work-related advice ranged from general advice to patient-physician collaboration about work-related decisions; (4) CWIC was driven by legislation in many countries; (5) specialists sometimes collaborated in multidisciplinary teams to provide CWIC; and (6) medical guidelines regarding CWIC were generally not available. Conclusion Medical specialists provide a wide variety of CWIC ranging from assessing a patient's occupation to extensive collaboration with patients and other professionals to support work participation. Lack of medical guidelines could explain the variety of these practices.
© Kluit L; van Bennekom CAM; Beumer A; Sluman MA; de Boer AGEM; de Wind A. Journal of Occupational Rehabilitation. 34(3):481-521, 2024 Sep.
Purpose Work disability affects a growing number of workers aged 55 and over (W55 +). While rehabilitation programs have demonstrated efficacy for workers with an average age of 42, they often have not been designed to meet unique needs of aging workers. This study aimed to describe the difficulties encountered by work rehabilitation professionals and explore their solutions for improving services offered to W55 +. Methods This study used a simple descriptive design with purposive sampling. Occupational therapists, physical therapists, and psychologists were mainly recruited in private clinics. An interview guide based on the Work Disability Paradigm was piloted and used with the participants. Qualitative interviews were conducted with work rehabilitation professionals and then transcribed. A thematic analysis was performed. Results The sample consisted of fifteen participants (average age 38 years) with near equal representation across genders and disciplines. Difficulties were identified in relation to the (1) characteristics of W55+, (2) work environment, (3) compensation system, and (4) communication among stakeholders. Five solutions were proposed to improve the services offered: provide healthcare professionals with access to tools and training, implement communication mechanisms, integrate a return-to-work coordinator, develop a joint action plan for managing W55+, and implement an integrative prevention approach in workplaces. Conclusions Our results represent a first step in mapping various stakeholders' needs to ensure better support for W55 + with work disabilities. These results delineate a roadmap for future research that should expand upon these stakeholders' perspectives to provide a more comprehensive description of their needs and potential solutions.
© Durand MJ; Coutu MF; Lecours A; Leonard G; Lederer V; Nastasia I; Carriere J; Paquette MA. Journal of Occupational Rehabilitation. 2024 Sep 11.
Purpose Considering current labour shortages, the recent increase in the number of aging workers in the labour market is deemed economically beneficial. However, due to specific characteristics (e.g. biological, generational), aging workers take longer to recover and return to work after an occupational injury. Yet, few studies have examined the rehabilitation, return, and stay at work process of aging workers and current knowledge makes it difficult for stakeholders to identify which interventions to use with this specific population. This study aimed to describe which interventions are used in the rehabilitation, return, and stay at work process of aging workers having suffered an occupational injury. Methods We conducted a five-step scoping review. Five databases were used for the literature search. A qualitative analysis of the retained manuscripts was conducted. Results Our analysis led to the extraction of information from seven manuscripts that concern the rehabilitation, return, and stay at work process of aging workers who suffered an occupational injury exclusively. We identified 19 interventions (e.g. work capacity development, work task modifications, permanent part-time work, and alternative roles) and were described according to the different phases of the Cycle of Work Disability Prevention (CWDP). Conclusions This study offers informative, non-prescriptive, and operational interventions useful for stakeholders who support aging workers. Furthermore, it is a knowledge base to develop future projects that promote the rehabilitation, return, and stay at work process of aging workers.
© Audet J; Lecours A. Work. 79(1):135-153, 2024.
Purpose Return-to-work coordinators (RTWC) support people on sickness absence and is a new healthcare occupation in Sweden. Its practitioners represent a variety of professions, there is no common undergraduate training and vague role and competence descriptions. The aim was to explore differences in training and competence according to original professions (occupational therapists, physiotherapists, counselling, and other professions) and coordinators' views on which professions they believe provide the best competence for the role. Methods All RTWCs (82) in one region were invited to answer a questionnaire (89% response rate). Mixed-methods analyses were applied. Results The results showed that counselling professions were more likely than other professional groups to have further training, particularly in conversation methods, and a lower proportion of them stated needing more knowledge about gender equality, social problems, insurance/benefit and conversation methods. The analysis of free-text answers identified three competence areas of importance: advice and guidance, a holistic view, and personality over profession. Occupational therapists and social workers were seen as having the best competence for the coordinating role. Conclusion The results outline some common values, norms and important competences for RTWCs that could help develop the RTW coordination training and pave the way for RTWCs professionalisation process.
© Azad A; Svärd V. European Journal of Social Work. Sep2024, Vol. 27 Issue 5, p938-951.
Août 2024
Purpose Enhancing workplace communication and support processes to enable individuals living with disabilities to sustain employment and return to work is a priority for workers, employers, and community stakeholders. The objective of this study was to evaluate a new resource that addresses support challenges, the Job Demands and Accommodation Planning Tool (JDAPT), and assess its use, relevance, and outcomes over a nine-month follow-up period. Methods Workers with physical and mental health/cognitive conditions causing limitations at work were recruited using purposive sampling. Online surveys were administered at baseline (prior to using the JDAPT), and at three and nine months post-baseline. Information was collected on demographics (e.g., age, gender) and work characteristics (e.g., job sector, organization size). Outcomes included assessing JDAPT use and relevance, and changes in self-efficacy, work productivity difficulties, employment concerns, difficulties with job demands, and absenteeism. Results Baseline participants were 269 workers (66% women; mean age 41 years) of whom 188 (69.9%) completed all three waves of data collection. Many workers reported using JDAPT strategies at and outside of work, and held positive perceptions of the tool's usability, relevance, and helpfulness. There were significant improvements (Time 1-2; Time 1-3) in self-efficacy, perceived work productivity, and absenteeism with moderate to large effect sizes in self-efficacy and productivity (0.46 to 0.78). Findings were consistent across gender, age, health condition, and work context variables. Conclusions The JDAPT can enhance support provision and provide greater transparency and consistency to workplace disability practices, which is critical to creating more inclusive and accessible employment opportunities.
© Gignac MAM; Bowring J; Navaratnerajah L; Saunders R; Jetha A; Thompson A; Shaw WS; Franche RL; Van Eerd D; Irvin E; Tompa E; Macdermid JC; Smith PM. Journal of Occupational Rehabilitation. 2024 Aug 09.
Juillet 2024
Purpose With the overall objective of providing implication for clinical and research practices regarding the identification and measurement of modifiable predicting factors for return to work (RTW) in people with musculoskeletal disorders (MSDs) and common mental disorders (CMDs), this study 1) systematically examined and synthetized the research evidence available in the literature on the topic, and 2) critically evaluated the tools used to measure each identified factor. Methods A systematic search of prognostic studies was conducted, considering four groups of keywords: 1) population (i.e., MSDs or CMDs), 2) study design (prospective), 3) modifiable factors, 4) outcomes of interest (i.e., RTW). Studies showing high risk of bias were eliminated. Tools used to measure prognostic factors were assessed using psychometric and usability criteria. Results From the 78 studies that met inclusion criteria, 19 (for MSDs) and 5 (for CMDs) factors reaching moderate or strong evidence were extracted. These factors included work accommodations, RTW expectations, job demands (physical), job demands (psychological), job strain, work ability, RTW self-efficacy, expectations of recovery, locus of control, referred pain (back pain), activities as assessed with disability questionnaires, pain catastrophizing, coping strategies, fears, illness behaviours, mental vitality, a positive health change, sleep quality, and participation. Measurement tools ranged from single-item tools to multi-item standardized questionnaires or subscales. The former generally showed low psychometric properties but excellent usability, whereas the later showed good to excellent psychometric properties and variable usability. Conclusions The rigorous approach to the selection of eligible studies allowed the identification of a relatively small set of prognostic factors, but with a higher level of certainty. For each factor, the present tool assessment allows an informed choice to balance psychometric and usability criteria.
© Villotti P; Kordsmeyer AC; Roy JS; Corbiere M; Negrini A; Lariviere C. PLoS ONE. 19(7):e0307284, 2024.
Purpose Previous research has systematically studied the effectiveness of Cognitive Behavioral Therapy (CBT)-based interventions in managing both mental and physical symptoms of chronic disease including depression, stress-related mental disorders (SMD), and chronic pain that are common causes of sick leave. However, a systematic review focusing on the effectiveness of CBT in facilitating RTW is lacking. This study compiles research on utilizing CBT-based interventions for helping employees on sick leave return to work. Methods Randomized controlled trials (RCT) published between 1 January 1990 and 27 June 2022 were searched in MEDLINE, EMBASE, The Cochrane Library, Scopus, PsycINFO, Web of Science, and PubMed. The primary outcome variables included a return to work (RTW) measure and sickness absences. The secondary outcomes include psychological conditions (mental illness, stress, anxiety, and depression) and physical condition (working ability, fatigue, and physical function). Results Thirty-four RCTs were included in the analysis. Fifteen RCTs with 1727 participants reported on sick leave. Results showed that participants who completed CBT intervention had reduced sick leave in days (mean reduction - 3.654; 95%CI - 5.253, - 2.046; p < 0.001) compared to the control group. Sixteen papers with 2298 participants reported that the intervention group RTW 1.5 days earlier (95%CI 1.019, 1.722; p < 0.05). CBT-based interventions were effective in managing fatigue, mental illness, and depression, and improving physical function while it showed no effects in managing stress, anxiety and working ability. Conclusions The findings indicate that CBT-based interventions are effective in reducing the length of sick leave and facilitating the RTW of employees in the intervention group.
© Xu H; Cai J; Sawhney R; Jiang S; Buys N; Sun J. Journal of Occupational Rehabilitation. 34(1):4-36, 2024 Mar.
Juin 2024
Purpose The aim of this systematic review is to identify vocational rehabilitation (VR) interventions that are effective to enhance return-to-work (RTW) for people on long-term sick leave (> 90 days) and to identify main elements of these interventions. Methods Six electronic databases were searched for peer-reviewed studies published up to February 2022. Each article was screened independently by two different reviewers. Thereafter, one author performed the data-extraction which was checked by another author. The EPHPP quality assessment tool was used to appraise the methodological quality of the studies. Results 11.837 articles were identified. 21 articles were included in the review, which described 25 interventions. Results showed that ten interventions were more effective than usual care on RTW. Two interventions had mixed results. The effective interventions varied widely in content, but were often more extensive than usual care. Common elements of the effective interventions were: coaching, counseling and motivational interviewing, planning return to work, placing the worker in work or teaching practical skills and advising at the workplace. However, these elements were also common in interventions that were not effective on RTW compared to usual care and can therefore not explain why certain interventions are effective and others are not. Conclusion The effective interventions included in this study were often quite extensive and aimed at multiple phases of the RTW-process of the worker. In the future, researchers need to describe the population and the content of the investigated interventions more elaborate to be able to better compare VR interventions and determine what elements make interventions effective.
© de Geus CJC; Huysmans MA; van Rijssen HJ; de Maaker-Berkhof M; Schoonmade LJ; Anema JR. Journal of Occupational Rehabilitation. 2024 Jun 07.
Purpose This study aimed to investigate the demographic, industrial and health-related, economic, and psycho-emotional factors that affect the life satisfaction of injured workers, and compare them according to the type of return to work. Methods Regression analysis was used to analyse data on 2,025 injured workers. Results Marital status (B =.967, p <.001), disability grade (B = -.129, p <.01), health status (B = 1.287, p <.001), socioeconomic status (B = 1.977, p <.001), ownership status (B =.585, p <.05), self-esteem (B =.246, p <.001), and self-efficacy (B =.049, p <.01) significantly affected the life satisfaction of injured workers who returned to their original workplace; and marital status (B =.991, p <.001), performance ability (B =.224, p <.001), health status (B = 1.066, p <.001), socioeconomic status (B = 2.025, p <.001), ownership status (B =.589, p <.01), self-esteem (B =.295, p <.001), and self-efficacy (B =.053, p <.001) significantly affected the life satisfaction of injured workers re-employed at other workplaces; ownership status (B = 1.853, p <.01) significantly affected the life satisfaction of injured workers who is self-employed. Conclusion Implications are discussed.
© Kim, Ja Young. Asia Pacific Journal of Social Work & Development. Jun2024, Vol. 34 Issue 2, p101-113.
Purpose Functional Capacity Evaluation (FCE) is a crucial component within return-to-work decision making. However, clinician-based physical FCE interpretation may introduce variability and biases. The rise of technological applications such as machine learning and artificial intelligence, could ensure consistent and precise results. This review investigates the application of information and communication technologies (ICT) in physical FCEs specific for return-to-work assessments. Methods Adhering to the PRISMA guidelines, a search was conducted across five databases, extracting study specifics, populations, and technological tools employed, through dual independent reviews. Results Nine studies were identified that used ICT in FCEs. These technologies included electromyography, heart rate monitors, cameras, motion detectors, and specific software. Notably, although some devices are commercially available, these technologies were at a technology readiness level of 5–6 within the field of FCE. A prevailing trend was the combined use of diverse technologies rather than a single, unified solution. Moreover, the primary emphasis was on the application of technology within study protocols, rather than a direct evaluation of the technology usability and feasibility. Conclusions The literature underscores limited ICT integration in FCEs. The current landscape of FCEs, marked by a high dependence on clinician observations, presents challenges regarding consistency and cost-effectiveness. There is an evident need for a standardized technological approach that introduces objective metrics to streamline the FCE process and potentially enhance its outcomes.
© Bhupal N; Bures L; Peterson E; Nicol S; Figeys M; Cruz AM. Work. Jun2024, p1-14.
Mai 2024
Purpose Previously, we reported that an inpatient multimodal occupational rehabilitation program (I-MORE) was more effective than outpatient Acceptance and Commitment Therapy (O-ACT) in reducing sickness absence and was cost-effective over a 24-month period. Here we present 7-years of follow-up on sick leave and the cost of lost production. Methods We randomized individuals aged 18-60, sick-listed due to musculoskeletal or mental health disorders to I-MORE (n = 82) or O-ACT (n = 79). I-MORE, lasting 3.5 weeks, integrated ACT, physical training, and work-related problem-solving. In contrast, O-ACT mainly offered six weekly 2.5 h group sessions of ACT. We measured outcomes using registry data for days on medical benefits and calculated costs of lost production. Our analysis included regression analyses to examine differences in sickness absence days, logistic general estimating equations for repeated events, and generalized linear models to assess differences in costs of lost production. Results Unadjusted regression analyses showed 80 fewer days of sickness absence in the 7-year follow-up for I-MORE compared to O-ACT (95% CI - 264 to 104), with an adjusted difference of 114 fewer days (95% CI - 298 to 71). The difference in costs of production loss in favour of I-MORE was 27,048 euros per participant (95% CI - 35,009 to 89,104). Conclusions I-MORE outperformed O-ACT in reducing sickness absence and production loss costs during seven years of follow-up, but due to a limited sample size the results were unprecise. Considering the potential for substantial societal cost savings from reduced sick leave, there is a need for larger, long-term studies to evaluate return-to-work interventions.
© Aasdahl L; Gismervik SO; Johnsen R; Vasseljen O; Bjornelv GMW; Bjorngaard. Journal of Occupational Rehabilitation. 2024 Apr 28
Purpose The aim of this study is to gain insight into the facilitators, barriers, and support needs of Dutch self-employed workers when returning to work (RTW) after sick leave. Methods Three focus groups were conducted, involving 15 Dutch self-employed workers who were on sick leave due to health problems. The transcripts were analysed through thematic content analysis. Results Five main themes regarding barriers, facilitators and needs of self-employed workers to RTW were identified: autonomy, social support, client management, financial security and information on sick leave. Having autonomy was considered a facilitator for RTW. However, the participants expressed a need for more financial support, additional guidance from occupational health professionals, and tailored information regarding RTW. Conclusion The results of this study emphasize a need for optimizing national policy and support for self-employed workers regarding sick leave and RTW.
© de Wit M; Montanus A; Bosma A; Juurlink T. Journal of Occupational & Environmental Medicine. 2024 May 15.
Purpose The aim of this study was to explore how early follow-up sessions (after 14 and 16 weeks of sick leave) with social insurance caseworkers was experienced by sick-listed workers, and how these sessions influenced their return-to-work process. Methods A qualitative interview study with sick-listed workers who completed two early follow-up sessions with caseworkers from the Norwegian Labor and Welfare Administration (NAV). Twenty-six individuals aged 30 to 60 years with a sick leave status of 50-100% participated in semi-structured interviews. The data was analyzed with thematic analysis. Results Participants' experiences of the early follow-up sessions could be categorized into three themes: (1) Getting an outsider's perspective, (2) enhanced understanding of the framework for long term sick-leave, and (3) the empathic and personal face of the social insurance system. Meeting a caseworker enabled an outsider perspective that promoted critical reflection and calibration of their thoughts. This was experienced as a useful addition to the support many received from their informal network, such as friends, family, and co-workers. The meetings also enabled a greater understanding of their rights and duties, possibilities, and limitations regarding welfare benefits, while also displaying an unexpected empathic and understanding perspective from those working in the social insurance system. Conclusion For sick-listed individuals, receiving an early follow-up session from social insurance caseworkers was a positive experience that enhanced their understanding of their situation, and promoted reflection towards RTW. Thus, from the perspective of the sick-listed workers, early sessions with social insurance caseworkers could be a useful addition to the overall sickness absence follow-up.
© Standal MI; Foldal VS; Aasdahl L; Fors EA; Solbjor M. BMC Health Services Research. 24(1):609, 2024 May 09.
Avril 2024
Purpose Research demonstrates sustained return to work (RTW) by individuals on medical leave is influenced by personal and job resources and job demands. Relatively few studies have been conducted in the workers' compensation context that is known to have longer absence durations for RTW. This study sought to illuminate workers' experience as they returned to work following a work injury that was either psychological in nature or involved more than 50 days of disability, with a focus on the co-worker, supervisor, and employer actions that supported their return. Methods Workers in Saskatchewan, Canada, with a work-related psychological or musculoskeletal injury, subsequent disability, and who returned to work in the last three years, were invited to complete an online survey comprising of free-text questions. Thematic analysis was used to explore participants' experiences. Results Responses from 93 individuals were analysed. These revealed that persistent pain, emotional distress, and loss of normal abilities were present during and beyond returning to work. Almost two-thirds indicated that the supervisors' and co-workers' support was critical to a sustained return to work: their needs were recognized and they received autonomy and support to manage work demands. By contrast, one-third indicated that the support they expected and needed from supervisors and employers was lacking. Conclusions Workers returning to work lacked personal resources but co-workers' and supervisors' support helped improve confidence in their ability to RTW. Supervisors and employers should acknowledge workers' experiences and offer support and autonomy. Likewise, workers can expect challenges when returning to work and may benefit from cultivating supportive relationships with co-workers and supervisors.
© Lewis I; Houdmont J. Frontiers in Rehabilitation Sciences. 5:1373888, 2024.
Purpose Rates of return to work (RTW) are declining in the Australian workers compensation system alongside significant economic and social costs, disputes, and secondary psychological injury. Non-medical assessment of workplace injuries now considers psychosocial and workplace factors, and worker participation in the assessment process is limited. This scoping review examines studies regarding non-medical assessment during the acute phase of rehabilitation in terms of costs, disputes, secondary psychological injury, and worker participation. Methods An electronic and manual search of relevant articles across four databases was conducted using PRISMA guidelines, followed by quality assessment. Results Of the 1,630 studies retrieved, 12 met the inclusion criteria with most focused on assessment for risk of obstructed or delayed RTW. Conclusions Non-medical assessment in the acute stage of rehabilitation identifies risk for delayed or complicated RTW, overlooking potential for the process of assessment to contribute to disputes and development of secondary psychological injury. Doubt around the capacity of workers to participate objectively in assessment persists. These are aspects of assessment worthy of further exploration for their impact on RTW outcomes.
© Anderson O; McLennan V; Buys N; Randall C. Disability & Rehabilitation. 1-11, 2024 Apr 09.
Purpose Value-based healthcare delivery focuses on optimizing care provided by measuring the healthcare outcomes which are most important to the clients relative to the total care costs. However, the understanding of what adds value for clients during work disability assessment is lacking. Objective: To explore what medical examiners (MEs) perceive as valuable during the work disability assessment process, by exploring possible: 1) facilitators, 2) barriers and 3) opportunities to add value for the client during the work disability assessment. Methods For this explorative qualitative study, 7 semi-structured interviews were conducted with MEs in the Netherlands. Thematic coding was performed for all interviews. Results A large variety of facilitators (n = 22), barriers (n = 17) and opportunities (n = 11) were identified and inductively subdivided into four main themes: 1) coherent process, including all time related aspects, 2) interdisciplinary collaboration, including all aspects related to the collaboration between the ME and other professionals, 3) client-centred interaction, including all aspects related to the supportive interplay from the ME towards the client, and 4) information provision on all aspects during the work disability assessment process towards the client to ensure a valuable work disability assessment process. Conclusions The overview of identified possible facilitators, barriers and opportunities to add value for clients from the perspective of the ME may stimulate improvement in the current work disability assessment practice and to better match the client needs.
© Hagendijk ME; Tan Z; Melles M; Hoving JL; van der Burg-Vermeulen SJ; Zipfel N. Work. 2024 Apr 08.
Purpose The aim of this qualitative study was to explore ways that employer support influenced successful return to work (RTW) in workers with disabilities. Methods We conducted a semi-structured interview study among 27 workers with disabilities in the Netherlands who received a partial disability benefit two years after sick leave and who continued working in paid (part-time) employment after a period of long-term sickness absence (> 2 years). We analyzed data by means of thematic analysis. Results We identified four types of employer support that were experienced as factors of successful RTW: 1. Supervisor accessibility; 2. Supervisor engagement; 3. Supervisor strategies; and 4. Supervisor-initiated work accommodations. More specifically, during the preparations for RTW phase, the supervisor's active role involved having a positive and open attitude toward facilitating RTW; during the initial RTW phase, the supervisor's role involved being creative in finding solutions for work accommodations; and during the sustained RTW phase, the supervisor's role included helping workers who still needed changes in their work situations. Conclusion The elements of successful employer support reveals that the pressure on the shoulders of the supervisor is high. Future research should further investigate whether supervisors need more phase-specific training from their organization.
© Jansen J; Brouwer S; Alma MA; Boot CRL. Disability & Rehabilitation. 1-8, 2024 Apr 25.
Mars 2024
Purpose Previous research has systematically studied the effectiveness of Cognitive Behavioral Therapy (CBT)-based interventions in managing both mental and physical symptoms of chronic disease including depression, stress-related mental disorders (SMD), and chronic pain that are common causes of sick leave. However, a systematic review focusing on the effectiveness of CBT in facilitating RTW is lacking. This study compiles research on utilizing CBT-based interventions for helping employees on sick leave return to work. Methods Randomized controlled trials (RCT) published between 1 January 1990 and 27 June 2022 were searched in MEDLINE, EMBASE, The Cochrane Library, Scopus, PsycINFO, Web of Science, and PubMed. The primary outcome variables included a return to work (RTW) measure and sickness absences. The secondary outcomes include psychological conditions (mental illness, stress, anxiety, and depression) and physical condition (working ability, fatigue, and physical function). Results Thirty-four RCTs were included in the analysis. Fifteen RCTs with 1727 participants reported on sick leave. Results showed that participants who completed CBT intervention had reduced sick leave in days (mean reduction - 3.654; 95%CI - 5.253, - 2.046; p < 0.001) compared to the control group. Sixteen papers with 2298 participants reported that the intervention group RTW 1.5 days earlier (95%CI 1.019, 1.722; p < 0.05). CBT-based interventions were effective in managing fatigue, mental illness, and depression, and improving physical function while it showed no effects in managing stress, anxiety and working ability. Conclusions The findings indicate that CBT-based interventions are effective in reducing the length of sick leave and facilitating the RTW of employees in the intervention group.
© Xu H; Cai J; Sawhney R; Jiang S; Buys N; Sun J. Journal of Occupational Rehabilitation. 34(1):4-36, 2024 Mar.
Purpose The purpose of this study was to develop a question prompt list (QPL) to support patients undergoing work-related medical rehabilitation in obtaining relevant information and to explore how patients and physicians rate the QPL regarding its usefulness, practicability, and perceived (additional) effort. Methods An initial item pool was assessed by rehabilitation patients (N = 3) in cognitive interviews, rated by physicians and other health professionals (N = 11), and then further modified. The final QPL version (16 items) was used by patients (N = 36) in medical admission interviews in an inpatient medical rehabilitation facility and then evaluated. Physicians evaluated the QPL after each interview with a study participant (N = 6; k = 39 interviews). Results The QPL was used by 50% of patients who rated its usefulness and comprehensibility positively. Neither the need for information nor satisfaction with the information received was correlated with QPL use. The physicians' assessment showed a positive evaluation regarding the provision of information and structuring of the conversation, but also a higher perceived time expenditure. Conclusion While initial testing of the QPL in work-related medical rehabilitation as a tool to support patient-provider communication generally showed a favorable evaluation by patients using it and physicians, future research should address its validity and effectiveness.
© Lukasczik M; Wolf HD; Vogel H. Frontiers in Rehabilitation Sciences. 5:1266065, 2024.
Purpose Considering current labour shortages, the recent increase in the number of aging workers in the labour market is deemed economically beneficial. However, due to specific characteristics (e.g. biological, generational), aging workers take longer to recover and return to work after an occupational injury. Yet, few studies have examined the rehabilitation, return, and stay at work process of aging workers and current knowledge makes it difficult for stakeholders to identify which interventions to use with this specific population. This study aimed to describe which interventions are used in the rehabilitation, return, and stay at work process of aging workers having suffered an occupational injury. Methods We conducted a five-step scoping review. Five databases were used for the literature search. A qualitative analysis of the retained manuscripts was conducted. Results Our analysis led to the extraction of information from seven manuscripts that concern the rehabilitation, return, and stay at work process of aging workers who suffered an occupational injury exclusively. We identified 19 interventions (e.g. work capacity development, work task modifications, permanent part-time work, and alternative roles) and were described according to the different phases of the Cycle of Work Disability Prevention (CWDP). Conclusions This study offers informative, non-prescriptive, and operational interventions useful for stakeholders who support aging workers. Furthermore, it is a knowledge base to develop future projects that promote the rehabilitation, return, and stay at work process of aging workers.
© Audet J; Lecours A. Work. 2024 Mar 01.
Purpose There is need for more knowledge about the relationship between work and cognitive functioning in sick-listed individuals. This study investigated whether the degree of work participation is relevant for recovery of cognitive functioning in sick-listed individuals. Methods 177 occupational rehabilitation participants and 70 controls participated in a non-randomised, longitudinal study. Participants completed computerised cognitive tests targeting sustained attention and working memory at start and end of rehabilitation and 3 and 12 months after rehabilitation. The change score performance in attention and memory between start and end, start and 3 months and 12 months was compared in individuals on sick leave 100-75%, 74-40% and 39-0% (three sick leave groups) of the time in the year after rehabilitation, and a control group not being on sick leave. Fixed effect analysis of covariance adjusting for education and work ability was used. Results The sick leave group 100-75% had significantly lower score on work ability compared to the other groups at baseline. The main findings indicated that the sick leave group 39-0% improved significantly more in sustained attention compared to the sick leave group 100-75% between start and end of rehabilitation and from start of rehabilitation to 3 and 12 months after. Conclusion The degree of work participation seems relevant to recovery of the cognitive function sustained attention in sick-listed individuals. These findings encourage work rehabilitation clinicians, work consultants and employers to develop RTW plans which take into account that graded employment influence cognitive functioning.
© Johansen T; Oyeflaten I; Eriksen HR; Lyby PS; Dittrich WH; Holsen I; Jakobsen H; Jensen C. Work. 77(3):949-961, 2024.
Purpose There are a wide range of interventions that are designed to influence employer behaviour with respect to the employment of people with disabilities. This study presents the results of a systematic review looking at employer-focused interventions to improve disability employment, focusing on interventions or policies taking placing in high-income countries as per the OECD. Methods This systematic review focuses on a broad range of potential employment-related outcomes, including the employment rate, time to return to work and length of sickness absence. The results of 71 papers that evaluate the effectiveness of a range of interventions were synthesised into a narrative review. Results Interventions are grouped into six broad categories: anti-discrimination legislation, quota systems, part-time sick leave, graded return to work and wage subsidy schemes. Anti-discrimination legislation is not effective at improving the employment prospects of people with disabilities. There is mixed evidence with respect to quota systems and wage subsidy schemes. However, the availability of part time sick leave or graded return to work are both consistently associated with improved work participation for people with disabilities.
© Derbyshire DW; Jeanes E; Khedmati Morasae E; Reh S; Rogers M. Social Science & Medicine. 347:116742, 2024 Mar 08.
Purpose In 2019, an initiative to reduce sickness absence in public sector workplaces in Denmark was introduced. The initiative involved appointing a sickness absence coordinator (SA coordinator) to oversee the implementation of workplace-based sickness absence interventions. Since the role of the SA coordinator is a novel concept introduced as part of the initiative, this study investigates the responsibilities of SA coordinators and the challenges they experienced in fulfilling this role during the implementation process. Methods Semi-structured interviews with and observations of SA coordinators from four public sector workplaces were carried out. We collected the first four interviews and observations during the implementation process with follow-up interviews collected at the end of the process. The data were analyzed using thematic analysis. Results The SA coordinators all experienced challenges in terms of lack of commitment among the line managers to participate in the intervention. They experienced being seen as a burden rather than a helping hand, and felt that the line managers might have difficulty recognizing the value of the SA coordinators. Potential ways to improve the collaboration between the SA coordinators and the line managers include considering hiring the SA coordinator in-house and incorporation of intervention components into existing activities to accommodate the busyness of the line managers. Conclusions To support the SA coordinators in carrying out their role and responsibilities, this study suggests that it is important to ensure commitment to the role, especially among the line managers in order to enhance good working relationships.
© Rasmussen L; Nielsen MBD; Garde AH; Kristiansen J, Journal of occupational rehabilitation, 2024 Mar 22
Février 2024
Purpose The aim of this study was to synthesize the findings of qualitative meta-syntheses (QMS) on return to work (RTW) of people with different chronic illnesses and to develop a generic RTW model that can provide advice on how to improve RTW interventions and strategies. Methods We conducted a systematic literature search in PubMed, Epistemonikos, CENTRAL, and PsycARTICLES to find relevant QMS, published in English or German between 2000 and 2021, and adapted the meta-ethnographic approach of Noblit and Hare to synthesize their findings. Results Nineteen QMS (five focusing on musculoskeletal disorders or chronic pain, four on acquired or traumatic brain injuries, four on cancer, two on mental disorders, one on spinal cord injury, and three on mixed samples) met our inclusion criteria for the meta-ethnographic synthesis. Through systematic comparison and reciprocal translation of the single QMS findings, we could identify a set of key cross-cutting themes/concepts, which formed the basis for four RTW principles and a generic RTW model. Conclusions RTW is a multifactorial and highly interactive multistakeholder process, embedded in an individual's life and working history, as well as in a determined social and societal context. It runs parallel and interdependently to the process of coping with the disease and realigning one's own identity, thus emphasizing the significance of RTW for the person. Besides symptoms and consequences of the disease, individual coping strategies, and RTW motivation, the course and success of RTW are strongly affected by the adaptability of the person's working environment and the social support in their private and working life. Thus, RTW is not only a problem of the individual, but also a matter of the social environment, especially the workplace, requiring a holistic, person-centered, and systemic approach, coordinated by a designated body, which considers the interests of all actors involved in the RTW process.
© Schwarz B; Banaschak H; Heyme R; von Kardorff E; Reims N; Streibelt M; Bethge M. Rehabilitation. 63(1):39-50, 2024 Feb.
Purpose Despite the significant economic impact of occupational injuries on companies and society, studies focused on analyzing the determinants of workdays lost due to sick leave remain scarce and incomplete. This paper contributes to this issue by (a) analyzing the drivers of sick leave duration, distinguishing factors that explain the health recovery time from those that could lead workers to a voluntary extension of the absence period, and (b) formulating and empirically testing the effect of gender, citizenship, temporary work, job tenure, amount of disability benefit, and size of the injured worker's firm on the number of days the employee is off work after the injury. Methods Hypotheses are tested on a comprehensive dataset that includes all nonfatal occupational injuries causing sick leave that occurred in the manufacturing sector in Spain during 2015-2019, with more than 400,000 injuries. We conduct ordinary least squares and count data regression models in which the number of days off work is regressed on employees and work characteristics while accounting for a set of variables to control the injury's nature and severity. Results The results show that after considering the intrinsic characteristics of the injury and the severity of the worker's injuries, women, native workers, workers with more seniority, workers with higher salaries, and those working in larger companies have longer periods of sick leave. The results suggest that moral hazard considerations significantly impact the time to return to work after an occupational injury. Conclusions Based on the findings, several insights for company managers and public decision-makers are discussed. Specifically, interventions aimed at improving the organization of work and the working conditions of workers in manufacturing industries are highlighted, as well as the need to improve control and supervision mechanisms during the recovery process of injured workers.
© Arocena P; Garcia-Carrizosa LM. Journal of Safety Research. 86:311-317, 2023 09.
Purpose Due to the Belgian health insurance system's controlling nature, work-disabled claimants can feel forced to return to work (RTW), increasing their risk of relapse. RTW out of interest or importance is considered more sustainable. Such autonomous motivation for RTW can be promoted through 'motivational counselling', an integration of self-determination theory and motivational interviewing. To adopt this, health insurance practitioners need training, which can be designed through intervention mapping as an evidence-based planning tool. This paper reports on the development of a motivational counselling training for health insurance practitioners. Methods Intervention mapping's six steps guided the formulation of programme goals and learning outcomes, matching the context. We then identified change methods which were translated into practical components. Together with the health insurances' input, this resulted in a concrete training programme with an implementation and evaluation plan. Results The training was designed to increase practitioners' knowledge, skills, and beliefs relevant for learning motivational counselling, which also requires solution-focused strategies. Methods like guided practice were translated into built-in exercises, feedback, and information, which were implemented through an online training format of five sessions including one follow-up. Conclusion Reporting about training development increases understanding of its effectiveness and implementation, which will be evaluated via pre- and post-training data collection amongst practitioners. Future trainings can benefit from this by accounting for health insurances' organizational barriers or building on the training's evidence-based backbone whilst only requiring specific adaptations for other stakeholders and contexts. Further research should evaluate motivational counselling's impact on claimants' RTW trajectories.
© Rymenans I; Van den Broeck A; Vanovenberghe C; Du Bois M; Lauwerier E, Journal of occupational rehabilitation, 2024 Feb 26.
Janvier 2024
Purpose Studies suggest that symptom reduction is not necessary for improved return-to-work after occupational rehabilitation programmes. This secondary analysis of a randomized controlled trial examined whether pain intensity and mental distress mediate the effect of an inpatient programme on sustainable return-to-work. Methods The randomized controlled trial compared inpatient multimodal occupational rehabilitation (n = 82) with outpatient acceptance and commitment therapy (n = 79) in patients sick-listed due to musculoskeletal and mental health complaints. Pain and mental distress were measured at the end of each programme, and patients were followed up on sick-leave for 12 months. Cox regression with an inverse odds weighted approach was used to assess causal mediation. Results The total effect on return-to-work was in favour of the inpatient programme compared with the control (hazard ratio (HR) 1.96; 95% confidence interval (95% CI) 1.15-3.35). There was no evidence of mediation by pain intensity (indirect effect HR, 0.98; 95% CI, 0.61-1.57, direct effect HR, 2.00; 95% CI, 1.02-3.90), but mental distress had a weak suppression effect (indirect effect HR, 0.89; 95% CI, 0.59-1.36, direct effect HR, 2.19; 95% CI, 1.13-4.26). Conclusion These data suggest that symptom reduction is not necessary for sustainable return-to-work after an inpatient multimodal occupational rehabilitation intervention.
© Aasdahl L; Nilsen TIL; Mork PJ; Fimland MS; Skarpsno ES. Journal of Rehabilitation Medicine. 56:jrm18385, 2024 Jan 12.
Purpose This paper describes how Canadian Return to Work coordinators (RTWC) framed their job roles relative to workers in ways that went beyond the usual professional norms of helping worker recovery. Methods In-depth interviews were conducted with 47 RTWCs across Canada in 2018-2019. We used critical discourse analysis to analyze the way coordinators viewed workers in the complex, multi-stakeholder system of RTW. Results We identified four ways that RTWCs positioned themselves relative to workers: as trust builders, experts, detectives and motivators. These roles reflected RTWCs position within the system; however, their discourse also contributed to the construction of a moral hierarchy that valued worker motivation and framed some workers as attempting to exploit the RTW system. Conclusions RTWCs' positions of power in the coordination process warrant further investigation of how they exercise judgement and discretion, particularly when the process depends on their ability to weigh evidence and manage cases in what might be seen as an objective and fair manner.
© Hopwood P; MacEachen E; Crouch M; Neiterman E; McKnight E; Malachowski C. Journal of Occupational Rehabilitation. 2024 Jan 24.
Purpose The challenges of returning to work after sickness absence demands a wide conceptual understanding of what hinders the employee's work participation. Thus, there is a need to know more about self-perceived barriers for Return to Work (RTW). This study aimed to investigate RTW barriers experienced by employees on long-term sick leave, through the lens of the Model of Human Occupation (MOHO). Methods The study was a large-scale qualitative interview study (n = 85) using semi-structured telephone interviews. Eligible participants had received sick leave benefits for between 6 months and 1.5 years. The data were analysed with quantitative and qualitative content analysis. A deductive approach using the MOHO concepts guided the analysis process. Results The study generated 941 coded meaning units describing barriers for RTW, of which we were able to code 895 within the framework of MOHO. In the person-specific concepts, performance capacity barriers were most often described (n = 303), followed by volitional barriers (n = 165) and barriers related to habituation (n = 66). Barriers related to the environmental components amounted to 361. Barriers in the occupational environment was dominant (n = 214). Conclusion Experienced barriers related to both environmental components and person-specific concepts.
© Stromstad K; Skarpaas LS; Haslerud SI; Alve YA; Sandqvist J; Aas RW. Scandinavian Journal of Occupational Therapy. 31(1):2297732, 2024 Jan.
Purpose Using simulation methods that replicate specific job demands can accelerate return-to-work following an illness or injury. However, the components of simulation vary markedly. The current study explores the perceptions and experiences of service users to better understand what aspects are required to facilitate a well-designed, work-specific simulation. Methods Thirteen injured workers (10 men, 3 women) and four staff (3 allied health, 1 manager) involved in a simulation-based rehabilitation program were interviewed. Interview data were analysed using reflexive thematic analysis. Results Three major themes resulted: 1) simulation can facilitate successful rehabilitation, 2) the importance of offering multiple, realistic simulations to replicate varying occupations, and 3) effective simulation involves collaboration with a worker’s existing health professionals. Conclusion Simulation tasks can be effectively integrated into injury rehabilitation, although are challenging to implement and require further validation studies. The present findings may provide some guidance for rehabilitation services looking to implement this method within a broader, biopsychosocial return-to-work program.
© Dorstyn D; Oxlad M; Whitburn S; Fedoric B; Roberts R; Chur-Hansen A. Journal of Vocational Rehabilitation. Jan2024, p1-9.
Décembre 2023
Purpose There is limited knowledge regarding the impact of rehabilitation on work ability. The aim of this study was to explore factors associated with work ability 12 months following a multidisciplinary rehabilitation program in a cohort with different diagnoses. Methods Of 9108 potentially eligible participants for the RehabNytte research project, 3731 were eligible for the present study, and 2649 participants (mean age 48.6 years, 71% female) consented to contribute with work-related data, and were included. Self-perceived work ability was assessed by the Work Ability Score (WAS) (0-10, 10 = best), during the follow-up period using paired t-tests and logistic regression to examine associations between demographic and disease-related factors and work ability at 12-month follow-up. Results The mean baseline WAS for the total cohort was 3.53 (SD 2.97), and increased significantly to 4.59 (SD 3.31) at 12-month follow-up. High work ability (WAS >= 8) at 12 months was associated with high self-perceived health at the baseline (OR 3.83, 95% CI 2.45, 5.96), while low work ability was associated with a higher number of comorbidities (OR 0.26, 95% CI 0.11, 0.61), medium pain intensity (OR 0.56, 95% CI 0.38, 0.83) and being married or cohabiting (OR 0.61, 95% CI 0.43, 0.88). There were no significant differences in work ability between participants receiving occupational and standard rehabilitation. Conclusions Work ability increased significantly over the follow-up period. High work ability at 12-month follow-up was associated with high self-perceived health at baseline, while being married or cohabiting, having higher number of comorbidities, and experiencing medium baseline pain intensity was associated with lower work ability. Rehabilitation interventions targeting these factors may potentially enhance work ability, leading to a positive impact on work participation among people in need of rehabilitation.
© Skinnes MN; Moe RH; Johansen T; Lyby PS; Dahl K; Eid I; Fagertun TC; Habberstad A; Johnsen TJ; Kjeken I; Klokkerud M; Linge AD; Lyken AD; Orpana A; Rajalahti T; Wilkie R; Uhlig T; On Behalf Of The RehabNytte Consortium. Journal of Clinical Medicine. 12(23), 2023 Nov 29.
Octobre 2023
Purpose The workplace accommodation process is often affected by ineffective and inefficient communications and information exchanges among disabled employees and other stakeholders. Information systems (IS) can play a key role in facilitating a more effective and efficient accommodation process since IS has been shown to facilitate business processes and effect positive organizational changes. Since there is little to no research that exists on IS use to facilitate the workplace accommodation process, this paper, as a critical first step, examines how IS have been used in the accommodation process. Methods Thirty-six interviews were conducted with disabled employees from various organizations. Open, axial, and selective coding were part of the analysis. Fuzzy set qualitative comparative analysis was used to identify different levels of IS use based on participants' descriptions. Results An IS used in the workplace accommodation process consists of electronic request form, accommodation checklist, special budget, specific role, ancillary service, formal policy and procedure. There are different levels of IS use in the current accommodation process. The high-level IS use often results in a better accommodation performance than the low-level IS use, including high efficiency, high effectiveness, and low emotional tolls. Nevertheless, the high-level IS use often uses a specific, inflexible template as well as disregards human elements in the accommodation process. Conclusion This work provides implications that future IS design should raise awareness of disability and accommodation, account for individual differences, involve multiple stakeholder inputs, as well as address the fundamental social issues in the accommodation process.
© Cao S. Work. 2023 Sep 30.
Purpose Inpatient rehabilitation is common in Germany to improve return-to-work outcomes. The objective of this systematic scoping review was to identify factors associated with return-to-work outcomes in musculoskeletal, psychological and oncological health conditions to improve tailoring of rehabilitation therapies. Methods A search was completed in Embase, Medline, PsycInfo and AMED until May 2023 for articles investigating inpatient rehabilitation including working-age patients with oncological, musculoskeletal, or psychological diseases using a quantitative design and reporting factors associated with return-to-work outcomes. Screening of all titles and abstracts was completed by one reviewer, full texts were read by two reviewers. Quality appraisal and data extraction was completed by two reviewers. Data was analysed using a narrative synthesis. Results Eighteen studies of moderate quality were included. The review identified a wide range of return-to-work parameters including employment status, work ability, sickness absence, retirement status and duration of employment since rehabilitation. In addition, 48 psychological, health- and work-related factors associated with return-to-work parameters were identified. Only one RCT investigated the relationship between a depression prevention intervention and a return-to-work outcome (work ability), which showed a significant effect. Conclusion In addition to the depression prevention intervention, only the factor 'health literacy' could be considered modifiable and be addressed as part of an inpatient rehabilitation programme. Furthermore, gradual work reintegration programs and/or workplace interventions in addition to inpatient rehabilitation should be further explored to improve return-to-work outcomes.
© Fohner K; Seipp H; Becker A; Maulbecker-Armstrong C; Schneider A; Seifart U; van der Wardt V. Psychology Health & Medicine. 1-25, 2023 Oct 12.
Purpose To investigate the causal effect of sense of coherence on long-term work participation after rehabilitation, including stratification by age and diagnoses. Methods Design: Longitudinal cohort study. Participants: Patients aged ≤ 60 years, employed and accepted for somatic interprofessional rehabilitation in 2015 (n = 192). Data collection & analysis: Patients reported sense of coherence before rehabilitation in 2015 and mental and physical functioning in 2016. Register data were used to measure work participation during 2018 and days working without social security benefits during 2016-18. Regression models were used to explore the total effect of sense of coherence and the possible mediation of functioning. Results are reported as odds ratios (95% confidence intervals). Results During 2018, 77% of the total study cohort participated in work activities. The subgroup with musculoskeletal diagnoses had the fewest days of working without social security benefits. A causal relationship was found between sense of coherence and long-term work participation. Some of the effect of sense of coherence was mediated by mental functioning. The total effect of sense of coherence was strongest for patients with musculo-skeletal diagnoses (work participation: 1.11 (1.05, 1.17), days working without social security benefits: 1.05 (0.01, 109)). Conclusion Improving coping resources may be beneficial to facilitate long-term work participation after injury or illness, especially for individuals with musculoskeletal diagnoses.
© Berget AM; Moen VP; Hustoft M; Assmus J; Strand LI; Skouen JS; Hetlevik Ø, Journal of rehabilitation medicine, 2023 Oct 19; Vol. 55, pp. jrm11982
Purpose Musculoskeletal and mental health complaints are common in the general population and frequent reasons for healthcare utilization and work absence. Illness perceptions, coping expectancies, rumination and self-stigma are important factors in the management of these health complaints and factors closely linked to health literacy (HL). The aims of the study were to identify helpful elements in a brief intervention (BI) targeting HL regarding common musculoskeletal and mental health complaints and to identify patient perceptions of how the intervention was helpful and whether it affected their subsequent coping. Methods Three focus group interviews with 14 patients were conducted. Systematic text condensation was used for the analysis, supported by the health literacy skill (HLS) framework to sharpen the focus on intervention elements related to the acquisition and utilization of HLSs. Results Results revealed the importance of receiving comprehensible health information and guidance, the use of metaphors to create recognizable narratives and the use of practical examples and exercises. Normalizing the experienced health complaints, together with a safe and accommodating clinical environment, facilitated the change process. Conclusion The BI initiated processes that contributed to acceptance, resilience and empowerment, aiding work–life balance and return to work. The study presents authentic narratives of value for future focus in BI.
© Johnsen TL; Tveito TH; Øyeflaten I. Health Promotion International, Oct2023; 38(5): 1-12.
Purpose Our process evaluation (trial registration: DRKS00022468) monitored the implementation of a multi-component strategy including case management aiming to improve rehabilitation coverage and work participation of people with a high risk of permanent work disability. Methods A risk score using administrative data, particularly on employment and welfare benefits, was employed to identify individuals with higher probability of receiving disability pension and therefore potentially needing support. These individuals were contacted by post and encouraged to phone their regional case manager if they needed assistance. Content for the intervention components was developed collaboratively with the case managers. We examined the sample reached, dose delivered, fidelity, dose received and satisfaction with the intervention. Results Out of 1074 individuals with high-risk scores were contacted, there were 57 case managements. The participants reached were in poor health, and 42.1% reported at least four diagnosed conditions, mostly musculoskeletal and mental disorders. About two-thirds (63.0%) reported poor work ability at baseline. On average, 72.5% of the content of the initial telephone contacts, 88.7% of the content of the face-to-face interviews and 45.2% of the content of the case management were delivered. The participants were highly satisfied with the various components and content of the intervention. Knowledge about rehabilitation improved significantly, with 43 of the 57 participants (75.4%) applying for rehabilitation, mainly medical rehabilitation. At the end of the case management intervention, most participants (91.7%) were still employed. Conclusion The risk score offers an opportunity to screen for people with a high risk of permanent work disability. Case management participants found participation worthwhile and were significantly better informed about participation services after completing case management. More than every second participant received medical or vocational rehabilitation.
© Remus L; Grope M; Lemke S; Bethge M, Die Rehabilitation, 2023 Oct 27
Septembre 2023
Purpose Police officers and others working in police services are exposed to challenging and traumatic situations that can result in physical and/or psychological injuries requiring time off work. Safely returning to work post-injury is critical, yet little is known about current return-to-work (RTW) practices in police services. This study examines RTW practices and experiences in police services from the perspective of RTW personnel and workers with physical and/or psychological health conditions. Methods We used a purposive sampling approach to recruit sworn and civilian members from several police services in Ontario, Canada. The recruited members had experienced RTW either as a person in a RTW support role or as a worker with a work-related injury/illness. We conducted and transcribed interviews for analysis and used qualitative research methods to identify themes in the data. Results Five overarching themes emerged. Two pointed to the context and culture of police services and included matters related to RTW processes, injury/illness complexity, the hierarchical nature of police organizations, and a culture of stoicism and stigma. The remaining three themes pointed to the RTW processes of accommodation, communication and trust-building. They included issues related to recovery from injury/illness, meaningful accommodation, timely and clear communication, malingering and trust. Conclusions Our findings point to potential areas for improving RTW practices in police services: greater flexibility, more clarity, stricter confidentiality and reduced stigma. More research is needed on RTW practices for managing psychological injuries to help inform policy and practice.
© Van Eerd D; Le Pouesard M; Yanar B; Irvin E; Gignac MAM; Jetha A; Morose T; Tompa E. Journal of Occupational Rehabilitation. 2023 Sep 21.
Purpose Return-to-work coordinators (RTWCs) give people on sick leave individualized support and coordinate between different stakeholders, including physicians. The aim of this study was to explore physicians’ experience of RTWCs and investigate factors that influence how much physicians collaborate with RTWCs, or refer patients to them, in primary, orthopaedic, and psychiatric care clinics. Methods Of the 1229 physicians responding to a questionnaire, 629 physicians who had access to a RTWC in their clinic answered to questions about collaborating with RTWCs. Results Among physicians who had access to a RTWC, 29.0% collaborated with a RTWC at least once a week. Physicians with a more favourable experience of RTWCs reported more frequent collaboration (adjusted OR 2.92, 95% CI 2.06–4.15). Physicians also collaborated more often with RTWCs if they reported to often deal with problematic sick-leave cases, patients with multiple diagnoses affecting work ability, and conflicts with patients over sickness certification. Conclusions Physicians who had more problematic sick-leave cases to handle and a favourable experience of RTWCs, also reported collaborating more often with RTWCs. The results indicate that RTWCs’ facilitation of contacts with RTW stakeholders and improvements in the sickness certification process may be of importance for physicians. Implications for Rehabilitation: This study of physicians’ experience of collaborating with return-to-work coordinators (RTWCs) observes that physicians reported more collaboration with or referrals to coordinators if they had a favourable experience of coordinators. The results indicate that physicians report more collaboration with or referrals to RTWCs if they had more problematic sick-leave cases to handle in the clinic. These findings imply that it might be possible to increase the collaboration between physicians and RTWCs in clinical settings by managing factors of importance. This study of physicians’ experience of collaborating with return-to-work coordinators (RTWCs) observes that physicians reported more collaboration with or referrals to coordinators if they had a favourable experience of coordinators. The results indicate that physicians report more collaboration with or referrals to RTWCs if they had more problematic sick-leave cases to handle in the clinic. These findings imply that it might be possible to increase the collaboration between physicians and RTWCs in clinical settings by managing factors of importance.
© Berglund E; Friberg E; Engblom M; Svärd V. Disability & Rehabilitation. Sep2023, p1-9.
Purpose Although workplace injury rehabilitation is a significant economic and social burden for injured workers and the community, it remains inconclusive whether the worker’s choice of provider and treatment type influences these costs or the outcome of rehabilitation. This study explored what choices injured workers could access during rehabilitation in terms of their provider and treatment, what hindered or helped their choice, and whether workers perceived that choice influenced the outcome of their rehabilitation. Methods A mixed methods study was employed, utilising an online survey and semi-structured telephone interviews. Results Injured workers reported that being able to choose their provider and treatment was not straightforward. Obstacles included systemic rigidity, poor relationships between stakeholders, and unfamiliarity with the system. Most survey respondents perceived that the degree of choice they had in their treatment influenced the outcome of their rehabilitation and sometimes also their occupational bond, career, and finances. Conclusions The study found that choice of provider and treatment type does matter for workers undergoing rehabilitation, impacting on outcomes including occupational bond, income, and disputes. In balancing the need for cost containment with social responsibility, both financial and psychosocial outcomes are relevant for those engaged in rehabilitation of injured workers.
© Anderson O; McLennan V; Randall C. Journal of Vocational Rehabilitation. Sep2023, p1-9.
Août 2023
Purpose There is a lack of knowledge about interprofessional rehabilitation for culturally diverse patients with chronic pain. This study explores experiences of healthcare professionals developing and working with rehabilitation with patients in need of an interpreter and their experience of working with interpreters. Methods Twelve healthcare professionals at two Swedish specialist rehabilitation centres were interviewed. Grounded theory principles were used for the data collection and analysis. Results The main category "Demanding and Meaningful Work" represents three concurrently interacting categories: "Frustration" includes the informants' doubts regarding the benefits of the rehabilitation, lack of care for patients and cultural dissonance between professionals and patients. "Challenges" describes problems in the rehabilitation work due to the need for interpreted mediated communication, the complexity in health status and social aspects among the patients. "Solutions" represents practical working methods and personal approaches developed by the informants for managing frustrations and challenges. Conclusions The informants' frustration and challenges when working with a new group of patients, vulnerable and different in their preconceptions, led to new solutions in working methods and approaches. When starting a pain rehabilitation programme for culturally diverse patients, it is important to consider the rehabilitation team's need for additional time and support. Implications for rehabilitation: Healthcare professionals who encounter immigrants with chronic pain need resources to develop their own skills in order to handle complex ethical questions as the patients represent a vulnerable patient group with many low status identities. In order to adapt rehabilitation programmes to patient groups with different languages and pre-understandings of chronic pain, there is a need for a team with specific qualities, i.e., close cooperation, an innovative atmosphere, time and also support from experts. For appropriate language interpretation it is important to have a professional interpreter and a healthcare professional who are aware of and adopt the rules, possibilities and restrictions of interpretation. The rehabilitation of patients in need of language interpretation needs more time and organisation compared to the rehabilitation of patients who speak the national language.
© Uhlin K; Persson E; Stalnacke BM; Lofgren M. Disability & Rehabilitation. 45(15):2434-2445, 2023 07.
Purpose People with long-term conditions or recovering from serious injuries can struggle to return to work. The evidence for occupational therapy supporting return to work is limited. We aimed to identify and explain how occupational therapy interventions work. Methods Systematic review. Seven databases were searched between 1 January 1980 and 15 June 2022. Studies measuring work-related outcomes among individuals receiving occupational therapy during absence from paid work were included. Multiple reviewers independently contributed to screening, quality appraisal and data extraction processes. Data were analysed as a narrative. Results Twenty studies with 3866 participants were included; 17 were assessed as having high risk of bias. Occupational therapy was inconsistently acknowledged affecting study identification and occupational therapy components were poorly described. Meta-analysis was unfeasible due to outcome heterogeneity. Individually tailored occupational therapy focused on return to work in musculoskeletal conditions indicated the most promising outcomes. Key intervention components included vocational assessment, goal setting and self-management. Key mechanisms of action included early intervention, individualised support and being responsive to needs. Conclusion Occupational therapists' contributions supporting return to work should be clearly attributed. Future effectiveness research should standardise the measurement of work outcomes to support meta-analysis. Developing a taxonomy for occupational therapy supporting return to work could facilitate comparisons across studies, highlighting occupational therapists' roles and facilitating training and benefits to patients.
© De Dios Perez B; McQueen J; Craven K; Radford K; Blake H; Smith B; Thomson L; Holmes J. British Journal of Occupational Therapy, Jul2023; 86(7): 467-481.
Purpose In recent decades, many countries have implemented return-to-work coordinators to combat high rates of sickness absence and insufficient collaboration in the return-to-work process. The coordinators should improve communication and collaboration between stakeholders in the return-to-work process for people on sickness absence. How they perform their daily work remains unexplored, and we know little about to what extent they collaborate and perform other work tasks to support people on sickness absence. This study examines which work models return-to-work coordinators use in primary healthcare, psychiatry and orthopaedics in Sweden. Methods A questionnaire was sent to all 82 coordinators in one region (89% response rate) with questions about the selection of patients, individual patient support, healthcare collaboration, and external collaboration. Random forest classification analysis was used to identify the models. Results Three work models were identified. In model A, coordinators were more likely to select certain groups of patients, spend more time in telephone than in face-to-face meetings, and collaborate fairly much. In Model B there was less patient selection and much collaboration and face-to-face meetings. Model C involved little patient selection, much telephone contact and very little collaboration. Model A was more common in primary healthcare, model C in orthopaedics, while model B was distributed equally between primary healthcare and psychiatry. Conclusion The work models correspond differently to the coordinator's assignments of supporting patients and collaborating with healthcare and other stakeholders. The differences lie in how much they actively select patients, how much they collaborate, and with whom. Their different distribution across clinical contexts indicates that organisational demands influence how work models evolve in practice.
© Svard V; Berglund E; Bjork Bramberg E; Gustafsson N; Engblom M; Friberg E. PLoS ONE. 18(8):e0290021, 2023.
Purpose The return-to-work (RTW) process for people with multimorbidity and psychosocial difficulties can be complicated. This study explores the organisational prerequisites for coordinating these patients' RTW processes from the perspective of coordinators in different clinical areas in Sweden. Methods Six focus group interviews were conducted with 24 coordinators working in primary healthcare (PHC), psychiatric and orthopaedic clinics. The data were analysed thematically, inspired by organisation theory. Results Coordinators described varying approaches to people with multimorbidity and psychosocial difficulties, with more hesitancy among PHC coordinators, who were perceived by other coordinators as hindering patient flows between clinical areas. Most organisational barriers to RTW were identified in the healthcare sector. These were long waiting times, physicians drawing up inadequate RTW plans, coordinators being involved late in the sickness absence process, and lack of rehabilitation programmes for people with multimorbidity. The barriers in relation to organisations such as Social Insurance Agency and Employment Services were caused by regulations and differing perspectives, priorities, and procedures. Conclusion Our findings indicate what is needed to improve the RTW process for patients with complex circumstances: better working conditions, steering, and guidelines; shorter waiting times; and a willingness among coordinators from different clinical areas to collaborate around patients. Implications for rehabilitation: RTW coordinators need sufficient physical and psychosocial working conditions as well as clear leadership. In order to avoid inequalities in access to RTW support, better systems are needed to identify patients who would benefit from rehabilitation and RTW coordination. There is a need for multilevel collaboration between clinical areas so that patients with multiple healthcare contacts and prolonged sickness absence can obtain support during the RTW process.
© Svard, Veronica; Jannas, Sandra. Disability & Rehabilitation. 45(18):2915-2924, 2023 Sep.
Purpose This study aimed to evaluate the effectiveness of motivational interviewing (MI) - a counselling approach offered by caseworkers at the Norwegian Labor and Welfare Administration (NAV) - on return to work (RTW) for individuals sick-listed for >=8 weeks due to any diagnoses. MI was compared to usual case management and an active control during 12 months of follow-up. Methods In a randomized clinical trial with three parallel arms, participants were randomized to MI (N=257), usual case management (N=266), or an active control group (N=252). MI consisted of two MI sessions while the active control involved two sessions without MI, both were offered in addition to usual case management. The primary outcome was number of sickness absence days based on registry data. Secondary outcomes included time to sustainable RTW, defined as four consecutive weeks without medical benefits. Results The median number of sickness absence days for the MI group was 73 days [interquartile range (IQR) 31-147], 76 days (35-134) for usual care, and 75 days (34-155) for active control. In total 89%, 88% and 86% of the participants, respectively, achieved sustainable RTW. The adjusted hazard ratio (HR) for time to sustainable RTW was 1.12 (95% CI 0.90-1.40) for MI compared to usual case management and HR 1.16 (95% CI 0.93-1.44) compared to the active control. Conclusions This study did not provide evidence that MI offered by NAV caseworkers to sick-listed individuals was more effective on RTW than usual case management or an active control. Providing MI in this context could be challenging as only half of the MI group received the intervention.
© Aasdahl L; Standal MI; Hagen R; Solbjor M; Bagoien G; Fossen H; Foldal VS; Bjorngaard JH; Rysstad T; Grotle M; Johnsen R; Fors EA. Scandinavian Journal of Work, Environment & Health. 2023 Aug 27.
Juillet 2023
Purpose Decisions to increase work participation must be informed and timely to improve return to work (RTW). The implementation of research into clinical practice relies on sophisticated yet practical approaches such as machine learning (ML). The objective of this study is to explore the evidence of machine learning in vocational rehabilitation and discuss the strengths and areas for improvement in the field. Methods We used the PRISMA guidelines and the Arksey and O'Malley framework. We searched Ovid Medline, CINAHL, and PsycINFO; with hand-searching and use of the Web of Science for the final articles. We included studies that are peer-reviewed, published within the last 10 years to consider contemporary material, implemented a form of "machine learning" or "learning health system", undertaken in a vocational rehabilitation setting, and has employment as a specific outcome. Results 12 studies were analyzed. The most commonly studied population was musculoskeletal injuries or health conditions. Most of the studies came from Europe and most were retrospective studies. The interventions were not always reported or specified. ML was used to identify different work-related variables that were predictive of return to work. However, ML approaches were varied and no standard or predominant ML approach was evident. Conclusions ML offers a potentially beneficial approach to identifying predictors of RTW. While ML uses a complex calculation and estimation, ML complements other elements of evidence-based practice such as the clinician's expertise, the worker's preference and values, and contextual factors around RTW in an efficient and timely manner.
© Escorpizo R; Theotokatos G; Tucker CA. Journal of Occupational Rehabilitation. 2023 Jun 28.
Juin 2023
Purpose Early, targeted treatment is critical to recovery and overall health following a work-related illness or injury. Limited research has explored the important dimensions of work-specific injury rehabilitation from both client and staff perspectives. Methods A total of 17 participants (13 clients with work-related injuries, 3 physiotherapists, 1 project manager) involved in a unique program providing allied health treatment in combination with return-to-work services, were interviewed. Data were analysed using reflexive thematic analysis. Results Four themes were generated: (1) a biopsychosocial approach to rehabilitation; (2) a self-paced environment where client outcomes are optimised through transparent and collaborative team processes; (3) comprehensive care aids client recovery and return to work; and (4) a desire for service expansion is hampered by systemic barriers. Conclusions Injured workers and staff provided very positive feedback about the biopsychosocial supports needed for successful return to work, particularly the use of in-house work-specific simulation tasks as gradual in-vivo exposure and collaboration with scheme stakeholders. How to best provide this holistic care within current legislative requirements remains a challenge.
© Dorstyn D; Oxlad M; Whitburn S; Fedoric B; Roberts R; Chur-Hansen A. Australian Health Review. 47(3):339-343, 2023 Jun.
Purpose Return-to-work (RTW) process often includes many phases. Still, multi-state analyses that follow relevant labour market states after a long-term sickness absence (LTSA), and include a comprehensive set of covariates, are scarce. The goal of this study was to follow employment, unemployment, sickness absence, rehabilitation, and disability pension spells using sequence analysis among all-cause LTSA absentees. Methods Register data covered full-time and partial sickness allowance, rehabilitation, employment, unemployment benefits, and permanent and temporary disability pension (DP), retrieved for a 30% representative random sample of Finnish 18-59 years old persons with a LTSA in 2016 (N = 25,194). LTSA was defined as a >= 30-day-long full-time sickness absence spell. Eight mutually exclusive states were constructed for each person and for 36 months after the LTSA. Sequence analysis and clustering were used to identify groups with different labour market pathways. In addition, demographic, socioeconomic, and disability-related covariates of these clusters were examined using multinomial regressions. Results We identified five clusters with emphases on the different states: (1) rapid RTW cluster (62% of the sample); (2) rapid unemployment cluster (9%); (3) DP after a prolonged sickness absence cluster (11%); (4) immediate or late rehabilitation cluster (6%); (5) other states cluster (6%). Persons with a rapid RTW (cluster 1) had a more advantaged background than other clusters, such as a higher frequency of employment and less chronic diseases before LTSA. Cluster 2 associated especially with pre-LTSA unemployment and lower pre-LTSA earnings. Cluster 3 was associated especially with having a chronic illness before LTSA. Those in cluster 4 were on average younger and had a higher educational level than others. Especially clusters 3 and 4 were associated with a LTSA based on mental disorders. Conclusions Among long-term sickness absentees, clear groups can be identified with both differing labour market pathways after LTSA and differing backgrounds. Lower socioeconomic background, pre-LTSA chronic diseases and LTSA caused by mental disorders increase the likelihood for pathways dominated by long-term unemployment, disability pensioning and rehabilitation rather than rapid RTW. LTSA based on a mental disorder can especially increase the likelihood for entering rehabilitation or disability pension.
© Perhoniemi R; Blomgren J; Laaksonen M. BMC Public Health. 23(1):1102, 2023 Jun 07.
Purpose Non-White workers face more frequent, severe, and disabling occupational and non-occupational injuries and illnesses when compared to White workers. It is unclear whether the return-to-work (RTW) process following injury or illness differs according to race or ethnicity. Objective: To determine racial and ethnic differences in the RTW process of workers with an occupational or non-occupational injury or illness. Methods A systematic review was conducted. Eight academic databases - Medline, Embase, PsycINFO, CINAHL, Sociological Abstracts, ASSIA, ABI Inform, and Econ lit - were searched. Titles/abstracts and full texts of articles were reviewed for eligibility; relevant articles were appraised for methodological quality. A best evidence synthesis was applied to determine key findings and generate recommendations based on an assessment of the quality, quantity, and consistency of evidence. Results 15,289 articles were identified from which 19 studies met eligibility criteria and were appraised as medium-to-high methodological quality. Fifteen studies focused on workers with a non-occupational injury or illness and only four focused on workers with an occupational injury or illness. There was strong evidence indicating that non-White and racial/ethnic minority workers were less likely to RTW following a non-occupational injury or illness when compared to White or racial/ethnic majority workers. Conclusions Policy and programmatic attention should be directed towards addressing racism and discrimination faced by non-White and racial/ethnic minority workers in the RTW process. Our research also underscores the importance of enhancing the measurement and examination of race and ethnicity in the field of work disability management.
© Jetha A; Navaratnerajah L; Shahidi FV; Carnide N; Biswas A; Yanar B; Siddiqi A. Journal of Occupational Rehabilitation. 2023 Jun 09.
Purpose Current interventions designed to facilitate return to work (RTW) after long-term sick leave show weak effects, indicating the need for new approaches to the RTW process. The importance of social relationships in the workplace is widely recognized in existing RTW literature, but very little is known about the role of the interpersonal problems of the returning worker. Current research indicates that a subset of these - hostile-dominant interpersonal problems - give particular disadvantages in several life areas. This prospective cohort study aims to test whether higher levels of interpersonal problems predict lower likelihood of RTW when controlling for symptom levels (H1); and whether higher levels of hostile-dominant interpersonal problems specifically predict lower likelihood of RTW (H2). Methods 189 patients on long-term sick leave completed a 31/2-week transdiagnostic RTW program. Before treatment, self-reported interpersonal problems, chronic pain, insomnia, fatigue levels, anxiety and depression were collected. RTW data for the following year were collected from the Norwegian Labour and Welfare Administration. Results A multivariable binary logistic regression analysis found that (H2) hostile-dominant interpersonal problems significantly predicted RTW (OR = 0.44, [95% CI: 0.19, 0.98], p = .045), while a corresponding analysis (H1) found that general interpersonal problems did not. Conclusion Hostile-dominant interpersonal problems negatively predict RTW after long-term sick leave, suggesting an overlooked factor in the field of occupational rehabilitation. The findings could open up new avenues for research and interventions entailed to individuals in the field of occupational rehabilitation.
© Nilsen DA; Nissen O; Nordfjaern T; Hara KW; Stiles TC. Journal of Occupational Rehabilitation. 2023 Jun 20.
Purpose Based on the theoretical framework of the Model of Preventive Behaviours at Work, the aim of this study was to describe the the occupational rehabilitation strategies the literature reports that support workers who have suffered an occupational injury in adopting preventive behaviours. Methods To conduct this scoping review, we used a systematic methodology in 7 steps : (1) definition of the research question and inclusion/exclusion criteria; (2) scientific and gray literature search; (3) determination of manuscripts' eligibility; (4) extraction and charting of information; (5) quality assessment; (6) interpretation; and (7) knowledge synthesis. Results We selected 46 manuscripts of various types (e.g. randomized trials, qualitative studies, governmental documents). Manuscripts were mainly of good or high quality according to our quality assessment. The strategies for coaching, engaging, educating and collaborating were mostly reported in the literature to support the development of the six preventive behaviours during occupational rehabilitation. The results also suggest that heterogeneity exists regarding the specificity of the strategies reported in the literature, which may have hindered our ability to provide rich and detailed descriptions. Literature also mainly describes individually oriented behaviours and reports strategies requiring a low level of worker involvement, which represent issues to adress in future researh projects. Conclusion The strategies described in this article reprensent concrete levers that occupational rehabilitation professionals can use to support workers in the adoption of preventive behaviours at work on return from having suffered an occupational injury.
© Lecours A; Coutu MF; Durand MJ. Journal of occupational rehabilitation, 2023 Jun 26.
Mai 2023
Purpose The International Classification of Functioning, Disability and Health is the WHO coding scheme for functioning-related data. Clear and unambiguous information regarding patients' work-related disabilities is important not only for the assessment of entitlement to paid sickness benefits but also for planning rehabilitation and return to work. The objective was to validate the content of ICF and ICF Core Sets for information on work-related disability in sick leave due to depression and long-term musculoskeletal pain. Specific aims: To describe to what extent (1) such data could be linked to ICF and (2) the result of the ICF linking in terms of ICF categories was represented in relevant ICF Core Sets. Methods An ICF-linking study following the ICF-linking rules. A random sample of sick leave certificates issued in primary care for either depression (n = 25) or long-term musculoskeletal pain (n = 34) was collected from a community with 55,000 inhabitants in Stockholm County, Sweden. Results The results of the ICF linking consisted of codings for (1) ICF categories and (2) other health information not possible to link to ICF. The ICF categories were compared to ICF Core Sets for coverage. The majority of the meaning units, 83% for depression and 75% for long-term musculoskeletal pain, were linked to ICF categories. The Comprehensive ICF Core Set for depression covered 14/16 (88%) of the ICF categories derived from the ICF linking. The corresponding figures were lower for both the Brief ICF Core Set for depression 7/16 (44%) and ICF Core Set for disability evaluation in social security 12/20 (60%). Conclusion The results indicates that ICF is a feasible code scheme for categorising information on work-related disability in sick leave certificates for depression and long-term musculoskeletal pain. As expected, the Comprehensive ICF Core Set for depression covered the ICF categories derived from the certificates for depression to a high degree. However, the results indicate that (1) sleep- and memory functions should be added to the Brief ICF Core Set for depression, and (2) energy-, attention- and sleep functions should be added to the ICF Core Set for disability evaluation in social security when used in this context.
© Fresk M; Grooten WJA; Brodin N; Backlund LG; Arrelov B; Skaner Y; Kiessling A. Frontiers in Rehabilitation Sciences. 4:1159208, 2023.
Avril 2023
Purpose This feasibility study focusses on the implementation and use of a decision aid, which supports vocational rehabilitation (VR) professionals in helping clients with a disability pension return to work in practice. The decision aid shows an overview of the clients' return to work barriers and suggests suitable VR interventions based on these barriers. Methods The study population consisted of VR professionals working at the Dutch Social Security Institute and their clients receiving a (partial) work disability pension. The feasibility was measured with concepts of the Linnan and Steckler framework and the attitude, social norm and self-efficacy model. Data were collected using questionnaires, checklists and qualitative interviews. Results Ten professionals participated in this study. Fifty-four clients were asked to fill in the questionnaire of the decision aid and 32 clients received VR care based on the decision aid. In general, VR professionals and clients were satisfied with the decision aid and perceived a few barriers for using the decision aid. Conclusions This study showed that it is feasible to implement and use the decision aid. To improve the implementation of this decision aid, it should be implemented in digital systems used by professionals to improve efficiency of working with the decision aid.
© de Geus CJC; Huysmans MA; van Rijssen HJ; Juurlink TT; de Maaker-Berkhof M; Anema JR. Journal of Occupational Rehabilitation. 2023 Apr 10.
Purpose Supervisors play a pivotal role in the sick leave process. Although responsibility for sick leave and return to work follow-up is increasingly placed on the workplace in Norway, few studies have explored supervisors' experiences. This study aims to explore supervisors' experiences with attending to employees' sick leave and return to work process. Methods This study consists of individual interviews with 11 supervisors from diverse workplaces that was analysed thematically. Results The supervisors emphasised the value of presence at the workplace, the need for them to obtain information and uphold dialogue, considering individual and environmental influences on return-to-work and allocating responsibility. Investing time and money was crucial to prevent or reduce the negative impact of sick leave. Conclusions The supervisors' perception of attending to sick leave and return-to-work largely reflect Norwegian legislation. However, they find obtaining information and managing responsibility challenging, suggesting that their responsibilities for return-to-work are perhaps disproportionate to their knowledge on attending this process. Individualised support and guidance on how to develop accommodations based on the employee's workability should be made available. The reciprocal nature of follow-up described also reveals how the return-to-work process is enmeshed with (inter)personal considerations possibly resulting in unequal treatment.
© Klevanger NE; Aasdahl L; By Rise M. PLoS ONE.18(4):e0284369, 2023.
Purpose Work participation is known to benefit people's overall health and wellbeing, but accessing vocational support during periods of sickness absence to facilitate return-to-work can be challenging for many people. In this study, we explored how vocational advice was delivered by trained vocational support workers (VSWs) to people who had been signed-off from work by their General Practitioner (GP), as part of a feasibility study testing a vocational advice intervention. Methods We investigated the discursive and interactional strategies employed by VSWs and people absent from work, to pursue their joint and respective goals. Theme-oriented discourse analysis was carried out on eight VSW consultations. Results These consultations were shown to be complex interactions, during which VSWs utilised a range of strategies to provide therapeutic support in discussions about work. These included; signalling empathy with the person's perspective; positively evaluating their personal qualities and prior actions; reflecting individuals' views back to them to show they had been heard and understood; fostering a collaborative approach to action-planning; and attempting to reassure individuals about their return-to-work concerns. Some individuals were reluctant to engage in return-to-work planning, resulting in back-and-forth interactional negotiations between theirs and the VSW's individual goals and agendas. This led to VSWs putting in considerable interactional 'work' to subtly shift the discussion towards return-to-work planning. Conclusion The discursive strategies we have identified have implications for training health professionals to facilitate work-orientated conversations with their patients, and will also inform training provided to VSWs ahead of a randomised controlled trial.
© Saunders B; Chew-Graham C; Sowden G; Cooke K; Walker-Bone K; Madan I; Parsons V; Linaker CH; Wynne-Jones G. Health: an Interdisciplinary Journal for the Social Study of Health, Illness & Medicine. 13634593221148446, 2023 Apr 24.
Purpose The objective of this study was to describe the interventions for the labor reintegration of workers on medical leave due to musculoskeletal and mental health diseases, according to actions related to the worker, the employer, and the workplace. Methods This study consists of a qualitative systematic review, without restriction of publication date, conducted in the Cochrane Central Register of Controlled Trials (CENTRAL) and MEDLINE/PubMed scientific bases. In addition, the Epistemonikos database was used. Results Nineteen articles were selected. It is observed that all interventions proposed actions with the workers, such as rehabilitation programs, therapies and return to work plans. Regarding the actions in the workplace, only three interventions articulated actions with workers and evaluation of the workplace. Finally, actions with employers were considered in 10 interventions with the objective of involving the employer in the improvement of the workplace and planning for the worker's return to work. Conclusion It can be seen that interventions for patients with musculoskeletal and mental health disorders can be divided into the following categories: worker-oriented interventions, employer-oriented interventions, and workplace actions. In each of these categories, various interventions can be seen, ranging from multidisciplinary intervention to exercise-based rehabilitation, in the case of musculoskeletal disorders, and occupational therapy to the psychotherapeutic method based on music, for mental health disorders.
© Toffoletto MC; Ahumada JD. Revista Brasileira de Medicina do Trabalho. 20(4):659-669, 2022 Oct-Dec.
Purpose Vocational rehabilitation (VR) involves complex skills, and often inter-disciplinary teams need to work effectively to meet the needs of stakeholders. Research highlights important influences on effective teamwork, including funding systems, team structure, policies and procedures, and effects of professional hierarchies. This qualitative study aimed to explore these issues in-depth including how factors interact to produce problems and solutions. We focused on identifying challenges and opportunities for VR teams working in the Aotearoa-New Zealand context which may also be transferrable to other settings. Methods Qualitative descriptive instrumental case study involving focus groups and interviews with two VR teams (n = 14). Teams worked in musculoskeletal injury and were geographically diverse. Reflexive thematic analysis was used to analyse the data. Results Analysis constructed three overarching themes: Having the Power, Being Human, and VR is Not for Everyone. Achieving trusting relationships within the team was paramount. This was achieved through seeing everyone as equal, and as human. Equality within the team was particularly important for professionals that occupied different positions of power in a wider professional hierarchy. VR specialist skills (experience and postgraduate qualifications) were often under-recognised, leading them to have little power in VR decision making processes. VR professionals also experienced competing demands between client needs and business drivers. Conclusion Findings offer detail of processes teams engage in to create effective team relationships and manage systemic factors to facilitate positive outcomes. Additionally, findings highlight opportunities in decision-making processes for VR medical certification that may increase job satisfaction and better utilize skills and expertise.
© McAulay L; Fadyl J; Terry G. Journal of occupational rehabilitation, 2023 Apr 06.
Mars 2023
Purpose Injured workers can experience adverse effects from work injury and claims processes. Workers may be treated unfairly by employers, compensation boards, and return-to-work coordinators; however, how workers respond to these challenges is unknown. This article describes how injured precarious workers responded behaviourally and emotionally to procedural unfairness in work injury and claims processes, and what workers did next. Methods Interviews were conducted with thirty-six precariously employed injured workers recruited in Ontario through social media, email, cold calling, word-of-mouth, and the "snowball" method. Thematic code summaries were analyzed to identify how precarious workers responded to procedural unfairness. Results Workers went through all or most of these five stages (not always linearly) when faced with procedural unfairness: (1) passive, (2) fought back, (3) quit pursuit of claim, (4) quit job, and (5) won or got further in fight. Feeling confused, angry, frustrated, unsupported, disappointed, determined, optimistic, and wary were common emotions. Conclusions Identifying unfairness and its emotional, behavioral, and material effects on workers is important to understand implications for compensation systems. Understanding and recognizing unfairness can equip employers, legal representatives, compensation boards, and physicians, to address and prevent it, and provide worker resources. Policy changes can ensure accountability and consequences to unfairness initiators.
© Billias N; MacEachen E; Sherifali S. Journal of Occupational Rehabilitation. 33(1):160-169, 2023 Mar.
Purpose The aims of this study were: (1) to explore the frequency of discrepancies in work accommodations reported by workers and their supervisors, and (2) to investigate whether these discrepancies are associated with full return to work (RTW). Methods We used data from a longitudinal survey study of long-term sick-listed workers and their supervisors (n = 406). Discrepancies in reports on implementing eight types of work accommodations were explored. Logistic regression analyses were conducted to test associations between discrepancies in reported work accommodations and odds of full RTW 27 months after the sick-leave onset. Results Discrepancies were the lowest for the work accommodation therapeutic RTW (53%) and the highest (85%) for job training or education and reimbursement of therapy or treatment. Four out of eight types of work accommodations were more often reported by workers than by their supervisors. Only a discrepancy on a job reassignment within the organization was associated with lower odds of full RTW (OR 0.56, 95%-CI 0.36-0.88). Conclusion We found substantial discrepancies in the reported implementation of work accommodations between workers and their supervisors. Future research should focus on disentangling mechanisms that lead to discrepancies to avoid inefficiencies in the RTW process.
© Jansen J; Snippen N; Koning P; Boot C; van Ooijen R; Brouwer S. BMC Public Health. 23(1):525, 2023 Mar 18.
Purpose Aging workers represent an emerging, growing, and essential population for the contemporary labour market. Considering their unique characteristics, these individuals are at risk of experiencing periods of disability at work due to different reasons (e.g., chronic diseases, occupational injuries) and a different return-to-work experience compared to younger workers. The scoping review presented in this article aimed to identify facilitators and barriers to returning to work in aging people who suffered a health impairment. Methods Information from 34 manuscripts was extracted and analyzed, enabling the identification of factors hindering and facilitating the return to work of aging individuals, with regard to four systems: the individual, work, health, and compensation. Results The results suggest levers accessible to the various stakeholders involved in the process of returning to work for aging individuals to promote their healthy, safe, and satisfactory participation in work after a period of disability.
© Lecours A; Bedard-Mercier R. Canadian Journal on Aging. 42(1):1-12, 2023 Mar.
Purpose Return to work from long-term sick leave is influenced by personal and social factors, which can be measured by resilience, a construct that describe healthy adaptation against adversity. This study aimed to validate the validity and psychometric properties of the resilience scale for adults in a sample of long-term sick-listed individuals, and to investigate measurement invariance when compared with a university student sample. Methods Confirmatory factor analysis was used on a sick-listed sample (n = 687) to identify the scale’s factor structure, and comparison with a university student sample (n = 241) was utilized to determine measurement invariance. Results Results show that a slightly modified factor structure, in accordance with previous research, achieved acceptable fit in the sick-listed sample, while comparisons with the student sample supported measurement invariance. Conclusion This means that the study to a large degree support the factor structure of the resilience scale for adults in long-term sick-listed. Furthermore, the results indicate that the scale is similarly understood among long-term sick-listed as in a previously validated student sample. Thus, the resilience scale for adults can be a valid and reliable measure of protective factors in the long-term sickness absence and return to work context, and the subscale and total score can be interpreted similarly in long-term sick-listed as in other populations.
© Standal MI; Hjemdal O; Foldal VS; Aasdahl L; Hagen R; Fors EA; Anyan F. Journal of occupational rehabilitation, 2023 Mar 27.
Février 2023
Purpose This study aimed to explore (1) whether self-reported assessment on work-related functioning, workability, return-to-work (RTW) self-efficacy, and expectation was useful in the professionals' assessment of sick-listed workers and could guide referral to interventions and (2) whether self-reporting in addition to "usual practice" could improve the RTW dialog and involvement in case management. Methods The qualitative study took place in two municipal job centers in 2021. The assessment was based on the Work Rehabilitation Questionnaire, RTW-Self-efficacy Scale-19, and single items of self-rated health, workability, and RTW expectations. Sick-listed workers (n = 36) were interviewed by telephone. Three focus-group interviews were conducted with professionals who had used the questionnaire. Data were coded and analyzed thematically. Results Three themes with seven subthemes emerged: (1) accessibility; (2) one tool in the RTW toolbox (subthemes: a supplementary tool, a tool for reflection, facilitating interdisciplinary communication, and enhancing active participation); and (3) the value of "ticking boxes" (subthemes: good days, bad days, the issue of power, and the cultural meaning of words). Conclusion The professionals would not recommend the present questionnaire for use during their rehabilitation team meeting for assessment, interdisciplinary communication, or choice of interventions. However, using the parts assessing RTW self-efficacy and expectation combined with a dialog may be of value early in the RTW process. The self-reporting assessment tool was perceived to be meaningful to some sick-listed workers, as it provided reflections on important aspects of the RTW process. Some workers believed that it might contribute to the rehabilitation team, and thus, it could improve their involvement.
© Momsen AH; Tonnesen M; Zwicky-Hauschild B; Nielsen CV; Escorpizo R; Langagergaard V; Stapelfeldt CM. Frontiers in Rehabilitation Sciences. 3:971574, 2022.
Purpose Workplace sickness absence is a major public health and economic problem, and common mental disorders (CMDs) such as anxiety and depression are associated with particularly high rates of long-term sickness absence. Effective return-to-work (RTW) interventions are required. This pilot study investigates the feasibility, acceptability, and potential effectiveness of a new therapist-assisted Web-based RTW intervention (Workable) for injured workers on sick leave for a psychological or physical injury. Methods A single-group open pilot trial design was used, with assessments at pre-treatment and post-treatment. The intervention consisted of 6 weeks of online modules and 6 coaching calls from a psychologist. Results A total of 13 participants were recruited and 9 completed all questionnaires. Program adherence was high, with 92% of participants completing the 6-week intervention. Participants reported high levels of intervention satisfaction and ease of use. There were large and significant reductions between pre- and post-treatment on measures of depression, anxiety, stress, and workdays missed over the past four weeks, along with a significant increase in self-reported work ability. Conclusion These results suggest that Workable is a feasible and acceptable intervention for injured workers, with the potential to improve mental health and RTW outcomes. A randomized controlled trial is required to determine the efficacy of the intervention.
© Crawford J; Spence J; Lovegrove T; Tam E; Collins D; Harvey SB; Deady M. International Journal of Environmental Research & Public Health 20(3), 2023 Jan 30.
Purpose Synthesising evidence of the effects of interventions to improve work participation among people with health problems is currently difficult due to heterogeneity in outcome measurements. A core outcome set for work participation is needed. Methods Following the Core Outcome Measures in Effectiveness Trials methodology, we used a five-step approach to reach international multistakeholder consensus on a core outcome set for work participation. Five subgroups of stakeholders took part in two rounds of discussions and completed two Delphi voting rounds on 26 outcomes. A consensus of >=80% determined core outcomes and 50%-80% consensus was required for candidate outcomes. Results Fifty-eight stakeholders took part in the Delphi rounds. Core outcomes were: 'any type of employment including self-employment', 'proportion of workers that return to work after being absent because of illness' and 'time to return to work'. Ten candidate outcomes were proposed, among others: 'sustainable employment', 'work productivity' and 'workers' perception of return to work'. Conclusion As a minimum, all studies evaluating the impact of interventions on work participation should include one employment outcome and two return to work outcomes if workers are on sick leave prior to the intervention.
© Ravinskaya M; Verbeek JH; Langendam M; Madan I; Verstappen SMM; Kunz R; Hulshof CTJ; Hoving JL; Delphi participants. BMJ Open. 13(2):e069174, 2023 Feb 15.
Purpose The aging workforce influences employability and health of the working population, with new challenges emerging. The focus has shifted from return to work only, to enhancing ability to stay at work. It is unclear whether factors that influence return to work (RTW) also apply to preserving health and helping workers stay at work (SAW). Study objectives were to identify factors contributing to SAW among industrial workers and map identified factors to the Arena of Work Disability Prevention model (WDP-Arena, a commonly used RTW model) to identify agreements and differences. Methods Scoping review; eight databases were searched between January 2005- January 2020. Manuscripts with SAW as outcome were included; manuscripts with (early) retirement as outcome were excluded. Factors contributing to SAW were mapped against the components of the WDP-Arena. Results Thirteen manuscripts were included. Most results aligned with the WDP-Arena. These were most often related to the Workplace and Personal system. Compared to RTW, in industrial workers fewer factors related to the Legislative and Insurance system or Health Care system were relevant for SAW. Societal/cultural/political context was not studied. Multidimensional factors (workability, vitality at work, balanced workstyle, general health, dietary habits) were related to SAW but did not align with components in the WDP-Arena. Conclusion Most factors that determine SAW in industrial workers could be mapped onto the WDP- Arena model. However, new influencing factors were found that could not be mapped because they are multidimensional. The life-course perspective in SAW is more evident than in RTW. Many elements of the Legislative and Insurance system and the Health Care system have not been studied.
© Six Dijkstra MWMC; Bieleman HJ; Soer R; Reneman MF; Gross DP. Occupational Health Science. 2023 Feb.
Janvier 2023
Purpose Several occupational health disciplines are involved in return to work guidance, implying that good interdisciplinary collaboration is important. A shared conceptual framework and a common language for the assessment of work capacity and guidance in return to work is expected to be at the benefit of appropriate and sustainable employability of sick employees. The International Classification of Functioning, Disability and Health (ICF) can be considered a shared conceptual framework and is also promising in terms of a common language. The purpose of the current study is to reach multidisciplinary consensus among occupational health professionals on the content of an ICF-based instrument for the assessment of work capacity and guidance in return to work. Methods To obtain multidisciplinary consensus we conducted a modified Delphi study among twelve occupational health experts, including four occupational physicians, four insurance physicians and four labour experts. The study included two e-mail rounds and two virtual meetings. In the consecutive rounds the experts assessed ICF items as well as a list of non-ICF-based work-related environmental factors on their relevance for the assessment of the work capacity and guidance in return to work together with their interpretability. Results The four consecutive Delphi rounds resulted in 20 items that are minimally needed for the assessment of the work capacity and return to work possibilities of employees on sick leave. The final list included six items on personal functioning, seven items on social functioning and seven items on physical functioning. Conclusions This set of items forms the core of an ICF-based instrument, which is expected to facilitate interdisciplinary and intradisciplinary communication because of the use of a shared conceptual framework. As such, it should be of help in the guidance in return to work of employees on sick leave and contribute to appropriate and sustainable employability.
© de Wind A; Donker-Cools BHPM; Jansen L; Luymes CH; van der Burg-Vermeulen SJ; Oomens S; Anema JR; Schaafsma FG. BMC Public Health. 22(1):2449, 2022 Dec 28.
Purpose This study aimed to investigate how the type of return to work after an industrial accident affects job retention. Methods Using data from the panel study of workers' compensation insurance first-third, and hazard ratios (HRs) and 95% confidence intervals were calculated for workers leaving their jobs. Results The HR leaving their jobs were higher in the "reemployed" compared with that in the "returned to original work," with HR of 2.69 (2.33-3.10). According workers' status, the HRs leaving their jobs were higher among the "reemployed" than among those who "returned to original work." Regular and daily workers' HRs were 1.70 (1.37-2.11) and 3.55 (2.96-4.26), respectively. Conclusions The findings suggest that to increase job retention rate, protection policies for reemployed workers or support for employers who hire reemployed workers should be considered.
© Bae SW; Won JU; Park WM. Journal of Occupational & Environmental Medicine. 65(1):e16-e20, 2023 Jan.
Purpose Workers who experience language barriers are at increased risk of work-related injuries and illnesses and face difficulties reporting these health problems to their employer and workers' compensation. In the existing occupational health and safety literature, however, such challenges are often framed in individual-level terms. We identify systemic barriers to reporting among injured workers who experience language barriers within the varying contexts of Ontario and Quebec, Canada. Methods This study merges data from two qualitative studies that investigated experiences with workers' compensation and return-to-work, respectively, for injured workers who experience language barriers. We conducted semi-structured interviews with 39 workers and 70 stakeholders in Ontario and Quebec. Audio recordings were transcribed and coded using NVivo software. The data was analysed thematically and iteratively. Results Almost all workers (34/39) had filed a claim, though most had initially delayed reporting their injuries or illnesses to their employer or to workers' compensation. Workers faced several obstacles to reporting, including confusion surrounding the cause and severity of injuries and illnesses; lack of information, misinformation, and disinformation about workers' compensation; difficulties accessing and interacting with care providers; fear and insecurity linked to precarity; claim suppression by employers; negative perceptions of, and experiences with, workers' compensation; and lack of supports. Language barriers amplified each of these difficulties, resulting in significant negative impacts in economic, health, and claim areas. Conclusion Improving the linguistic and cultural competence of organizations and their representatives is insufficient to address under-reporting among workers who experience language barriers. Efforts to improve timely reporting must tackle the policies and practices that motivate and enable under-reporting for workers, physicians, and employers.
© Premji S; Begum M; Medley A. American Journal of Industrial Medicine. 66(2):122-131, 2023 Feb.
Purpose Common mental health and musculoskeletal disorders (CMDs and MSDs) are two of the most significant causes of non-participation in employment amongst working age adults. This case study fills an important gap in the scientific literature on reintegration back to work after sickness absence due to CMDs and MSDs. It particularly examines the return to work (RTW) experiences of sick-listed employees to understand the facilitators and barriers of sustainable RTW. Methods Using a realist evaluation approach within a qualitative inquiry, perceptions of employees were explored to provide in-depth understanding of what, how and under what circumstances sustainable RTW can be enabled for employees absent on a short- or long-term basis. Repeat face-to-face semi-structured interviews were conducted with 22 participants (15 women and 7 men, aged 30-50 years and sick-listed with MSDs and CMDs) who were recruited using purposive sampling. Data was thematically analysed. Results A total of 2 main codes and 5 subcodes were developed and grouped into three theoretical abstractions. As a result of validating the context, mechanism, and outcome configurations with accounts of participants, all three initial theories explaining the most prominent mechanisms that either facilitates or impedes a sustainable RTW for people with CMDs and MSDs were justified. Conclusions Our findings reveal the active role of line managers on the RTW outcomes of returning employees. However, line-manager's competence and ability to effectively support and implement appropriate RTW strategies suited to employees' hinges on working in alignment with key stakeholders and returning employees.
© Etuknwa A; Daniels K; Nayani R; Eib C. International Journal of Environmental Research & Public Health [Electronic Resource]. 20(2), 2023 Jan 06.
Purpose Work injury can put older workers at higher risk of disability and early retirement. Rapid population ageing has raised questions about the ability of older workers to continue working, especially for those who have experienced work injury. Career development practices have been highlighted as a form of rehabilitation support to enable longer working lives of injured older workers. The purpose of this study was to explore whether career development practices contribute to higher expected retirement age for injured older workers (aged 45 and above). Methods A total of 274 older Australian workers employed at large organisations completed a survey about their health, retirement intentions, work injury, and engagement with career development practices. Hierarchical multiple regression and two-way analysis of variances were used to analyse the data. Results Work injury contributed to significantly lower expected retirement age for older workers. Work training and development predicted a significant amount of variance in expected retirement age of injured older workers, and enabled them to work to later retirement ages. There was no statistically significant difference in injured older workers' expected retirement age for those who participated in career discussion with their managers and those who did not participate. Conclusion Lack of career development support can affect injured older workers' ability to participate in employment. The findings highlight the importance for rehabilitation and human resource professionals to have a proactive and educative role in providing career development support to injured older workers.
© Mok I; Mackenzie L; Thomson K. Work. 2023, Vol. 74 Issue 1, p183-191.
Décembre 2022
Purpose Certifying long-term sick leave and coordinating complex rehabilitation programs are essential activities of social insurance doctors. These doctors have a role in preventing the decreased work capacity of employees that may lead to leaving the labour market and the transition of these employees to other social insurance benefits, such as a work disability pension. Objective: Analysis of long-term sick leaves (over 183 days) to identify risk factors and population groups with low potential for work capacity rehabilitation. Method We conducted a cross-sectional study between September 2019 and September 2020. The information was collected from the National Institute of Medical Assessment and Work Capacity Rehabilitation Bucharest registers and the EXPMED application. The data were statistically analysed using PSPP software. Results The highest rehabilitation percentage was achieved in cases of traumatic injuries (73.17%), followed by musculoskeletal diseases (70.06%). We noticed lower recovery in cases of nervous system diseases (50.56%) and cardiovascular diseases (44.23%). In the group that summed up the other pathologies, the recovery percentage was 58.37%. People who regained their work capacity were significantly younger (mean age 47.87 y +/- 8.93) than those who turned to other forms of social benefits, such as a disability pension or an old-age pension (mean age 53.16 y +/- 8.43). Conclusion Most of the subjects (72%) regained their work capacity and did not need a disability pension. We identified the sociodemographic and morbidity characteristics of people on long-term sick leave along with target groups requiring intensive intervention measures.
© Oancea C; Capraru RS; Stanescu AMA; Gherman DM. BMC Public Health. 22(1):2249, 2022 Dec 02.
Purpose Research has long documented the low cost and effectiveness of most workplace accommodations to enable qualified people with disabilities to seek, secure, and maintain employment. Methods RETAIN Kentucky's return to work and stay at work intervention involves focused training for participants on requesting needed accommodations from their employers. Results In this article, we describe the win-win approach to reasonable accommodations, which serves as the basis for helping Kentuckians with disabilities identify and request on-the-job supports to aid in their efforts to remain in the workforce. Conclusions Workers with disabilities are more likely to stay in the workforce and continue making valuable contributions to the national and global economies if they have effective accommodations and other employment supports available to them.
© Rumrill PD; Rumrill SP; Wickert K; Sheppard-Jones K; Baumunk M; Roessler RT. Work. 2022 Nov 28.