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Saghebdoust S, Khadivar F, Ekrami M, Mehrizi MAA, Lajimi AV, Zahmatkesh MRR, Pak N, Jouibari MF, Mirsaeed SSG, Boustani MR. Transforaminal Endoscopic Lumbar Diskectomy versus Open Microdiskectomy for Symptomatic Lumbar Disk Herniation: A Comparative Cohort Study on Costs and Long-Term Outcomes. J Neurol Surg A Cent Eur Neurosurg 2023. [PMID: 37879346 DOI: 10.1055/s-0043-1775760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
BACKGROUND Transforaminal endoscopic lumbar diskectomy (TELD) is considered an effective treatment for lumbar disk herniation (LDH). There is a paucity of studies comparing in detail the costs and long-term clinical outcomes of TELD and open microdiskectomy (MD), especially in developing countries. Thus, we sought to provide a multidimensional insight into this matter by comparing the direct costs and long-term outcomes of TELD with those of MD. METHODS The electronic health records of 434 patients with LDH who underwent either TELD or MD were collected from February 2011 to October 2014. Within a 7-year follow-up period, 412 patients, comprising 203 patients treated with TELD and 209 patients treated with MD, were fully evaluated. Patient characteristics, operative time, intraoperative blood loss (IBL), postoperative hospital stay, time to return to work (RTW), perioperative complications, and direct costs were collected. Clinical outcomes were assessed using the Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and modified MacNab criteria. RESULTS The postoperative ODI and VAS scores improved significantly in both groups (p < 0.001). In accordance with the modified MacNab criteria, the rate of excellent and good outcomes was 88.67 and 88.03% in the TELD and MD groups, respectively. There were no significant differences between the groups in the clinical outcomes and perioperative complications. However, IBL, hospital stay, and RTW were significantly reduced in the TELD group (p < 0.05). Twenty-one cases in the TELD group and nine in the MD group underwent reoperation due to recurrence (p < 0.05). Total inpatient cost per patient was $1,596 in the TELD group and $1,990 in the MD group (p < 0.05). CONCLUSION TELD for the treatment of symptomatic LDH could be an affordable strategy, providing certain advantages of minimally invasive procedures such as shorter hospital stay and earlier recovery along with comparable clinical outcomes to the conventional surgical method.
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Affiliation(s)
- Sajjad Saghebdoust
- Department of Neurosurgery, Razavi Hospital, Mashhad, Iran
- Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Department of Neurosurgery, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farshid Khadivar
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Mehran Ekrami
- Department of Neurosurgery, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Amir Valinezhad Lajimi
- Department of Neurosurgery, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Reza Rouhbakhsh Zahmatkesh
- Department of Neurosurgery, Razavi Hospital, Mashhad, Iran
- Department of Neurosurgery, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Neda Pak
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Morteza Faghih Jouibari
- Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mohammad Reza Boustani
- Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Department of Neurosurgery, Golestan Hospital, Tehran, Iran
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Audet J, Lecours A, Nastasia I. Experiences in the return-to-work process of workers having suffered occupational injuries in small and medium size enterprises. Work 2023; 74:265-281. [PMID: 36214011 DOI: 10.3233/wor-210763] [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: 01/15/2023] Open
Abstract
BACKGROUND Small and medium-sized enterprises (SMEs) represent 95 % of businesses and are economically essential. When occupational injuries occur, scientific literature suggests that the return-to-work (RTW) success rate is proportional to the size of enterprises and the way RTW is managed may put workers in SMEs at risk. As most studies on RTW organizational practices have been conducted with large enterprises, little is known about how RTW is managed in SMEs. OBJECTIVE The aim of this study was to explore SME's organizational practices in the RTW process of workers having suffered an occupational injury. METHODS Semi-structured phone interviews were conducted with 15 participants from 3 different stakeholder categories (i.e., SME representatives, workers, and healthcare professionals) in order to explore their experiences regarding RTW in SMEs. Data were analyzed using a phenomenological analysis strategy. RESULTS SMEs' organisational practices evoked by participants gather in three themes: 1) Reducing the risks of occupational injuries (i.e., ensuring injury prevention), 2) Managing occupational injuries (i.e., dealing with the initial occupational injury, handling administrative aspects of work disability, and being actively involved in the RTW process), and 3) Preventing consequences of occupational injuries (i.e., adapting operations following injuries). CONCLUSION Organizational practices for RTW are used diversely in SMEs. Proposed lines of action adapted to the realities and needs of SMEs may be beneficial to hundreds of thousands of workers, enterprises and professionals involved in the RTW process.
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Affiliation(s)
- Jessika Audet
- Département d'ergothérapie, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada.,Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Québec, QC, Canada
| | - Alexandra Lecours
- Département d'ergothérapie, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada.,Center for Interdisciplinary Research in Rehabilitation and Social Integration (Cirris), Québec, QC, Canada
| | - Iuliana Nastasia
- Institut de Recherche Robert-Sauvé en Santé et en Sécurité du Travail (IRSST), Montréal, QC, Canada
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Hedlund Å, Boman E, Kristofferzon ML, Nilsson A. Development and psychometric evaluation of a theory-based questionnaire measuring women's return-to-work beliefs after long-term sick leave for common mental disorders. Work 2023; 76:109-124. [PMID: 36806536 PMCID: PMC10578269 DOI: 10.3233/wor-220301] [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: 06/08/2022] [Accepted: 11/02/2022] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND Common mental disorders (CMDs) are currently a major cause of long-term sick leave, with women being most affected. OBJECTIVE Using the Theory of Planned Behaviour (TPB), we aimed to describe the development and psychometric evaluation of a new questionnaire to measure women's beliefs about return to work (RTW) after long-term sick leave for CMDs. METHODS Data were collected in central Sweden from women on long-term sick leave (2- 24 months) for CMDs. The questionnaire was developed by conducting an elicitation study with 20 women and included both direct and indirect measures. Subsequently, 282 women participated in a psychometric evaluation and 35 of them in a test-retest procedure. Psychometric properties were evaluated by determining reliability (internal consistency [Cronbach's alpha] and test-retest stability [intraclass correlation coefficient]), construct validity (exploratory factor analysis) and content validity. RESULTS The development resulted in 60 questionnaire items. Content validity assessment showed that the women overall found it easy to complete the questionnaire. Reliability analyses showed satisfactory results for both direct and indirect measures, with a few exceptions. Factor analyses of the indirect scales showed that items were generally in line with the TPB, but that items related to life as a whole/personal life and items related to work were separated into two different factors. CONCLUSION The questionnaire, called the RTW Beliefs Questionnaire, showed promising results and can among women with CMDs be considered useful, especially the scales for direct measures. This questionnaire gives opportunity to identify new potential predictors for RTW.
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Affiliation(s)
- Åsa Hedlund
- Department of Caring Sciences, University of Gävle, Gävle, Sweden
| | - Eva Boman
- Department of Occupational Health Science and Psychology, University of Gävle, Gävle, Sweden
| | | | - Annika Nilsson
- Department of Caring Sciences, University of Gävle, Gävle, Sweden
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Sullivan V, Wilson MN, Gross DP, Jensen OK, Shaw WS, Steenstra IA, Hayden JA. Expectations for Return to Work Predict Return to Work in Workers with Low Back Pain: An Individual Participant Data (IPD) Meta-Analysis. JOURNAL OF OCCUPATIONAL REHABILITATION 2022; 32:575-590. [PMID: 35152369 DOI: 10.1007/s10926-022-10027-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/01/2022] [Indexed: 06/14/2023]
Abstract
Purpose Low back pain is associated with disability and lost productivity due to inability of workers to return to work. Personal recovery expectation beliefs may be associated with return to work outcomes in those with low back pain at high risk for chronic disability. We aimed to (1) assess whether workers' expectations for return to work, following a low back pain episode, are associated with subsequent return to work; and (2) explore the relationships between return to work expectations and other prognostic factors in their association with work outcomes.Methods We conducted an Individual Participant Data (IPD) meta-analysis using data from five prospective cohort studies identified by a Cochrane prognostic factor review. A one-stage IPD meta-analysis approach was applied. Multi-level mixed effects models were used to determine the unadjusted and adjusted associations between expectations and return to work (logistic regression) and time to return to work (parametric survival models with Weibull distribution).Results The final dataset included 2302 participants. Positive expectations for return to work were associated with return to work at follow-up in both unadjusted (Odds Ratio (OR) 2.95; 95% Confidence Interval (CI) 2.21, 3.95) (n = 2071) and comprehensively adjusted (OR 2.01; 95% CI 1.46, 2.77) (n = 1109) models. Similar findings were identified for shorter length of time to return to work in both unadjusted (HR 2.40; 95% CI 2.09, 2.75) (n = 1156) and minimally adjusted (HR 2.43; 95% CI 2.12, 2.79) (n = 1154) models.Conclusions Results suggest workers with low expectations for return to work are at increased risk for long-term work disability.
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Affiliation(s)
- Victoria Sullivan
- Department of Community Health & Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada.
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
| | - Maria N Wilson
- Department of Community Health & Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Douglas P Gross
- Department of Physical Therapy, University of Alberta, Edmonton, Canada
| | - Ole Kudsk Jensen
- Spine Center, University Research Clinic for Innovative Patient Pathways, Silkeborg Regional Hospital, Silkeborg, Denmark
| | - William S Shaw
- Division of Occupational and Environmental Medicine, Departments of Medicine and Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Ivan A Steenstra
- Epidemiologist, Director Program Evaluation & Research Outcomes, LifeWorks, Toronto, ON, Canada
| | - Jill A Hayden
- Department of Community Health & Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
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Hedlund Å, Nilsson A, Boman E, Kristofferzon M. Predictors of return to work and psychological well-being among women during/after long-term sick leave due to common mental disorders - a prospective cohort study based on the theory of planned behaviour. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e5245-e5258. [PMID: 35894151 PMCID: PMC10087653 DOI: 10.1111/hsc.13943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 07/01/2022] [Accepted: 07/12/2022] [Indexed: 06/15/2023]
Abstract
Common mental disorders are associated with long-term sick leave, especially among women. There is a lack of theory-based research regarding the impact of personal factors on return to work and psychological well-being. Therefore, the aim of this study was to examine whether return-to-work beliefs and perceived health were predictors of return to work and psychological well-being among women during or after long-term sick leave for common mental disorders, based on the Theory of Planned Behaviour. This was a prospective cohort study with a 1-year follow-up. At baseline, women (n = 282) had been on full- or part-time sick leave for common mental disorders for 2-24 months. Data were collected in October 2019-January 2020 and October 2020-January 2021 in Sweden. The Social Insurance Agency identified the women at baseline. The Return-To-Work Beliefs Questionnaire, EuroQol Visual Analogue Scale and General Health Questionnaire-12 were used. Multiple logistic and linear regression analyses were conducted. The women were divided into two groups: full-time sick leave or part-time sick leave at baseline. The results showed that stronger return-to-work intention significantly predicted return to work among women on full-time sick leave at baseline. No significant predictors of return to work were found among women on part-time sick leave at baseline. Psychological well-being was predicted by stronger social pressure to return to work (full-time group) and a more positive attitude toward returning to work and better perceived health (part-time group). We concluded that the Theory of Planned Behaviour can be useful for understanding return to work among women on full-time sick leave, and what underlies psychological well-being in both groups. However, return to work and psychological well-being were predicted by different factors, indicating that a multifactorial approach should be used in supporting women to return to work after long-term sick leave for common mental disorders.
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Affiliation(s)
- Åsa Hedlund
- Department of Caring SciencesUniversity of GävleGävleSweden
| | - Annika Nilsson
- Department of Caring SciencesUniversity of GävleGävleSweden
| | - Eva Boman
- Department of Occupational Health and PsychologyUniversity of GävleGävleSweden
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La Torre G, Lia L, Francavilla F, Chiappetta M, De Sio S. Factors that facilitate and hinder the return to work after stroke: an overview of systematic reviews. LA MEDICINA DEL LAVORO 2022; 113:e2022029. [PMID: 35766644 PMCID: PMC9437659 DOI: 10.23749/mdl.v113i3.13238] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 06/09/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Stroke is one of the leading causes of death and disability in the industrialized world and a large part of stroke survivors is of working age. A very important goal for these people is to return to work after stroke as it facilitates independent living and guarantees a high level of self-esteem and life satisfaction. AIM To find the main factors that facilitate and hinder the return to work (RTW) in people who suffered from stroke through an overview of systematic reviews. METHODS A systematic search using keywords and medical subject heading terms was conducted in January 2022, three electronic databases were searched: Medline (PubMed), Scopus and ISI Web. The articles that address the question of returning to work or maintaining employment of people of working age after stroke were included in the systematic review, as well as studies describing factors that facilitate and/or hinder RTW after stroke. Only systematic reviews written in English language were included in this overview. RESULTS The search revealed 180 records after removing duplicates, but only a total of 24 systematic reviews were included in the overview. This research shows that in people who have suffered from a stroke, individual abilities, socioeconomic factors, healthcare factors, and disabilities resulting from the stroke itself are the most critical factors influencing the RTW. Conclusion: Future research should focus on cognitive disabilities, as main RTW hindering factor, and vocational rehabilitation, as the more suitable factor for improving the RTW in stroke survivors.
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Abedi M, Gane E, Aplin T, Zerguine H, Johnston V. Barriers and Facilitators Associated with Return to Work Following Minor to Serious Road Traffic Musculoskeletal Injuries: A Systematic Review. JOURNAL OF OCCUPATIONAL REHABILITATION 2022; 32:13-26. [PMID: 34241769 DOI: 10.1007/s10926-021-09994-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/30/2021] [Indexed: 06/13/2023]
Abstract
Purpose To identify factors impeding or facilitating Return to Work (RTW) after minor to serious musculoskeletal Road Traffic Injuries (RTI). Methods Six electronic databases were searched for studies published 1997-2020. Quantitative and qualitative studies were included if they investigated barriers or facilitators associated with RTW in people with minor to serious musculoskeletal RTI aged over 16 years. Methodological quality was assessed using McMaster Critical Review Form for Quantitative studies and McMaster Critical Review Form for Qualitative Studies. Results are presented narratively as meta-analysis was not possible. Results Eleven studies (10 quantitative and 1 qualitative) were included. There was strong evidence that individuals with higher overall scores on the (short-form or long-form) Örebro Musculoskeletal Pain Questionnaire (ÖMPQ) at baseline were less likely to RTW, and individuals with higher RTW expectancies at baseline were more likely to RTW after musculoskeletal RTI. There was weak evidence for higher disability levels and psychiatric history impeding RTW after musculoskeletal RTI. Conclusions Post-injury scores on the ÖMPQ and RTW expectancies are the most influential factors for RTW after minor to serious musculoskeletal RTI. There is a need to identify consistent measures of RTW to facilitate comparisons between studies.
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Affiliation(s)
- Masoumeh Abedi
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia.
| | - Elise Gane
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
- Physiotherapy Department, Princess Alexandra Hospital, Brisbane, QLD, Australia
- Centre for Functioning and Health Research, Metro South Health, Brisbane, QLD, Australia
| | - Tammy Aplin
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
- Allied Health Research Collaborative, The Prince Charles Hospital, Brisbane, QLD, Australia
| | - Haroun Zerguine
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Venerina Johnston
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
- RECOVER Injury Research Centre, The University of Queensland, Brisbane, QLD, Australia
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Liu F, Zhang Z, Lin B, Ping Z, Mei Y. Assessing the psychometric properties of the Chinese return-to-work self-efficacy questionnaire using Rasch model analysis. Health Qual Life Outcomes 2022; 20:27. [PMID: 35172850 PMCID: PMC8848945 DOI: 10.1186/s12955-022-01929-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 01/25/2022] [Indexed: 01/01/2023] Open
Abstract
Background Self-efficacy is a significant predictor of return to work and affects the confidence of survivors to return to work after illness. The Return-to-work self-efficacy (RTW-SE) questionnaire is a self-report questionnaire to assess confidence in returning to work with good reliability and validity. The aim of this study was to translate and cross-culturally adapt the RTW-SE questionnaire into Chinese and examine the psychometric properties among young and middle-aged stroke survivors using Rasch model analysis. Methods The cross-cultural adaptation and translation procedures followed a dual-translation approach. The psychometric properties of the RTW-SE questionnaire were examined using Rasch model analysis by Winsteps software. The unidimensionality and local independence were analyzed by principal component analysis of the residuals (PCAR) and standardized residual correlations.Category diagnostics were performed for scale function, and the item fit, reliability, and separation were also validated. Item-person maps were used to examine the distribution and matching of item’s location and person ability. Finally, the differential item functioning (DIF) was used to measure gender-related group equivalence. Results A total of 366 participants aged 23–59 years were recruited from three communities in Zhengzhou. The RTW-SE questionnaire demonstrated unidimensionality and a 5-point Likert rating scale was more appropriate to investigate young and middle-aged stroke survivors’self-efficacy. There was a good fit for the items with both person and item reliabilities greater than 0.8 and separation indices of 3.75 and 3.94, respectively. The item location was identified from the item-person map as not covering person ability, but the scale did not have an age-related DIF. Conclusions The results confirm evidence of appropriate psychometric properties of the RTW-SE questionnaire and can be used as a reliable and validated instrument for measuring self-efficacy to return to work in young and middle-aged Chinese patients with stroke.
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Affiliation(s)
- Feng Liu
- School of Nursing and Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, 450001, Henan, China
| | - Zhenxiang Zhang
- School of Nursing and Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, 450001, Henan, China.
| | - Beilei Lin
- School of Nursing and Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, 450001, Henan, China
| | - Zhiguang Ping
- School of Nursing and Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, 450001, Henan, China
| | - Yongxia Mei
- School of Nursing and Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, 450001, Henan, China
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Duong HP, Garcia A, Hilfiker R, Léger B, Luthi F. Systematic Review of Biopsychosocial Prognostic Factors for Return to Work After Acute Orthopedic Trauma: A 2020 Update. FRONTIERS IN REHABILITATION SCIENCES 2022; 2:791351. [PMID: 36188871 PMCID: PMC9397710 DOI: 10.3389/fresc.2021.791351] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 12/17/2021] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To provide updated evidence on prognostic factors for return to work (RTW) in the early and late phases after acute orthopedic trauma from a biopsychosocial perspective. METHODS A systematic review of articles indexed in the MEDLINE, CINAHL, and Embase databases between 2010 and 2020 was performed. The inclusion criteria were cohort studies of employed populations sustaining acute orthopedic trauma with follow-up data on RTW. Biopsychosocial prognostic factors for RTW must be reported in the multiple regression models and divided into early (≤ 6 months) and late phases (> 6 months) postinjury. Two reviewers performed study selection, assessed the risk of bias and quality using the Quality in Prognosis Studies (QUIPS) tool and the Newcastle-Ottawa Scale (NOS), and extracted data independently. RESULTS Thirty articles were included with a follow-up period of 1-58 months. Based on the QUIPS tool, 7 studies (23%) were considered to have a low risk of bias, and 21 studies (70%) were considered to have a moderate risk of bias. Based on the NOS, the quality was high in 87% of the included studies. The RTW rates ranged from 22% to 74% in the early phase and from 44% to 94% in the late phase. In the early phase, strong evidence was found for injury severity. In the late phase, strong evidence was found for age, injury severity, level of pain, self-efficacy, educational level, blue-collar work, and compensation status; moderate evidence was found for recovery expectations and physical workload. There was limited or inconsistent evidence for the other factors. CONCLUSION Based on the levels of evidence, injury severity should be considered as one of the key barriers to RTW in the early and late phases postinjury. This finding underlines the need for serious injury prevention efforts. Our results also emphasize the multifaceted actions of the biopsychosocial model to facilitate RTW: promoting policies for older injured workers, improving access to medical and rehabilitation facilities, and adapting physical workload. Multiple other factors are likely important but require additional high-quality studies to assess their role in the RTW process.
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Affiliation(s)
- Hong Phuoc Duong
- Department of Medical Research, Clinique Romande de Réadaptation, Sion, Switzerland
| | - Anne Garcia
- Department of Musculoskeletal Rehabilitation, Clinique Romande de Réadaptation, Sion, Switzerland
| | - Roger Hilfiker
- School of Health Sciences, HES-SO Valais-Wallis, Sion, Switzerland
| | - Bertrand Léger
- Department of Medical Research, Clinique Romande de Réadaptation, Sion, Switzerland
| | - François Luthi
- Department of Medical Research, Clinique Romande de Réadaptation, Sion, Switzerland
- Department of Musculoskeletal Rehabilitation, Clinique Romande de Réadaptation, Sion, Switzerland
- Department of Physical Medicine and Rehabilitation, Orthopedic Hospital, Lausanne University Hospital, Lausanne, Switzerland
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Rashid M, Kristofferzon ML, Nilsson A. Predictors of return to work among women with long-term neck/shoulder and/or back pain: A 1-year prospective study. PLoS One 2021; 16:e0260490. [PMID: 34813601 PMCID: PMC8610267 DOI: 10.1371/journal.pone.0260490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 11/10/2021] [Indexed: 11/24/2022] Open
Abstract
Background Sick leave due to musculoskeletal pain, particularly in the neck/shoulders and back, is one of the major public health problems in Western countries such as Sweden. The aim of this study was to identify predictors of return to work (RTW) among women on sick leave due to long-term neck/shoulder and/or back pain. Methods This was a prospective cohort study with a 1-year follow-up. The study participants were recruited from a local Swedish Social Insurance Agency register and had all been on sick leave for ≥ 1 month due to long-term (≥ 3 months) neck/shoulder and/or back pain. Data on predictors and outcome were collected using a self-administered questionnaire. A total of 208 women aged 23–64 years were included at baseline, and 141 responded at the 1-year follow-up. Cluster analyses were performed to identify one predictor from each cluster for use in the regression model. Results At the 1-year follow-up, 94 of the 141 women had RTW and 47 had not. Women who engaged in more coping through increasing behavioral activities (OR: 1.14, 95% CI: 1.03–1.25) and those who more strongly believed they would return to the same work within 6 months (OR: 1.22, 95% CI: 1.10–1.37) had an increased probability of RTW. Receiving more social support outside work (OR: 0.50, 95% CI: 0.28–0.92) decreased the odds of RTW at the 1-year follow-up. Conclusions Behavioral activities, beliefs about returning to the same work, and social support outside work were predictors of RTW at the 1-year follow-up. Healthcare professionals should consider these predictors in their efforts to prevent prolonged sick leave and to promote RTW in this population.
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Affiliation(s)
- Mamunur Rashid
- Department of Public Health and Sports Sciences, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden
| | - Marja-Leena Kristofferzon
- Department of Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden
| | - Annika Nilsson
- Department of Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden
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Maddineshat M, Cheraghi F, Ghaleiha A, Khalafbeigi M, Sadeghian E. Identifying Return to Work Perception in People With Serious Mental Illness: A Qualitative Study. J Psychosoc Nurs Ment Health Serv 2021; 60:11-20. [PMID: 34677119 DOI: 10.3928/02793695-20211014-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The current qualitative study sought to identify return to work (RTW) perception among people with serious mental illness (SMI) referred to a psychiatric hospital affiliated with Hamadan University of Medical Sciences. In total, 24 individuals were recruited, including working people with SMI, families, employers, and mental health team members who participated in in-depth, semi-structured interviews. Forty interviews were conducted. Interviews were analyzed based on the conventional content analysis approach. Accordingly, two themes were found, including The Need to Continue Working and Flexible and Supportive Strategies. The first theme included two categories: personal obligations and socioeconomic necessities. The second theme included three categories: coping with mental illness, requesting support from others, and coping with work conditions. Findings revealed that the need to continue working has a significant effect on RTW perception among people with SMI. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].
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Ahn Y, Yoo BR, Jung JM. The irony of the transforaminal approach: A comparative cohort study of transforaminal endoscopic lumbar discectomy for foraminal versus paramedian lumbar disc herniation. Medicine (Baltimore) 2021; 100:e27412. [PMID: 34622848 PMCID: PMC8500638 DOI: 10.1097/md.0000000000027412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 09/17/2021] [Indexed: 01/05/2023] Open
Abstract
Transforaminal endoscopic lumbar discectomy (TELD) is useful for soft lumbar disc herniation (LDH). Although the transforaminal approach can reach the foraminal disc zone, the risk of exiting nerve root irritation along the path is considerable. Few studies have assessed the difficulties of TELD for foraminal LDH. The objective of this study is to compare the clinical results of TELD between foraminal or far-lateral LDH and paramedian LDH.Between June 2016 and July 2017, 135 consecutive patients with single-level LDH were treated with TELD for 2 years. Among them, 25 patients had foraminal or far-lateral LDH (foraminal group), and the remaining 110 patients had central or subarticular LDH (paramedian group). Perioperative data and clinical outcomes were evaluated using the visual analog pain scale, Oswestry Disability Index, and modified Macnab criteria.The foraminal group showed a higher rate of significant access pain (24.00% vs 8.19%, P < .05). The foraminal group also had a longer duration of surgery, length of hospital stay, and return to work (all P < .05). Pain scores and functional status were significantly improved in both groups. Although there were no differences in the outcomes at 2 years postoperatively, early pain and disability at 6 weeks were higher in the foraminal group.Ironically, the early clinical results of TELD for foraminal LDH may be less favorable than those for paramedian LDH. Therefore, great care should be taken during TELD for foraminal or far-lateral LDH.
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Gragnano A, Villotti P, Larivière C, Negrini A, Corbière M. A Systematic Search and Review of Questionnaires Measuring Individual psychosocial Factors Predicting Return to Work After Musculoskeletal and Common Mental Disorders. JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:491-511. [PMID: 33355911 PMCID: PMC8298352 DOI: 10.1007/s10926-020-09935-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/20/2020] [Indexed: 05/07/2023]
Abstract
Purpose Individual psychosocial factors are crucial in the return to work (RTW) process of workers with musculoskeletal disorders (MSDs) and common mental disorders (CMDs). However, the quality and validity of the questionnaires used to measure these factors have rarely been investigated. The present systematic search and literature review aims at identifying, categorizing, and evaluating the questionnaires (measurement tools) used to measure individual psychosocial factors related to the perception of the personal condition and motivation to RTW that are predictive of successful RTW among workers with MSDs or CMDs. Methods Through a systematic search on PubMed, Web of Science, and PsycINFO library databases and grey literature, we identified the individual psychosocial factors predictive of successful RTW among these workers. Then, we retrieved the questionnaires used to measure these factors. Finally, we searched for articles validating these questionnaires to describe them exhaustively from a psychometric and practical point of view. Results: The review included 76 studies from an initial pool of 2263 articles. Three common significant predictors of RTW after MSDs and CMDs emerged (i.e., RTW expectations, RTW self-efficacy, and work ability), two significant predictors of RTW after MSDs only (i.e., work involvement and the self-perceived connection between health and job), and two significant predictors of RTW after CMDs only (i.e., optimism and pessimism). We analyzed 30 questionnaires, including eight multiple-item scales and 22 single-item measures. Based on their psychometric and practical properties, we evaluated one of the eight multiple-item scales as questionable and five as excellent. Conclusions: With some exceptions (i.e., self-efficacy), the tools used to measure individual psychosocial factors show moderate to considerable room for improvement.
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Affiliation(s)
- Andrea Gragnano
- Department of Psychology, Università degli Studi di Milano-Bicocca, Piazza dell'Ateneo Nuovo, 1, Milan, 20126, Italy.
| | - Patrizia Villotti
- Career counselling - Department of Education and Pedagogy, Université du Québec à Montréal, Montreal, Canada
| | - Christian Larivière
- Institut de Recherche Robert-Sauvé en Santé et en Sécurité du Travail, Montreal, Canada
| | - Alessia Negrini
- Institut de Recherche Robert-Sauvé en Santé et en Sécurité du Travail, Montreal, Canada
| | - Marc Corbière
- Career counselling - Department of Education and Pedagogy, Université du Québec à Montréal, Montreal, Canada
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada
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Hedlund Å. An overlooked concept? Intention to return to work among individuals on sick leave due to common mental disorders: A scoping review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:602-611. [PMID: 33506561 DOI: 10.1111/hsc.13293] [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] [Received: 09/23/2020] [Revised: 12/14/2020] [Accepted: 01/05/2021] [Indexed: 06/12/2023]
Abstract
Intention to return to work (RTW) is an important predictor of actual RTW among individuals on sick leave in general. However, it is not known whether this is also the case for individuals with common mental disorders (CMDs). Because CMDs are a leading cause of disability worldwide, the RTW process is often more complex and sick leave periods are longer than for other diagnoses. Thus, it is important to focus solely on this group. The purpose of this scoping review was to summarise studies targeting individuals' RTW intention and its importance for actual RTW after sick leave due to CMDs. Studies relevant for the aim were identified by a structured searching in three electronic databases (PubMed, CINAHL and PsycINFO) from their inception until the end of June 2020, as well as grey literature and reference lists of included articles. To cover all aspects of "intention", close concepts such as "expectation" and "willingness" were searched for as well. After the selection process, 10 original research papers were included in the review: eight quantitative and two qualitative. Nine of the studies used the concept "expectation" and one "intention". There was also a lack of consistency in measurements across studies. However, they showed that intention (expectation) was a significant predictor of actual RTW. The conclusion is that RTW intention among individuals after sick leave due to CMDs has been narrowly investigated, with a lack of consistency in measurements. Future research should use behavioural-psychological theories to cover the concept "intention" in a more comprehensive and consistent manner.
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Affiliation(s)
- Åsa Hedlund
- Department of Caring Sciences, University of Gävle, Gävle, Sweden
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Hedlund Å, Kristofferzon ML, Boman E, Nilsson A. Are return to work beliefs, psychological well-being and perceived health related to return-to-work intentions among women on long-term sick leave for common mental disorders? A cross-sectional study based on the theory of planned behaviour. BMC Public Health 2021; 21:535. [PMID: 33740921 PMCID: PMC7977300 DOI: 10.1186/s12889-021-10562-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 03/05/2021] [Indexed: 12/01/2022] Open
Abstract
Background Long-term sick leave due to common mental disorders (CMDs) is a great burden in society today, especially among women. A strong intention to return to work (RTW) as well as symptom relief may facilitate RTW in this group. However, there is a lack of knowledge regarding what constitutes a strong intention. The Theory of Planned Behaviour is well-suited to identifying underlying beliefs about intentions to perform a behaviour. By including psychological well-being and perceived health, a more comprehensive picture of determinants of RTW intention might be achieved. Thus, the aim of the present study was to identify associations between RTW beliefs, psychological well-being, perceived health and RTW intentions among women on long-term sick leave due to CMDs, and to do so based on the Theory of Planned Behaviour. Methods The study was cross-sectional. Between October 2019 and January 2020, 282 women on long-term sick leave (> 2 months) due to CMDs were included in the study. The questionnaires for data collection were: “RTW Beliefs Questionnaire”, the “General Health Questionnaire -12” and the “EuroQol Visual Analogue Scale”. Standard multiple regression analysis was performed both with and without adjustment for potential confounders. Results The results showed that a more positive attitude towards RTW, stronger social pressure to RTW, higher perceived control over RTW and higher psychological well-being were associated with stronger RTW intention. The adjusted analysis eliminated the importance of psychological well-being for RTW intention, but showed that women who reported that their employer had taken actions to facilitate their RTW had stronger RTW intention. Conclusion The RTW beliefs, derived from the Theory of Planned Behaviour, were all important for a strong RTW intention, while psychological well-being and perceived health showed weaker associations. Furthermore, having an employer that take actions for facilitating RTW was associated with stronger RTW intentions. Though some caution is warranted regarding the representativeness of the sample, the results do improve our understanding of some important determinants of RTW intention among women on long-term sick leave for CMDs. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10562-w.
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Affiliation(s)
- Åsa Hedlund
- Department of Caring Sciences, University of Gävle, Kungsbäcksvägen 47, 801 76, Gävle, Sweden.
| | | | - Eva Boman
- Department of Occupational Health and Psychology, University of Gävle, Gävle, Sweden
| | - Annika Nilsson
- Department of Caring Sciences, University of Gävle, Kungsbäcksvägen 47, 801 76, Gävle, Sweden
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Abstract
OBJECTIVE This study aims to build a predictive model for "return to work" (RTW) after sick leave by using a machine-learning algorithm. METHODS Panel data of 2000 participants (1686 males and 314 females) from the Labor Welfare Research Institute of the Korea Workers' Compensation & Welfare Service were used. A gradient boosting machine (GBM) was used to build the predictive model. RESULTS The GBM showed excellent performance in a binary classification (returned to work vs not working). However, the model of the three-group classification showed suboptimal performance. CONCLUSIONS Although machine-learning algorithms using common predictive factors can accurately predict whether one can work after sick leave, they cannot differentiate the form of returning to work. Future research with detailed information based on the injury or disease is warranted.
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Tousignant-Laflamme Y, Longtin C, Coutu MF, Gaudreault N, Kairy D, Nastasia I, Leonard G. What are the essential components of a self-management program designed to help workers with chronic low back pain stay at work? A mapping review. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2020. [DOI: 10.1080/21679169.2020.1822443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Yannick Tousignant-Laflamme
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Canada
- Research Centre of the CHUS, CIUSSS de l’Estrie-CHUS, Sherbrooke, Canada
| | - Christian Longtin
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Canada
| | - Marie-France Coutu
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Canada
- Centre for Action in Work Disability Prevention and Rehabilitation (CAPRIT) affiliated with the Centre de recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean Research Center on Health Innovations (CR-CSIS), Université de Sherbrooke, Longueuil, Canada
| | - Nathaly Gaudreault
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Canada
- Research Centre of the CHUS, CIUSSS de l’Estrie-CHUS, Sherbrooke, Canada
| | - Dahlia Kairy
- Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM) du Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l’Ile-de-Montréal, Montreal, Canada
- School of Rehabilitation, Université de Montréal, Montreal, Canada
- Centre de recherche interdisciplinaire en réadaptation, Montreal, Canada
| | - Iuliana Nastasia
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), Montreal, Canada
| | - Guillaume Leonard
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Canada
- Research Center on Aging, CIUSSS de l’Estrie-CHUS, Sherbrooke, Canada
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Smith P, LaMontagne AD, Lilley R, Hogg-Johnson S, Sim M. Are there differences in the return to work process for work-related psychological and musculoskeletal injuries? A longitudinal path analysis. Soc Psychiatry Psychiatr Epidemiol 2020; 55:1041-1051. [PMID: 32047973 DOI: 10.1007/s00127-020-01839-3] [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: 10/25/2019] [Accepted: 02/03/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE To examine differences in the return to work (RTW) process for workers' compensation claimants with psychological injuries compared to those with musculoskeletal (MSK) injuries. METHODS We collected data from 869 workers' compensation claimants in Victoria, Australia, at three time points over a 12-month period (21% with psychological injury claims). RTW was assessed through self-report. Potential mediators were identified at the personal, health-care provider, workplace and system levels. The relationships between injury type, mediating factors and RTW were assessed using path analysis, with adjustment for confounders through inverse probability weighting. RESULTS We observed better RTW outcomes for claimants with MSK injuries (compared to those with psychological injuries) at T1 and T2, but not at T3. We also observed differences between psychological injuries and MSK injuries and all but two of the mediating factors examined. These differences, in particular related to supervisor response to injury, consultative RTW planning and offers of accommodation, as well as differences in mental health symptoms, explained approximately two-thirds of differences in RTW between injury types at T1. Differences in RTW at T2 were explained by mediating factors, and differences in RTW at T1. CONCLUSION Claimants with work-related psychological injuries experience a variety of challenges in RTW compared to those with MSK injuries. While treating and preventing further exacerbation of psychological symptoms should remain an important part of the rehabilitation process, other modifiable factors, in particular supervisor response to injury and consultative RTW planning and modified duties, should be prioritised to reduce inequalities in RTW across injury types.
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Affiliation(s)
- Peter Smith
- Institute for Work and Health, 481 University Ave, Suite 800, Toronto, ON, M5G 2E9, Canada. .,Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia. .,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
| | | | - Rebbecca Lilley
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Sheilah Hogg-Johnson
- Institute for Work and Health, 481 University Ave, Suite 800, Toronto, ON, M5G 2E9, Canada.,Canadian Memorial Chiropractic College, North York, ON, Canada
| | - Malcolm Sim
- Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia
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Percutaneous Endoscopic Cervical Discectomy Versus Anterior Cervical Discectomy and Fusion: A Comparative Cohort Study with a Five-Year Follow-Up. J Clin Med 2020; 9:jcm9020371. [PMID: 32013206 PMCID: PMC7073710 DOI: 10.3390/jcm9020371] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 01/26/2020] [Indexed: 11/16/2022] Open
Abstract
Percutaneous endoscopic cervical discectomy (PECD) is an effective minimally invasive surgery for soft cervical disc herniation in properly selected cases. The current gold standard is anterior cervical discectomy and fusion (ACDF). However, few studies have evaluated the outcome of PECD compared with ACDF. We compared the surgical results of PECD and ACDF. Data from patients treated with single-level PECD (n = 51) or ACDF (n = 64) were analyzed. Patients were prospectively entered into the clinical database and their records were retrospectively reviewed. Perioperative data and clinical outcomes were evaluated using the visual analogue scale (VAS), Neck Disability Index (NDI), and modified Macnab criteria. VAS and NDI results significantly improved in both groups. The rates of excellent or good results were 88.24% and 90.63% in the PECD and ACDF group, respectively. The revision rates were 3.92% and 1.56% in the PECD and ACDF group, respectively. Operative time, hospital stay, and time to return to work were reduced in the PECD group compared to the ACDF group (p < 0.001). The five-year outcomes of PECD were comparable to those of conventional ACDF. PECD provided the typical benefits of minimally invasive surgery and may be an effective alternative for treating soft cervical disc herniation.
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Hayden JA, Wilson MN, Riley RD, Iles R, Pincus T, Ogilvie R. Individual recovery expectations and prognosis of outcomes in non-specific low back pain: prognostic factor review. Cochrane Database Syst Rev 2019; 2019:CD011284. [PMID: 31765487 PMCID: PMC6877336 DOI: 10.1002/14651858.cd011284.pub2] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Low back pain is costly and disabling. Prognostic factor evidence can help healthcare providers and patients understand likely prognosis, inform the development of prediction models to identify subgroups, and may inform new treatment strategies. Recent studies have suggested that people who have poor expectations for recovery experience more back pain disability, but study results have differed. OBJECTIVES To synthesise evidence on the association between recovery expectations and disability outcomes in adults with low back pain, and explore sources of heterogeneity. SEARCH METHODS The search strategy included broad and focused electronic searches of MEDLINE, Embase, CINAHL, and PsycINFO to 12 March 2019, reference list searches of relevant reviews and included studies, and citation searches of relevant expectation measurement tools. SELECTION CRITERIA We included low back pain prognosis studies from any setting assessing general, self-efficacy, and treatment expectations (measured dichotomously and continuously on a 0 - 10 scale), and their association with work participation, clinically important recovery, functional limitations, or pain intensity outcomes at short (3 months), medium (6 months), long (12 months), and very long (> 16 months) follow-up. DATA COLLECTION AND ANALYSIS We extracted study characteristics and all reported estimates of unadjusted and adjusted associations between expectations and related outcomes. Two review authors independently assessed risks of bias using the Quality in Prognosis Studies (QUIPS) tool. We conducted narrative syntheses and meta-analyses when appropriate unadjusted or adjusted estimates were available. Two review authors independently graded and reported the overall quality of evidence. MAIN RESULTS We screened 4635 unique citations to include 60 studies (30,530 participants). Thirty-five studies were conducted in Europe, 21 in North America, and four in Australia. Study populations were mostly chronic (37%), from healthcare (62%) or occupational settings (26%). General expectation was the most common type of recovery expectation measured (70%); 16 studies measured more than one type of expectation. Usable data for syntheses were available for 52 studies (87% of studies; 28,885 participants). We found moderate-quality evidence that positive recovery expectations are strongly associated with better work participation (narrative synthesis: 21 studies; meta-analysis: 12 studies, 4777 participants: odds ratio (OR) 2.43, 95% confidence interval (CI) 1.64 to 3.62), and low-quality evidence for clinically important recovery outcomes (narrative synthesis: 12 studies; meta-analysis: 5 studies, 1820 participants: OR 1.89, 95% CI 1.49 to 2.41), both at follow-up times closest to 12 months, using adjusted data. The association of recovery expectations with other outcomes of interest, including functional limitations (narrative synthesis: 10 studies; meta-analysis: 3 studies, 1435 participants: OR 1.40, 95% CI 0.85 to 2.31) and pain intensity (narrative synthesis: 9 studies; meta-analysis: 3 studies, 1555 participants: OR 1.15, 95% CI 1.08 to 1.23) outcomes at follow-up times closest to 12 months using adjusted data, is less certain, achieving very low- and low-quality evidence, respectively. No studies reported statistically significant or clinically important negative associations between recovery expectations and any low back pain outcome. AUTHORS' CONCLUSIONS We found that individual recovery expectations are probably strongly associated with future work participation (moderate-quality evidence) and may be associated with clinically important recovery outcomes (low-quality evidence). The association of recovery expectations with other outcomes of interest is less certain. Our findings suggest that recovery expectations should be considered in future studies, to improve prognosis and management of low back pain.
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Affiliation(s)
- Jill A Hayden
- Dalhousie UniversityDepartment of Community Health & Epidemiology5790 University AvenueRoom 403HalifaxNSCanadaB3H 1V7
| | - Maria N Wilson
- Dalhousie UniversityDepartment of Community Health and EpidemiologyHalifaxNova ScotiaCanada
| | - Richard D Riley
- Keele UniversitySchool of Primary, Community and Social CareDavid Weatherall Building, Keele University CampusKeeleStaffordshireUKST5 5BG
| | - Ross Iles
- Monash UniversityDepartment of Physiotherapy, Faculty of Medicine, Nursing and Health SciencesPeninsula CampusFrankstonVictoriaAustralia3199
| | - Tamar Pincus
- Royal Holloway University of LondonDepartment of PsychologyEghamSurreyUKTW20 0EX
| | - Rachel Ogilvie
- Dalhousie UniversityCommunity Health & Epidemiology5760 University AvenueHalifaxCanadaB3H 1V7
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Return to work after breast cancer treatments: Rebuilding everything despite feeling “in-between”. Eur J Oncol Nurs 2019; 41:165-172. [DOI: 10.1016/j.ejon.2019.06.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 06/02/2019] [Accepted: 06/10/2019] [Indexed: 11/21/2022]
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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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Ahn Y, Lee U, Lee YJ, Keum HJ. Laser-Assisted Microdiscectomy for Far Lateral Lumbar Disc Herniation at the L5-S1 Level. Photomed Laser Surg 2018; 36:555-561. [PMID: 30239265 DOI: 10.1089/pho.2018.4497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Laser-assisted paraspinal microdiscectomy for far lateral lumbar disc herniation (LDH) enables direct access to the foraminal or far lateral zone with minimal tissue injury and preserves facet joints, thereby preventing postoperative segmental instability. We demonstrated the clinical outcomes of this technique and discussed the pros and cons of laser use in lumbar disc surgery. BACKGROUND The microdiscectomy technique for L5-S1 far lateral zone may be difficult due to the limited surgical field with narrowed disc space, hypertrophied facet, and sacral ala. Thus, we used carbon dioxide (CO2) laser for sophisticated decompression. METHODS Eighty-four patients who were treated with microdiscectomy for far lateral LDH at the L5-S1 level were evaluated. Among them, 40 patients were treated using CO2 laser-assisted microdiscectomy, and the remaining 44 patients using conventional microdiscectomy. Perioperative and postoperative data were compared between the two groups with 2 years of follow-up. Clinical outcomes were assessed using the visual analog scale (VAS), Oswestry disability index (ODI), and modified Macnab criteria. RESULTS VAS and ODI significantly improved in both groups. An excellent or good outcome was rated in 80% and 77.3% of the laser and conventional group, respectively. There was no significant difference in global outcomes. However, hospital stay and time to return to work were significantly shorter in the laser group (p < 0.05). CONCLUSIONS CO2 laser-assisted paraspinal microdiscectomy is effective for treating far lateral LDH. The pinpoint laser scalpel enables delicate and complete decompression in a limited surgical field with minimal tissue trauma.
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Affiliation(s)
- Yong Ahn
- 1 Department of Neurosurgery, Gil Medical Center, Gachon University College of Medicine , Incheon, South Korea
| | - Uhn Lee
- 1 Department of Neurosurgery, Gil Medical Center, Gachon University College of Medicine , Incheon, South Korea
| | - Yong Jae Lee
- 1 Department of Neurosurgery, Gil Medical Center, Gachon University College of Medicine , Incheon, South Korea
| | - Han Joong Keum
- 2 Department of Neurosurgery, Wooridul Spine Hospital , Seoul, South Korea
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de Vries H, Fishta A, Weikert B, Rodriguez Sanchez A, Wegewitz U. Determinants of Sickness Absence and Return to Work Among Employees with Common Mental Disorders: A Scoping Review. JOURNAL OF OCCUPATIONAL REHABILITATION 2018; 28:393-417. [PMID: 28980107 PMCID: PMC6096498 DOI: 10.1007/s10926-017-9730-1] [Citation(s) in RCA: 118] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Purpose To present an overview of the existing evidence on prognostic factors of (recurrent) sickness absence (SA) and return to work (RTW) among workers with a common mental disorder (CMD). This scoping review provides information about determinants for SA and RTW, which could be used to develop better interventions aimed at the prevention of SA and promotion of RTW among workers with a CMD. Methods Relevant articles were identified in PubMed, Embase, PsycINFO, PSYNDEX, and SINGLE up to October 2016. In order to be included, studies should provide insight into prognostic factors of SA or RTW of workers with a CMD. We classified all factors according to the domains of the International Classification of Functioning, Disability and Health. Results Our searches identified 2447 possible relevant articles, of which 71 were included for data extraction. There is consistent evidence in ≥3 studies that previous episodes of CMD, higher symptom severity, previous absenteeism, co-morbidity, high job demands, low job control, high job strain, female gender, lower educational level, smoking behavior, and low perceived general health are predictors of SA in people with CMDs. Earlier RTW is consistently predicted by lower symptom severity, having no previous absenteeism, younger age, and positive expectations concerning sick-leave duration or RTW. Conclusions The amount of research on determinants for SA and RTW in workers with CMD has increased dramatically in recent years, although most studies are from the Netherlands and Scandinavia. There are some research gaps identified in this scoping review that need further attention in primary and secondary studies. Based on the summary of the evidence, we provide guidance for policy, practice and research.
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Affiliation(s)
- Haitze de Vries
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Postbus 30001, 9700 RB, Groningen, The Netherlands.
| | - Alba Fishta
- Department of Evidence-based Occupational Health, Workplace Health Management, Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany
| | - Beate Weikert
- Department of Evidence-based Occupational Health, Workplace Health Management, Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany
| | - Alejandra Rodriguez Sanchez
- Department of Evidence-based Occupational Health, Workplace Health Management, Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany
| | - Uta Wegewitz
- Department of Evidence-based Occupational Health, Workplace Health Management, Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany
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den Bakker CM, Anema JR, Zaman AGNM, de Vet HCW, Sharp L, Angenete E, Allaix ME, Otten RHJ, Huirne JAF, Bonjer HJ, de Boer AGEM, Schaafsma FG. Prognostic factors for return to work and work disability among colorectal cancer survivors; A systematic review. PLoS One 2018; 13:e0200720. [PMID: 30110333 PMCID: PMC6093640 DOI: 10.1371/journal.pone.0200720] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 07/02/2018] [Indexed: 12/22/2022] Open
Abstract
Background Colorectal cancer is diagnosed progressively in employed patients due to screening programs and increasing retirement age. The objective of this study was to identify prognostic factors for return to work and work disability in patients with colorectal cancer. Methods The research protocol was published at PROSPERO with registration number CRD42017049757. A systematic review of cohort and case-control studies in colorectal cancer patients above 18 years, who were employed when diagnosed, and who had a surgical resection with curative intent were included. The primary outcome was return to work or work disability. Potentially prognostic factors were included in the analysis if they were measured in at least three studies. Risk of bias was assessed according to the QUality In Prognosis Studies tool. A qualitative synthesis analysis was performed due to heterogeneity between studies. Quality of evidence was evaluated according to Grading of Recommendation Assessment, Development and Evaluation. Results Eight studies were included with a follow-up period of 26 up to 520 weeks. (Neo)adjuvant therapy, higher age, and more comorbidities had a significant negative influence on return to work. A previous period of unemployment, extensive surgical resection and postoperative complications significantly increased the risk of work disability. The quality of evidence for these prognostic factors was considered very low to moderate. Conclusion Health care professionals need to be aware of these prognostic factors to select patients eligible for timely intensified rehabilitation in order to optimize the return to work process and prevent work disability.
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Affiliation(s)
- Chantal M. den Bakker
- Department of Occupational and Public Health, VU University medical center, Amsterdam Public Health research institute, Amsterdam, The Netherlands
- Department of Surgery, VU University medical center, Amsterdam, The Netherlands
- * E-mail:
| | - Johannes R. Anema
- Department of Occupational and Public Health, VU University medical center, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - AnneClaire G. N. M. Zaman
- Academic Medical Center, Amsterdam Public Health research institute, Coronel Institute of Occupational Health, University of Amsterdam, Amsterdam, The Netherlands
| | - Henrika C. W. de Vet
- Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, VU University medical center, Amsterdam, The Netherlands
| | - Linda Sharp
- Institute of Health & Society, Newcastle University, Newcastle, United Kingdom
| | - Eva Angenete
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Göteburg, Sweden
| | - Marco E. Allaix
- Department of Surgical Sciences, University of Torino, Torino, Italy
| | | | - Judith A. F. Huirne
- Department of Gynaecology, VU University medical center, Amsterdam, The Netherlands
| | - Hendrik J. Bonjer
- Department of Surgery, VU University medical center, Amsterdam, The Netherlands
| | - Angela G. E. M. de Boer
- Academic Medical Center, Amsterdam Public Health research institute, Coronel Institute of Occupational Health, University of Amsterdam, Amsterdam, The Netherlands
| | - Frederieke G. Schaafsma
- Department of Occupational and Public Health, VU University medical center, Amsterdam Public Health research institute, Amsterdam, The Netherlands
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Lane TJ, Lilley R, Hogg-Johnson S, LaMontagne AD, Sim MR, Smith PM. A Prospective Cohort Study of the Impact of Return-to-Work Coordinators in Getting Injured Workers Back on the Job. JOURNAL OF OCCUPATIONAL REHABILITATION 2018; 28:298-306. [PMID: 28702768 DOI: 10.1007/s10926-017-9719-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Purpose To assess the impact of workplace-based return-to-work (RTW) Coordinators' interpersonal and functional activities on RTW outcomes. Methods Multivariable logistic regression analyses of cross-sectional and longitudinal survey responses of 632 injured workers with at least 10 days of work absence in Victoria, Australia, adjusting for demographic and other workplace factors. Outcome was being back at work for at least 1 month, measured at both baseline and 6 month follow-up survey. Participant responses to stressfulness of Coordinator interactions were dichotomised into good and poor and evaluated as a proxy for Coordinators' interpersonal activities, while having a RTW plan was evaluated as a proxy for functional activities. Results At baseline, RTW plans doubled the odds of RTW (OR 2.02; 95% CI 1.40-2.90) and attenuated the impact of good Coordinator interactions (1.14; 0.77-1.70). At 6-month follow-up, the opposite was observed: good interactions nearly doubled odds of RTW (1.90; 1.22-2.95) while RTW plans were non-significant (1.02; 0.68-1.54). Conclusions Differences between when the two Coordinator activities were effective may be due to the nature of claimants who RTW in each survey period. Length of shorter-duration claims are influenced by injury related factors, while psychosocial factors tend to be more important for longer-duration claims. Such factors may determine whether a claimant is more likely to respond to Coordinators' functional or interpersonal activities. The findings have important implications for increasing Coordinator effectiveness.
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Affiliation(s)
- Tyler J Lane
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC, 3004, Australia.
- Institute for Safety, Compensation and Recovery Research, Monash University, Melbourne, VIC, Australia.
| | - Rebbecca Lilley
- Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Sheilah Hogg-Johnson
- Institute for Work and Health, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Canadian Memorial Chiropractic College, Toronto, Canada
| | - Anthony D LaMontagne
- Centre for Population Health Research, Deakin University, Geelong, VIC, Australia
| | - Malcolm R Sim
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Peter M Smith
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
- Institute for Work and Health, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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Bilodeau K, Tremblay D, Durand MJ. Exploration of the contexts surrounding the implementation of an intervention supporting return-to-work after breast cancer in a primary care setting: starting point for an intervention development. J Multidiscip Healthc 2018; 11:75-83. [PMID: 29440910 PMCID: PMC5798536 DOI: 10.2147/jmdh.s152947] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Many recommendations have been made regarding survivorship care provided by teams of primary care professionals. However, the nature of that follow-up, including support for return-to-work (RTW) after cancer, remains largely undefined. As implementation problems are frequently context-related, a pilot study was conducted to describe the contexts, according to Grol and Wensing, in which a new intervention is to be implemented. This pilot study is the first of three steps in intervention development planning. METHOD In-depth semi-structured interviews (n=6) were carried out with stakeholders selected for their knowledgeable perspective of various settings, such as hospitals, primary care, employers, and community-based organizations. Interviews focused on participants' perceptions of key contextual facilitators and barriers to consider for the deployment of an RTW intervention in a primary care setting. Data from interviews were transcribed and analyzed. A content analysis was performed based on an iterative process. RESULTS An intervention supporting the process of RTW in primary care makes sense for participants. Results suggest that important levers are present in organizational, professional, and social settings. However, many barriers, mainly related to organizational settings, have been identified, eg, distribution of tasks for survivor follow-up, continuity of information, and coordination of care between specialized oncology care and general primary care. CONCLUSION To develop and deploy the intervention, recommendations that emerged from this pilot study for overcoming barriers were identified, eg, training (professionals, survivors, and employers), the use of communication tools, and adopting a practice guide for survivor care. The results were also helpful in focusing on the relevance of an intervention supporting the RTW process as a component of primary care for survivors.
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Affiliation(s)
- Karine Bilodeau
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, QC, Canada
- Hôpital Charles-LeMoyne Research Center, Longueuil, QC, Canada
| | - Dominique Tremblay
- Hôpital Charles-LeMoyne Research Center, Longueuil, QC, Canada
- School of Nursing, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, QC, Canada
| | - Marie-José Durand
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, QC, Canada
- Centre for Action in Work Disability Prevention and Rehabilitation, Longueuil, QC, Canada
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Jeong I, Park JB, Kim HR, Yoon JH, Won JU, Roh J. Impacts of Return-to-Work Type and Period on Job Retention in Workers with Occupational Injuries and Diseases. J Korean Med Sci 2018; 33:e2. [PMID: 29215811 PMCID: PMC5729637 DOI: 10.3346/jkms.2018.33.e2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 09/24/2017] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Despite the necessity of job retention in achieving return-to-work (RTW) goals, many workers leave their jobs after returning to work. The objective of this study was to examine the impacts of RTW type and period on job retention in Korean workers with occupational injuries and diseases. METHODS Data were derived from the Panel Study of Worker's Compensation Insurance, including data from 2,000 systemically sampled workers who had finished recuperation in 2012; three waves of survey data were included in the analyses. Workers who returned to work (n = 1,610) were included in the analysis of the relationship between RTW type and job retention, and 664 workers who returned to their original workplaces were included in the analysis of the relationship between RTW period and job retention. The participants completed a questionnaire, and administrative data were provided by workers' compensation insurance. RESULTS A Cox proportional-hazards regression analysis showed an increased hazard ratio (HR) for non-retention of 2.66 (95% confidence interval, 2.11-3.35) in reemployed workers compared to that in workers returning to their original workplaces. Among workers returning to their original workplaces, HRs for non-retention were increased in workers with a RTW period of 13-24 months (3.03 [1.52-6.04]) and > 24 months (5.33 [2.14-13.25]) compared to workers with a RTW period of ≤ 3 months. CONCLUSION RTW type and period were significantly related to job retention, suggesting that policies for promoting job retention rate should be implemented.
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Affiliation(s)
- Inchul Jeong
- Department of Occupational and Environmental Medicine, Ajou University School of Medicine, Suwon, Korea
| | - Jae Bum Park
- Department of Occupational and Environmental Medicine, Ajou University School of Medicine, Suwon, Korea
| | - Hyoung Ryoul Kim
- Department of Occupational and Environmental Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Jin Ha Yoon
- Department of Preventive Medicine, Institute for Occupational Health, and Graduate School of Public Health, Yonsei University College of Medicine, Seoul, Korea
- Incheon Workers' Health Center, Incheon, Korea
| | - Jong Uk Won
- Department of Preventive Medicine, Institute for Occupational Health, and Graduate School of Public Health, Yonsei University College of Medicine, Seoul, Korea
- Incheon Workers' Health Center, Incheon, Korea
| | - Jaehoon Roh
- Department of Preventive Medicine, Institute for Occupational Health, and Graduate School of Public Health, Yonsei University College of Medicine, Seoul, Korea
- Incheon Workers' Health Center, Incheon, Korea.
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Steenstra IA, Munhall C, Irvin E, Oranye N, Passmore S, Van Eerd D, Mahood Q, Hogg-Johnson S. Systematic Review of Prognostic Factors for Return to Work in Workers with Sub Acute and Chronic Low Back Pain. JOURNAL OF OCCUPATIONAL REHABILITATION 2017; 27:369-381. [PMID: 27647141 PMCID: PMC5591348 DOI: 10.1007/s10926-016-9666-x] [Citation(s) in RCA: 129] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Purpose We systematically reviewed the evidence on factors that predict duration of sick leave in workers after 6 weeks low back pain (LBP) related sick leave. We hypothesized that different factors affect the duration of the leave depending on the time away from work. Methods The review occurred in seven phases: (1) developing the central question, (2) conducting the literature search, (3) identifying relevant publications, (4) quality appraisal, (5) data extraction, (6) evidence synthesis, and (7) knowledge translation. We searched for studies that reported episodes of LBP and sick leave that lasted more than 6 weeks. All included studies reported at least one prognostic factor where return to work was the outcome. Results We identified twenty-two relevant publications. The impact of pain, functional status and radiating pain seems to change with duration of work disability. Workers' recovery expectations remain important after 6 weeks. Modified duties are rarely studied in later phases of work disability. Depression/mental health did not appear to be an important factor in later phases. Workplace physical factors remain important. There is insufficient evidence that pain catastrophising and fear avoidance are predictive factors in later phases. There was moderate evidence for age in the later phases. Functional capacity and claim related factors were supported by some evidence. Discusion Physical demands in the workplace are preventing workers from getting back to work in a timely fashion across phases. The psychosocial work environment is understudied in later phases. Overall, we cannot conclude that prognostic factors change over time.
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Affiliation(s)
- Ivan A Steenstra
- Institute for Work and Health, Toronto, ON, Canada.
- Ted Rogers School of Management, Ryerson University, 350 Victoria Street, Toronto, ON, M5B 2K3, Canada.
| | | | - Emma Irvin
- Institute for Work and Health, Toronto, ON, Canada
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Steenstra IA, Franche RL, Furlan AD, Amick B, Hogg-Johnson S. The Added Value of Collecting Information on Pain Experience When Predicting Time on Benefits for Injured Workers with Back Pain. JOURNAL OF OCCUPATIONAL REHABILITATION 2016; 26:117-124. [PMID: 26152837 DOI: 10.1007/s10926-015-9592-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Objectives Some injured workers with work-related, compensated back pain experience a troubling course in return to work. A prediction tool was developed in an earlier study, using administrative data only. This study explored the added value of worker reported data in identifying those workers with back pain at higher risk of being on benefits for a longer period of time. Methods This was a cohort study of workers with compensated back pain in 2005 in Ontario. Workplace Safety and Insurance Board (WSIB) data was used. As well, we examined the added value of patient-reported prognostic factors obtained from a prospective cohort study. Improvement of model fit was determined by comparing area under the curve (AUC) statistics. The outcome measure was time on benefits during a first workers' compensation claim for back pain. Follow-up was 2 years. Results Among 1442 workers with WSIB data still on full benefits at 4 weeks, 113 were also part of the prospective cohort study. Model fit of an established rule in the smaller dataset of 113 workers was comparable to the fit previously established in the larger dataset. Adding worker rating of pain at baseline improved the rule substantially (AUC = 0.80, 95 % CI 0.68, 0.91 compared to benefit status at 180 days, AUC = 0.88, 95 % CI 0.74, 1.00 compared to benefits status at 360 days). Conclusion Although data routinely collected by workers' compensation boards show some ability to predict prolonged time on benefits, adding information on experienced pain reported by the worker improves the predictive ability of the model from 'fairly good' to 'good'. In this study, a combination of prognostic factors, reported by multiple stakeholders, including the worker, could identify those at high risk of extended duration on disability benefits and in potentially in need of additional support at the individual level.
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Affiliation(s)
- Ivan A Steenstra
- Institute for Work & Health, 481 University Ave., Suite 800, Toronto, ON, M5G 2E9, Canada.
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
| | - Renée-Louise Franche
- Institute for Work & Health, 481 University Ave., Suite 800, Toronto, ON, M5G 2E9, Canada
- WorkSafe BC, Vancouver, BC, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Andrea D Furlan
- Institute for Work & Health, 481 University Ave., Suite 800, Toronto, ON, M5G 2E9, Canada
- Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Ben Amick
- Institute for Work & Health, 481 University Ave., Suite 800, Toronto, ON, M5G 2E9, Canada
- Department of Health Policy and Management, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Sheilah Hogg-Johnson
- Institute for Work & Health, 481 University Ave., Suite 800, Toronto, ON, M5G 2E9, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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Labour market trajectories following sickness absence due to self-reported all cause morbidity--a longitudinal study. BMC Public Health 2016; 16:337. [PMID: 27083893 PMCID: PMC4833917 DOI: 10.1186/s12889-016-3017-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 04/08/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To investigate differences in return to work (RTW) and employment trajectories in individuals on sick leave for either mental health reasons or other health related reasons. METHODS This study was based on 2036 new sickness absence cases who completed a questionnaire on social characteristics, expectations for RTW and reasons for sickness absence. They were divided into two exposure groups according to their self-reported sickness absence reason: mental health reasons or other health reasons. The outcome was employment status during the following 51 weeks and was measured both as time-to-event analysis and with sequence analysis. RESULTS Individuals with mental health reasons for sickness absence had a higher risk of not having returned to work (RR 0.87 (0.80;0.93)). Adjusting for gender, age, education and employment did not change the estimate, however, after adding RTW expectations to the model, the excess risk was no longer present (RR 1.01 (0.95;1.08)). In relation to the sequence analysis, individuals with mental health related absence had significantly higher odds of being in the sickness absence cluster and significantly lower odds for being in the fast RTW cluster, but when adjusting for RTW expectations, the odds were somewhat attenuated and no longer significant. CONCLUSIONS Employees on sick leave due to self-reported mental health problems spent more weeks in sickness absence and temporary benefits and had a higher risk of not having returned to work within a year compared to employees on sick leave due to other health reasons. The difference could be explained by their lower RTW expectations at baseline. This emphasises the need to develop suitable and specific interventions to facilitate RTW for this group of sickness absentees.
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Prang KH, Bohensky M, Smith P, Collie A. Return to work outcomes for workers with mental health conditions: A retrospective cohort study. Injury 2016; 47:257-65. [PMID: 26489393 DOI: 10.1016/j.injury.2015.09.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 09/07/2015] [Accepted: 09/17/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVES The aims of this study were to describe predictors of sustained return to work (RTW) among a cohort of workers with compensated work-related mental health conditions (MHCs); and to examine predictors of subsequent absences due to the same condition. METHODS This study was a retrospective analysis of compensation claims data in Victoria, Australia. We selected workers with an accepted wage replacement claim due to a work-related MHC from 1 January 2002 to 31 December 2009, with two years of follow-up data. RESULTS We identified 8358 workers meeting our inclusion criteria. The median age of workers was 44 years (Interquartile range (IQR): 36-51) and 56% were female. In a multivariable Cox regression analysis, older age, being from a small organisation, working in some specific industry segments, consulting a psychiatrist or psychologist, using medications, and having a previous claim were all associated with a delayed RTW. Workers experiencing work pressure, assault/workplace violence or other mental stress factors, working in the public administration and safety industry and having a medical incapacity certification between 3-4 days and 5-7 days had a higher rate of multiple RTW attempts. CONCLUSION This study identified a number of risk factors associated with a delayed RTW and multiple attempts at RTW. Predictors may help identify high-risk groups and facilitate the RTW process of workers with MHCs.
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Affiliation(s)
- Khic-Houy Prang
- Institute for Safety, Compensation and Recovery Research, Monash University, Melbourne, Victoria, Australia; Monash Injury Research Institute, Monash University, Melbourne, Victoria, Australia.
| | - Megan Bohensky
- Department of Medicine, Melbourne University, Melbourne, Victoria, Australia
| | - Peter Smith
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Institute for Work & Health, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Alex Collie
- Institute for Safety, Compensation and Recovery Research, Monash University, Melbourne, Victoria, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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van Vilsteren M, van Oostrom SH, de Vet HCW, Franche R, Boot CRL, Anema JR. Workplace interventions to prevent work disability in workers on sick leave. Cochrane Database Syst Rev 2015; 2015:CD006955. [PMID: 26436959 PMCID: PMC9297123 DOI: 10.1002/14651858.cd006955.pub3] [Citation(s) in RCA: 131] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Work disability has serious consequences for individuals as well as society. It is possible to facilitate resumption of work by reducing barriers to return to work (RTW) and promoting collaboration with key stakeholders. This review was first published in 2009 and has now been updated to include studies published up to February 2015. OBJECTIVES To determine the effectiveness of workplace interventions in preventing work disability among sick-listed workers, when compared to usual care or clinical interventions. SEARCH METHODS We searched the Cochrane Work Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and PsycINFO databases on 2 February 2015. SELECTION CRITERIA We included randomised controlled trials (RCTs) of workplace interventions that aimed to improve RTW for disabled workers. We only included studies where RTW or conversely sickness absence was reported as a continuous outcome. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed risk of bias of the studies. We performed meta-analysis where possible, and we assessed the quality of evidence according to GRADE criteria. We used standard methodological procedures expected by Cochrane. MAIN RESULTS We included 14 RCTs with 1897 workers. Eight studies included workers with musculoskeletal disorders, five workers with mental health problems, and one workers with cancer. We judged six studies to have low risk of bias for the outcome sickness absence.Workplace interventions significantly improved time until first RTW compared to usual care, moderate-quality evidence (hazard ratio (HR) 1.55, 95% confidence interval (CI) 1.20 to 2.01). Workplace interventions did not considerably reduce time to lasting RTW compared to usual care, very low-quality evidence (HR 1.07, 95% CI 0.72 to 1.57). The effect on cumulative duration of sickness absence showed a mean difference of -33.33 (95% CI -49.54 to -17.12), favouring the workplace intervention, high-quality evidence. One study assessed recurrences of sick leave, and favoured usual care, moderate-quality evidence (HR 0.42, 95% CI 0.21 to 0.82). Overall, the effectiveness of workplace interventions on work disability showed varying results.In subgroup analyses, we found that workplace interventions reduced time to first and lasting RTW among workers with musculoskeletal disorders more than usual care (HR 1.44, 95% CI 1.15 to 1.82 and HR 1.77, 95% CI 1.37 to 2.29, respectively; both moderate-quality evidence). In studies of workers with musculoskeletal disorders, pain also improved (standardised mean difference (SMD) -0.26, 95% CI -0.47 to -0.06), as well as functional status (SMD -0.33, 95% CI -0.58 to -0.08). In studies of workers with mental health problems, there was a significant improvement in time until first RTW (HR 2.64, 95% CI 1.41 to 4.95), but no considerable reduction in lasting RTW (HR 0.79, 95% CI 0.54 to 1.17). One study of workers with cancer did not find a considerable reduction in lasting RTW (HR 0.88, 95% CI 0.53 to 1.47).In another subgroup analysis, we did not find evidence that offering a workplace intervention in combination with a cognitive behavioural intervention (HR 1.93, 95% CI 1.27 to 2.93) is considerably more effective than offering a workplace intervention alone (HR 1.35, 95% CI 1.01 to 1.82, test for subgroup differences P = 0.17).Workplace interventions did not considerably reduce time until first RTW compared with a clinical intervention in workers with mental health problems in one study (HR 2.65, 95% CI 1.42 to 4.95, very low-quality evidence). AUTHORS' CONCLUSIONS We found moderate-quality evidence that workplace interventions reduce time to first RTW, high-quality evidence that workplace interventions reduce cumulative duration of sickness absence, very low-quality evidence that workplace interventions reduce time to lasting RTW, and moderate-quality evidence that workplace interventions increase recurrences of sick leave. Overall, the effectiveness of workplace interventions on work disability showed varying results. Workplace interventions reduce time to RTW and improve pain and functional status in workers with musculoskeletal disorders. We found no evidence of a considerable effect of workplace interventions on time to RTW in workers with mental health problems or cancer.We found moderate-quality evidence to support workplace interventions for workers with musculoskeletal disorders. The quality of the evidence on the effectiveness of workplace interventions for workers with mental health problems and cancer is low, and results do not show an effect of workplace interventions for these workers. Future research should expand the range of health conditions evaluated with high-quality studies.
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Affiliation(s)
- Myrthe van Vilsteren
- VU University Medical CenterDepartment of Public and Occupational Health, EMGO Institute for Health and Care ResearchPO Box 7057AmsterdamNetherlands1007 MB
| | - Sandra H van Oostrom
- National Institute for Public Health and the EnvironmentCentre for Nutrition, Prevention and Health ServicesBilthovenNetherlands
| | - Henrica CW de Vet
- VU University Medical CenterDepartment of Epidemiology and Biostatistics, EMGO Institute for Health and Care ResearchPO Box 7057AmsterdamNetherlands1007 MB
| | | | - Cécile RL Boot
- EMGO Institute for Health and Care Research, VU University Medical CenterDepartment of Public and Occupational HealthAmsterdamNetherlands
| | - Johannes R Anema
- VU University Medical CenterDepartment of Public and Occupational Health, EMGO Institute for Health and Care ResearchPO Box 7057AmsterdamNetherlands1007 MB
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Ebrahim S, Malachowski C, Kamal El Din M, Mulla SM, Montoya L, Bance S, Busse JW. Measures of patients' expectations about recovery: a systematic review. JOURNAL OF OCCUPATIONAL REHABILITATION 2015; 25:240-55. [PMID: 25100443 DOI: 10.1007/s10926-014-9535-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
INTRODUCTION Patients' expectations regarding their prognosis has been shown to affect recovery. We completed a systematic review to identify measures that assess patients' expectations of recovery. METHODS Eligible studies explored the association between patients' expectations of recovery, and return to work or claim resolution. We searched electronic databases (MEDLINE and PSYCInfo) from inception to June 21, 2014, bibliographies of eligible studies, relevant systematic reviews and our personal files. Reviewers determined study eligibility and study quality, and completed data extraction. RESULTS Of 14,509 unique citations, 46 studies were eligible with majority of the studies (n = 27; 59 %) rated as low quality, primarily due to substantial missing data and inappropriate adjustment for age, gender and illness severity in their regression models. We identified 5 measures and 41 individual items assessing recovery expectations. Three of seven (43 %) studies using a measure to assess recovery expectations reported psychometric properties, with only one reporting both reliability and construct validity. Only two measures (Expectations of Recovery Scale and the Work-related Recovery Expectations Questionnaire) were externally validated in different populations. Overall, 44 (96 %) studies found that patient recovery expectations was a significant predictor of return to work or sick leave/disability claim resolution. CONCLUSIONS Very few studies assessing recovery expectations use a psychometrically valid measure. Current evidence suggests that patients with lower recovery expectations are less likely to resolve their disability claim or return to work versus patients with higher recovery expectations. Further validation of existing measures for assessing patient recovery expectations, or development of a new measure that addresses the limitations of existing ones, is required.
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Affiliation(s)
- Shanil Ebrahim
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada,
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Hayden JA, Tougas ME, Riley R, Iles R, Pincus T. Individual recovery expectations and prognosis of outcomes in non-specific low back pain: prognostic factor exemplar review. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2014. [DOI: 10.1002/14651858.cd011284] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Jill A Hayden
- Dalhousie University; Department of Community Health & Epidemiology; 5790 University Avenue Room 403 Halifax NS Canada B3H 1V7
| | | | - Richard Riley
- Keele University; Research Institute for Primary Care and Health Sciences; David Weatherall Building, Keele University Campus Staffordshire England UK ST5 5BG
| | - Ross Iles
- Monash University; Department of Physiotherapy, Faculty of Medicine, Nursing and Health Sciences; Peninsula Campus Frankston Victoria Australia 3199
| | - Tamar Pincus
- Royal Holloway University of London; Department of Psychology; Egham Surrey UK TW20 0EX
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Nastasia I, Coutu MF, Tcaciuc R. Topics and trends in research on non-clinical interventions aimed at preventing prolonged work disability in workers compensated for work-related musculoskeletal disorders (WRMSDs): a systematic, comprehensive literature review. Disabil Rehabil 2014; 36:1841-56. [PMID: 24472007 DOI: 10.3109/09638288.2014.882418] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE This study sought to provide an overview of the main topics and trends in contemporary research on successful non-clinical interventions for preventing prolonged work disability in workers compensated for work-related musculoskeletal disorders (WRMSDs). METHODS A systematic electronic search (English and French) was performed in ten scientific databases using keywords and descriptors. After screening the identified titles and abstracts using specific sets of criteria, categorical and thematic analyses were performed on the retained articles. RESULTS Five main topics appear to dominate the research: (1) risk factors and determinants; (2) effectiveness of interventions (programmes, specific components, strategies and policies); (3) viewpoints, experiences and perceptions of specific actors involved in the intervention process; (4) compensation issues; and (5) measurement issues. A currently widespread trend is early screening to identify risks factors for appropriate intervention and multidisciplinary, multimodal approaches. Morover, workplace-related psychosocial and ergonomic factors are considered vital to the success and sustainability of return-to-work (RTW) interventions. Finally, involving workplace actors, and more specifically, affected workers, in the RTW process appears to be a powerful force in improving the chances of moving workers away from disabled status. CONCLUSIONS The findings of this literature review provide with information about the main topics and trends in research on rehabilitation interventions, revealing some successful modalities of intervention aimed at preventing prolonged work disability. IMPLICATIONS FOR REHABILITATION Successful intervention for preventing prolonged work disability in workers compensated for WRMSDs address workplace issues: physical and psychosocial demands at work, ability of the workers to fill these demands, work organization and support of the worker, and worker' beliefs and attitudes related to work. Successful intervention promotes collaboration, coordination between all actors and stakeholders involved in the process of rehabilitation. Strategies able to mobilize the employees, employers, insurers and health care providers are still needed to be implemented.
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Affiliation(s)
- Iuliana Nastasia
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST) , Montreal, Quebec , Canada and
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Early Intervention with Compensated Lower Back-Injured Workers at Risk for Work Disability: Fixed versus Flexible Approach. PSYCHOLOGICAL INJURY & LAW 2013. [DOI: 10.1007/s12207-013-9165-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Biering K, Hjøllund NH, Lund T. Methods in measuring return to work: a comparison of measures of return to work following treatment of coronary heart disease. JOURNAL OF OCCUPATIONAL REHABILITATION 2013; 23:400-405. [PMID: 23184388 DOI: 10.1007/s10926-012-9405-x] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
PURPOSE Methods of measuring return to work (RTW) following temporary disability are diverse. The purpose of this study was to compare different measures of RTW within a 12-month period using a well-defined population of patients treated with Percutaneous Coronary Intervention (PCI) and weekly administrative data on transfer payments. METHODS Different RTW measures were defined based on weekly data from 12 months follow-up after PCI and agreement between definitions was expressed as Cohen's kappa. Prognostic factors for RTW were compared using logistic regression. RESULTS Among those working before the PCI, 70 % were back to work at 6 months after the PCI and 76 % 1 year after when using cross-sectional measures and excluding those who left the workforce permanently during follow up. When using a time to event measure, 77 % experienced RTW during follow up, while only 60 % experienced RTW without recurrent sick-leave events during the following year. We found moderate to near perfect agreement when comparing the measures, with lowest agreement between the time-to-event measure without relapses compared to the other measures. When comparing prognostic factors for the different RTW outcomes, we found most associations similar in size, except from the clinical measure left ventricular ejection fraction, possibly related to recurrent sick leave. CONCLUSIONS Different measures revealed some differences in proportions of RTW. However, high agreement between RTW-definitions was found. Choice of RTW-definitions should depend on study purpose; simple cross-sectional methods are sufficient in prediction of RTW and analysis of risk factors, while methods capturing relapses are recommended when sustainability, prognosis and vulnerability are in focus.
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Affiliation(s)
- Karin Biering
- Department of Occupational Medicine, Regional Hospital West Jutland, DK-7400 Herning, Denmark.
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Ebrahim S, Guyatt GH, Walter SD, Heels-Ansdell D, Bellman M, Hanna SE, Patelis-Siotis I, Busse JW. Association of psychotherapy with disability benefit claim closure among patients disabled due to depression. PLoS One 2013; 8:e67162. [PMID: 23840614 PMCID: PMC3696037 DOI: 10.1371/journal.pone.0067162] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Accepted: 05/14/2013] [Indexed: 11/24/2022] Open
Abstract
Background Depression is the most frequent reason for receiving disability benefits in North America, and treatment with psychotherapy is often funded by private insurers. No studies have explored the association between the provision of psychotherapy for depression and time to claim closure. Methods Using administrative data from a Canadian disability insurer, we evaluated the association between the provision of psychotherapy and short-term disability (STD) and long-term disability (LTD) claim closure by performing Cox proportional hazards regression. Results We analyzed 10,508 STD and 10,338 LTD claims for depression. In our adjusted analyses, receipt of psychotherapy was associated with longer time to STD closure (HR [99% CI] = 0.81 [0.68 to 0.97]) and faster LTD claim closure (1.42 [1.33 to 1.52]). In both STD and LTD, older age (0.90 [0.88 to 0.92] and 0.83 [0.80 to 0.85]), per decade), a primary diagnosis of recurrent depression versus non-recurrent major depression (0.78 [0.69 to 0.87] and 0.80 [0.72 to 0.89]), a psychological secondary diagnosis (0.90 [0.84 to 0.97] and 0.66 [0.61 to 0.71]), or a non-psychological secondary diagnosis (0.81 [0.73 to 0.90] and 0.77 [0.71 to 0.83]) versus no secondary diagnosis, and an administrative services only policy ([0.94 [0.88 to 1.00] and 0.87 [0.75 to 0.996]) or refund policy (0.86 [0.80 to 0.92] and 0.73 [0.68 to 0.78]) compared to non-refund policy claims were independently associated with longer time to STD claim closure. Conclusions We found, paradoxically, that receipt of psychotherapy was independently associated with longer time to STD claim closure and faster LTD claim closure in patients with depression. We also found multiple factors that were predictive of time to both STD and LTD claim closure. Our study has limitations, and well-designed prospective studies are needed to establish the effect of psychotherapy on disabling depression.
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Affiliation(s)
- Shanil Ebrahim
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario Canada.
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Schandelmaier S, Ebrahim S, Burkhardt SCA, de Boer WEL, Zumbrunn T, Guyatt GH, Busse JW, Kunz R. Return to work coordination programmes for work disability: a meta-analysis of randomised controlled trials. PLoS One 2012. [PMID: 23185429 PMCID: PMC3501468 DOI: 10.1371/journal.pone.0049760] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background The dramatic rise in chronically ill patients on permanent disability benefits threatens the sustainability of social security in high-income countries. Social insurance organizations have started to invest in promising, but costly return to work (RTW) coordination programmes. The benefit, however, remains uncertain. We conducted a systematic review to determine the long-term effectiveness of RTW coordination compared to usual practice in patients at risk for long-term disability. Methods and Findings Eligible trials enrolled employees on work absence for at least 4 weeks and randomly assigned them to RTW coordination or to usual practice. We searched 5 databases (to April 2, 2012). Two investigators performed standardised eligibility assessment, study appraisal and data extraction independently and in duplicate. The GRADE framework guided our assessment of confidence in the meta-analytic estimates. We identified 9 trials from 7 countries, 8 focusing on musculoskeletal, and 1 on mental complaints. Most trials followed participants for 12 months or less. No trial assessed permanent disability. Moderate quality evidence suggests a benefit of RTW coordination on proportion at work at end of follow-up (risk ratio = 1.08, 95% CI = 1.03 to 1.13; absolute effect = 5 in 100 additional individuals returning to work, 95% CI = 2 to 8), overall function (mean difference [MD] on a 0 to 100 scale = 5.2, 95% CI = 2.4 to 8.0; minimal important difference [MID] = 10), physical function (MD = 5.3, 95% CI = 1.4 to 9.1; MID = 8.4), mental function (MD = 3.1, 95% CI = 0.7 to 5.6; MID = 7.3) and pain (MD = 6.1, 95% CI = 3.1 to 9.2; MID = 10). Conclusions Moderate quality evidence suggests that RTW coordination results in small relative, but likely important absolute benefits in the likelihood of disabled or sick-listed patients returning to work, and associated small improvements in function and pain. Future research should explore whether the limited effects persist, and whether the programmes are cost effective in the long term.
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Affiliation(s)
- Stefan Schandelmaier
- Academy of Swiss Insurance Medicine, University Hospital Basel, Basel, Switzerland.
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Øyeflaten I, Lie SA, Ihlebæk CM, Eriksen HR. Multiple transitions in sick leave, disability benefits, and return to work. - A 4-year follow-up of patients participating in a work-related rehabilitation program. BMC Public Health 2012; 12:748. [PMID: 22954254 PMCID: PMC3490737 DOI: 10.1186/1471-2458-12-748] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2012] [Accepted: 09/03/2012] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Return to work (RTW) after long-term sick leave can be a long-lasting process where the individual may shift between work and receiving different social security benefits, as well as between part-time and full-time work. This is a challenge in the assessment of RTW outcomes after rehabilitation interventions. The aim of this study was to analyse the probability for RTW, and the probabilities of transitions between different benefits during a 4-year follow-up, after participating in a work-related rehabilitation program. METHODS The sample consisted of 584 patients (66% females), mean age 44 years (sd = 9.3). Mean duration on various types of sick leave benefits at entry to the rehabilitation program was 9.3 months (sd = 3.4)]. The patients had mental (47%), musculoskeletal (46%), or other diagnoses (7%). Official national register data over a 4-year follow-up period was analysed. Extended statistical tools for multistate models were used to calculate transition probabilities between the following eight states; working, partial sick leave, full-time sick leave, medical rehabilitation, vocational rehabilitation, and disability pension; (partial, permanent and time-limited). RESULTS During the follow-up there was an increased probability for working, a decreased probability for being on sick leave, and an increased probability for being on disability pension. The probability of RTW was not related to the work and benefit status at departure from the rehabilitation clinic. The patients had an average of 3.7 (range 0-18) transitions between work and the different benefits. CONCLUSIONS The process of RTW or of receiving disability pension was complex, and may take several years, with multiple transitions between work and different benefits. Access to reliable register data and the use of a multistate RTW model, makes it possible to describe the developmental nature and the different levels of the recovery and disability process.
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Affiliation(s)
- Irene Øyeflaten
- The National Centre for Occupational Rehabilitation, Haddlandvegen 20, 3864, Rauland, Norway
| | | | - Camilla M Ihlebæk
- Uni Health, Uni Research, Bergen, Norway
- Health UMB, IHA, University of Life Sciences, Ås, Norway
| | - Hege R Eriksen
- Uni Health, Uni Research, Bergen, Norway
- Department of Health Promotion and Development, University of Bergen, Bergen, Norway
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Kausto J, Solovieva S, Virta LJ, Viikari-Juntura E. Partial sick leave associated with disability pension: propensity score approach in a register-based cohort study. BMJ Open 2012; 2:bmjopen-2012-001752. [PMID: 23144260 PMCID: PMC3533026 DOI: 10.1136/bmjopen-2012-001752] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES To support sustainability of the welfare society enhanced work retention is needed among those with impaired work ability. Partial health-related benefits have been introduced for this target. The aim was to estimate the effects of partial sick leave on transition to disability pension applying propensity score methods. DESIGN Register-based cohort study. SETTING Sample from the national sickness insurance registers representative of the Finnish working population (full-time workers) with long-term sickness absence due to musculoskeletal disorders, mental disorders, traumas or tumours. PARTICIPANTS All recipients of partial or full sickness benefit whose sick leave period had ended between 1 May and 31 December 2007 were included. The sample was limited to four most prevalent diagnostic groups-mental and musculoskeletal disorders, traumas and tumours. The total sample consisted of 1047 subjects on partial sick leave (treatment group) and 28 380 subjects on full sick leave (control group). A subsample (1017 and 25 249 subjects, respectively) was formed to improve the comparability of the two groups. OUTCOME MEASURES A three-category measure and a binary measure for the occurrence of disability pension on the last day of 2008 were computed. RESULTS Partial sickness benefit reduced the risk (change in absolute risk) of full disability pension by 6% and increased the risk of partial disability pension by 8% compared with full sick leave. The effects did not differ markedly for the two main diagnostic groups of musculoskeletal and mental disorders. In men, the use of full disability pension was reduced by 10% with a 5% increase in the use of partial disability pension, while in women the effects were close to those of the total sample. CONCLUSIONS Our findings suggest that combining work with partial sick leave may provide one means to increase work retention at population level. The use of partial sick leave could be encouraged among men.
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Affiliation(s)
- Johanna Kausto
- Finnish Institute of Occupational Health, Helsinki, Finland
| | | | - Lauri J Virta
- Research Department, Social Insurance Institution, Turku, Finland
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