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Karlsson I, Sandman L, Axén I, Kwak L, Sernbo E, Björk Brämberg E. Ethical challenges from a problem-solving intervention with workplace involvement: a qualitative study among employees with common mental disorders, first-line managers, and rehabilitation coordinators. Int J Qual Stud Health Well-being 2024; 19:2308674. [PMID: 38324667 PMCID: PMC10851822 DOI: 10.1080/17482631.2024.2308674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 01/18/2024] [Indexed: 02/09/2024] Open
Abstract
PURPOSE This study aims to explore ethical challenges potentially arising from a problem-solving intervention with workplace involvement (PSI-WPI) in primary health care (with first-line manager involvement) for employees on sickness absence due to common mental disorders. METHODS A qualitative design guided by the theoretical framework for systematic identification of ethical aspects of healthcare technologies. Semi-structured interviews were performed with coordinators (n = 6), employees (n = 13), and first-line managers (n = 8). Reflexive thematic analysis was used to analyse and interpret themes. RESULTS A main theme was identified "the workplace and healthcare hold different organizational value logics" and four sub-themes: "the PSI-WPI challenged the organizational goals and values of the workplace and healthcare", "the PSI-WPI challenged organizational values on fairness", "the PSI-WPI challenged the professional roles of first-line managers and rehabilitation coordinators" and "the PSI-WPI introduced a need for the employee to juggle the employee and patient roles". CONCLUSION Different organizational value logics, values, and goals can introduce ethical challenges. We advise clarifying stakeholders' roles and preparing employees and managers for the return to work process by providing sufficient information. The ethical challenges and suggested measures to minimize them, should be considered when planning return to work interventions that involve several stakeholders.
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Affiliation(s)
- Ida Karlsson
- Institute of Environmental Medicine, Unit of Intervention and Implementation Research for Worker Health, Karolinska Institutet, Stockholm, Sweden
| | - Lars Sandman
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Iben Axén
- Institute of Environmental Medicine, Unit of Intervention and Implementation Research for Worker Health, Karolinska Institutet, Stockholm, Sweden
| | - Lydia Kwak
- Institute of Environmental Medicine, Unit of Intervention and Implementation Research for Worker Health, Karolinska Institutet, Stockholm, Sweden
| | - Elisabet Sernbo
- Faculty of Social Sciences, Department of Social Work, University of Gothenburg, Gothenburg, Sweden
| | - Elisabeth Björk Brämberg
- Institute of Environmental Medicine, Unit of Intervention and Implementation Research for Worker Health, Karolinska Institutet, Stockholm, Sweden
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Svärd V, Arapovic Johansson Z, Holmlund L, Hellman T, Kwak L, Björk Brämberg E. Collaboration in the return-to-work process after sick leave due to common mental disorders: a qualitative study of stakeholders' views on goals and roles. BMC Public Health 2024; 24:1567. [PMID: 38862931 PMCID: PMC11165787 DOI: 10.1186/s12889-024-19063-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 06/05/2024] [Indexed: 06/13/2024] Open
Abstract
BACKGROUND This study explores how the goals of collaboration in the return-to-work (RTW) process for people with common mental disorders are described by the stakeholders involved, and how they experience stakeholders' roles and responsibilities in relation to these goals. METHODS Interviews were conducted with 41 participants from three Swedish regions. Nine of the participants were workers, six employer representatives, four occupational health professionals, four social insurance officers, 18 RTW coordinators and five physicians. Thematic analysis was conducted. RESULTS Three main themes and overarching goals when collaborating on RTW were identified. In the first theme, 'creating an informative environment', all stakeholders emphasised clear roles and responsibilities. The second theme, 'striving for consensus in an environment of negotiations', addressed negotiations about when and how to collaborate, on what and with whom, and reveal different views on stakeholders' goals, roles and responsibilities in collaboration. The third theme identified goals for 'creating a supportive environment' for both workers and other stakeholders. Coordinators are found to have an important role in achieving a supportive environment, and in neutralising power imbalances between workers and their employers and social insurance officers. CONCLUSIONS Competing goals and priorities were identified as hindering successful collaboration, contributing to a spectrum of complex versus easy RTW collaboration. This study suggests some basic conditions for achieving a collaborative arena that is neutral in terms of power balance, where all stakeholders can share their views.
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Affiliation(s)
- Veronica Svärd
- Department of Social Work, School of Social Sciences, Södertörn University, Huddinge, SE-141 89, Sweden.
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, SE-171 77, Sweden.
| | - Zana Arapovic Johansson
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, SE-171 77, Sweden
| | - Lisa Holmlund
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, SE-171 77, Sweden
- Division of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, SE-141 83, Sweden
| | - Therese Hellman
- Occupational and Environmental Medicine, Department of Medical Sciences, Uppsala University, Uppsala, SE-751 85, Sweden
- Department of Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala, SE-751 85, Sweden
| | - Lydia Kwak
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, SE-171 77, Sweden
| | - Elisabeth Björk Brämberg
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, SE-171 77, Sweden
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Adalja B, Aplin T, Sterling M, Johnston V. Implementation of the "clinical framework for the delivery of health services" by treating healthcare professionals: perspectives of regulators and insurers. Disabil Rehabil 2024; 46:556-564. [PMID: 36762623 DOI: 10.1080/09638288.2023.2171496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 01/17/2023] [Indexed: 02/11/2023]
Abstract
PURPOSE To understand the current utilisation of the clinical framework for delivery of health services to manage compensable musculoskeletal injuries from the perspectives of insurer case managers and clinical panel members. MATERIALS AND METHODS Using a qualitative descriptive approach, 15 semi-structured interviews were conducted with members of key organisations including WorkSafe Victoria and Transport Accident Commission Victoria. All interviews were recorded and transcribed verbatim and analysed using thematic analysis. RESULTS Four over-arching themes were identified: (i) current use of the framework and principles is suboptimal leading to several problems including lack of evidence-based treatment by clinicians; (ii) barriers to optimal use of the framework include lack of adequate training of healthcare professionals on the framework principles and financial aspects of the compensation system; (iii) utilisation of the framework could be improved with training from peak associations, insurers, and regulating bodies; and (iv) optimal use of the framework will result in better health and work outcomes. CONCLUSIONS The current use of the framework and its principles is suboptimal but can be improved by addressing the identified barriers.IMPLICATIONS FOR REHABILITATIONRehabilitation of compensable musculoskeletal injuries is often complex.Implementing the "Clinical Framework for Delivery of Health Services" can lead to provision of time and cost effective, evidence-based rehabilitation for compensable injuries, ultimately improving patient outcomes.Clinicians can enhance the implementation of the framework principles by integrating evidence-based practice and recommendations from clinical practice guidelines in treatment of compensable musculoskeletal injuries.Implementation of the framework principles may be enhanced by reviewing the compensation funding model to allow the healthcare practitioners adequate time and remuneration to adopt the framework principles when treating persons with compensable injuries.
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Affiliation(s)
- Bhavya Adalja
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
| | - Tammy Aplin
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
- Allied Health Research Collaborative, The Prince Charles Hospital, Chermside, Australia
| | - Michele Sterling
- RECOVER Injury Research Centre, The University of Queensland, Herston, Australia
- NHMRC Centre of Research Excellence in Road Traffic Injury Recovery, The University of Queensland, Herston, Australia
| | - Venerina Johnston
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
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Sears JM, Wickizer TM, Franklin GM, Fulton-Kehoe D, Hannon PA, Harris JR, Graves JM, McGovern PM. Development and maturation of the occupational health services research field in the United States over the past 25 years: Challenges and opportunities for the future. Am J Ind Med 2023; 66:996-1008. [PMID: 37635638 DOI: 10.1002/ajim.23532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 08/09/2023] [Accepted: 08/14/2023] [Indexed: 08/29/2023]
Abstract
Work is an important social determinant of health; unfortunately, work-related injuries remain prevalent, can have devastating impact on worker health, and can impose heavy economic burdens on workers and society. Occupational health services research (OHSR) underpins occupational health services policy and practice, focusing on health determinants, health services, healthcare delivery, and health systems affecting workers. The field of OHSR has undergone tremendous expansion in both definition and scope over the past 25 years. In this commentary, focusing on the US, we document the historical development and evolution of OHSR as a research field, describe current doctoral-level OHSR training, and discuss challenges and opportunities for the OHSR field. We also propose an updated definition for the OHSR field: Research and evaluation related to the determinants of worker health and well-being; to occupational injury and illness prevention and surveillance; to healthcare, health programs, and health policy affecting workers; and to the organization, access, quality, outcomes, and costs of occupational health services and related health systems. Researchers trained in OHSR are essential contributors to improvements in healthcare, health systems, and policy and programs to improve worker health and productivity, as well as equity and justice in job and employment conditions. We look forward to the continued growth of OHSR as a field and to the expansion of OHSR academic training opportunities.
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Affiliation(s)
- Jeanne M Sears
- Department of Health Systems and Population Health, University of Washington, Seattle, Washington, USA
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA
- Harborview Injury Prevention and Research Center, Seattle, Washington, USA
- Institute for Work and Health, Toronto, Ontario, Canada
| | - Thomas M Wickizer
- Division of Health Services Management and Policy, The Ohio State University, Columbus, Ohio, USA
| | - Gary M Franklin
- Department of Health Systems and Population Health, University of Washington, Seattle, Washington, USA
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA
- Department of Neurology, University of Washington, Seattle, Washington, USA
- Washington State Department of Labor and Industries, Tumwater, Washington, USA
| | - Deborah Fulton-Kehoe
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA
| | - Peggy A Hannon
- Department of Health Systems and Population Health, University of Washington, Seattle, Washington, USA
- Health Promotion Research Center, University of Washington, Seattle, Washington, USA
| | - Jeffrey R Harris
- Department of Health Systems and Population Health, University of Washington, Seattle, Washington, USA
- Health Promotion Research Center, University of Washington, Seattle, Washington, USA
| | - Janessa M Graves
- College of Nursing, Washington State University, Spokane, Washington, USA
| | - Patricia M McGovern
- Division of Environmental Health Sciences, University of Minnesota, Minneapolis, Minnesota, USA
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Meling HM, Anderssen N, Ruths S, Hjörleifsson S, Haukenes I. Stakeholder views on work participation for workers with depression and intersectoral collaboration in depression care: a focus group study with a salutogenic perspective. Scand J Prim Health Care 2023; 41:204-213. [PMID: 37526348 PMCID: PMC10478590 DOI: 10.1080/02813432.2023.2238019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 06/02/2023] [Indexed: 08/02/2023] Open
Abstract
OBJECTIVE To explore how stakeholders in depression care view intersectoral collaboration and work participation for workers with depression. DESIGN Focus group study applying reflexive thematic analysis using a salutogenic perspective. SETTING AND SUBJECTS We conducted seven focus group interviews in six different regions in Norway with 39 participants (28 women); three groups consisted of general practitioners (GPs), two of psychologists and psychiatrists and two of social welfare workers and employers (of which one group also included GPs). RESULTS Stakeholders considered work participation salutary for most workers with depression, given the right conditions (e.g. manageable work accommodations and accepting and inclusive workplaces). They also highlighted work as an integral source of meaningfulness to many workers with depression. Early collaborative efforts and encouraging sick-listed workers to stay connected to the workplace were considered important to avoid long and passive sickness absences. Furthermore, stakeholders' views illuminated why intersectoral collaboration matters in depression care; individual stakeholders have limited information about a worker's situation, but through collaboration and shared insight, especially in in-person collaborative meetings, they (and the worker) can gain a shared understanding of the situation, thereby enabling more optimal support. Ensuring adequate information flow for optimal and timely follow-up of workers was also emphasized. CONCLUSIONS Stakeholders highlighted the salutary properties of work participation for workers with depression under the right conditions. Intersectoral collaboration could support these conditions by sharing insight and knowledge, building a shared understanding of the worker's situation, assuring proper information flow, and ensuring early and timely follow-up of the worker.
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Affiliation(s)
- Heidi Marie Meling
- Research Unit for General Practice, NORCE – Norwegian Research Centre, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Norman Anderssen
- Research Unit for General Practice, NORCE – Norwegian Research Centre, Bergen, Norway
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Sabine Ruths
- Research Unit for General Practice, NORCE – Norwegian Research Centre, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Stefán Hjörleifsson
- Research Unit for General Practice, NORCE – Norwegian Research Centre, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Inger Haukenes
- Research Unit for General Practice, NORCE – Norwegian Research Centre, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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Chen Z, Pow SK, Ong LX, Tan LL, Lim SM, Hwang YFJ. Evaluation of a return to work coordination programme for injured workers in a public hospital in Singapore. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2023; 52:296-309. [PMID: 38904511 DOI: 10.47102/annals-acadmedsg.2022232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/22/2024]
Abstract
Introduction This study evaluates the effectiveness of a hospital-based return to work (RTW) programme in facilitating injured workers to RTW earlier through personalised case management. Factors associated with programme effectiveness are also examined. Method This was a quasi-experimental study comparing 81 participants who underwent conventional treatment before the RTW programme with 108 participants who directly received the RTW intervention. Analyses included time to RTW and the factors associated with dropout. Stratified analysis and multivariate logistic regression were used to mitigate potential selection bias from the additional recruitment process for the intervention group. Results Participants in the intervention group returned to work 59.5 days earlier, with 84% able to RTW 6 months post injury compared with the control (63%; P<0.01). Stratified analysis found the intervention to be associated with better RTW outcomes among males, younger workers, non-residents, blue-collared workers, workers from the construction, marine, manufacturing and metalworking industries, and workers having lower Work Ability score (WAS), while light-duty provision was a possible confounder. The better outcomes in the intervention group were also independent of company size and injury severity. After adjusting for the above factors, the intervention group had 2.2 times higher odds of RTW at 6 months (95% confidence interval 0.84–5.90). Lower WAS and longer delay in initial RTW assessment were associated with delayed RTW within the intervention group. Migrant workers experienced higher dropout rates, thus being identified as a vulnerable group. Conclusion The RTW coordination model of care is effective in facilitating RTW, with early programme referral being an important facilitator and WAS as a useful screening tool for delayed RTW.
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Affiliation(s)
- Zhenzhen Chen
- Occupational Therapy Section, Department of Rehabilitation, National University Hospital, Singapore
| | - Siok Kee Pow
- Occupational Therapy Section, Department of Rehabilitation, National University Hospital, Singapore
| | - Li Xin Ong
- Occupational Therapy Section, Department of Rehabilitation, National University Hospital, Singapore
| | - Lay Lay Tan
- Occupational Therapy Section, Department of Rehabilitation, National University Hospital, Singapore
| | - See Ming Lim
- Occupational Health Clinic, National University Hospital, Singapore
| | - Yi-Fu Jeff Hwang
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Occupational Medicine, Woodlands Health, Singapore
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Farias L, Holmlund L, Asaba E. Stakeholders' Expectations of Return-to-Work After Spinal Cord Injury: A 1-Year Follow-Up. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2023; 43:180-187. [PMID: 35574664 PMCID: PMC10021116 DOI: 10.1177/15394492221097355] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Understanding the process of return-to-work is key to supporting people's social participation and health after a disability. This phenomenographic study aimed to explore the expectations and ways of understanding return-to-work from the perspectives of three stakeholder types: three workers with spinal cord injuries, their employers, and an occupational therapist coordinator. Participants were interviewed twice, at 6 and 12 months, after having participated in a research-based return-to-work intervention in Sweden. A phenomenographic approach was used to analyze the data. The findings highlight how stakeholders' different expectations prevented them from openly discussing more flexible arrangements to make return-to-work viable and sustainable. The study contributes to occupational therapy practice by raising awareness of the challenges of work reintegration. It also adds to the body of knowledge in occupational science by illuminating how normative social expectations and policy concerning work/productivity influence the return-to-work process.
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Affiliation(s)
| | | | - Eric Asaba
- Karolinska Institutet, Huddinge, Sweden.,Stockholms Sjukhem Foundation, Sweden
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Wilson TN, Nambiema A, Porro B, Descatha A, Aublet-Cuvelier A, Evanoff B, Roquelaure Y. Effectiveness of Physical Activity Interventions on Return to Work After a Cancer Diagnosis: A Systematic Review and Meta-analysis. JOURNAL OF OCCUPATIONAL REHABILITATION 2023; 33:4-19. [PMID: 35779184 PMCID: PMC10025244 DOI: 10.1007/s10926-022-10052-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 06/02/2022] [Indexed: 06/15/2023]
Abstract
Purpose The aim of this study was to assess the effectiveness of physical activity (PA) interventions on return to work (RTW) in cancer survivors, compared to usual care, and to determine the dose of PA needed to improve this outcome. Methods A systematic review and meta-analysis were conducted according to PRISMA guidelines. Six electronic databases including PubMed, Embase, Web of Science, CENTRAL, PsycINFO, and Scopus were searched to identify studies, and completed by a search of grey literature and health organization websites. Two authors performed screening, selection, and data extraction independently. Study and intervention characteristics were extracted and summarized. Pooled risk ratio (RR) was estimated using a weight random-effects model with 95% confidence intervals (CIs). Results A total of 2655 records were identified, of which 8 intervention studies were included. The sample size of the included studies varied between 41 and 240, giving a total of 1087 participants aged between 18 and 75 years. Compared with usual care, PA interventions had a significant positive effect on RTW among cancer survivors with a pooled RR of 1.29 (95% CI 1.17, 1.42). We found that PA interventions (aerobic and resistance exercises) with an exercise dose between 7.6 METs.h/week and 15 METs.h/week, consisting in 50-60 min per session of moderate to vigorous physical exercise, twice a week seems relevant in improving RTW. Conclusions Our results showed, with moderate quality evidence that PA interventions are more effective than usual care in increasing the rate of RTW in cancer survivors. SYSTEMATIC REVIEW REGISTRATION: PROSPERO Registration Number, CRD42020203614.
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Affiliation(s)
- Têtê Norbert Wilson
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, environnement et travail) - UMR_S 1085, 49000, Angers, France.
| | - Aboubakari Nambiema
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, environnement et travail) - UMR_S 1085, 49000, Angers, France
| | - Bertrand Porro
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, environnement et travail) - UMR_S 1085, 49000, Angers, France
| | - Alexis Descatha
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, environnement et travail) - UMR_S 1085, 49000, Angers, France
| | - Agnès Aublet-Cuvelier
- Direction des Etudes et de Recherches, INRS (Institut National de Recherche Et de Sécurité), 1 rue du Morvan, CS60027, 54519, Vandœuvre-lès-Nancy, France
| | - Bradley Evanoff
- Division of General Medical Sciences, Washington University School of Medicine, St. Louis, MO, 63310, USA
| | - Yves Roquelaure
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, environnement et travail) - UMR_S 1085, 49000, Angers, France
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GPs' experiences of a collaborative care model for patients with common mental disorders who need sick leave certification: a qualitative study. BJGP Open 2022; 6:BJGPO.2022.0042. [PMID: 35977733 PMCID: PMC9904781 DOI: 10.3399/bjgpo.2022.0042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 07/02/2022] [Accepted: 07/13/2022] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND GPs are an important part of collaboration around patients with common mental disorders (CMD) in primary care. The Co-Work-Care model was implemented to further improve collaboration, and emphasised working more closely with patients through active dialogues among care managers, rehabilitation coordinators, and GPs. This enhanced collaborative model also included a person-centred dialogue meeting with patients' employers. AIM The aim of this study was to explore GPs' experiences of the Co-Work-Care model, an organisation of collaborative care at the primary care centre (PCC) that includes a person-centred dialogue meeting in the care of patients with CMD who need sick leave certification. DESIGN & SETTING Qualitative individual and group interviews were conducted with Swedish GPs with experience of the Co-Work-Care trial where the PCC was an intervention PCC with the enhanced collaboration model. METHOD GPs were sampled purposefully from different Co-Work-Care intervention PCCs in Sweden. Focus group and individual, in-depth semi-structured interviews were conducted. All interviews were analysed by systematic text condensation (STC), according to Malterud. RESULTS The following three codes describing the GPs' experiences of working in the Co-Work-Care model were identified: (1) a structured work approach; (2) competency of the care manager and the rehabilitation coordinator; and (3) gaining control through close collaboration. CONCLUSION Overall, GPs' experience was that the enhanced collaboration reduced their workload and enabled them to focus on medical care. Patient care was perceived as safer and more effective. These advantages may result in higher quality in medical and rehabilitation decisions, as well as a more sustainable and less stressful work situation for GPs.
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Ravinskaya M, Verbeek JH, Langendam MW, Madan I, Verstappen SMM, Kunz R, Hulshof CTJ, Hoving JL. Preferred Methods of Measuring Work Participation: An International Survey Among Trialists and Cochrane Systematic Reviewers. JOURNAL OF OCCUPATIONAL REHABILITATION 2022; 32:620-628. [PMID: 35347539 PMCID: PMC9668767 DOI: 10.1007/s10926-022-10031-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/14/2022] [Indexed: 06/14/2023]
Abstract
Purpose Heterogeneity in work participation (WP) outcomes measurements hampers large scale evidence synthesis in systematic reviews of trials. In this survey we explore authors' reasons for choosing specific WP outcomes and their measurement methods, including employment status, absence from work, at-work productivity loss, and employability. Methods We contacted authors of 260 trials and 69 systematic reviews and asked closed and open-ended questions about previously used WP outcomes and measurement methods as well as their opinion on the best way to measure WP. Results In total, 91 authors from a wide range of professional backgrounds completed the survey. The majority of authors (86%) chose WP outcomes based on their use in previous similar studies. In most studies (88%), patients had not been involved in the process of selecting the WP outcome. Authors judged feasibility to be an important factor for choosing a measurement instrument (67%). Additionally, valid measurement tools should be available, easy to administer and not too time consuming. Although authors preferred registry data for long term follow-up, the availability and validity of registries was seen as a barrier. Most of the reviewers (72%) struggled to pool data because of variation in follow-up times and cut off points and varying definitions of work outcomes. Almost all (92%) respondents support the use of a Core Outcome Set for Work. Conclusions There is strong support from authors of trials and systematic reviews to develop a core outcome set on work participation outcomes for the evaluation of interventions.
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Affiliation(s)
- Margarita Ravinskaya
- Amsterdam UMC, Academic Medical Center, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
| | - Jos H Verbeek
- Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Miranda W Langendam
- Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Department Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Ira Madan
- Guy's and St Thomas' NHS Trust and Faculty of Life Sciences and Medicine, King's College London, Centre for Musculoskeletal Health and Work, London, UK
| | - Suzanne M M Verstappen
- Centre for Epidemiology Versus Arthritis, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
| | - Regina Kunz
- Academic Unit EbIM, Evidence Based Insurance Medicine, Department of Clinical Research, University of Basel, Basel, Switzerland
| | - Carel T J Hulshof
- Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Jan L Hoving
- Amsterdam UMC, Location Academic Medical Center, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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A general framework for selecting work participation outcomes in intervention studies among persons with health problems: a concept paper. BMC Public Health 2022; 22:2189. [DOI: 10.1186/s12889-022-14564-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 11/07/2022] [Indexed: 11/27/2022] Open
Abstract
Abstract
Background
Work participation is important for health and can be considered as engagement in a major area of life which is of significance for most people, but it can also be thought of as fulfilling or discharging a role. Currently, academic research lacks a comprehensive classification of work participation outcomes. The International Classification of Functioning is the foremost model in defining work functioning and its counterpart work disability, but it does not provide a critical (core) set of outcomes. Standardizing the definitions and nomenclature used in the research of work participation would ensure that the outcomes of studies are comparable, and practitioners and guideline developers can better decide what works best. As work participation is a broad umbrella term including outcome categories which need unambiguous differentiation, a framework needs to be developed first.
Aim
To propose a framework which can be used to develop a generic core outcome set for work participation.
Methods
First, we performed a systematic literature search on the concept of (work) participation, views on how to measure it, and on existing classifications for outcome measurements. Next, we derived criteria for the framework and proposed a framework based on the criteria. Last, we applied the framework to six case studies as a proof of concept.
Results
Our literature search provided 2106 hits and we selected 59 studies for full-text analysis. Based on the literature and the developed criteria we propose four overarching outcome categories: (1) initiating employment, (2) having employment, (3) increasing or maintaining productivity at work, and (4) return to employment. These categories appeared feasible in our proof-of-concept assessment with six different case studies.
Conclusion
We propose to use the framework for work participation outcomes to develop a core outcome set for intervention studies to improve work participation.
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Stynen D, Houkes I, van Amelsvoort L, Jansen N, Kant IJ. Opportunities, barriers and facilitators of an indicated prevention strategy to prevent future long-term sickness absence in SMEs: A qualitative study. Work 2022; 74:871-889. [PMID: 36442177 DOI: 10.3233/wor-210282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The efficacy of an indicated prevention strategy for long-term absence due to sickness has been demonstrated and is implemented in multinational companies. Such a strategy may also be beneficial for small and medium-sized enterprises (SMEs). However, due to the different contexts, adoption, and implementation of this strategy in SMEs may be quite different. OBJECTIVE This study aims to investigate the opportunities, barriers, and facilitators for adoption and implementation of this preventive strategy, as anticipated by employers and employees of SMEs. METHODS A qualitative needs assessment was conducted using semi-structured interviews with higher managers (n = 15) and a focus group with employees (n = 8). Purposive sampling was used, and data were analyzed using content analysis. RESULTS Employers had positive expectations concerning the gains of the preventive strategy, whereas employees had more reservations. Anticipated gains and intentions to implement the preventive strategy were rooted in underlying conceptions of the causes of sickness absence and the responsibilities of stakeholders. One key barrier shared across employers and employees concerned the potential lack of confidentiality. For employees, the role of the occupational health professional in the prevention of sickness absence was perceived as uncommon. Employers stressed lack of capacity and resources as a barrier, whereas employees stressed lack of follow-up by the employer as a barrier. CONCLUSIONS SMEs are considerably receptive to the implementation of an indicated prevention strategy for long-term absence. Insight into the barriers and facilitators gives clues for wider and optimal implementation across a wider range of organizational settings.
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Affiliation(s)
- Dave Stynen
- Department of Organisation, Faculty of Management, Open Universiteit, Heerlen, the Netherlands.,Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Inge Houkes
- Department of Social Medicine, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Ludo van Amelsvoort
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Nicole Jansen
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - IJmert Kant
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
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Negri L, Spoladore D, Fossati M, Arlati S, Cocchi MG, Corbetta C, Davalli A, Sacco M. Proposal for an ICF-based methodology to foster the return to work of persons with disability. Work 2022; 74:649-662. [PMID: 36278385 DOI: 10.3233/wor-211226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Employment is an essential component of life as it provides income, sense of engagement and opportunities for personal development. Unemployment due to disability following an accident may have dramatic social and psychological consequences on individuals; it is thus fundamental to foster return to work of these persons. OBJECTIVE The present work was aimed to develop a methodology determining suitable jobs for people living with disability after a job-related accident. METHODS The Occupational Information Network (O*NET) taxonomy was combined with the International Classification of Functioning, Disability and Health (ICF) to match individual resources with specific job requirements. ICF Linking Rules were employed by two independent groups of researchers to associate ICF codes to O*NET skill and ability descriptors. RESULTS O*NET descriptors were linked to 92 unique ICF codes. A "Criticality score" combining ICF and O*NET features to assess suitability of selected jobs for persons with disabilities was also proposed. CONCLUSIONS The proposed methodology represents a novel instrument to support return to work; the capability to assess specific work-related facets through the lens of both the ICF model and O*NET taxonomy would conceivably provide vocational rehabilitation specialists and occupational therapists with a useful tool fostering job placement of workers with disability.
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Affiliation(s)
- Luca Negri
- Scientific Institute, I.R.C.C.S "E. Medea", Lecco, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Daniele Spoladore
- Institute of Intelligent Industrial Technologies and Systems for Advanced Manufacturing, National Research Council, Lecco, Italy.,Department of Pure and Applied Sciences, Insubria University, Varese, Italy
| | | | - Sara Arlati
- Institute of Intelligent Industrial Technologies and Systems for Advanced Manufacturing, National Research Council, Lecco, Italy.,Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | | | | | - Angelo Davalli
- National Institute for Insurance Against Accidents at Work, Bologna, Italy
| | - Marco Sacco
- Institute of Intelligent Industrial Technologies and Systems for Advanced Manufacturing, National Research Council, Lecco, Italy
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14
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Porro B, Tamminga SJ, de Boer AGEM, Petit A, Roquelaure Y, Greidanus MA. Identification of actions to be taken by managers to facilitate the return to work of cancer survivors: Consensus between managers and cancer survivors. BMC Public Health 2022; 22:1905. [PMID: 36224592 PMCID: PMC9555691 DOI: 10.1186/s12889-022-14271-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 09/28/2022] [Indexed: 11/10/2022] Open
Abstract
Background Managers are considered to be main stakeholders in the return to work (RTW) of cancer survivors. However, the perspectives of cancer survivors and managers differ on what managerial actions should be taken during the RTW of cancer survivors. This difference might put effective collaboration and successful RTW at risk. Therefore, this study aims to reach consensus among managers and cancer survivors on the managerial actions to be taken during the four different RTW phases of cancer survivors (i.e., Disclosure, Treatment, RTW plan, Actual RTW). Methods The Technique for Research of Information by Animation of a Group of Experts (TRIAGE) was implemented with managers and cancer survivors (hereafter referred to as “experts”). An initial list of 24 actions was derived from a previous study. Firstly, for each action, fifteen experts were asked to indicate individually how important this action is per RTW phase (Likert scale from 1 – “Not important at all” to 6 – “Very important”). Consensus was reached when ≥ 80% (i.e., ≥ twelve experts) of the experts rated that action ≥5. Secondly, for each phase of the RTW process, the 15 actions with the highest percentage were discussed with eight experts during the collective consultation, except for the actions that already reached consensus. After discussion, the experts voted whether each action was important (“yes” / “no”) and consensus required ≥ 87.5% (i.e., ≥ seven experts) of the experts to consider an action as important. Results Twenty-five managerial actions were finally retained for at least one of the RTW phases, e.g., Disclosure: “respect privacy” and “radiate a positive attitude”, Treatment: “show appreciation” and “allow sufficient sick leave”, RTW Plan: “tailor” and “communicate”, and Actual RTW: “support practically” and “balance interest”. Conclusion Cancer survivors and managers reached consensus on the importance of 25 managerial actions, distributed into each phase of the RTW process. These actions should be considered an interplay of managerial actions by different stakeholders on the part of the employer (e.g., direct supervisor, HR-manager), and should be a responsibility that is shared by these stakeholders. The collective implementation of these actions within the company will help cancer survivors feel fully supported. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14271-w.
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Affiliation(s)
- B Porro
- Univ. Angers, CHU Angers, Univ. Rennes, Inserm, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, SFR ICAT, F-49000, Angers, France.
| | - S J Tamminga
- Department of Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.,Amsterdam Public Health research institute, Societal Participation & Health, Amsterdam, The Netherlands
| | - A G E M de Boer
- Department of Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.,Amsterdam Public Health research institute, Societal Participation & Health, Amsterdam, The Netherlands
| | - A Petit
- Univ. Angers, CHU Angers, Univ. Rennes, Inserm, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, SFR ICAT, F-49000, Angers, France
| | - Y Roquelaure
- Univ. Angers, CHU Angers, Univ. Rennes, Inserm, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, SFR ICAT, F-49000, Angers, France
| | - M A Greidanus
- Department of Public and Occupational Health, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.,Amsterdam Public Health research institute, Societal Participation & Health, Amsterdam, The Netherlands
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15
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Hopwood P, MacEachen E, Neiterman E, Malachowski C, McKnight E, Crouch M, McDonald E. A Standpoint Approach to Return-to-Work Coordination: Understanding Union Roles. JOURNAL OF OCCUPATIONAL REHABILITATION 2022; 32:564-573. [PMID: 35107699 DOI: 10.1007/s10926-022-10025-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/14/2022] [Indexed: 06/14/2023]
Abstract
Purpose This study examined how the participation of union representatives impacted return-to-work (RTW) processes, and explored key activities undertaken by union representatives involved in return-to-work coordination. Methods Forty-seven RTW coordinators (RTWCs) participated in in-depth, semi-structured interviews in 2018 as part of a cross-Canadian study investigating their strategies for managing challenges in the RTW process. The study included RTWCs from a variety of organisation types, including unionized organizations. Audio-recordings were transcribed, coded, and analysed using constant case comparison and deviant case analysis leading to the development of findings themes. Results Our findings highlight the role of union representatives in RTW processes and how their activities are seen by other parties involved with work accommodation. First, we describe Union RTWC's administrative functions and the extent of their involvement in RTW accommodation negotiations. Second, we examine how Union and Non-union RTWCs framed the same RTW processes differently, according to their own accountabilities. Finally, we identify the positive ways that union participation figured into the RTW process, including playing a role in identifying viable modified work and serving as a trusted party to help reluctant workers engage with RTW plans. Conclusions We introduce a standpoint perspective to shed light on how Union and Non-union RTWCs approached accommodation issues and consider acknowledgement of power relations as a starting point for managing divergent interests.
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16
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Maddineshat M, Cheraghi F, Ghaleiha A, Khalafbeigi M, Sadeghian E. Exploring the return-to-work process in working people with serious mental illness. Arch Psychiatr Nurs 2022; 38:21-28. [PMID: 35461643 DOI: 10.1016/j.apnu.2021.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 12/18/2021] [Accepted: 12/24/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Few studies examined the return-to-work (RTW) process in working people after recovery from serious mental illness (SMI). PURPOSE The RTW process was explored in working people with SMI. METHOD A qualitative study was conducted using the grounded theory. Twenty seven interviews were analyzed using Corbin and Strauss's approach (2015). RESULTS The core category "syncing with an ordinary workstream" emerged with three categories: "proceeding RTW strategies," "staying at work strategies," and "relative adaptation with work." CONCLUSION "Syncing with an ordinary workstream" can help researchers develop a new practice model to facilitate the RTW process in working people with SMI.
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Affiliation(s)
- Maryam Maddineshat
- School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran. https://twitter.com/MMaddineshat
| | - Fatemeh Cheraghi
- School of Nursing and Midwifery, Chronic Disease (Home Care) Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ali Ghaleiha
- Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medical Sciences, Hamadan, Iran. https://twitter.com/drghalehia
| | - Mitra Khalafbeigi
- Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran. https://twitter.com/BeigiMitra
| | - Efat Sadeghian
- School of Nursing and Midwifery, Chronic Diseases (Home Care) Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.
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17
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Bridger K, Kellezi B, Kendrick D, Kettlewell J, Holmes J, Timmons S, Andrews I, Fallon S, Radford K. Patients views on which return-to-work outcomes should be prioritised: A nominal group technique focus group. Br J Occup Ther 2022. [DOI: 10.1177/03080226211072766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective Injuries can have a long-lasting effect on ability to return to work, but there is little research on which outcomes are most important to patients. This study aims to identify and prioritise return-to-work outcomes important to patients for evaluating vocational rehabilitation interventions. Methods Nominal group technique focus group with trauma patients. Results Focus group participants ( n = 6) included mostly traumatic brain injuries, a range of occupation types, ages and both genders. Participants identified and prioritised their eight most important outcomes which were: sense of purpose and life satisfaction, understanding the impact of injury, assessment of readiness to return to work, using SMART (specific, measurable, achievable, relevant and time-bound) goals, facilitated reintegration to work, assessing capacity to return to work, collaboration between key stakeholders and improved employer and employee knowledge. Many of these were measures of the process of, rather than change outcomes of vocational rehabilitation. Conclusions The range of outcomes identified by trauma patients highlights the complex process of return to work and the need for vocational rehabilitation evaluations to incorporate a broader range of outcomes. Measures of the process of vocational rehabilitation are also important to trauma patients and should be included in such evaluations.
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Affiliation(s)
- Kay Bridger
- Division of Primary Care, School of Medicine, Nottingham University, Nottingham, UK
| | - Blerina Kellezi
- Department of Psychology, School of Social Sciences, Nottingham Trent University, Nottingham, UK
| | - Denise Kendrick
- Division of Primary Care, School of Medicine, Nottingham University, Nottingham, UK
| | - Jade Kettlewell
- Division of Primary Care, School of Medicine, Nottingham University, Nottingham, UK
| | - Jain Holmes
- Division of Primary Care, School of Medicine, Nottingham University, Nottingham, UK
| | | | - Isabel Andrews
- Division of Primary Care, School of Medicine, Nottingham University, Nottingham, UK
| | - Stephen Fallon
- Division of Primary Care, School of Medicine, Nottingham University, Nottingham, UK
| | - Kate Radford
- Division of Rehabilitation, Aging and Wellbeing, School of Medicine, Nottingham University, Nottingham, UK
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18
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Meulenbroek P, O'Neil-Pirozzi TM, Sohlberg MM, Lemoncello R, Byom L, Ness B, MacDonald S, Phillips B. Tutorial: The Speech-Language Pathologist's Role in Return to Work for Adults With Traumatic Brain Injury. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:188-202. [PMID: 34929113 DOI: 10.1044/2021_ajslp-21-00129] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE Return to work (RTW) is a major life participation metric used for persons with a traumatic brain injury (TBI). Speech-language pathologists (SLPs) have clinical expertise in the cognitive-communication aspects of TBI. This clinical focus article aims to support the clinical practice of SLPs by summarizing key interprofessional vocational rehabilitation (VR) models and illustrating the role of the SLP throughout the RTW process with a case study. METHOD This clinical focus article was written by the Academy of Neurologic Communication Disorders and Sciences TBI Research Group along with a VR expert. Authors engaged in deliberative, agenda-based discussions beginning with a literature review based on previous systematic studies. Discussions explored relevant VR and SLP practices. RESULTS This clinical focus article presents key VR models in parallel with SLP assessment and treatment to illustrate best practice patterns in an RTW field with a dearth of SLP-specific literature. We summarize general VR approaches and four evidence-supported VR models for adults with TBI. We highlight how a model of interprofessional assessment can assist with planning and communication of important work-related concerns. We illustrate how the chronological model of work return can assist with developing goals and planning treatment. CONCLUSIONS SLPs play an important role in identifying, managing, and collaborating with an RTW team following TBI. A working knowledge of VR models can assist with improving the dialogue between SLPs and VR professionals and can inform practice when working with persons with TBI who have work return as a goal.
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Affiliation(s)
- Peter Meulenbroek
- Communication Sciences and Disorders, University of Kentucky, Lexington
| | - Therese M O'Neil-Pirozzi
- Communication Sciences and Disorders, Northeastern University, Boston, MA
- Spaulding/Harvard Traumatic Brain Injury Model System, Boston, MA
| | | | - Rik Lemoncello
- School of Communication Sciences and Disorders, Pacific University, Forest Grove, OR
| | - Lindsey Byom
- Division of Speech and Hearing Sciences, Department of Allied Health Sciences, University of Chapel Hill, NC
| | - Bryan Ness
- Communication Sciences and Disorders, California Baptist University, Riverside
| | - Sheila MacDonald
- Sheila MacDonald & Associates, University of Toronto, Ontario, Canada
| | - Brian Phillips
- Special Education & Rehabilitation Counseling, Utah State University, Logan
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19
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Leiva R, Rochaix L, Kiefer N, Dupont JCK. Evaluating the Impact of Intensive Case Management for Severe Vocational Injuries on Work Incapacity and Costs. JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:807-821. [PMID: 33704657 PMCID: PMC8558282 DOI: 10.1007/s10926-021-09967-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/18/2021] [Indexed: 06/12/2023]
Abstract
Purpose This study investigates the impact of an intensive case management program on sick leave days, permanent work incapacity levels and treatment costs for severe vocational injuries set up by the French National Insurance Fund in five health insurance districts. Methods The method employed relies on a four-step matching procedure combining Coarsened Exact Matching and Propensity Score Matching, based on an original administrative dataset. Average Treatment effects on the Treated were estimated using a parametric model with a large set of covariates. Results After one-year follow-up, workers in the treatment group had higher sickness absence rates, with 22 extra days, and the program led to 2.7 (95% CI 2.3-3.1) times more diagnoses of permanent work incapacity in the treatment group. With an estimated yearly operational cost of 2,722 € per treated worker, the average total extra treatment cost was 4,569 € for treated workers, which corresponds to a cost increase of 29.2% for the insurance fund. Conclusions The higher costs found for the treatment group are mainly due to longer sick leave duration for the moderate severity group, implying higher cash transfers in the form of one-off indemnities. Even though workers in the treated group have more diagnoses of permanent work incapacity, the difference of severity between groups is small. Our results on longer sick leave duration are partly to be explained by interactions between the case managers and the occupational physicians that encouraged patients to stay longer off-work for better recovery, despite the higher costs that this represented for the insurance fund and the well-documented adverse side effects of longer periods off-work.
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Affiliation(s)
- Rolando Leiva
- Hospinnomics (PSE - École d'Économie de Paris, Assistance Publique Hôpitaux de Paris - AP-HP) and UCL, London, UK.
| | - Lise Rochaix
- Hospinnomics (PSE - École d'Économie de Paris, Assistance Publique Hôpitaux de Paris - AP-HP), Paris, France
| | - Noémie Kiefer
- Hospinnomics (PSE - École d'Économie de Paris, Assistance Publique Hôpitaux de Paris - AP-HP), Paris, France
| | - Jean-Claude K Dupont
- Hospinnomics (PSE - École d'Économie de Paris, Assistance Publique Hôpitaux de Paris - AP-HP), Paris, France
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20
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Xie Y, Hutting N, Bartys S, Johnston V. Interventions to Promote Work-Focused Care by Healthcare Providers for Individuals with Musculoskeletal Conditions a Scoping Review. JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:840-865. [PMID: 33811292 DOI: 10.1007/s10926-021-09971-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/08/2021] [Indexed: 06/12/2023]
Abstract
PURPOSE Building on an emerging body of evidence, this scoping review aimed to provide an overview of current interventions to promote work-focused care by healthcare providers for individuals with musculoskeletal conditions and to identify current knowledge gaps for future research. METHODS Literature searches were performed in Pubmed, CINAHL, EMBASE, and PsycInfo using Medical Subject Heading terms and text words relating to musculoskeletal conditions, interventions to promote work-focused care and work-related outcomes. Articles involving any interventions with elements of work-focused care delivered by healthcare providers to manage musculoskeletal conditions were reviewed for suitability and inclusion. RESULTS A total of 22 articles (18 intervention trials) were identified. Most studies were multidisciplinary interventions incorporating one or more elements of work-focused care including: work-related assessment to identify barriers to working, vocational advice/coaching or education to address barriers to working, involvement of the workplace stakeholders, restoration of fitness for work and regular communication with multidisciplinary team members. Most studies (61 %) concluded that their interventions achieved the desired work-related outcomes although firm conclusions could not be made regarding the effectiveness of a particular component, content or strategy of work-focused care itself because of the variability in the type and number of elements and outcomes used. CONCLUSIONS There is good evidence demonstrating the potential for healthcare providers to improve work outcomes for those with musculoskeletal conditions. Additional training is required to increase confidence in this area of practice. Accepting that work-focused care is important, however, does not diminish the challenge it presents.
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Affiliation(s)
- Yanfei Xie
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - Nathan Hutting
- Research Group Occupation and Health, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Serena Bartys
- Centre for Applied Research in Health, School of Human & Health Sciences, The University of Huddersfield, Huddersfield, UK
| | - Venerina Johnston
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia.
- RECOVER Injury Research Centre, The University of Queensland, Brisbane, QLD, Australia.
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21
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Killip SC, MacDermid JC, Sinden KE, Gewurtz RE, Scott L. Identifying predictors of return to work and the duration of time off work in first responders affected with musculoskeletal injuries or mental health issues. Int Arch Occup Environ Health 2021; 95:723-735. [PMID: 34674035 DOI: 10.1007/s00420-021-01800-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 07/23/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE To identify predictors of return to work, duration of time off work, and claim closure for first responders experiencing injuries or illnesses, and summarize the claim data. METHODS First responder claims collected between January 2012 and July 2017 were obtained from a disability management company. Known predictors of return to work were extracted from the data including age, sex, diagnosis, years of service, claim lag, medical report lag, and the return-to-work duties. Survival analyses were performed to identify predictors of return to work and claim closure using the Cox proportional regression analysis. Log-rank tests were performed to identify predictors that affected the rate of return to work and claim closure. Summary statistics were performed for the injury and return-to-work data. RESULTS 60 of the 67 (89.6%) identified first responders returned to work within the data collection period. Musculoskeletal injuries predicted an increased likelihood of returning to work (hazard ratio = 2.0, 95%CI = 1.14-3.60) and a shorter duration of time off work (37 days on average) compared to mental health issues. Everyday of claim lag and medical report lag predicted a 2% decrease in likelihood of return to work. Returning to work was the only predictor of claim closure. 45 (67.2%) first responders returned to their pre-absence duties. 22 (32.8%) mental health claims and 45 (67.2%) injury claims were identified. CONCLUSIONS 89.6% of first responders returned to work, although only 67.2% returned to their pre-absence duties. Predictors of return to work included injury type, as first responders with musculoskeletal injuries returned to work sooner, and claim and medical lag delayed the return to work.
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Affiliation(s)
- Shannon C Killip
- School of Rehabilitation Science, McMaster University, 1400 Main Street West IAHS 403, Hamilton, ON, L8S 4L8, Canada.
| | - Joy C MacDermid
- School of Rehabilitation Science, McMaster University, 1400 Main Street West IAHS 403, Hamilton, ON, L8S 4L8, Canada.,Physical Therapy and Surgery, Western University, London, ON, Canada.,Clinical Research Lab, Hand and Upper Limb Centre, St. Joseph's Health Centre, London, ON, Canada
| | - Kathryn E Sinden
- School of Kinesiology, Lakehead University, 955 Oliver Rd, Thunder Bay, ON, P7B 5E1, Canada
| | - Rebecca E Gewurtz
- School of Rehabilitation Science, McMaster University, 1400 Main Street West IAHS 403, Hamilton, ON, L8S 4L8, Canada
| | - Liz Scott
- School of Psychology, Capella University, Minnesota, USA.,CEO of Organizational Solutions Inc., 2186 Mountain Grove Ave. #253, Burlington, ON, L7P 4X4, Canada
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22
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Corbière M, Willems L, Guay S, Panaccio A, Lecomte T, Mazaniello-Chézol M. Développement et tests utilisateurs de l’application Web PRATICAdr : Plateforme de Retour Au Travail axée sur les Interactions et la Communication entre les Acteurs, intégrant un programme Durable favorisant le Rétablissement. SANTE MENTALE AU QUEBEC 2021. [DOI: 10.7202/1081515ar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction Les troubles mentaux courants (TMC) représentent de 30 % à 50 % des absences maladies toutes confondues. Le succès du retour au travail (RAT) n’est pas dû au seul fait de l’individu, mais plutôt au résultat de l’interaction entre les acteurs impliqués dans le processus. De nombreuses applications en santé mentale ont été développées pour améliorer la prise en charge des patients et optimiser la communication entre les professionnels, sans toutefois être validées. De plus, aucune solution technologique n’a été développée à ce jour pour faciliter à la fois la concertation des acteurs du RAT (p. ex. gestionnaire, professionnels de la santé) et l’accompagnement systématique de l’employé dans son RAT.
Objectif Pour combler ces lacunes, l’objectif de cet article est double : 1) décrire le développement de l’application PRATICAdr, Plateforme de Retour Au Travail axée sur les Interactions et la Communication entre les Acteurs : un programme Durable favorisant le Rétablissement ; 2) documenter les tests utilisateurs de l’application PRATICAdr.
Méthode Le développement de PRATICAdr se décline en 3 phases : 1) l’analyse des besoins ; 2) la conceptualisation des mécanismes internes à l’application et des techniques de programmation ; 3) le test de l’application en situation réelle. L’application est évaluée par des questionnaires et entrevues pour mesurer la satisfaction des utilisateurs.
Résultats PRATICAdr permet de suivre en temps réel le parcours des acteurs impliqués dans l’accompagnement personnalisé de l’employé dans son RAT. La schématisation du processus de RAT et l’inclusion d’outils d’évaluation validés systématisent la concertation et la prise de décision partagée des acteurs, ainsi que le suivi et les actions posées en vue d’entreprendre un RAT favorisant le rétablissement. L’interface de PRATICAdr a été développée pour simplifier l’expérience utilisateur de l’employé en absence maladie et des acteurs du RAT. Les résultats de satisfaction des premiers utilisateurs de PRATICAdr, 16 employés d’une grande organisation dans le domaine de la santé en processus de RAT à la suite d’un TMC, apprécient (moyenne > 9/10) non seulement la Plateforme Web, mais également la participation des acteurs du RAT et les questionnaires inclus dans PRATICAdr. Des éléments d’amélioration sont aussi proposés.
Conclusion PRATICAdr est implantée dans 2 grandes organisations (> 15 000 employés) afin d’évaluer son efficacité auprès d’employés en absence maladie en raison d’un TMC et en processus de RAT. Dans le cadre de cet article, l’objectif était de présenter non seulement le développement de PRATICAdr, mais aussi de mesurer la satisfaction des utilisateurs. Les premiers résultats indiquent une appréciation élevée chez les employés en absence maladie, utilisateurs de PRATICAdr. En termes de pistes futures, l’intégration de l’apprentissage automatique sera abordée dans l’objectif de personnaliser le programme de RAT selon les prédictions de durée d’absence maladie et de RAT durable.
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Affiliation(s)
- Marc Corbière
- Professeur titulaire du Département d’éducation et pédagogie – Counseling de carrière, Université du Québec à Montréal – Chercheur au Centre de recherche de l’Institut universitaire en santé mentale de Montréal (CR-IUSMM) – Titulaire de la Chaire de recherche en santé mentale et travail, Fondation de l’IUSMM
| | | | - Stéphane Guay
- Professeur titulaire à l’École de criminologie et au Département de psychiatrie et d’addictologie – Université de Montréal – Directeur du Centre de recherche de l’Institut universitaire en santé mentale de Montréal (CR-IUSMM)
| | - Alexandra Panaccio
- Professeure agrégée au Département de Management et Vice-Doyenne Agrément et relations avec le corps professoral, École de gestion John-Molson, Université Concordia
| | - Tania Lecomte
- Professeur titulaire du Département de pyschologie – Université de Montréal – Chercheuse au Centre de recherche de l’Institut universitaire en santé mentale de Montréal (CR-IUSMM)
| | - Maud Mazaniello-Chézol
- Candidate au Doctorat au Département de Médecine de Famille – Université McGill ; Professionnelle de recherche à la Chaire de recherche en santé mentale et travail, Fondation de l’IUSMM
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Klevanger NE, Fimland MS, Rise MB. Aligning stakeholders' understandings of the return-to-work process: a qualitative study on workplace meetings in inpatient multimodal occupational rehabilitation. Int J Qual Stud Health Well-being 2021; 16:1946927. [PMID: 34278973 PMCID: PMC8291062 DOI: 10.1080/17482631.2021.1946927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Purpose: Although it is believed that involving the workplace and stakeholders in return-to-work interventions is beneficial, Norwegian occupational rehabilitation programmes rarely do. During 2015–2016, Hysnes Rehabilitation Centre provided inpatient multimodal occupational rehabilitation, including workplace meetings with employees, supervisors, and rehabilitation therapists. This study aims to explore the meetings´ content and stakeholders´ experiences.Methods: This was a multiple case study including non-participant observation of workplace meetings and interviews with participantsResults: Essential features of meetings included revealing and aligning the employee’s and supervisor’s understandings. Three components seemed instrumental in developing shared understandings leading to appropriate adjustments: 1) disclosing causes of absence, 2) validating difficulties, attitudes, and efforts, and 3) delimiting responsibility. Therapists played a vital role in addressing these components, supporting employees, and ensuring planning of appropriate solutions.Conclusion: Developing shared understandings by addressing and aligning illness- and return-to-work representations appears important for return-to-work interventions. Although pivotal to developing appropriate adjustments, disclosure depends upon supervisors’ display of understanding and should not be encouraged without knowledge of the employee´s work situation. How supervisors relate to employees and implement adjustments may be as important as the types of adjustments. The therapist’s support and validation of employees in vulnerable situations also seem valuable.Trial registration: The trial is registered at clinicaltrials.gov (NCT02541890), 4 September 2015. https://clinicaltrials.gov/ct2/show/NCT02541890.
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Affiliation(s)
- Nina Elisabeth Klevanger
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Marius Steiro Fimland
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Unicare Helsefort Rehabilitation Centre, Rissa, Norway.,Department of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Marit By Rise
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
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Understanding the Process and Challenges for Return-to-Work Post-Hematopoietic Cell Transplantation from a Musculoskeletal Perspective: A Narrative Review. Occup Ther Int 2021; 2021:5568513. [PMID: 34316293 PMCID: PMC8277503 DOI: 10.1155/2021/5568513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 05/02/2021] [Accepted: 06/18/2021] [Indexed: 12/20/2022] Open
Abstract
The current paper seeks to inform healthcare professionals on how adapting various components of return to work (RTW) programs that are already in use by other musculoskeletal rehabilitation settings can help optimize return to work process for patients with or without musculoskeletal manifestations, posthematopoietic cell transplantation. Since there is no universally agreed RTW structure for hematopoietic cell transplant patients, a narrative approach has been taken utilizing evidence from the existing musculoskeletal return to work assessment publications to help draw parallel for the hematopoietic cell transplant patients. Databases were searched including PUBMED, CINHAL, AMED, SCOPUS, and Cochrane using keywords RTW, functional restoration program, hematopoietic cell transplant, bone marrow transplant, stem cell transplant, and musculoskeletal functional assessment. The authors have managed to outline and propose a structured RTW assessment and monitoring program which can aid in getting patients back to employment by utilizing the functional capacity and job evaluation to help hematopoietic cell transplantation patients reintegrate socially. Patients undergoing hematopoietic cell transplant require additional support and a robust assessment system to allow safe RTW. The proposed model of RTW assessment can prove to be beneficial in helping patients return to work safely. Clinical Significance. To acknowledge the individuality in functional limitation is important in determining not only the rehab needs but also the RTW capabilities. The proposed RTW plan not only promotes an individualized approach to patients but also provides a structure for return to work assessments for hematopoietic cell transplantation patients, thus, eliminating the need for guess work by healthcare professionals. In line with the International Classification of Functioning, Disability, and Health (ICF) recommendations, a RTW assessment combined with a job evaluation helps healthcare professionals and stakeholders to understand the unique challenges and strengths of a patient and thereby design an individualized therapy approach.
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Corbière M, Mazaniello-Chézol M, Lecomte T, Guay S, Panaccio A. Developing a collaborative and sustainable return to work program for employees with common mental disorders: a participatory research with public and private organizations. Disabil Rehabil 2021; 44:5199-5211. [PMID: 34086528 DOI: 10.1080/09638288.2021.1931481] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
PURPOSE To disentangle the key steps of the return to work (RTW) process and offer clearer recovery-focused and sustainable RTW for people on sick leave due to common mental disorders (CMDs). METHODS This participatory research involves two large Canadian organizations. In each organization, we established an advisory committee composed of RTW stakeholders. We collected information in semi-structured interviews from RTW stakeholders (n = 26) with each member of the advisory committee in each organization, as well as with employees who had recently experienced CMDs. The interviews examined the RTW process for employees on sick leave due to CMDs as well as RTW stakeholders' perceptions of barriers and facilitators. A thematic approach was used to synthesize the data, following which, results were discussed with the two advisory committees to identify solutions considering key RTW steps. RESULTS Ten common key steps within the three RTW phases emerged from the semi-structured interviews with RTW stakeholders and discussions with the two advisory committees: 1) At the beginning of sickness absence and involvement of disability management team (phase 1), we found 3 steps (e.g., taking charge of the file), 2) during the involvement in treatment rehabilitation with health professionals and preparation of the RTW (phase 2), 4 steps (e.g., RTW preparation), and finally 3) the RTW and follow-up (phase 3) consists of 3 steps (e.g., gradual RTW). CONCLUSION A participatory study involving RTW stakeholders helped identify 10 common key steps within three phases to support RTW sustainability of people with CMDs. Future research will need to address how RTW coordinators intervene in the RTW process of employees with CMDs within these steps.IMPLICATIONS FOR REHABILITATIONRehabilitation professionals will benefit from a detailed description of the RTW process (10 steps spread out over 3 RTW phases), allowing them to standardize it while adopting a personalized approach for the employee on sick leave.Rehabilitation professionals are informed of stakeholders' role and actions required in the RTW process; as such the communication between RTW stakeholders should be improved.RTW coordinators will be able to tailor more precisely their intervention, considering the detailed RTW process and RTW stakeholders' role and actions, and thus will become the pivot occupational health specialists for the RTW process.
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Affiliation(s)
- Marc Corbière
- Research Chair Mental Health and Work, Institut universitaire en santé mentale de Montréal, Montreal, QC, Canada.,Research Centre, Institut universitaire en santé mentale de Montréal, Montreal, QC, Canada.,Department of Education and Pedagogy, Université du Québec à Montréal, Montreal, QC, Canada
| | - Maud Mazaniello-Chézol
- Research Chair Mental Health and Work, Institut universitaire en santé mentale de Montréal, Montreal, QC, Canada.,Research Centre, Institut universitaire en santé mentale de Montréal, Montreal, QC, Canada.,Department of Family Medicine, McGill University, Montreal, QC, Canada
| | - Tania Lecomte
- Research Centre, Institut universitaire en santé mentale de Montréal, Montreal, QC, Canada.,Department of Psychology, Université de Montréal, Montreal, QC, Canada
| | - Stéphane Guay
- Research Centre, Institut universitaire en santé mentale de Montréal, Montreal, QC, Canada.,School of Criminology, Université de Montréal, Montreal, QC, Canada
| | - Alexandra Panaccio
- John Molson School of Business, Concordia University, Montreal, QC, Canada
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Health-care providers' perspectives on factors influencing return-to-work after surgery for nontraumatic conditions of the upper extremity. J Hand Ther 2021; 33:87-95.e1. [PMID: 30857893 DOI: 10.1016/j.jht.2018.09.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 09/21/2018] [Accepted: 09/22/2018] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN This study is a descriptive survey. INTRODUCTION Health care providers (HCPs) are key stakeholders who facilitate workers' return to work (RTW) following upper extremity surgery. Hand therapists play a major role in this process, yet we do not know if and/or how their perspectives differ from other HCPs. PURPOSE OF THE STUDY This study examined HCPs' opinion on factors that influence RTW after surgery for nontraumatic upper extremity conditions and whether HCPs from different disciplines differed in their opinion. METHODS HCPs (occupational therapists, physiotherapists, hand therapists, exercise physiologists, psychologists, surgeons, and general practitioners) completed a survey rating 50 factors on a worker's ability to RTW. Each factor was scored using a 5-point Likert scale from "not" to "extremely" influential, which was later dichotomised. Agreement was indicated at 75%. The level of disagreement between disciplines was examined. RESULTS Respondents (n = 787) identified 20 factors being influential on RTW. They are (in order from highest to lowest) poor pain coping (the highest, >85% of respondents), postoperative psychological state, RTW self-efficacy, employer/supervisor's support, employer's unwillingness for job modification, recovery expectations, job satisfaction, suitable duties availability, whether the job can be modified, and mood disorder diagnosis. There was agreement that two factors do not influence RTW, gender, and preemployment medical assessment. There was disagreement (P < .05) between HCP disciplines on six factors (obesity, comorbidities, doctors' RTW recommendation, diagnosis, fitness, income). There were no consistent patterns with respect to which professions disagreed across all six factors. Hand therapists differed from the other disciplines for three of the factors including diagnosis, comorbidities, and doctor's recommendation for RTW. DISCUSSION The factors that stakeholders agreed as having the greatest influence were mainly related to the worker (pain and psychological factors) and the workplace and are amenable to RTW interventions. CONCLUSION Interventions facilitating RTW and future research should consider the factors identified by HCPs in this study.
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Holmlund L, Hellman T, Engblom M, Kwak L, Sandman L, Törnkvist L, Björk Brämberg E. Coordination of return-to-work for employees on sick leave due to common mental disorders: facilitators and barriers. Disabil Rehabil 2020; 44:3113-3121. [PMID: 33280451 DOI: 10.1080/09638288.2020.1855263] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE To identify facilitators of and barriers to the coordination of return-to-work between the primary care services, the employee, and the employers from the perspective of coordinators and employees on sick leave due to common mental disorders (CMDs). MATERIAL AND METHODS Descriptive qualitative study. Semi-structured interviews were conducted with eighteen coordinators and nine employees on sick leave due to CMDs. The Consolidated Framework for Implementation Research (CFIR) was used as a starting point for the interview guides and in the thematic analysis of data. RESULTS The results show facilitators and barriers related to the CFIR domains "intervention characteristics," "outer setting," "inner setting," and "characteristics of individuals." Positive attitudes, an open dialogue in a three-party meeting, and a common ground for the sick leave process at the primary care centre facilitated coordination, while an unclear packaging, conflicts at the employee's workplace, and a lack of team-based work were examples of barriers. CONCLUSION The results indicate a need for the detailed packaging of coordination; formalization of coordinators' qualifications and levels of training; and acknowledgement of the role of organizational factors in the implementation of coordination. This is important to further develop and evaluate the efficacy of coordination.IMPLICATIONS FOR REHABILITATIONPositive attitudes to coordination, an open dialogue in a three-party meeting, leadership engagement, routines for the return to work (RTW) process at the primary care centre, and collegial alliances were identified as facilitators.An unclear packaging of the intervention, conflicts at the employee's workplace, lack of team-based work, and lack of coordinator training were identified as barriers.A detailed intervention packaging adapted for the specific setting and formalization of coordinators' qualifications and training is necessary for coordination of RTW.Recognizing organizational factors were identified as being important for the implementation of coordination of RTW for persons on sick leave due to CMDs.
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Affiliation(s)
- Lisa Holmlund
- Institute of Environmental Medicine, Unit of Intervention and Implementation Research for Worker Health, Karolinska Institutet, Stockholm, Sweden
| | - Therese Hellman
- Institute of Environmental Medicine, Unit of Intervention and Implementation Research for Worker Health, Karolinska Institutet, Stockholm, Sweden.,Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden
| | - Monika Engblom
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Academic Primary Health Care Centre, Region Stockholm, Sweden
| | - Lydia Kwak
- Institute of Environmental Medicine, Unit of Intervention and Implementation Research for Worker Health, Karolinska Institutet, Stockholm, Sweden
| | - Lars Sandman
- Department of Health, Medicine and Caring Sciences, National Centre for Priorities in Health, Linköping university, Linköping, Sweden
| | - Lena Törnkvist
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Academic Primary Health Care Centre, Region Stockholm, Sweden
| | - Elisabeth Björk Brämberg
- Institute of Environmental Medicine, Unit of Intervention and Implementation Research for Worker Health, Karolinska Institutet, Stockholm, Sweden.,Department of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Boileau-Falardeau F, Turcotte JR, Lafleur PA, Corbière M. Dilemmes des médecins traitants lors du retour au travail de personnes aux prises avec un trouble mental courant : illustration par des vignettes cliniques. SANTE MENTALE AU QUEBEC 2020. [DOI: 10.7202/1073530ar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction Les troubles mentaux courants (TMC) sont une des causes majeures d’invalidité au travail dans le monde. Plusieurs études démontrent que plus la durée de l’arrêt de travail est longue, plus minces sont les chances que la personne avec un TMC retourne au travail. Il est donc important que l’arrêt de travail soit d’une durée adéquate pour permettre à l’individu un rétablissement durable tout en diminuant les risques de rechute. Les médecins traitants ont un rôle important à jouer dans le cadre de la reprise professionnelle des personnes avec un TMC.
Objectif Cet article a comme principal objectif de présenter des vignettes cliniques supportées par la littérature relativement à la gestion par les médecins traitants de la reprise professionnelle de leurs patients avec un TMC.
Méthodologie Issues d’expériences cliniques, 3 vignettes cliniques illustrant plusieurs dilemmes que des médecins traitants peuvent rencontrer lors de la reprise professionnelle de leurs patients avec un TMC sont présentées. Les dilemmes sont soutenus par des articles publiés entre 2000 à 2020, provenant des bases de données Medline et PsycInfo.
Résultats et discussion Les 3 vignettes portent sur les dilemmes relatifs aux thèmes suivants : 1) l’évaluation du potentiel thérapeutique des arrêts de travail ; 2) le rôle d’expert octroyé aux médecins traitants et au processus d’évaluation de la capacité à travailler ; 3) les aspects administratifs liés à cette évaluation ; 4) la relation thérapeutique médecin-patient. La littérature nous indique que ce sont des dilemmes récurrents chez les médecins traitants dans le contexte de la gestion de la reprise professionnelle à la suite d’un TMC.
Conclusion La gestion des arrêts maladie chez les travailleurs avec un TMC par les médecins traitants comporte plusieurs dilemmes. Ces dilemmes mettent en lumière, entre autres, l’importance pour les médecins traitants de travailler en collaboration avec les autres acteurs et d’obtenir leur soutien et collaboration. Ces observations nous amènent à conduire une revue plus systématique de l’expérience des médecins traitants et de leurs besoins.
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Affiliation(s)
- Fabienne Boileau-Falardeau
- M.D., FRCPC, candidate à la maitrise en sciences biomédicales, Université de Montréal. Psychiatre, CIUSSS du Nord-de-l’Île-de-Montréal
| | - Jean-Robert Turcotte
- M.D., MPH FRCPC ; Psychiatre et professeur adjoint, Université de Montréal et CIUSSS du Nord-de-l’Île-de-Montréal
| | - Paul-André Lafleur
- M.D. Psychiatre légiste et professeur adjoint, Université de Montréal et CIUSSS du Nord-de-l’Île-de-Montréal
| | - Marc Corbière
- Ph. D. Professeur titulaire au Département d’éducation et pédagogie - Counseling de carrière, Université du Québec à Montréal (UQAM) ; Chercheur au Centre de recherche de l’Institut universitaire en santé mentale de Montréal (CR-IUSMM) ; Titulaire de la Chaire de recherche en santé mentale et travail, Fondation de l’IUSMM
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Camisa V, Gilardi F, Di Brino E, Santoro A, Vinci MR, Sannino S, Bianchi N, Mesolella V, Macina N, Focarelli M, Brugaletta R, Raponi M, Ferri L, Cicchetti A, Magnavita N, Zaffina S. Return on Investment (ROI) and Development of a Workplace Disability Management Program in a Hospital-A Pilot Evaluation Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218084. [PMID: 33147861 PMCID: PMC7662934 DOI: 10.3390/ijerph17218084] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 10/19/2020] [Accepted: 10/20/2020] [Indexed: 12/14/2022]
Abstract
The progressive ageing of the working population and the increase in related chronic diseases tend to affect working capacity. The aim of this study was to evaluate a Workplace Disability Management Program (WDMP) within a pediatric hospital. Absenteeism due to healthcare workers’ (HCWs) pre- and post- WDMP and the related costs were used for the program evaluation. The Return on Investment (ROI), the Break-Even Analysis (BEA) and the value of the average annual productivity of HCWs who took advantage of the Disability Management (DM) interventions to assess the economic impact of the program, were also used. The HCWs enrolled in the program were 131 (approximately 4% of hospital staff), of which 89.7% females and with an average age of 50.4 years (SD ± 8.99). Sick leave days of the HCWs involved decreased by 66.6% in the year following the end of WDMP compared to the previous one (p < 0.001). The total estimated cost reduction of absenteeism is 427,896€ over a year. ROI was equal to 27.66€. BEA indicated that the break-even point was reached by implementing the program on 3.27 HCWs. The program evaluation demonstrated the particular effectiveness of the implemented WDMP model, acting positively on the variables that affect productivity and the limitation to work.
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Affiliation(s)
- Vincenzo Camisa
- Health Directorate, Occupational Medicine Service, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy; (V.C.); (F.G.); (A.S.); (M.R.V.); (R.B.)
- Post-Graduate School of Occupational Health, Catholic University of Sacred Heart, 00168 Rome, Italy; (L.F.); (N.M.)
| | - Francesco Gilardi
- Health Directorate, Occupational Medicine Service, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy; (V.C.); (F.G.); (A.S.); (M.R.V.); (R.B.)
| | - Eugenio Di Brino
- Graduate School of Health Economics and Management, Catholic University of Sacred Heart (ALTEMS), 00168 Rome, Italy; (E.D.B.); (A.C.)
| | - Annapaola Santoro
- Health Directorate, Occupational Medicine Service, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy; (V.C.); (F.G.); (A.S.); (M.R.V.); (R.B.)
| | - Maria Rosaria Vinci
- Health Directorate, Occupational Medicine Service, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy; (V.C.); (F.G.); (A.S.); (M.R.V.); (R.B.)
- Post-Graduate School of Occupational Health, Catholic University of Sacred Heart, 00168 Rome, Italy; (L.F.); (N.M.)
| | - Serena Sannino
- Health Directorate, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy; (S.S.); (M.R.)
| | - Natalia Bianchi
- Nursing and Health Allied Professionals Service, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy;
| | - Valentina Mesolella
- Human Resources Directorate, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy; (V.M.); (N.M.); (M.F.)
| | - Nadia Macina
- Human Resources Directorate, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy; (V.M.); (N.M.); (M.F.)
| | - Michela Focarelli
- Human Resources Directorate, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy; (V.M.); (N.M.); (M.F.)
| | - Rita Brugaletta
- Health Directorate, Occupational Medicine Service, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy; (V.C.); (F.G.); (A.S.); (M.R.V.); (R.B.)
| | - Massimiliano Raponi
- Health Directorate, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy; (S.S.); (M.R.)
| | - Livia Ferri
- Post-Graduate School of Occupational Health, Catholic University of Sacred Heart, 00168 Rome, Italy; (L.F.); (N.M.)
| | - Americo Cicchetti
- Graduate School of Health Economics and Management, Catholic University of Sacred Heart (ALTEMS), 00168 Rome, Italy; (E.D.B.); (A.C.)
| | - Nicola Magnavita
- Post-Graduate School of Occupational Health, Catholic University of Sacred Heart, 00168 Rome, Italy; (L.F.); (N.M.)
- Department of Woman, Child & Public Health, Gemelli Policlinic Foundation IRCCS, 00168 Rome, Italy
| | - Salvatore Zaffina
- Health Directorate, Occupational Medicine Service, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy; (V.C.); (F.G.); (A.S.); (M.R.V.); (R.B.)
- Human Resources Directorate, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy; (V.M.); (N.M.); (M.F.)
- Correspondence: ; Tel.: +39-06-6859-3150; Fax: +39-06-6859-3852
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Age Differences in Return-to-Work Following Injury: Understanding the Role of Age Dimensions Across Longitudinal Follow-up. J Occup Environ Med 2020; 62:e680-e687. [PMID: 32956237 DOI: 10.1097/jom.0000000000002029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To examine the overall association between chronological age and return-to-work (RTW), and understand if existing data could be used to better understand the role of age-related dimensions (functional, psychosocial, organizational, life-stage) in explaining these associations. METHODS We used survey data from a prospective cohort of injured workers in Victoria, Australia. Path models examined the relationship between chronological age and RTW, and the proportion mediated via age dimensions. RESULTS Older chronological age was associated with non-RTW, although the pattern was not observed consistently across follow-up surveys. A proportion of the overall relationship between chronological age and non-RTW was explained by functional and life-stage age and RTW status at previous time points. CONCLUSIONS Findings underscore the importance of moving beyond age measured only in chronological years, towards more complex conceptual and analytical models that recognize age as a multidimensional construct.
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Corbière M, Mazaniello-Chézol M, Bastien MF, Wathieu E, Bouchard R, Panaccio A, Guay S, Lecomte T. Stakeholders' Role and Actions in the Return-to-Work Process of Workers on Sick-Leave Due to Common Mental Disorders: A Scoping Review. JOURNAL OF OCCUPATIONAL REHABILITATION 2020; 30:381-419. [PMID: 31673934 DOI: 10.1007/s10926-019-09861-2] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The lack of knowledge regarding the roles and actions of return to work (RTW) stakeholders create confusion and uncertainty about how and when to RTW after experiencing a common mental disorder (CMD). Purpose The purpose of this scoping review is to disentangle the various stakeholders' role and actions in the RTW process of workers on sick-leave due to CMDs. The research question is: What is documented in the existing literature regarding the roles and actions of the identified stakeholders involved in the RTW process of workers on sick-leave due to CMDs? Methods In conducting this scoping review, we followed Arksey and O'Malley's (Int J Soc Res Methodol 8:19-32, 2005) methodology, consisting of different stages (e.g., charting the data by categorizing key results). Results 3709 articles were screened for inclusion, 243 of which were included for qualitative synthesis. Several RTW stakeholders (n=11) were identified (e.g., workers on sick leave due to CMDs, managers, union representatives, rehabilitation professionals, insurers, return to work coordinators). RTW stakeholders' roles and actions inter- and intra-system were recommended, either general (e.g., know and understand the perspectives of all RTW stakeholders) or specific to an actor (e.g., the return to work coordinator needs to create and maintain a working alliance between all RTW stakeholders). Furthermore, close to 200 stakeholders' actions, spread out on different RTW phases, were recommended for facilitating the RTW process. Conclusions Eleven RTW stakeholders from the work, heath and insurance systems have been identified, as well as their respective roles and actions. Thanks to these results, RTW stakeholders and policy makers will be able to build practical relationships and collaboration regarding the RTW of workers on sick leave due to CMDs.
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Affiliation(s)
- Marc Corbière
- Department of Education, Career counselling, Université du Québec à Montréal, C.P. 8888 succursale Centre-ville, Montreal, QC, H3C 3P8, Canada.
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal (CR-IUSMM), Montreal, QC, Canada.
| | - Maud Mazaniello-Chézol
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal (CR-IUSMM), Montreal, QC, Canada
- Department of Family Medicine, McGill University, Montreal, QC, Canada
| | - Marie-France Bastien
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal (CR-IUSMM), Montreal, QC, Canada
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada
| | - Estelle Wathieu
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal (CR-IUSMM), Montreal, QC, Canada
- Department of Art History, Concordia University, Montreal, QC, Canada
| | | | - Alexandra Panaccio
- John Molson School of Business, Concordia University, Montréal, QC, Canada
| | - Stéphane Guay
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal (CR-IUSMM), Montreal, QC, Canada
- Department of Psychiatry and Addictology, Université de Montreal, Montreal, QC, Canada
| | - Tania Lecomte
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal (CR-IUSMM), Montreal, QC, Canada
- Department of Psychology, Université de Montréal, Montreal, QC, Canada
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Cheng ASK, Ng PHF, Sin ZPT, Lai SHS, Law SW. Smart Work Injury Management (SWIM) System: Artificial Intelligence in Work Disability Management. JOURNAL OF OCCUPATIONAL REHABILITATION 2020; 30:354-361. [PMID: 32236811 DOI: 10.1007/s10926-020-09886-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE This paper aims to illustrate an example of how to set up a work injury database: the Smart Work Injury Management (SWIM) system. It is a secure and centralized cloud platform containing a set of management tools for data storage, data analytics, and machine learning. It employs artificial intelligence to perform in-depth analysis via text-mining techniques in order to extract both dynamic and static data from work injury case files. When it is fully developed, this system can provide a more accurate prediction model for cost of work injuries. It can also predict return-to-work (RTW) trajectory and provide advice on medical care and RTW interventions to all RTW stakeholders. The project will comprise three stages. Stage one: to identify human factors in terms of both facilitators and barriers RTW through face-to-face interviews and focus group discussions with different RTW stakeholders in order to collect opinions related to facilitators, barriers, and essential interventions for RTW of injured workers; Stage two: to develop a machine learning model which employs artificial intelligence to perform in-depth analysis. The technologies used will include: 1. Text-mining techniques including English and Chinese work segmentation as well as N-Gram to extract both dynamic and static data from free-style text as well as sociodemographic information from work injury case files; 2. Principle component/independent component analysis to identify features of significant relationships with RTW outcomes or combine raw features into new features; 3. A machine learning model that combines Variational Autoencoder, Long and Short Term Memory, and Neural Turning Machines. Stage two will also include the development of an interactive dashboard and website to query the trained machine learning model. Stage three: to field test the SWIM system. CONCLUSION SWIM ia secure and centralized cloud platform containing a set of management tools for data storage, data analytics, and machine learning. When it is fully developed, SWIM can provide a more accurate prediction model for the cost of work injuries and advice on medical care and RTW interventions to all RTW stakeholders. ETHICS The project has been approved by the Ethics Committee for Human Subjects at the Hong Kong Polytechnic University and is funded by the Innovation and Technology Commission (Grant # ITS/249/18FX).
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Affiliation(s)
- Andy S K Cheng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong.
| | - Peter H F Ng
- Department of Computing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Zackary P T Sin
- Department of Computing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Sun H S Lai
- Total Rehabilitaton Management (HK) Limited, Wanchai Road, Wanchai, Hong Kong
| | - S W Law
- Department of Orthopaedics & Traumatology, Alice Ho Miu Ling Nethersole Hospital/Tai Po Hospital, Tai Po, NT, Hong Kong
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Shaw WS, Main CJ, Findley PA, Collie A, Kristman VL, Gross DP. Opening the Workplace After COVID-19: What Lessons Can be Learned from Return-to-Work Research? JOURNAL OF OCCUPATIONAL REHABILITATION 2020; 30:299-302. [PMID: 32562129 PMCID: PMC7303572 DOI: 10.1007/s10926-020-09908-9] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Affiliation(s)
- William S. Shaw
- University of Connecticut School of Medicine, 263 Farmington Ave, Farmington, CT 06030 USA
| | - Chris J. Main
- Keele University, Keele, North Staffordshire ST5 5BG UK
| | - Patricia A. Findley
- Rutgers, the State University of New Jersey, 120 Albany Street, New Brunswick, NJ USA
| | - Alex Collie
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC 3004 Australia
| | - Vicki L. Kristman
- EPID@Work Research Institute and Department of Health Sciences, Lakehead University, 955 Oliver Road, Thunder Bay, ON P7B 5E1 Canada
| | - Douglas P. Gross
- University of Alberta, 2-50 Corbett Hall, Edmonton, AB T6G 2G4 Canada
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Holmlund L, Guidetti S, Eriksson G, Asaba E. Return-to-work: Exploring professionals' experiences of support for persons with spinal cord injury. Scand J Occup Ther 2020; 28:571-581. [PMID: 32755475 DOI: 10.1080/11038128.2020.1795245] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE To generate knowledge about how professional stakeholders organise and experience the support of the return-to-work (RTW) process for persons with spinal cord injury (SCI). METHODS Constructivist grounded theory approach. Professional stakeholders (n = 34) involved in the RTW process and representing three Swedish Regions were recruited into seven focus groups. Analysis followed initial, focussed, and theoretical coding. FINDINGS The core category - mediating intentions to support work and possibilities of working through social, labour market, and societal context - illustrates complexities of when and how to support a person with SCI in the RTW process, and a risk of delayed, unequal, or absent RTW processes. Analysis outlines: (1) Assessment of ability to work - uncertainty of how and when; (2) Planning RTW - divide between dynamic and rule-based perspectives; (3) Work re-entry - unequal paths towards viable solutions. CONCLUSIONS In RTW after SCI, it is critical to acknowledge how the RTW process is situated in relation to the person and context. A possible direction - grounded in an occupational perspective - through early identification of needs and resources and coordination derived from the SCI rehabilitation setting within healthcare is suggested. This can facilitate a time-sensitive and equal RTW process.
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Affiliation(s)
- Lisa Holmlund
- Department of Neurobiology, Care Science and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.,Spinalis SCI Unit, Rehab Station Stockholm, Stockholm, Sweden
| | - Susanne Guidetti
- Department of Neurobiology, Care Science and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden
| | - Gunilla Eriksson
- Department of Neurobiology, Care Science and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.,Department of Neuroscience, Rehabilitation Medicine, Uppsala University, Uppsala, Sweden
| | - Eric Asaba
- Department of Neurobiology, Care Science and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden.,Research, Education, and Development Unit, Stockholms Sjukhem Foundation, Stockholm, Sweden.,Department of Occupational Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
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Graff HJ, Deleu NW, Christiansen P, Rytter HM. Facilitators of and barriers to return to work after mild traumatic brain injury: A thematic analysis. Neuropsychol Rehabil 2020; 31:1349-1373. [PMID: 32584206 DOI: 10.1080/09602011.2020.1778489] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Individuals with mild traumatic brain injury (mTBI) may experience protracted symptoms affecting their ability to work. Several actors may facilitate or act as a barrier to a successful return to work (RTW). This qualitative study used semi-structured in-depth interviews with 22 adults with mTBI at 2-5 years post injury, targeting experiences of how different actors facilitated or acted as a barrier in the RTW process, and encompassed the mTBI trajectory from the acute phase to the post-acute phase. A thematic analysis with a hermeneutical phenomenological approach was used to analyse data. Three main themes emerged. (1) Worker-employer relationship: Workplace accommodations such as decreased working hours, modified working conditions, and support from co-workers were lacking. (2) The role of the general practitioner: The general practitioner was lacking treatment and referral opportunities and failed to provide the patient with relevant and individualized guidance. (3) Municipal case management: Participants perceived being met with distrust by social workers, follow-up assessments were too frequent, unnecessary, and did not target concussion, and rehabilitation was referred too late. Clinical practice guidelines to improve referral to relevant concussion rehabilitation in case of persistent symptoms are needed to inform clinicians, employers, and public institutions to facilitate a successful RTW.
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Affiliation(s)
- Heidi Jeannet Graff
- Department of Anaesthesia, Centre of Head and Orthopaedics, University Hospital Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Danish Concussion Center, Copenhagen, Denmark
| | - Nicole W Deleu
- Centre for Rehabilitation of Brain Injury, Copenhagen, Denmark
| | | | - Hana Malá Rytter
- Danish Concussion Center, Copenhagen, Denmark.,Department of Psychology, University of Copenhagen, Copenhagen, Denmark.,Department of Neurology, University Hospital Bispebjerg - Frederiksberg, Copenhagen, Denmark
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36
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Iles R, Sheehan L, Munk K, Gosling C. Development and Pilot Assessment of the PACE Tool: Helping Case Managers Identify and Respond to Risk Factors in Workers' Compensation Case Management. JOURNAL OF OCCUPATIONAL REHABILITATION 2020; 30:167-182. [PMID: 31541425 DOI: 10.1007/s10926-019-09858-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose The aim was to develop a tool to be applied by workers' compensation case managers to guide intervention and avoid delayed return to work. Methods The Plan of Action for a CasE (PACE) tool was developed based on a review of existing literature, focus groups with case managers and analysis of existing claims data. Combined with analysis of existing case manager practice, these sources were used to determine key constructs for inclusion in the tool to be aligned with the demands of case manager workload. Mapping of existing interventions was used to match risk identified by the tool with appropriate intervention. Results The final PACE tool consisted of 41 questions divided into Ready (worker), Set (employer) and Go (treating practitioner) categories. Questions in the tool were linked to appropriate case manager actions. Data collection was completed by case managers for 524 claims within the first 2 weeks of the claim being accepted. The most commonly identified risks for delayed RTW included both worker and employer expectations of RTW, as well as certification of capacity. Factor analysis identified two factors operating across the tool categories. Case managers reported benefits in using the tool, but reported it also increased their workload. Conclusions The PACE tool is a unique example of the implementation of risk identification in case management practice. It demonstrates that case managers are ideally placed to collect information to identify risk of delayed RTW. Future work will establish the impact of case-manager led intervention based on identified risks on outcomes for injured workers.
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Affiliation(s)
- Ross Iles
- Insurance Work and Health Group, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, 3004, Australia.
- Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, Frankston, Australia.
| | - Luke Sheehan
- Insurance Work and Health Group, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, 3004, Australia
| | - Karen Munk
- Employers Mutual Limited (EML), Sydney, Australia
| | - Cameron Gosling
- Department of Community Emergency Health and Paramedic Practice, School of Primary and Allied Health Care, Monash University, Frankston, Australia
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Iles RA, Sheehan LR, Gosling CM. Assessment of a new tool to improve case manager identification of delayed return to work in the first two weeks of a workers' compensation claim. Clin Rehabil 2020; 34:656-666. [PMID: 32183561 DOI: 10.1177/0269215520911417] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine whether the Plan of Action for a Case (PACE) tool improved identification of workers at risk of delayed return to work. DESIGN Prospective cohort of workers with accepted workers' compensation claims in the state of New South Wales, Australia. INTERVENTIONS The 41-item PACE tool was completed by the case manager within the first two weeks of a claim. The tool gathered information from the worker, employer and treating practitioner. Multivariate logistic regression models predicted work time loss of at least one and three months. RESULTS There were 524 claimants with complete PACE information. A total of 195 (37.2%) had work time loss of at least one month and 83 (15.8%) had time loss of at least three months. Being male, injury location, an Orebro Musculoskeletal Pain Screening Questionnaire-Short Form score >50, having a small employer, suitable duties not being available, being certified unfit, and the worker having low one-month recovery expectations predicted time loss of over one month. For three months, injury location, a Short Form Orebro score >50, no return-to-work coordinator, and being certified unfit were significant predictors. The model incorporating PACE information provided a significantly better prediction of both one- and three-month outcomes than baseline information (area-under-the-curve statistics-one month: 0.85 and 0.68, respectively; three months: 0.85 and 0.69, respectively; both P < 0.001). CONCLUSION The PACE tool improved the ability to identify workers at risk of ongoing work disability and identified modifiable factors suited to case manager-led intervention.
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Affiliation(s)
- Ross A Iles
- Insurance Work and Health Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.,Department of Physiotherapy, School of Primary and Allied Health Care, Monash University, Melbourne, VIC, Australia
| | - Luke R Sheehan
- Insurance Work and Health Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Cameron McR Gosling
- Department of Community Emergency Health and Paramedic Practice, School of Primary and Allied Health Care, Monash University, Melbourne, VIC, Australia
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Jetha A, Yanar B, Lay AM, Mustard C. Work Disability Management Communication Bottlenecks Within Large and Complex Public Service Organizations: A Sociotechnical Systems Study. JOURNAL OF OCCUPATIONAL REHABILITATION 2019; 29:754-763. [PMID: 31016463 DOI: 10.1007/s10926-019-09836-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Purpose Within large and complex organizations work disability (WD) communication bottlenecks emerge and contribute to avoidable disability days. Our study utilized soft systems methods to better understand communication problems in WD management. Methods Semi-structured interviews were conducted with disability case managers (n = 10), frontline supervisors (n = 15) and human resource/labor relations specialists (n = 5) within three public service organizations. Interview questions asked about organizational WD system structure and communication practices. Thematic analysis was conducted to examine system structure and emergent communication bottlenecks. Results WD communication took place across a number of internal and external stakeholders. Communication bottlenecks tended to concentrate within WD case manager and frontline supervisor activities. Inconsistent communication across organizations, challenges interacting with external stakeholders, mental health disability information exchange, lack of WD communication experience and previous worker performance represented communication bottlenecks that contributed to avoidable disability days. Conclusions To strengthen communication practices, systems-focused responses towards organizational WD management are required.
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Affiliation(s)
- Arif Jetha
- Institute for Work & Health, 481 University Avenue, Toronto, ON, M5G 2E9, Canada.
- Dalla Lana School of Public, Health University of Toronto, Toronto, ON, Canada.
| | - Basak Yanar
- Institute for Work & Health, 481 University Avenue, Toronto, ON, M5G 2E9, Canada
| | - A Morgan Lay
- Institute for Work & Health, 481 University Avenue, Toronto, ON, M5G 2E9, Canada
| | - Cameron Mustard
- Institute for Work & Health, 481 University Avenue, Toronto, ON, M5G 2E9, Canada
- Dalla Lana School of Public, Health University of Toronto, Toronto, ON, Canada
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Peters SE, Coppieters MW, Ross M, Johnston V. Experts' perspective on a definition for delayed return-to-work after surgery for nontraumatic upper extremity disorders: Recommendations and implications. J Hand Ther 2019; 31:315-321. [PMID: 28341323 DOI: 10.1016/j.jht.2017.02.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 02/10/2017] [Accepted: 02/13/2017] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Descriptive study. INTRODUCTION A delayed return to work (RTW) is often associated with poorer outcomes after a workplace injury but is ill defined. PURPOSE OF THE STUDY To define delayed RTW after surgery for nontraumatic upper extremity conditions. METHODS Experts were consulted to define delayed RTW and whether a universal time point can determine the transition from early to delayed RTW. RESULTS Forty-two experts defined a delayed RTW as either a worker not returning to preinjury (or similar) work within the expected time frame (45%); not returning to any type of work (36%); or recovering slower than expected (12%). Two-thirds of experts believed that universal time points to delineate delayed RTW should be avoided. DISCUSSION Multiple factors complicate a uniform definition of delayed RTW. CONCLUSION Defining delayed RTW should be individualized with due consideration to the type of work. Time-based cutoffs for outcome measurement may not be appropriate with continuous measures more appropriate in research. LEVEL OF EVIDENCE Decision analysis V.
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Affiliation(s)
- Susan E Peters
- Department of Occupational Therapy, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia; Brisbane Hand and Upper Limb Research Institute, Brisbane Private Hospital, Brisbane, Australia.
| | - Michel W Coppieters
- Department of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia; Department of Movement Sciences, MOVE Research Institute Amsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; School of Allied Health Sciences, Faculty of Health, Griffith University, Gold Coast, Australia
| | - Mark Ross
- Brisbane Hand and Upper Limb Research Institute, Brisbane Private Hospital, Brisbane, Australia; Department of Orthopedic Surgery, School of Medicine, The University of Queensland, St Lucia, Australia; Orthopaedic Department, Princess Alexandra Hospital, Woolloongabba, Australia
| | - Venerina Johnston
- Department of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
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Greidanus MA, Tamminga SJ, de Rijk AE, Frings-Dresen MHW, de Boer AGEM. What Employer Actions Are Considered Most Important for the Return to Work of Employees with Cancer? A Delphi Study Among Employees and Employers. JOURNAL OF OCCUPATIONAL REHABILITATION 2019; 29:406-422. [PMID: 30027426 PMCID: PMC6531608 DOI: 10.1007/s10926-018-9800-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Purpose Employers are important stakeholders in the return to work (RTW) of employees with cancer. However, it is unclear what employer actions are most important to that process. The objective, therefore, was to reach consensus on what employer actions are considered most important for the RTW of employees with cancer, by employers and employees separately. Methods A two-round online Delphi study was conducted with two expert panels: one with 23 employers and one with 29 employees with cancer. The results from each panel were analysed separately. Out of 24 suggested employer actions, participants selected the 10 they considered most important for RTW in each of the following RTW phases: (1) disclosure, (2) treatment, (3) RTW plan, and (4) actual RTW. The consensus threshold was set at ≥ 80% during the second round. Results The employer and employee expert panels both reached consensus on the importance of 'emotional support', 'practical support', 'allow sufficient sick leave', 'plan return to work', 'adjust expectations', 'assess work ability', and 'show appreciation'. Employers also reached consensus on 'communicate' and 'treat normally', and employees on 'handle unpredictability'. All these employer actions were considered to be specific for one to three RTW phases. Conclusions Employers reached consensus on the importance of nine employer actions, employees on eight. Both stakeholder perspectives showed great similarities, but did vary regarding important employer actions during the employee's treatment. We recommend developing interventions targeting the employer, meeting both employer and employee needs in each RTW phase, to enhance RTW support for employees with cancer.
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Affiliation(s)
- M A Greidanus
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Meibergdreef 9, Amsterdam, The Netherlands.
| | - S J Tamminga
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Meibergdreef 9, Amsterdam, The Netherlands
| | - A E de Rijk
- Department of Social Medicine, Faculty of Health, Medicine and Life Sciences, Research Institute Primary Care and Public Health (CAPHRI), Maastricht University, Universiteitssingel 40, Maastricht, The Netherlands
| | - M H W Frings-Dresen
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Meibergdreef 9, Amsterdam, The Netherlands
| | - A G E M de Boer
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Meibergdreef 9, Amsterdam, The Netherlands
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Robichaud MM, Truchon M, St-Arnaud L, Nastasia I. Insurers’ perspective on barriers and facilitators for return to work after occupational injuries. Work 2019; 63:81-97. [DOI: 10.3233/wor-192910] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- Marie-Maxime Robichaud
- Faculty of Education, Centre de recherche et d’intervention sur l’éducation et la vie au travail (CRIEVAT), Université Laval, Quebec, Canada
| | - Manon Truchon
- School of Psychology, Université Laval, Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Quebec, Canada
| | - Louise St-Arnaud
- Faculty of Education, Centre de recherche et d’intervention sur l’éducation et la vie au travail (CRIEVAT), Université Laval, Quebec, Canada
| | - Iuliana Nastasia
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), Montreal, Quebec, Canada
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Gruß I, Hanson G, Bradley C, McMullen C, Ritzwoller D, Hodge S, Varga A, Banegas MP. Colorectal cancer survivors' challenges to returning to work: A qualitative study. Eur J Cancer Care (Engl) 2019; 28:e13044. [PMID: 31006931 DOI: 10.1111/ecc.13044] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 02/22/2019] [Accepted: 03/25/2019] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To assess the challenges and needs of colorectal cancer (CRC) survivors in maintaining employment and returning to work (RTW) from the perspectives of both CRC survivors and employers in the United States. METHODS Semi-structured interviews with CRC survivors (n = 10) and employers (n = 4) were transcribed, coded and thematically analysed using NVivo 12 software. RESULTS Workplace challenges for survivors included the following: inadequate availability of paid and unpaid leave, limited availability of workplace accommodations, and employers' lack of knowledge about CRC and the recovery process. Survivors were concerned about the lack of adequate financial resources to take unpaid leave and the need to relearn control of bodily functions. Workplace challenges for employers of cancer survivors included the following: limited institutional flexibility to provide individualised accommodations, communication with frontline managers about leave availability for employees and communication with employees about legal protections and limitations. Employers perceived that employees were unwilling to take leave. CONCLUSION Colorectal cancer survivors in the US face difficult, sometimes insurmountable, challenges when trying to balance their physical and financial needs within the constraints of employment. Employers recognise challenges associated with this concern. Multi-level interventions-ranging from flexible work schedules to training for frontline managers-might facilitate the RTW process.
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Affiliation(s)
- Inga Gruß
- Kaiser Permanente Center for Health Research, Portland, Oregon
| | - Ginger Hanson
- Johns Hopkins University School of Nursing, Baltimore, Maryland
| | - Cathy Bradley
- Colorado School of Public Health, University of Colorado Denver, Aurora, Colorado
| | - Carmit McMullen
- Kaiser Permanente Center for Health Research, Portland, Oregon
| | - Debra Ritzwoller
- Kaiser Permanente Colorado Institute for Health Research, Aurora, Colorado
| | - Stephanie Hodge
- Kaiser Permanente Center for Health Research, Portland, Oregon
| | - Alexandra Varga
- Kaiser Permanente Center for Health Research, Portland, Oregon
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Kayes NM, Martin RA, Bright FA, Kersten P, Pollock A. Optimizing the real-world impact of rehabilitation reviews: increasing the relevance and usability of systematic reviews in rehabilitation. Eur J Phys Rehabil Med 2019; 55:331-341. [PMID: 30990002 DOI: 10.23736/s1973-9087.19.05793-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Despite a growing portfolio of rehabilitation reviews, uptake of review findings into practice remains slow, with review findings perceived to be lacking in relevance and usability for stakeholders. Key aspects of review design, production and dissemination have been identified to contribute to this knowledge translation (KT) gap. AIM The aim of this study is to identify strategies relevant to rehabilitation review design, production and dissemination which have the potential to optimize uptake of review findings into practice. RESULTS Two strategies are discussed, drawing on case examples of existing rehabilitation reviews, including: 1) involving stakeholders in review design, production and dissemination; and 2) moving towards theory-based, mixed methods review design. The merits of these strategies are discussed with reference to the unique and specific characteristics of the rehabilitation context, where there is complexity inherent in the multiple interacting components across population, intervention, context and implementation processes. CONCLUSIONS Moving towards theory-based, mixed methods reviews which involve stakeholders may be a critical first step in supporting uptake of review findings into rehabilitation practice. Doing so also has the potential to support advances in knowledge and practice in rehabilitation through theory development, as well as creating the context for evidence-based practice.
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Affiliation(s)
- Nicola M Kayes
- Center for Person-centered Research, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand -
| | - Rachelle A Martin
- Rehabilitation Teaching and Research Unit, University of Otago and Burwood Academy of Independent Living, Christchurch, New Zealand
| | - Felicity A Bright
- Center for Person-centered Research, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Paula Kersten
- School of Health Sciences, University of Brighton, Brighton, UK
| | - Alex Pollock
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
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Graff HJ, Siersma V, Møller A, Kragstrup J, Andersen LL, Egerod I, Malá Rytter H. Labour market attachment after mild traumatic brain injury: nationwide cohort study with 5-year register follow-up in Denmark. BMJ Open 2019; 9:e026104. [PMID: 30975680 PMCID: PMC6500196 DOI: 10.1136/bmjopen-2018-026104] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 03/12/2019] [Accepted: 03/13/2019] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Sickness absence after mild traumatic brain injury (mTBI) is frequent due to postconcussive symptoms. We examined labour market attachment following mTBI up to 5 years postinjury. DESIGN AND SETTING Nationwide cohort study with register follow-up. PARTICIPANTS Patients between 18 and 60 years with mTBI (International Classification of Diseases, version 10 diagnosis S06.0) were extracted from the Danish National Patient Register (n=19 732). Controls were matched on sex, age and municipality (n=18 640). Patients with spinal cord and column injuries, traumatic brain injury and concussions 5 years preinjury or as secondary diagnosis to the concussion in the inclusion period were excluded. PRIMARY AND SECONDARY OUTCOME MEASURES Data were extracted from the Danish Register for Evaluation of Marginalization. Primary outcome was 'not attending ordinary work' defined as receiving any social transfer payment. Secondary outcomes were health-related benefits, limited attachment to the labour market, permanent lack of attachment to the labour market and death. RESULTS 5 years after diagnosis, 43% of patients were not attending ordinary work. The odds increased from 6 months (OR 1.30, 95% CI 1.24 to 1.36) to 5 years (OR 1.54, 95% CI 1.45 to 1.63). The odds of health-related benefits were 32% (OR 1.32, 95% CI 1.22 to 1.42) at 6 months and 22% (OR 1.22, 95% CI 1.12 to 1.33) at 5 years. Limited attachment to the labour market showed increased odds at 5 years (OR 1.38, 95% CI 1.27 to 1.51) and the odds of permanent lack of attachment to the labour market were higher for patients compared with controls (OR 2.59, 95% CI 2.30 to 2.92). Death was more than two times higher at 5 years postinjury (OR 2.62, 95% CI 2.10 to 3.26). CONCLUSIONS 43% of concussed patients were not attending ordinary work 5 years postinjury and received health and social transfer benefits. We conclude that mTBI has a long-term impact on labour market attachment. Prevention and treatment of persisting postconcussive symptoms should be considered. TRIAL REGISTRATION NUMBER NCT03214432; Results.
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Affiliation(s)
- Heidi Jeannet Graff
- Department of Anaesthesia, Centre of Head and Orthopaedics, University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Volkert Siersma
- Department of Public Health, The Research Unit for General Practice and Section of General Practice, University of Copenhagen, Copenhagen, Denmark
| | - Anne Møller
- Department of Public Health, The Research Unit for General Practice and Section of General Practice, University of Copenhagen, Copenhagen, Denmark
- Department of Occupational and Social Medicine, Copenhagen University Hospital Holbaek, Holbaek, Denmark
| | - Jakob Kragstrup
- Department of Public Health, The Research Unit for General Practice and Section of General Practice, University of Copenhagen, Copenhagen, Denmark
| | - Lars L Andersen
- Musculoskeletal disorders and physical workload, National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Ingrid Egerod
- Department of intensive care, Centre for Cancer and Organ Diseases, University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Hana Malá Rytter
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
- Department of Neurology, University Hospital Bispebjerg-Frederiksberg, Copenhagen, Denmark
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Bohatko-Naismith J, James C, Guest M, Rivett DA, Ashby S. An exploratory study of the injured worker’s experience and relationship with the workplace return to work coordinator in NSW, Australia. INTERNATIONAL JOURNAL OF WORKPLACE HEALTH MANAGEMENT 2019. [DOI: 10.1108/ijwhm-07-2018-0089] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to provide insight into the injured worker’s perspective of experiences with their workplace return to work coordinator (RTWC), and explore some of the barriers they encountered in the return to work process.
Design/methodology/approach
Semi-structured interviews were conducted with ten injured workers from New South Wales, Australia. The thematic analysis of transcripts was completed.
Findings
The findings provide an insight into the experiences of injured workers and their relationship with RTWCs. Five key themes emerged from the data: return to work experiences and the RTWC role, high turnover and lack of consistency in the role, RTWC “ideal”, knowledge and skills, communication skills and the RTWC role and GP visits privacy and conflict of interest with peer RTWCs.
Practical implications
The role of the workplace RTWC in the return to work process for injured workers is important and these findings are highly relevant to the return to work sector. Consistency within the role at the workplace and careful consideration of the specific traits and characteristics required by an individual to perform the role need to be observed during the selection process by employers when appointing a workplace RTWC to assist injured workers return to work.
Originality/value
This is the first Australian study to examine the injured workers views and experiences with the workplace RTWC and other factors that shape the return to work process.
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Harari D, Casarotto RA. Effectiveness of a multifaceted intervention to manage musculoskeletal disorders in workers of a medium-sized company. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2019; 27:247-257. [DOI: 10.1080/10803548.2019.1575052] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Denise Harari
- Department of Physiotherapy, Communication Science & Disorders and Occupational Therapy, University of Sao Paulo, Brazil
| | - Raquel Aparecida Casarotto
- Department of Physiotherapy, Communication Science & Disorders and Occupational Therapy, University of Sao Paulo, Brazil
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Skarpaas LS, Haveraaen LA, Småstuen MC, Shaw WS, Aas RW. The association between having a coordinator and return to work: the rapid-return-to-work cohort study. BMJ Open 2019; 9:e024597. [PMID: 30782911 PMCID: PMC6398742 DOI: 10.1136/bmjopen-2018-024597] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 11/29/2018] [Accepted: 12/05/2018] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES The aim of this study was to assess if the reported provision of a coordinator was associated with time to first return to work (RTW) and first full RTW among sick-listed employees who participated in different rapid-RTW programmes in Norway. DESIGN The study was designed as a cohort study. SETTING Rapid-RTW programmes financed by the regional health authority in hospitals and Norwegian Labour and Welfare Administration in Norway. PARTICIPANTS The sample included employees on full-time sick leave (n=326) who participated in rapid-RTW programmes (n=43), who provided information about the coordination of the services they received. The median age was 46 years (minimum-maximum 21-67) and 71% were female. The most common reported diagnoses were musculoskeletal (57%) and mental health disorders (14%). INTERVENTIONS The employees received different types of individually tailored RTW programmes all aimed at a rapid RTW; occupational rehabilitation (64%), treatment for medical or psychological issues, including assessment, and surgery (26%), and follow-up and work clarification services (10%). It was common to be provided with a coordinator (73%). PRIMARY AND SECONDARY OUTCOME MEASURES Outcomes were measured as time to first RTW (graded and 100%) and first full RTW (100%). RESULTS Employees provided with a coordinator returned to work later than employees who did not have a coordinator; a median (95% CI) of 128 (80 to 176) days vs 61 (43 to 79) days for first RTW, respectively. This difference did not remain statistically significant in the adjusted regression analysis. For full RTW, there was no statistically significant difference between employees provided with a coordinator versus those who were not. CONCLUSIONS The model of coordination, provided in the Norwegian rapid-RTW programmes was not associated with a more rapid RTW for sick-listed employees. Rethinking how RTW coordination should be organised could be wise in future programme development.
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Affiliation(s)
- Lisebet Skeie Skarpaas
- Presenter - Making Sense of Science, Stavanger, Norway
- Department of Occupational Therapy, Prosthetics and Orthotics, Oslo Metropolitan University, Oslo, Norway
| | | | | | - William S Shaw
- Division of Occupational & Environmental Medicine, University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Randi Wågø Aas
- Presenter - Making Sense of Science, Stavanger, Norway
- Department of Occupational Therapy, Prosthetics and Orthotics, Oslo Metropolitan University, Oslo, Norway
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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Dekkers-Sánchez PM, de Wind AE. Enhancing medical evaluations of sick-listed employees: an educational intervention to improve professional practice of physicians performing work ability assessments of employees on long-term sick leave. Int Arch Occup Environ Health 2019; 92:729-738. [PMID: 30673838 DOI: 10.1007/s00420-019-01409-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 01/17/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE Long-term sick leave (LTSL) is a complex phenomenon. Medical and non-medical factors can delay return-to-work (RTW); therefore, the assessment of work ability is complicated. A checklist for identifying factors associated with delayed RTW was developed in a prior study to facilitate the exploration of barriers and facilitators for RTW. The purpose of the present study was to determine if use of the checklist enhances professional practice of physicians performing work ability assessments of employees on long-term sick leave and whether the reporting of work ability assessments improved when using the checklist in the routinely practice-based context. METHODS An educational intervention study was performed using qualitative framework analysis. Thirty-five Dutch physicians were asked to identify and report the barriers and facilitators for RTW and the consequences for the work ability and for the prognosis regarding work reintegration using the checklist. A pre-post qualitative analysis of the medical records was performed using a gradual classification of the reporting of the work ability to evaluate the change in reporting following the educational intervention. RESULTS A total of 337 work ability assessments were performed using the checklist. The identification of factors influencing RTW and the comprehensiveness of the medical records increased when compared with the reporting before the educational intervention. The reporting of the work ability assessments improved after the educational intervention. Most physicians reported at least one of the factors of the checklist. 72% participants reported and described adequately at least one factor. 48% participants reported how the factors influenced the work ability, 20% participants reported how the factors influenced the prognosis regarding RTW and 12% participants reported which advice was provided by the physician to influence the barriers for RTW. CONCLUSIONS Use of the checklist enhances professional practice of physicians performing work ability assessments of employees on long-term sick leave and is associated with increased identification of barriers and facilitators for RTW. The use of the checklist should be considered to improve professional practice of physicians performing work ability assessments.
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Affiliation(s)
- Patricia M Dekkers-Sánchez
- Department of Social Medical Affairs, Dutch Employee Insurance Agency (UWV), Rotterdam, The Netherlands.
| | - Annette E de Wind
- Department of Social Medical Affairs, Dutch Employee Insurance Agency (UWV), Rotterdam, The Netherlands.,Environment and Health, Department of Public Health and Primary Care, KU Leuven University, Leuven, Belgium
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Lefever M, Decuman S, Perl F, Braeckman L, Van de Velde D. The efficacy and efficiency of Disability Management in job-retention and job-reintegration. A systematic review. Work 2018; 59:501-534. [PMID: 29733052 DOI: 10.3233/wor-182709] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Disability management (DM) is a systematic method to ensure job-retention and job-reintegration in competitive employment for individuals with a disability. There is evidence that 'returning to work' has a positive impact on the individual, the company and on the society. However, a clear overview of the efficacy and efficiency of the DM programs is scarce. OBJECTIVE To systematically review the efficacy and efficiency of the disability management programs. Cochrane, PubMed, Google Scholar, and Web of Science were searched from 1994 to 2015. METHODS Two reviewers independently evaluated the articles on title, abstract, and full text. The data extraction and results are documented according to the study designs. RESULTS Twenty-eight articles were included in the review. These 28 articles consisted of 7 systematic reviews, 3 randomized controlled trials, 9 clinical trials, 4 mixed-method studies and 5 qualitative studies. CONCLUSIONS The DM program has shown to be effective and efficient. A consensus about the DM components is still not reached. Nevertheless, some components are emphasized more than others; job accommodation, facilitation of transitional duty, communication between all stakeholders, health care provider advice, early intervention, and acceptance, goodwill and trust in the stakeholders, in the organization, and in the disability management process.
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Affiliation(s)
- Marlies Lefever
- Department of Rehabilitation Sciences and Physiotherapy, Occupational Therapy Program, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Saskia Decuman
- Department of Benefits, National Institute of Health and Disability Insurance, Brussels, Belgium.,Department of Internal Medicine, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - François Perl
- Department of Benefits, National Institute of Health and Disability Insurance, Brussels, Belgium
| | - Lutgart Braeckman
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Dominique Van de Velde
- Department of Rehabilitation Sciences and Physiotherapy, Occupational Therapy Program, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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Awang H, Mansor N. Predicting Employment Status of Injured Workers Following a Case Management Intervention. Saf Health Work 2018; 9:347-351. [PMID: 30370168 PMCID: PMC6129999 DOI: 10.1016/j.shaw.2017.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 09/27/2017] [Accepted: 11/09/2017] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The success of an injury intervention program can be measured by the proportion of successful return to work (RTW). This study examined factors of successful return to employment among workers suffering from work-related injuries. METHODS Data were obtained from the Social Security Organization, Malaysia database consisting of 10,049 RTW program participants in 2010-2014. The dependent variable was the RTW outcome which consisted of RTW with same employer, RTW with new employer or unsuccessful return. Multinomial logistic regression was performed to test the likelihood of successful return with same employer and new employer against unsuccessful return. RESULTS Overall, 65.3% of injured workers were successfully returned to employment, 52.8% to the same employer and 12.5% to new employer. Employer interest; motivation; age 30-49 years; intervention less than 9 months; occupational disease; injuries in the lower limbs, upper limbs, and general injuries; and working in the manufacturing, services, and electrical/electronics were associated with returning to work with the same employer against unsuccessful return. Male, employer interest, motivation, age 49 years or younger, intervention less than 6 months, occupational disease, injuries in the upper limbs and services sector of employment were associated with returning to new employer against unsuccessful return. CONCLUSION There is a need to strengthen employer commitment for early and intensified intervention that will lead to improvement in the RTW outcome.
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Affiliation(s)
- Halimah Awang
- Social Security Research Centre, University of Malaya, Kuala Lumpur, Malaysia
| | - Norma Mansor
- Social Security Research Centre, University of Malaya, Kuala Lumpur, Malaysia
- Faculty of Economics and Administration, University of Malaya, Kuala Lumpur, Malaysia
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