1
|
Chowdhury AR, Graham PL, Schofield D, Costa DS, Nicholas M. Productivity outcomes from chronic pain management interventions in the working age population; a systematic review. Pain 2024; 165:1233-1246. [PMID: 38323645 PMCID: PMC11090028 DOI: 10.1097/j.pain.0000000000003149] [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: 06/17/2023] [Revised: 11/02/2023] [Accepted: 11/06/2023] [Indexed: 02/08/2024]
Abstract
ABSTRACT Productivity loss because of chronic pain in the working age population is a widespread concern internationally. Interventions for chronic pain in working age adults might be expected to achieve enhanced productivity in terms of reduced costs of workers' compensation insurance, reduced disability support, and improved rates of return to work for injured workers. This would require the use of measures of productivity in the evaluation of chronic pain management interventions. The aim of this review was to identify and interpret the productivity outcomes of randomised controlled trials reported by studies that conducted economic evaluations (eg, cost-effectiveness and cost-utility) of chronic pain management interventions in the working age population published from database inception to March 2023. Econlit, Embase, and Pubmed electronic databases were searched, yielding 12 studies that met the selection criteria. All 12 studies used absenteeism to measure productivity, translating return to work measures into indirect costs. Only one study included return to work as a primary outcome. Ten studies found no statistically significant improvements in productivity-related costs. Despite evidence for reduced pain-related disability after pain management interventions, this review suggests that the use of measures for assessing productivity gains is lacking. Including such measures would greatly assist administrators and payers when considering the broader societal benefits of such interventions.
Collapse
Affiliation(s)
- Anonnya Rizwana Chowdhury
- Faculty of Medicine and Health, Pain Management Research Institute, University of Sydney, Sydney, Australia
| | - Petra L. Graham
- School of Mathematical and Physical Sciences, Faculty of Science and Engineering, Macquarie University, Sydney, Australia
| | - Deborah Schofield
- Centre for Economic Impacts of Genomic Medicine (GenIMPACT), Macquarie Business School, Macquarie University, Sydney, Australia
| | - Daniel S.J. Costa
- Faculty of Medicine and Health, Pain Management Research Institute, University of Sydney, Sydney, Australia
| | - Michael Nicholas
- Faculty of Medicine and Health, Pain Management Research Institute, University of Sydney, Sydney, Australia
| |
Collapse
|
2
|
Larinier N, Vuillerme N, Balaguier R. Effectiveness of warm-up interventions on work-related musculoskeletal disorders, physical and psychosocial functions among workers: a systematic review. BMJ Open 2023; 13:e056560. [PMID: 37130661 PMCID: PMC10163487 DOI: 10.1136/bmjopen-2021-056560] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 03/12/2023] [Indexed: 05/04/2023] Open
Abstract
OBJECTIVES The aim of this systematic review was to identify from published literature the available evidence regarding the effects of warm-up intervention implemented in the workplace on work -related musculoskeletal disorders (WMSDs) and physical and psychosocial functions. DESIGN Systematic review. DATA SOURCES The following four electronic databases were searched (from inception onwards to October 2022): Cochrane Central Register of Controlled Trials (CENTRAL), PubMed (Medline), Web of Science and Physiotherapy Evidence Database (PEDro). ELIGIBILITY CRITERIA Randomised and non-randomised controlled studies were included in this review. Interventions should include a warm-up physical intervention in real-workplaces. DATA EXTRACTION AND SYNTHESIS The primary outcomes were pain, discomfort, fatigue and physical functions. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and used the Grading of Recommendations, Assessment, Development and Evaluation evidence synthesis. To assess the risk of bias, the Cochrane ROB2 was used for randomised controlled trial (RCT) and the Risk Of Bias In Non-randomised Studies-of Interventions was used for the non-RCT studies. RESULTS Three studies met the inclusion criterion, one cluster RCT and two non-RCTs. There was an important heterogeneity in the included studies principally concerning population and warm-up intervention exercises. There were important risks of bias in the four selected studies, due to blinding and confounding factors. Overall certainty of evidence was very low. CONCLUSION Due to the poor methodological quality of studies and conflicting results, there was no evidence supporting the use of warm-up to prevent WMSDs in the workplace. The present findings highlighted the need of good quality studies targeting the effects of warm-up intervention to prevent WMSDs. PROSPERO REGISTRATION NUMBER CRD42019137211.
Collapse
Affiliation(s)
- Nicolas Larinier
- AGEIS, Université Grenoble Alpes, Saint-Martin-d'Heres, France
- Opti'Mouv, St Paul, France
| | - Nicolas Vuillerme
- AGEIS, Université Grenoble Alpes, Saint-Martin-d'Heres, France
- Opti'Mouv, St Paul, France
- Institut Universitaire de France, Paris, France
| | - Romain Balaguier
- AGEIS, Université Grenoble Alpes, Saint-Martin-d'Heres, France
- Opti'Mouv, St Paul, France
| |
Collapse
|
3
|
Kiltz U, Hoeper K, Hammel L, Lieb S, Hähle A, Meyer-Olson D. Work participation in patients with axial spondyloarthritis: high prevalence of negative workplace experiences and long-term work impairment. RMD Open 2023; 9:e002663. [PMID: 36927848 PMCID: PMC10030742 DOI: 10.1136/rmdopen-2022-002663] [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: 08/11/2022] [Accepted: 02/15/2023] [Indexed: 03/18/2023] Open
Abstract
INTRODUCTION Axial spondyloarthritis (axSpA) is a chronic inflammatory disease that typically affects people in their second and third decades of life, which are important years for establishing a professional career. We aim to study outcomes of work participation (WP) and their associations with demographic and clinical confounders, in addition to prevalence of negative workplace experiences in axSpA. METHODS In total, 770 patients with axSpA participated in the multicentre, observational ATTENTUS-axSpA survey in Germany. Demographic information, clinical parameters and patient-related outcomes (including disease activity and function) with a focus on WP were prospectively recorded. RESULTS A high prevalence of negative workplace experiences was reported among the 770 patients analysed. Overall, 23.4% of patients were not employed and 6.5% received disability pensions. Current work cessation was prevalent in 120 patients, and 28 of those were out of work for 10 years or longer. Of the 590 currently employed patients, 31.9% reported absenteeism and 35.9% reported presenteeism for >1 month within the past year. Multivariate logistic regression identified low disease activity (Bath Ankylosing Spondylitis Disease Activity Index), better physical function (Bath Ankylosing Spondylitis Functional Index) and better global functioning (Assessment of SpondylAarthritis International Society-Health Index) as the main predictors for unimpaired WP (n=242). Importantly, biological treatment, disease duration, age, sex, education level and body mass index were not reliable predictors. DISCUSSION Despite improvements in pharmacological treatment options, we still observed substantially impaired WP in patients with axSpA. These data emphasise the high unmet need for targeted strategies to provide improved medical and social care.
Collapse
Affiliation(s)
- Uta Kiltz
- Ruhr-Universität Bochum, Bochum, Germany
- Rheumatology, Rheumazentrum Ruhrgebiet, Herne, Germany
| | - Kirsten Hoeper
- Rheumatologie and Immunologie, Regionales Kooperatives Rheumazentrum Niedersachsen eV, Hannover, Germany
- Klinik für Rheumatologie und Immunologie, Medizinische Hochschule Hannover, Hannover, Germany
| | - Ludwig Hammel
- Deutsche Vereinigung Morbus Bechterew e.V, Schweinfurt, Germany
| | | | | | - Dirk Meyer-Olson
- Klinik für Rheumatologie und Immunologie, Medizinische Hochschule Hannover, Hannover, Germany
- Rheumatologie, m&i Fachklinik Bad Pyrmont, Bad Pyrmont, Germany
| |
Collapse
|
4
|
Soler-Font M, Ramada JM, Montero-Moraga JM, Palencia-Sánchez F, Merelles A, Macdonald EB, Serra C. What is meant by case management for the return-to-work of workers with musculoskeletal disorders? A scoping review. Work 2021; 70:1069-1087. [PMID: 34842208 DOI: 10.3233/wor-205172] [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: 11/15/2022] Open
Abstract
BACKGROUND Case management interventions have shown to be effective to prevent musculoskeletal pain and disability, but a single definition has not been achieved, nor an agreed profile for case managers. OBJECTIVE To describe the elements that define case management and case managers tasks for return-to-work of workers with musculoskeletal disorders (MSDs). METHODS A comprehensive computerized search of articles published in English until February 16, 2021 was carried out in several bibliographic databases. Grey literature was obtained through a search of 13 key websites. A peer-review screening of titles and abstracts was carried out. Full text in-depth analysis of the selected articles was performed for data extraction and synthesis of results. RESULTS We identified 2,422 documents. After full-text screening 31 documents were included for analysis. These were mostly European and North American and had an experimental design. Fifteen documents were published between 2010 to 2021 and of these 7 studies were published from 2015. Fifteen elements were identified being the commonest "return-to-work programme" (44.4%) and "multidisciplinary assessment/interdisciplinary intervention" (44.4%). Of 18 tasks found, the most frequent was "establishing goals and planning return-to-work rehabilitation" (57.7%). Eighteen referral services were identified. CONCLUSIONS Despite there were several elements frequently reported, some elements with scientific evidence of their importance to deal with MSDs (e.g. early return-to-work) were almost not mentioned. This study proposes key points for the description of case management and case managers tasks.
Collapse
Affiliation(s)
- Mercè Soler-Font
- Center for Research in Occupational Health (CiSAL), University Pompeu Fabra - Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,CIBER of Epidemiology and Public Health, Madrid, Spain
| | - José Maria Ramada
- Center for Research in Occupational Health (CiSAL), University Pompeu Fabra - Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,CIBER of Epidemiology and Public Health, Madrid, Spain.,Occupational Health Service, Parc de Salut Mar, Barcelona, Spain
| | - José Maria Montero-Moraga
- Public Health and Preventive Medicine Training Unit, Parc de Salut Mar, University Pompeu Fabra - Public Health Agency of Barcelona, Barcelona, Spain
| | - Francisco Palencia-Sánchez
- Departamento de Medicina Preventiva y Social, Facultad de Medicina, Pontificia Universidad Javerina, Bogotá, Colombia
| | - Antoni Merelles
- Center for Research in Occupational Health (CiSAL), University Pompeu Fabra - Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Nursing Department, Nursing and Podiatry Faculty, University of Valencia, Valencia, Spain
| | | | - Consol Serra
- Center for Research in Occupational Health (CiSAL), University Pompeu Fabra - Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,CIBER of Epidemiology and Public Health, Madrid, Spain.,Occupational Health Service, Parc de Salut Mar, Barcelona, Spain
| |
Collapse
|
5
|
Fassier JB, Sarnin P, Rouat S, Péron J, Kok G, Letrilliart L, Lamort-Bouché M. Interventions Developed with the Intervention Mapping Protocol in Work Disability Prevention: A Systematic Review of the Literature. JOURNAL OF OCCUPATIONAL REHABILITATION 2019; 29:11-24. [PMID: 29948471 DOI: 10.1007/s10926-018-9776-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Purposes Intervention mapping (IM) is a protocol for developing effective behavior change interventions. It has been used for 10 years to develop work disability prevention (WDP) interventions, but it is not known to what extent and with what success. The main objective of this study was to review the effectiveness of these interventions. Secondary objectives were to review their fidelity to the IM protocol, their theoretical frameworks and their content. Methods A search strategy was conducted in MEDLINE, Web of Science, PsycINFO, Pascal, Francis, and BDSP. All titles and abstracts were reviewed. A standardized extraction form was developed. All included studies were reviewed by two reviewers blinded to each other. Results Eight WDP interventions were identified aimed at return to work (RTW; n = 6) and self-management at work (n = 2). RTW interventions targeted workers with stress-related mental disorders (n = 1), low back pain (n = 1), musculoskeletal disorders (n = 1), cancer (n = 2) and gynecological surgery (n = 1). The fidelity to the IM protocol was weaker for the participatory planning group. Matrices of change, change methods, and applications were systematically reported. The main theoretical frameworks used were the attitude-social influence-self efficacy model (n = 4) and the theory of planned behavior (n = 2). Half of the interventions included a workplace component (n = 4). Two interventions were reported as effective, and one partially effective. Conclusion The IM protocol is used in WDP since 2007. The participative dimension appears underused. Few theoretical frameworks were used. Implications are to better consider the stakeholders involvement, and mobilize theoretical frameworks with greater attempts to intervene on the work environment.
Collapse
Affiliation(s)
- J B Fassier
- Univ Lyon, Université Claude Bernard Lyon 1, Unité mixte de recherche Epidémiologique et de Surveillance Transport Travail Environnement, UMRESTTE UMR T 9405, 8 Avenue Rockefeller, 69008, Lyon, France.
- Hospices civils de Lyon, service de médecine et santé au travail, Lyon, France.
| | - P Sarnin
- Univ Lyon, Université Lumière Lyon 2, GREPS - EA 4163 (Groupe de recherche en psychologie sociale), Lyon, France
| | - S Rouat
- Univ Lyon, Université Lumière Lyon 2, GREPS - EA 4163 (Groupe de recherche en psychologie sociale), Lyon, France
| | - J Péron
- Univ Lyon, Université Claude Bernard Lyon 1, Laboratoire de Biométrie et Biologie Evolutive LBBE - UMR 5558, Lyon, France
- Service d'oncologie médicale. Institut de Cancérologie des Hospices Civils de Lyon (IC-HCL), Pierre-Bénite, France
| | - G Kok
- Department of Work and Social Psychology, Maastricht University, Maastricht, The Netherlands
| | - L Letrilliart
- Univ Lyon, Université Claude Bernard Lyon 1, Health Services and Performance Research, HESPER Université Lyon 2, Lyon, France
- Univ Lyon, Université Claude Bernard Lyon 1, Collège Universitaire de médecine générale, 8 Avenue Rockefeller, 69008, Lyon, France
| | - M Lamort-Bouché
- Univ Lyon, Université Claude Bernard Lyon 1, Unité mixte de recherche Epidémiologique et de Surveillance Transport Travail Environnement, UMRESTTE UMR T 9405, 8 Avenue Rockefeller, 69008, Lyon, France
- Univ Lyon, Université Claude Bernard Lyon 1, Collège Universitaire de médecine générale, 8 Avenue Rockefeller, 69008, Lyon, France
| |
Collapse
|
6
|
Vogel N, Schandelmaier S, Zumbrunn T, Ebrahim S, de Boer WEL, Busse JW, Kunz R. Return-to-work coordination programmes for improving return to work in workers on sick leave. Cochrane Database Syst Rev 2017; 3:CD011618. [PMID: 28358173 PMCID: PMC6464073 DOI: 10.1002/14651858.cd011618.pub2] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND To limit long-term sick leave and associated consequences, insurers, healthcare providers and employers provide programmes to facilitate disabled people's return to work. These programmes include a variety of coordinated and individualised interventions. Despite the increasing popularity of such programmes, their benefits remain uncertain. We conducted a systematic review to determine the long-term effectiveness of return-to-work coordination programmes compared to usual practice in workers at risk for long-term disability. OBJECTIVES To assess the effects of return-to-work coordination programmes versus usual practice for workers on sick leave or disability. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 11), MEDLINE, Embase, CINAHL and PsycINFO up to 1 November 2016. SELECTION CRITERIA We included randomised controlled trials (RCTs) that enrolled workers absent from work for at least four weeks and randomly assigned them to return-to-work coordination programmes or usual practice. DATA COLLECTION AND ANALYSIS Two review authors independently screened titles, abstracts and full-text articles for study eligibility; extracted data; and assessed risk of bias from eligible trials. We contacted authors for additional data where required. We conducted random-effects meta-analyses and used the GRADE approach to rate the quality of the evidence. MAIN RESULTS We identified 14 studies from nine countries that enrolled 12,568 workers. Eleven studies focused on musculoskeletal problems, two on mental health and one on both. Most studies (11 of 14) followed workers 12 months or longer. Risk of bias was low in 10 and high in 4 studies, but findings were not sensitive to their exclusion.We found no benefits for return-to-work coordination programmes on return-to-work outcomes.For short-term follow-up of six months, we found no effect on time to return to work (hazard ratio (HR) 1.32, 95% confidence interval (CI) 0.93 to 1.88, low-quality evidence), cumulative sickness absence (mean difference (MD) -16.18 work days per year, 95% CI -32.42 to 0.06, moderate-quality evidence), the proportion of participants at work at end of the follow-up (risk ratio (RR) 1.06, 95% CI 0.86 to 1.30, low-quality evidence) or on the proportion of participants who had ever returned to work, that is, regardless of whether they had remained at work until last follow-up (RR 0.87, 95% CI 0.63 to 1.19, very low-quality evidence).For long-term follow-up of 12 months, we found no effect on time to return to work (HR 1.25, 95% CI 0.95 to 1.66, low-quality evidence), cumulative sickness absence (MD -14.84 work days per year, 95% CI -38.56 to 8.88, low-quality evidence), the proportion of participants at work at end of the follow-up (RR 1.06, 95% CI 0.99 to 1.15, low-quality evidence) or on the proportion of participants who had ever returned to work (RR 1.03, 95% CI 0.97 to 1.09, moderate-quality evidence).For very long-term follow-up of longer than 12 months, we found no effect on time to return to work (HR 0.93, 95% CI 0.74 to 1.17, low-quality evidence), cumulative sickness absence (MD 7.00 work days per year, 95% CI -15.17 to 29.17, moderate-quality evidence), the proportion of participants at work at end of the follow-up (RR 0.94, 95% CI 0.82 to 1.07, low-quality evidence) or on the proportion of participants who had ever returned to work (RR 0.95, 95% CI 0.88 to 1.02, low-quality evidence).We found only small benefits for return-to-work coordination programmes on patient-reported outcomes. All differences were below the minimal clinically important difference (MID). AUTHORS' CONCLUSIONS Offering return-to-work coordination programmes for workers on sick leave for at least four weeks results in no benefits when compared to usual practice. We found no significant differences for the outcomes time to return to work, cumulative sickness absence, the proportion of participants at work at end of the follow-up or the proportion of participants who had ever returned to work at short-term, long-term or very long-term follow-up. For patient-reported outcomes, we found only marginal effects below the MID. The quality of the evidence ranged from very low to moderate across all outcomes.
Collapse
Affiliation(s)
- Nicole Vogel
- EbIM Evidence‐based Insurance MedicineDepartment Clinical ResearchUniversity of Basel HospitalSpitalstrasse 8+12BaselSwitzerland4031
- Hirslanden Klinik BirshofLeonardoReinacherstrasse 28MünchensteinSwitzerland4142
| | - Stefan Schandelmaier
- McMaster UniversityDepartment of Health Research Methods, Evidence, and Impact1280 Main Street WestHamiltonONCanadaL8S4L8
- University of BaselBasel Institute for Clinical Epidemiology and Biostatistics, Department of Clinical ResearchSpitalstrasse 12BaselSwitzerland4031
| | - Thomas Zumbrunn
- University of Basel HospitalClinical Trial UnitSchanzenstrasse 55BaselSwitzerland4031
| | | | - Wout EL de Boer
- EbIM Evidence‐based Insurance MedicineDepartment Clinical ResearchUniversity of Basel HospitalSpitalstrasse 8+12BaselSwitzerland4031
| | - Jason W Busse
- McMaster UniversityDepartment of Anesthesia1280 Main Street West, Rm. 2C12HamiltonONCanadaL8S 4K1
| | - Regina Kunz
- EbIM Evidence‐based Insurance MedicineDepartment Clinical ResearchUniversity of Basel HospitalSpitalstrasse 8+12BaselSwitzerland4031
| | | |
Collapse
|
7
|
Soteriades ES. A workplace modified duty program for employees in an oncology center. Work 2017; 56:157-164. [PMID: 28128788 DOI: 10.3233/wor-162478] [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: 11/15/2022] Open
Abstract
BACKGROUND Workplace modified duty programs may provide reasonable accommodations to employees who have partial temporary job disability and could work on duty accommodations until they fully recover. However, little is known about the implementation barriers and effectiveness of such programs. OBJECTIVE This study is aimed at evaluating the implementation of a modified duty program for employees in an oncology center. METHODS A modified duty program for employees working at the Bank of Cyprus Oncology Center, a non profit organization with 200 employees located in the Republic of Cyprus was evaluated based on the health records of the occupational medicine department. RESULTS Employees' participation in the program was 3%. A total of 12 employees participated (6 each year). The participants were all women and the mean participation period was 21.6 days (range 10 - 65 days). The two most frequent reasons for a modified duty assignment were pregnancy and back pain. Employees were assigned either on limited duties or on a combination of limited duties and reduced work hours. Employees reported being very satisfied with their participation based on a follow-up narrative oral assessment. CONCLUSION The small participation rate does not allow for advanced statistical analyses. Further studies from larger organizations are urgently needed to evaluate the effectiveness of modified duty programs. The development of a legal framework for such modified duty programs in Cyprus as well as internationally may promote their implementation in order to facilitate the effective management of temporary partial job disability for the benefit of both employees and businesses.
Collapse
Affiliation(s)
- Elpidoforos S Soteriades
- Department of Occupational and Environmental Medicine, Cyprus Institute of Biomedical Sciences (CIBS), Nicosia, Cyprus.,Department of Occupational Health, Bank of Cyprus Oncology Center, Nicosia, Cyprus.,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Environmental and Occupational Medicine and Epidemiology (EOME), Boston, MA, USA
| |
Collapse
|
8
|
Frank A. Vocational Rehabilitation: Supporting Ill or Disabled Individuals in (to) Work: A UK Perspective. Healthcare (Basel) 2016; 4:E46. [PMID: 27438864 PMCID: PMC5041047 DOI: 10.3390/healthcare4030046] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 06/08/2016] [Accepted: 06/28/2016] [Indexed: 11/17/2022] Open
Abstract
Work is important for one's self-esteem, social standing and ability to participate in the community as well as for the material advantages it brings to individuals and their families. The evidence suggests that the benefits of employment outweigh the risks of work and are greater than the risks of long-term unemployment or sickness absence. Individuals may be born with physical or intellectual disadvantages (e.g., cerebral palsy), or they may be acquired during childhood or adult life. Some progressive conditions may present in childhood or adolescence (e.g., some muscular dystrophies) and these need to be distinguished from those presenting later in life (e.g., trauma, stroke). Vocational rehabilitation (VR) thus takes three forms: preparing those with a disability, health or mental health condition for the world of work, job retention for those in work and assisting those out of work into new work. Important components of VR consist of the attributes of the individual, the skills/knowledge of their health professionals, the knowledge and attitudes of actual or potential employers and the assistance that is provided by the state or other insurance facility. Charities are playing an increasing role.
Collapse
Affiliation(s)
- Andrew Frank
- Vocational Rehabilitation Association, 42 The Croft, High Barnet, Herts EN5 2TL, UK.
- Department of Clinical Sciences, College of Health and Life Sciences, Brunel University London, Middlesex, UB8 3PH, UK.
| |
Collapse
|
9
|
Lammerts L, Schaafsma FG, Eikelenboom M, Vermeulen SJ, van Mechelen W, Anema JR, Penninx BWJH. Longitudinal Associations Between Biopsychosocial Factors and Sustainable Return to Work of Sick-Listed Workers with a Depressive or Anxiety Disorder. JOURNAL OF OCCUPATIONAL REHABILITATION 2016; 26:70-9. [PMID: 26094030 PMCID: PMC4749650 DOI: 10.1007/s10926-015-9588-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
PURPOSE Only a limited number of studies have investigated return to work of sick-listed workers with mental health problems, and more knowledge is needed about the influence of non-disorder-related factors. This study aimed to identify longitudinal associations between demographic, personality, disorder-related and work-related characteristics and sustainable return to work of sicklisted workers with a depressive or anxiety disorder. METHODS We used data of a large Dutch cohort study to prospectively study longitudinal associations between biopsychosocial factors and sustainable return to work in 2 years. Associations were studied by means of univariable and multivariable logistic regression analysis. Participants who were sick-listed at baseline and had a lifetime diagnosis of a depressive and/or anxiety disorder were included in this study (N = 215). RESULTS In 2 years, 51.6% of the participants returned to work sustainably. Age, household income, extraversion, employment status, skill discretion and job security were significantly (P B 0.05) associated with sustainable RTW in 2 years in the univariable analyses. The multivariable analysis revealed significant associations between sustainable return to work and age (OR per 10 years = 0.67; 95% CI 0.47–0.95), household income (OR per 100 Euro’s a month = 1.04; 95% CI 1.00–1.08) and being on sickness benefit versus being (self-)employed (OR 0.39; 95% CI 0.20–0.77). CONCLUSIONS In the long-run not disorder-related factors, but an older age, the absence of a job and a low household income seem to complicate return to work. Policy and research should focus on facilitators and barriers for return to work of workers with these characteristics.
Collapse
Affiliation(s)
- Lieke Lammerts
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.
- Research Centre for Insurance Medicine, AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands.
| | - Frederieke G Schaafsma
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.
- Research Centre for Insurance Medicine, AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands.
| | - Merijn Eikelenboom
- Department of Psychiatry, EMGO+ Institute for Health and Care Research, VU University Medical Center/GGZ inGeest, Amsterdam, The Netherlands.
| | - Sylvia J Vermeulen
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.
| | - Willem van Mechelen
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.
| | - Johannes R Anema
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.
- Research Centre for Insurance Medicine, AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands.
| | - Brenda W J H Penninx
- Department of Psychiatry, EMGO+ Institute for Health and Care Research, VU University Medical Center/GGZ inGeest, Amsterdam, The Netherlands.
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands.
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
| |
Collapse
|
10
|
Abstract
BACKGROUND Young adults with chronic health conditions can experience barriers to work performance, ability, and their present and future worker roles. OBJECTIVE Work readiness resources can expand individuals' work skills, abilities, and interests. METHODS Five work readiness tools are presented (1) building an occupational profile, (2) generating environmental strategies, (3) on-the-job strategy use, and exploration of online tools (4) O*NET® and (5) O*NET® Interest Profiler, along with two theories (Knowles's Andragogy and Lawton's Ecological Model) to guide tool use. RESULTS Use of these tools can assist young adults to better manage their health and expand their vocational identities for success at work. CONCLUSIONS These approaches and tools support health professionals, community partners, and vocational organizations in their efforts to help young adults with chronic conditions.
Collapse
Affiliation(s)
| | - Christine Berg
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA
| |
Collapse
|
11
|
Beemster TT, van Velzen JM, van Bennekom CAM, Frings-Dresen MHW, Reneman MF. Cost-effectiveness of 40-hour versus 100-hour vocational rehabilitation on work participation for workers on sick leave due to subacute or chronic musculoskeletal pain: study protocol for a randomized controlled trial. Trials 2015. [PMID: 26215748 PMCID: PMC4518875 DOI: 10.1186/s13063-015-0861-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although vocational rehabilitation is a widely advocated intervention for workers on sick leave due to subacute or chronic nonspecific musculoskeletal pain, the optimal dosage of effective and cost-effective vocational rehabilitation remains unknown. The objective of this paper is to describe the design of a non-inferiority trial evaluating the effectiveness and cost-effectiveness of 40-h multidisciplinary vocational rehabilitation compared with 100-h multidisciplinary vocational rehabilitation on work participation for workers on sick leave due to subacute or chronic musculoskeletal pain. METHODS/DESIGN A non-inferiority study design will be applied. The study population consists of workers who are on part-time or full-time sick leave due to subacute or chronic nonspecific musculoskeletal pain. Two multidisciplinary vocational rehabilitation programs following the bio-psychosocial approach will be evaluated in this study: 40-h vocational rehabilitation and 100-h vocational rehabilitation, both delivered over a maximum of 15 weeks. The 100-h vocational rehabilitation comprises five modules: work participation coordination, graded activity, cognitive behavioral therapy, group education, and relaxation. The 40-h vocational rehabilitation comprises work participation coordination and a well-reasoned choice from the other four modules. Four rehabilitation centers will participate in this study, each delivering both interventions. Patients will be randomized into one of the interventions, stratified for the duration of sick leave (<6 weeks or ≥ 6 weeks) and type of sick leave (part-time or full-time). The primary outcome is work participation, measured by self-reported sick leave days, and will be assessed at baseline, mid-term, discharge, and at 2, 4, 6, 8, 10, and 12 months follow-up. Secondary outcomes are work ability, disability, quality of life, and physical functioning and will be assessed at baseline, discharge, and at 6 and 12 months follow-up. Cost outcomes are absenteeism, presenteeism, healthcare usage, and travelling costs. Cost-effectiveness will be evaluated from the societal and employer perspectives. DISCUSSION The results obtained from this study will be useful for vocational rehabilitation practice and will provide stakeholders with relevant insights into two versions of vocational rehabilitation. TRIAL REGISTRATION Dutch Trial Register identifier: NTR4362 (registered 17 March 2014).
Collapse
Affiliation(s)
- Timo T Beemster
- Department of Rehabilitation Medicine, Center for Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. .,Department of Research and Development, Heliomare Rehabilitation Center, Wijk aan Zee, The Netherlands. .,Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
| | - Judith M van Velzen
- Department of Research and Development, Heliomare Rehabilitation Center, Wijk aan Zee, The Netherlands. .,Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
| | - Coen A M van Bennekom
- Department of Research and Development, Heliomare Rehabilitation Center, Wijk aan Zee, The Netherlands. .,Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
| | - Monique H W Frings-Dresen
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
| | - Michiel F Reneman
- Department of Rehabilitation Medicine, Center for Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| |
Collapse
|
12
|
Riaño-Casallas MI, Palencia-Sánchez F. Los costos de la enfermedad laboral: revisión de literatura. REVISTA FACULTAD NACIONAL DE SALUD PÚBLICA 2015. [DOI: 10.17533/udea.rfnsp.v33n2a09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
|
13
|
Return to Work Practices and Research with Spinal Cord Injury: An Australian Perspective. THE AUSTRALIAN JOURNAL OF REHABILITATION COUNSELLING 2015. [DOI: 10.1017/jrc.2015.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Post-injury return to work (RTW) is an important rehabilitation outcome regardless of injury type. With Spinal Cord Injury (SCI), the odds of successful RTW are lower than for the general population of work-injured. Australians living with a SCI have a higher RTW rate than many other developed countries, including the United States. Important influences on relatively higher post-injury RTW rates in the Australian context include its universal disability care policy, Australia's suite of no-fault accident insurance systems that allow for multi-faceted rehabilitation services to be provided to eligible individuals in addition to appropriate rewards for rehabilitation service providers. A combination of these systemic factors is important when delivering comprehensive rehabilitation services to those with catastrophic injuries, such as SCI. The empirical evidence on drivers of successful RTW post SCI is, however, limited in comparison to the evidence on interventions for enhanced coping following SCI. Future studies could consider the relative merits of specific RTW interventions with SCI contrasting policy and capitation systems as well as utilising study designs that take into account pre-morbid work participation and secondary health conditions.
Collapse
|
14
|
van Egmond MP, Duijts SFA, Vermeulen SJ, van der Beek AJ, Anema JR. Return to work in sick-listed cancer survivors with job loss: design of a randomised controlled trial. BMC Cancer 2015; 15:63. [PMID: 25886150 PMCID: PMC4350300 DOI: 10.1186/s12885-015-1051-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 01/28/2015] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Despite long-term or permanent health problems, cancer survivors are often motivated to return to work. For cancer survivors who have lost their job, return to work can be more challenging compared to employed survivors, as they generally find themselves in a more vulnerable social and financial position. Cancer survivors with job loss may therefore be in need of tailored return to work support. However, there is a lack of return to work intervention programs specifically targeting these cancer survivors. The number of cancer survivors with job loss in developed countries is rising due to, amongst others, increases in the incidence and survivor rate of cancer, the retirement age and the proportion of flexible employment contracts. Hence, we consider it important to develop a tailored return to work intervention program for cancer survivors with job loss, and to evaluate its effectiveness compared to usual care. METHODS/DESIGN This study employs a two-armed randomised controlled trial with a follow-up period of 12 months. The study population (n = 164) will be recruited from a national sample of cancer survivors (18-60 years), who have been sick-listed for 12-36 months. Participants will be randomised by using computerized blocked randomisation (blocks of four). All participants will receive usual care as provided by the Dutch Social Security Agency. Additionally, participants in the intervention group will receive a tailored return to work intervention program, which includes vocational rehabilitation and supportive psychosocial components, as well as (therapeutic) placement at work. The primary outcome measure is duration until sustainable return to work; the secondary outcome measure is rate of return to work. Other parameters include, amongst others, fatigue, coping strategy and quality of life. We will perform Cox regression analyses to estimate hazard ratios for time to sustainable return to work. DISCUSSION The hypothesis of this study is that a tailored approach for cancer survivors with job loss is more effective, regarding return to work, compared to usual care. The results of this study will provide insight into the ways in which return to work can be facilitated for cancer survivors with job loss. TRIAL REGISTRATION Netherlands Trial Register: NTR3562 .
Collapse
Affiliation(s)
- Martine P van Egmond
- Department of Public and Occupational Health, VU University Medical Center, EMGO+ Institute for Health and Care Research, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands. .,Dutch Research Center for Insurance Medicine, AMC-UMCG-UWV-VUmc, Amsterdam, the Netherlands.
| | - Saskia F A Duijts
- Department of Public and Occupational Health, VU University Medical Center, EMGO+ Institute for Health and Care Research, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands. .,Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands.
| | - Sylvia J Vermeulen
- Department of Public and Occupational Health, VU University Medical Center, EMGO+ Institute for Health and Care Research, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands.
| | - Allard J van der Beek
- Department of Public and Occupational Health, VU University Medical Center, EMGO+ Institute for Health and Care Research, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands. .,Dutch Research Center for Insurance Medicine, AMC-UMCG-UWV-VUmc, Amsterdam, the Netherlands.
| | - Johannes R Anema
- Department of Public and Occupational Health, VU University Medical Center, EMGO+ Institute for Health and Care Research, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands. .,Dutch Research Center for Insurance Medicine, AMC-UMCG-UWV-VUmc, Amsterdam, the Netherlands.
| |
Collapse
|
15
|
Lammerts L, Vermeulen SJ, Schaafsma FG, van Mechelen W, Anema JR. Return to work of workers without a permanent employment contract, sick-listed due to a common mental disorder: design of a randomised controlled trial. BMC Public Health 2014; 14:594. [PMID: 24919561 PMCID: PMC4061521 DOI: 10.1186/1471-2458-14-594] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 05/22/2014] [Indexed: 11/24/2022] Open
Abstract
Background Workers without a permanent employment contract represent a vulnerable group within the working population. Mental disorders are a major cause of sickness absence within this group. Common mental disorders are stress-related, depressive and anxiety disorders. To date, little attention has been paid to effective return to work interventions for this type of sick-listed workers. Therefore, a participatory supportive return to work program has been developed. It combines elements of a participatory return to work program, integrated care and direct placement in a competitive job. The objective of this paper is to describe the design of a randomised controlled trial to evaluate the cost-effectiveness of this program compared to care as usual. Methods/Design The cost-effectiveness of the participatory supportive return to work program will be examined in a randomised controlled trial with a follow-up of twelve months. The program strongly involves the sick-listed worker in the identification of obstacles for return to work and possible solutions, resulting in a consensus based action plan. This plan will be used as a starting point for the search of suitable competitive employment with support of a rehabilitation agency. During this process the insurance physician of the sick-listed worker contacts other caregivers to promote integrated care. Workers eligible to participate in this study have no permanent employment contract, have applied for a sickness benefit at the Dutch Social Security Agency and are sick-listed between two and fourteen weeks due to mental health problems. The primary outcome measure is the duration until first sustainable return to work in a competitive job. Outcomes are measured at baseline and after three, six, nine and twelve months. Discussion If the participatory supportive return to work program proves to be cost-effective, the social security system, the sick-listed worker and society as a whole will benefit. A cost-effective return to work program will lead to a reduction of costs related to sickness absence. For the sick-listed worker a cost-effective program results in earlier sustainable return to work, which can be associated with both social and health benefits. Trial registration The trial registration number and date is NTR3563, August 7, 2012.
Collapse
Affiliation(s)
| | | | | | | | - Johannes R Anema
- Department of Public and Occupational Health, EMGO + Institute for Health and Care Research, VU University Medical Centre, P,O, Box 7057, Amsterdam 1007 MB, The Netherlands.
| |
Collapse
|
16
|
Côté JN, Ngomo S, Stock S, Messing K, Vézina N, Antle D, Delisle A, Bellemare M, Laberge M, St-Vincent M. Quebec Research on Work-related Musculoskeletal Disorders. ACTA ACUST UNITED AC 2014. [DOI: 10.7202/1023009ar] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This paper aimed to demonstrate the contribution of the research performed by the musculoskeletal disorders (MSD) Research Axis group of the Quebec Occupational Health and Safety Research Network towards better understanding of work-related MSD (WMSD) development and prevention. Although the group targets its work to the Quebec population, its work has significant impact around the world, placing MSD axis members and knowledge and expertise created in Quebec on the international map. Results from the contribution of members are relevant, primarily in the demonstration of the implication of physical workload as well as organizational and psychosocial work-related factors in the development of WMSDs. Also, members have demonstrated that gender, sex, social class, age and ethno-cultural groups interact in various ways with WMSD determinants. Efforts are devoted towards improving understanding of the physiological responses linked with MSDs, which could also lead to new workplace practices in rehabilitation. The group emphasizes the integration of prevention procedures from the design stage to the workplace intervention. Members have proposed research-based tools for best practices at work and also an original conceptual model as a key, novel element of a theoretical conceptualization of WMSDs. Moreover, the group focuses on improving WMSD surveillance, using multiple sources of information, providing information on newly identified health risks and developing new methods of assessing risk in order to effectively prevent disability in the working population. Finally, results from research of the MSD axis group have implications for orienting legal processes, improving legal recognition of MSDs as occupational diseases, and contributing to the evolution of legal thinking. However, much remains to be done. To that end, the group plans and encourages new initiatives for further advancement. In conclusion, the originality of the work places the group in a favourable position to address the complexity underlying WMSDs, combining expertise that enriches fundamental, clinical and population-based research.
Collapse
Affiliation(s)
- Julie N. Côté
- Associate Professor, McGill University, Montréal, Quebec
| | - Suzy Ngomo
- Assistant Professor, Université du Québec à Chicoutimi, Chicoutimi, Quebec
| | - Susan Stock
- FRCPC, Clinical Professor, Université de Montréal/Institut national de santé publique du Québec, Montréal, Quebec
| | - Karen Messing
- Professor Emeritus, Université du Québec à Montréal, Montréal, Quebec
| | - Nicole Vézina
- Full Professor, Université du Québec à Montréal, Montréal, Quebec
| | | | - Alain Delisle
- Full Professor, Université de Sherbrooke, Sherbrooke, Quebec
| | | | - Marie Laberge
- Assistant Professor, Université de Montréal, Montréal, Quebec
| | - Marie St-Vincent
- Senior Researcher, Institut de recherche Robert-Sauvé en santé et en sécurité du travail, Montréal, Quebec
| |
Collapse
|
17
|
Hansmann J, Groeber F, Kahlig A, Kleinhans C, Walles H. Bioreactors in tissue engineering-principles, applications and commercial constraints. Biotechnol J 2012; 8:298-307. [DOI: 10.1002/biot.201200162] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Revised: 10/05/2012] [Accepted: 10/30/2012] [Indexed: 01/14/2023]
|
18
|
Ståhl C. Implementing interorganizational cooperation in labour market reintegration: a case study. JOURNAL OF OCCUPATIONAL REHABILITATION 2012; 22:209-219. [PMID: 22033650 DOI: 10.1007/s10926-011-9337-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
INTRODUCTION To bring people with complex medical, social and vocational needs back to the labour market, interorganizational cooperation is often needed. Yet, studies of processes and strategies for achieving sustainable interorganizational cooperation are sparse. The aim of this study was to analyse the implementation processes of Swedish legislation on financial coordination, with specific focus on different strategies for and perspectives on implementing interorganizational cooperation. METHODS A multiple-case study was used, where two local associations for financial coordination were studied in order to elucidate and compare the development of cooperative work in two settings. The material, collected during a 3-year period, consisted of documents, individual interviews with managers, and focus groups with officials. RESULTS Two different implementation strategies were identified. In case 1, a linear strategy was used to implement cooperative projects, which led to difficulties in maintaining cooperative work forms due to a fragmented and time-limited implementation process. In case 2, an interactive strategy was used, where managers and politicians were continuously involved in developing a central cooperation team that became a central part of a developing structure for interorganizational cooperation. An interactive cooperation strategy with long-term joint financing was here shown to be successful in overcoming organizational barriers to cooperation. CONCLUSIONS It is suggested that a strategy based on adaptation to local conditions, flexibility and constant evaluation is preferred for developing sustainable interorganizational cooperation when implementing policies or legislation affecting interorganizational relationships.
Collapse
Affiliation(s)
- Christian Ståhl
- National Centre for Work and Rehabilitation, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
| |
Collapse
|
19
|
MacEachen E, Kosny A, Ferrier S, Lippel K, Neilson C, Franche RL, Pugliese D. The 'ability' paradigm in vocational rehabilitation: challenges in an Ontario injured worker retraining program. JOURNAL OF OCCUPATIONAL REHABILITATION 2012; 22:105-117. [PMID: 21894535 DOI: 10.1007/s10926-011-9329-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
INTRODUCTION In recent years, a focus on workers' ability, rather than impairment, has guided disability management services. However, a challenge with the notion of 'ability' is identification of the border between ability and inability. This article considers this gray zone of disability management in the case of a workers' compensation vocational retraining program for injured workers in Ontario. METHODS In-depth interviews and focus groups were conducted with a purposive sample of 71 participants who were directly involved with the vocational retraining process. Workers in the program had on average incurred injury 3 years earlier. Procedural and legal documents were also analyzed. Principles of grounded theory and discourse analysis guided the data gathering and analysis. RESULTS A program focus on worker abilities did not allow for consideration of unresolved medical problems. Concepts such as maximum medical rehabilitation distracted attention from workers' ongoing chronic and unstable health situations, and incentive levers to employers directed some of the least capable workers into the program. As well, communication pathways for discussing health problems were limited by rules and provider reluctance to reveal problems. Therefore, workers completing the program were deemed 'employable', while ongoing and problematic health conditions preventing employment remained relatively uncharted and invisible. CONCLUSIONS This study reinforces how the shift in disability management paradigm to a focus on ability and return to work requires consideration of environmental conditions, including policies and programs and implementation. A focus on the environment in which worker ability can be enacted might be as important as a focus on improving individual worker characteristics.
Collapse
Affiliation(s)
- E MacEachen
- Institute for Work & Health, Toronto, ON, Canada.
| | | | | | | | | | | | | |
Collapse
|
20
|
van Beurden KM, Vermeulen SJ, Anema JR, van der Beek AJ. A participatory return-to-work program for temporary agency workers and unemployed workers sick-listed due to musculoskeletal disorders: a process evaluation alongside a randomized controlled trial. JOURNAL OF OCCUPATIONAL REHABILITATION 2012; 22:127-40. [PMID: 21656252 PMCID: PMC3274681 DOI: 10.1007/s10926-011-9314-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
INTRODUCTION Beside (cost-)effectiveness, the feasibility of an intervention is important for successful implementation in daily practice. This study concerns the process evaluation of a newly developed participatory return-to-work (RTW) program for workers without an employment contract, sick-listed due to musculoskeletal disorders. The program consisted of a stepwise process, guided by an independent RTW coordinator, aimed at making a consensus-based RTW plan with the possibility of a temporary (therapeutic) workplace. The aims of this study were to describe the reach and extent of implementation of the new program, the satisfaction and experiences of all stakeholders, and the perceived barriers and facilitators for implementation of the program in daily practice. METHODS Temporary agency workers and unemployed workers, sick-listed for 2-8 weeks due to musculoskeletal disorders were eligible for this study. Data were collected from the workers; their insurance physicians and labour experts at the Dutch Social Security Agency; RTW coordinators; and case managers from participating vocational rehabilitation agencies. Data collection took place using professionals' reports, standardized matrices, questionnaires at baseline and at 3-month follow-up, and group interviews with the professionals. RESULTS Of the 79 workers who were allocated to the participatory RTW program group, 72 workers actually started with the intervention. Overall, implementation of the program was performed according to protocol. However, offering of suitable temporary workplaces was delayed with 44.5 days. Results showed satisfaction with the RTW coordinator among the workers and three quarters of the labour experts experienced a minor or major contribution of the presence of the RTW coordinator. Several barriers for implementation were identified, such as the administrative time-investment, unclear information about the program, no timely offering of temporary (therapeutic) workplaces, and the need for additional support in case of complex health problems. CONCLUSIONS This study indicates overall feasibility for implementation of the participatory RTW program in daily practice. However, to overcome important barriers, more attention should be paid to improve timely offering of suitable temporary workplaces, to describe more clearly the program goals and the professional's roles, and to offer additional support for workers suffering from complex multi-causal health problems. TRIAL REGISTRATION NTR1047.
Collapse
Affiliation(s)
- Karlijn M. van Beurden
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
- Research Center for Insurance Medicine AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands
| | - Sylvia J. Vermeulen
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
- Research Center for Insurance Medicine AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands
| | - Johannes R. Anema
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
- Research Center for Insurance Medicine AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands
| | - Allard J. van der Beek
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
- Research Center for Insurance Medicine AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands
| |
Collapse
|
21
|
Vermeulen SJ, Anema JR, Schellart AJM, Knol DL, van Mechelen W, van der Beek AJ. A participatory return-to-work intervention for temporary agency workers and unemployed workers sick-listed due to musculoskeletal disorders: results of a randomized controlled trial. JOURNAL OF OCCUPATIONAL REHABILITATION 2011; 21:313-24. [PMID: 21336673 PMCID: PMC3173632 DOI: 10.1007/s10926-011-9291-7] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
INTRODUCTION Within the labour force workers without an employment contract represent a vulnerable group. In most cases, when sick-listed, these workers have no workplace/employer to return to. Therefore, the aim of this study was to evaluate the effectiveness on return-to-work of a participatory return-to-work program compared to usual care for unemployed workers and temporary agency workers, sick-listed due to musculoskeletal disorders. METHODS The workers, sick-listed for 2-8 weeks due to musculoskeletal disorders, were randomly allocated to the participatory return-to-work program (n = 79) or to usual care (n = 84). The new program is a stepwise procedure aimed at making a consensus-based return-to-work plan, with the possibility of a temporary (therapeutic) workplace. Outcomes were measured at baseline, 3, 6, 9 and 12 months. The primary outcome measure was time to sustainable first return-to-work. Secondary outcome measures were duration of sickness benefit, functional status, pain intensity, and perceived health. RESULTS The median duration until sustainable first return-to-work was 161 days in the intervention group, compared to 299 days in the usual care group. The new return-to-work program resulted in a non-significant delay in RTW during the first 90 days, followed by a significant advantage in RTW rate after 90 days (hazard ratio of 2.24 [95% confidence interval 1.28-3.94] P = 0.005). No significant differences were found for the measured secondary outcomes. CONCLUSIONS The newly developed participatory return-to-work program seems to be a promising intervention to facilitate work resumption and reduce work disability among temporary agency workers and unemployed workers, sick-listed due to musculoskeletal disorders.
Collapse
Affiliation(s)
- Sylvia J. Vermeulen
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Centre, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
- Research Centre for Insurance Medicine AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands
| | - Johannes R. Anema
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Centre, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
- Research Centre for Insurance Medicine AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands
| | - Antonius J. M. Schellart
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Centre, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
- Research Centre for Insurance Medicine AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands
| | - Dirk L. Knol
- Department of Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, The Netherlands
| | - Willem van Mechelen
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Centre, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
- Research Centre for Insurance Medicine AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands
| | - Allard J. van der Beek
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Centre, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
- Research Centre for Insurance Medicine AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands
| |
Collapse
|
22
|
|