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Karlsson I, Sandman L, Axén I, Kwak L, Sernbo E, Björk Brämberg E. Ethical challenges from a problem-solving intervention with workplace involvement: a qualitative study among employees with common mental disorders, first-line managers, and rehabilitation coordinators. Int J Qual Stud Health Well-being 2024; 19:2308674. [PMID: 38324667 PMCID: PMC10851822 DOI: 10.1080/17482631.2024.2308674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 01/18/2024] [Indexed: 02/09/2024] Open
Abstract
PURPOSE This study aims to explore ethical challenges potentially arising from a problem-solving intervention with workplace involvement (PSI-WPI) in primary health care (with first-line manager involvement) for employees on sickness absence due to common mental disorders. METHODS A qualitative design guided by the theoretical framework for systematic identification of ethical aspects of healthcare technologies. Semi-structured interviews were performed with coordinators (n = 6), employees (n = 13), and first-line managers (n = 8). Reflexive thematic analysis was used to analyse and interpret themes. RESULTS A main theme was identified "the workplace and healthcare hold different organizational value logics" and four sub-themes: "the PSI-WPI challenged the organizational goals and values of the workplace and healthcare", "the PSI-WPI challenged organizational values on fairness", "the PSI-WPI challenged the professional roles of first-line managers and rehabilitation coordinators" and "the PSI-WPI introduced a need for the employee to juggle the employee and patient roles". CONCLUSION Different organizational value logics, values, and goals can introduce ethical challenges. We advise clarifying stakeholders' roles and preparing employees and managers for the return to work process by providing sufficient information. The ethical challenges and suggested measures to minimize them, should be considered when planning return to work interventions that involve several stakeholders.
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Affiliation(s)
- Ida Karlsson
- Institute of Environmental Medicine, Unit of Intervention and Implementation Research for Worker Health, Karolinska Institutet, Stockholm, Sweden
| | - Lars Sandman
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Iben Axén
- Institute of Environmental Medicine, Unit of Intervention and Implementation Research for Worker Health, Karolinska Institutet, Stockholm, Sweden
| | - Lydia Kwak
- Institute of Environmental Medicine, Unit of Intervention and Implementation Research for Worker Health, Karolinska Institutet, Stockholm, Sweden
| | - Elisabet Sernbo
- Faculty of Social Sciences, Department of Social Work, University of Gothenburg, Gothenburg, Sweden
| | - Elisabeth Björk Brämberg
- Institute of Environmental Medicine, Unit of Intervention and Implementation Research for Worker Health, Karolinska Institutet, Stockholm, Sweden
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Prior E, Papathomas A, Rhind D. Navigating athlete mental health: Perspectives from performance directors within elite sport. PSYCHOLOGY OF SPORT AND EXERCISE 2024; 73:102661. [PMID: 38735507 DOI: 10.1016/j.psychsport.2024.102661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 05/08/2024] [Accepted: 05/09/2024] [Indexed: 05/14/2024]
Abstract
Performance directors lead high-performance programmes within elite sport and where they opt to invest resources has implications for athletes. This study explores performance directors' perspectives on mental health and illness and their experiences of managing these within elite sport. We conducted semi-structured interviews with 11 performance directors, resulting in 18 h of data. Interviews were transcribed verbatim and analysed using reflexive thematic analysis. We constructed three themes: 1) making sense of mental health: legitimacy vs. scepticism; 2) mental health as athlete responsibility; and 3) simplifying and sanitising mental health. Performance directors used physical health analogies to make sense of mental health, sometimes describing unrealistic expectations regarding mental health management. They also positioned athletes as responsible for finding solutions to their mental health concerns, at times overlooking the impact of the elite sport environment. Some performance directors shared over-simplified perceptions of mental health, often focusing on 'the positive' and neglecting to talk about the more challenging aspects of mental health and illness. Educating performance directors, as well as others in leadership positions, on the complexities of mental health and illness is recommended. This should include how mental illness differs from physical illness and injury, how to respond when athletes disclose mental health concerns, and how mental illness recovery is often nonlinear and subjectively defined.
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Affiliation(s)
- Erin Prior
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, UK.
| | - Anthony Papathomas
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, UK
| | - Daniel Rhind
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough, UK
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Jaffe RH, Coyte PC, Chan BCF, Hancock-Howard RL, Malhotra AK, Ladha K, Wilson JR, Witiw CD. Traumatic Cervical Spinal Cord Injury and Income and Employment Status. JAMA Netw Open 2024; 7:e2418468. [PMID: 38916890 PMCID: PMC11200142 DOI: 10.1001/jamanetworkopen.2024.18468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 04/20/2024] [Indexed: 06/26/2024] Open
Abstract
Importance Spinal cord injury (SCI) causes drastic changes to an individual's physical health that may be associated with the ability to work. Objective To estimate the association of SCI with individual earnings and employment status using national administrative health databases linked to income tax data. Design, Setting, and Participants This was a retrospective, national, population-based cohort study of adults who were hospitalized with cervical SCI in Canada between January 2005 and December 2017. All acute care hospitalizations for SCI of adults ages 18 to 64 years were included. A comparison group was constructed by sampling from individuals in the injured cohort. Fiscal information from their preinjury years was used for comparison. The injured cohort was matched with the comparison group based on age, sex, marital status, province of residence, self-employment status, earnings, and employment status in the year prior to injury. Data were analyzed from August 2022 to January 2023. Main outcomes and Measures The first outcome was the change in individual annual earnings up to 5 years after injury. The change in mean yearly earnings was assessed using a linear mixed-effects differences-in-differences regression. Income values are reported in 2022 Canadian dollars (CAD $1.00 = US $0.73). The second outcome was the change in employment status up to 5 years after injury. A multivariable probit regression model was used to compare proportions of individuals employed among those who had experienced SCI and the paired comparison group of participants. Results A total of 1630 patients with SCI (mean [SD] age, 47 [13] years; 1304 male [80.0%]) were matched to patients in a preinjury comparison group (resampled from the same 1630 patients in the SCI group). The mean (SD) of preinjury wage earnings was CAD $46 000 ($48 252). The annual decline in individual earnings was CAD $20 275 (95% CI, -$24 455 to -$16 095) in the first year after injury and CAD $20 348 (95% CI, -$24 710 to -$15 985) in the fifth year after injury. At 5 years after injury, 52% of individuals who had an injury were working compared with 79% individuals in the preinjury comparison group. SCI survivors had a decrease in employment of 17.1 percentage points (95% CI, 14.5 to 19.7 percentage points) in the first year after injury and 17.8 percentage points (14.5 to 21.1 percentage points) in the fifth year after injury. Conclusions and Relevance In this study, SCI was associated with a decline in earnings and employment up to 5 years after injury for adults aged 18 to 64 years in Canada.
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Affiliation(s)
- Rachael H. Jaffe
- Institute for Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada
- Division of Neurosurgery, St Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Peter C. Coyte
- Institute for Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada
| | - Brian C.-F. Chan
- Institute for Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | | | - Armaan K. Malhotra
- Institute for Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada
- Division of Neurosurgery, St Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Karim Ladha
- Institute for Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada
- Department of Anesthesiology and Pain Medicine, St Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Jefferson R. Wilson
- Institute for Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada
- Division of Neurosurgery, St Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Christopher D. Witiw
- Institute for Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada
- Division of Neurosurgery, St Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada
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Newington L, Ceh D, Sandford F, Parsons V, Madan I. Supporting work participation for adults with hand and upper limb conditions: A survey of the British Association of hand therapists. HAND THERAPY 2024; 29:75-84. [PMID: 38827651 PMCID: PMC11143940 DOI: 10.1177/17589983241238424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 02/18/2024] [Indexed: 06/04/2024]
Abstract
Introduction Musculoskeletal disorders affect over a third of the UK adult population and are a common reason for sick leave from work. The aims of this study were to describe the reported provision of work participation support for adults with hand and upper limb conditions by UK hand therapists, and to identify potential training needs in this area. Methods A previous survey of the Australian Hand Therapy Association was adapted for the UK. The electronic questionnaire was distributed to members of the British Association of Hand Therapists. Eligible individuals were UK-based occupational therapists or physiotherapists whose role included the assessment and/or treatment of patients ≥18 years with hand or upper limb issues. Results There were 123 participants (17% response rate). The most frequently reported work participation interventions were discussing graded return to work and sign-posting patients to speak with their doctor. The Allied Health Professionals Health and Work Report and Fit Note were not regularly used, and respondents reported low levels of confidence in issuing these documents. Barriers to providing work recommendations included a perceived lack of time, skills, knowledge and training. Facilitators included the patient discussing work as a rehabilitation goal. Conclusion Development opportunities for UK hand therapists include increasing patient awareness that they can ask for work-related advice and documentation, promoting existing health and work training, developing hand therapy-specific resources, and ensuring access to electronic Fit Notes. International opportunities include the continuation of this survey with a focus on generating exemplar work participation strategies to inform further research.
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Affiliation(s)
- Lisa Newington
- Barts Bone and Joint Health, Queen Mary University of London, London, UK
- Hand Therapy, Barts Health NHS Trust, London, UK
- London Centre for Work and Health, London, UK
| | - Daniel Ceh
- Hand Therapy, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - Fiona Sandford
- Hand Therapy, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
- School of Biomedical Engineering and Imaging Sciences, School of Life Couse and Population Sciences, King’s College London, London, UK
| | - Vaughan Parsons
- London Centre for Work and Health, London, UK
- Occupational Health, Safety and Wellbeing Service, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
- Faculty of Life Sciences and Medicine, King’s College London, London, UK
| | - Ira Madan
- London Centre for Work and Health, London, UK
- Occupational Health, Safety and Wellbeing Service, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
- Faculty of Life Sciences and Medicine, King’s College London, London, UK
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Angerer P, Gündel H, Kröger C, Rothermund E. [Rationale, models, and impact of workplace-based psychotherapeutic services]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2024:10.1007/s00103-024-03892-8. [PMID: 38806746 DOI: 10.1007/s00103-024-03892-8] [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: 01/03/2024] [Accepted: 05/06/2024] [Indexed: 05/30/2024]
Abstract
Mental illnesses and behavioral disorders are very common among the working population, affecting up to a third of employees each year, and are associated with great suffering, the risk of chronicity, and the loss of employment. Economically, mental illnesses cause high costs. In order to mitigate these consequences and increase the chances of recovery, rapid diagnosis, early and appropriate treatment where necessary, and-over and above the usual psychotherapy approach-attention to the work-related causes are of crucial importance.Psychotherapeutic Consultation at the Workplace (PT-A) attempts to meet these requirements. It offers psychotherapeutic help at short notice and close to the workplace for employees suffering from mental stress; provides (depending on the problem) counseling, diagnostics, prevention, and short-term or bridging therapy; and supports reintegration after a longer period of mental illness. It is helpful to cooperate closely with the company medical service, which consults the PT‑A, refers employees to it, provides information on the company situation, and can support reintegration if necessary. Funding is often provided by the company but can also be provided by health insurance companies in integrated care models.This article begins by describing the history and principles of PT‑A and the role of work stress in the development of psychological and psychosomatic disorders. The implementation of PT‑A is then outlined using two examples. Finally, the current study "Early Intervention at the Workplace" ("Frühe Intervention am Arbeitsplatz" [friaa]), to which several articles in this special issue refer, is briefly presented.
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Affiliation(s)
- Peter Angerer
- Institut für Arbeits‑, Sozial- und Umweltmedizin, Centre for Health and Society, Medizinische Fakultät und Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Deutschland.
| | - Harald Gündel
- Klinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Ulm, Ulm, Deutschland
| | - Christoph Kröger
- Abteilung Klinische Psychologie und Psychotherapie, Institut für Psychologie, Universität Hildesheim, Hildesheim, Deutschland
| | - Eva Rothermund
- Klinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Ulm, Ulm, Deutschland
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Boets I, Luyten S, Vandenbroeck S, Godderis L. Success rate and predictors of return to work after implementation of a formal return-to-work trajectory: A retrospective cohort study. Work 2024:WOR230412. [PMID: 38759085 DOI: 10.3233/wor-230412] [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: 05/19/2024] Open
Abstract
BACKGROUND Long term sick leave (SL) is increasing in Europe, several countries have legislative initiatives to reduce long-term absenteeism. OBJECTIVE We evaluated the impact of a legally defined return-to-work (RTW) trajectory on the RTW of employees on sick leave in Belgium. METHODS This was a retrospective register-based cohort study of employees (n = 1416) who followed an RTW trajectory in 2017. We linked workers' data from a prevention service with social security data. By multinomial logistic regression, we analysed which characteristics predicted the RTW with the same or another employer. RESULTS One year after their RTW trajectory, 69.2% of the 1416 employees did not RTW; 10.7% returned to work with the same employer and 20.1% with a new employer. Duration of SL was an important predictor for the RTW with both the same employer and another employer. The odds of RTW were lower when the SL duration was > 6 months compared to < 6 months. Marital status, organization-size, and the occupational physician decision had a significant impact on the RTW with the same employer. Age and who initiated the RTW-trajectory were important predictors on the RTW with another employer. CONCLUSIONS Overall, 30.8% of employees returned to work after their RTW trajectory. A one-size-fits-all approach is not recommended. A stepped approach with an early, informal start of the RTW process is advised. When employees or employers fail to initiate the RTW on their own, a legally defined RTW trajectory could be useful. In particular, RTW with another employer seemed a positive effect of the RTW-trajectory.
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Affiliation(s)
- Isabelle Boets
- Centre for Environment and Health, KU Leuven, University of Leuven, Leuven, Belgium
- Group IDEWE, External Service for Prevention and Protection at Work, Heverlee, Belgium
| | - Steven Luyten
- Student at Department of Public Health and Primary Care, KU Leuven, University of Leuven, Leuven, Belgium
| | - Sofie Vandenbroeck
- Centre for Environment and Health, KU Leuven, University of Leuven, Leuven, Belgium
- Group IDEWE, External Service for Prevention and Protection at Work, Heverlee, Belgium
| | - Lode Godderis
- Centre for Environment and Health, KU Leuven, University of Leuven, Leuven, Belgium
- Group IDEWE, External Service for Prevention and Protection at Work, Heverlee, Belgium
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Brämberg E, Åhsberg E, Fahlström G, Furberg E, Gornitzki C, Ringborg A, Thoursie PS. Effects of work-directed interventions on return-to-work in people on sick-leave for to common mental disorders-a systematic review. Int Arch Occup Environ Health 2024:10.1007/s00420-024-02068-w. [PMID: 38710801 DOI: 10.1007/s00420-024-02068-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 04/23/2024] [Indexed: 05/08/2024]
Abstract
PURPOSE To evaluate the body of evidence of the effects of work-directed interventions on return-to-work for people on sick leave due to common mental disorders (i.e., mild to moderate depression, anxiety, adjustment disorders and reactions to severe stress). METHODS The systematic review was conducted in accordance with an a priori developed and registered protocol (Prospero CRD42021235586). The certainty of evidence was assessed by two independent reviewers using the Grading of Recommendations, Assessment, Development and Evaluations. RESULTS We reviewed 14,794 records published between 2015 and 2021. Of these, eight RCTs published in eleven articles were included in the analysis. POPULATION Working age adults (18 to 64 years), on sick leave due to mild to moderate depression, anxiety, adjustment disorders or reactions to severe stress. INTERVENTION Work-directed interventions. COMPARATOR No comparator, Standard care, or other measures. OUTCOME return to work, number of days on sick leave, income. Overall, the effects of work-focused CBT and work-focused team-based support on RTW resulted in increased or faster return-to-work compared with standard care or no intervention (low certainty of evidence). The effects of Individual Placement and Support showed no difference in RTW compared with standard care (very low certainty of evidence). CONCLUSION Interventions involving the workplace could increase the probability of RTW. Areas in need of improvement in the included studies, for example methodological issues, are discussed. Further, suggestions are made for improving methodological rigor when conducting large scale trials.
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Affiliation(s)
- Elisabeth Brämberg
- Unit of Intervention- and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden.
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Elizabeth Åhsberg
- Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU), Stockholm, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Gunilla Fahlström
- Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU), Stockholm, Sweden
| | - Elisabet Furberg
- Department of Philosophy, Stockholm University, Stockholm, Sweden
| | - Carl Gornitzki
- Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU), Stockholm, Sweden
| | - Anna Ringborg
- Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU), Stockholm, Sweden
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Mohebbi F, Forati AM, Torres L, deRoon-Cassini TA, Harris J, Tomas CW, Mantsch JR, Ghose R. Exploring the Association Between Structural Racism and Mental Health: Geospatial and Machine Learning Analysis. JMIR Public Health Surveill 2024; 10:e52691. [PMID: 38701436 PMCID: PMC11102033 DOI: 10.2196/52691] [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: 09/13/2023] [Revised: 01/15/2024] [Accepted: 03/20/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Structural racism produces mental health disparities. While studies have examined the impact of individual factors such as poverty and education, the collective contribution of these elements, as manifestations of structural racism, has been less explored. Milwaukee County, Wisconsin, with its racial and socioeconomic diversity, provides a unique context for this multifactorial investigation. OBJECTIVE This research aimed to delineate the association between structural racism and mental health disparities in Milwaukee County, using a combination of geospatial and deep learning techniques. We used secondary data sets where all data were aggregated and anonymized before being released by federal agencies. METHODS We compiled 217 georeferenced explanatory variables across domains, initially deliberately excluding race-based factors to focus on nonracial determinants. This approach was designed to reveal the underlying patterns of risk factors contributing to poor mental health, subsequently reintegrating race to assess the effects of racism quantitatively. The variable selection combined tree-based methods (random forest) and conventional techniques, supported by variance inflation factor and Pearson correlation analysis for multicollinearity mitigation. The geographically weighted random forest model was used to investigate spatial heterogeneity and dependence. Self-organizing maps, combined with K-means clustering, were used to analyze data from Milwaukee communities, focusing on quantifying the impact of structural racism on the prevalence of poor mental health. RESULTS While 12 influential factors collectively accounted for 95.11% of the variability in mental health across communities, the top 6 factors-smoking, poverty, insufficient sleep, lack of health insurance, employment, and age-were particularly impactful. Predominantly, African American neighborhoods were disproportionately affected, which is 2.23 times more likely to encounter high-risk clusters for poor mental health. CONCLUSIONS The findings demonstrate that structural racism shapes mental health disparities, with Black community members disproportionately impacted. The multifaceted methodological approach underscores the value of integrating geospatial analysis and deep learning to understand complex social determinants of mental health. These insights highlight the need for targeted interventions, addressing both individual and systemic factors to mitigate mental health disparities rooted in structural racism.
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Affiliation(s)
- Fahimeh Mohebbi
- College of Engineering and Applied Science, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
| | - Amir Masoud Forati
- Department of Medicine, University of Wisconsin-Madison, Madison, WI, United States
| | - Lucas Torres
- Department of Psychology, Marquette University, Milwaukee, WI, United States
| | - Terri A deRoon-Cassini
- Division of Trauma & Acute Care Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Jennifer Harris
- Community Relations-Social Development Commission, Milwaukee, WI, United States
| | - Carissa W Tomas
- Division of Epidemiology, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, United States
| | - John R Mantsch
- Department of Pharmacology & Toxicology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Rina Ghose
- College of Engineering and Applied Science, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
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Pedersen ER, Anke A, Langøy EE, Olsen MI, Søndenaa E. Mental health, challenging behaviour, diagnosis, and access to employment for people with intellectual disabilities in Norway. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13217. [PMID: 38459896 DOI: 10.1111/jar.13217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 11/09/2023] [Accepted: 02/10/2024] [Indexed: 03/11/2024]
Abstract
BACKGROUND Studies have found that presence of challenging behaviours and mental health problems limits employment for people with intellectual disabilities. This study investigates the associations between age, gender, living condition, level of intellectual disability, diagnoses, behaviour, mental health, and employment in adults with intellectual disabilities in Norway. METHOD A cross-sectional community-based survey including 214 adult participants (56% men) with intellectual disabilities. RESULTS In our sample, 25% had no organised day activity, 27% attended non-work day care, 19% attended sheltered employment, or day care with production, without pay and 29% worked in paid sheltered employment. One participant attended mainstream employment. Moderate and severe/profound level of intellectual disability, possible organic condition and irritability significantly reduced the odds of employment (paid and unpaid). CONCLUSION Findings suggest unequal access to the sheltered employment that was meant to be inclusive. More individualised evaluation of prerequisites is suggested to further facilitate employment for this group.
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Affiliation(s)
- Erlend Refseth Pedersen
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Audny Anke
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway
- Faculty of Health Sciences, Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
- Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Model and Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Emmy Elizabeth Langøy
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
- Høgskolen i Molde, Molde, Norway
| | - Monica Isabel Olsen
- Faculty of Humanities, Social Sciences and Teacher Education, Department of Teacher Education and Pedagogy, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Erik Søndenaa
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
- St. Olavs Hospital, Centre for Research and Education in Forensic Psychiatry, Trondheim, Norway
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McDonnall MC, Cmar JL. Employment and retirement among workers who develop vision loss in midlife. Work 2024:WOR230669. [PMID: 38640188 DOI: 10.3233/wor-230669] [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: 04/21/2024] Open
Abstract
BACKGROUND Vision loss increases with age and is thus more likely to happen later in one's career. With more individuals working beyond typical retirement age, the possibility of experiencing vision loss while working has increased. OBJECTIVE The purpose of this study was to investigate how developing vision loss during midlife affects employment and retirement. METHOD Using longitudinal Health and Retirement Study data, we identified a sample of 167 workers, 44 to 64 years old, who developed vision loss and a matched comparison sample of 800 workers who did not. We explored job retention and retirement differences between the groups and differences between people with vision loss who retained jobs versus those who did not. RESULTS Vision loss was associated with leaving the labor force, although there was a clear trend over time of increasing likelihood of job retention. Occupational category was associated with job retention and people who continued working had more favorable financial situations. Retirees with vision loss were more likely to report involuntary retirement and dissatisfaction with retirement. CONCLUSIONS The decreasing likelihood of leaving the labor market after vision loss is an encouraging finding of this study. Workers who left the labor force after vision loss were more likely to be in precarious financial positions, and retirees did not have positive experiences with retirement. Assisting workers with vision loss to remain in the labor force is of vital importance, and increasing awareness and usage of free services for this population may reduce involuntary retirement and its negative consequences.
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Affiliation(s)
- Michele C McDonnall
- The National Research & Training Center on Blindness & Low Vision, Mississippi State University, USA
| | - Jennifer L Cmar
- The National Research & Training Center on Blindness & Low Vision, Mississippi State University, USA
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Hobden B, Bryant J, Davis R, Heard T, Rumbel J, Newman J, Rose B, Lambkin D, Sanson-Fisher R, Freund M. Co-occurring psychological distress and alcohol or other drug use among Indigenous Australians: Data from the National Aboriginal and Torres Strait Islander Health Survey. Aust N Z J Psychiatry 2024:48674241244601. [PMID: 38581252 DOI: 10.1177/00048674241244601] [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] [Indexed: 04/08/2024]
Abstract
OBJECTIVES To determine the prevalence and demographic, social and health characteristics associated with co-occurring psychological distress symptoms, risky alcohol and/or substance use among a national sample of Aboriginal and Torres Strait Islander people aged 15 years or older. METHODS This study uses secondary cross-sectional data from the 2018-19 National Aboriginal and Torres Strait Islander Health Survey (NATSIHS). Data were collected via face-to-face interviews with those living in private dwellings across Australia. Participants were Aboriginal and Torres Strait Islander people (n = 10,579) aged 15 years or older. Data pertaining to psychological distress, alcohol and substance use were obtained and weighted to represent the total population of Aboriginal and Torres Strait Islander people in Australia. RESULTS A total of 20.3% participants were found to have co-occurring psychological distress, risky alcohol use and/or substance use, and 4.0% reported co-occurrence of all three conditions. Female participants in a registered marriage and fully engaged in study or employment had lower rates of co-occurring conditions. Poorer self-rated health, one or more chronic conditions and increased experiences of unfair treatment and physical harm in the past 12 months were associated with increased rates of co-occurring conditions. CONCLUSION A range of potential risk and protective factors were identified for co-occurring psychological distress, risky alcohol and/or substance use among Aboriginal and Torres Strait Islander people. This information is critical for planning effective holistic strategies to decrease the burden of suffering imposed upon the individual, family and community members impacted by co-occurring conditions.
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Affiliation(s)
- Breanne Hobden
- Health Behaviour Research Collaborative, School of Medicine and Public Health, College of Health, Medicine, and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
- Equity in Health and Wellbeing Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Jamie Bryant
- Health Behaviour Research Collaborative, School of Medicine and Public Health, College of Health, Medicine, and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
- Equity in Health and Wellbeing Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Robert Davis
- Health Behaviour Research Collaborative, School of Medicine and Public Health, College of Health, Medicine, and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
- Equity in Health and Wellbeing Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Todd Heard
- Health Behaviour Research Collaborative, School of Medicine and Public Health, College of Health, Medicine, and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
- Wiyiliin ta CAMHS, Hunter New England Local Health District, NSW Health, Newcastle, NSW, Australia
- Systems Neuroscience Group, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Jenn Rumbel
- Systems Neuroscience Group, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- Wollotuka Institute, Purai Global Indigenous History Centre, The University of Newcastle, Callaghan, NSW, Australia
| | - Jamie Newman
- Orange Aboriginal Medical Service, Orange, NSW, Australia
| | - Bron Rose
- Yimamulinbinkaan, Aboriginal Mental Health Service & Social Emotional Wellbeing Workforce, Hunter New England Mental Health Service, Hunter New England Local Health District, NSW Health, Newcastle, NSW, Australia
| | - David Lambkin
- Clinical Research Design and Statistics, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Rob Sanson-Fisher
- Health Behaviour Research Collaborative, School of Medicine and Public Health, College of Health, Medicine, and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
- Equity in Health and Wellbeing Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Megan Freund
- Health Behaviour Research Collaborative, School of Medicine and Public Health, College of Health, Medicine, and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
- Equity in Health and Wellbeing Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
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12
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Bond GR, Al-Abdulmunem M, Ressler DR, Drake RE. Mental Health Impact of COVID Pandemic on Veterans Transitioning from Military. J Behav Health Serv Res 2024; 51:275-288. [PMID: 38133794 PMCID: PMC10940484 DOI: 10.1007/s11414-023-09869-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2023] [Indexed: 12/23/2023]
Affiliation(s)
- Gary R Bond
- Social Policy and Economics Research, Westat, Inc., New Hampshire Office, Wheeler Professional Park, 1 Oak Ridge Road, Building 3, Second Floor, Suite 2 West, West Lebanon, NH, 03784, USA.
| | - Monirah Al-Abdulmunem
- Social Policy and Economics Research, Westat, Inc., New Hampshire Office, Wheeler Professional Park, 1 Oak Ridge Road, Building 3, Second Floor, Suite 2 West, West Lebanon, NH, 03784, USA
| | - Daniel R Ressler
- Social Policy and Economics Research, Westat, Inc., New Hampshire Office, Wheeler Professional Park, 1 Oak Ridge Road, Building 3, Second Floor, Suite 2 West, West Lebanon, NH, 03784, USA
| | - Robert E Drake
- Social Policy and Economics Research, Westat, Inc., New Hampshire Office, Wheeler Professional Park, 1 Oak Ridge Road, Building 3, Second Floor, Suite 2 West, West Lebanon, NH, 03784, USA
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
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13
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Derbyshire DW, Jeanes E, Khedmati Morasae E, Reh S, Rogers M. Employer-focused interventions targeting disability employment: A systematic review. Soc Sci Med 2024; 347:116742. [PMID: 38484455 DOI: 10.1016/j.socscimed.2024.116742] [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: 08/03/2023] [Revised: 02/20/2024] [Accepted: 02/29/2024] [Indexed: 04/20/2024]
Abstract
There are a wide range of interventions that are designed to influence employer behaviour with respect to the employment of people with disabilities. This study presents the results of a systematic review looking at employer-focused interventions to improve disability employment, focusing on interventions or policies taking placing in high-income countries as per the OECD. This systematic review focuses on a broad range of potential employment-related outcomes, including the employment rate, time to return to work and length of sickness absence. The results of 71 papers that evaluate the effectiveness of a range of interventions were synthesised into a narrative review. Interventions are grouped into six broad categories: anti-discrimination legislation, quota systems, part-time sick leave, graded return to work and wage subsidy schemes. Anti-discrimination legislation is not effective at improving the employment prospects of people with disabilities. There is mixed evidence with respect to quota systems and wage subsidy schemes. However, the availability of part time sick leave or graded return to work are both consistently associated with improved work participation for people with disabilities.
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Affiliation(s)
- Daniel W Derbyshire
- Department of Public Health and Sports Science, University of Exeter, Exeter, United Kingdom.
| | - Emma Jeanes
- Department of Management, University of Exeter, Exeter, United Kingdom
| | | | - Susan Reh
- Department of Management, University of Exeter, Exeter, United Kingdom
| | - Morwenna Rogers
- NIHR ARC South West Peninsula (PenARC), University of Exeter Medical School, University of Exeter, Exeter, United Kingdom
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14
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Ferry F, Rosato M, Curran E, Leavey G. Occupation type, family demands and mental health: analysis of linked administrative data. J Ment Health 2024; 33:150-158. [PMID: 36876750 DOI: 10.1080/09638237.2023.2182416] [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: 03/22/2022] [Revised: 07/28/2022] [Accepted: 01/28/2023] [Indexed: 03/07/2023]
Abstract
BACKGROUND While employment generally promotes positive health and wellbeing, some jobs may be less salutogenic than others. Few studies have examined mental health across a range of broadly defined occupation types using a large population sample. AIMS To examine the prevalence of mental health problems across a wide range of occupation types, and further examine the association of family demands, controlling for key social determinants and health-related factors. METHODS We used linked administrative data from 2011 NI Census returns; NI Properties data; and Enhanced Prescribing Data (EPD) 2011/12. We examined self-reported mental health problems and receipt of psychotropic medication among 553,925 workers aged 25 and 59 years. RESULTS Self-reported chronic mental ill health was more prevalent among workers in lower paid occupations, while "public- facing" occupations had the highest rates of medication. In fully adjusted models, informal caregivers were less likely to report mental health problems but more likely to be in receipt of psychotropic medication, as were lone parents. The association of family demands also varied across occupational groupings. CONCLUSION Future development of mental health at work plans should take cognisance of occupation specific mental health risk and wider family circumstances to support workers' mental wellbeing most effectively.
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Affiliation(s)
- Finola Ferry
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Coleraine, UK
- Administrative Data Research Centre Northern Ireland (ADRC-NI), Belfast, UK
| | - Michael Rosato
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Coleraine, UK
- Administrative Data Research Centre Northern Ireland (ADRC-NI), Belfast, UK
| | - Emma Curran
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Coleraine, UK
- Administrative Data Research Centre Northern Ireland (ADRC-NI), Belfast, UK
| | - Gerard Leavey
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Coleraine, UK
- Administrative Data Research Centre Northern Ireland (ADRC-NI), Belfast, UK
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15
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de Geus CJC, Huysmans MA, van Rijssen HJ, Juurlink TT, de Maaker-Berkhof M, Anema JR. A Decision Aid to Support Vocational Rehabilitation Professionals Offering Tailored Care to Benefit Recipients with a Long-Term Work Disability: A Feasibility Study. JOURNAL OF OCCUPATIONAL REHABILITATION 2024; 34:128-140. [PMID: 37036619 PMCID: PMC10899301 DOI: 10.1007/s10926-023-10105-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/07/2023] [Indexed: 06/19/2023]
Abstract
PURPOSE This feasibility study focusses on the implementation and use of a decision aid, which supports vocational rehabilitation (VR) professionals in helping clients with a disability pension return to work in practice. The decision aid shows an overview of the clients' return to work barriers and suggests suitable VR interventions based on these barriers. METHODS The study population consisted of VR professionals working at the Dutch Social Security Institute and their clients receiving a (partial) work disability pension. The feasibility was measured with concepts of the Linnan and Steckler framework and the attitude, social norm and self-efficacy model. Data were collected using questionnaires, checklists and qualitative interviews. RESULTS Ten professionals participated in this study. Fifty-four clients were asked to fill in the questionnaire of the decision aid and 32 clients received VR care based on the decision aid. In general, VR professionals and clients were satisfied with the decision aid and perceived a few barriers for using the decision aid. CONCLUSIONS This study showed that it is feasible to implement and use the decision aid. To improve the implementation of this decision aid, it should be implemented in digital systems used by professionals to improve efficiency of working with the decision aid.
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Affiliation(s)
- Christa J C de Geus
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL, 1081 BT, Amsterdam, The Netherlands
- Research Centre for Insurance Medicine, AMC-UMCG-VUmc-UWV, Amsterdam, The Netherlands
| | - Maaike A Huysmans
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL, 1081 BT, Amsterdam, The Netherlands.
- Research Centre for Insurance Medicine, AMC-UMCG-VUmc-UWV, Amsterdam, The Netherlands.
| | - H Jolanda van Rijssen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL, 1081 BT, Amsterdam, The Netherlands
- Dutch Institute of Employee Benefit Schemes (UWV), Amsterdam, The Netherlands
- Research Centre for Insurance Medicine, AMC-UMCG-VUmc-UWV, Amsterdam, The Netherlands
| | - Trees T Juurlink
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL, 1081 BT, Amsterdam, The Netherlands
- Research Centre for Insurance Medicine, AMC-UMCG-VUmc-UWV, Amsterdam, The Netherlands
| | - Marianne de Maaker-Berkhof
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL, 1081 BT, Amsterdam, The Netherlands
- Research Centre for Insurance Medicine, AMC-UMCG-VUmc-UWV, Amsterdam, The Netherlands
| | - Johannes R Anema
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL, 1081 BT, Amsterdam, The Netherlands
- Research Centre for Insurance Medicine, AMC-UMCG-VUmc-UWV, Amsterdam, The Netherlands
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16
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Thomson RM, Kopasker D, Bronka P, Richiardi M, Khodygo V, Baxter AJ, Igelström E, Pearce A, Leyland AH, Katikireddi SV. Short-term impacts of Universal Basic Income on population mental health inequalities in the UK: A microsimulation modelling study. PLoS Med 2024; 21:e1004358. [PMID: 38437214 PMCID: PMC10947674 DOI: 10.1371/journal.pmed.1004358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 03/18/2024] [Accepted: 02/05/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Population mental health in the United Kingdom (UK) has deteriorated, alongside worsening socioeconomic conditions, over the last decade. Policies such as Universal Basic Income (UBI) have been suggested as an alternative economic approach to improve population mental health and reduce health inequalities. UBI may improve mental health (MH), but to our knowledge, no studies have trialled or modelled UBI in whole populations. We aimed to estimate the short-term effects of introducing UBI on mental health in the UK working-age population. METHODS AND FINDINGS Adults aged 25 to 64 years were simulated across a 4-year period from 2022 to 2026 with the SimPaths microsimulation model, which models the effects of UK tax/benefit policies on mental health via income, poverty, and employment transitions. Data from the nationally representative UK Household Longitudinal Study were used to generate the simulated population (n = 25,000) and causal effect estimates. Three counterfactual UBI scenarios were modelled from 2023: "Partial" (value equivalent to existing benefits), "Full" (equivalent to the UK Minimum Income Standard), and "Full+" (retaining means-tested benefits for disability, housing, and childcare). Likely common mental disorder (CMD) was measured using the General Health Questionnaire (GHQ-12, score ≥4). Relative and slope indices of inequality were calculated, and outcomes stratified by gender, age, education, and household structure. Simulations were run 1,000 times to generate 95% uncertainty intervals (UIs). Sensitivity analyses relaxed SimPaths assumptions about reduced employment resulting from Full/Full+ UBI. Partial UBI had little impact on poverty, employment, or mental health. Full UBI scenarios practically eradicated poverty but decreased employment (for Full+ from 78.9% [95% UI 77.9, 79.9] to 74.1% [95% UI 72.6, 75.4]). Full+ UBI increased absolute CMD prevalence by 0.38% (percentage points; 95% UI 0.13, 0.69) in 2023, equivalent to 157,951 additional CMD cases (95% UI 54,036, 286,805); effects were largest for men (0.63% [95% UI 0.31, 1.01]) and those with children (0.64% [95% UI 0.18, 1.14]). In our sensitivity analysis assuming minimal UBI-related employment impacts, CMD prevalence instead fell by 0.27% (95% UI -0.49, -0.05), a reduction of 112,228 cases (95% UI 20,783, 203,673); effects were largest for women (-0.32% [95% UI -0.65, 0.00]), those without children (-0.40% [95% UI -0.68, -0.15]), and those with least education (-0.42% [95% UI -0.97, 0.15]). There was no effect on educational mental health inequalities in any scenario, and effects waned by 2026. The main limitations of our methods are the model's short time horizon and focus on pathways from UBI to mental health solely via income, poverty, and employment, as well as the inability to integrate macroeconomic consequences of UBI; future iterations of the model will address these limitations. CONCLUSIONS UBI has potential to improve short-term population mental health by reducing poverty, particularly for women, but impacts are highly dependent on whether individuals choose to remain in employment following its introduction. Future research modelling additional causal pathways between UBI and mental health would be beneficial.
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Affiliation(s)
- Rachel M. Thomson
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland, United Kingdom
| | - Daniel Kopasker
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland, United Kingdom
| | - Patryk Bronka
- Institute for Social and Economic Research, University of Essex, Essex, England, United Kingdom
| | - Matteo Richiardi
- Institute for Social and Economic Research, University of Essex, Essex, England, United Kingdom
| | - Vladimir Khodygo
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland, United Kingdom
| | - Andrew J. Baxter
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland, United Kingdom
| | - Erik Igelström
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland, United Kingdom
| | - Anna Pearce
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland, United Kingdom
| | - Alastair H. Leyland
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland, United Kingdom
| | - S. Vittal Katikireddi
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland, United Kingdom
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17
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Li AKC, Nowrouzi-Kia B. Relationships between employment status with self-perceived mental and physical health in Canada. AIMS Public Health 2024; 11:236-257. [PMID: 38617416 PMCID: PMC11007413 DOI: 10.3934/publichealth.2024012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 02/22/2024] [Accepted: 02/27/2024] [Indexed: 04/16/2024] Open
Abstract
Background The annual cost of mental illnesses in Canada is estimated to be $50 billion. Research from other countries have suggested that employment status is associated with mental and physical health. Within the Canadian context, there is a dearth of research on the relationship between employment and mental health. Objective To explore the relationships between age, gender, income, and employment status on mental and physical health. Methods The 2021 Canadian Digital Health Survey dataset was used for this study. Data records, which included responses for the questions on age, gender, income, employment status, mental, and physical health, were used in the analysis. Ordinal logistics regression was applied to investigate the associations that may exist between mental and physical health with the various sociodemographic factors. Descriptive statistics were also provided for the data. Results The total sample size included in the analysis was 10,630. When compared to respondents who had full-time employment, those who were unemployed were more likely to have lower self-perceived mental health (OR: 1.91; 95% CI: 1.55-2.34). Retired respondents were less likely to have worse mental health than respondents who were employed full-time (OR: 0.78; 95% CI: 0.68-0.90). Self-perceived physical health was more likely to be lower for those who were unemployed (OR: 1.74; 95% CI: 1.41-2.14) or retired (OR: 1.28; 95% CI: 1.12-1.48) when compared to respondents employed full-time. The likelihood of worsening mental and physical health was also found to be associated with age, gender, and income. Conclusion Our findings support the evidence that different factors contribute to worsening mental and physical health. Full-time employment may confer some protective effects or attributes leading to an increased likelihood of having improved mental health compared to those who are unemployed. Understanding the complex relationships on how various factors impact mental health will help better inform policymakers, clinicians, and other stakeholders on how to allocate its limited resources.
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Affiliation(s)
- Anson Kwok Choi Li
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Suite 425, Toronto, ON, Canada M5T 3M6
- Department of Biology, University of Western Ontario, 1151 Richmond Street, London, ON, Canada N6A 3K7
- ReSTORE Lab, Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue Toronto, ON, Canada M5G 1V7
| | - Behdin Nowrouzi-Kia
- ReSTORE Lab, Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue Toronto, ON, Canada M5G 1V7
- Krembil Research Institute-University Health Network, 60 Leonard Ave, Toronto, ON, Canada, M5T 0S8
- Centre for Research in Occupational Safety & Health, Laurentian University, 935 Ramsey Lake Rd, Sudbury, ON, Canada P3E 2C
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18
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León-Herrera S, Samper-Pardo M, Oliván-Blázquez B, Sánchez-Recio R, Magallón-Botaya R, Sánchez-Arizcuren R. Loss of socioemotional and occupational roles in individuals with Long COVID according to sociodemographic and clinical factors: Secondary data from a randomized clinical trial. PLoS One 2024; 19:e0296041. [PMID: 38386633 PMCID: PMC10883534 DOI: 10.1371/journal.pone.0296041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 11/20/2023] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Long COVID syndrome can have a major impact on life organization. Its persistent symptoms may cause a potentially disabling condition that affects the quality of life of those suffering from it. The resulting loss of functional independence hinders the ability to return to normal life. Many research studies carried out on this novel syndrome have focused on describing its extensive symptomatology. Studies on later repercussions, however, such as disability or loss of significant roles, remain scarce. This study examines the loss of socioemotional and occupational roles experienced by individuals suffering from Long COVID, as a result of the disease. A secondary objective is to analyze the sociodemographic and clinical factors associated with this loss of roles. PATIENTS AND METHODS A cross-sectional study was conducted with the participation of 100 patients diagnosed with Long COVID, over the age of 18, and attended by Primary Health Care in the Autonomous Community of Aragon. The main study variable was the loss of significant socioemotional and occupational roles by the participants. Sociodemographic and clinical data were also collected through a structured interview. Subsequently, a descriptive, correlational, and regression-based statistical analysis was performed using the SPSS Statistics program. RESULTS Based on the 100 study participants, the median number of roles lost was 3 (IQR 2) and the median number of valuable roles lost was 2 (IQR 2). More cognitive impairment and not having an active work role were predictors of a greater loss of valuables roles. CONCLUSION Long COVID symptoms hinder the development of socioemotional and occupational roles. Healthcare professionals should consider this when intervening to ensure that their patients may recover their life as it was before the disease.
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Affiliation(s)
- Sandra León-Herrera
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
| | | | - Bárbara Oliván-Blázquez
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
| | - Raquel Sánchez-Recio
- Department of Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain
| | - Rosa Magallón-Botaya
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain
- Department of Medicine, University of Zaragoza, Zaragoza, Spain
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Holmlund L, Ljungberg HT, Bültmann U, Brämberg EB. Navigating work and life- a qualitative exploration of managers' and employees' views of return-to-work after sick leave due to common mental disorders. BMC Public Health 2024; 24:372. [PMID: 38317150 PMCID: PMC10840186 DOI: 10.1186/s12889-024-17765-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 01/13/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Incorporating multiple perspectives and contexts in knowledge mobilisation for return-to-work after sick leave due to common mental disorders can promote interprofessional and organisational strategies for facilitating the return-to-work process. This study aimed to explore the facilitators of and barriers to return-to-work after common mental disorders. This exploration considered the perspectives of employees and managers and the realms of work and private life. METHODS A qualitative approach was used with data from 27 semi-structured telephone interviews. The strategic sample consisted of employees who returned to work after sick leave due to common mental disorders (n = 17) and managers responsible for their return-to-work process (n = 10). Thematic analysis conducted in a six-step process was used to generate themes in the interview data. RESULTS The analysis generated three main themes with subthemes, illustrating experiences of barriers to and facilitators of return-to-work positioned in the employees' private and work contexts: (1) Getting along: managing personal difficulties in everyday life; (2) Belonging: experiencing social connectedness and support in work and private life; and (3) Organisational support: fostering a supportive work environment. The results contribute to a comprehensive understanding of the return-to-work process, including the challenges individuals face at work and in private life. CONCLUSIONS The study suggests that return-to-work after sick leave due to CMDs is a dynamic and ongoing process embedded in social, organisational, and societal environments. The results highlight avenues for an interprofessional approach and organisational learning to support employees and managers, including space for the employee to recover during the workday. TRIAL REGISTRATION This study recruited employees from a two-armed cluster-randomised controlled trial evaluating a problem-solving intervention for reducing sick leave among employees sick-listed due to common mental disorders (reg. NCT3346395).
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Affiliation(s)
- Lisa Holmlund
- Institute of Environmental Medicine, Unit of Intervention and Implementation Research for Worker Health, Karolinska Institutet, SE-171 77, Stockholm, Box 210, Sweden.
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Fack 23 200, SE-141 83, Stockholm, Huddinge, Sweden.
| | - Helena Tinnerholm Ljungberg
- Institute of Environmental Medicine, Unit of Intervention and Implementation Research for Worker Health, Karolinska Institutet, SE-171 77, Stockholm, Box 210, Sweden
| | - Ute Bültmann
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands
| | - Elisabeth Björk Brämberg
- Institute of Environmental Medicine, Unit of Intervention and Implementation Research for Worker Health, Karolinska Institutet, SE-171 77, Stockholm, Box 210, Sweden
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, SE-405 30, Gothenburg, Box 100, Sweden
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20
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Nilsson T, Svensson M, Falkenström F, Perrin S, Johansson H, Viborg G, Sandell R. Effects of panic-specific cognitive behavioural and psychodynamic psychotherapies on work ability in a doubly randomised clinical trial. Psychother Res 2024; 34:137-149. [PMID: 37127937 DOI: 10.1080/10503307.2023.2190044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 03/08/2023] [Indexed: 05/03/2023] Open
Abstract
Objective: The effects of panic-specific psychotherapy on occupational functioning remain under-researched. This study tests whether two brief psychotherapies for Panic Disorder with or without Agoraphobia (PD/A) may generate improvement in work ability. Methods: Adults (N = 221) with a primary diagnosis of PD/A were randomised to wait-list, panic-focused psychodynamic psychotherapy (PFPP), panic control treatment (PCT), or to the choice between the two treatments. Participants completed the Work Ability Inventory (WAI) at baseline, post-treatment, and during 24-month follow-ups. Change in WAI scores were assessed using segmented multilevel linear growth models, and mediation was explored through path analysis. Results: WAI scores changed from the moderate to good range between baseline and post-treatment (SMD = 0.45; 95% CI [0.33, 0.57]) and continued to increase throughout the follow-up (SMD = 0.16; 95% CI [0.03, 0.28]) with no differences between treatments or allocation forms. In PFPP (but not in PCT) pre- to post-treatment change in WAI was mediated by reduction in panic symptoms and WAI predicted employment status and absences. Conclusions: Two brief panic specific psychotherapies, one cognitive behavioural and one psychodynamic, produced short and long-term increases in work ability.
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Affiliation(s)
| | | | | | - Sean Perrin
- Department of Psychology, Lund University, Lund, Sweden
| | | | - Gardar Viborg
- Department of Psychology, Lund University, Lund, Sweden
| | - Rolf Sandell
- Department of Psychology, Lund University, Lund, Sweden
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21
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Pearson A. Who cares about the carers? A call to action on behalf of mothers of disabled children. FRONTIERS IN SOCIOLOGY 2024; 8:1304676. [PMID: 38274840 PMCID: PMC10808806 DOI: 10.3389/fsoc.2023.1304676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 12/20/2023] [Indexed: 01/27/2024]
Abstract
This 'perspective' article is an urgent call to action on behalf of mothers (and indeed fathers) of disabled children in the wake of the COVID-19 pandemic. In doing so draws attention to the 'perfect storm' experienced by United Kingdom-based parents of reduced support and increased stress, coupled with the effects of isolation. It also illuminates some of the impact of actions taken, and not taken, during and after the pandemic and the enduring effects for working parent-carers. In doing so I argue that, despite facing these extreme challenges, these parents have been a neglected group from both a policy and research perspective. The call to action therefore extends to society, employers, and to the research community.
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Affiliation(s)
- Alison Pearson
- Department of Health and Community Sciences, University of Exeter, Exeter, United Kingdom
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Murphy BM, Rogerson MC, Le Grande MR, Hesselson S, Iismaa SE, Graham RM, Jackson AC. Psychosocial and lifestyle impacts of spontaneous coronary artery dissection: A quantitative study. PLoS One 2024; 19:e0296224. [PMID: 38181032 PMCID: PMC10769080 DOI: 10.1371/journal.pone.0296224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 12/07/2023] [Indexed: 01/07/2024] Open
Abstract
INTRODUCTION Recent studies suggest that acute myocardial infarction due to spontaneous coronary artery dissection (SCAD) carries significant psychosocial burden. This survey-based quantitative study builds on our earlier qualitative investigation of the psychosocial impacts of SCAD in Australian SCAD survivors. The study aimed to document the prevalence and predictors of a broad range of psychosocial and lifestyle impacts of SCAD. METHOD Australian SCAD survivors currently enrolled in the Victor Chang Cardiac Research Institute genetics study were invited to participate in an online survey to assess the psychosocial impacts of SCAD. Participants completed a questionnaire, developed using findings from our earlier qualitative research, which assessed 48 psychosocial and five lifestyle impacts of SCAD. Participants also provided demographic and medical data and completed validated measures of anxiety and depression. RESULTS Of 433 SCAD survivors invited to participate, 310 (72%) completed the questionnaire. The most common psychosocial impacts were 'shock about having a heart attack' (experienced by 87% respondents), 'worry about having another SCAD' (81%), 'concern about triggering another SCAD' (77%), 'uncertainty about exercise and physical activity' (73%) and 'confusion about safe levels of activity and exertion' (73.0%) and 'being overly aware of bodily sensations' (73%). In terms of lifestyle impacts, the SCAD had impacted on work capacity for almost two thirds of participants, while one in ten had sought financial assistance. The key predictors of psychosocial impacts were being under 50, current financial strain, and trade-level education. The key predictors of lifestyle impacts were being over 50, SCAD recurrence, trade-level education, and current financial strain. All psychosocial impacts and some lifestyle impacts were associated with increased risk of anxiety and/or depression. CONCLUSION AND IMPLICATIONS This quantitative study extends our previous qualitative investigation by documenting the prevalence of each of 48 psychosocial and five lifestyle impacts identified in our earlier focus group research, and by providing risk factors for greater SCAD impacts. The findings suggest the need for supports to address initial experiences of shock, as well as fears and uncertainties regarding the future, including SCAD recurrence and exercise resumption. Support could be targeted to those with identified risk factors. Strategies to enable SCAD survivors to remain in or return to the paid workforce are also indicated.
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Affiliation(s)
- Barbara M. Murphy
- Australian Centre for Heart Health, Melbourne, Victoria, Australia
- School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | | | - Michael R. Le Grande
- Australian Centre for Heart Health, Melbourne, Victoria, Australia
- School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | | | - Siiri E. Iismaa
- Victor Chang Cardiac Research Institute, Sydney, New South Wales, Australia
- St Vincent’s Hospital, Sydney, New South Wales, Australia
| | - Robert M. Graham
- Victor Chang Cardiac Research Institute, Sydney, New South Wales, Australia
- St Vincent’s Hospital, Sydney, New South Wales, Australia
| | - Alun C. Jackson
- Australian Centre for Heart Health, Melbourne, Victoria, Australia
- School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
- Centre on Behavioral Health, University of Hong Kong, Pokfulam, Hong Kong
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Ravinskaya M, Verbeek JH, Langendam M, Daams JG, Hulshof CTJ, Hoving JL. Intermethod agreement of self-reports compared to register data collection for return to work and sickness absence: a systematic review and meta-analysis. J Clin Epidemiol 2024; 165:111209. [PMID: 37931821 DOI: 10.1016/j.jclinepi.2023.10.025] [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: 06/30/2023] [Revised: 09/25/2023] [Accepted: 10/31/2023] [Indexed: 11/08/2023]
Abstract
OBJECTIVES To determine the intermethod agreement of self-reported vs. register data of 'sickness absence' (SA) and 'return to work' (RTW) outcome measurements. STUDY DESIGN AND SETTING We conducted a systematic review and a meta-analysis of studies reporting mean differences (MDs) and sensitivity and specificity for self-report vs. register data and an inductive analysis of the self-report question formulations. An information specialist searched Medline, Embase, PsycINFO for studies published from inception to November 2022. Screening and data extraction was done by two authors independently. RESULTS Twenty-three studies were included of which eighteen with an overall high risk of bias. Self-reports had a pooled MD of 1.84 SA days (95% confidence interval [CI] 0.26-3.41, I2 98%, 18 studies, 38,716 participants) compared to registries which varied among studies from 204 more to 17 days less. The median average sick leave in studies in the self-report group was 8 days (interquartile range 4-23 days). Being absent from work measured with self-report had a sensitivity of 0.83 (0.76-0.88 95% CI) and a specificity of 0.92 (0.88-0.94 95% CI) compared to registry data. The high heterogeneity amongst the studies could not be explained by recall time, gender, register type, prospective or retrospective self-reports, health problem, SA at baseline or risk of bias. Studies lacked standard outcome reporting, had unclearly formulated questions in self-reports and there was little information on the registers' quality. CONCLUSION Current self-reports may differ from register-based absence data but in an inconsistent way. Due to inconsistency and high risk of bias the evidence is judged to be of very low certainty. Further research is needed to develop clear standard questions which can be used for SA and RTW self-reports. Quality of registers needs to be better evaluated. Percentage positive and negative agreement, MDs and 2 × 2 tables should be reported for studies investigating agreement between SA and RTW outcome measures.
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Affiliation(s)
- Margarita Ravinskaya
- Department of Public and Occupational Health, Cochrane Work, Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - Jos H Verbeek
- Department of Public and Occupational Health, Cochrane Work, Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Miranda Langendam
- Epidemiology and Data Science, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands; Amsterdam Public Health Research Institute, Methodology, Amsterdam, The Netherlands
| | - Joost G Daams
- Department of Public and Occupational Health, Cochrane Work, Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands; Epidemiology and Data Science, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Carel T J Hulshof
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Jan L Hoving
- Department of Public and Occupational Health, Cochrane Work, Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
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Hammer NM, Olsen M, Larsen HB, Wreford Andersen E, Oksbjerg Dalton S, Allerslev Horsbøl T, Envold Bidstrup P. Work-related consequences of losing a child with cancer: A nationwide population-based cohort study. Pediatr Blood Cancer 2024; 71:e30720. [PMID: 37837181 DOI: 10.1002/pbc.30720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 10/02/2023] [Accepted: 10/03/2023] [Indexed: 10/15/2023]
Abstract
BACKGROUND Parents who lose a child are at increased risk of impaired mental health, which may negatively affect their work ability. The aims of this study were to examine the risk for reduced labor market affiliation in parents who lost a child with cancer compared to a matched parent cohort, and factors associated with the bereaved parents' labor market affiliation. METHODS We conducted a nationwide population-based cohort study using Danish registry data. We followed bereaved parents (n = 1609) whose child died with cancer at age less than 30 during 1992-2020, and a matched, population-based sample of parents (n = 15,188) of children with no history of childhood cancer. Cox proportional hazard models and fractional logit models were performed separately for mothers and fathers. RESULTS Cancer-bereaved mothers had an overall increased risk of long-term sick leave (hazard ratio [HR] = 1.62; 95% confidence interval [CI]: 1.48-1.77), unemployment (HR = 1.53; CI: 1.37-1.70), and lower odds of working in the first 2 years following the loss (odds ratio [OR] = 0.44; CI: 0.39-0.49), while bereaved fathers had lower odds of working (OR = 0.65; CI: 0.53-0.79), and increased risk of permanently reduced work ability (HR = 1.29; 95% CI: 1.01-1.66), compared to the matched cohort of parents of cancer-free children. Younger parental age, lower education, and being a single parent were identified as the main determinants of the bereaved parents' reduced labor market affiliation. CONCLUSIONS Cancer-bereaved parents are at increased risk of reduced labor market affiliation, compared with a matched, population-based sample of parents. Certain groups of bereaved parents may be at particularly high risk, and targeted bereavement interventions are warranted.
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Affiliation(s)
- Nanna Maria Hammer
- Department of Paediatrics and Adolescent Medicine, Copenhagen Palliative Team for Children and Adolescents, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Paediatrics and Adolescent Medicine, Paediatric Oncology Research Laboratory, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Psychological Aspects of Cancer, Cancer Survivorship, Danish Cancer Institute, Copenhagen, Denmark
| | - Marianne Olsen
- Department of Paediatrics and Adolescent Medicine, Paediatric Oncology Research Laboratory, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Pediatrics and Adolescent Medicine, Section of Pediatric Hematology and Oncology, Aalborg University Hospital, Aalborg, Denmark
| | - Hanne Baekgaard Larsen
- Department of Paediatrics and Adolescent Medicine, Paediatric Oncology Research Laboratory, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Susanne Oksbjerg Dalton
- Cancer Survivorship, Danish Cancer Institute, Copenhagen, Denmark
- Department of Clinical Oncology and Palliative Care, Zealand University Hospital, Naestved, Denmark
| | - Trine Allerslev Horsbøl
- Cancer Survivorship, Danish Cancer Institute, Copenhagen, Denmark
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Pernille Envold Bidstrup
- Psychological Aspects of Cancer, Cancer Survivorship, Danish Cancer Institute, Copenhagen, Denmark
- Institute of Psychology, University of Copenhagen, Copenhagen, Denmark
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25
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Zhang D. Presidential Address, 2023-Setting New Norms for Integrated and Competitive Employment: Challenges, Opportunities, Strategies. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2023; 61:445-453. [PMID: 38011741 DOI: 10.1352/1934-9556-61.6.445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
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26
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White SW, Schall C, Santos JD, Maddox BB, Hillier A, Klinger L, Pugliese C. Promoting Quality of Life: Suggestions for Mental Health Care Providers Working with Young Autistic Adults. AUTISM IN ADULTHOOD 2023; 5:347-355. [PMID: 38116052 PMCID: PMC10726189 DOI: 10.1089/aut.2022.0106] [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: 03/29/2023]
Abstract
There is a growing population of autistic adults in need of supports from a service delivery system that, at present, fails to accommodate their needs adequately and equitably. Unfortunately, there is a shortage of trained behavioral health service providers to meet the needs of young autistic adults. Quality of life (QoL), or one's perception of, and satisfaction with, life in relation to held goals and expectations, has been identified as a key outcome of interest by autistic self-advocates. By supporting autistic clients to hone their strengths and interests, integrate various aspects of their identity, identify goals, and connect to appropriate resources, providers can promote clients' self-knowledge and self-determination, in the service of improving QoL. In this Perspectives article, we offer concrete recommendations to mental health providers, including those who do not specialize in autism, with the goal of supporting implementation of evidence-based strategies that improve QoL and promote self-determination among young autistic clients.
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Affiliation(s)
- Susan W. White
- Center for Youth Development and Intervention, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Carol Schall
- Autism Center for Education, Rehabilitation Research and Training Center, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Jin Delos Santos
- Project REACH, College of Staten Island at the City University of New York, Staten Island, New York, USA
| | - Brenna B. Maddox
- TEACCH Autism Program, Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Ashleigh Hillier
- Department of Psychology, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Laura Klinger
- TEACCH Autism Program, Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Cara Pugliese
- Center for Autism Spectrum Disorders, Children's National Hospital, Washington, District of Columbia, USA
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Penton T, Bowling N, Vafeiadou A, Hammond C, Bird G, Banissy MJ. Attitudes to Interpersonal Touch in the Workplace in Autistic and non-Autistic Groups. J Autism Dev Disord 2023; 53:4731-4743. [PMID: 36083393 PMCID: PMC10627924 DOI: 10.1007/s10803-022-05710-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2022] [Indexed: 10/14/2022]
Abstract
Unemployment and underemployment have consistently been shown to be higher in autistic adults relative to non-autistic adults. This may be due, in part, to a lack of workplace accommodations being made for autistic people. One factor that may contribute to employment inequalities in autistic people is differences in attitudes towards interpersonal touch. This study acts as a preliminary investigation into whether employed autistic and non-autistic participants differ in their attitudes towards touch in the workplace, and in their loneliness and wellbeing. The current dataset was drawn from a larger online survey (the Touch Test) designed to explore attitudes and experiences towards touch. We found that employed autistic participants had more negative attitudes to general, social and workplace touch relative to non-autistic participants. Autistic participants also experienced greater loneliness and reduced wellbeing. Attachment-related anxiety was the only significant predictor of wellbeing in employed autistic adults. However, attachment-related anxiety, general attitudes to touch and the role of touch in the workplace predicted wellbeing in employed non-autistic adults. With regards to loneliness, general attitudes to touch and the role of touch in the workplace predicted loneliness in autistic participants. We also replicated the finding that a greater proportion of autistic participants were unemployed relative to non-autistic participants. Collectively, this research highlights the importance of considering touch in research investigating employment, and its impact on loneliness and wellbeing, in autistic participants.
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Affiliation(s)
- Tegan Penton
- Department of Psychology, Goldsmiths, University of London, SE14 6NW, London, UK.
| | - Natalie Bowling
- School of Human Sciences, University of Greenwich, SE10 9LS, London, UK
| | - Aikaterini Vafeiadou
- Department of Psychology, Goldsmiths, University of London, SE14 6NW, London, UK
| | - Claudia Hammond
- School of Psychology, University of Sussex, BN1 9RH, Brighton, UK
| | - Geoffrey Bird
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, SE5 8AF, London, UK
- Department of Experimental Psychology, University of Oxford, OX1 3PH, Oxford, UK
| | - Michael J Banissy
- Department of Psychology, Goldsmiths, University of London, SE14 6NW, London, UK
- School of Psychological Science, University of Bristol, BS8 1QU, Bristol, UK
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Fischer IC, Schnurr PP, Pietrzak RH. Employment status among US military veterans with a history of posttraumatic stress disorder: Results from the National Health and Resilience in Veterans Study. J Trauma Stress 2023; 36:1167-1175. [PMID: 37821772 DOI: 10.1002/jts.22977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/01/2023] [Accepted: 09/04/2023] [Indexed: 10/13/2023]
Abstract
The current study examined the prevalence and correlates of employment status in a nationally representative sample of U.S. military veterans with a probable lifetime history of posttraumatic stress disorder. Participants were 4,609 veterans from National Health and Resilience in Veterans Study (NHRVS) Bivariate analyses compared the employment status of veterans with regard to sociodemographic, military, health, and psychiatric characteristics. A multinomial regression analysis was conducted to determine the effect of lifetime PTSD status on employment and identify variables that differentiated employment status among veterans with a history of PTSD. In the total sample, 450 (weighted 12.5%) screened positive for lifetime PTSD. Veterans with PTSD were more than twice as likely to be unemployed, OR = 2.41, and retired, OR = 2.26, and nearly 4 times as likely to be disabled, OR = 3.84, relative to those without PTSD. Among veterans with PTSD, 203 (54.0%) were employed, 178 were retired (28.2%), 31 (7.3%) were unemployed, and 38 (10.5%) were disabled. Relative to employed veterans, retired veterans were older and reported more medical conditions; unemployed veterans were almost 5 times as likely to be female; disabled veterans reported lower income, more medical conditions, and more severe symptoms of current major depressive disorder but less severe symptoms of alcohol use disorder, ORs = 0.88-4.88. This study provides an up-to-date characterization of employment status in a nationally representative sample of U.S. military veterans with a history of PTSD. Results may inform efforts to provide sustainable employment in this segment of the population.
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Affiliation(s)
- Ian C Fischer
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, Connecticut, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Paula P Schnurr
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, White River Junction, Vermont, USA
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Robert H Pietrzak
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, Connecticut, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
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McDonnall MC, Cmar JL, McKnight Z. College Degree Majors and Associated Earnings: Are There Differences Between People with Visual Impairments and the General Population? JOURNAL OF VOCATIONAL REHABILITATION 2023; 59:263-272. [PMID: 38528915 PMCID: PMC10961939 DOI: 10.3233/jvr-230044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
BACKGROUND College graduates without visual impairments earn more than college graduates with visual impairments. Differences in degree majors obtained or differences in earnings associated with degree majors for the two groups might explain this discrepancy in earnings. OBJECTIVE The purpose of this study was to examine (a) differences in degree major categories and (b) relationships between degree majors and earnings for college graduates with and without visual impairments. METHOD We obtained data for college-educated, working-age adults from the American Community Survey. We utilized descriptive statistics to compare degree major categories by visual impairment and multiple regression to evaluate predictors of annual earnings for college graduates who worked full-time/full-year. RESULTS Small differences in degree majors obtained were found between college graduates with and without visual impairments. Significant predictors of earnings included 23 out of 25 degree majors and several other demographic and socioeconomic characteristics. Effects of three majors and several other variables differed for people with visual impairments. CONCLUSION People with visual impairments were slightly more likely to hold degrees with lower-paying majors and less likely to hold degrees with two higher-paying majors. Regardless of degree major, college graduates with visual impairments had substantially lower average earnings than the general population.
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Affiliation(s)
- Michele C. McDonnall
- The National Research & Training Center on Blindness & Low Vision, Mississippi State University
| | - Jennifer L. Cmar
- The National Research & Training Center on Blindness & Low Vision, Mississippi State University
| | - Zhen McKnight
- The National Research & Training Center on Blindness & Low Vision, Mississippi State University
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Solomon M, Hernandez JAY, Ruder S, Bothra S, Gonzales C, Kecskemeti K, Takarae Y. Commentary: The challenges and promises of competitively employing autistic adults in the United States. Autism Res 2023; 16:2054-2060. [PMID: 37668324 DOI: 10.1002/aur.3009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 07/23/2023] [Indexed: 09/06/2023]
Abstract
Current United States statistics suggest that autistic individuals will experience high unemployment and underemployment rates throughout their lives. Furthermore, despite the passage of federal legislation to employ young autistic adults in competitive integrated settings, where they work alongside non-disabled workers and earn at least minimum wage, most individuals receiving state services still are placed in day programs or sheltered workshops. Since meaningful employment is the most important determinant of life satisfaction, this failure is a critical societal problem, exerting increasing pressure for systems change. But the news is not all bad. Private sector companies have increased their hiring of disabled workers, producing a growing base of expertise in the recruitment, on-boarding, training, and management of autistic employees. This has led to a growing recognition that autistic individuals can be ideal workers. Autism researchers have advanced the field by investigating these private industry programs as well as conducting efficacy trials of interventions and services that help autistic individuals in the workplace. However, gaps in knowledge persist stemming from the heterogeneity of autistic workers, limited knowledge about those not receiving state services, and a system of federal services that is fragmented, poorly coordinated, difficult to navigate, and over-taxed. Autism researchers can continue to improve outcomes of autistic workers through investigations of the fit between autistic workers, their preferences, and the characteristics of available jobs, and through effectiveness trails of promising employment interventions and services that promote systems change that help break down the barriers to better integration of existing state services and resources in the United States.
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Affiliation(s)
- Marjorie Solomon
- Department of Psychiatry and Behavioral Sciences, MIND Institute & Imaging Research Center, University of California, Sacramento, California, USA
| | - Jo Ann Yon Hernandez
- Department of Psychiatry and Behavioral Sciences, MIND Institute & Imaging Research Center, University of California, Sacramento, California, USA
| | - Steve Ruder
- Center for Excellence in Developmental Disabilities, MIND Institute, University of California, Sacramento, California, USA
| | - Surina Bothra
- Department of Psychiatry and Behavioral Sciences, MIND Institute & Imaging Research Center, University of California, Sacramento, California, USA
| | - Catherine Gonzales
- Department of Psychiatry and Behavioral Sciences, MIND Institute & Imaging Research Center, University of California, Sacramento, California, USA
| | - Kali Kecskemeti
- Department of Psychiatry and Behavioral Sciences, MIND Institute & Imaging Research Center, University of California, Sacramento, California, USA
| | - Yukari Takarae
- Department of Psychiatry and Behavioral Sciences, MIND Institute & Imaging Research Center, University of California, Sacramento, California, USA
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Berget AM, Moen VP, Hustoft M, Assmus J, Strand LI, Skouen JS, Hetlevik Ø. Effect of sense of coherence on long-term work participation among rehabilitation patients: a longitudinal study. J Rehabil Med 2023; 55:jrm11982. [PMID: 37855386 PMCID: PMC10599156 DOI: 10.2340/jrm.v55.11982] [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: 04/04/2023] [Accepted: 09/26/2023] [Indexed: 10/20/2023] Open
Abstract
OBJECTIVE To investigate the causal effect of sense of coherence on long-term work participation after rehabilitation, including stratification by age and diagnoses. DESIGN Longitudinal cohort study. PARTICIPANTS Patients aged ≤ 60 years, employed and accepted for somatic interprofessional rehabilitation in 2015 (n = 192). METHODS Patients reported sense of coherence before rehabilitation in 2015 and mental and physical functioning in 2016. Register data were used to measure work participation during 2018 and days working without social security benefits during 2016-18. Regression models were used to explore the total effect of sense of coherence and the possible mediation of functioning. Results are reported as odds ratios (95% confidence intervals). RESULTS During 2018, 77% of the total study cohort participated in work activities. The subgroup with musculoskeletal diagnoses had the fewest days of working without social security benefits. A causal relationship was found between sense of coherence and long-term work participation. Some of the effect of sense of coherence was mediated by mental functioning. The total effect of sense of coherence was strongest for patients with musculo-skeletal diagnoses (work participation: 1.11 (1.05, 1.17), days working without social security benefits: 1.05 (0.01, 109)). CONCLUSION Improving coping resources may be beneficial to facilitate long-term work participation after injury or illness, especially for individuals with musculoskeletal diagnoses.
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Affiliation(s)
- Anne Mette Berget
- Centre of Habilitation and Rehabilitation in Western Norway, Haukeland University Hospital, Bergen, Norway; Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
| | - Vegard Pihl Moen
- Centre of Habilitation and Rehabilitation in Western Norway, Haukeland University Hospital, Bergen, Norway; Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
| | - Merethe Hustoft
- Centre of Habilitation and Rehabilitation in Western Norway, Haukeland University Hospital, Bergen, Norway; Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
| | - Jörg Assmus
- Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
| | - Liv Inger Strand
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Jan Sture Skouen
- Department of Physical Medicine and Rehabilitation, Haukeland University Hospital, Bergen, Norway
| | - Øystein Hetlevik
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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Thomson RM, Kopasker D, Leyland A, Pearce A, Katikireddi SV. To what extent does income explain the effect of unemployment on mental health? Mediation analysis in the UK Household Longitudinal Study. Psychol Med 2023; 53:6271-6279. [PMID: 36453184 PMCID: PMC10520578 DOI: 10.1017/s0033291722003580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 10/18/2022] [Accepted: 10/31/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Employment and income are important determinants of mental health (MH), but the extent that unemployment effects are mediated by reduced income is unclear. We estimated the total effect (TE) of unemployment on MH and the controlled direct effect (CDE) not acting via income. METHODS We included adults 25-64 years from nine waves of the UK Household Longitudinal Study (n = 45 497/obs = 202 297). Unemployment was defined as not being in paid employment; common mental disorder (CMD) was defined as General Health Questionnaire-12 score ≥4. We conducted causal mediation analysis using double-robust marginal structural modelling, estimating odds ratios (OR) and absolute differences for effects of unemployment on CMD in the same year, before (TE) and after (CDE) blocking the income pathway. We calculated percentage mediation by income, with bootstrapped standard errors. RESULTS The TE of unemployment on CMD risk was OR 1.66 (95% CI 1.57-1.76), with 7.09% (6.21-7.97) absolute difference in prevalence; equivalent CDEs were OR 1.55 (1.46-1.66) and 6.08% (5.13-7.03). Income mediated 14.22% (8.04-20.40) of the TE. Percentage mediation was higher for job losses [15.10% (6.81-23.39)] than gains [8.77% (0.36-17.19)]; it was lowest for those 25-40 years [7.99% (-2.57 to 18.51)] and in poverty [2.63% (-2.22 to 7.49)]. CONCLUSIONS A high proportion of the short-term effect of unemployment on MH is not explained by income, particularly for younger people and those in poverty. Population attributable fractions suggested 16.49% of CMD burden was due to unemployment, with 13.90% directly attributable to job loss rather than resultant income changes. Similar analytical approaches could explore how this differs across contexts, by other factors, and consider longer-term effects.
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Affiliation(s)
- Rachel M. Thomson
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Daniel Kopasker
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Alastair Leyland
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Anna Pearce
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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Murphy JK, Noble JM, Chakraborty PA, Michlig G, Michalak EE, Greenshaw AJ, Lam RW. Values and preferences related to workplace mental health programs and interventions: An international survey. PLoS One 2023; 18:e0283057. [PMID: 37756304 PMCID: PMC10530006 DOI: 10.1371/journal.pone.0283057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 08/25/2023] [Indexed: 09/29/2023] Open
Abstract
INTRODUCTION This study explores the perspectives of workers and managers on workplace programs and interventions that seek to promote mental wellbeing, and prevent and treat mental health conditions The results contributed supporting evidence for the development of the WHO's first global guidelines for mental health and work, which provide evidence-based recommendations to support the implementation of workplace mental health programs and supports, to improve their acceptability, appropriateness, and uptake. METHODS An international online survey was used to examine the values and preferences among workers and managers related to workplace mental health prevention, protection, promotion, and support programs and services. The survey was made available in English, French, and Spanish and recruitment consisted of convenience sampling. Descriptive statistics were used to analyse the survey data. Rapid thematic qualitative analysis was used to analyse the results of open-ended questions. RESULTS N = 451 responses representing all WHO regions were included in the analysis. These results provide a unique international perspective on programs and supports for mental health at work, from the standpoint of workers and managers. Results suggest that workers value interventions developed in consultation with workers (including indicated, selective and universal interventions), increased training and capacity building among managers, and targeted interventions to address the pervasive impact of stigma on perceptions about mental health at work and help-seeking. CONCLUSION The findings of this study seek to reflect the perspectives of workers and their managers, and therein to promote improved access, availability and uptake of mental health programs and supports at work and-ultimately- to support the potential of workplaces as environments that promote and support mental health.
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Affiliation(s)
- Jill K. Murphy
- Faculty of Medicine, Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Jasmine M. Noble
- Faculty of Medicine and Dentistry, Department of Psychiatry, University of Alberta, Edmonton, Canada
- Faculty of Science, Department of Computing Science, University of Alberta, Edmonton, Canada
| | - Promit Ananyo Chakraborty
- Faculty of Medicine, School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Georgia Michlig
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States of America
| | - Erin E. Michalak
- Faculty of Medicine, Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Andrew J. Greenshaw
- Faculty of Medicine and Dentistry, Department of Psychiatry, University of Alberta, Edmonton, Canada
| | - Raymond W. Lam
- Faculty of Medicine, Department of Psychiatry, University of British Columbia, Vancouver, Canada
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Mavindidze E, Nhunzvi C, Van Niekerk L. Supported employment interventions for workplace mental health of persons with mental disabilities in low-to-middle income countries: A scoping review. PLoS One 2023; 18:e0291869. [PMID: 37733732 PMCID: PMC10513264 DOI: 10.1371/journal.pone.0291869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 09/06/2023] [Indexed: 09/23/2023] Open
Abstract
OBJECTIVE To review the evidence of supported employment interventions in low-to-middle income countries, documents their impact for persons with mental disorders in the open labour market and well as support decision making for its wider implementation in the workplace. DESIGN The scoping review is conducted following guidelines in the Arksey and O'Malley (2005) Framework. DATA SOURCES AND ELIGIBILITY Eleven databases which are PubMed, Scopus, Academic Search Premier, the Cumulative Index to Nursing and Allied Health Literature, Africa-Wide Information, Humanities International Complete, Web of Science, PsychInfo, SocINDEX, Open Grey and Sabinet were searched for articles published between January 2006 and January 2022. Both peer-reviewed articles and grey literature were eligible if they were on supported employment interventions in low-to-middle income countries. Only articles published in English were included. STUDY APPRAISAL AND SYNTHESIS Articles were screened at title, abstract and full article levels by two independent teams with the use of Rayyan software. Deductive thematic analysis was used to synthesize evidence on the supported employment interventions implemented in LMICs, capturing evidence of their outcomes for persons with mental disabilities securing competitive work. RESULTS The search yielded 7347 records and after screening by title and abstract, 188 studies were eligible for full article screening. Eight studies were included in this scoping review. Thematic descriptions of the findings were based on the availability of supported employment interventions within the context, the type of supported employment interventions as well as mental health and vocational outcomes in the workplace. CONCLUSIONS There is limited evidence of supported employment interventions in low-to-middle income countries despite the promising potential it has as an intervention to address mental health problems in the workplace and facilitate work participation by persons with mental disabilities.
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Affiliation(s)
- Edwin Mavindidze
- Faculty of Medicine and Health Sciences, Department of Primary Health Care Sciences, Occupational Therapy Programme, Rehabilitation Sciences Unit, University of Zimbabwe, Harare, Zimbabwe
| | - Clement Nhunzvi
- Faculty of Medicine and Health Sciences, Department of Primary Health Care Sciences, Occupational Therapy Programme, Rehabilitation Sciences Unit, University of Zimbabwe, Harare, Zimbabwe
| | - Lana Van Niekerk
- Faculty of Medicine and Health Sciences, Division of Occupational Therapy, Stellenbosch University, Cape Town, Western Cape, South Africa
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Harvey C, Zirnsak TM, Brasier C, Ennals P, Fletcher J, Hamilton B, Killaspy H, McKenzie P, Kennedy H, Brophy L. Community-based models of care facilitating the recovery of people living with persistent and complex mental health needs: a systematic review and narrative synthesis. Front Psychiatry 2023; 14:1259944. [PMID: 37779607 PMCID: PMC10539575 DOI: 10.3389/fpsyt.2023.1259944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 08/23/2023] [Indexed: 10/03/2023] Open
Abstract
Objective This study aims to assess the effectiveness of community-based models of care (MoCs) supporting the recovery of individuals who experience persistent and complex mental health needs. Method We conducted a systematic review and narrative synthesis of MoC studies reporting clinical, functional, or personal recovery from October 2016 to October 2021. Sources were Medline, EMBASE, PsycInfo, CINAHL, and Cochrane databases. Studies were grouped according to MoC features. The narrative synthesis was led by our researchers with lived experience. Results Beneficial MoCs ranged from well-established to novel and updated models and those explicitly addressing recovery goals and incorporating peer support: goal-focused; integrated community treatment; intensive case management; partners in recovery care coordination; rehabilitation and recovery-focused; social and community connection-focused; supported accommodation; and vocational support. None of our diverse group of MoCs supporting recovery warranted a rating of best practice. Established MoCs, such as intensive case management, are promising practices regarding clinical and functional recovery, with potential for enhancements to support personal recovery. Emerging practice models that support personal and functional recovery are those where consumer goals and priorities are central. Conclusion Evidence for established models of care shows that there is a need for inevitable evolution and adaptation. Considering the high importance of effective MoCs for people experiencing persistent and complex mental health needs, further attention to service innovation and research is required. Greater emphasis on the inclusion of lived and living experience in the design, delivery, implementation, and research of MoCs is needed, to enhance MOCs' relevance for achieving individual consumer recovery outcomes.
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Affiliation(s)
- Carol Harvey
- Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
- North West Area Mental Health, Division of Mental Health, Northern Health, Melbourne, VIC, Australia
| | - Tessa-May Zirnsak
- Social Work and Social Policy, Department of Community and Clinical Health, La Trobe University, Bundoora, VIC, Australia
| | - Catherine Brasier
- Social Work and Social Policy, Department of Community and Clinical Health, La Trobe University, Bundoora, VIC, Australia
| | | | - Justine Fletcher
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Bridget Hamilton
- Centre for Mental Health Nursing, Department of Nursing, The University of Melbourne, Melbourne, VIC, Australia
| | - Helen Killaspy
- Department of Epidemiology and Applied Clinical Research, Division of Psychiatry, University College London, London, United Kingdom
- Camden and Islington NHS Foundation Trust, London, United Kingdom
| | - Peter McKenzie
- The Bouverie Centre, School of Psychology and Public Health, La Trobe University, Brunswick, VIC, Australia
| | - Hamilton Kennedy
- Centre for Mental Health Nursing, Department of Nursing, The University of Melbourne, Melbourne, VIC, Australia
| | - Lisa Brophy
- Social Work and Social Policy, Department of Community and Clinical Health, La Trobe University, Bundoora, VIC, Australia
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Ye L, Kavanagh A, Petrie D, Dickinson H, Aitken Z. Part-time versus full-time employment and mental health for people with and without disability. SSM Popul Health 2023; 23:101446. [PMID: 37334329 PMCID: PMC10275711 DOI: 10.1016/j.ssmph.2023.101446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 05/22/2023] [Accepted: 06/06/2023] [Indexed: 06/20/2023] Open
Abstract
Objectives This paper investigates the relationship between part-time and full-time employment and mental health for people with and without disability, as well as differences in the relationship by age and sex. Methods Using data from 13,219 working-aged people (15-64 years) in the labour force who participated in five annual waves of a longitudinal cohort study in Australia, the analysis used fixed effect regression models to examine within-person changes in mental health associated with changes in employment status (full-time; part-time; unemployed). Differences in the relationship between employment status and mental health by disability, sex, and age were assessed. Results Among people with disability, there was evidence that working part-time and full-time were associated with a 4.2-point (95% CI 2.6, 5.7) and 6.0-point (95% CI 4.4, 7.6) increase in mental health scores compared with when they were unemployed. For people without disability, there were much smaller differences in mental health associated with working part-time (β = 1.0, 95% CI 0.2, 1.9) and full-time (β = 1.4, 95% CI 0.5, 2.2) compared with when they were unemployed. The positive effects of both part-time and full-time employment were of greater magnitude for people with disability aged younger than 45 years compared to those aged 45 years and older. Conclusions The results of this study suggest that both part-time and full-time employment may have beneficial effects on the mental health of people with disability, particularly for younger people. The findings underscore the value of employment for people with disability, given we found much larger beneficial mental health effects in comparison to people without disability.
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Affiliation(s)
- Lu Ye
- Disability and Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Anne Kavanagh
- Disability and Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Dennis Petrie
- Centre for Health Economics, Monash Business School, Monash University, Caulfield East, Victoria, Australia
| | - Helen Dickinson
- Public Service Research Group, School of Business, UNSW Canberra, Canberra, ACT, Australia
| | - Zoe Aitken
- Disability and Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
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Hoff A, Poulsen RM, Fisker JP, Hjorthøj C, Nordentoft M, Christensen U, Bojesen AB, Eplov LF. Integrated Mental Healthcare and Vocational Rehabilitation for People on Sick Leave with Anxiety or Depression: 24-Month Follow-up of the Randomized IBBIS Trial. JOURNAL OF OCCUPATIONAL REHABILITATION 2023; 33:570-580. [PMID: 36849841 PMCID: PMC10495506 DOI: 10.1007/s10926-023-10094-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/13/2023] [Indexed: 06/18/2023]
Abstract
Integration of vocational rehabilitation and mental healthcare has shown some effect on work participation at 1-year follow-up after sick leave with depression and anxiety. We aimed to study the effect on work and health outcomes at 2-year follow-up, why we performed a randomized trial was conducted to study the effectiveness of integrated intervention (INT) compared to service as usual (SAU) and best practice mental healthcare (MHC). We included 631 participants, and at 24-month follow-up, we detected no differences in effect between INT and SAU. Compared to MHC, INT showed faster return-to-work (RTW) rates (p = 0.044) and a higher number of weeks in work (p = 0.024). No symptom differences were observed between the groups at 24 months. In conclusion, compared to SAU, INT was associated with a slightly higher work rate reaching borderline statistical significance at 12-month follow-up and lower stress levels at 6-month follow-up. The disappearance of relative effect between 12 and 24 months may be explained by the fact that the intervention lasted less than 12 months or by delayed spontaneous remission in the SAU group after 12 months. Despite the lack of effect at long-term follow-up, INT still performed slightly better than SAU overall. Moderate implementation difficulties, may partly explain the absence of the hypothesized effect. Integrated intervention, as implemented in this trial, showed some positive effects on mid-term vocational status and short-term stress symptom levels. However, these effects were not sustained beyond the duration of the intervention.
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Affiliation(s)
- Andreas Hoff
- Copenhagen Research Centre for Mental Health - CORE, Mental Health Centre Copenhagen, Copenhagen University Hospital, Gentofte Hospitalsvej 15, Hellerup, 2900, Denmark.
| | - Rie Mandrup Poulsen
- The National Board of Social Services in Denmark, Edisonsvej 1, Odense, 5000, Denmark
| | - Jonas Peter Fisker
- Hejmdal Private hospital, Martinsvej 7-9, Frederiksberg C, 1926, Denmark
| | - Carsten Hjorthøj
- Copenhagen Research Centre for Mental Health - CORE, Mental Health Centre Copenhagen, Copenhagen University Hospital, Gentofte Hospitalsvej 15, Hellerup, 2900, Denmark
- Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
| | - Merete Nordentoft
- Copenhagen Research Centre for Mental Health - CORE, Mental Health Centre Copenhagen, Copenhagen University Hospital, Gentofte Hospitalsvej 15, Hellerup, 2900, Denmark
| | - Ulla Christensen
- Department of Public Health, Faculty of Health and Medical Science, University of Copenhagen, Øster Farimagsgade 5, P.O.B. 2099, Copenhagen K, 1014, Denmark
| | - Anders Bo Bojesen
- Copenhagen Research Centre for Mental Health - CORE, Mental Health Centre Copenhagen, Copenhagen University Hospital, Gentofte Hospitalsvej 15, Hellerup, 2900, Denmark
| | - Lene Falgaard Eplov
- Copenhagen Research Centre for Mental Health - CORE, Mental Health Centre Copenhagen, Copenhagen University Hospital, Gentofte Hospitalsvej 15, Hellerup, 2900, Denmark
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Drake RE, Bond GR. Individual placement and support: History, current status, and future directions. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2023; 2:e122. [PMID: 38867819 PMCID: PMC11114326 DOI: 10.1002/pcn5.122] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 06/06/2023] [Accepted: 06/28/2023] [Indexed: 06/14/2024]
Abstract
Over the past three decades, Individual Placement and Support (IPS) has emerged as a robust evidence-based approach to helping people with severe mental illnesses, such as schizophrenia, bipolar disorder, and major depression, to obtain and succeed in competitive employment. This review addresses the history, principles, research, and future directions of IPS. It covers current evidence on employment outcomes, cost-effectiveness, and nonvocational outcomes. It also describes current attempts to extend IPS to new populations. The authors provide an overview of numerous systematic reviews and meta-analyses of randomized controlled trials involving people with serious mental illness. For studies addressing nonvocational outcomes and new populations, the review uses best available evidence. Published reviews agree that IPS enables patients with serious mental illness in high-income countries to succeed in competitive employment at a higher rate than patients who receive other vocational interventions. Within IPS programs, quality of implementation, measured by standardized fidelity scales, correlates with better outcomes. Employment itself leads to enhanced income, psychosocial outcomes, clinical improvements, and decreased mental health service use. As IPS steadily spreads to new populations and new settings, research is active across high-income countries and spreading slowly to middle-income countries. IPS is an evidence-based practice for people with serious mental illness in high-income countries. It shows promise to help other disability groups also, and emerging research aims to clarify adaptations and outcomes.
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Affiliation(s)
- Robert E. Drake
- Department of PsychiatryColumbia University Vagelos College of Physicians and SurgeonsNew York CityNew YorkUSA
- Westat CorporationRockvilleMarylandUSA
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Clarke J, Kinchin I, Kochovska S, Johnson MJ, Currow DC. What If… Caregivers' Subsequent Workforce Participation Was a Measure of Palliative Care Services' Impact? An Hypothesis-Generating Study. J Palliat Med 2023; 26:1042-1047. [PMID: 36720072 DOI: 10.1089/jpm.2022.0498] [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] [Indexed: 02/02/2023] Open
Abstract
Background: Hospice/palliative care emphasizes excellent care for patients, but what about longer-term caregiver outcomes after their caregiving role? What is the role of services in working to ensure that caregivers can re-engage with all aspects of life, including paid employment given that this is an identified stressor for caregivers? Aim: This hypothesis-generating study aimed to explore self-reported, post-care workforce participation, and any association with hospice/palliative care contact. Design: Cross-sectional random population interviews. Setting/Participants: People in the general population were randomly selected for face-to-face interviews about well-being including end-of-life care in South Australia. Questions included experiences of people dying an expected death and whether interviewees provided care. Demographic data included current workforce participation. A regression model explored associations with workforce participation. Results: Of 8945 interviews over three years, 171 participants aged 20-60 years (working age) provided intermittent hands-on care: two in five were men and two in three had qualifications beyond high school; one in two decedents had accessed palliative care services. Reflecting the bivariable analyses, logistic regression models showed associations with workforce participation and: being male (odds ratio [OR] 6.71); use of palliative care services (OR 4.85); and higher levels of education (OR 3.54). Conclusion: An association between workforce participation after caregiving ceased and the use of palliative care services was described, controlling for key factors. Reasons may include continued working, greater rates of return to work, earlier return to work or that people in the workforce are more likely to access services.
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Affiliation(s)
- Joseph Clarke
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, United Kingdom
| | - Irina Kinchin
- Trinity College Institute of Medicine, School of Medicine, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Slavica Kochovska
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Miriam J Johnson
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, United Kingdom
| | - David C Currow
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
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Simons IA, Goderie T, Lissenberg-Witte BI, Versfeld NJ, Kramer SE, van Wier MF. The Effects of Tinnitus and Tinnitus Annoyance on Need for Recovery After Work: Results of the Netherlands Longitudinal Study on Hearing. Ear Hear 2023; 44:768-775. [PMID: 36573900 PMCID: PMC10262992 DOI: 10.1097/aud.0000000000001323] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVES The first aim of this study was to examine the relationship between having tinnitus and the need for recovery after work (NFR). The second aim was to investigate whether the level of tinnitus annoyance is associated with NFR. DESIGN Data from the 5- and 10-year follow-up measurement rounds of the Netherlands Longitudinal Study on Hearing (NL-SH) were used in a cross-sectional analyses. The NL-SH is a web-based prospective cohort study and includes participants aged 18 to 70 years at baseline. For this study, we included only participants who worked at least 12 hours/week and were under the age of 65 years. Participants completed questionnaires on demographic, socioeconomic, psychosocial, hearing-related, and work-related characteristics. In addition, participants answered questions about hearing ability and tinnitus and performed an online digit-triplet speech recognition in noise test to measure the speech reception threshold (SRT) in noise. Participants were asked if (1) they suffer from tinnitus and (2) to rate tinnitus annoyance on a 0-100 numeric rating scale. A linear mixed model was used (1) to estimate the overall (i.e., cross-sectional) association between having tinnitus and NFR and (2) to estimate the overall association between the level of tinnitus annoyance and NFR. The models were checked for effect modification and confounding of factors known to be associated with either tinnitus or NFR and available in the NL-SH. RESULTS The study sample comprised 770 unique participants in total; 686 and 335 participants at 5- and 10-year follow-up, respectively. Distress, somatization, and self-reported hearing disability appeared to be confounding factors in the analysis of having tinnitus and NFR. After adjusting for these factors, participants with tinnitus had a 2.5% higher NFR (95% confidence interval: -0.9 to 5.9; p = 0.15). In the analysis of tinnitus annoyance and NFR, SRT was an effect modifier. Distress, somatization, depression, and self-reported hearing disability were confounders. After adjustment for effect modification and confounding, tinnitus annoyance was not significantly associated with NFR ( p = 0.79 for tinnitus annoyance). CONCLUSIONS This study showed that having tinnitus was not associated with a higher NFR. Also, higher levels of tinnitus annoyance were not associated with a higher NFR. NFR was associated with the psychological factors distress, somatization, and depression, which are known to be intricately related to tinnitus. A longitudinal study design is recommended as it can assess the sequence of events, which might help disentangle the association between tinnitus, NFR, and psychological factors.
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Affiliation(s)
- Iris A Simons
- Amsterdam UMC location Vrije Universiteit Amsterdam, Otolaryngology-Head and Neck Surgery, section Ear and Hearing, Amsterdam, The Netherlands
- Amsterdam Public Health, Quality of Care, Amsterdam, The Netherlands
- These authors contributed equally to this work and share first authorship
| | - Thadé Goderie
- Amsterdam UMC location Vrije Universiteit Amsterdam, Otolaryngology-Head and Neck Surgery, section Ear and Hearing, Amsterdam, The Netherlands
- Amsterdam Public Health, Quality of Care, Amsterdam, The Netherlands
- These authors contributed equally to this work and share first authorship
| | - Birgit I Lissenberg-Witte
- Amsterdam UMC location Vrije Universiteit Amsterdam, Epidemiology and Data Science, Amsterdam, The Netherlands
| | - Niek J Versfeld
- Amsterdam UMC location Vrije Universiteit Amsterdam, Otolaryngology-Head and Neck Surgery, section Ear and Hearing, Amsterdam, The Netherlands
| | - Sophia E Kramer
- Amsterdam UMC location Vrije Universiteit Amsterdam, Otolaryngology-Head and Neck Surgery, section Ear and Hearing, Amsterdam, The Netherlands
- Amsterdam Public Health, Quality of Care, Amsterdam, The Netherlands
| | - Marieke F van Wier
- Amsterdam UMC location Vrije Universiteit Amsterdam, Otolaryngology-Head and Neck Surgery, section Ear and Hearing, Amsterdam, The Netherlands
- Amsterdam Public Health, Quality of Care, Amsterdam, The Netherlands
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Marx W, Manger SH, Blencowe M, Murray G, Ho FYY, Lawn S, Blumenthal JA, Schuch F, Stubbs B, Ruusunen A, Desyibelew HD, Dinan TG, Jacka F, Ravindran A, Berk M, O'Neil A. Clinical guidelines for the use of lifestyle-based mental health care in major depressive disorder: World Federation of Societies for Biological Psychiatry (WFSBP) and Australasian Society of Lifestyle Medicine (ASLM) taskforce. World J Biol Psychiatry 2023; 24:333-386. [PMID: 36202135 PMCID: PMC10972571 DOI: 10.1080/15622975.2022.2112074] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/24/2022] [Accepted: 08/07/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVES The primary objectives of these international guidelines were to provide a global audience of clinicians with (a) a series of evidence-based recommendations for the provision of lifestyle-based mental health care in clinical practice for adults with Major Depressive Disorder (MDD) and (b) a series of implementation considerations that may be applicable across a range of settings. METHODS Recommendations and associated evidence-based gradings were based on a series of systematic literature searches of published research as well as the clinical expertise of taskforce members. The focus of the guidelines was eight lifestyle domains: physical activity and exercise, smoking cessation, work-directed interventions, mindfulness-based and stress management therapies, diet, sleep, loneliness and social support, and green space interaction. The following electronic bibliographic databases were searched for articles published prior to June 2020: PubMed, EMBASE, The Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Methodology Register), CINAHL, PsycINFO. Evidence grading was based on the level of evidence specific to MDD and risk of bias, in accordance with the World Federation of Societies for Biological Psychiatry criteria. RESULTS Nine recommendations were formed. The recommendations with the highest ratings to improve MDD were the use of physical activity and exercise, relaxation techniques, work-directed interventions, sleep, and mindfulness-based therapies (Grade 2). Interventions related to diet and green space were recommended, but with a lower strength of evidence (Grade 3). Recommendations regarding smoking cessation and loneliness and social support were based on expert opinion. Key implementation considerations included the need for input from allied health professionals and support networks to implement this type of approach, the importance of partnering such recommendations with behaviour change support, and the need to deliver interventions using a biopsychosocial-cultural framework. CONCLUSIONS Lifestyle-based interventions are recommended as a foundational component of mental health care in clinical practice for adults with Major Depressive Disorder, where other evidence-based therapies can be added or used in combination. The findings and recommendations of these guidelines support the need for further research to address existing gaps in efficacy and implementation research, especially for emerging lifestyle-based approaches (e.g. green space, loneliness and social support interventions) where data are limited. Further work is also needed to develop innovative approaches for delivery and models of care, and to support the training of health professionals regarding lifestyle-based mental health care.
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Affiliation(s)
- Wolfgang Marx
- Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Sam H Manger
- College of Medicine and Dentistry, James Cook University, Queensland, Australia
- Australasian Society of Lifestyle Medicine, Melbourne, Australia
| | - Mark Blencowe
- Australasian Society of Lifestyle Medicine, Melbourne, Australia
| | - Greg Murray
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia
| | - Fiona Yan-Yee Ho
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong SAR
| | - Sharon Lawn
- Lived Experience Australia Ltd, Adelaide, Australia
- Flinders University, College of Medicine and Public Health, Adelaide, Australia
| | - James A. Blumenthal
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham NC 27710
| | - Felipe Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Anu Ruusunen
- Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland
| | - Hanna Demelash Desyibelew
- Department of Nutrition and Dietetics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | | | - Felice Jacka
- Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Arun Ravindran
- Department of Psychiatry & Institute of Medical Sciences, University of Toronto. Centre for Addiction and Mental Health, Toronto, Canada
| | - Michael Berk
- Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Adrienne O'Neil
- Deakin University, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
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Pienkowski T, Keane A, de Lange E, Kapoor V, Khanyari M, Ravi R, Smit IPJ, Castelló y Tickell S, Hazenbosch M, Arlidge WNS, Baranyi G, Brittain S, Papworth S, Saxena S, Hout V, Milner‐Gulland EJ. Psychological distress and workplace risk inequalities among conservation professionals. CONSERVATION SCIENCE AND PRACTICE 2023. [DOI: 10.1111/csp2.12918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
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Examining the impact of reasonable accommodation appraisals on New Zealand managers' attitudes toward hiring people with disability. EQUALITY, DIVERSITY AND INCLUSION: AN INTERNATIONAL JOURNAL 2023. [DOI: 10.1108/edi-08-2021-0207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PurposeManagers are responsible for implementing reasonable accommodation (RA) for people with disabilities (PwD). Yet, little is known about the extent to which managerial views of RA shape attitudes toward PwD. The study draws on conservation of resources (COR) and job demands and resources (JD-R) theories to examine the relationship between managerial views of RA availability and implementation ease on attitudes towards hiring PwD.Design/methodology/approachIn total, 162 full-time managers at a large New Zealand (NZ) healthcare organisation completed an online survey. Moderated multiple regressions were conducted to test the main effects and interactions between perceptions of RA process and attitudes towards hiring PwD.FindingsThe study results indicate that line managers held positive attitudes towards hiring PwD when they viewed RA implementation as easy, particularity around the provision of flexible work arrangements.Research limitations/implicationsThis study shows the importance of gaging managers' views of RA processes to understand their attitudes toward PwD and highlights potential linkages between managerial perspectives on RA, PwD experiences in the organisation and the effectiveness of disability support and inclusion initiatives.Practical implicationsRA availability from the organisation is insufficient to elicit positive managerial attitudes toward hiring PwD. Policies and procedures that reduce RA implementation complexity are expected to foster positive managerial attitudes toward PwD and improve employment outcomes for this employee group.Originality/valueThis study is the first to test how managerial attitudes towards hiring PwD are influenced by views of RA availability from the organisation and of RA implementation ease. It also provides a multidimensional measure that captures managerial views of RA availability from the organisation and RA implementation ease.
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Ottomanelli L, Cotner BA, Swanson SJ, Dirk L, Arriola NB, Carlomagno J, Toscano R. Individual Placement and Support Helps People With Spinal Cord Injury Find and Keep Jobs They Want. Arch Phys Med Rehabil 2023:S0003-9993(23)00054-0. [PMID: 36736601 DOI: 10.1016/j.apmr.2022.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/04/2022] [Accepted: 11/13/2022] [Indexed: 02/05/2023]
Affiliation(s)
- Lisa Ottomanelli
- Research Service of the James A. Haley Veterans' Hospital (JAHVH), and the Rehabilitation and Mental Health Counseling Program, Department of Child and Family Studies, College of Behavioral and Community Sciences, University of South Florida (USF), Tampa, FL.
| | - Bridget A Cotner
- Research Service of the JAHVH; Department of Anthropology, USF, is Secretary of the ACRM Military and Veterans Affairs Networking Group
| | | | - Lynn Dirk
- Tampa VA Research and Education Foundation
| | | | - Joe Carlomagno
- Vocational Rehabilitation Services, Veterans Health Administration, Washington, DC
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Butenko D, Rinaldi M, Brinchmann B, Brandseth OL, Killackey E, Mykletun A. The personality profile of IPS employment specialists, and how it relates to job satisfaction: A longitudinal cohort study. Scand J Psychol 2023; 64:71-79. [PMID: 35997312 PMCID: PMC10087514 DOI: 10.1111/sjop.12864] [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: 10/25/2021] [Revised: 07/03/2022] [Accepted: 08/01/2022] [Indexed: 01/11/2023]
Abstract
The role of the Individual Placement and Support (IPS) employment specialist is a new type of occupation within mental healthcare. High turnover among employment specialists necessitates improvement in their recruitment and retention. One element that impacts retention is job satisfaction. We assessed the personality of 38 employment specialists (Big 5 Inventory-2) and measured job satisfaction over three time periods. Compared to norm data, employment specialists were significantly higher on Extraversion (ΔT = 8.0, CI: 5.59-10.42), Agreeableness (ΔT = 7.8, CI: 5.56-10.12), Conscientiousness (ΔT = 3.3, CI: 0.8-5.84), Open-mindedness (ΔT = 3.5, CI: 0.97-6.07), while lower on Negative emotionality (ΔT = -3.5, CI: -6.5 to -0.42). Extraversion had a substantial longitudinal positive effect on job satisfaction (β at T1 = 0.39; CI: 0.10-0.73) (β at T2 = 0.40; CI: 0.03-0.80), while Negative emotionality - a substantial negative effect (β at T1 = -0.60; CI: -0.90 to -0.30) (β at T2 = -0.50; CI: -0.90 to -0.12). Male gender was significantly associated with higher job satisfaction at the time point 1 (β = -0.46; CI: -0.80 to -0.14). Age, length of employment in the role, Agreeableness, Conscientiousness and Open-mindedness were not found to have substantial significant effects on job satisfaction of employment specialists. Recruiting employment specialists who score high on Extraversion and low on Negative emotionality may be a good fit for the role and job satisfaction.
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Affiliation(s)
- Daniil Butenko
- Centre for work and mental health, Nordland Hospital trust, Bodø, Norway.,Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine, Faculty of Medicine, University in Bergen, Bergen, Norway
| | - Miles Rinaldi
- Centre for work and mental health, Nordland Hospital trust, Bodø, Norway.,South West London and St George's Mental Health NHS Trust, London, UK
| | - Beate Brinchmann
- Centre for work and mental health, Nordland Hospital trust, Bodø, Norway.,UiT The Arctic University of Norway, Tromsø, Norway
| | - Oda Lekve Brandseth
- Centre for work and mental health, Nordland Hospital trust, Bodø, Norway.,Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Eoin Killackey
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Arnstein Mykletun
- Centre for work and mental health, Nordland Hospital trust, Bodø, Norway.,Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway.,UiT The Arctic University of Norway, Tromsø, Norway.,Norwegian Institute of Public Health, Oslo, Norway
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Tholl AD, Lima TCS, Nogueira SPBO, Faleiros F, Marques-Vieira C, Viegas SMF, de Souza JM, Gonçalves N, Nitschke RG, da Cruz DA, Antunes NA, Ilha J. Labour market participation among rehabilitated individuals with spinal cord injury in Brazil: a cross-sectional study. Spinal Cord 2023; 61:119-124. [PMID: 36064765 DOI: 10.1038/s41393-022-00846-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 07/29/2022] [Accepted: 07/29/2022] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Cross-sectional study. OBJECTIVE To document the labour market participation rate and investigate the impact of social and economic characteristics on this outcome among individuals with spinal cord injury or disease (SCI/D) who participated in a multidisciplinary rehabilitation programme in Brazil. SETTING A specialised rehabilitation centre in southern Brazil. METHODS An interview was performed with former rehabilitation clients with SCI/D. A total of 111 community-dwelling individuals with SCI/D who had been previously rehabilitated in a large regional rehabilitation centre were considered. Employment status and demographic, injury, work, and economic characteristics were self-reported via interview. Descriptive statistical analyses were performed. RESULTS The labour market participation rate was 21.6% (24 individuals). Five respondents were employed in formal work activities, and the other 19 were involved in informal activities (self-employed). Since the onset of injury, a shorter time was associated with nonparticipation in occupational work. Individuals with a higher level of education were more likely to be working. Household income was higher among the participants who had returned to work than among those who had not returned. CONCLUSION There is a relatively low labour market participation rate among rehabilitated individuals with SCI/D in southern Brazil. The rehabilitation services should emphasise vocational training, access to education, and employment support for individuals with SCI/D from early onset after the injury. Public policies must be revised to support labour market participation among individuals with SCI/D in Brazil.
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Affiliation(s)
- Adriana D Tholl
- Department of Nursing, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil.
| | - Thamyres C S Lima
- Department of Nursing, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | | | - Fabiana Faleiros
- College of Nursing, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | | | - Selma M F Viegas
- Nursing School, Universidade Federal de São João del-Rei, Campus Centro-Oeste, Divinópolis, MG, Brazil
| | - Janaína M de Souza
- Department of Nursing, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - Natália Gonçalves
- Department of Nursing, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - Rosane G Nitschke
- Department of Nursing, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - Danielle A da Cruz
- Department of Nursing, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - Natália A Antunes
- Department of Nursing, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - Jocemar Ilha
- Department of Physiotherapy, Universidade do Estado de Santa Catarina, Florianópolis, SC, Brazil
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Finne J, Holt K. Mental health professionals' expectations and efforts to include employment for people with moderate to severe mental illness in treatment settings. BMC Psychiatry 2023; 23:82. [PMID: 36721128 PMCID: PMC9890801 DOI: 10.1186/s12888-023-04568-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 01/24/2023] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Research suggests that employment is an important factor for recovery and improved quality of life for people with mental illnesses. Mental health professionals often serve as gatekeepers for employment interventions, yet little is known about their expectations about employment for people with mental illness in Norway. The purpose of this study is to examine mental health professionals' expectations and efforts to include employment for people with moderate to severe mental illness in treatment settings. METHODS Two hundred seven mental health professionals were recruited from municipal mental health services, specialized clinics, social media, and professionals' networks across Norway. Participants completed a survey package comprising demographic questions, current practices and a revised version of the self-reported measure Expectations for the Employability of People with Serious Mental Illness (EESMI), a validated measure consisting of three subscales. RESULTS Results suggested overall favorable expectations of employment for people with moderate to severe mental illness. Analyses revealed that patients participating more frequently in collaborative meetings predicted more favorable expectations about employment among mental health professionals compared to less frequent meetings. In addition, findings suggest that psychiatrist hold more negative expectations about employment in comparison to the other educational groups. Lastly, more than half of mental health professionals reported that they have integrated discussions about employment, and routines to address work-oriented activity in consultations with patients, however, there are substantial variations in routines for addressing work or work-oriented activity as a topic in consultations with patients. CONCLUSIONS These results suggest that efforts are being made to integrate employment in treatment settings for people with mental illness in Norway; however, more work is needed to remove barriers and facilitate evidence-based approaches.
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Affiliation(s)
- Joakim Finne
- Work Research Institute, Oslo Metropolitan University, Oslo, Norway.
| | - Karin Holt
- Regional Center for Violence, Traumatic Stress, and Suicide Prevention, Oslo, Norway ,grid.411279.80000 0000 9637 455XDivision of Mental Health Services, Akershus University Hospital, 1478 Lørenskog, Norway
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Mavragani A, Svedberg P, Lexén A, Tjörnstrand C, Strid C, Bejerholm U. Co-design Process of a Digital Return-to-Work Solution for People With Common Mental Disorders: Stakeholder Perception Study. JMIR Form Res 2023; 7:e39422. [PMID: 36652285 PMCID: PMC9892984 DOI: 10.2196/39422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 10/18/2022] [Accepted: 10/19/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Service users and other stakeholders have had few opportunities to influence the design of their mental health and return-to-work services. Likewise, digital solutions often fail to align with stakeholders' needs and preferences, negatively impacting their utility. mWorks is a co-design initiative to create a digital return-to-work solution for persons with common mental disorders that is acceptable and engaging for those receiving and delivering the intervention. OBJECTIVE This study aimed to describe stakeholder perceptions and the involvement of a design process during the prototype development of mWorks. METHODS A co-design approach was used during the iterative development of mWorks. Overall, 86 stakeholders were recruited using a combination of purposeful and convenience sampling. Five stakeholder groups represented service users with experience of sick leave and common mental disorders (n=25), return-to-work professionals (n=19), employers (n=1), digital design and system developers (n=4), and members of the public (n=37). Multiple data sources were gathered using 7 iterations, from March 2018 to November 2020. The rich material was organized and analyzed using content analysis to generate themes and categories that represented this study's findings. RESULTS The themes revealed the importance of mWorks in empowering service users with a personal digital support solution that engages them back in work. The categories highlighted that mWorks needs to be a self-management tool that enables service users to self-manage as a supplement to traditional return-to-work services. It was also important that content features helped to reshape a positive self-narrative, with a focus on service users' strengths and resources to break the downward spiral of ill health during sick leave. Additional crucial features included helping service users mobilize their own strategies to cope with thoughts and feelings and formulate goals and a plan for their work return. Once testing of the alpha and beta prototypes began, user engagement became the main focus for greater usability. It is critical to facilitate the comprehension and purpose of mWorks, offer clear guidance, and enhance motivational and goal-setting strategies. CONCLUSIONS Stakeholders' experience-based knowledge asserted that mWorks needs to empower service users by providing them with a personal support tool. To enhance return-to-work prospects, users must be engaged in a meaningful manner while focusing on their strengths and resources.
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Affiliation(s)
| | - Petra Svedberg
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Annika Lexén
- Department of Health Science, Lund University, Lund, Sweden
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Brucks A, Lang A, Blank D, Lincke HJ, Riedl L, Siafis S, Brieger P, Hamann J. How do employees currently admitted to acute psychiatric inpatient units rate their psychosocial working conditions with the COPSOQ (Copenhagen Psychosocial Questionnaire). Int J Soc Psychiatry 2023:207640221143914. [PMID: 36591697 DOI: 10.1177/00207640221143914] [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] [Indexed: 01/03/2023]
Abstract
BACKGROUND In recent years it could be shown that psychosocial working conditions and mental health of employees are closely correlated. One well-established instrument to measure psychosocial stress at work is the COPSOQ (Copenhagen Psychosocial Questionnaire, German Standard Version). It is an 84 item self-rating instrument addressing several domains of psychosocial working conditions and is generally used for risk assessments in companies. AIMS To examine associations between COPSOQ ratings with clinical features and symptoms of employees who currently suffer from an episode of a mental illness requiring inpatient treatment. METHOD For 265 inpatients with mental disorders who participated in a cluster randomized trial (RETURN-study) COPSOQ-data were available as part of the baseline data acquisition. These data were compared with the German COPSOQ validation sample of the Freiburg research center for occupational sciences (FFAW; approximately 250,000 participants). For subdomains of the COPSOQ that showed major and significant differences between the two samples regression analyses were done to predict COPSOQ scores within the RETURN-sample. RESULTS Psychiatric inpatients did not assess their working conditions significantly different compared to the population based FFAW sample. However, with regard to the effects of working conditions (general health, burnout, presenteeism, and intention to leave the job) there were major differences between the two samples with the clinical sample expressing more negative views. In the RETURN sample these were predicted by a greater expression of depressive symptoms. CONCLUSIONS The linkage between work and mental wellbeing is complex. Mental illness is not necessarily a result of poor working conditions, while good working conditions may not in every case prevent symptoms of bad health, even if such associations exist.
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Affiliation(s)
- Adele Brucks
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Technische Universität München, Germany
| | - Anne Lang
- Kbo-Isar-Amper-Klinikum Region München, Germany
| | | | - Hans-Joachim Lincke
- Freiburger Forschungsstelle für Arbeitswissenschaften GmbH, Freiburg, Germany
| | - Lina Riedl
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Technische Universität München, Germany
| | - Spyridon Siafis
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Technische Universität München, Germany
| | | | - Johannes Hamann
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Technische Universität München, Germany
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Job Retention and Reintegration in People with Mental Health Problems: A Descriptive Evaluation of Supported Employment Routine Programs. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2023; 50:128-136. [PMID: 36289141 PMCID: PMC9832069 DOI: 10.1007/s10488-022-01227-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 09/28/2022] [Indexed: 02/04/2023]
Abstract
PURPOSE Striking evidence supports the effectiveness of supported employment (SE) in achieving competitive employment in individuals with mental health problems. Yet, little is known whether SE is effective to maintain employment in individuals at risk of job loss. We aimed to descriptively compare SE for employed clients (SE-retention) and unemployed clients (SE-integration) regarding competitive employment. METHODS We used administrative data from January 2017 to October 2021 provided by a vocational rehabilitation center in Switzerland including all individuals (≥ 18yrs.) with mental health problems who participated either in SE-retention or SE-reintegration. The outcome was the proportion with competitive employment at discharge. Logistic regression was used to assess time trends and to descriptively compare SE-treatments. We used propensity score weighting, including personal, clinical and program-specific information to reduce group differences. RESULTS A total of 556 participants primarily diagnosed with mood/stress-related, schizophrenia and personality disorders were included (n = 297 SE-retention, n = 259 SE-reintegration) with median age 41 years and 57% female gender. The overall weighted comparison favored SE-retention over SE-reintegration OR 4.85 (95%-CI 3.10 to 7.58, p < 0.001) with predicted employment of 67.3% and 29.9% for SE-retention and SE-reintegration, respectively. While success for SE-reintegration remained stable over time, SE-retention showed an increase in more recent years. CONCLUSION SE-retention provides an approach for early work-related support that can prevent labor market exclusion. In contrast, reintegration is likely to require more efforts to achieve employment and may result in less favorable outcomes. It is therefore necessary that further research includes appropriate comparison groups to evaluate the effectiveness of SE-retention programs as well as the economic and individual benefits.
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