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Gómez V, Ehrmann Feldman D, Côté D, Kairy D, Laberge M, León A, Miciak M, Morin M, Saunders S, Orozco T, Hudon A. Physiotherapy experiences of injured immigrant workers in Quebec: an intersectional perspective. Disabil Rehabil 2024:1-11. [PMID: 39229647 DOI: 10.1080/09638288.2024.2393802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 08/13/2024] [Accepted: 08/14/2024] [Indexed: 09/05/2024]
Abstract
PURPOSE Immigrant workers are more likely to suffer work-related injuries compared to native-born Canadians. Their physical rehabilitation usually involves physiotherapy. This study sought to better understand the experiences of injured immigrant workers receiving compensation and physiotherapy treatments. MATERIALS AND METHODS We conducted a qualitative study using an interpretive descriptive methodology. Semi-structured interviews were completed with 10 compensated immigrant workers about the physiotherapy services they received. Transcripts were analyzed thematically and with an intersectional lens. RESULTS Two major themes were identified: 1) complex pathways to physiotherapy, and 2) key pillars of physiotherapy experiences. The first theme demonstrates that a lack of familiarity with the health and compensation systems, delayed access to physiotherapy, and cumulative burdens complicate the care of immigrant workers. The second theme shows that moral/emotional support, pain relief, and the recognition of sociocultural beliefs and fears are key aspects to improving the experiences of care for these workers. CONCLUSIONS This study offers new insights into physiotherapy in the context of a work injury, which may help physiotherapists adapt care to the complex needs of immigrant workers. The intersectional lens used in the analysis offers interesting ways of accounting for the multiple social identities of these workers.
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Affiliation(s)
- Victoria Gómez
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal CRIR, Montréal, Canada
| | - Debbie Ehrmann Feldman
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal CRIR, Montréal, Canada
- Centre de recherche en Santé Publique (CResP), Montréal, Canada
| | - Daniel Côté
- Faculty of Arts and Science - Department of Anthropology, Université de Montréal, Montréal, Canada
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), Montréal, Canada
| | - Dahlia Kairy
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal CRIR, Montréal, Canada
| | - Marie Laberge
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada
- Centre de recherche du CHU Ste-Justine, Montréal, Canada
| | - Amelia León
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), Montréal, Canada
| | - Maxi Miciak
- Faculty of Rehabilitation Medicine, College of Health Sciences, University of Alberta, Edmonton, Canada
| | - Maud Morin
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal CRIR, Montréal, Canada
| | - Sara Saunders
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montréal, Canada
| | - Tatiana Orozco
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Anne Hudon
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal CRIR, Montréal, Canada
- Centre de recherche en éthique (CRÉ), Montréal, Canada
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Uhlin K, Persson E, Bäärnhielm S, Borg K, Löfgren M, Stålnacke BM. Interdisciplinary pain rehabilitation for immigrants with chronic pain who need language interpretation. J Rehabil Med 2024; 56:jrm13466. [PMID: 38407432 PMCID: PMC10910276 DOI: 10.2340/jrm.v56.13466] [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: 06/19/2023] [Accepted: 01/11/2024] [Indexed: 02/27/2024] Open
Abstract
OBJECTIVE To investigate outcomes in patients with chronic pain after participation in an interdisciplinary pain rehabilitation programme with language interpreters, and to investigate the outcomes in women and men separately. DESIGN Prospective multi-centre cohort study. PATIENTS Ninety-five patients in Sweden with chronic pain who have insufficient knowledge of the Swedish language. METHODS Duration and intensity of pain, anxiety and depression, health-related quality of life and fear of movement were evaluated before and after the programme. Patients were compared with a reference group comprising Swedish-speaking patients participating in an ordinary interdisciplinary pain rehabilitation programme. RESULTS Before the interdisciplinary pain rehabilitation programme with language interpreters, all variables except pain duration differed significantly to the detriment of the studied group. The studied group showed significant improvements after the interdisciplinary pain rehabilitation programme with language interpreters, with regards to pain intensity, depression and fear of movement. The reference group improved significantly for all variables. The women in the studied group showed significant improvements for the same variables as the whole group, while the men in the studied group did not improve in any of the variables. CONCLUSION This study indicates that patients with chronic pain, and especially women, who have insufficient knowledge of Swedish seem to benefit from participating in an interdisciplinary pain rehabilitation programme with language interpreters. The result may be of value for the further development of rehabilitation programmes with language interpreters.
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Affiliation(s)
- Karin Uhlin
- Karolinska Institutet, Department of Clinical Sciences, Division of Rehabilitation Medicine, Danderyd Hospital, Stockholm, Sweden; Danderyd University Hospital, Department of Rehabilitation Medicine, Stockholm, Sweden.
| | - Elisabeth Persson
- Karolinska Institutet, Department of Clinical Sciences, Division of Rehabilitation Medicine, Danderyd Hospital, Stockholm, Sweden; Danderyd University Hospital, Department of Rehabilitation Medicine, Stockholm, Sweden
| | - Sofie Bäärnhielm
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Transcultural Centre, Region Stockholm, Sweden
| | - Kristian Borg
- Karolinska Institutet, Department of Clinical Sciences, Division of Rehabilitation Medicine, Danderyd Hospital, Stockholm, Sweden; Danderyd University Hospital, Department of Rehabilitation Medicine, Stockholm, Sweden
| | - Monika Löfgren
- Karolinska Institutet, Department of Clinical Sciences, Division of Rehabilitation Medicine, Danderyd Hospital, Stockholm, Sweden; Danderyd University Hospital, Department of Rehabilitation Medicine, Stockholm, Sweden
| | - Britt-Marie Stålnacke
- Karolinska Institutet, Department of Clinical Sciences, Division of Rehabilitation Medicine, Danderyd Hospital, Stockholm, Sweden; Department of Community Medicine and Rehabilitation, Rehabilitation Medicine, Umeå University, Umeå, Sweden
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Yelton MJ, Jildeh TR. Cultural Competence and the Postoperative Experience: Pain Control and Rehabilitation. Arthrosc Sports Med Rehabil 2023; 5:100733. [PMID: 37645397 PMCID: PMC10461144 DOI: 10.1016/j.asmr.2023.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 04/03/2023] [Indexed: 08/31/2023] Open
Abstract
Healthcare inequities exist across healthcare and have been shown to influence patient care and outcomes. In the field of orthopaedic surgery, healthcare disparities have been shown to manifest in the realms of postoperative pain management and rehabilitation. Previous literature has demonstrated that socioeconomic status, sex, gender, race, and ethnicity influence postoperative pain management and can precipitate a negative patient experience, manifesting as poorly managed pain and undertreatment of minorities and patients of lower socioeconomic status. A similar body of literature has revealed similar barriers in postoperative rehabilitation, particularly with regard to accessibility, language, rapport, and culture. These disparities impact patients, ranging from diminished surgical satisfaction to postoperative morbidity. As the United States becomes increasingly diverse, cultural competence plays a major role in combating these disparities. This article presents methods to promote cultural competence, including greater diversity in the medical field, a greater emphasis on cultural competency in education and training programs at all levels of healthcare, increased resources allocated to researching healthcare inequities, and more effective mechanisms of patient education.
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Affiliation(s)
- Mitchell J. Yelton
- Michigan State University College of Human Medicine, East Lansing, Michigan, U.S.A
| | - Toufic R. Jildeh
- Department of Orthopaedics, Michigan State University, East Lansing, Michigan, U.S.A
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Uhlin K, Persson E, Stålnacke BM, Löfgren M. Healthcare professionals' experiences and perspectives of team-based interdisciplinary pain rehabilitation with immigrants requiring an interpreter. A qualitative study. Disabil Rehabil 2022:1-12. [PMID: 35996890 DOI: 10.1080/09638288.2022.2111608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE There is a lack of knowledge about interprofessional rehabilitation for culturally diverse patients with chronic pain. This study explores experiences of healthcare professionals developing and working with rehabilitation with patients in need of an interpreter and their experience of working with interpreters. METHODS Twelve healthcare professionals at two Swedish specialist rehabilitation centres were interviewed. Grounded theory principles were used for the data collection and analysis. RESULTS The main category "Demanding and Meaningful Work" represents three concurrently interacting categories: "Frustration" includes the informants' doubts regarding the benefits of the rehabilitation, lack of care for patients and cultural dissonance between professionals and patients. "Challenges" describes problems in the rehabilitation work due to the need for interpreted mediated communication, the complexity in health status and social aspects among the patients. "Solutions" represents practical working methods and personal approaches developed by the informants for managing frustrations and challenges. CONCLUSIONS The informants' frustration and challenges when working with a new group of patients, vulnerable and different in their preconceptions, led to new solutions in working methods and approaches. When starting a pain rehabilitation programme for culturally diverse patients, it is important to consider the rehabilitation team's need for additional time and support.IMPLICATIONS FOR REHABILITATIONHealthcare professionals who encounter immigrants with chronic pain need resources to develop their own skills in order to handle complex ethical questions as the patients represent a vulnerable patient group with many low status identitiesIn order to adapt rehabilitation programmes to patient groups with different languages and pre-understandings of chronic pain, there is a need for a team with specific qualities, i.e., close cooperation, an innovative atmosphere, time and also support from expertsFor appropriate language interpretation it is important to have a professional interpreter and a healthcare professional who are aware of and adopt the rules, possibilities and restrictions of interpretationThe rehabilitation of patients in need of language interpretation needs more time and organisation compared to the rehabilitation of patients who speak the national language.
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Affiliation(s)
- Karin Uhlin
- Division of Rehabilitation Medicine, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.,Department of Rehabilitation Medicine, Danderyd University Hospital, Stockholm, Sweden
| | - Elisabeth Persson
- Department of Pain Rehabilitation, Skåne University Hospital, Lund, Sweden
| | - Britt-Marie Stålnacke
- Division of Rehabilitation Medicine, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.,Department of Community Medicine and Rehabilitation, Rehabilitation Medicine, Umeå University, Umeå, Sweden
| | - Monika Löfgren
- Division of Rehabilitation Medicine, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.,Department of Rehabilitation Medicine, Danderyd University Hospital, Stockholm, Sweden
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Premji S, Begum M, Medley A, MacEachen E, Côté D, Saunders R. Le retour au travail dans un contexte de barrières linguistiques : Une étude comparative des politiques et des pratiques d’indemnisation des victimes de lésion professionnelle au Québec et en Ontario. PERSPECTIVES INTERDISCIPLINAIRES SUR LE TRAVAIL ET LA SANTÉ 2021. [DOI: 10.4000/pistes.7007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Premji S, Begum M, Medley A, MacEachen E, Côté D, Saunders R. Return-to-Work in a Language Barrier Context : Comparing Quebec’s and Ontario’s Workers’ Compensation Policies and Practices. PERSPECTIVES INTERDISCIPLINAIRES SUR LE TRAVAIL ET LA SANTÉ 2021. [DOI: 10.4000/pistes.7144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
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McGowan E, Beamish N, Stokes E, Lowe R. Core competencies for physiotherapists working with refugees: a scoping review. Physiotherapy 2020; 108:10-21. [PMID: 32693237 DOI: 10.1016/j.physio.2020.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To summarise the existing knowledge base that can inform the development of a core competency profile for physiotherapists to support and deliver rehabilitation services to refugees. METHOD In this scoping review, a comprehensive search of peer-reviewed and grey literature was conducted. The search parameters included studies relevant to the physiotherapy profession and published between 2000 and 2019. MEDLINE, EMBASE, CINAHL, PEDro, and Ovid PsycINFO databases were searched. Grey literature was accessed through website searches, Google Scholar, and direct requests. FINDINGS Three themes were identified in the literature. The first theme encompassed the physical and mental health of refugees. The second theme explored the cultural competence physiotherapists need to work with refugees. This theme included the cultural influences on health and healthcare and communication strategies that could be used to optimise healthcare for refugees. The last theme described refugees and the healthcare system which encompassed the challenges that refugees face in accessing healthcare and navigating the healthcare system. The main physiotherapy competencies detected in the literature were an understanding of refugee health, the administration of culturally competent care and knowledge of healthcare systems as they relate to refugees. CONCLUSION This comprehensive search identified three themes that can be used to inform the development of a competency profile for physiotherapists working with refugees. These themes are, however, rather vague and non-specific and signal the need for research to further examine the physiotherapy competencies necessary to provide the highest quality of care for this growing population.
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Affiliation(s)
- Emer McGowan
- Discipline of Physiotherapy, Trinity College, The University of Dublin, Dublin, Ireland.
| | | | - Emma Stokes
- Department of Physiotherapy & Rehabilitation Science, QU Health, Qatar University, Doha, Qatar.
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Mirza M, Harrison EA, Roman M, Miller KA, Jacobs EA. Walking the talk: understanding how language barriers affect the delivery of rehabilitation services. Disabil Rehabil 2020; 44:301-314. [DOI: 10.1080/09638288.2020.1767219] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Mansha Mirza
- Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL, USA
| | - Elizabeth A. Harrison
- Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL, USA
| | - Marissa Roman
- Rehabilitation Sciences Program, University of Illinois at Chicago, Chicago, IL, USA
| | - Kathryn A. Miller
- School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Elizabeth A. Jacobs
- Departments of Population Health and Internal Medicine, University of Texas, Austin, TX, USA
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Sociocultural factors influencing physiotherapy management in culturally and linguistically diverse people with persistent pain: a scoping review. Physiotherapy 2020; 107:292-305. [PMID: 32026832 DOI: 10.1016/j.physio.2019.08.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND People with persistent pain from culturally and linguistically diverse (CALD) communities experience significant health inequities. OBJECTIVE To synthesise the sociocultural factors influencing pain management between CALD patients with persistent pain and physiotherapists treating CALD patients. DATA SOURCES Major electronic databases MEDLINE, AMED, Scopus, Web of Science, PsycINFO and Google Scholar were searched until July 2018. STUDY SELECTION Studies were included if they explored clinical interactions between physiotherapists and patients with persistent pain from diverse ethnocultural backgrounds. STUDY APPRAISAL The methodological quality of qualitative and quantitative studies were assessed using the Critical Appraisal Skills Programme (CASP) Checklist and Mixed Methods Appraisal Tool (MMAT) respectively. SYNTHESIS METHOD A thematic synthesis approach was used to extract the common themes. RESULTS Sixteen articles from 16 studies were included. Eleven studies were qualitative and five studies were quantitative. Ten explored patients' perspectives, four explored physiotherapists' perspectives, and two explored both. Key factors included: (a) language competence; (b) active vs passive coping strategies; (c) gendered influences; (d) cultural-spiritual beliefs, illness perceptions and expression of pain; (e) treatment satisfaction and; (f) barriers to access. CONCLUSION Discordant perspectives on causation, pain management approaches, and patient autonomy in management are evident between CALD patients and physiotherapists. Such discordance potentially create stress in the therapeutic alliance and undermines the efficacy of pain management interventions. To mitigate such barriers, it is crucial to foster cultural competence in physiotherapy and equip physiotherapists with opportunities to maximise their sociocultural awareness, knowledge and skill practising physiotherapy in cultural plural societies.
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Hendy J, Vandrevala T, Ahmed A, Kelly C, Gray L, Ala A. Feeling misidentified: Understanding migrant's readiness to engage in health care screening. Soc Sci Med 2019; 237:112481. [DOI: 10.1016/j.socscimed.2019.112481] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 07/22/2019] [Accepted: 08/03/2019] [Indexed: 02/07/2023]
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Jones L, Sheeran N, Lanyon H, Evans K, Martincovic T. Nurses’ perceptions of communicating with minority parents in a neonatal nursery: a communication accommodation theory approach. ACTA ACUST UNITED AC 2018. [DOI: 10.1080/17538068.2018.1460959] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Liz Jones
- School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Nicola Sheeran
- School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Hanna Lanyon
- School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Karina Evans
- School of Applied Psychology, Griffith University, Brisbane, Australia
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Grandpierre V, Milloy V, Sikora L, Fitzpatrick E, Thomas R, Potter B. Barriers and facilitators to cultural competence in rehabilitation services: a scoping review. BMC Health Serv Res 2018; 18:23. [PMID: 29334968 PMCID: PMC5769395 DOI: 10.1186/s12913-017-2811-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 12/18/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is an important need to evaluate whether rehabilitation services effectively address the needs of minority culture populations with North America's increasingly diverse population. The objective of this paper was therefore to review and assess the state of knowledge of barriers and facilitators to cultural competence in rehabilitation services. METHOD Our scoping review focused on cultural competence in rehabilitation services. Rehabilitation services included in this review were: audiology, speech-language pathology, physiotherapy, and occupational therapy. A search strategy was developed to identify relevant articles published from inception of databases until April 2015. Titles and abstracts were screened by two independent reviewers according to specific eligibility criteria with the use of a liberal-accelerated approach. Full-text articles meeting inclusion criteria were then screened. Key study characteristics were abstracted by the first reviewer, and findings were verified by the second reviewer. RESULTS After duplicates were removed, 4303 citations were screened. Included articles suggest that studies on cultural competence occur most frequently in occupational therapy (n = 17), followed by speech language pathology (n = 11), physiotherapy (n = 6), and finally audiology (n = 1). Primary barriers in rehabilitation services include language barriers, limited resources, and cultural barriers. Primary facilitators include cultural awareness amongst practitioners, cultural awareness in services, and explanations of health care systems. CONCLUSION To our knowledge, this review is the first to summarize barriers and facilitators to cultural competence in rehabilitation fields. Insufficient studies were found to draw any conclusions with regards to audiological services. Minimal perspectives based on patient/caregiver experiences in all rehabilitation fields underscore a research gap. Future studies should aim to explore both patient/caregiver and practitioner perspectives as such data can help inform culturally competent practices.
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Affiliation(s)
- Viviane Grandpierre
- Children’s Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1 USA
- University of Ottawa, Roger Guindon Hall, 455 Smyth Road, Ottawa, ON K1H 8L1 USA
| | - Victoria Milloy
- University of Ottawa, Roger Guindon Hall, 455 Smyth Road, Ottawa, ON K1H 8L1 USA
| | - Lindsey Sikora
- University of Ottawa, Roger Guindon Hall, 455 Smyth Road, Ottawa, ON K1H 8L1 USA
| | - Elizabeth Fitzpatrick
- Children’s Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1 USA
- University of Ottawa, Roger Guindon Hall, 455 Smyth Road, Ottawa, ON K1H 8L1 USA
| | - Roanne Thomas
- University of Ottawa, Roger Guindon Hall, 455 Smyth Road, Ottawa, ON K1H 8L1 USA
| | - Beth Potter
- University of Ottawa, Roger Guindon Hall, 455 Smyth Road, Ottawa, ON K1H 8L1 USA
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Gravel S, Dubé J, Côté D, White BW, Gratton D. Le retour au travail d’immigrants ayant subi une lésion professionnelle : les embûches de la rencontre interculturelle et la précarité du lien d’emploi. ACTA ACUST UNITED AC 2017. [DOI: 10.7202/1040609ar] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cet article rapporte une partie des résultats d'une étude exploratoire sur le processus de réadaptation et de retour au travail en contexte de relations interculturelles. Cette étude avait deux objectifs : identifier les stratégies mises de l'avant par les différents acteurs pour faciliter le processus de réadaptation et de retour au travail des travailleurs immigrants et décrire les contraintes, les obstacles et les aides au processus selon la perspective des différents acteurs. Des entrevues semi-dirigées ont ainsi été menées auprès de 47 répondants : cliniciens, agents d'indemnisation et conseillers en réadaptation de la CNESST, employeurs et travailleurs immigrants victimes d'une lésion reconnue et indemnisée. Au-delà des barrières linguistiques et culturelles, deux facteurs nuisent au retour en emploi des travailleurs immigrants : d'une part, la précarité du lien d'emploi freine leurs efforts et mine leur volonté de consolider leur état de santé et, d'autre part, la menace ou la perte réelle du lien d'emploi amène une rupture symbolique dans leur processus d'intégration. Cette rupture est importante pour ceux qui sont surqualifiés pour leur poste, surtout si leur emploi est un passage obligé pour acquérir une expérience de travail au Canada et viser ensuite un emploi à la hauteur de leurs compétences. Le processus de réadaptation peut soit se transformer en un « parcours déshonorant », soit fournir une occasion d'améliorer sa situation sur un marché du travail discriminant. Adapter les programmes à la réalité de ces travailleurs immigrants est possible, mais pose un dilemme moral et éthique : comment motiver les travailleurs à se rétablir tout en explorant un autre créneau d'emploi si leur lien d'emploi risque d'être rompu, alors que les règles relatives au droit de retour au travail prévoient la réintégration de l'emploi prélésionnel ou tout autre poste jugé équivalent?
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Affiliation(s)
- Sylvie Gravel
- Institut Santé et société, Université du Québec à Montréal, Montréal, Canada
| | - Jessica Dubé
- Université du Québec à Montréal, Montréal, Canada
| | - Daniel Côté
- Institut de recherche Robert Sauvé en santé et sécurité au travail, Montréal, Canada
| | - Bob W. White
- Université du Québec à Montréal, Montréal, Canada
| | - Danielle Gratton
- Centre intégré de santé et de services sociaux (CIUSS) Laval, Montréal, Canada
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Premji S. Barriers to Return-to-Work for Linguistic Minorities in Ontario: An Analysis of Narratives from Appeal Decisions. JOURNAL OF OCCUPATIONAL REHABILITATION 2015; 25:357-67. [PMID: 25240395 DOI: 10.1007/s10926-014-9544-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
PURPOSE Previous research has shown that linguistic minorities have inferior workers' compensation experiences and outcomes; however little information exists on the structural barriers they face in relation to return-to-work (RTW). We sought to address this gap by describing barriers to RTW for linguistic minorities in Ontario using narratives from appeal decisions. METHODS We examined decisions by the Ontario Workplace Safety and Insurance Appeals Tribunal. We searched the full text of decisions rendered between October 1, 2010 and September 30, 2011 for the keyword "English". A total of 378 decisions were generated. After eliminating decisions that did not involve linguistic minorities we retained half (189) for analysis. We summarized the issues around language for each decision and identified broad themes across decisions. RESULTS We found that linguistic minorities' limitations with regards to communication and power left them vulnerable to abuse, incomprehension and misperception by employers, care providers and adjudicators. In addition, specific RTW policies and practices failed to properly consider or mitigate their lack of English proficiency. These interpersonal and structural barriers negatively impacted linguistic minorities' eligibility to benefits and services and the appropriateness thereof, as well as their eventual return to work. CONCLUSIONS Our research highlights the need to move beyond efforts to improve the linguistic competence of compensation boards to target the structural factors that impede equal access at every stage of the process.
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Affiliation(s)
- Stephanie Premji
- Department of Health, Aging and Society, School of Labour Studies, McMaster University, 1280 Main Street West, Kenneth Taylor Hall, Room 701, Hamilton, ON, L8S 4M4, Canada,
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Coté D. La réadaptation au travail des personnes issues de l’immigration et des minorités ethnoculturelles : défis, perspectives et pistes de recherche. PERSPECTIVES INTERDISCIPLINAIRES SUR LE TRAVAIL ET LA SANTÉ 2014. [DOI: 10.4000/pistes.3633] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Côté D. Intercultural communication in health care: challenges and solutions in work rehabilitation practices and training: a comprehensive review. Disabil Rehabil 2012; 35:153-63. [PMID: 22616895 DOI: 10.3109/09638288.2012.687034] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE The purpose of this comprehensive literature review it to explore cross-cultural issues in occupational rehabilitation and work disability prevention. METHOD A literature review on cross-cultural issues was performed in medicine, health sciences, and social sciences databases (PubMed, Ingenta, Canadian Centre for Occupational Health and Safety, Ergonomics Abstract, Google Scholar, OSH Update and the Quebec Workers' Compensation Board data base). A total of 27 documents published until 2010 in English or French were selected and analyzed. RESULTS Cross-cultural issues in occupational rehabilitation show that representations of pain, communication and therapist-patient relationship and intercultural competence could be presented as the major topics covered in the selected literature. As for the general topic of immigrant workers and OSH, barriers were identified revealing personal, relational, contextual and structural levels that put immigrant and minority workers in situation of vulnerability (ex. linguistic and cultural barriers, lack of knowledge of the system, precarious work or exposition to higher risk hazards, etc.). Cultural issues in occupational rehabilitation put less attention to work-related contextual factors but emphasized on attitude and pain behaviours, perceptions of illness and appropriate treatment, therapist-patient relationship and cultural competences among OT professionals. CONCLUSIONS The growth of immigration in countries such as Canada poses a real challenge to the delivery of health care and rehabilitation services. Despite growing concerns in providing culturally appropriate heath cares, intervention models, tools and training tools are still lacking in occupational rehabilitation and disability management. Nevertheless, cultural competence seems to be a promising concept to be implemented in work rehabilitation and disability management.
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Affiliation(s)
- Daniel Côté
- Occupational Health and Safety Research Institute Robert-Sauvé (IRSST) Quebec, Canada.
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Omu O, Reynolds F. Health professionals’ perceptions of cultural influences on stroke experiences and rehabilitation in Kuwait. Disabil Rehabil 2011; 34:119-27. [DOI: 10.3109/09638288.2011.591883] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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