Quoi de neuf?

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

Purpose Chronic pain (pain > 3 months) is a disabling condition affecting around one fifth of the population. Chronic pain significantly affects a person's psychological and physical health and often interferes with the ability to work. It is one of the most common reasons for extended sick leave and persons with chronic pain often have difficulties returning to work. Interpreting the experiences of currently available is necessary in order to facilitate a return to working life. Therefore, this study aimed to describe and interpret the meaning of support during the return-to-work process for persons on sick leave due to chronic pain. Method A qualitative interview study was conducted with 14 participants (12 women and 2 men) who experienced sick leave due to chronic pain. The participants were recruited through patient organizations focusing on pain or pain-related conditions. Collected data was analyzed using a phenomenological hermeneutical approach. Results Have my back as I get back to work was the theme of the analysis, along with six subthemes. Being able to work was important for the participants. However, they often experienced returning to work was a battle for support, dealing with fragmentized backing from the involved stakeholders. Participants with access to collaborative support involving competent care, recognition and the possibility to influence their work felt valuable and capable as persons and workers. Thus, they were provided conditions allowing a successful re-entry into the workplace. Conclusions Our findings contribute to an enhanced understanding of the importance of stakeholder support in persons with chronic pain re-entering the workplace after an extended break due to sick leave. Through an inclusive, collaborative and flexible approach involving all stakeholders working towards the same goal, a person with chronic pain can feel supported in developing and cultivating the capabilities necessary to manage life and work.

© Lundin Å; Ekman I; Andréll P; Lundberg, M; Wallström S. PLoS ONE, Vol. 19 Issue 10, p1-15

Purpose Pain attributed to musculoskeletal disorders are a significant hinderance to work ability and economic growth, especially in developing countries. Quality of life and lived experience of workers with musculoskeletal disorders have not been explored enough to determine whether person-centred care is provided. There is a wealth of evidence for using the biomedical approach in the management of workers with musculoskeletal disorders, which has proved ineffective in reducing absenteeism and symptoms experienced by workers. The purpose of this study was to explore the lived experience of workers seeking care for musculoskeletal disorders and how their pain attitudes and beliefs influenced their experience. Methods A qualitative approach with thematic analysis was used. Purposive sampling was used to recruit six participants for semi-structured interviews. All participants were either experiencing pain attributed to a musculoskeletal disorder or had received care for a musculoskeletal disorder. Results Pain attitudes and beliefs of workers with a musculoskeletal disorder and healthcare professionals greatly influenced the care and recovery process of musculoskeletal disorders. There is a primary biomedical lens informing care of workers with musculoskeletal disorders received. Workers expect healthcare professionals to explore their concerns further, but the focus of care for most participants was their presenting complaint. There is also a need for the autonomy of workers to be preserved, and communication between healthcare professionals and workers with musculoskeletal disorders needs to improve. Conclusions Many stakeholders are involved in the recovery process from musculoskeletal disorders. There is a need for a biopsychosocial informed practice to improve return-to-work (RTW) in workers with musculoskeletal disorders. Change is needed at all healthcare system levels to reduce the negative experiences of workers and maladaptive pain beliefs that is associated with persisting symptoms and extended absenteeism.

© Petersen B; Steyl T; Phillips J. BMC Musculoskeletal Disorders. Vol. 25 Issue 1, p1-17.

Purpose Common mental disorders are common reasons for long-term sick leave, especially among women. Return to work is often complex and unsuccessful, why more knowledge is needed regarding women's health and psychological well-being in the return-to-work process. Therefore, the aim was to describe women's health and psychological well-being in the return-to-work process, from women's and first-line managers' perspectives. Methods Individual interviews were conducted with 17 women and 16 first-line managers. Qualitative content analysis was performed based on the content areas "Women's health (i.e. overall well-being, both physical and psychological) throughout the whole RTW process" and "Women's psychological well-being (happiness, meaning and a sense of being significant) at work after work resumption" Themes and categories were created. Results Women and managers had similar descriptions, i.e. that women's health and psychological well-being depend on the individual characteristics of women themselves, their private life, work and other stakeholders. However, women described relational work tasks (e.g. meeting patients) as beneficial for health, and highlighted small stressors in the work environment, which the managers did not. Having work that was compatible with private life, being in good health, having stimulating work tasks and strengthening relationships at work were important for the women's psychological well-being. Conclusions Based on women's and first-line managers experiences, promotion of women's health and psychological well-being during the return-to-work process requires individually adapted assessments and actions involving women's entire life situation. First-line managers should know that relational work tasks (e.g., meeting patients) can be beneficial for women's health as well as that minor stressor in the work environment can put their health at risk.

© Hedlund A; Kristofferzon ML; Boman E; Nieuwenhuijsen K; Nilsson A. BMC Public Health. 24(1):2834, 2024 Oct 15.

Purpose Nurses diagnosed with cancer face unique challenges when returning to work, yet there is limited understanding of their transition. Objective: To explore nurses' return-to-work experiences post cancer diagnosis and clarify related facilitators and challenges. Methods This focus group study employed a content analysis with constant comparative approach and member checking. This study recruited nurses treated for any type of cancer who had experience returning to clinical positions. Results Five focus groups with 17 female nurses (mean age=51.8) were performed; 47.1% had breast cancer. Four main themes were identified: (a) motivation, incentives, and the need to return to work; (b) setbacks hindering the return; (c) navigating new work dynamics; and (d) evolving professional role during the return to work. Conclusions This study illustrates personal and professional growth and struggles that attend returning to work as a nurse with cancer. This insight informs strategies to support continuing these nurses' careers. 

© You KL; Wang Y; Zhang Y; Bender CM; Fennimore LA; Rosenzweig MQ; Dierkes A; Terry MA; Raina K; Thomas TH.  Nursing Outlook. 72(6):102290, 2024 Oct 09.

Purpose A key goal for working age stroke survivors is to return to work, yet only around 50% achieve this at 12 months. Currently, there is limited evidence of effectiveness of early stroke-specialist vocational rehabilitation (ESSVR) interventions from randomised controlled trials. This study examined fidelity to ESSVR and explored social and structural factors which may have influenced implementation in the RETurn to work After stroKE (RETAKE) randomised controlled trial. Methods Mixed-methods process evaluation assessing intervention fidelity and incorporating longitudinal case-studies exploring stroke survivors' experiences of support to return to work. Normalisation Process Theory, and the Conceptual Model for Implementation Fidelity, informed data collection and analysis. Results Sixteen sites across England and Wales participated in RETAKE. Forty-eight occupational therapists (OTs), supported by 6 mentors experienced in vocational rehabilitation (VR), delivered the intervention (duration 12 months) between February 2018 and April 2022. Twenty-six participants (15 ESSVR, 11 usual care (UC)) were included in longitudinal case-studies. An additional 18 participants (8 ESSVR and 10 UC) were interviewed once. Nineteen OTs, 6 mentors and 19 service managers were interviewed. Fidelity was measured for 39 ESSVR participants; mean fidelity score was 78.8% (SD:19.2%, range 31-100%). Comparison of the experiences of ESSVR and UC participants indicated duration and type of support to return to work were perceived to be better for ESSVR participants. They received early, co-ordinated support including employer liaison and workplace adjustments where appropriate. In contrast, UC participants reported limited or no VR or return to work support from health professionals. Typically, UC support lasted 2-8 weeks, with poor communication and co-ordination between rehabilitation providers. Mentor support for OTs appeared to increase fidelity. Service managers indicated ESSVR would enhance post-stroke services. Conclusions ESSVR was valued by participants and was delivered with fidelity; implementation appeared to be facilitated by mentor support for OTs.

© Clarke DJ; Powers K; Trusson D; Craven K; Phillips J; Holmes J; McKevitt C; Bowen A; Watkins CL; Farrin AJ; Wright-Hughes A; Sach T; Chambers R; Radford K.  PLoS ONE. 19(10):e0311101, 2024.

Purpose Employers are key in supporting stroke survivors to return to work (RTW) but do not always have knowledge/skills or guidance to do so. Objectives: To explore employers' needs for provision of post-stroke RTW support. Methods Mixed-methods study. Participants recruited through voluntary response/purposive sampling. Survey of employers investigated stroke knowledge (maximum score: 7), RTW process knowledge (maximum score: 8), and perceived competency for actions supporting RTW (maximum score: 100%). Regression analyses explored relationships between employers' demographic/contextual characteristics and knowledge and perceived competency scores. Interviews with employers explored factors influencing their post-stroke RTW support. Interview data were analyzed using a framework analysis. Survey/interview findings were synthesized with those from a qualitative systematic review. Results Across the survey (n = 50), interviews (n = 7), and review (25 studies), employers' support was influenced by stroke survivors' decisions to disclose stroke-related limitations, employers' knowledge regarding roles/responsibilities, employers' communication skills, and information provided by healthcare. Regression analyses: Human resources/occupational health support was positively associated with stroke knowledge (s = 2.30, 95% CI 0.36-4.41, p = 0.013) and RTW process knowledge (s = 5.12, 95% CI 1.80-6.87, p = 0.001). Post-stroke RTW experience was positively associated with stroke knowledge (s = 1.36, 95% CI 0.46-2.26, p = 0.004) and perceived competency (s = 31.13, 95% CI 18.40-44.76, p = 0.001). Organization size (i.e. working in a larger organization) was positively associated with RTW process knowledge (s = 2.96, 95% CI 1.52-4.36, p = <.001). Conclusions Employers' RTW support was influenced by personal and environmental factors; they may benefit from education and guidance on stroke and their roles/responsibilities during the RTW process.

© Craven K; Kettlewell J; De Dios Perez B; Powers K; Holmes J; Radford KA. Topics in Stroke Rehabilitation. 1-13, 2024 Oct 04.