What leads to the expectation to return to work? Insights from a Theory of Planned Behavior (TPB) model of future work outcomes

OBJECTIVE

This study used a Theory of Planned Behavior (TPB) model to identify the factors influencing the future work expectations and outcomes of employees with a musculoskeletal injury.

PARTICIPANTS

Australians with a compensable work injury (N=174), mean age=43.7 years, 53.2% male, 48.3% back injury , and 34.2% unskilled.

METHODS

A TPB model of the target behavior 'working, or continuing to work … three months from now' was constructed. A questionnaire measuring the model's components was completed at baseline and three-months follow-up.

RESULTS

The model met standard psychometric requirements. Attitude, Subjective Norm and Perceived Behavioral Control explained 76% of the variance in Behavioral Intention (<formula>R^{2}</formula>= 0.76, p< 0.001). Behavioral Intention (the expectation to return to work) explained 51% of the variance in work participation at follow-up (Nagelkerke <formula>R^{2}</formula>=0.51, p< 0.001; sensitivity=86.4%, specificity=71.2%). The strength of key influences on expectations varied according to employment status, but included the availability of modified duties, social aspects of work, the opinion of the treating doctor, co-worker support, pain, and functional limitations.

CONCLUSION

The TPG is a useful model and conceptual framework for integrating the biopsychosocial determinantsof return to work (RTW) and identifying the influences on future work expectations and outcomes.

Views on the diagnostic labels of autism and Asperger's disorder and the proposed changes in the DSM

With the approaching release of the DSM V in 2013, there has been much debate about the proposal to remove the diagnostic label of Asperger's disorder from the new DSM. This study explored how health and education professionals perceive the conditions of autism and Asperger's disorder and their views on the proposed diagnostic changes. Analysis of the 547 participant responses confirmed an increase stigma is associated with the label of autism, with autism considered to be a more severe than the condition of Asperger's disorder. Approximately half of the participants reported being opposed to proposed diagnostic changes and of the remaining participants, 22% supported the proposed changes and 28% expressed uncertainty.

Parental and professional beliefs on the treatment and management of ADHD

OBJECTIVE

This study examined parental and professional beliefs about the efficacy of various treatment strategies for ADHD.

METHOD

Parents of children with and without ADHD and seven medical and nonmedical professional groups (N = 673) completed a questionnaire examining their beliefs about the efficacy of various treatment regimes.

RESULTS

Principle component analysis identified four factors-school-based interventions, medical and allied health interventions, parent interventions, and nontraditional interventions. Although there were some group differences in the level of endorsement for these factors, there was a high degree of concordance between the groups. The school-based interventions factor was the most highly endorsed, whereas the nontraditional interventions factor was the least endorsed by the sample as a whole.

CONCLUSION

The results suggest that the low level of interdisciplinary interaction that has been reported in the literature is not due to differences in beliefs about the efficacy of various treatment strategies for ADHD.

The Effects of Diagnostic Labelling on the Implicit Theories of Attention-Deficit/Hyperactivity Disorder Held by Health Professionals

Attention-deficit/hyperactivity disorder (ADHD) is the most recent diagnostic label used to describe a behavioural condition of which the essential features are developmentally inappropriate levels of inattention, impulsivity and overactivity. ADHD has attracted both controversy and attention from the professional and scientific community. However, little is known regarding the explanatory models (implicit theories) of health professionals or of their beliefs regarding the treatment of this condition, specifically the impact of diagnostic labelling on their decisions concerning treatment. This study manipulated the presence versus absence of the diagnostic label ‘ADHD’ in a vignette study describing the symptoms of this condition. The vignette was presented to professionals in the educational, mental health and allied health fields. After reading the vignette, participants were required to complete a questionnaire examining implicit beliefs concerning ADHD. The results confirmed that the presence of the diagnostic label (ADHD) changed the causal explanations by professional groups. However, the presence of the diagnostic label did not significantly change the beliefs about the optimal treatment strategy for this condition.

Outcomes of participation objective, participation subjective (POPS) measure following traumatic brain injury

PRIMARY OBJECTIVE

To investigate the participation of adults living with traumatic brain injury in regional and rural NSW as measured by the Participation Objective Participation Subjective (POPS) measure.

RESEARCH DESIGN

A quantitative survey of a single cohort as the first of a two phase mixed methods study.

METHODS AND PROCEDURES

One hundred and thirty-one adults with a TBI were recruited through eight rural brain injury rehabilitation programmes in NSW. These adults completed a range of survey instruments, including the POPS.

MAIN OUTCOMES AND RESULTS

The POPS measure supported findings from other research that identified varying impacts of TBI. However, in contrast to other studies, there was no correlation between participation scores and age, gender, time since injury and severity of injury.

CONCLUSIONS

The findings from this study suggest that the issue of participation of adults with TBI living in non-metropolitan areas needs to be further researched.

Does the ??rebro Musculoskeletal Pain Questionnaire predict outcomes following a work-related compensable injury?

The objective of this prospective study was to investigate the usefulness of the Orebro Musculoskeletal Pain Questionnaire (OMPQ) to predict return to work outcomes following a compensable musculoskeletal injury. Participants (n=196 injured workers, 66% male, 36% with back pain) were screened at 4-12 weeks, and followed up at 6 months, post-injury. Total scores on the OMPQ were able to differentiate between work status on both occasions, indicating the potential predictive validity of this instrument. This is the first study to evaluate the OMPQ in a compensable injury population, and although replication with a larger sample is required, the findings have significant relevance to the recommendation of routine screening for the early identification of injured workers at risk of long-term disability.

The impact of ward design on the behaviour, occupational satisfaction and well-being of psychiatric nurses

Studies have shown that modifications to the physical environment of psychiatric institutions are associated with positive changes in patients' behaviour, attitudes and perceptions. However, little attention has been paid to the impact such modifications to the physical environment have on the nursing staff. The building of two completely new wards at a rural psychiatric hospital provided an opportunity to examine this issue. Measures of the nursing staffs' observed behaviour and self-ratings of burnout and job satisfaction were obtained in both the old and the new wards. The results showed that the new wards were associated with largely positive changes in behaviour and increased burnout, but there was no change in job satisfaction. However, it was clear that a vital component in the success of any environmental manipulation is an appropriate, corresponding change in the organizational climate.

The quality of psychiatric nurses' interactions with patients: an observational study

The behaviour of nursing staff in each ward of a psychiatric hospital was observed at 5-min intervals for between 7 and 10 h per day for 10 days. The nurses' behaviour was equally divided between interacting with patients, interacting with staff, solitary task oriented behaviour and other behaviours. There was less staff-patient interaction in the acute ward than in the long-term and psychogeriatric wards and senior nurses interacted less with patients and engaged in more solitary task oriented behaviour. Of the interactions with patients, almost 25% were rated as positive and only 0.3% negative. In the long-term wards almost 47% of the interactions were positive.

Stress and detention

The psychological response to detention is examined. It is argued that detention imposes severe stress and that many detainees seem to exhibit the characteristic symptoms of a post-traumatic stress disorder. The contention that detention is stressful is based on the fact that detainees are held in isolation and have no control over the situation, both of these factors having been shown to be associated with the experiencing of stress. Individual differences affecting the responses to stress are discussed, as are the long-term consequences of detention.

The primacy-recency effect in counselor response

It has been suggested that when responding to a client's statement which contains two sequentially distinguishable messages, a counselor will tend to focus on the latter message, i.e., there is a recency effect. The present study investigated this contention empirically. Twenty-six experienced telephone counselors each responded to 12 client statements, all of which contained two distinct messages. The responses were classified according to their focus, and chi-square tests were performed on these frequencies for each statement. The results provided no support for the recency hypothesis, but rather showed that the Ss tended to make responses that were either nonspecific or included both messages. It also appeared that the Ss responded to the content rather than the positioning of the messages.