Workplace rehabilitation and supportive conditions at work: a prospective study

Career shock of female academics during Covid-19: can the transactional stress model offer coping strategies?

Purpose

Through addressing female academics in four public universities in Egypt, the author of this paper aims to answer the question: How do female academics cope with the career shock resulting from the spread of COVID-19?

Design/methodology/approach

The author used a qualitative research method through semi-structured interviews with 32 female academics from four public universities selected from among 26 public institutions of higher education in Egypt. Thematic analysis was subsequently used to determine the main ideas in the transcripts.

Findings

The findings assert that the following three strategies: heroism, cronyism and temporalism are used by female academics in the Egyptian context to cope with the career shocks they feel during the time of COVID-19. The findings assert that female academics try to reassert their professionalism in their academic duties and familial obligations even after the spread of COVID-19. Moreover, they tend to use forms of cronyism behaviour to alleviate the effect of the career shock, mostly via hypocritical phrases. Furthermore, the thought that COVID-19 is a temporary stage helps female academics to actively accept their challenging new work conditions.

Originality/value

This paper contributes by filling a gap in human resources management and higher education in which empirical studies on the career shock of female academics have been limited so far.

Utilization rates of Active Release Techniques® in the workplace: A descriptive study

BACKGROUND: Workplace safety is a necessary and frequent topic of discussion for researchers, employers, and workers. It is estimated that annual losses caused by work-related injuries cost the United States $140 to $145 billion. Specifically, work-related musculoskeletal disorders (WMSD) have risen from just over 10% to 50% of the total claims from 1952 to 1996, accounting for more than 345,00 days lost and more than $57 million in WSIB costs in 2015. Novel approaches to managing WMSDs, such as Active Release Techniques®, need to be explored to ensure the ongoing health of workers. OBJECTIVE: This descriptive study provides the details of the 697,002 onsite treatments across 448 sites in North America between 2014–2018 provided by Active Release Techniques® Corporate Solutions (ARTCS) practitioners. The objective was to calculate the total number of treatments, cost per closed case, percent improvement, and the number of cases referred to worker’s compensation. METHODS: All charting was done on the ARTCS EMR portal. The lead author was given a spreadsheet of the results sanitized of all identifying data in order to perform the aforementioned calculations. RESULTS: From 2014 to 2018, ARTCS providers opened 199,077 new cases, with an average cost to the employer of $306.69 USD per case and an average percent improvement in pain (VNPS) of 87.2%. The most frequently treated areas were the shoulder (32,574 cases), hip (6,633 cases), and low back (27,873 cases), respectively. A total of 48,946 cases were work-related pain/discomfort, of which 1,110 (2.27%) went on to worker’s compensation. CONCLUSION: ARTCS in the workplace has shown a positive trend in terms of reducing pain intensity. The cost was low as compared to worker’s compensation claims, as was the rate of cases (2.27%) referred to worker’s compensation. Additional studies, including prospective data collection and a control group, are warranted to substantiate this.

Workplace physiotherapy for musculoskeletal pain-relief in office workers: A pilot study

BACKGROUND

Musculoskeletal pain is highly prevalent among office workers and causes high costs to the public health system. Strategies including education and exercise are recommended, with major benefits when conducted by physical therapists in the occupational environment. However, the required investment is uncommon among companies. This study aimed to evaluate the efficacy of a multimodal physiotherapy intervention to relieve musculoskeletal pain in office workers.

MATERIALS AND METHODS

The study employed a single group study with a pre-post study design and was conducted at Universidad San Jorge in 2018. Outcome variables were: workplace ergonomics (INSHT Guide), existence and severity of musculoskeletal disorders (Nordic Musculoskeletal Questionnaire), musculoskeletal pain intensity (Numeric Rating Scale), and Clinical Global Impression Scale. Office workers in a university setting (n = 24, 19 females) were assessed at baseline, after 4 weeks of in-person sessions and following 3 weeks of autonomous performance. The physiotherapy program included education, ergonomic supervision, self-treatment, strengthening, and stretching exercises. A repeated-measures ANOVA or Friedman test (with post hoc comparisons) and Chi-squared test were used to compare the study variables.

RESULTS

At baseline, cervical spine (54%), shoulder (42%), and lumbar regions (37.5%) were the most symptomatic regions according to the Nordic Musculoskeletal Questionnaire. Even if the proportion of symptomatic areas did not decrease significantly after the intervention, a great reduction of musculoskeletal pain intensity was observed after the program in the cervical (P < 0.001), lower back (P = 0.005), shoulder (P = 0.006) regions, and in the overall pain level (P < 0.001).

CONCLUSIONS

These results support that a multimodal physiotherapy program can relieve work-related musculoskeletal pain in office workers and serve as a basis for future controlled trials.

Effectiveness of integrative medicine practices on workers' health within private companies

Introduction:

The attention to workers’ health is fundamental not only considering economical aspects (reducing absenteeism) but also for guaranteeing their quality of life.

Objectives:

To verify whether integrative medicine practices are effective for workers in private companies.

Methods:

Data were obtained from medical records of the acupuncture service of Irmandade da Santa Casa de Misericórdia de Piracicaba, in the state of São Paulo, Brazil. This is a descriptive study that evaluated the effectiveness of invasive and non-invasive integrative medicine practices in workers’ health through the use of the visual numeric scale for measuring pain, as well as independent variables (sex, age, types of physical and emotional complaints). Our sample consisted of 259 workers in 14 companies. Results were statistically evaluated using a Student’s t-test and a significance level of p = 0.05.

Results:

Most of the patients that sought integrative medicine services were women (73%), with a mean age of 38 years. The mean visual numeric scale value for workers that had physical pain complaints at the first session was 4.96, while that at the final session was 1.38; this reduction was significant (p < 0.0001). Emotional symptoms showed a visual numeric scale reduction of 5.18 to 1.90 (p < 0.0001). Regardless of the practice type (invasive or non-invasive), we observed a reduction in visual numeric scale values over integrative medicine sessions, although invasive therapies resulted in a stronger reduction than non-invasive ones (p < 0.0001).

Conclusions:

Overall, integrative medicine practices had a positive impact on workers’ health, reducing physical and emotional pain.

Unravelling the process between career shock and career (un)sustainability: exploring the role of perceived human resource management

Purpose

Employees need a sustainable career to prolong their working lives. The ability, motivation and opportunity to work form an important basis for sustainable careers across the lifespan. However, over the lifespan of their careers employees are likely to experience several career shocks (e.g. becoming chronically ill or being fired) which might result in unsustainable trajectories. This study aims to contribute to the literature on sustainable careers by unraveling the process through which careers shocks relate to career (un)sustainability and what role perceptions of human resource practices play in the process.

Design/methodology/approach

Thirty-three in-depth retrospective interviews with participants of 50 years and older were conducted and analyzed using a template analysis.

Findings

Results showed that career shocks influence career sustainability through a process of changes in demands or changes in resources, which in turn, relate to changes in person–job fit. When person-job–fit diminished, the ability, motivation and opportunity to continue working decreased, whereas when person–job fit improved, the ability, motivation and opportunity to continue working improved as well. Organizations appear to be able to diminish the negative consequences of career shocks by offering job resources such as HR practices in response to career shocks.

Research limitations/implications

A limitation of this study is the retrospective nature of the interviews, which could have resulted in recollection bias.

Practical implications

This study gives HRM practitioners insight into the HR practices that are effective in overcoming career shocks.

Originality/value

This study extends existing literature by including career shocks as possible predictors of sustainable careers.

The Influence of Social Support and Social Integration Factors on Return to Work Outcomes for Individuals with Work-Related Injuries: A Systematic Review

Purpose In occupational rehabilitation, the biopsychosocial model endorses the role of social factors in worker recovery. We conducted a systematic review to explore three questions examining the role of social support for the return-to-work (RTW) of individuals with work-related injury: (1) What are the worker-identified social barriers and facilitators in RTW; (2) What is the relationship between social factors and RTW; and (3) What is the effectiveness of social interventions for RTW. Methods Systematic searches of six databases were conducted for each research question. These identified 11 studies meeting inclusion criteria for Research Question 1, and 12 studies for Research Question 2. No studies were identified that met inclusion criteria for Research Question 3. A narrative synthesis approach was used to analyse the included studies. Results Research Question 1 identified five themes in social barriers and facilitators to RTW, including contact/communication, person-centred approaches, mutual trust, reaction to injury, and social relationships. Research Question 2 identified moderate support for reaction to injury and social integration/functioning as predictors of RTW and weak evidence for co-worker support. Four studies reported significant associations between social factors and RTW, six reported mixed findings with at least one significant social predictor, and two found no significant relationships. However, conclusions were limited by the inconsistency in measurement of social factors. Conclusions Our findings indicate that social support and integration may influence RTW following work-related injury, and highlights the need for further systematic examination of social factors in the field of occupational rehabilitation.

The management of work-related musculoskeletal injuries in an occupational health setting: the role of the physical therapist

With the emergence of work-related musculoskeletal disorders and the associated high cost of injured workers, physical therapists are in a unique position to help employers manage these concerns through multidisciplinary injury prevention programs, education, ergonomics, on-site treatment, and return to work programs. The purpose of this paper, through a review of the literature, is to describe the effect that workplace injuries have on employees and the economic burden on employers. Furthermore, this paper will highlight the effectiveness a physical therapist can have in the occupational health setting as part of a multidisciplinary team on ergonomics, employee health, prevention of work-related musculoskeletal disorders, return to work programs, and on-site treatment interventions, such as therapeutic exercise and manual intervention. This review of the literature suggests that participation in ergonomics and on-site physical therapy treatment in the workplace (e.g., education, exercise, manual intervention) has a positive effect on decreasing work-related musculoskeletal disorders, decreasing costs associated with these injuries, increasing work productivity, and decreasing absenteeism and improving presenteeism amongst workers. It is important to ensure that payers, employers, and employees are aware of the crucial role physical therapists can play in occupational health. Physical therapists also need to advocate for their role in occupational health and offer expert care to workers in a nontraditional manner.

Workplace Interventions can Reduce Sickness Absence for Persons With Work-Related Neck and Upper Extremity Disorders: A One-Year Prospective Cohort Study

OBJECTIVE

The objective of this study was to investigate whether workplace interventions are effective in reducing sickness absence in persons with work-related neck and upper extremity disorders and whether disorder improvement after intervention reduces sickness absence.

METHODS

This study was a prospective cohort study of workers with work-related neck pain or upper extremity disorders. Data were obtained from the Swedish "Work-related disorders" and "Work environment" surveys. Register data on sickness-absence 1 year after the surveys were made and obtained from the Swedish health insurance database.

RESULTS

A significant lower number of sickness-absence days were found for workers reporting improvement after intervention.

CONCLUSION

The findings in this study suggest that workplace intervention can reduce sickness absence for workers with neck or upper extremity disorders only if the intervention improves the disorder. The interventions were most effective in reducing medium long sickness absence periods.

An exploratory study of the injured worker’s experience and relationship with the workplace return to work coordinator in NSW, Australia

Purpose

The purpose of this paper is to provide insight into the injured worker’s perspective of experiences with their workplace return to work coordinator (RTWC), and explore some of the barriers they encountered in the return to work process.

Design/methodology/approach

Semi-structured interviews were conducted with ten injured workers from New South Wales, Australia. The thematic analysis of transcripts was completed.

Findings

The findings provide an insight into the experiences of injured workers and their relationship with RTWCs. Five key themes emerged from the data: return to work experiences and the RTWC role, high turnover and lack of consistency in the role, RTWC “ideal”, knowledge and skills, communication skills and the RTWC role and GP visits privacy and conflict of interest with peer RTWCs.

Practical implications

The role of the workplace RTWC in the return to work process for injured workers is important and these findings are highly relevant to the return to work sector. Consistency within the role at the workplace and careful consideration of the specific traits and characteristics required by an individual to perform the role need to be observed during the selection process by employers when appointing a workplace RTWC to assist injured workers return to work.

Originality/value

This is the first Australian study to examine the injured workers views and experiences with the workplace RTWC and other factors that shape the return to work process.

The effectiveness of multi-dimensional resilience rehabilitation programs after traumatic physical injuries: a systematic review and meta-analysis

Objective: To synthesize evidence of the effectiveness of socio-ecological resilience rehabilitation programs on returning to work (RTW), self-efficacy, and stress mitigation following traumatic physical injuries.Methods: PubMed, Scopus, Proquest, Cinahl, Web of Science, Clinical Trials Database, and the Cochrane Central Register of Controlled Trials databases were searched. Methodological quality was assessed using the PEDro tool.Study selection: Randomized interventions aimed at promoting resilience.Data extraction: Twenty one studies were reviewed (11,904 participants). Data from 19 studies of high methodological quality were pooled using a random-effects meta-analysis. Mean differences for continuous outcomes and risk ratios for binary outcomes were calculated.Data synthesis: Resilience rehabilitation programs significantly increased the likelihood of ever RTW (OR 2.09, 95% CI 0.99-4.44, p = 0.05), decreased the number of days taken to return to work (mean difference -7.80, 95% CI -13.16 to -2.45, p ≤ 0.001), and increased total self-efficacy scores (mean difference 5.19, 95% CI 3.12-7.26, p < 0.001). Subgroup analyses found that favorable return to work outcomes resulted from programs involving workplace support (p < 0.001) and for people with musculoskeletal or orthopedic injuries (p = 0.02).Conclusions: Compared to rehabilitation programs providing standard care following injuries, programs aimed at developing resilience could improve reemployment outcomes and self-efficacy.Implications for rehabilitationIndividual resilience may be an important factor promoting functional recovery after traumatic injury.Resilience rehabilitation programs are effective in enabling patients' return to work and increasing their self efficacy. In particular, programs involving the workplace are important components for enabling optimal work participation outcomes.

Disability and return to work after MRI on suspicion of scaphoid fracture: Influence of MRI pathology and occupational mechanical exposures

Objectives

We aimed to determine the prognosis after early MRI on clinical suspicion of scaphoid fracture, hypothesising that MRI pathology is associated with more disability and that MRI pathology and high occupational mechanical hand-arm exposures are associated with slower return to work (RTW).

Methods

We conducted a follow-up study of a cohort of 469 patients, who were scanned in the period 2006 to 2010. The respondents constituted our cohort for disability analysis and the subset that was in the labour market at the time of the trauma constituted our sub-cohort for RTW analysis. Questionnaires included disability scores, job title, and lifestyle factors. Job titles were linked with a job exposure matrix to estimate occupational exposures. Register information was obtained on time until RTW. We used logistic regression analysis of disability and Cox regression analysis of time until RTW.

Results

The proportion that responded was 53% (249/469) for the disability analysis and 59% (125/212) for the RTW analysis. The mean age at follow up was 43.5 years, the mean time since trauma was 4.8 years, 53% had injury of the dominant hand, and 54% had MRI pathology. Men constituted 43% of the cohort and 56% of the sub-cohort. MRI pathology was not associated with more disability [e.g., for a 'Disabilities of the Arm Shoulder and Hand'-score ≥20 the odds ratio was 0.58 (95% confidence interval 0.26–1.17)]. Patients without MRI pathology and with low occupational exposures were off work for an average of four weeks. Patients with MRI pathology or high occupational exposures were off work for twice as long time.

Conclusion

MRI pathology was not associated with more disability. For patients, who were in the labour market at the time of the trauma, MRI pathology and high occupational mechanical hand-arm exposures were associated with slower RTW.

Work ability, effort-reward imbalance and disability pension claims

Background

Effort-reward imbalance (ERI) and self-rated work ability are known independent correlates and predictors of intended disability pension claims. However, little research has focused on the interrelationship between the three and whether self-rated work ability mediates the relationship between ERI and intended disability pension claims.

Aims

To investigate whether self-rated work ability mediates the association between ERI and intended disability pension claims.

Methods

Baseline data from participants of the Third German Sociomedical Panel of Employees, a 5-year cohort study that investigates determinants of work ability, rehabilitation utilization and disability pensions in employees who have previously received sickness benefits, were analysed. We tested direct associations between ERI with intended disability pension claims (Model 1) and self-rated work ability (Model 2). Additionally, we tested whether work ability mediates the association between ERI and intended disability pension claims (Model 3).

Results

There were 2585 participants. Model 1 indicated a significant association between ERI and intended disability pension claims. Model 2 showed a significant association between ERI and self-rated work ability. The mediation in Model 3 revealed a significant indirect association between ERI and intended disability pension claims via self-rated work ability. There was no significant direct association between ERI and intended disability pension claims.

Conclusions

Our results support the adverse health-related impact of ERI on self-rated work ability and intended disability pension claims.

Medical and allied health staff self-reported long-term conditions

Purpose

The purpose of this paper is to describe the self-reported long-term conditions of medical officers and allied health staff working in a regional public health service in northern Australia and how these conditions are managed.

Design/methodology/approach

A cross-sectional survey design was used. The sample was all medical officers and allied health staff employed in mid-2015.

Findings

Of the 365 respondents, 217 (59.5 per cent) reported having at least one long-term condition. There was a statistically significant association between professional group and the number of long-term conditions reported, χ2=10.24, p<0.05. A greater proportion of medical officers (n=29, 43.9 per cent) reported having only one long-term condition compared with allied health staff (n=36, 24.5 per cent). The top four categories of conditions were respiratory, musculoskeletal, mental health and episodic and paroxysmal, although the patterns varied amongst the professional groups, and across age groups. Respondents usually managed their main long-term conditions with personal strategies, rarely using workplace strategies.

Research limitations/implications

Although somewhat low, the response rate of 32 per cent was similar to previous surveys in this health service. Since this survey, the health service has implemented a broad Health and Wellness Programme to support their qualified workforce. Future evaluations of this programme will be undertaken, including whether the programme has assisted health professionals to manage their long-term conditions.

Practical implications

There is an urgent need for targeted, workplace-based health promotion strategies to support staff with long-term conditions. Such strategies would complement self-management approaches, and also provide an important recruitment and retention initiative.

Originality/value

This study adds empirical evidence regarding the long-term conditions among health professionals and their self-management strategies. Little is known about the long-term conditions among the various health professional groups and the findings thus make an important contribution to the existing literature.

Importance of social capital at the workplace for return to work among women with a history of long-term sick leave: a cohort study

BACKGROUND

The workplace is an essential source of social capital for many people; it provides mutual support and gives meaning to life. However, few prospective studies have thoroughly investigated the importance of aspects of social capital in the workplace. The aim of this study was to investigate the associations between aspects of social capital (social support, sense of community, and quality of leadership) at the workplace, and work ability, working degree, and vitality among women with a history of long-term sick leave from human service organizations.

METHODS

A longitudinal cohort study was performed among women with a history of long-term sick leave. The study started in 2005, and the women were followed up at 6 months, 1 year, and 6 years using self-reported questionnaires (baseline n = 283). Linear mixed models were used for longitudinal analysis of the repeated measurements of prospective degree of work ability, working degree, and vitality. Analyses were performed with different models; the explanatory variables for each model were social support, sense of community, and quality of leadership and time.

RESULTS

Social capital in terms of quality of leadership (being good at solving conflicts and giving high priority to job satisfaction), sense of community (co-operation between colleagues) and social support (help and support from immediate superiors and colleagues) increased the women's work ability score (WAS) as well as working degree over time. Additionally, social capital in terms of quality of leadership increased the women's vitality score over time.

CONCLUSIONS

A sustainable return-to-work process among individuals with a history of long-term sick leave, going in and out of work participation, could be supported with social support, good quality of leadership, and a sense of community at the workplace. The responsibility for the rehabilitation process can not be reduced to an individual problem, but ought to include all stakeholders involved in the process, such as managers, colleagues, health care services, and the social security agency.

Women with Neck Pain on Long-Term Sick Leave-Approaches Used in the Return to Work Process: A Qualitative Study

Purpose There are difficulties in the process of return to work (RTW) from long-term sick leave, both in general and regarding sick leave because of neck pain in particular. Neck pain is difficult to assess, problematic to rehabilitate, and hard to cure; and it is not always easy to decide whether the pain is work-related. The outcome of RTW could be dependent upon individuals' approaches, defensive or offensive behaviors, and choices related to their self-efficacy. The aim of this study was to identify approaches used in the RTW process among women with neck pain on long-term sick leave from human service organizations. Methods This is a qualitative descriptive study based on grounded theory. A Swedish cohort of 207 women with a history of long-term sick leave with neck pain from human service organizations answered open-ended written questions at 0, 6, and 12 months, and 6 years; and 16 women were interviewed. Results Individuals expressed their coping approaches in terms of fluctuating in work status over time: either as a strategy or as a consequence. Periods of sick leave were interwoven with periods of work. The women were either controlling the interaction or struggling in the interaction with stakeholders. Conclusions Return to work outcomes may be improved if the fluctuating work status over time is taken into account in the design of rehabilitation efforts for women with a history of long-term sick leave and with chronical musculoskeletal conditions.

Social support outside work and return to work among women on long-term sick leave working within human service organizations

AIM

To investigate the relationships between return to work and social support outside work among women on long-term sick leave from human service organizations.

BACKGROUND

Work is an important part of life and is, in general, considered to be supportive of health and wellbeing. Few studies have thoroughly investigated the importance of aspects of social support outside work for return to work.

METHODS

A cohort of women on long-term sick leave was followed with questionnaires from 2005 to 2012.

RESULTS

The availability of social attachment increased the women's work ability, return to work, and vitality significantly more over time. There were positive relationships between return to work and seeking support in terms of emotional support and comfort and expressing unpleasant feelings.

CONCLUSIONS

Important resources to increase return to work can be found in factors outside work, such as close social relationships and support seeking. Thus, it is important to take the woman's whole life situation into account and not focus solely on aspects related to the workplace.

Manager Experiences with the Return to Work Process in a Large, Publically Funded, Hospital Setting: Walking a Fine Line

PURPOSE

Previous research on the role of managers in the return to work (RTW) process has primarily been conducted in contexts where the workplace has declared organizational responsibility for the process. While this is a common scenario, in some countries, including Denmark, there is no explicit legal obligation on the workplace to accommodate RTW. The aim of this study was to gain knowledge about the potential roles and contributions of managers in supporting returning employees in a context where they have no legal obligation to actively support RTW.

METHODS

Nineteen Danish hospital managers participated in a one-on-one interview or focus group discussions aimed at identifying barriers and facilitators for supporting employees in their RTW. Five individual interviews and two focus group discussions were conducted. Transcripts were analysed using thematic content analysis.

RESULTS

Four main themes were identified: (1) 'Coordinator and collaborator'; (2) 'Dilemmas of the RTW policy enforcer'; (3) 'The right to be sick and absent'; and (4) 'Keep the machinery running…'. Our findings indicated that supervisors' capacity to support returning workers was related to individual, communication, organizational, and policy factors. Instances were observed where supervisors faced the dilemma of balancing ethical and managerial principles with requirements of keeping staffing budgets.

CONCLUSION

Although it is not their legislative responsibility, Danish managers play a key role in the RTW process. As has been observed in other contexts, Danish supervisors struggle to balance considerations for the returning worker with those of their teams.

Return to work from long-term sick leave: a six-year prospective study of the importance of adjustment latitudes at work and home

PURPOSE

The aim was to investigate the long-term importance of adjustment latitude for increased work ability and return to work among female human service workers on long-term sick leave.

METHODS

A cohort of female human service workers on long-term sick leave (>60 days) was given a questionnaire four times (0, 6, 12, 60 months). Linear mixed models were used for longitudinal analysis of the repeated measurements of work ability and return to work.

RESULTS

Having a higher level of adjustment latitude was associated with both increased work ability and return to work. Adjustments related to work pace were strongly associated with increased work ability, as were adjustments to the work place. Having individual opportunities for taking short breaks and a general acceptance of taking short breaks were associated with increased work ability. At home, a higher level of responsibility for household work was related to increased work ability and return to work. Individuals with possibilities for adjustment latitude, especially pace and place at work, and an acceptance of taking breaks had greater increased work ability over time and a greater work ability compared with individuals who did not have such opportunities.

CONCLUSIONS

This study highlights the importance of opportunities for adjustment latitude at work to increase work ability and return to work among female human service workers who have been on long-term sick leave. The results support push and pull theories for individual decision-making on return to work.