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Sacco MJ, Divita G, Rasch E. Development of an ontology to characterize mental functioning. Disabil Rehabil 2024; 46:3739-3748. [PMID: 37702040 PMCID: PMC10932805 DOI: 10.1080/09638288.2023.2252337] [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: 03/19/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 09/14/2023]
Abstract
PURPOSE OF THE ARTICLE This article describes a conceptual and methodological approach to integrating functional information into an ontology to categorize mental functioning, which to date is an under-developed area of classification, and supports our work with the United States (U.S.) Social Security Administration (SSA). DESIGN AND METHODOLOGICAL PROCEDURES Conceptualizing and defining mental functioning was paramount to develop natural language processing (NLP) tools to support our use case. The International Classification of Functioning, Disability, and Health (ICF) was the framework used to conceptualize mental functioning at the activities and participation level in clinical records. To address challenges that arose when applying the ICF as to what should or should not be classified as mental functioning, a mental functioning domain ontology was developed that rearranged, reclassified and incorporated all ICF key components, concepts, classifications, and their definitions. CONCLUSIONS Challenges emerged in the extent to which we could directly align components in the ICF into an applied ontology of mental functioning. These conceptual challenges required rearrangement of ICF components to adequately support our use case within the social security disability determination process. Findings also have implications to support future NLP efforts for behavioral health outcomes and policy research.
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Affiliation(s)
- Maryanne J Sacco
- Rehabilitation Medicine Department, Epidemiology and Biostatistics Section, National Institutes of Health, Clinical Center, Bethesda, MD, USA
| | - Guy Divita
- Rehabilitation Medicine Department, Epidemiology and Biostatistics Section, National Institutes of Health, Clinical Center, Bethesda, MD, USA
| | - Elizabeth Rasch
- Rehabilitation Medicine Department, Epidemiology and Biostatistics Section, National Institutes of Health, Clinical Center, Bethesda, MD, USA
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Villotti P, Kordsmeyer AC, Roy JS, Corbière M, Negrini A, Larivière C. Systematic review and tools appraisal of prognostic factors of return to work in workers on sick leave due to musculoskeletal and common mental disorders. PLoS One 2024; 19:e0307284. [PMID: 39018306 PMCID: PMC11253986 DOI: 10.1371/journal.pone.0307284] [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: 11/29/2023] [Accepted: 07/03/2024] [Indexed: 07/19/2024] Open
Abstract
With the overall objective of providing implication for clinical and research practices regarding the identification and measurement of modifiable predicting factors for return to work (RTW) in people with musculoskeletal disorders (MSDs) and common mental disorders (CMDs), this study 1) systematically examined and synthetized the research evidence available in the literature on the topic, and 2) critically evaluated the tools used to measure each identified factor. A systematic search of prognostic studies was conducted, considering four groups of keywords: 1) population (i.e., MSDs or CMDs), 2) study design (prospective), 3) modifiable factors, 4) outcomes of interest (i.e., RTW). Studies showing high risk of bias were eliminated. Tools used to measure prognostic factors were assessed using psychometric and usability criteria. From the 78 studies that met inclusion criteria, 19 (for MSDs) and 5 (for CMDs) factors reaching moderate or strong evidence were extracted. These factors included work accommodations, RTW expectations, job demands (physical), job demands (psychological), job strain, work ability, RTW self-efficacy, expectations of recovery, locus of control, referred pain (back pain), activities as assessed with disability questionnaires, pain catastrophizing, coping strategies, fears, illness behaviours, mental vitality, a positive health change, sleep quality, and participation. Measurement tools ranged from single-item tools to multi-item standardized questionnaires or subscales. The former generally showed low psychometric properties but excellent usability, whereas the later showed good to excellent psychometric properties and variable usability. The rigorous approach to the selection of eligible studies allowed the identification of a relatively small set of prognostic factors, but with a higher level of certainty. For each factor, the present tool assessment allows an informed choice to balance psychometric and usability criteria.
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Affiliation(s)
- Patrizia Villotti
- Department of Education and Pedagogy–Career Counseling, Université du Québec à Montréal, Montréal, Canada
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal, Montréal, Canada
| | - Ann-Christin Kordsmeyer
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Jean-Sébastien Roy
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval, Quebec City, Canada
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec, Rehabilitation Institute, Quebec City, Canada
| | - Marc Corbière
- Department of Education and Pedagogy–Career Counseling, Université du Québec à Montréal, Montréal, Canada
- Centre de recherche de l’Institut universitaire en santé mentale de Montréal, Montréal, Canada
| | - Alessia Negrini
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail, Montréal, Canada
| | - Christian Larivière
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail, Montréal, Canada
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3
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Hochhauser M, Liberman E. Health status and ergonomics education: A comparison between student nurses and first-year nursing staff. Nurs Open 2024; 11:e2239. [PMID: 38988218 PMCID: PMC11237340 DOI: 10.1002/nop2.2239] [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: 12/06/2022] [Revised: 11/28/2023] [Accepted: 06/21/2024] [Indexed: 07/12/2024] Open
Abstract
AIMS To (a) compare student nurses' health status and levels of ergonomics knowledge and awareness to those of first-year nursing staff and (b) investigate the association between nurses' ergonomic compliance and health status with their educational preparedness. DESIGN This cohort study compared ergonomics awareness and knowledge, and health status of nurses when they were students and after their first-year working in medical facilities. METHODS In total, 133 4th-year student nurses completed a survey; 45 of them completed a second survey after working 1 year in a medical facility. Their health status was compared over time using repeated-measures ANOVA. Correlation tests were used to analyse associations between ergonomics knowledge and awareness, health status, demographic variables and educational preparedness. RESULTS Respondents in both surveys displayed weak knowledge of ergonomic principles significantly associated with increased pain intensity and educational preparedness. PATIENT CONTRIBUTION Ergonomics training should be expanded during nursing studies and first-year training to prevent long-term health disorders.
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Affiliation(s)
| | - Elena Liberman
- Maccabi Health Services - Nursing Clinic, Lev Ha'ir Medical Center, Jerusalem, Israel
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Nagdee N, de Andrade VM, Banoo M. The dizzying cycle: a qualitative study showing the effects of vestibular disorders and stress on work experience. Int J Audiol 2024; 63:431-438. [PMID: 37079320 DOI: 10.1080/14992027.2023.2199444] [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: 04/13/2022] [Accepted: 03/28/2023] [Indexed: 04/21/2023]
Abstract
OBJECTIVE Quantitative studies have explored the work abilities of persons with specific vestibular-related symptoms, but there seems to be a dearth of research that has explored the work experience of persons-with- vestibular- disorders, so this qualitative study explored this phenomenon. DESIGN Audio-recorded semi-structured interviews were conducted online. Thematic analysis was used to analyse the transcripts. Together, two researchers coded the transcripts and deductively identified the main themes on the main components of the expanded International Classification of Functioning, Disability, and Health scheme, and thereafter generated the sub-themes inductively. STUDY SAMPLE Fourteen people with various vestibular disorders and occupations in South Africa participated in the study. RESULTS Participants reported having difficulty performing work-related tasks requiring attention to detail and ambulation, and work environmental conditions triggered their vestibular-related symptoms. Some participants received time off from work and support from their supervisors and colleagues, while others did not. Seeking mental services allowed them to overcome their negative feelings, medication suppressed their vestibular-related symptoms, and vestibular rehabilitation allowed them to focus on their work. CONCLUSION Vestibular-related symptoms may hinder persons- with- vestibular- disorders from completing and participating in work-related activities, which may result in them experiencing negative feelings. The nature of some of the work-related tasks that they need to complete and experiencing negative feelings may trigger their vestibular-related symptoms. Together, the work-related activity limitations, participation restrictions, and environmental and personal factors may cause persons- with- vestibular- disorders to experience disability in their workplaces. To prevent this potential disability, persons with vestibular disorders should be supported by and receive workplace accommodations. Furthermore, they should be enrolled into work rehabilitation programmes that include, vestibular rehabilitation, medication regimens, and mental health services.
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Affiliation(s)
- Nabeelah Nagdee
- Department of Speech-Pathology and Audiology, University of the Witwatersrand, Johannesburg, South Africa
| | - Victor Manuel de Andrade
- Department of Speech-Pathology and Audiology, University of the Witwatersrand, Johannesburg, South Africa
| | - Mahdiyyah Banoo
- Department of Speech-Pathology and Audiology, University of the Witwatersrand, Johannesburg, South Africa
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Rymenans I, Van den Broeck A, Vanovenberghe C, Du Bois M, Lauwerier E. Developing a Training in Motivational Counselling to Promote Return to Work: An Intervention Mapping Approach. JOURNAL OF OCCUPATIONAL REHABILITATION 2024:10.1007/s10926-024-10177-z. [PMID: 38407744 DOI: 10.1007/s10926-024-10177-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/03/2024] [Indexed: 02/27/2024]
Abstract
PURPOSE Due to the Belgian health insurance system's controlling nature, work-disabled claimants can feel forced to return to work (RTW), increasing their risk of relapse. RTW out of interest or importance is considered more sustainable. Such autonomous motivation for RTW can be promoted through 'motivational counselling', an integration of self-determination theory and motivational interviewing. To adopt this, health insurance practitioners need training, which can be designed through intervention mapping as an evidence-based planning tool. This paper reports on the development of a motivational counselling training for health insurance practitioners. METHODS Intervention mapping's six steps guided the formulation of programme goals and learning outcomes, matching the context. We then identified change methods which were translated into practical components. Together with the health insurances' input, this resulted in a concrete training programme with an implementation and evaluation plan. RESULTS The training was designed to increase practitioners' knowledge, skills, and beliefs relevant for learning motivational counselling, which also requires solution-focused strategies. Methods like guided practice were translated into built-in exercises, feedback, and information, which were implemented through an online training format of five sessions including one follow-up. CONCLUSION Reporting about training development increases understanding of its effectiveness and implementation, which will be evaluated via pre- and post-training data collection amongst practitioners. Future trainings can benefit from this by accounting for health insurances' organizational barriers or building on the training's evidence-based backbone whilst only requiring specific adaptations for other stakeholders and contexts. Further research should evaluate motivational counselling's impact on claimants' RTW trajectories.
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Affiliation(s)
- I Rymenans
- Department of Work and Organisation Studies, KU Leuven, Leuven, Belgium.
| | - A Van den Broeck
- Department of Work and Organisation Studies, KU Leuven, Leuven, Belgium
- Optentia, North West University, Vanderbijlpark, South Africa
| | - C Vanovenberghe
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
- Department of Experimental Clinical and Health Psychology, UGent, Ghent, Belgium
| | - M Du Bois
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - E Lauwerier
- Department of Experimental Clinical and Health Psychology, UGent, Ghent, Belgium
- Department of Psychology, Open University of the Netherlands, Heerlen, The Netherlands
- Department of Public Health and Primary Care, UGent, Ghent, Belgium
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Habenicht R, Fehrmann E, Blohm P, Ebenbichler G, Fischer-Grote L, Kollmitzer J, Mair P, Kienbacher T. Machine Learning Based Linking of Patient Reported Outcome Measures to WHO International Classification of Functioning, Disability, and Health Activity/Participation Categories. J Clin Med 2023; 12:5609. [PMID: 37685676 PMCID: PMC10488436 DOI: 10.3390/jcm12175609] [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: 06/14/2023] [Revised: 08/06/2023] [Accepted: 08/23/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND In the primary and secondary medical health sector, patient reported outcome measures (PROMs) are widely used to assess a patient's disease-related functional health state. However, the World Health Organization (WHO), in its recently adopted resolution on "strengthening rehabilitation in all health systems", encourages that all health sectors, not only the rehabilitation sector, classify a patient's functioning and health state according to the International Classification of Functioning, Disability and Health (ICF). AIM This research sought to optimize machine learning (ML) methods that fully and automatically link information collected from PROMs in persons with unspecific chronic low back pain (cLBP) to limitations in activities and restrictions in participation that are listed in the WHO core set categories for LBP. The study also aimed to identify the minimal set of PROMs necessary for linking without compromising performance. METHODS A total of 806 patients with cLBP completed a comprehensive set of validated PROMs and were interviewed by clinical psychologists who assessed patients' performance in activity limitations and restrictions in participation according to the ICF brief core set for low back pain (LBP). The information collected was then utilized to further develop random forest (RF) methods that classified the presence or absence of a problem within each of the activity participation ICF categories of the ICF core set for LBP. Further analyses identified those PROM items relevant to the linking process and validated the respective linking performance that utilized a minimal subset of items. RESULTS Compared to a recently developed ML linking method, receiver operating characteristic curve (ROC-AUC) values for the novel RF methods showed overall improved performance, with AUC values ranging from 0.73 for the ICF category d850 to 0.81 for the ICF category d540. Variable importance measurements revealed that minimal subsets of either 24 or 15 important PROM variables (out of 80 items included in full set of PROMs) would show similar linking performance. CONCLUSIONS Findings suggest that our optimized ML based methods more accurately predict the presence or absence of limitations and restrictions listed in ICF core categories for cLBP. In addition, this accurate performance would not suffer if the list of PROM items was reduced to a minimum of 15 out of 80 items assessed.
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Affiliation(s)
- Richard Habenicht
- Karl-Landsteiner-Institute of Outpatient Rehabilitation Research, 1230 Vienna, Austria; (R.H.); (P.B.); (G.E.); (L.F.-G.); (T.K.)
| | - Elisabeth Fehrmann
- Karl-Landsteiner-Institute of Outpatient Rehabilitation Research, 1230 Vienna, Austria; (R.H.); (P.B.); (G.E.); (L.F.-G.); (T.K.)
- Department of Psychology, Karl Landsteiner University of Health Sciences, 3500 Krems, Austria
| | - Peter Blohm
- Karl-Landsteiner-Institute of Outpatient Rehabilitation Research, 1230 Vienna, Austria; (R.H.); (P.B.); (G.E.); (L.F.-G.); (T.K.)
| | - Gerold Ebenbichler
- Karl-Landsteiner-Institute of Outpatient Rehabilitation Research, 1230 Vienna, Austria; (R.H.); (P.B.); (G.E.); (L.F.-G.); (T.K.)
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, 1090 Vienna, Austria
| | - Linda Fischer-Grote
- Karl-Landsteiner-Institute of Outpatient Rehabilitation Research, 1230 Vienna, Austria; (R.H.); (P.B.); (G.E.); (L.F.-G.); (T.K.)
| | - Josef Kollmitzer
- Department of Biomedical Engineering, TGM College for Higher Vocational Education, 1200 Vienna, Austria;
| | - Patrick Mair
- Department of Psychology, Harvard University, Cambridge, MA 02138, USA;
| | - Thomas Kienbacher
- Karl-Landsteiner-Institute of Outpatient Rehabilitation Research, 1230 Vienna, Austria; (R.H.); (P.B.); (G.E.); (L.F.-G.); (T.K.)
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Kloosterman LM, Hendrickx A, Scafoglieri A, Jager-Wittenaar H, Dekker R. Functioning of People with Lipoedema According to All Domains of the International Classification of Functioning, Disability and Health: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1989. [PMID: 36767355 PMCID: PMC9915552 DOI: 10.3390/ijerph20031989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/13/2023] [Accepted: 01/19/2023] [Indexed: 06/18/2023]
Abstract
Lipoedema is a painful non-pitting diffuse "fatty" swelling, usually confined to the legs, that occurs mainly in women. This scoping review aimed to provide an overview of the available research on the functioning of people with lipoedema, according to the International Classification of Functioning, Disability and Health (ICF) framework. Relevant publications and gray literature were retrieved until October 2022. The results sections of each publication were organized using a thematic framework approach. All included studies reported at least one outcome fitting within the domains of body functions and body structures, with most studies focusing on the categories of "sensation of pain", "immunological system functions", and "weight maintenance functions". The ICF domains of activities and participation and environmental factors were mentioned in a small number of the included studies (17 and 13%, respectively), while the domain of personal factors was studied in half of the included studies. In conclusion, the emphasis of lipoedema research is on its description from a disorder-oriented point of view in the form of body functions and body structures, with a lack of information about the other domains of functioning.
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Affiliation(s)
- Lise Maren Kloosterman
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, 9714 CA Groningen, The Netherlands
- FAITH Research, 9714 CA Groningen, The Netherlands
- Center of Expertise for Lymphovascular Medicine, Nij Smellinghe Hospital, Compagnonsplein 1, 9202 NN Drachten, The Netherlands
- Experimental Anatomy Research Department, Vrije Universiteit Brussel, 1090 Brussels, Belgium
| | - Ad Hendrickx
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, 9714 CA Groningen, The Netherlands
- FAITH Research, 9714 CA Groningen, The Netherlands
- Center of Expertise for Lymphovascular Medicine, Nij Smellinghe Hospital, Compagnonsplein 1, 9202 NN Drachten, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Health Psychology, 9700 RB Groningen, The Netherlands
| | - Aldo Scafoglieri
- Experimental Anatomy Research Department, Vrije Universiteit Brussel, 1090 Brussels, Belgium
| | - Harriët Jager-Wittenaar
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, 9714 CA Groningen, The Netherlands
- FAITH Research, 9714 CA Groningen, The Netherlands
- Experimental Anatomy Research Department, Vrije Universiteit Brussel, 1090 Brussels, Belgium
- University of Groningen, University Medical Center Groningen, Department of Oral and Maxillofacial Surgery, 9700 RB Groningen, The Netherlands
| | - Rienk Dekker
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, 9700 RB Groningen, The Netherlands
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Hennaert S, Decuman S, Désiron H, Braeckman L, De Baets S, Van de Velde D. IMBA-ICF linking by integrating consensus methods: How group consensus of experts can contribute to in-depth linking of instruments to the ICF. Work 2023; 75:479-493. [PMID: 35912763 DOI: 10.3233/wor-210256] [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: 10/16/2022] Open
Abstract
BACKGROUND A frame of reference is needed to increase the comparability of vocational rehabilitation assessment instruments and the interpretation of their results. The International Classification of Functioning, Disability and Health (ICF) is a relevant framework, and when linking rules are used, items from existing assessment instruments can be linked to the appropriate categories as described in the ICF. OBJECTIVE To develop an adapted linking methodology in which experts are involved by means of the application of consensus methods and to transfer this result in a step-by-step set of guidelines, supporting researchers and professionals, linking complex instruments to the ICF. METHODS The main researcher developed the initial linking of the Integration von Menschen mit Behinderungen in die Arbeitswelt (IMBA) to the ICF by rigorously applying the refined ICF linking rules. To validate this linking, the Delphi and nominal group technique was integrated through different steps, and experts were involved in the process. The method section describes the linking process chronologically with focuses on the used approach, the involvement of experts, and the processing of the output. RESULTS The results are presented in a 7-step set of guidelines describing the chronological process from the initial to the validated linking. These guidelines describe the core elements in the application of the linking rules and consensus methods in a manual for researchers who are interested in linking complex instruments to the ICF by involving experts. CONCLUSIONS The Delphi and nominal group technique can be successfully integrated in the linking process, making it possible to involve experts in linking complex instruments to the ICF. A homogeneous composition of the expert panel in terms of knowledge, a heterogeneous composition in terms of setting, a rigorous and repeated application of the linking rules, and structured processing of the output are essential to achieve a valid linking.
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Affiliation(s)
- Stien Hennaert
- Vocational Rehabilitation Service, Flanders (GTB), Belgium
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Saskia Decuman
- Department of Internal Health and Pediatrics, Faculty of Medicine and Health, Ghent University, Ghent, Belgium
- Disability Benefits Department, National Institute of Health and Disability Insurance, Brussels, Belgium
| | - Huget Désiron
- Faculty Biomedical Sciences - Environment and Health, KU Leuven, Leuven, Belgium
- Scientific collaborator: PXL University College, Hasselt, Belgium
- ACT Désiron, Hasselt, Belgium
| | - Lutgart Braeckman
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Stijn De Baets
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Occupational Therapy Program, Ghent University, Ghent, Belgium
| | - Dominique Van de Velde
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Occupational Therapy Program, Ghent University, Ghent, Belgium
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Ibikunle PO, Rhoda A, Smith MR, Useh U. Applying the ICF codes, flag model and C-OAR-SE in the development of return-to-work assessment scale for stroke survivors. Work 2023; 75:1427-1437. [PMID: 36710708 DOI: 10.3233/wor-220120] [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: 01/25/2023] Open
Abstract
BACKGROUND The Return-to-Work Assessment Scale (RAS) was developed in 2021 by Ibikunle et al. to assess return-to-work among post-stroke survivors. OBJECTIVE The aim of this study was to describe how the conceptual (flag model and ICF) and theoretical framework (C-OAR-SE) were used in developing the RAS. METHOD The development of the RAS consisted of three phases: (i) Initial item generation (ii) Face and content validity (iii) Psychometric testing. With each phase embracing the flag model, international classification of functioning, disability and health (ICF) and the C-OAR-SE an acronym for the six aspects of the theory: 'C' [construct definition], 'OAR' [object representation, attribute classification, and rater entity identification], and 'SE' [selection of item type and answer scale, as well as, enumeration]. RESULTS A triangulated approach drawn on three separate theories and models. Phase one was developed by using the flag model which provided the semi-structured open ended questions that materialized into the draft instrument while phases two and three were developed using the ICF and the C-OAR-SE. The scale consists of two sections, A and B. Section A comprises general information about post-stroke survivors, which would not be scored, while section B includes three parts that are important to consider when deciding to return-to-work. CONCLUSION An instrument called RAS was developed, an excellent, internally consistent, as well as reliable tool that has demonstrated good group and structural validity.
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Affiliation(s)
- Peter O Ibikunle
- Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Nnewi Campus, Nnewi, Nigeria
- Department of Physiotherapy, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, Republic of South Africa
- Lifestyle Diseases Research Entity, Faculty of Health Sciences, North West University, Mahikeng, Republic of South Africa
| | - Anthea Rhoda
- Department of Physiotherapy, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, Republic of South Africa
| | - Mario R Smith
- Department of Psychology, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, Republic of South Africa
| | - Ushotanefe Useh
- Lifestyle Diseases Research Entity, Faculty of Health Sciences, North West University, Mahikeng, Republic of South Africa
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10
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de Wind A, Donker-Cools BHPM, Jansen L, Luymes CH, van der Burg-Vermeulen SJ, Oomens S, Anema JR, Schaafsma FG. Development of the core of an ICF-based instrument for the assessment of work capacity and guidance in return to work of employees on sick leave: a multidisciplinary modified Delphi study. BMC Public Health 2022; 22:2449. [PMID: 36578011 PMCID: PMC9795420 DOI: 10.1186/s12889-022-14653-0] [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: 07/07/2022] [Accepted: 11/16/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Several occupational health disciplines are involved in return to work guidance, implying that good interdisciplinary collaboration is important. A shared conceptual framework and a common language for the assessment of work capacity and guidance in return to work is expected to be at the benefit of appropriate and sustainable employability of sick employees. The International Classification of Functioning, Disability and Health (ICF) can be considered a shared conceptual framework and is also promising in terms of a common language. The purpose of the current study is to reach multidisciplinary consensus among occupational health professionals on the content of an ICF-based instrument for the assessment of work capacity and guidance in return to work. METHODS To obtain multidisciplinary consensus we conducted a modified Delphi study among twelve occupational health experts, including four occupational physicians, four insurance physicians and four labour experts. The study included two e-mail rounds and two virtual meetings. In the consecutive rounds the experts assessed ICF items as well as a list of non-ICF-based work-related environmental factors on their relevance for the assessment of the work capacity and guidance in return to work together with their interpretability. RESULTS The four consecutive Delphi rounds resulted in 20 items that are minimally needed for the assessment of the work capacity and return to work possibilities of employees on sick leave. The final list included six items on personal functioning, seven items on social functioning and seven items on physical functioning. CONCLUSIONS This set of items forms the core of an ICF-based instrument, which is expected to facilitate interdisciplinary and intradisciplinary communication because of the use of a shared conceptual framework. As such, it should be of help in the guidance in return to work of employees on sick leave and contribute to appropriate and sustainable employability.
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Affiliation(s)
- Astrid de Wind
- grid.509540.d0000 0004 6880 3010Amsterdam UMC location University of Amsterdam, Public and Occupational Health, Amsterdam, the Netherlands ,grid.16872.3a0000 0004 0435 165XAmsterdam Public Health research institute, Societal Participation and Health, Amsterdam, the Netherlands
| | - Birgit H. P. M. Donker-Cools
- grid.509540.d0000 0004 6880 3010Amsterdam UMC location University of Amsterdam, Public and Occupational Health, Amsterdam, the Netherlands ,grid.16872.3a0000 0004 0435 165XAmsterdam Public Health research institute, Societal Participation and Health, Amsterdam, the Netherlands ,Research Center for Insurance Medicine, Amsterdam, The Netherlands
| | - Lyanne Jansen
- grid.509540.d0000 0004 6880 3010Amsterdam UMC location University of Amsterdam, Public and Occupational Health, Amsterdam, the Netherlands ,grid.16872.3a0000 0004 0435 165XAmsterdam Public Health research institute, Societal Participation and Health, Amsterdam, the Netherlands ,Research Center for Insurance Medicine, Amsterdam, The Netherlands
| | - Clare H. Luymes
- grid.509540.d0000 0004 6880 3010Amsterdam UMC location University of Amsterdam, Public and Occupational Health, Amsterdam, the Netherlands ,grid.16872.3a0000 0004 0435 165XAmsterdam Public Health research institute, Societal Participation and Health, Amsterdam, the Netherlands ,Research Center for Insurance Medicine, Amsterdam, The Netherlands
| | - Sylvia J. van der Burg-Vermeulen
- grid.509540.d0000 0004 6880 3010Amsterdam UMC location University of Amsterdam, Public and Occupational Health, Amsterdam, the Netherlands ,grid.16872.3a0000 0004 0435 165XAmsterdam Public Health research institute, Societal Participation and Health, Amsterdam, the Netherlands
| | - Shirley Oomens
- grid.450078.e0000 0000 8809 2093HAN University of Applied Sciences, Occupation and health research group, Arnhem, the Netherlands ,grid.10417.330000 0004 0444 9382Radboudumc, Department of Primary and Community Care, Nijmegen School of Occupational Health, Nijmegen, the Netherlands
| | - Johannes R. Anema
- grid.16872.3a0000 0004 0435 165XAmsterdam Public Health research institute, Societal Participation and Health, Amsterdam, the Netherlands ,Research Center for Insurance Medicine, Amsterdam, The Netherlands ,grid.509540.d0000 0004 6880 3010Amsterdam UMC location Vrije Universiteit Amsterdam, Public and Occupational Health, Amsterdam, the Netherlands
| | - Frederieke G. Schaafsma
- grid.509540.d0000 0004 6880 3010Amsterdam UMC location University of Amsterdam, Public and Occupational Health, Amsterdam, the Netherlands ,grid.16872.3a0000 0004 0435 165XAmsterdam Public Health research institute, Societal Participation and Health, Amsterdam, the Netherlands ,Research Center for Insurance Medicine, Amsterdam, The Netherlands
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11
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Otte T, Decuman S, Gelade W, Duyver C. Perceptions of medical advisers on ICF core-sets’ use for evaluating work incapacity related to back pain in French-speaking Belgium. Work 2022; 74:1401-1418. [PMID: 36502361 DOI: 10.3233/wor-210247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND: There is willingness in Europe to implement the use of a biopsychosocial model such as the International Classification of Functioning, Disability and Health (ICF) for assessing work incapacity. OBJECTIVE: A preliminary study was conducted to investigate the perceptions of medical advisers on the value of structuring clients’ biopsychosocial information in an ICF-based report. METHOD: A sample (n = 101) received a perception questionnaire after watching two comparative videos based on a clinical case. Questions relating to work incapacity were also asked. The data was analysed using quantitative methods. Comments were also collected. RESULTS: Before knowing the ICF-based report, 61.96% of the respondents believed a return to work seems possible by providing adapted work or a different job. There is an increase of 8.69 pp (p-value: 0.077) after reading the report. Opening up the initial sample to more insurance physicians (n = 119), the difference is more significant (p-value: 0.012). Also, 71.9% of respondents believe they have a better view of the client’s biopsychosocial situation after reading the report. Respondents recognise the clinical and diagnostic relevance of ICF but say it cannot be used at the moment for various reasons, such as the time required or the need for a multidisciplinary team and effective coordination. Older respondents are less enthusiastic about the appropriateness of using ICF. CONCLUSION: The respondents identify an added value in having a biopsychosocial based-report. After learning about the report, more physicians see opportunities for professional re-integration than before. The medical advisers and their team must be strengthened and receive a clear role in order to empower them.
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Affiliation(s)
- Thomas Otte
- Department of Disability Benefits, Belgian National Institute for Health and Disability Insurance, Brussels, Belgium
| | - Saskia Decuman
- Department of Disability Benefits, Belgian National Institute for Health and Disability Insurance, Brussels, Belgium
| | - Wouter Gelade
- Center for Research in the Economics of Development, University of Namur, Namur, Belgium
| | - Corentin Duyver
- Centre Académique de Médecine Générale, Université catholique de Louvain, Brussels, Belgium
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12
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Stynen D, Houkes I, van Amelsvoort L, Jansen N, Kant IJ. Opportunities, barriers and facilitators of an indicated prevention strategy to prevent future long-term sickness absence in SMEs: A qualitative study. Work 2022; 74:871-889. [PMID: 36442177 DOI: 10.3233/wor-210282] [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: 11/24/2022] Open
Abstract
BACKGROUND The efficacy of an indicated prevention strategy for long-term absence due to sickness has been demonstrated and is implemented in multinational companies. Such a strategy may also be beneficial for small and medium-sized enterprises (SMEs). However, due to the different contexts, adoption, and implementation of this strategy in SMEs may be quite different. OBJECTIVE This study aims to investigate the opportunities, barriers, and facilitators for adoption and implementation of this preventive strategy, as anticipated by employers and employees of SMEs. METHODS A qualitative needs assessment was conducted using semi-structured interviews with higher managers (n = 15) and a focus group with employees (n = 8). Purposive sampling was used, and data were analyzed using content analysis. RESULTS Employers had positive expectations concerning the gains of the preventive strategy, whereas employees had more reservations. Anticipated gains and intentions to implement the preventive strategy were rooted in underlying conceptions of the causes of sickness absence and the responsibilities of stakeholders. One key barrier shared across employers and employees concerned the potential lack of confidentiality. For employees, the role of the occupational health professional in the prevention of sickness absence was perceived as uncommon. Employers stressed lack of capacity and resources as a barrier, whereas employees stressed lack of follow-up by the employer as a barrier. CONCLUSIONS SMEs are considerably receptive to the implementation of an indicated prevention strategy for long-term absence. Insight into the barriers and facilitators gives clues for wider and optimal implementation across a wider range of organizational settings.
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Affiliation(s)
- Dave Stynen
- Department of Organisation, Faculty of Management, Open Universiteit, Heerlen, the Netherlands.,Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Inge Houkes
- Department of Social Medicine, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Ludo van Amelsvoort
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Nicole Jansen
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - IJmert Kant
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
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13
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Nichol L, Wallace SJ, Pitt R, Rodriguez AD, Hill AJ. Communication partner perspectives of aphasia self-management and the role of technology: an in-depth qualitative exploration. Disabil Rehabil 2022; 44:7199-7216. [PMID: 34747289 DOI: 10.1080/09638288.2021.1988153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE "Self-management" empowers individuals to take responsibility for their healthcare through skill-building, personal growth, and self-efficacy related to chronic health condition management. Self-management approaches may benefit people with aphasia (PwA); however, PwA are often excluded from stroke self-management research and there is no published research reporting on aphasia-specific self-management programs. Communication partners (CPs) are involved in the rehabilitation and day-to-day lives of PwA, thus giving them unique insights and knowledge of PwA needs. The present study aimed to investigate CP experiences and perspectives regarding aphasia self-management and to explore CP perceptions of the use of technology in aphasia self-management. METHODS In-depth, semi-structured interviews with 14 CPs living in Australia. Interview data was analysed using qualitative content analysis. RESULTS Analysis revealed six core themes: (1) aphasia self-management is embedded into everyday life, (2) CPs provide comprehensive self-management support, (3) speech-language pathologists (SLPs) provide tools and support to enable PwA to self-manage, (4) aphasia self-management can be enhanced by technological supports, (5) potential positive outcomes of aphasia self-management, and (6) factors influencing successful aphasia self-management. CONCLUSIONS Aphasia self-management programs should focus on individual needs, functional communication in daily life, and social interaction. PwA and CPs are central to these programs, assisted by SLPs. Technology should be explored to augment aphasia self-management.Implications for RehabilitationCommunication partners suggest that people with aphasia are already engaging in aspects of self-management and that more formal aphasia-specific self-management approaches may be beneficial.Dedicated aphasia self-management programs should be situated in daily life with a focus on functional communication, life participation, confidence, and independence.Communication partners, speech-language pathologists, and technology are key support sources for aphasia self-management.Further input should be sought from communication partners in the development of aphasia self-management programs.
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Affiliation(s)
- Leana Nichol
- Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Sarah J Wallace
- Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.,NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia
| | - Rachelle Pitt
- Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.,NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia.,West Moreton Health, Ipswich, Australia
| | - Amy D Rodriguez
- Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.,Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Medical Center, Decatur, GA, United States
| | - Annie J Hill
- Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.,Surgical, Treatment and Rehabilitation Service (STARS), Metro North Hospital and Health Service, Brisbane, Australia
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14
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Hennaert S, Decuman S, Désiron H, Alles T, Bühne D, Braeckman L, De Baets S, Van de Velde D. Linking of the ‘Integration von Menschen mit Behinderungen in die Arbeitswelt’ (IMBA) to the ‘International Classification of Functioning, Disability and Health’ (ICF). Work 2022; 72:1359-1380. [DOI: 10.3233/wor-210257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: The assessment of work capacity, workable work and the need for a common language is challenging in labour market policy. Being a specific instrument to facilitate Return To Work (RTW), the Integration von Menschen mit Behinderungen in die Arbeitswelt (IMBA) might facilitate the documentation of the individual’s work capacity, the job-related workload and the match between these two elements. Since the International Classification of Functioning, Disability and Health (ICF) is worldwide recognized as frame of reference in RTW, this paper presents the linking of IMBA to the ICF, since this is assumed to be beneficial to support RTW. OBJECTIVE: The establishment of the IMBA-ICF linking in order to study 1) the relationship between IMBA and ICF; 2) the content comparison of IMBA with work-related ICF core sets; and 3) the extent to which the linking addresses the challenges in RTW policy. METHODS: A content comparison of IMBA and ICF was conducted, using a 7- step linking methodology in which the Delphi and Nominal Group Technique are integrated in the implementation of the ICF linking rules. An explorative conversion of the scoring systems of IMBA and ICF was established based on expert opinions. RESULTS: In the main 70 IMBA items, 107 concepts have been identified of which 94 were linked to 87 different ICF categories. Body functions and activities and participation are the most presented ICF components in contrast to the environmental factors. IMBA items regarding occupational safety and work organization are respectively ‘not covered’ and ‘not defined’ in ICF. CONCLUSIONS: An integration of IMBA and ICF addresses the challenges in RTW policy in the assessment of work capacity, workable work and the need for a common language. In order to do so, extension of ICF terminology regarding ‘occupational safety’ and ‘work organization’ is priority. In depth quantitative research is necessary to support the conversion of both scoring systems.
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Affiliation(s)
- S. Hennaert
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - S. Decuman
- Department of Internal Medicine and Pediatrics, Faculty of Medicine and Health, Ghent University, Ghent, Belgium
- Department of Research and Quality, National Institute of Health and Disability Insurance, Brussels, Belgium
| | - H. Désiron
- Faculty Biomedical Sciences, University Leuven (KU Leuven), Leuven, Belgium
- Scientific collaborator at Hogeschool PXL, Hasselt, Belgium
- CEO, ACT Désiron, Hasselt, Belgium
| | - T. Alles
- Institute for Quality Assurance in Prevention and Rehabilitation, German Sport University Cologne, Cologne, Germany
| | - D. Bühne
- Institute for Quality Assurance in Prevention and Rehabilitation, German Sport University Cologne, Cologne, Germany
| | - L. Braeckman
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - S. De Baets
- Occupational Therapy Program, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - D. Van de Velde
- Occupational Therapy Program, Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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15
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de Beer J, Heerkens Y, Engels J, van der Klink J. Factors relevant to work participation from the perspective of adults with developmental dyslexia: a systematic review of qualitative studies. BMC Public Health 2022; 22:1083. [PMID: 35642026 PMCID: PMC9158268 DOI: 10.1186/s12889-022-13436-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 05/13/2022] [Indexed: 11/29/2022] Open
Abstract
Background This review is focused on workers with developmental dyslexia (DD). In this review DD is considered an expression of neurodiversity, a consequence of a natural variant of the brain. Evidence was synthesized to explore which factors workers with DD consider relevant for their participation in work and whether these factors reflect shifts in the concepts of health and sustainable employability. The factors were classified according to the International Classification of Functioning, Disability and Health (ICF), adapted for occupational health. Methods A systematic review of qualitative studies was performed. Two search strings were used to determine the population and the context of work. The factors were classified using a recently proposed rearrangement of the ICF scheme that places participation in a central position and incorporates preliminary lists of work-related environmental factors and personal factors. Results Fifty-one factors were found that appeared in 35% or more of the included studies and that were relevant to work participation according to the workers themselves. These factors were dispersed over all ICF categories. In the category Functions and Structures (11 factors), most of the factors had negative connotations. In the category Activities (9 factors), all the factors cause difficulties, except speaking (which is ambiguous). In the category Participation (4 factors), the formal relationships are important for the degree of participation. Overall, more than half of the factors are environmental (18) or personal (9) and they both hinder and facilitate work participation. Conclusions The results of this review give an indication for the importance of the biopsychosocial model as a relevant approach for people with a disability in the world of work. This review also adds data for the usefulness of the proposals for the reconsideration of the ICF scheme. The data has not (yet) returned any visible trends revealing that the concept of neurodiversity is common in organizations.
Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13436-x.
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Affiliation(s)
- Joost de Beer
- Tranzo, Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands. .,Department Occupation & Health, HAN University of Applied Sciences, Nijmegen, The Netherlands.
| | - Yvonne Heerkens
- Department Occupation & Health, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Josephine Engels
- Department Occupation & Health, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Jac van der Klink
- Tranzo, Scientific Center for Care and Wellbeing, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands.,Optentia, North-West University of South Africa, Vanderbijlpark, South Africa
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16
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Ravn MB, Uhd M, Svendsen ML, Ørtenblad L, Maribo T. How to Facilitate Adherence to Cardiac Rehabilitation in Primary Health Settings for Ischaemic Heart Disease Patients. The Perspectives of Health Professionals. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:837175. [PMID: 36188961 PMCID: PMC9397980 DOI: 10.3389/fresc.2022.837175] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 02/25/2022] [Indexed: 12/21/2022]
Abstract
Background Cardiac rehabilitation (CR) is a class 1A recommendation and an integrated part of standard treatment for patients with cardiac disease. In Denmark, CR adheres to European guidelines, it is group-based and partly conducted in primary health settings. Despite high evidence for the benefits of CR, it remains underutilized. How to facilitate CR adherence in primary health settings is poorly understood. Aim This study explores health professional's perspectives on how to facilitate CR adherence for patients with ischaemic heart disease in primary health settings. Methods Data were collected through focus group discussions. Respondents were health professionals specialized in and working with CR in primary health settings. Data were analyzed using thematic analysis. Results Eleven health professionals participated in two focus group discussions. Five themes emerged as facilitators of CR; (1) placing the person at the center, (2) coherent programme, (3) flow of information, (4) contextual factors, and (5) feeling of belonging. Conclusion This study illuminates the complexity of facilitating adherence to CR in primary health settings and provides ways in which health professionals may facilitate adherence. Placing the person at the center is pivotal and may be done by adapting CR offers to patients' social context, culture and life circumstances and ensuring a feeling of belonging. The rhetoric related to CR should be positive and throughout the entire course of treatment health professionals should possess a generic and collective approach to and view of CR. Perceiving these elements as potential facilitators is of vital importance and addressing them may facilitate adherence.
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Affiliation(s)
- Maiken Bay Ravn
- Department of Public Health, Centre for Rehabilitation Research, Aarhus University, Aarhus, Denmark
- DEFACTUM, Central Denmark Region, Aarhus, Denmark
- *Correspondence: Maiken Bay Ravn
| | - Maria Uhd
- DEFACTUM, Central Denmark Region, Aarhus, Denmark
| | | | | | - Thomas Maribo
- Department of Public Health, Centre for Rehabilitation Research, Aarhus University, Aarhus, Denmark
- DEFACTUM, Central Denmark Region, Aarhus, Denmark
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17
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Lyhne CN, Nielsen CV, Kristiansen ST, Bjerrum MB. 'Work is a motivator in life' Strategies in managing work participation among highly educated employees with depression. Work 2021; 69:1063-1073. [PMID: 34219699 DOI: 10.3233/wor-213536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Work participation among employees with depression is hampered due to cognitive impairments. Although studies show higher levels of work disability among people with a lower education, highly educated employees may encounter specific challenges in fulfilling their work role due to the cognitive impairments of depression, as they often perform cognitively demanding jobs. There is little knowledge about their challenges and opportunities with regard to work participation. OBJECTIVE To investigate how highly educated employees with depression manage work participation by focusing on their views on opportunities and challenges in fulfilling their work role. METHODS Eight individual interviews with highly educated employees with depression were conducted. Transcripts were analysed using qualitative content analysis. RESULTS The analysis revealed four categories: struggling with acknowledging depression and disclosure; fear of being stigmatised at work; work is a motivator in life; and striving to fulfil the work role at the expense of private life activities. CONCLUSIONS Highly educated employees with depression need guidance regarding the disclosure of information about health issues and work ability. To successfully manage their work role, they need a clear plan with outlined tasks, demands and goals. Healthcare professionals and workplaces should support them in setting limits with regard to work tasks and working hours.
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Affiliation(s)
- Cecilie N Lyhne
- Research Unit of Nursing and Healthcare, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Claus V Nielsen
- Department of Public Health, Aarhus University, Aarhus, Denmark.,DEFACTUM, Central Denmark Region, Denmark.,Regional Hospital West Jutland, Herning, Denmark
| | - Sanne T Kristiansen
- Research Unit of Nursing and Healthcare, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Merete B Bjerrum
- Research Unit of Nursing and Healthcare, Department of Public Health, Aarhus University, Aarhus, Denmark.,The Centre of Clinical Guidelines - Danish National Clearing House, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,The Danish Centre of Systematic Reviews - A JBI Centre of Excellence, The University of Adelaide, Adelaide, South Australia, Australia
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18
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Zirikly A, Desmet B, Newman-Griffis D, Marfeo EE, McDonough C, Goldman H, Chan L. Viewpoint: An Information Extraction Framework for Disability Determination Using a Mental Functioning Use-Case (Preprint). JMIR Med Inform 2021; 10:e32245. [PMID: 35302510 PMCID: PMC8976250 DOI: 10.2196/32245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 10/08/2021] [Accepted: 01/16/2022] [Indexed: 01/08/2023] Open
Abstract
Natural language processing (NLP) in health care enables transformation of complex narrative information into high value products such as clinical decision support and adverse event monitoring in real time via the electronic health record (EHR). However, information technologies for mental health have consistently lagged because of the complexity of measuring and modeling mental health and illness. The use of NLP to support management of mental health conditions is a viable topic that has not been explored in depth. This paper provides a framework for the advanced application of NLP methods to identify, extract, and organize information on mental health and functioning to inform the decision-making process applied to assessing mental health. We present a use-case related to work disability, guided by the disability determination process of the US Social Security Administration (SSA). From this perspective, the following questions must be addressed about each problem that leads to a disability benefits claim: When did the problem occur and how long has it existed? How severe is it? Does it affect the person’s ability to work? and What is the source of the evidence about the problem? Our framework includes 4 dimensions of medical information that are central to assessing disability—temporal sequence and duration, severity, context, and information source. We describe key aspects of each dimension and promising approaches for application in mental functioning. For example, to address temporality, a complete functional timeline must be created with all relevant aspects of functioning such as intermittence, persistence, and recurrence. Severity of mental health symptoms can be successfully identified and extracted on a 4-level ordinal scale from absent to severe. Some NLP work has been reported on the extraction of context for specific cases of wheelchair use in clinical settings. We discuss the links between the task of information source assessment and work on source attribution, coreference resolution, event extraction, and rule-based methods. Gaps were identified in NLP applications that directly applied to the framework and in existing relevant annotated data sets. We highlighted NLP methods with the potential for advanced application in the field of mental functioning. Findings of this work will inform the development of instruments for supporting SSA adjudicators in their disability determination process. The 4 dimensions of medical information may have relevance for a broad array of individuals and organizations responsible for assessing mental health function and ability. Further, our framework with 4 specific dimensions presents significant opportunity for the application of NLP in the realm of mental health and functioning beyond the SSA setting, and it may support the development of robust tools and methods for decision-making related to clinical care, program implementation, and other outcomes.
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Affiliation(s)
- Ayah Zirikly
- Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, United States
- Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, United States
- Malone Center for Engineering in Healthcare, Johns Hopkins University, Baltimore, MD, United States
| | - Bart Desmet
- Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, United States
| | - Denis Newman-Griffis
- Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, United States
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA, United States
| | - Elizabeth E Marfeo
- Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, United States
- Department of Occupational Therapy, Tufts University, Medford, MA, United States
| | - Christine McDonough
- Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, United States
- School of Health and Rehabilitation Science, University of Pittsburgh, Pittsburgh, PA, United States
| | - Howard Goldman
- Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, United States
- Department of Psychiatry, School of Medicine, University of Maryland, Baltimore, MD, United States
| | - Leighton Chan
- Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, United States
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19
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Lyhne CN, Pedersen P, Nielsen CV, Bjerrum MB. Needs for occupational assistance among young adults with ADHD to deal with executive impairments and promote occupational participation - a qualitative study. Nord J Psychiatry 2021; 75:362-369. [PMID: 33380255 DOI: 10.1080/08039488.2020.1862911] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE To examine perceived aspects of importance among young adults with ADHD to participate and engage in occupational activities, and to explain how support from occupational specialists can assist them to deal with executive impairments. MATERIALS AND METHODS Individual interviews with eight young adults with attention-deficit/hyperactivity disorder. The interview guide was based on assumptions derived from the literature regarding executive functioning and issues related to participation in occupational activities, alongside the needs for social support. Interview transcripts were analysed using qualitative content analysis. RESULTS Four categories emerged from the analysed interviews: (1) Being involved in an occupational environment fulfils a need for social contact, (2) Occupational activities must be clear and within interest (3) Self-confidence and daily routines are prerequisites for occupational participation (4) Having a lifeline providing continuous support is important. CONCLUSIONS Routines, interest and structure in everyday life are important to engage in occupational activities. There is a need for continuous support from a trusted person to establish and maintain healthy daily routines. Occupational specialists can be a vital resource, as they possess specific knowledge on the possibilities for occupation, and additionally, they can fulfil the young adults' needs for continuous support. There is a need for studies questioning how some young adults with ADHD fulfil their work role despite executive impairments. Focusing on executive functioning can be a valuable supplement to the focus on specific diagnoses in research and practice.
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Affiliation(s)
- Cecilie N Lyhne
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | - Claus V Nielsen
- Department of Public Health, Aarhus University, Aarhus, Denmark.,DEFACTUM, Central Denmark Region, Aarhus, Denmark.,Department of Social Medicine and Rehabilitation, Regional Hospital West Jutland, Central Denmark Region, Herning, Denmark
| | - Merete B Bjerrum
- Department of Public Health, Aarhus University, Aarhus, Denmark.,The Centre of Clinical Guidelines - Danish National Clearing House, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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20
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Schaffernicht SK, Moder K, Quendler E. Evaluation of a profile comparison system for the inclusion of people with disabilities in horticulture: A case study in Austria. Work 2021; 68:483-490. [PMID: 33522995 DOI: 10.3233/wor-203389] [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 To promote the successful and sustainable inclusion of people with disabilities in different activities such as work, more precise job matching efforts may be of value, especially because people with disabilities are employed at a lower rate than people without disabilities. Requirement profiles as well as profile comparisons have not yet been recorded for horticultural work processes. OBJECTIVE The aim of this study was to document precisely the work process of the cuttings production of the flower tradescantia and to compare the capabilities of people with disabilities with the requirements for this work process for the purpose of verifying that the tool employed was usable. METHODS A skilled worker performed the cuttings production of tradescantias according to good horticultural practice. Additionally, five people with disabilities participated in this study. On the one hand, a structured questionnaire was used to collect the data. On the other hand, the work processes were documented with video recordings and described related to REFA (Association for Work Design, Business Organization and Corporate Development) and evaluated according to IMBA (Integration of People with Disabilities into the Working Environment). RESULTS Apart from the too long working hours, the work in the cuttings production was feasible for the five subjects who had different types of disabilities. There were situations of underchallenges of different degrees, but no overchallenges. It was necessary to assess each subject individually for the risk of accident. CONCLUSIONS IMBA proved to be an effective tool to evaluate and analyse work activities for the purpose of including people with disabilities into horticultural work processes. Thus, it has the potential to facilitate a socially sustainable and skill-oriented work participation for persons with disabilities.
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Affiliation(s)
| | - Karl Moder
- University of Natural Resources and Life Sciences, Institute of Applied Statistics and Computing, Vienna, Austria
| | - Elisabeth Quendler
- University of Natural Resources and Life Sciences, Institute of Agricultural Engineering, Vienna, Austria
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21
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van der Mei SF, Alma MA, de Rijk AE, Brouwer S, Gansevoort RT, Franssen CFM, Bakker SJL, Hemmelder MH, Westerhuis R, van Buren M, Visser A. Barriers to and Facilitators of Sustained Employment: A Qualitative Study of Experiences in Dutch Patients With CKD. Am J Kidney Dis 2021; 78:780-792. [PMID: 34118302 DOI: 10.1053/j.ajkd.2021.04.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 04/02/2021] [Indexed: 02/06/2023]
Abstract
RATIONALE & OBJECTIVE Although patients with chronic kidney disease (CKD) are at risk for work disability and loss of employment, not all experience work disruption. We aimed to describe the barriers to and facilitators of sustained employment experienced by Dutch patients with CKD. STUDY DESIGN Qualitative study using semistructured interviews. SETTING & PARTICIPANTS 27 patients with CKD glomerular filtration rate categories 3b-5 (G3b-G5) from 4 nephrology outpatient clinics in The Netherlands. ANALYTICAL APPROACH Content analyses with constant comparison of interview data based on the International Classification of Functioning, Disability and Health framework. RESULTS Participants were 6 patients with CKD G3b-G4, 8 patients receiving maintenance dialysis, and 13 patients with functioning kidney transplants. We identified health-related barriers (symptoms, physical toll of dialysis/transplantation, limited work capacity) and facilitators (few physical symptoms, successful posttransplantation recovery, absence of comorbidities, good physical condition), personal barriers (psychological impact, limited work experience) and facilitators (positive disposition, job satisfaction, work attitude, person-job fit), and environmental barriers and facilitators. Environmental barriers were related to nephrology care (waiting time, use of a hemodialysis catheter) and work context (reorganization, temporary contract, working hours, physical demands); environmental facilitators were related to nephrology care (personalized dialysis, preemptive transplant), work context (large employer, social climate, job requiring mental rather than physical labor, flexible working hours, adjustment of work tasks, reduced hours, remote working, support at work, peritoneal dialysis exchange facility), and support at home. Occupational health services and social security could be barriers or facilitators. LIMITATIONS The study sample of Dutch patients may limit the transferability of these findings to other countries. CONCLUSIONS The wide range of barriers and facilitators in all International Classification of Functioning, Disability and Health components suggests great diversity among patients and their circumstances. These findings underline the importance of personalized nephrology and occupational health care as well as the importance of individually tailored workplace accommodations to promote sustained employment for patients with CKD.
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Affiliation(s)
| | - Manna A Alma
- Department of Health Sciences, Applied Health Research, Groningen
| | - Angelique E de Rijk
- Department of Social Medicine, CAPHRI Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht
| | - Sandra Brouwer
- Department of Health Sciences, Community and Occupational Medicine, Groningen
| | | | | | | | - Marc H Hemmelder
- Department of Internal Medicine, Medical Centre Leeuwarden, Leeuwarden
| | - Ralf Westerhuis
- University Medical Center Groningen, University of Groningen; Dialysis Center Groningen, Groningen
| | - Marjolijn van Buren
- Department of Internal Medicine, HagaHospital, The Hague; Department of Nephrology, Leiden University Medical Center, Leiden, The Netherlands
| | - Annemieke Visser
- Department of Health Sciences, Applied Health Research, Groningen
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22
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Sengers JH, Abma FI, Wilming L, Roelofs PDDM, Heerkens YF, Brouwer S. Content Validation of a Practice-Based Work Capacity Assessment Instrument Using ICF Core Sets. JOURNAL OF OCCUPATIONAL REHABILITATION 2021; 31:293-315. [PMID: 32803465 PMCID: PMC8172508 DOI: 10.1007/s10926-020-09918-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE A shift from providing long-term disability benefits to promoting work reintegration of people with remaining work capacity in many countries requires new instruments for work capacity assessments. Recently, a practice-based instrument addressing biopsychosocial aspects of functioning, the Social Medical Work Capacity instrument (SMWC), was developed. Our aim was to examine the content validity of the SMWC using ICF core sets. METHODS First, we conducted a systematic search to identify relevant ICF core sets for the working age population. Second the content of these core sets were mapped to assess the relevance and comprehensiveness of the SMWC. Next, we compared the content of the SMWC with the ICF-core sets. RESULTS Two work-related core sets and 31 disease-specific core sets were identified. The SMWC and the two work-related core sets overlap on 47 categories. Compared to the work-related core sets, the Body Functions and Activities and Participation are well represented in the new instrument, while the component Environmental factors is under-represented. Compared to the disease-specific core sets, items related to the social and domestic environmental factors are under-represented, while the SMWC included work-related factors complementary to the ICF. CONCLUSION The SMWC content seems relevant, but could be more comprehensive for the purpose of individual work capacity assessments. To improve assessing relevant biopsychosocial aspects, it is recommended to extend the instrument by adding personal and environmental (work- and social-related) factors as well as a more tailored use of the SMWC for assessing work capacity of persons with specific diseases or underlying illness.
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Affiliation(s)
- Johan H Sengers
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Dutch Social Security Institute: Institute for Employee Benefits Schemes (UWV), Amsterdam, The Netherlands
- Research Centre for Insurance Medicine, AMC-UMCG-UWV-VUMC, Amsterdam, The Netherlands
| | - Femke I Abma
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
- Research Centre for Insurance Medicine, AMC-UMCG-UWV-VUMC, Amsterdam, The Netherlands.
| | - Loes Wilming
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Research Centre for Insurance Medicine, AMC-UMCG-UWV-VUMC, Amsterdam, The Netherlands
| | - Pepijn D D M Roelofs
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Research Centre for Insurance Medicine, AMC-UMCG-UWV-VUMC, Amsterdam, The Netherlands
| | - Yvonne F Heerkens
- HAN University of Applied Sciences, Nijmegen, The Netherlands
- Dutch Institute of Allied Health Care, Amersfoort, The Netherlands
| | - Sandra Brouwer
- Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Research Centre for Insurance Medicine, AMC-UMCG-UWV-VUMC, Amsterdam, The Netherlands
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23
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Newman-Griffis D, Fosler-Lussier E. Automated Coding of Under-Studied Medical Concept Domains: Linking Physical Activity Reports to the International Classification of Functioning, Disability, and Health. Front Digit Health 2021; 3:620828. [PMID: 33791684 PMCID: PMC8009547 DOI: 10.3389/fdgth.2021.620828] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 02/16/2021] [Indexed: 11/13/2022] Open
Abstract
Linking clinical narratives to standardized vocabularies and coding systems is a key component of unlocking the information in medical text for analysis. However, many domains of medical concepts, such as functional outcomes and social determinants of health, lack well-developed terminologies that can support effective coding of medical text. We present a framework for developing natural language processing (NLP) technologies for automated coding of medical information in under-studied domains, and demonstrate its applicability through a case study on physical mobility function. Mobility function is a component of many health measures, from post-acute care and surgical outcomes to chronic frailty and disability, and is represented as one domain of human activity in the International Classification of Functioning, Disability, and Health (ICF). However, mobility and other types of functional activity remain under-studied in the medical informatics literature, and neither the ICF nor commonly-used medical terminologies capture functional status terminology in practice. We investigated two data-driven paradigms, classification and candidate selection, to link narrative observations of mobility status to standardized ICF codes, using a dataset of clinical narratives from physical therapy encounters. Recent advances in language modeling and word embedding were used as features for established machine learning models and a novel deep learning approach, achieving a macro-averaged F-1 score of 84% on linking mobility activity reports to ICF codes. Both classification and candidate selection approaches present distinct strengths for automated coding in under-studied domains, and we highlight that the combination of (i) a small annotated data set; (ii) expert definitions of codes of interest; and (iii) a representative text corpus is sufficient to produce high-performing automated coding systems. This research has implications for continued development of language technologies to analyze functional status information, and the ongoing growth of NLP tools for a variety of specialized applications in clinical care and research.
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Affiliation(s)
- Denis Newman-Griffis
- Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA, United States
- Epidemiology & Biostatistics Section, Rehabilitation Medicine Department, National Institutes of Health Clinical Center, Bethesda, MD, United States
| | - Eric Fosler-Lussier
- Department of Computer Science and Engineering, The Ohio State University, Columbus, OH, United States
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24
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Hutting N, Boucaut R, Gross DP, Heerkens YF, Johnston V, Skamagki G, Stigmar K. Work-Focused Health Care: The Role of Physical Therapists. Phys Ther 2020; 100:2231-2236. [PMID: 32929495 DOI: 10.1093/ptj/pzaa166] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/23/2020] [Accepted: 08/21/2020] [Indexed: 01/21/2023]
Affiliation(s)
- Nathan Hutting
- School of Organisation and Development, Research Group Occupation and Health, HAN University of Applied Sciences, PO Box 6960, 6503 GL Nijmegen, the Netherlands
| | - Rose Boucaut
- Allied Health & Human Performance, University of South Australia, Adelaide, Australia
| | - Douglas P Gross
- Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada
| | - Yvonne F Heerkens
- School of Organisation and Development, Research Group Occupation and Health, HAN University of Applied Sciences
| | - Venerina Johnston
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Glykeria Skamagki
- School of Health, Physiotherapy, Coventry University, Coventry, United Kingdom
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25
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Sykes CR, Maribo T, Stallinga HA, Heerkens Y. Remodeling of the ICF: A commentary. Disabil Health J 2020; 14:100978. [PMID: 32863192 DOI: 10.1016/j.dhjo.2020.100978] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 07/22/2020] [Accepted: 07/23/2020] [Indexed: 10/23/2022]
Abstract
Since its publication in 2001 the International Classification of Functioning, Disability and Health (ICF) has attracted debate about the content and the model presented. After almost 20 years use, regular updating since 2008 and with the prospect of a new edition in 2020 there is increasing interest in the ICF as a tool to meet contemporary information requirements. Information on functioning is important across not only health systems, but all areas where change in functioning is important: education, employment, and social welfare for example. This commentary responds to the issues raised in a commentary by Mitra & Shakespeare in 2019 and supports review of the ICF in the current context by informing users and providers of data on human functioning how they might engage in the maintenance, updating, and modernisation of the ICF.
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Affiliation(s)
- Catherine R Sykes
- University of Sydney, 75 East Street, Lidcombe, NSW, 2141, Australia.
| | | | | | - Yvonne Heerkens
- Dutch Institute of Allied Health Care (NPi), Amersfoort, the Netherlands; HAN University of Applied Sciences, Nijmegen, the Netherlands
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26
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Black ME, Matthews LR, Millington MJ. Issues facing employability assessment in total and permanent disability insurance claims: A rehabilitation perspective. Work 2019; 64:569-577. [PMID: 31683498 DOI: 10.3233/wor-193018] [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 Expert employment information helps life insurers to decide total and permanent disability claims. The employability assessment model was developed a decade ago by rehabilitation counselors and has not been critically examined. OBJECTIVE This exploratory descriptive study aims to elicit key issues of employability assessment within Australian life insurance. METHODS Ten rehabilitation advisors with knowledge of employability assessment in the total and permanent disability sector participated in a single focus group. They each nominated issues of concern about employability assessment. These issues were collated then discussed within the group. Qualitative thematic analysis was used to identify key issues. RESULTS The predominant theme was the forensic nature of employment evidence. There were three categories of key issues. First, assessment providers- their training, qualifications, experience, and role. Second, methodology- approaches that provide most realistic information about a claimant's likelihood of work. Third, policy definitions that illustrate reliance on legal interpretation of employability. CONCLUSIONS To withstand legal scrutiny, the credentials of providers, assessment methodology, and quality of forensic reports are key issues which need to be addressed. This foundational study will contribute to broader research on this topic, with implications particularly for rehabilitation, life insurance, and claimants.
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Affiliation(s)
- Margaret E Black
- Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW, Australia
| | - Lynda R Matthews
- Faculty of Health Sciences, The University of Sydney, Lidcombe, NSW, Australia
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27
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Cauter JVD, Bacquer DD, Clays E, Smedt DD, Kotseva K, Braeckman L. Return to work and associations with psychosocial well-being and health-related quality of life in coronary heart disease patients: Results from EUROASPIRE IV. Eur J Prev Cardiol 2019; 26:1386-1395. [DOI: 10.1177/2047487319843079] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Coronary heart disease (CHD) can lead to loss of workability and early retirement. We aimed to investigate return to work (RTW) and its relationship towards psychosocial well-being and health-related quality of life (HRQoL). Design Secondary analyses were applied to cross-sectional data from the EUROASPIRE IV survey (European Action on Secondary and Primary prevention through Intervention to Reduce Events). Methods Participants were examined and interviewed at 6–36 months following the recruiting event. Psychosocial well-being and HRQoL were evaluated by completing the ‘Hospital Anxiety and Depression Scale’ and ‘HeartQoL’ questionnaire. Using generalised mixed models, we calculated the odds ratios for RTW. Depression, anxiety and adjusted means of HeartQoL were estimated accounting for RTW. Results Out of 3291 employed patients, the majority (76.0%) returned to work, of which 85.6% were men, but there was a general underrepresentation of women. Young ( p < 0.001), high-educated ( p < 0.001) patients without prior cardiovascular events ( p < 0.05) were better off regarding RTW. No significant associations with CHD risk factors and cardiac rehabilitation were established. Those that rejoined the workforce were less susceptible to psychosocial distress (anxiety/depression, p < 0.001) and experienced a better quality of life ( p < 0.001). Conclusion These findings provide evidence that non-modifiable factors (sociodemographic factors, cardiovascular history), more than classical risk factors, are associated with RTW, and that patients who resume work display better psychosocial well-being and HRQoL. Our results illustrate a need for tailored cardiac rehabilitation with a focus on work-related aspects, mental health and HRQoL indicators to reach sustainable RTW, especially in vulnerable groups like less educated and elderly patients.
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Affiliation(s)
- Joy Van de Cauter
- Department of Public Health and Primary Care, Ghent University, Gent, Belgium
| | - Dirk De Bacquer
- Department of Public Health and Primary Care, Ghent University, Gent, Belgium
| | - Els Clays
- Department of Public Health and Primary Care, Ghent University, Gent, Belgium
| | - Delphine De Smedt
- Department of Public Health and Primary Care, Ghent University, Gent, Belgium
| | - Kornelia Kotseva
- Department of Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, London, UK
| | - Lutgart Braeckman
- Department of Public Health and Primary Care, Ghent University, Gent, Belgium
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28
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Ansuategui Echeita J, Bethge M, van Holland BJ, Gross DP, Kool J, Oesch P, Trippolini MA, Chapman E, Cheng ASK, Sellars R, Spavins M, Streibelt M, van der Wurff P, Reneman MF. Functional Capacity Evaluation in Different Societal Contexts: Results of a Multicountry Study. JOURNAL OF OCCUPATIONAL REHABILITATION 2019; 29:222-236. [PMID: 29802582 PMCID: PMC6510856 DOI: 10.1007/s10926-018-9782-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Purpose To examine factors associated with Functional Capacity Evaluation (FCE) results in patients with painful musculoskeletal conditions, with focus on social factors across multiple countries. Methods International cross-sectional study was performed within care as usual. Simple and multiple multilevel linear regression analyses which considered measurement's dependency within clinicians and country were conducted: FCE characteristics and biopsychosocial variables from patients and clinicians as independent variables; and FCE results (floor-to-waist lift, six-minute walk, and handgrip strength) as dependent variables. Results Data were collected for 372 patients, 54 clinicians, 18 facilities and 8 countries. Patients' height and reported pain intensity were consistently associated with every FCE result. Patients' sex, height, reported pain intensity, effort during FCE, social isolation, and disability, clinician's observed physical effort, and whether FCE test was prematurely ended were associated with lift. Patient's height, Body Mass Index, post-test heart-rate, reported pain intensity and effort during FCE, days off work, and whether FCE test was prematurely ended were associated with walk. Patient's age, sex, height, affected body area, reported pain intensity and catastrophizing, and physical work demands were associated with handgrip. Final regression models explained 38‒65% of total variance. Clinician and country random effects composed 1-39% of total residual variance in these models. Conclusion Biopsychosocial factors were associated with every FCE result across multiple countries; specifically, patients' height, reported pain intensity, clinician, and measurement country. Social factors, which had been under-researched, were consistently associated with FCE performances. Patients' FCE results should be considered from a biopsychosocial perspective, including different social contexts.
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Affiliation(s)
- Jone Ansuategui Echeita
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, P.O. Box 30.002, 9750 RA, Haren, Groningen, The Netherlands.
| | - Matthias Bethge
- Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - Berry J van Holland
- Institute for Sports Studies, Hanze University of Applied Sciences, Groningen, The Netherlands
| | - Douglas P Gross
- Department of Physical Therapy, University of Alberta, Edmonton, AB, Canada
| | - Jan Kool
- Rehabilitation Centre Valens, Valens, Switzerland
| | - Peter Oesch
- Rehabilitation Centre Valens, Valens, Switzerland
| | - Maurizio A Trippolini
- Center for Disability Research, Liberty Mutual Research Institute for Safety, Hopkinton, Boston, USA
- PhD in Rehabilitation Sciences Program, Institute for Health Professions, Massachusetts General Hospital (MGH), Charlestown, Boston, USA
- Department of Work Rehabilitation, Rehaklinik Bellikon, Suva Care, Bellikon, Switzerland
| | | | - Andy S K Cheng
- Ergonomics and Human Performance Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | | | | | - Marco Streibelt
- Department of Rehabilitation, German Federal Pension Insurance, Berlin, Germany
| | - Peter van der Wurff
- Research & Development, Military Rehabilitation Center Aardenburg, Doorn, The Netherlands
- Institute for Human Movement Studies, HU University of Applied Sciences, Utrecht, The Netherlands
| | - Michiel F Reneman
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, P.O. Box 30.002, 9750 RA, Haren, Groningen, The Netherlands
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29
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de Brouwer CPM, van Amelsvoort LGPM, Heerkens YF, Widdershoven GAM, Kant IJ. Implementing the ICF in Occupational Health; building a curriculum as an exemplary case. Work 2018; 57:173-186. [PMID: 28527235 DOI: 10.3233/wor-172548] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND This paper addresses the need for a paradigm shift from post-diagnosis tertiary care towards maintenance and promotion of health across the lifespan, for healthcare in general and in occupational healthcare specifically. It is based on the assumption that the realization of this paradigm shift may be facilitated by teaching (future) occupational health professionals to use the International Classification of Functioning, Disability and Health (ICF). OBJECTIVE Describing the development of a an ICF based occupational health curriculum. METHODS Grafting a training trajectory in the ICF for educating the biopsychosocial health paradigm, onto a training trajectory in the Critical Appraisal of a Topic (CAT), a method for teaching evidence based practice skills. RESULTS The development process of the training trajectories in the master program Work, Health, and Career at Maastricht University is described as an example of an intervention for shifting the paradigm in healthcare curricula. The expected results are a shift from the biomedical towards the biopsychosocial paradigm, a reductionist approach towards a more holistic view on cases, a reactive way of working towards a more proactive work style, and from using a merely quantifiable evidence base towards using a broad evidence base. CONCLUSIONS Incorporating the biopsychosocial paradigm into the assessment and scientific reasoning skills of students is not only valuable in occupational healthcare but might be a valuable approach for all disciplines in healthcare for which contextual factors are important e.g. rehabilitation, psychiatry and nutritional science.
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Affiliation(s)
- Carin P M de Brouwer
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Ludovic G P M van Amelsvoort
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Yvonne F Heerkens
- Research Group Occupation and Health, HAN University of Applied Sciences, Nijmegen, The Netherlands and Dutch Institute of Allied Health Care, Amersfoort, The Netherlands
| | - Guy A M Widdershoven
- Department of Medical Humanities, VU University Medical Center, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - IJmert Kant
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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30
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van Amelsvoort LGPM, de Brouwer CPM, Heerkens YF, Widdershoven GAM, Kant IJ. Fostering functioning of workers: A new challenge for prevention in occupational health. Work 2018; 57:153-156. [PMID: 28582941 DOI: 10.3233/wor-172549] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Given large changes in working conditions and society, occupational health care has to prioritize its efforts towards fostering health and functioning of workers and as such promote work participation. This requires that more emphasis is given on the application of biopsychological models in the care of workers. Although a biopsychological approach is often mentioned as essential part of occupational health care, it's application is often hampered in practice, by practical barriers and lack of practical knowledge. This is illustrated by a study that uncovered facilitating and hindering factors in the implementation process of a preventive strategy, proven effective in reducing the risk of long term sickness absence. To facilitate the use of biopsychological models in occupational health care, it is shown that setting up a training curriculum is possible, based on the International Classification of Functioning, Disability and Health (ICF) grafted on available training in evidence based practice skills is possible. Furthermore, there is a need for elaboration of the personal factors relevant for workers and the relevant work-related environmental factors to support practical application of ICF in occupational health care. A paradigm shift in occupational health care can facilitate widespread implementation of the biopsychosocial approach in occupational health and may stimulate occupational health professionals to further integrate this approach in their daily practice.
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Affiliation(s)
- Ludovic G P M van Amelsvoort
- Department of Epidemiology, Program of Functioning and Rehabilitation, CAPRHI School of Public Health, Maastricht University, Maastricht, The Netherlands
| | - Carin P M de Brouwer
- Department of Epidemiology, Program of Functioning and Rehabilitation, CAPRHI School of Public Health, Maastricht University, Maastricht, The Netherlands
| | - Yvonne F Heerkens
- Research Group Occupation & Health, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Guy A M Widdershoven
- Department of Medical Humanities, VU University Medical Center, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - IJmert Kant
- Department of Epidemiology, Program of Functioning and Rehabilitation, CAPRHI School of Public Health, Maastricht University, Maastricht, The Netherlands
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31
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de Brouwer CPM, Verdonk P, van Amelsvoort LGPM, Jansen NWH, Kant IJ, Widdershoven GAM. Experiences of occupational physicians with the implementation of indicated prevention for long term sickness absence. Work 2018; 57:157-172. [PMID: 28582940 DOI: 10.3233/wor-172547] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Functioning including work participation, is an emerging challenge in occupational health. The prevention of long term sickness absence (LTSA) through a strategy involving screening and structured early consultation (preventive strategy) was proven effective and can address participation issues. Implementation of this strategy has proven difficult. OBJECTIVE The aim of this study is to investigate the experiences of occupational physicians (OPs) delivering a structured early consultation to office workers, in order to enhance implementation of the strategy. METHODS In this case study, a mixed method design was used. Interviews and surveys were conducted to obtain an in-depth picture of OPs experiences. RESULTS Factors hindering implementation in relation to the OPs were difficulties in communicating the risk of future sick leave, prioritization of other tasks, maintaining a reactive approach due to work pressure, preference for prevention on the level of the work environment, privacy issues related to labeling workers to have mental or psychosocial issues, and the biomedical model being the mental model in use. CONCLUSIONS Implementation of the preventive strategy seems to require a more profound focus on the biopsychosocial approach. Training of relevant skills is important to achieve a focus on prevention and fostering health over the lifespan.
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Affiliation(s)
- Carin P M de Brouwer
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Petra Verdonk
- Department of Medical Humanities, VU University Medical Center, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Ludovic G P M van Amelsvoort
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Nicole W H Jansen
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - IJmert Kant
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Guy A M Widdershoven
- Department of Medical Humanities, VU University Medical Center, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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32
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Kant IJ, van Amelsvoort LG. Applying a biopsychosocial perspective in occupational health: Easier said than done! Work 2017; 57:149-151. [DOI: 10.3233/wor-172550] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- IJmert Kant
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Ludovic G.P.M. van Amelsvoort
- Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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