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Lecours A, Coutu MF, Durand MJ. Fostering Stay at Work After a Period of Disability: A Scoping Review of Occupational Rehabilitation Strategies to Support Workers in the Adoption of Preventive Behaviours. JOURNAL OF OCCUPATIONAL REHABILITATION 2024; 34:56-70. [PMID: 37358726 DOI: 10.1007/s10926-023-10122-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/05/2023] [Indexed: 06/27/2023]
Abstract
PURPOSE Based on the theoretical framework of the Model of Preventive Behaviours at Work, the aim of this study was to describe the the occupational rehabilitation strategies the literature reports that support workers who have suffered an occupational injury in adopting preventive behaviours. METHODS To conduct this scoping review, we used a systematic methodology in 7 steps : (1) definition of the research question and inclusion/exclusion criteria; (2) scientific and gray literature search; (3) determination of manuscripts' eligibility; (4) extraction and charting of information; (5) quality assessment; (6) interpretation; and (7) knowledge synthesis. RESULTS We selected 46 manuscripts of various types (e.g. randomized trials, qualitative studies, governmental documents). Manuscripts were mainly of good or high quality according to our quality assessment. The strategies for coaching, engaging, educating and collaborating were mostly reported in the literature to support the development of the six preventive behaviours during occupational rehabilitation. The results also suggest that heterogeneity exists regarding the specificity of the strategies reported in the literature, which may have hindered our ability to provide rich and detailed descriptions. Literature also mainly describes individually oriented behaviours and reports strategies requiring a low level of worker involvement, which represent issues to adress in future researh projects. CONCLUSION The strategies described in this article reprensent concrete levers that occupational rehabilitation professionals can use to support workers in the adoption of preventive behaviours at work on return from having suffered an occupational injury.
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Affiliation(s)
- Alexandra Lecours
- Département d'ergothérapie, Université du Québec à Trois-Rivières, 555 Boul de l'Université, Drummondville, Québec, J2C 0R5, Canada.
- Centre interdisciplinaire de recherche en réadaptation et intégration sociale, Quebec, Canada.
| | - Marie-France Coutu
- École de réadaptation, Université de Sherbrooke, Sherbrooke, Canada
- Centre d'action en prévention et réadaptation de l'incapacité au travail, Longueuil, Canada
| | - Marie-José Durand
- École de réadaptation, Université de Sherbrooke, Sherbrooke, Canada
- Centre d'action en prévention et réadaptation de l'incapacité au travail, Longueuil, Canada
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Petrosyan H, Leonardi C, Thakral A, Roth J, Russoniello N, Goldin Y, Parikh S. Barriers and factors associated with adherence to a home exercise program of adults with musculoskeletal pain. J Back Musculoskelet Rehabil 2024; 37:473-485. [PMID: 38108342 DOI: 10.3233/bmr-230178] [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] [Indexed: 12/19/2023]
Abstract
BACKGROUND Home exercise programs (HEPs) are cost-effective and efficacious treatments for musculoskeletal pain conditions. Although HEPs are an important part of the continuum of care, non-adherence limits their effectiveness. OBJECTIVE The objective of this study was to examine adherence and specific barriers to clinician-prescribed HEPs in adults with musculoskeletal pain. METHODS A cross-sectional study was conducted with a total of 300 patients presenting to an outpatient pain clinic in an academic medical center. Participants' self-reported information, including HEP completion frequency and barriers, was collected through a survey. RESULTS The participants' mean age was 54.1 ± 15.8 years (females = 133 (65.5%)). Of 203 participants, 99 (48.8%) adhered to HEP, 56 (27.6%) partially adhered, and 48 (23.6%) did not adhere. One hundred eighty-seven (92.1%) participants reported receiving adequate instructions, and 175 (86.2%) reported receiving instructional materials. Age and "sufficient instructions" were found to be significant determinants of adherence (p< 0.05), while gender and handouts were not (p> 0.05). Pain in more than one body part was significantly (p< 0.05) associated with motivational barriers for non-adherence. CONCLUSION Age and participants' perception of sufficient instructions were significant factors for non-adherence. These results emphasize the importance of therapist-provided instructions to overcome barriers to adherence.
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Affiliation(s)
- Hayk Petrosyan
- Department of Physical Medicine and Rehabilitation, Hackensack Meridian JFK Johnson Rehabilitation Institute, Edison, NJ, USA
- Department of Physical Medicine and Rehabilitation, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Christopher Leonardi
- Department of Physical Medicine and Rehabilitation, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Aakash Thakral
- Department of Physical Medicine and Rehabilitation, Hackensack Meridian JFK Johnson Rehabilitation Institute, Edison, NJ, USA
| | - Jason Roth
- Department of Physical Medicine and Rehabilitation, Hackensack Meridian JFK Johnson Rehabilitation Institute, Edison, NJ, USA
| | - Nicholas Russoniello
- Department of Physical Medicine and Rehabilitation, Hackensack Meridian JFK Johnson Rehabilitation Institute, Edison, NJ, USA
| | - Yelena Goldin
- Department of Physical Medicine and Rehabilitation, Hackensack Meridian JFK Johnson Rehabilitation Institute, Edison, NJ, USA
| | - Sagar Parikh
- International Spine Pain and Performance Center, Washington, DC, USA
- Center for Interventional Pain and Spine, Wilmington, DE, USA
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Skamagki G, Carpenter C, King A, Wåhlin C. How do Employees with Chronic Musculoskeletal Disorders Experience the Management of Their Condition in the Workplace? A Metasynthesis. JOURNAL OF OCCUPATIONAL REHABILITATION 2023; 33:702-712. [PMID: 36849842 PMCID: PMC10684637 DOI: 10.1007/s10926-023-10099-2] [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: 01/23/2023] [Indexed: 06/18/2023]
Abstract
This metasynthesis contributes to an understanding of the experiences, perceptions, and attitudes of employees on managing chronic musculoskeletal disorders (CMSDs) at work. Many studies in this field are concerned with prevention or return-to-work (RTW) programmes. However, the purpose of this review was to synthesise evidence that only focuses on the employees' management of their CMSDs at work. The SPIDER framework was used to structure the question "How do employees with CMSDs experience the management of their condition in the workplace"? The literature search focused on articles published between 2011 and 2021, and the search was conducted using the following databases: MEDLINE, SCOPUS, CINAHL, AMED, PsycINFO. The review identified nine articles that explored employees' experiences of managing CMSDs at work. Thematic synthesis was used to create analytic themes which provided a more in-depth discussion of these experiences. The identified themes were: 'employees actively seek ways to manage their conditions', 'influence of work environment on employees with CMSDs' and 'optimising the relationship between employees and managers. This metasynthesis suggests that the ability to negotiate workplace support and manage CMSDs at work is influenced by the cultural and social environment of the organisation. Effective communication, care and trust between the employee is needed. The review also illustrated the need for healthcare professionals to provide support to employees at work.
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Affiliation(s)
- Glykeria Skamagki
- Department of Physiotherapy, School of Sport, Exercise and Rehabilitation, University of Birmingham, Birmingham, UK.
| | - Christine Carpenter
- Department of Physiotherapy, University of British Columbia, Vancouver, Canada
| | - Andrew King
- Department of Physiotherapy, Coventry University, Coventry, UK
| | - Charlotte Wåhlin
- Department of Health, Medicine and Caring Sciences, Occupational and Environmental Medicine Center, Division of Prevention, Rehabilitation and Community Medicine, Unit of Intervention and Implementation Research, Institute for Environmental Medicine, Linköping University, Karolinska Institutet, Stockholm, Sweden
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Chester R, Daniell H, Belderson P, Wong C, Kinsella P, McLean S, Hill J, Banerjee A, Naughton F. Behaviour Change Techniques to promote self-management and home exercise adherence for people attending physiotherapy with musculoskeletal conditions: A scoping review and mapping exercise. Musculoskelet Sci Pract 2023; 66:102776. [PMID: 37301059 DOI: 10.1016/j.msksp.2023.102776] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 05/11/2023] [Accepted: 05/13/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Many patients with musculoskeletal problems do not adhere to home exercises or self-management advice provided by physiotherapists. This is due to numerus factors, many of which can be targeted by Behaviour Change Techniques. OBJECTIVES 1) Undertake a scoping review to identify the modifiable determinants (barriers and facilitators) of home exercise adherence and self-management for the physiotherapy management of people with musculoskeletal problems and map them to the Theoretical Domains Framework and Behaviour Change Techniques. 2) For determinants with supporting evidence from ≥2 studies, provide examples of Behaviour Change Techniques for clinical practice. DESIGN This review follows the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. METHOD Four electronic databases were searched from inception to December 2022. Two independent reviewers carried out manuscript selection, data extraction, quality assessment, and mapping, the latter using the Theory and Techniques Tool. RESULTS Thirteen modifiable determinants were identified in 28 studies. The most frequently identified were self-efficacy, social support, and task appreciation. Determinants were mapped to 7 of 14 Theoretical Domains Framework categories, which in turn mapped onto 42 of 93 Behaviour Change Techniques, the most common being problem solving and instruction on how to perform behaviour. CONCLUSIONS By identifying determinants to home exercise adherence and self-management and mapping these to Behaviour Change Techniques, this review has improved understanding of their selection, targeting, and potential application to musculoskeletal physiotherapy practice. This provides support for physiotherapists targeting the determinants of importance for the patient in front of them.
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Affiliation(s)
- Rachel Chester
- School of Health Sciences, Faculty of Medicine and Health, University of East Anglia, Norwich Research Park, Norfolk, NR4 7TJ, United Kingdom.
| | - Helena Daniell
- School of Health Sciences, Faculty of Medicine and Health, University of East Anglia, Norwich Research Park, Norfolk, NR4 7TJ, United Kingdom; Physiotherapy Department, Norfolk and Norwich University Hospital, NHS Trust, Norwich, United Kingdom.
| | - Pippa Belderson
- School of Health Sciences, Faculty of Medicine and Health, University of East Anglia, Norwich Research Park, Norfolk, NR4 7TJ, United Kingdom.
| | - Carl Wong
- Department of Therapies, Charing Cross Hospital, Imperial College Healthcare NHS Trust, Fulham Palace Road, London, W6 8RF, United Kingdom.
| | - Paula Kinsella
- Flint House Police Rehabilitation, Reading Road, Goring, Reading, RG8 0LL, United Kingdom; Faculty of Health and Wellbeing, Sheffield Hallam University, Collegiate Campus, Collegiate Cres, Broomhall, Sheffield, S10 2BP, United Kingdom.
| | - Sionnadh McLean
- Faculty of Health and Wellbeing, Sheffield Hallam University, Collegiate Campus, Collegiate Cres, Broomhall, Sheffield, S10 2BP, United Kingdom.
| | - Jonathan Hill
- School of Medicine, Keele University, Keele, Staffordshire, ST5 5BG, United Kingdom.
| | - Anirban Banerjee
- Keele University, Keele, Staffordshire, ST5 5BG, United Kingdom.
| | - Felix Naughton
- School of Health Sciences, Faculty of Medicine and Health, University of East Anglia, Norwich Research Park, Norfolk, NR4 7TJ, United Kingdom.
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St-Georges M, Hutting N, Hudon A. Competencies for Physiotherapists Working to Facilitate Rehabilitation, Work Participation and Return to Work for Workers with Musculoskeletal Disorders: A Scoping Review. JOURNAL OF OCCUPATIONAL REHABILITATION 2022; 32:637-651. [PMID: 35384629 DOI: 10.1007/s10926-022-10037-8] [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: 03/16/2022] [Indexed: 06/14/2023]
Abstract
Purpose The aim of this scoping review was to synthesize the literature addressing the competencies that physiotherapists in a clinical setting need to facilitate the rehabilitation, work participation, and return to work of workers with musculoskeletal disorders.Methods We conducted a scoping review in accordance with Arksey & O'Malley's five-step method. The following categories of keywords were used during searches in Embase, Medline and CINAHL in May 2020: (1) physiotherapy/physical therapy; (2) return to work, work participation or occupational health; and (3) education/professional competencies/guidelines. Two authors reviewed the full-text papers and agreed on the selection of articles for inclusion. The selected articles were then charted in an Excel grid and descriptively analyzed.Results Three main categories of competencies were identified: (1) Understanding and interacting with patients who are workers; (2) Planning rehabilitation with other stakeholders; and (3) Reaching out to the workplace. The fourth category named "Obstacles to the development of work-related competencies", regroups several obstacles that were identified as potentially impeding the development of work-related competencies by physiotherapists.Conclusion The findings of this scoping review inform physiotherapy clinicians, educators and regulators on the specific knowledge, skills, abilities, and attitudes that appear to play a role in facilitating the rehabilitation of workers with musculoskeletal disorders. We trust that this study will lead to new initiatives that will define, implement and evaluate the effectiveness of these competencies in practice, along with rekindling the discussions about the place of work rehabilitation in the physiotherapy profession.
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Affiliation(s)
- Mélodie St-Georges
- School of Rehabilitation, Faculty of Medicine, University of Montreal, C.P. 6128 Succ. Centre-ville, Montreal, Québec, H3C 3J7, Canada
| | - Nathan Hutting
- School of Organisation and Development, Research Group Occupation & Health, HAN University of Applied Sciences, PO Box 6960, 6503 GL, Nijmegen, The Netherlands
| | - Anne Hudon
- School of Rehabilitation, Faculty of Medicine, University of Montreal, C.P. 6128 Succ. Centre-ville, Montreal, Québec, H3C 3J7, Canada.
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), Centre intégré de services sociaux et de santé du Centre-Sud-de-l'Ile-de-Montréal (CIUSSS CSMTL), Montreal, Quebec, Canada.
- Centre de Recherche en Éthique (CRÉ), Montreal, Canada.
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Skamagki G, Carpenter C, King A, Wåhlin C. Management of Chronic Musculoskeletal Disorders in the Workplace from the Perspective of Older Employees: A Mixed Methods Research Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159348. [PMID: 35954704 PMCID: PMC9367967 DOI: 10.3390/ijerph19159348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 07/11/2022] [Accepted: 07/21/2022] [Indexed: 02/01/2023]
Abstract
(1) Background: This mixed methods research (MMR) study explored older employees’ experiences of chronic musculoskeletal disorders (CMSDs) in relation to their employment, their perspectives on managing these conditions in the workplace and the strategies used to facilitate and maintain their roles and responsibilities. The services offered to them were also identified. (2) Methods: A mixed methods exploratory sequential design was implemented. In the first qualitative phase, 16 semi-structured interviews gathered in-depth information from older employees. The findings informed the development of an online questionnaire in the survey phase, which was administered to older employees (N = 107). Both sets of findings were then integrated using a narrative joint display. (3) Results: The phenomena of presenteeism and leaveism were important components of employees’ strategies for managing their condition. The integrated findings highlighted the roles of employers, managers and social support in encouraging disclosure and supporting the management of CMSDs. The results also emphasised how self-management and professional health services are crucial for sustaining employability. (4) Conclusions: Current challenges call for employers to identify effective ways to support the ageing workforce and invest in training opportunities for managers and collaborative opportunities with healthcare professionals and other stakeholders. A flexible, empathetic and resourceful work environment is optimal for supporting sustained employability for an ageing workforce.
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Affiliation(s)
- Glykeria Skamagki
- School of Sport, Exercise and Rehabilitation Sciences, Department of Physiotherapy, University of Birmingham, Birmingham B15 2TT, UK
- Correspondence: ; Tel.: +44-(0)-121-678-1000
| | - Christine Carpenter
- Department of Occupational Sciences and Occupational Therapy, University of British Columbia, Vancouver, BC V6T 1Z4, Canada;
| | - Andrew King
- School of Nursing, Midwifery and Health, Department of Physiotherapy, Coventry University, Coventry CV1 5FB, UK;
| | - Charlotte Wåhlin
- Occupational and Environmental Medicine Center, Department of Health, Medicine and Caring Sciences, Division of Prevention, Division of Rehabilitation and Community Medicine, Linköping University, SE-581 83 Linköping, Sweden;
- Unit of Intervention and Implementation Research, Institute for Environmental Medicine, Karolinska Institute, SE-171 77 Stockholm, Sweden
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Fearnley J, Joseph L, Vasanthan L, Sitilertpisan P, Paungmali A, Pirunsan U. Methods of engagement and levels of involvement of stakeholders in the management of work-related musculoskeletal disorders: A systematic scoping review. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-021-01663-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Hudon A, Hunt M, Ehrmann Feldman D. Physiotherapy for injured workers in Canada: are insurers' and clinics' policies threatening good quality and equity of care? Results of a qualitative study. BMC Health Serv Res 2018; 18:682. [PMID: 30176873 PMCID: PMC6122715 DOI: 10.1186/s12913-018-3491-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 08/22/2018] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND In recent years, significant efforts have been made to improve the provision of care for compensated injured workers internationally. However, despite increasing efforts at implementing best practices in this field, some studies show that policies overseeing the organisation of care for injured workers can have perverse influences on healthcare providers' practices and can prevent workers from receiving the best care possible. The influence of these policies on physiotherapists' practices has yet to be investigated. Our objectives were thus to explore the influence of 1) workers' compensation boards' and 2) physiotherapy clinics' policies on the care physiotherapists provide to workers with musculoskeletal injuries in three large Canadian provinces. METHODS The Interpretive Description framework, a qualitative methodological approach, guided this inquiry. Forty participants (30 physiotherapists and 10 leaders and administrators from physiotherapy professional groups and workers' compensation boards) were recruited in British Columbia, Ontario and Quebec to participate in an in-depth interview. Inductive analysis was conducted using constant comparative techniques. RESULTS Narratives from participants show that policies of workers' compensation boards and individual physiotherapy clinics have significant impacts on physiotherapists' clinical practices. Policies found at both levels often place physiotherapists in uncomfortable positions where they cannot always do what they believe to be best for their patients. Because of these policies, treatments provided to compensated injured workers markedly differ from those provided to other patients receiving physiotherapy care at the same clinic. Workers' compensation board policies such as reimbursement rates, end points for treatment and communication mechanisms, and clinic policies such as physiotherapists' remuneration schemes and restrictions on the choice of professionals had negative influences on care. Policies that were viewed as positive were board policies that recognize, promote and support physiotherapists' duties and clinics that provide organisational support for administrative tasks. CONCLUSION In Canada, workers' compensation play a significant role in financing physiotherapy care for people injured at work. Despite the best intentions in promoting evidence-based guidelines and procedures regarding rehabilitation care for injured workers, complex policy factors currently limit the application of these recommendations in practice. Research that targets these policies could contribute to significant changes in clinical settings.
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Affiliation(s)
- Anne Hudon
- Faculty of Medicine, School of Rehabilitation, University of Montreal, Pavillon du Parc, office 402-27, C.P. 6128, Succ. Centre-ville, Montréal, Québec H3C 3J7 Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada
- Institut de Recherche en Santé Publique de l’Université de Montréal (IRSPUM), Montréal, Canada
| | - Matthew Hunt
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada
- School of Physical and Occupational Therapy, McGill University, Hosmer House, Room 205, 3630 Promenade Sir William Osler, Montréal, Québec H3G 1Y5 Canada
| | - Debbie Ehrmann Feldman
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada
- Institut de Recherche en Santé Publique de l’Université de Montréal (IRSPUM), Montréal, Canada
- Department of Physical Therapy, School of Rehabilitation, Faculty of Medicine, University of Montreal, Pavillon du Parc, C.P. 6128, Succ. Centre-ville, Montréal, Québec H3C 3J7 Canada
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Skamagki G, King A, Duncan M, Wåhlin C. A systematic review on workplace interventions to manage chronic musculoskeletal conditions. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2018; 23:e1738. [PMID: 30126016 DOI: 10.1002/pri.1738] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 06/05/2018] [Accepted: 07/11/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND PURPOSE A review to investigate whether there are effective workplace interventions that manage chronic musculoskeletal disorders. METHODS The literature search included published articles between 2008 and 2017. The databases used in this search were MEDLINE, Scopus, CINAHL, AMED, PsycINFO, Academic Search Complete, Cochrane, and PEDro. A limited search on websites for relevant grey literature was also conducted. RESULTS The review included 12 studies that investigated effectiveness of a specific strength exercise programme or interventions provided by health professionals at the workplace when compared with controls or interventions not at the workplace. Seven studies were classified as high quality (>85% of criteria met) and five studies were classified as acceptable. Studies were heterogeneous preventing a meta-analysis. No intervention was clearly superior to another. DISCUSSION There was some consistency in the results of the selected studies, suggesting that workplace interventions such as high-intensity strength exercises and/or integrated health care can decrease pain and symptoms for employees who experience long-term musculoskeletal disorders. However, the current research is limited.
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Affiliation(s)
| | - Andrew King
- Department of Physiotherapy, Coventry University, Coventry, UK
| | - Michael Duncan
- School of Life Sciences, Coventry University, Coventry, UK
| | - Charlotte Wåhlin
- Occupational and Environmental Medicine Centre, County Council of Östergötland, Linköping, Sweden.,Unit of Intervention and Implementation Research Institute for Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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