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de Geus CJC, Huysmans MA, van Rijssen HJ, de Maaker-Berkhof M, Schoonmade LJ, Anema JR. Elements of Return-to-Work Interventions for Workers on Long-Term Sick Leave: A Systematic Literature Review. JOURNAL OF OCCUPATIONAL REHABILITATION 2024:10.1007/s10926-024-10203-0. [PMID: 38849612 DOI: 10.1007/s10926-024-10203-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/21/2024] [Indexed: 06/09/2024]
Abstract
PURPOSE The aim of this systematic review is to identify vocational rehabilitation (VR) interventions that are effective to enhance return-to-work (RTW) for people on long-term sick leave (> 90 days) and to identify main elements of these interventions. METHODS Six electronic databases were searched for peer-reviewed studies published up to February 2022. Each article was screened independently by two different reviewers. Thereafter, one author performed the data-extraction which was checked by another author. The EPHPP quality assessment tool was used to appraise the methodological quality of the studies. RESULTS 11.837 articles were identified. 21 articles were included in the review, which described 25 interventions. Results showed that ten interventions were more effective than usual care on RTW. Two interventions had mixed results. The effective interventions varied widely in content, but were often more extensive than usual care. Common elements of the effective interventions were: coaching, counseling and motivational interviewing, planning return to work, placing the worker in work or teaching practical skills and advising at the workplace. However, these elements were also common in interventions that were not effective on RTW compared to usual care and can therefore not explain why certain interventions are effective and others are not. CONCLUSION The effective interventions included in this study were often quite extensive and aimed at multiple phases of the RTW-process of the worker. In the future, researchers need to describe the population and the content of the investigated interventions more elaborate to be able to better compare VR interventions and determine what elements make interventions effective.
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Affiliation(s)
- Christa J C de Geus
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van Der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
- Research Centre for Insurance Medicine, AMC-UMCG-VUmc-UWV, Amsterdam, The Netherlands
| | - Maaike A Huysmans
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van Der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
- Research Centre for Insurance Medicine, AMC-UMCG-VUmc-UWV, Amsterdam, The Netherlands.
| | - H Jolanda van Rijssen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van Der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
- Dutch Institute of Employee Benefit Schemes (UWV), Amsterdam, The Netherlands
- Research Centre for Insurance Medicine, AMC-UMCG-VUmc-UWV, Amsterdam, The Netherlands
| | - Marianne de Maaker-Berkhof
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van Der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
- Research Centre for Insurance Medicine, AMC-UMCG-VUmc-UWV, Amsterdam, The Netherlands
| | - Linda J Schoonmade
- University Library, Vrije Universiteit Amsterdam NL, De Boelelaan 1117, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Johannes R Anema
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van Der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
- Research Centre for Insurance Medicine, AMC-UMCG-VUmc-UWV, Amsterdam, The Netherlands
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de Geus CJC, van Rijssen HJ, de Graaf-Zijl M, Anema JR, Huysmans MA. Tailored vocational rehabilitation for people with a work disability pension in The Netherlands; an in-depth data analysis of the content and outcomes of vocational rehabilitation trajectories of the Social Security Institute. Disabil Rehabil 2024:1-8. [PMID: 38515281 DOI: 10.1080/09638288.2024.2328335] [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: 04/06/2023] [Accepted: 03/02/2024] [Indexed: 03/23/2024]
Abstract
PURPOSE People with a work disability pension receive vocational rehabilitation (VR) services from the Dutch Social Security Institute (SSI) in order to facilitate return-to-work (RTW). The SSI offers tailored VR existing of two trajectories (aimed at getting fit for work or aimed at returning to work). The purpose of this study is to describe the current practice of VR. This includes a description of client characteristics, RTW barriers and the intensity, duration, content and the outcomes of the offered trajectories. MATERIALS AND METHODS We analyzed data from 197 clients that were randomly selected from clients who attended a VR trajectory between 1 January t 2017 and 31 December 2018. Data were obtained from the SSI registration databases and client files. RESULTS Both VR trajectories at the SSI have a different aim, but in practice the content of the VR interventions often overlaps. Around half of both trajectories reached their goal. Reasons for unsuccessful trajectories were that the client did not find work or barriers were more complex than initially assessed. CONCLUSIONS The SSI delivers tailored VR to the specific needs of the client, however substantiations for why a certain VR intervention is offered are limited. Guidelines are needed to support professionals.
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Affiliation(s)
- Christa J C de Geus
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Research Center for Insurance Medicine, AMC-UMCG-VUmc-UWV, Amsterdam, The Netherlands
| | - H Jolanda van Rijssen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Research Center for Insurance Medicine, AMC-UMCG-VUmc-UWV, Amsterdam, The Netherlands
- UWV, Dutch Institute of Employee Benefit Schemes (UWV), Amsterdam, The Netherlands
| | | | - Johannes R Anema
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Research Center for Insurance Medicine, AMC-UMCG-VUmc-UWV, Amsterdam, The Netherlands
| | - Maaike A Huysmans
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Research Center for Insurance Medicine, AMC-UMCG-VUmc-UWV, Amsterdam, The Netherlands
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LoMartire R, Johansson P, Frumento P. Sickness Absence and Disability Pension Among Patients With Chronic Pain in Interdisciplinary Treatment or Unspecified Interventions. THE JOURNAL OF PAIN 2023; 24:2003-2013. [PMID: 37348775 DOI: 10.1016/j.jpain.2023.06.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 06/07/2023] [Accepted: 06/09/2023] [Indexed: 06/24/2023]
Abstract
Interdisciplinary treatment is a widely implemented strategy for the rehabilitation of patients with chronic pain. A primary treatment objective is to decrease the load on the social insurance system; however, it is questionable whether interdisciplinary treatment reduces sickness absence and disability pension (SA/DP). This register-based observational study compared SA and DP between patients in interdisciplinary treatment and unspecified interventions. With data from 7,752 Swedish specialist health care patients in their prime working age, we analyzed total net SA/DP days over 3 years from the first visit to a pain rehabilitation center. A zero-one-inflated beta model, adjusted for theoretically substantiated confounders, was used to estimate the mean differences in total days and the proportions of patients with both zero and maximum days. Compared with unspecified interventions, interdisciplinary treatment resulted in a mean (95% confidence interval) absolute increase of 50 (37, 62) total days, a 13.0% (11.3%, 14.6%) decrease in patients with zero days, and a 1.5% (.2%, 2.8%) decrease in patients with the maximum days. These findings support that interdisciplinary treatment increases SA/DP compared to less intensive interventions but reduces the risk of maximum days, implying that it is advantageous for patients with the highest absence. This highlights the need for improved patient selection procedures and the adaptation of interdisciplinary treatment programs to more adequately target SA/DP reduction. PERSPECTIVES: This study provides an accessible overview of SA/DP among working-age patients with chronic pain in Swedish specialist health care. It also shows that interdisciplinary treatment does not decrease SA/DP more than alternative treatments in most patients but is advantageous for the patients with the longest absence.
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Affiliation(s)
- Riccardo LoMartire
- Center for Clinical Research Dalarna, Uppsala University, Falun, Region Dalarna, Sweden
| | - Per Johansson
- Department of Statistics, Uppsala University, Uppsala, Region Uppsala, Sweden; Yau Mathematical Science Center, Tsinghua University, Beijing, China
| | - Paolo Frumento
- Department of Political Sciences, University of Pisa, Pisa, Administrative Region of Tuscany, Italy
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Aili K, Hellman T, Svartengren M, Danielsson K. Including a Three-Party Meeting Using the Demand and Ability Protocol in an Interdisciplinary Pain Rehabilitation Programme for a Successful Return to Work Process. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16614. [PMID: 36554495 PMCID: PMC9778674 DOI: 10.3390/ijerph192416614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 12/07/2022] [Accepted: 12/08/2022] [Indexed: 06/17/2023]
Abstract
The Demand and Ability Protocol (DAP) is used in three-party meetings involving an employee, an employer, and a representative from the rehabilitation team. The aim of this study is to investigate the inclusion of an intervention using the DAP in an interdisciplinary pain rehabilitation programme (IPRP) compared to usual care. This non-randomised controlled trial included patients assigned to an IPRP in Sweden. The intervention group received a DAP intervention targeting their work situation in addition to the usual care provided by the IPRP. The control group received IPRP only. Outcome measures were collected from the Swedish Quality Registry for Pain Rehabilitation. Results demonstrated improvements in both groups regarding self-reported anxiety, depression and EQ5D. Sleep was improved in the intervention group but not in the control group. No statistical differences in outcomes were observed between the groups. In conclusion, adding the DAP intervention to IPRP seemed to have the potential to improve sleep among the patients, which may indicate an overall improvement regarding health outcomes from a longer perspective. The results were less clear, however, regarding the work-related outcomes of sickness absence and workability.
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Affiliation(s)
- Katarina Aili
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, 751 85 Uppsala, Sweden
- Department of Health and Sport, School of Health and Welfare, Halmstad University, 301 18 Halmstad, Sweden
| | - Therese Hellman
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, 751 85 Uppsala, Sweden
- Department of Occupational and Environmental Medicine, Uppsala University Hospital, 751 85 Uppsala, Sweden
| | - Magnus Svartengren
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, 751 85 Uppsala, Sweden
- Department of Occupational and Environmental Medicine, Uppsala University Hospital, 751 85 Uppsala, Sweden
| | - Katarina Danielsson
- Department of Medical Sciences, Psychiatry, Uppsala University, 751 85 Uppsala, Sweden
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5
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Svanholm F, Liedberg GM, Löfgren M, Björk M. Stakeholders' experience of collaboration in the context of interdisciplinary rehabilitation for patients with chronic pain aiming at return to work. Disabil Rehabil 2022; 44:8388-8399. [PMID: 35060831 DOI: 10.1080/09638288.2021.2018051] [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: 01/19/2023]
Abstract
BACKGROUND AND PURPOSE Chronic pain is a major reason for sick leave worldwide. Interdisciplinary pain rehabilitation programs (IPRPs), workplace interventions, and stakeholder collaboration may support patients in their return to work (RTW). Few studies have examined stakeholders' experiences of important components in the RTW rehabilitation process for patients with chronic pain, especially in the context of IPRP. This study explores and describes stakeholders' experiences with stakeholder collaboration and factors related to RTW for patients with chronic pain who have participated in IPRP. METHODS Six focus groups, three pair and four individual interviews were conducted with a total of 28 stakeholder representatives from three societal and three health care stakeholders. Data were analyzed using qualitative content analysis. RESULTS The participants revealed that stakeholder collaboration and a tailored RTW rehabilitation plan were important strategies although they noted that these strategies were not working sufficiently efficient as presently implemented. The different stakeholders' paradigms and organizational prerequisites were described as hindrances of such strategies and that the degree of tailoring depended on individual attitudes. CONCLUSIONS More knowledge transfer and flexibility, clearer responsibilities, and better coordination throughout the RTW rehabilitation process may increase the efficiency of stakeholder collaboration and support for patients.Implications for rehabilitationStakeholders need to have a close dialogue initiated before IPRP to be able to reach consensus and shared decision making in the RTW rehabilitation plan throughout the RTW rehabilitation process.Individually tailored solutions based on a thorough assessment of each patient's work ability and context are identified during IPRP and shall be included in the shared RTW rehabilitation plan.The responsibilities of the stakeholders need to be clarified and documented in the RTW rehabilitation plan.The role of RCs should be developed to improve the coordination throughout the patients' RTW rehabilitation process.
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Affiliation(s)
- Frida Svanholm
- Department of Health, Medicine and Caring Sciences, Pain and Rehabilitation Centre, Linköping University, Linköping, Sweden
| | - Gunilla M Liedberg
- Department of Health, Medicine and Caring Sciences, Pain and Rehabilitation Centre, Linköping University, Linköping, Sweden
| | - Monika Löfgren
- Department of Clinical Sciences, Department of Rehabilitation Medicine, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden
| | - Mathilda Björk
- Department of Health, Medicine and Caring Sciences, Pain and Rehabilitation Centre, Linköping University, Linköping, Sweden
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You DS, Ziadni MS, Hettie G, Darnall BD, Cook KF, Von Korff MR, Mackey SC. Comparing Perceived Pain Impact Between Younger and Older Adults With High Impact Chronic Pain: A Cross-Sectional Qualitative and Quantitative Survey. FRONTIERS IN PAIN RESEARCH (LAUSANNE, SWITZERLAND) 2022; 3:850713. [PMID: 35465295 PMCID: PMC9030949 DOI: 10.3389/fpain.2022.850713] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 03/07/2022] [Indexed: 01/19/2023]
Abstract
High impact chronic pain (HICP) is a recently proposed concept for treatment stratifying patients with chronic pain and monitoring their progress. The goal is to reduce the impact of chronic pain on the individual, their family, and society. The US National Pain Strategy defined HICP as the chronic pain associated with substantial restrictions on participation in work, social, and self-care activities for at least 6 months. To understand the meaning and characteristics of HICP from the younger (<65 years old) and older adults (≥65 years old) with chronic pain, our study examined patients' perceived pain impact between the two age groups. We also characterize the degree of pain impact, assessed with the Patient-Reported Outcomes Measurement Information System (PROMIS) pain interference (PI), between adults and older adults with HICP. We recruited patients at a tertiary pain clinic. The survey included open-ended questions about pain impact, the Graded Chronic Pain Scale-Revised to identify patients' meeting criteria for HICP, and the Patient-Reported Outcomes Measurement Information System (PROMIS®) 8-item PI short form (v.8a). A total of 55 younger adults (65.5% women, 72.7% HICP, mean age = 55.0 with SD of 16.2) and 28 older adults (53.6% women, 64.3% HICP, mean age = 72.6 with SD of 5.4) with chronic pain participated in this study. In response to an open-ended question in which participants were asked to list out the areas of major impact pain, those with HICP in the younger group most commonly listed work, social activity, and basic physical activity (e.g., walking and standing); for those in the older group, basic physical activity, instrumental activity of daily living (e.g., housework, grocery shopping), and participating in social or fun activity for older adults with HICP were the most common. A 2 × 2 ANOVA was conducted using age (younger adults vs. older adults) and HICP classification (HICP vs. No HICP). A statistically significant difference was found in the PROMIS-PI T-scores by HICP status (HICP: M = 58.4, SD = 6.3; No HICP: M = 67.8, SD = 6.3), but not by age groups with HICP. In conclusion, perceived pain impacts were qualitatively, but not quantitatively different between younger and older adults with HICP. We discuss limitations and offer recommendations for future research.
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Affiliation(s)
- Dokyoung S. You
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Maisa S. Ziadni
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Gabrielle Hettie
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Beth D. Darnall
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
| | | | - Michael R. Von Korff
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
| | - Sean C. Mackey
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, United States,*Correspondence: Sean C. Mackey
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Coordination and Perceived Support for Return to Work: A Cross-Sectional Study among Patients in Swedish Healthcare. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074040. [PMID: 35409721 PMCID: PMC8997974 DOI: 10.3390/ijerph19074040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/21/2022] [Accepted: 03/26/2022] [Indexed: 12/02/2022]
Abstract
Background: Receiving support from a return-to-work (RTW) coordinator (RTWC) may be beneficial for people on long-term sick leave. The aim of this study was to investigate whether the number of contacts with an RTWC and their involvement in designing rehabilitation plans for the patients were associated with perceiving support for RTW, emotional response to the RTWC, and healthcare utilization. Methods: In this cross-sectional study, 274 patients who had recently been in contact with an RTWC in Swedish primary or psychiatric care answered questions regarding their interaction with an RTWC, perceived support for RTW, and emotional response to the RTWC. Results: Having more contact with an RTWC was associated with perceiving more support in the RTW process (adjusted OR 4.14, 95% CI 1.49–11.47). RTWC involvement in designing a rehabilitation plan for the patient was associated with perceiving more support in the RTW process from an RTWC and having a more positive emotional response to the RTWC. Conclusions: From the patient’s perspective, this study indicates that the involvement of an RTWC and receiving a rehabilitation plan that an RTWC has helped to design might be perceived as important in the RTW process.
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Larsson K, Hurtigh AL, Andersén ÅMV, Anderzén I. Vocational Rehabilitation Professionals’ Perceptions of Facilitators and Barriers to Return to Work: A Qualitative Descriptive Study. REHABILITATION COUNSELING BULLETIN 2021. [DOI: 10.1177/00343552211060013] [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]
Abstract
This is a qualitative descriptive study of professionals’ perceptions of facilitators and barriers for returning to work for women on long-term sick leave due to musculoskeletal pain and/or common mental disorder who participated in a vocational rehabilitation project. Data were collected through semi-structured interviews with 13 purposefully selected professionals from the Swedish Social Insurance Agency, the Swedish Public Employment Service, the health care services, and the municipal services. The interviews were analyzed with a manifest content analysis. The main facilitators were the close cooperation between the professionals and the individual support that was offered to the project participants. The main barriers were differences among the stakeholders’ missions and goals, limitation in project duration and within the labor market, and the project participants’ personal factors. These results emphasize the importance of cooperation between the professionals from the various stakeholders and focus on the individual’s resources and needs. The study highlights the value of including health care professionals in vocational rehabilitation to benefit from their specific knowledge of the target group and their strengths and needs. Moreover, the study highlights the need to incorporate collaboration with employers and align with the local labor market in the development of vocational rehabilitation interventions.
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Franz F, Surquin M, Fantoni Quinton SF, Leroyer A. Visites de reprise pour pathologies ostéoarticulaires ou troubles mentaux en Hauts-de-France : populations concernées, actions réalisées et facteurs liés à la décision d’inaptitude. ARCH MAL PROF ENVIRO 2021. [DOI: 10.1016/j.admp.2021.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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10
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LoMartire R, Björk M, Dahlström Ö, Constan L, Frumento P, Vixner L, Gerdle B, Äng BO. The value of interdisciplinary treatment for sickness absence in chronic pain: A nationwide register-based cohort study. Eur J Pain 2021; 25:2190-2201. [PMID: 34189810 DOI: 10.1002/ejp.1832] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Interdisciplinary treatment (IDT) is an internationally recommended intervention for chronic pain, despite inconclusive evidence of its effects on sickness absence. METHODS With data from 25,613 patients in Swedish specialist healthcare, we compared sickness absence, in the form of both sick leave and disability pensions, over a 5-year period between patients either allocated to an IDT programme or to other/no interventions (controls). To obtain population-average estimates, a Markov multistate model with theory-based inverse probability weights was used to compute both the proportion of patients on sickness absence and the total sickness absence duration. RESULTS IDT patients were more likely than controls to receive sickness absence benefits at any given time (baseline: 49% vs. 46%; 5-year follow-up: 36% vs. 35%), and thereby also had a higher total duration, with a mean (95% CI) of 67 (87, 48) more days than controls over the 5-year period. Intriguingly, sick leave was higher in IDT patients (563 [552, 573] vs. 478 [466, 490] days), whereas disability pension was higher in controls (152 [144, 160] vs. 169 [161, 178] days). CONCLUSION Although sickness absence decreased over the study period in both IDT patients and controls, we found no support for IDT decreasing sickness absence more than other/no interventions in chronic pain patients. SIGNIFICANCE In this large study of chronic pain patients in specialist healthcare, sickness absence is compared over a 5-year period between patients in an interdisciplinary treatment programme and other/no interventions. Sickness absence decreased over the study period in bothgroups; however, there was no support forthat it decreased more with interdisciplinary treatment than alternative interventions.
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Affiliation(s)
- Riccardo LoMartire
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.,Department of Research and Higher Education, Center for Clinical Research Dalarna, Uppsala University, Region Dalarna, Falun, Sweden
| | - Mathilda Björk
- Pain and Rehabilitation Centre, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Örjan Dahlström
- Department of Behavioural, Sciences and Learning, Linköping University, Linköping, Sweden
| | - Lea Constan
- Department of Arts and Crafts, Konstfack: University of Arts, Crafts and Design, Stockholm, Sweden
| | - Paolo Frumento
- Department of Political Sciences, University of Pisa, Pisa, Italy
| | - Linda Vixner
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Björn Gerdle
- Pain and Rehabilitation Centre, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Björn O Äng
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.,Department of Research and Higher Education, Center for Clinical Research Dalarna, Uppsala University, Region Dalarna, Falun, Sweden.,School of Health and Welfare, Dalarna University, Falun, Sweden
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McParland JL, Andrews P, Kidd L, Williams L, Flowers P. A scoping review to ascertain the parameters for an evidence synthesis of psychological interventions to improve work and wellbeing outcomes among employees with chronic pain. Health Psychol Behav Med 2021; 9:25-47. [PMID: 34104548 PMCID: PMC8158208 DOI: 10.1080/21642850.2020.1863809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background: Psychological interventions have mixed effects on improving employee outcomes, partly due to significant variability across studies and a lack of focus on mechanisms of action. This scoping review reports on the parameters of these interventions and examines intervention content to bring clarity to this heterogeneous topic area and direct future systematic review work. Method: Six databases were searched (Cinahl, Cochrane, Embase, Medline, PsychINFO and Web of Science) from April 2010 to August 2020, and a grey literature search was undertaken. Screening was undertaken independently by two authors. The results summarised country, participant and employment characteristics, psychological interventions and work, health and wellbeing outcomes. 10% of the papers were analysed to determine the feasibility of coding intervention descriptions for theory and behaviour change technique (BCT) components. Results: Database searches yielded 9341 titles, of which 91 studies were included. Most studies were conducted in Europe (78%) and included males and females (95%) ranging in age from 31-56.6 years although other demographic, and employment information was lacking. Musculoskeletal pain was common (87%). Psychological interventions commonly included cognitive behavioural therapy (30%) and education (28%). Most studies employed a randomised control trial design (64%). Over half contained a control group (54%). Interventions were delivered in mostly healthcare settings (72%) by health professionals. Multiple outcomes were often reported, many of which involved measuring sickness absence and return-to-work (62%) and pain and general health (53%). Within the feasibility analysis, most papers met the minimum criteria of containing one paragraph of intervention description, but none explicitly mentioned theory or BCTs. Conclusion: Psychological interventions for employees with chronic pain vary in their nature and implementation. We have shown scoping reviews can be used to assess the feasibility of applying tools from health psychology to identify the content of these interventions in future systematic review work to improve intervention development.
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Affiliation(s)
- Joanna L McParland
- Department of Psychology, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, UK
| | - Pamela Andrews
- Department of Psychology, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, UK
| | - Lisa Kidd
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, Scotland, UK
| | - Lynn Williams
- Department of Psychological Sciences and Health, Faculty of Humanities and Social Sciences, University of Strathclyde, Glasgow, Scotland, UK
| | - Paul Flowers
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland, UK
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Blank D, Brieger P, Hamann J. [Return to Work after Mental Disorders - A Scoping Review]. PSYCHIATRISCHE PRAXIS 2020; 48:119-126. [PMID: 33271622 DOI: 10.1055/a-1310-2591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Workers on sick-leave due to a mental disorder have enormous problems to return to work. The main objective of this review is to examine different return-to-work (RTW) interventions. METHODS We conduct a systematic literature research. RESULTS 88 articles were screened and 29 studies included. The included RTW-interventions build on different approaches: 1) individual, 2) workplace, 3) mental health services. The majority of the interventions showed positive effects on the return-to-work process. CONCLUSION Even if not all interventions could be readily transferred to the German context, the findings indicate ways improving the transition from the mental health system to the workplace.
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Affiliation(s)
- Daniela Blank
- kbo-Isar-Amper-Klinikum gGmbH, Akademisches Lehrkrankenhaus der LMU München, Akademisches Lehrkrankenhaus der LMU München
| | - Peter Brieger
- kbo-Isar-Amper-Klinikum gGmbH, Akademisches Lehrkrankenhaus der LMU München, Akademisches Lehrkrankenhaus der LMU München
| | - Johannes Hamann
- Klinik für Psychiatrie und Psychotherapie, Klinikum rechts der Isar, Technische Universität München
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Figueredo JM, García-Ael C, Gragnano A, Topa G. Well-Being at Work after Return to Work (RTW): A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207490. [PMID: 33076302 PMCID: PMC7602369 DOI: 10.3390/ijerph17207490] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/08/2020] [Accepted: 10/09/2020] [Indexed: 12/26/2022]
Abstract
Background: Employees’ well-being at work after the return to work (RTW) is considered a key aspect of rehabilitation and maintenance of workability. This systematic review aimed at identifying the common psychosocial factors that predict the subjective and psychological well-being in RTW processes after having a long-standing health problem or disability. Objective: To evaluate the subjective and psychological well-being at work of employees with chronic or long-standing health problems or those returning to work after any cause of disability. Data source: Systematic review of articles published in English or Spanish using PsycINFO, PsycARTICLES, MEDLINE, Psychology, and Behavioral Sciences Collection, and Pubpsych. An additional study was identified by contacting expert academics in the field. The search equations used included terms such as Return to Work, Long-Standing Health Problems or Disability, Work Health Balance, and job satisfaction or subjective well-being. Eligibility criteria for the studies: Studies that included a measure of employees’ well-being at work following return to work were selected for the review. Evaluation of the studies and synthesis methods: The studies were selected using predefined fields which included quality criteria. Results: Of the 264 articles returned by the initial search, a total of 20 were finally selected. Results were organized around the three different theoretical approaches for understanding RTW and its antecedents and consequences: (a) RTW and autonomy at work have a positive effect on psychological well-being; (b) job demand is linked to less job satisfaction, whereas a higher level on the work–health balance is associated with job satisfaction and work engagement; (c) internal and external support is linked to job satisfaction in the case of a disease. Limitations: The evidence provided by the results is restricted by the limited availability of studies focusing on well-being at work following return to work. Moreover, the studies identified are of different kinds, thereby preventing comparisons. Conclusions and implications of the main findings: Employees’ subjective well-being after return to work has received very little attention to date. Given its importance in the current configuration of the labor market, it should be the object of more research.
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Affiliation(s)
- José-María Figueredo
- International School of Doctorate, National Distance Education University (UNED), 28040 Madrid, Spain;
| | - Cristina García-Ael
- Department of Social and Organizational Psychology, National Distance Education University (UNED), 28040 Madrid, Spain;
| | - Andrea Gragnano
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy;
| | - Gabriela Topa
- Department of Social and Organizational Psychology, National Distance Education University (UNED), 28040 Madrid, Spain;
- Correspondence:
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Osaji J, Ojimba C, Ahmed S. The Use of Acceptance and Commitment Therapy in Substance Use Disorders: A Review of Literature. J Clin Med Res 2020; 12:629-633. [PMID: 33029268 PMCID: PMC7524566 DOI: 10.14740/jocmr4311] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 08/18/2020] [Indexed: 12/18/2022] Open
Abstract
Background Acceptance and commitment therapy (ACT) is a form of behavioral therapy that teaches people to learn to accept rather than avoid challenging situations in their lives. ACT has shown to be an intervention with great success in the reduction of various mental disorders and substance use disorders (SUDs). The core of ACT when used in SUD treatment is guiding people to accept the urges and symptoms associated with substance misuse (acceptance) and use psychological flexibility and value-based interventions to reduce those urges and the symptoms (commitment). The purpose of this study is to review the existing literature to examine the evidence on the use of ACT in the management of SUD. Methods A thorough search of four databases (CINAHL, PubMed.gov, PsycINFO and PsycNET) from 2011 to 2020 was conducted using search terms like ACT, ACT and SUD, ACT, and substance misuse. The articles retrieved were critically appraised using the Critically Appraised Topic (CAT) Checklist. Results Most of the studies showed that ACT was effective in the management of SUD showing significant evidence of a reduction in substance use or total discontinuation with subsequent abstinence. Conclusions The literature review concluded that success has been achieved using ACT either as monotherapy or in combination with other therapy in the treatment of individuals with SUD.
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Affiliation(s)
- Joy Osaji
- Texas Tech University Health Science Center, Lubbock, TX, USA
| | | | - Saeed Ahmed
- Rutland Regional Medical Center, Rutland, VT, USA
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Svanholm F, Liedberg GM, Löfgren M, Björk M. Factors of importance for return to work, experienced by patients with chronic pain that have completed a multimodal rehabilitation program – a focus group study. Disabil Rehabil 2020; 44:736-744. [DOI: 10.1080/09638288.2020.1780479] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Frida Svanholm
- Pain and Rehabilitation Center, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Gunilla Margareta Liedberg
- Pain and Rehabilitation Center, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Monika Löfgren
- Department of Clinical Sciences and Department of Rehabilitation Medicine, Karolinska Institute and Danderyd Hospital, Stockholm, Sweden
| | - Mathilda Björk
- Pain and Rehabilitation Center, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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de Miranda CB, Silva-Junior JS, Fernandes GA, Fischer FM. Trends in the Cumulative Incidence of Vocational Rehabilitation Indicators in Brazil, 2007-2016. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17113952. [PMID: 32503137 PMCID: PMC7313003 DOI: 10.3390/ijerph17113952] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 05/19/2020] [Accepted: 05/26/2020] [Indexed: 11/16/2022]
Abstract
Vocational rehabilitation (VR) aims at improving work ability to facilitate workers’ return to work. VR is provided in Brazil by the public social security system. The aim of the present study was to analyze trends in VR indicators for Brazil from 2007 to 2016. Based on open-access, secondary aggregate data, we calculated the cumulative incidence of VR indicators. We fitted Prais-Winsten generalized linear regression models to estimate trends and calculated annual percent variation with the corresponding 95% confidence interval (95% CI). The mean cumulative incidence of referrals to VR services was 37.16/1000 temporary disability benefits granted and exhibited a decreasing trend of −6.92% (95% CI: −8.38; −5.43). The mean cumulative incidence of admissions to VR services was 57.34/100 referrals and exhibited an increasing trend of 3.31% (95% CI: 1.13; 5.53). The mean cumulative incidence of rehabilitation was 57.43/100 admissions and remained stable along the analyzed period, −2.84 (95% CI: −5.87; 0.29). Our findings evidence a reduction in the number of workers referred for VR, an increase of admissions, and stability in the cumulative incidence of rehabilitated workers.
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Affiliation(s)
- Cristiano Barreto de Miranda
- Graduate Public Health Program, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil
- Correspondence:
| | - João Silvestre Silva-Junior
- Department of Medicine, São Camilo University Center, Av. Nazaré, 1501, Ipiranga, São Paulo 04263-200, Brazil;
| | - Gisele Aparecida Fernandes
- Group of Epidemiology and Statistics on Cancer, AC Camargo Cancer Center, Rua Tagua, 440, São Paulo 01508-010, Brazil;
| | - Frida Marina Fischer
- Department of Environmental Health, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil;
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Gaupp R, Walter M, Bader K, Benoy C, Lang UE. A Two-Day Acceptance and Commitment Therapy (ACT) Workshop Increases Presence and Work Functioning in Healthcare Workers. Front Psychiatry 2020; 11:861. [PMID: 33132922 PMCID: PMC7571517 DOI: 10.3389/fpsyt.2020.00861] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Accepted: 08/07/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND In this controlled naturalistic study performed in healthcare workers we examined the effect of a two-day acceptance commitment therapy (ACT) workshop on work presence and productivity, i.e. the influence the workshop had on treatment efficacy in a routine hospital care setting. AIM To examine the influence of ACT on productivity and presence in healthcare workers. METHOD Study participants were all healthcare workers (nurses, medical doctors, physiotherapists, social workers, and art therapists) of four inpatient wards for depression. Half of the healthcare workers attended the workshop. Measures were evaluated 3 months after the intervention in the study participants and the patients treated by them in the same time period. RESULTS A significantly higher treatment efficacy [as measured with HoNOS (Health of the nation outcome scales) change in the patients treated by the participants] has been observed in the healthcare workers who attended the ACT workshop when compared to the control group who did not attend the workshop. Moreover, the work presence of the participants of the ACT workshop was increased when compared with the time period before the intervention and with the presence of the control group. A cost analysis showed that ACT workshops lead to a significant return of investment for the employer as the costs for the workshop were ten times compensated by the increase of work presence in participants of the workshop. CONCLUSION These findings provide support that ACT interventions motivate healthcare workers to work and increase their patients' treatment quality. To our knowledge this is the first study showing an ACT workshop in healthcare workers can influence HoNOS outcome in the treated patients.
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Affiliation(s)
- Rainer Gaupp
- University Psychiatric Clinics (UPK) Basel, Basel, Switzerland
| | - Marc Walter
- University Psychiatric Clinics (UPK) Basel, Basel, Switzerland
| | - Klaus Bader
- University Psychiatric Clinics (UPK) Basel, Basel, Switzerland
| | - Charles Benoy
- University Psychiatric Clinics (UPK) Basel, Basel, Switzerland
| | - Undine E Lang
- University Psychiatric Clinics (UPK) Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland
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Rüsch N, Staiger T, Waldmann T, Dekoj MC, Brosch T, Gabriel L, Bahemann A, Oexle N, Klein T, Nehf L, Becker T. Efficacy of a peer-led group program for unemployed people with mental health problems: Pilot randomized controlled trial. Int J Soc Psychiatry 2019; 65:333-337. [PMID: 31056997 DOI: 10.1177/0020764019846171] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND People with long-term unemployment and mental health problems often find it difficult to take active steps toward help-seeking and job search and to navigate the complex system of available services. Likewise, job center staff would welcome interventions to improve the reintegration of long-term unemployed individuals with mental health problems into the labor market. AIM To examine the efficacy of a peer-led group program that supports unemployed people with mental health problems in terms of help-seeking, job search and recovery. METHODS Based on participatory research, a four-session group program was designed and evaluated in a pilot randomized controlled trial (RCT) with 42 participants, randomized to the program ( n = 23) or treatment as usual ( n = 19). Outcomes were assessed at baseline (T0), 3 weeks (T1), 6 weeks (T2) and 6 months later (T3). RESULTS There were no significant intervention effects on primary outcomes (job search self-efficacy and help-seeking). But compared to the control group, intervention participants showed significant improvements in depressive symptoms ( p = .02) and recovery ( p = .04) at T2 with medium effect sizes. There were trend-level positive program effects on self-stigma, hopelessness and secrecy. CONCLUSION This pilot RCT provides initial evidence for the efficacy of a peer-led group program to improve symptoms and recovery among unemployed participants with mental health problems.
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Affiliation(s)
- Nicolas Rüsch
- 1 Department of Psychiatry II, Ulm University and BKH Günzburg, Ulm, Germany
| | - Tobias Staiger
- 1 Department of Psychiatry II, Ulm University and BKH Günzburg, Ulm, Germany
| | - Tamara Waldmann
- 1 Department of Psychiatry II, Ulm University and BKH Günzburg, Ulm, Germany
| | | | - Thorsten Brosch
- 1 Department of Psychiatry II, Ulm University and BKH Günzburg, Ulm, Germany
| | - Lisa Gabriel
- 1 Department of Psychiatry II, Ulm University and BKH Günzburg, Ulm, Germany
| | | | - Nathalie Oexle
- 1 Department of Psychiatry II, Ulm University and BKH Günzburg, Ulm, Germany
| | - Thomas Klein
- 1 Department of Psychiatry II, Ulm University and BKH Günzburg, Ulm, Germany
| | - Luise Nehf
- 1 Department of Psychiatry II, Ulm University and BKH Günzburg, Ulm, Germany
| | - Thomas Becker
- 1 Department of Psychiatry II, Ulm University and BKH Günzburg, Ulm, Germany
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