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Liedberg GM, Björk M, Coutu MF, Durand MJ, Turesson C. Translation and initial cross-cultural adaptation of the tool for support-gradual return-to-work for persons with chronic musculoskeletal pain to the Swedish setting. Work 2024:WOR230665. [PMID: 38728197 DOI: 10.3233/wor-230665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND A well-defined and clear procedure is a key factor supporting return-to-work and enhancing collaboration and understanding between employers and employees. The adaptation of the Tool for Support-Gradual Return to Work, TS-GRTW, addresses relevant cultural aspects valuable for wider adoption. OBJECTIVE develop a Swedish version, the GRTWswe, for implementation and integration into the Swedish labor market's RTW process. This involved translating, culturally adapting, and assessing the appropriateness and utility. METHODS In the initial step, a double back translation was performed to create an initial translated version. This version was then utilized in individual consultations, accompanied by an agreement questionnaire. For the subsequent step, group consultations were held to refine and customize the tool to suit the Swedish context. Ten occupational therapists completed the questionnaires, with mean agreement scores surpassing three on a four-point scale. Out of these, nine participated in group consultations. RESULTS The findings suggest the requirement for specific modifications to the GRTWswe. These adaptations are essential because of cultural differences in organizational structures and reference frameworks. Moreover, participants unanimously agreed to broaden the scope of target groups, encompassing employees without regard for diagnosis and expanding the range of professions that can utilize this tool. This step aims to enhance the tool's applicability and usefulness. CONCLUSIONS The study found strong alignment between questionnaire responses and group consultations outcomes, affirming the adapted tool's suitability for use in a Swedish context. The tool benefits employers and employees by enhancing communication, encouraging collaboration, and structuring processes, promising lasting improvements to work conditions.
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Affiliation(s)
- Gunilla M Liedberg
- Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine, Linköping University, Linköping, Sweden
| | - Mathilda Björk
- Department of Health, Pain and Rehabilitation Centre, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Marie-France Coutu
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Quebec, Canada
| | - Marie-José Durand
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Quebec, Canada
| | - Christina Turesson
- Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine, Linköping University, Linköping, Sweden
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Larivière C, Preuss R, Coutu MF, Sullivan MJ, Roy N, Henry SM. Disability reduction following a lumbar stabilization exercise program for low back pain: large vs. small improvement subgroup analyses of physical and psychological variables. BMC Musculoskelet Disord 2024; 25:358. [PMID: 38704535 PMCID: PMC11069239 DOI: 10.1186/s12891-024-07480-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 04/28/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Little is known about why patients with low back pain (LBP) respond differently to treatment, and more specifically, to a lumbar stabilization exercise program. As a first step toward answering this question, the present study evaluates how subgroups of patients who demonstrate large and small clinical improvements differ in terms of physical and psychological changes during treatment. METHODS Participants (n = 110) performed the exercise program (clinical sessions and home exercises) over eight weeks, with 100 retained at six-month follow-up. Physical measures (lumbar segmental instability, motor control impairments, range of motion, trunk muscle endurance and physical performance tests) were collected twice (baseline, end of treatment), while psychological measures (fear-avoidance beliefs, pain catastrophizing, psychological distress, illness perceptions, outcome expectations) were collected at four time points (baseline, mid-treatment, end of treatment, follow-up). The participants were divided into three subgroups (large, moderate and small clinical improvements) based on the change of perceived disability scores. ANOVA for repeated measure compared well-contrasted subgroups (large vs. small improvement) at different times to test for SUBGROUP × TIME interactions. RESULTS Statistically significant interactions were observed for several physical and psychological measures. In all these interactions, the large- and small-improvement subgroups were equivalent at baseline, but the large-improvement subgroup showed more improvements over time compared to the small-improvement subgroup. For psychological measures only (fear-avoidance beliefs, pain catastrophizing, illness perceptions), between-group differences reached moderate to strong effect sizes, at the end of treatment and follow-up. CONCLUSIONS The large-improvement subgroup showed more improvement than the small-improvement subgroup with regard to physical factors typically targeted by this specific exercise program as well as for psychological factors that are known to influence clinical outcomes.
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Affiliation(s)
- Christian Larivière
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), 505, boul. De Maisonneuve Ouest, Montreal, QC, H3A 3C2, Canada.
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363, Hudson Road, office 061, Montreal, QC, H3S 1M9, Canada.
| | - Richard Preuss
- School of Physical & Occupational Therapy, McGill University, 845 Sherbrooke Wst, Montreal, QC, H3G 1Y5, Canada
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363, Hudson Road, office 061, Montreal, QC, H3S 1M9, Canada
| | - Marie-France Coutu
- Charles-Le Moyne Hospital Research Centre, University of Sherbrooke, 150 Place Charles-Le Moyne, Office 200, Longueuil, QC, J4K 0A8, Canada
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363, Hudson Road, office 061, Montreal, QC, H3S 1M9, Canada
| | - Michael J Sullivan
- Department of Psychology, McGill University, 1205 Docteur Penfield, Montreal, QC, H3A 1B1, Canada
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363, Hudson Road, office 061, Montreal, QC, H3S 1M9, Canada
| | - Nicolas Roy
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 6363, Hudson Road, office 061, Montreal, QC, H3S 1M9, Canada
| | - Sharon M Henry
- Department of Neurological Sciences, University of Vermont, Burlington, VT, 05401, USA
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Lecours A, Coutu MF, Durand MJ. Fostering Stay at Work After a Period of Disability: A Scoping Review of Occupational Rehabilitation Strategies to Support Workers in the Adoption of Preventive Behaviours. J Occup Rehabil 2024; 34:56-70. [PMID: 37358726 DOI: 10.1007/s10926-023-10122-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/05/2023] [Indexed: 06/27/2023]
Abstract
PURPOSE Based on the theoretical framework of the Model of Preventive Behaviours at Work, the aim of this study was to describe the the occupational rehabilitation strategies the literature reports that support workers who have suffered an occupational injury in adopting preventive behaviours. METHODS To conduct this scoping review, we used a systematic methodology in 7 steps : (1) definition of the research question and inclusion/exclusion criteria; (2) scientific and gray literature search; (3) determination of manuscripts' eligibility; (4) extraction and charting of information; (5) quality assessment; (6) interpretation; and (7) knowledge synthesis. RESULTS We selected 46 manuscripts of various types (e.g. randomized trials, qualitative studies, governmental documents). Manuscripts were mainly of good or high quality according to our quality assessment. The strategies for coaching, engaging, educating and collaborating were mostly reported in the literature to support the development of the six preventive behaviours during occupational rehabilitation. The results also suggest that heterogeneity exists regarding the specificity of the strategies reported in the literature, which may have hindered our ability to provide rich and detailed descriptions. Literature also mainly describes individually oriented behaviours and reports strategies requiring a low level of worker involvement, which represent issues to adress in future researh projects. CONCLUSION The strategies described in this article reprensent concrete levers that occupational rehabilitation professionals can use to support workers in the adoption of preventive behaviours at work on return from having suffered an occupational injury.
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Affiliation(s)
- Alexandra Lecours
- Département d'ergothérapie, Université du Québec à Trois-Rivières, 555 Boul de l'Université, Drummondville, Québec, J2C 0R5, Canada.
- Centre interdisciplinaire de recherche en réadaptation et intégration sociale, Quebec, Canada.
| | - Marie-France Coutu
- École de réadaptation, Université de Sherbrooke, Sherbrooke, Canada
- Centre d'action en prévention et réadaptation de l'incapacité au travail, Longueuil, Canada
| | - Marie-José Durand
- École de réadaptation, Université de Sherbrooke, Sherbrooke, Canada
- Centre d'action en prévention et réadaptation de l'incapacité au travail, Longueuil, Canada
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Coutu MF, Durand MJ, O'Hagan F, Gosselin P, Nastasia I, Berbiche D, Labrecque MÉ, Pettigrew S, Bordeleau M. Workers' Worries, Pain, Psychosocial Factors, and Margin of Manoeuvre, in Relation to Outcomes in a Return-to-Work Program: An Exploratory Study. J Occup Rehabil 2023:10.1007/s10926-023-10155-x. [PMID: 37996721 DOI: 10.1007/s10926-023-10155-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/30/2023] [Indexed: 11/25/2023]
Abstract
PURPOSE To explore the intensity and variation of workers' worries, pain, psychosocial factors, and margin of manoeuvre before and after a return-to-work program, and identified the psychosocial factors associated with non-return to work at the end of the rehabilitation program. METHODS A pre-post study design was used. A convenience sample of 80 workers starting a return-to-work program and having a compensated musculoskeletal injury that caused an absence of more than three months from their regular work was recruited. Data were collected at baseline and at the end of the rehabilitation program on the nature of the worries and maintenance factors defined in Dugas' generalized anxiety and worry model, using validated questionnaires. The margin of manoeuvre was assessed by the treating occupational therapist. A series of descriptive analyses were performed, as well as Generalized Estimating Equations analyses. RESULTS Workers' worries were work-related or disability-related 83% of the time at baseline. These worries were essentially based on the situation then occurring at work 90% of the time. For the Generalized Estimating Equations analyses on work status, the final model was significant, explaining 54% of the variance in non-return to work (Pseudo R2 = 0.54; p = 0.0001). Workers were 8.52 times less likely to return to work when the margin of manoeuvre was insufficient, and twice as likely not to return to work in the presence of intense worry. Worries were significantly associated with insufficient margin of manoeuvre. CONCLUSION A strong association between workers' lack of margin of manoeuvre at work and their worries about their return to work, and poor work outcomes, supports the importance of the worker-environment interaction in rehabilitation programs.
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Affiliation(s)
- Marie-France Coutu
- Centre for Action in Work Disability Prevention and Rehabilitation (CAPRIT), Université de Sherbrooke - Longueuil Campus, 150 Place Charles-Le Moyne, Longueuil, QC, Canada.
- Faculty of Medicine and Health Sciences, Université de Sherbrooke - Longueuil Campus, 150 Place Charles-Le Moyne, Longueuil, QC, Canada.
- Centre de recherche Charles-Le Moyne (CRCLM), Université de Sherbrooke - Longueuil Campus, 150 Place Charles-Le Moyne, Longueuil, QC, Canada.
| | - Marie-José Durand
- Centre for Action in Work Disability Prevention and Rehabilitation (CAPRIT), Université de Sherbrooke - Longueuil Campus, 150 Place Charles-Le Moyne, Longueuil, QC, Canada
- Faculty of Medicine and Health Sciences, Université de Sherbrooke - Longueuil Campus, 150 Place Charles-Le Moyne, Longueuil, QC, Canada
- Centre de recherche Charles-Le Moyne (CRCLM), Université de Sherbrooke - Longueuil Campus, 150 Place Charles-Le Moyne, Longueuil, QC, Canada
| | - Fergal O'Hagan
- Department of Psychology, Trent University, 1600 West Bank Drive, Peterborough, ON, Canada
| | - Patrick Gosselin
- Department of Psychology, Université de Sherbrooke, 2500 Boulevard de l'Université, Sherbrooke, QC, Canada
| | - Iuliana Nastasia
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), 505 Boulevard De Maisonneuve Ouest, Montreal, QC, Canada
| | - Djamal Berbiche
- Faculty of Medicine and Health Sciences, Université de Sherbrooke - Longueuil Campus, 150 Place Charles-Le Moyne, Longueuil, QC, Canada
- Centre de recherche Charles-Le Moyne (CRCLM), Université de Sherbrooke - Longueuil Campus, 150 Place Charles-Le Moyne, Longueuil, QC, Canada
| | - Marie-Élise Labrecque
- Centre for Action in Work Disability Prevention and Rehabilitation (CAPRIT), Université de Sherbrooke - Longueuil Campus, 150 Place Charles-Le Moyne, Longueuil, QC, Canada
- Faculty of Medicine and Health Sciences, Université de Sherbrooke - Longueuil Campus, 150 Place Charles-Le Moyne, Longueuil, QC, Canada
- Centre de recherche Charles-Le Moyne (CRCLM), Université de Sherbrooke - Longueuil Campus, 150 Place Charles-Le Moyne, Longueuil, QC, Canada
| | - Sara Pettigrew
- Centre for Action in Work Disability Prevention and Rehabilitation (CAPRIT), Université de Sherbrooke - Longueuil Campus, 150 Place Charles-Le Moyne, Longueuil, QC, Canada
- Faculty of Medicine and Health Sciences, Université de Sherbrooke - Longueuil Campus, 150 Place Charles-Le Moyne, Longueuil, QC, Canada
- Centre de recherche Charles-Le Moyne (CRCLM), Université de Sherbrooke - Longueuil Campus, 150 Place Charles-Le Moyne, Longueuil, QC, Canada
| | - Martine Bordeleau
- Elderly, Neurostimulation and Pain Research Group, Research Centre on Aging, 1036 Rue Belvédère Sud, Sherbrooke, QC, Canada
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, 2500 Boulevard de l'Université, Sherbrooke, QC, Canada
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Carrière JS, Donayre Pimentel S, Bou Saba S, Boehme B, Berbiche D, Coutu MF, Durand MJ. Recovery expectations can be assessed with single-item measures: findings of a systematic review and meta-analysis on the role of recovery expectations on return-to-work outcomes after musculoskeletal pain conditions. Pain 2023; 164:e190-e206. [PMID: 36155605 PMCID: PMC10026834 DOI: 10.1097/j.pain.0000000000002789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/15/2022] [Accepted: 09/06/2022] [Indexed: 11/26/2022]
Abstract
ABSTRACT The objective of this systematic review is to quantify the association between recovery expectations and return-to-work outcomes in adults with musculoskeletal pain conditions. In addition, this review has the second objective to compare the predictive utility of single-item and multi-item recovery expectation scales on return-to-work outcomes. Relevant articles were selected from Embase, PsycINFO, PubMed, Cochrane, and manual searches. Studies that assessed recovery expectations as predictors of return-to-work outcomes in adults with musculoskeletal pain conditions were eligible. Data were extracted on study characteristics, recovery expectations, return-to-work outcomes, and the quantitative association between recovery expectations and return-to-work outcomes. Risk of bias was assessed using the Effective Public Health Practice Project. Odds ratios were pooled to examine the effects of recovery expectations on return-to-work outcomes. Chi-square analyses compared the predictive utility of single-item and multi-item recovery expectation scales on return-to-work outcomes. Thirty studies on a total of 28,741 individuals with musculoskeletal pain conditions were included in this review. The odds of being work disabled at follow-up were twice as high in individuals with low recovery expectations (OR = 2.06 [95% CI 1.20-2.92] P < 0.001). Analyses also revealed no significant differences in the predictive value of validated and nonvalidated single-item measures of recovery expectations on work disability (χ 2 = 1.68, P = 0.19). There is strong evidence that recovery expectations are associated with return-to-work outcomes. The results suggest that single-item measures of recovery expectations can validly be used to predict return-to-work outcomes in individuals with musculoskeletal pain conditions.
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Affiliation(s)
- Junie S. Carrière
- École de réadaptation, Faculté de médecine et des sciences de la santé, Centre de Recherche Charles-Le Moyne, Centre d'action en prévention et en réadaptation de l'incapacité au travail, Université de Sherbrooke, Longueuil, QC, Canada
| | | | - Sabine Bou Saba
- School of Mind and Brain, Humboldt Universität zu Berlin, Berlin, Germany
| | - Blake Boehme
- Department of Psychology, University of Regina, Regina, Saskatchewan
| | - Djamal Berbiche
- Département des sciences de la santé communautaire, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Marie-France Coutu
- École de réadaptation, Faculté de médecine et des sciences de la santé, Centre de Recherche Charles-Le Moyne, Centre d'action en prévention et en réadaptation de l'incapacité au travail, Université de Sherbrooke, Longueuil, QC, Canada
| | - Marie-José Durand
- École de réadaptation, Faculté de médecine et des sciences de la santé, Centre de Recherche Charles-Le Moyne, Centre d'action en prévention et en réadaptation de l'incapacité au travail, Université de Sherbrooke, Longueuil, QC, Canada
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Tousignant-Laflamme Y, Longtin C, Coutu MF, Gaudreault N, Kairy D, Nastasiag I, Léonard G. Self-management programs to ensure sustainable return to work following long-term sick leave due to low back pain: A sequential qualitative study. Work 2023:WOR220202. [PMID: 36641727 DOI: 10.3233/wor-220202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Low back pain (LBP) is a prevalent condition frequently leading to disability. Research suggests that self-management (SM) programs for chronic LBP should include strategies to promote sustainable return to work. OBJECTIVES This study aimed to 1) validate and prioritize the essential content elements of a SM program in light of the needs of workplace representatives, and 2) identify the main facilitators and barriers to be considered when developing and implementing a SM program delivered via information and communication technologies (ICT). METHODS A sequential qualitative design was used. We recruited workplace representatives and potential future users of SM programs (union representatives and employers) and collected data through focus groups and nominal group techniques to validate the relevance of the different elements included into 3 broad categories (Understand, Learn, Apply), as well as to highlight potential barriers and facilitators. RESULTS Eleven participants took part in this study. The content elements proposed in the literature for SM programs were found to align with potential future users' needs, with participants ranking the same elements as those proposed in the scientific literature as the most important across all categories. Although some barriers were identified, workplace representatives believed that ICT offer an appropriate strategy for delivering individualized SM programs to injured workers who have returned to work. CONCLUSION Our study suggests that the elements identified in the literature as essential components of SM programs designed to ensure a sustainable return to work for people with LBP are in line with the needs of future users.
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Affiliation(s)
- Yannick Tousignant-Laflamme
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, QC,Canada.,Clinical Research Centre of the CHUS, CIUSSS de l'Estrie-CHUS, Sherbrooke, QC,Canada
| | - Christian Longtin
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, QC,Canada
| | - Marie-France Coutu
- CAPRIT, Université de Sherbrooke, Longueuil, QC,Canada.,School of Rehabilitation, Université de Sherbrooke, Longueuil, QC,Canada
| | - Nathaly Gaudreault
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, QC,Canada.,Clinical Research Centre of the CHUS, CIUSSS de l'Estrie-CHUS, Sherbrooke, QC,Canada
| | - Dahlia Kairy
- School of Rehabilitation, Université de Montréal, Montréal, QC,Canada.,Centre de Recherche Interdisciplinaire en Réadaptation, Montréal, QC,Canada
| | | | - Guillaume Léonard
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, QC,Canada.,Research Centre on Aging, CIUSSS de l'Estrie-CHUS, Sherbrooke, QC,Canada
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Coutu MF, Durand MJ, Coté D, Tremblay D, Sylvain C, Gouin MM, Bilodeau K, Nastasia I, Paquette MA. Ethnocultural Minority Workers and Sustainable Return to Work Following Work Disability: A Qualitative Interpretive Description Study. J Occup Rehabil 2022; 32:773-789. [PMID: 35616770 DOI: 10.1007/s10926-022-10044-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/28/2022] [Indexed: 06/15/2023]
Abstract
Purpose This article provides a state-of-the-art review of issues and factors associated with the sustainable return to work (S-RTW) of ethnocultural minority workers experiencing disability situations attributable to one of four major causes: musculoskeletal disorders, common mental disorders, other chronic diseases or cancer. Methods Using an interpretive description method, an integrative review was conducted of the literature on ethnocultural factors influencing S-RTW issues and factors associated with these four major work-disability causes. An initial review of the 2006-2016 literature was subsequently updated for November 2016-May 2021. To explore and contextualize the results, four focus groups were held with RTW stakeholders representing workplaces, insurers, the healthcare system and workers. Qualitative thematic analysis was performed. Results A total of 56 articles were analyzed and 35 stakeholders participated in four focus groups. Two main findings emerged. First, belonging to an ethnocultural minority group appears associated with cumulative risk factors that may contribute to vulnerability situations and compound the complexity of S-RTW. Second, cultural differences with respect to the prevailing host-country culture may generate communication and trust issues, and conflicts in values and representations, in turn possibly hindering the establishment of positive relationships among all stakeholders and the ability to meet workers' needs. Being a woman in these groups and/or having a lower level of integration into the host country's culture also appear associated with greater S-RTW challenges. Conclusions Based on our findings, we recommend several possible strategies, such as the cultural humility model, for preventing differences from exacerbating the already significant vulnerability situation of some ethnocultural minority workers.
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Affiliation(s)
- Marie-France Coutu
- Centre d'action en Prévention et Réadaptation des Incapacités au Travail (CAPRIT), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada.
- Centre de Recherche Charles-le Moyne (CRCLM), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada.
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada.
| | - Marie-José Durand
- Centre d'action en Prévention et Réadaptation des Incapacités au Travail (CAPRIT), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- Centre de Recherche Charles-le Moyne (CRCLM), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
| | - Daniel Coté
- Institut de Recherche Robert-Sauvé en Santé et en Sécurité du Travail (IRSST), 505 Boulevard De Maisonneuve West, Montreal, QC, H3A 3C2, Canada
| | - Dominique Tremblay
- Centre de Recherche Charles-le Moyne (CRCLM), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- School of Nursing, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles-Le Moyne, Longueuil, QC, J4K 0A8, Canada
| | - Chantal Sylvain
- Centre d'action en Prévention et Réadaptation des Incapacités au Travail (CAPRIT), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- Centre de Recherche Charles-le Moyne (CRCLM), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
| | - Marie-Michelle Gouin
- Department of Management and Human Resource Management, School of Management, Université de Sherbrooke, 2500 Boulevard de l'Université, Sherbrooke, QC, J1K 2R1, Canada
| | - Karine Bilodeau
- Faculty of Nursing, Université de Montréal, Station Centre-ville, PO Box 6128, Montreal, QC, H3C 3J7, Canada
| | - Iuliana Nastasia
- Institut de Recherche Robert-Sauvé en Santé et en Sécurité du Travail (IRSST), 505 Boulevard De Maisonneuve West, Montreal, QC, H3A 3C2, Canada
| | - Marie-Andrée Paquette
- Centre d'action en Prévention et Réadaptation des Incapacités au Travail (CAPRIT), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- Centre de Recherche Charles-le Moyne (CRCLM), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
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Coutu MF, Durand MJ, Coté D, Tremblay D, Sylvain C, Gouin MM, Bilodeau K, Nastasia I, Paquette MA, Labrecque ME. Building a Common Language to Facilitate Discussion Among Stakeholders in Work Disability: A Consensus Group Approach. J Occup Rehabil 2022; 32:529-537. [PMID: 35076855 DOI: 10.1007/s10926-022-10022-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/03/2022] [Indexed: 06/14/2023]
Abstract
PURPOSE Work disability stakeholders may not share the same understanding and solutions among themselves or with researchers, causing misunderstandings and hindering collaboration regarding solutions for preventing work disability. To reduce such differences, this study sought to build a common vocabulary among stakeholders and researchers, using a transdisciplinary research framework. METHODS A consensus method based on a constructivist approach was used. A theoretical sampling method was applied to identify researchers or stakeholders representing one of the four systems in the work disability paradigm. A preliminary set of definitions for key terms was assessed using a Web-based questionnaire. It documented participants' level of agreement with each term's inclusion and relevance in the field, and the clarity of the definition, while soliciting suggestions for other terms or clearer definitions. Disagreements were discussed at group meetings, yielding consensus on the final terms and definitions. RESULTS Eleven stakeholders representing patients, employers, unions, healthcare professionals, and legislative and insurance systems, along with 10 multidisciplinary researchers, participated. The questionnaire yielded initial consensus on the inclusion and definitions of 49 terms, and 109 suggestions mostly for modified definitions (average = 6 suggestions/term). Two preliminary terms were excluded and three terms were added. Ultimately, 80 terms and their definitions yielded consensus. CONCLUSIONS The process we used to build a common vocabulary was carried out within a transdisciplinary framework. It required a constructivist approach, promoting idea exchanges among participants and co-construction of generally agreed results. The results were rooted in local contexts, thus ensuring the same reference points, regardless of participants' different understandings.
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Affiliation(s)
- Marie-France Coutu
- Centre for Action in Work Disability Prevention and Rehabilitation (CAPRIT), Université de Sherbrooke - Longueuil Campus, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada.
- Centre de Recherche Charles-Le Moyne (CRCLM), Université de Sherbrooke - Longueuil Campus, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada.
- Faculty of Medicine and Health Sciences, School of Rehabilitation, Université de Sherbrooke - Longueuil Campus, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada.
| | - Marie-José Durand
- Centre for Action in Work Disability Prevention and Rehabilitation (CAPRIT), Université de Sherbrooke - Longueuil Campus, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- Centre de Recherche Charles-Le Moyne (CRCLM), Université de Sherbrooke - Longueuil Campus, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- Faculty of Medicine and Health Sciences, School of Rehabilitation, Université de Sherbrooke - Longueuil Campus, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
| | - Daniel Coté
- Institut de Recherche Robert-Sauvé en Santé et en Sécurité du Travail (IRSST), 505 Boulevard De Maisonneuve Ouest, Montreal, QC, H3A 3C2, Canada
| | - Dominique Tremblay
- Centre de Recherche Charles-Le Moyne (CRCLM), Université de Sherbrooke - Longueuil Campus, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- Faculty of Medicine and Health Sciences, School of Nursing, Université de Sherbrooke - Longueuil Campus, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
| | - Chantal Sylvain
- Centre for Action in Work Disability Prevention and Rehabilitation (CAPRIT), Université de Sherbrooke - Longueuil Campus, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- Centre de Recherche Charles-Le Moyne (CRCLM), Université de Sherbrooke - Longueuil Campus, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- Faculty of Medicine and Health Sciences, School of Rehabilitation, Université de Sherbrooke - Longueuil Campus, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
| | - Marie-Michelle Gouin
- Department of Management and Human Resource Management, School of Management, Université de Sherbrooke - Longueuil Campus, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
| | - Karine Bilodeau
- Faculty of Nursing, Université de Montréal, Station Centre-ville, PO Box 6128, Montreal, QC, H3C 3J7, Canada
| | - Iuliana Nastasia
- Institut de Recherche Robert-Sauvé en Santé et en Sécurité du Travail (IRSST), 505 Boulevard De Maisonneuve Ouest, Montreal, QC, H3A 3C2, Canada
| | - Marie-Andrée Paquette
- Centre for Action in Work Disability Prevention and Rehabilitation (CAPRIT), Université de Sherbrooke - Longueuil Campus, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- Centre de Recherche Charles-Le Moyne (CRCLM), Université de Sherbrooke - Longueuil Campus, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
| | - Marie-Elise Labrecque
- Centre for Action in Work Disability Prevention and Rehabilitation (CAPRIT), Université de Sherbrooke - Longueuil Campus, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- Centre de Recherche Charles-Le Moyne (CRCLM), Université de Sherbrooke - Longueuil Campus, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
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9
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Lecours A, Durand MJ, Coutu MF, Groleau C, Bédard-Mercier R. Stay at Work After a Period of Disability Due to an Occupational Injury: A Complex Process Marked by Social Exchanges. J Occup Rehabil 2022; 32:319-328. [PMID: 34668121 DOI: 10.1007/s10926-021-10008-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/01/2021] [Indexed: 06/13/2023]
Abstract
Purpose Rooted in a social exchange lens, this study aimed to explore the interactions between the factors influencing stay at work after a period of disability due to an occupational injury. Methods Based on a descriptive interpretative research design, interviews with 15 participants (i.e., representatives of workers, workplaces, insurers, and the health care system) were conducted to gather their perspectives about stay at work. Qualitative data was analyzed through thematic analysis. Results Ten different factors interacting together and influencing stay at work were identified. These factors prevail either during stay at work or previously. They are either related to the person (personal resources, occupation outside of work), environment (accommodations, support, access to rehabilitation services) or interaction between the person and her/his environment (perceptions, leeway, communication and information), whether it concerns the workplace, health services or insurance. Conclusions This study contributes to the advancement of knowledge concerning two main themes: (1) the importance of considering social exchanges as factors of success, and (2) the importance of considering the stay at work within a larger process.
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Affiliation(s)
- Alexandra Lecours
- Department of Occupational Therapy, Université du Québec à Trois-Rivières, 555 Boul de l'Université, Drummondville, QC, J2C 0R5, Canada.
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec, Canada.
| | - Marie-José Durand
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Quebec, Canada
- Centre d'action en prévention et réadaptation des incapacités au travail (CAPRIT), Université de Sherbrooke, Quebec, Canada
| | - Marie-France Coutu
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Quebec, Canada
- Centre d'action en prévention et réadaptation des incapacités au travail (CAPRIT), Université de Sherbrooke, Quebec, Canada
| | - Charles Groleau
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec, Canada
| | - Roxanne Bédard-Mercier
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec, Canada
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10
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Légaré F, Stacey D, Forest PG, Archambault P, Boland L, Coutu MF, Giguère AMC, LeBlanc A, Lewis KB, Witteman HO. Shared decision-making in Canada: Update on integration of evidence in health decisions and patient-centred care government mandates. Z Evid Fortbild Qual Gesundhwes 2022; 171:22-29. [PMID: 35606312 DOI: 10.1016/j.zefq.2022.04.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/12/2022] [Accepted: 04/13/2022] [Indexed: 06/15/2023]
Abstract
In Canada, government mandates for patient-centred care (PCC) vary across the 10 provinces and three territories. Although basic medical and hospital services are provided for all, health care options for patients also depend on having private insurance. Thus, the current design of the Canadian healthcare system has several implications for PCC and shared decision-making (SDM). Since 2007, this is our fourth update on SDM in Canada. The aim of this paper is to provide an update on the current state of SDM and patient and public involvement in Canada. Overall, we still observed the difficulty of implementing any sort of national strategy partly because of the decentralized nature of the healthcare system. Second, national professional education programs are complicated by licensure and scope of practice variations across jurisdictions. Third, there are variations in the availability of different options covered by universal healthcare. Canada has experienced some favorable development as PCC is now explicitly articulated in the policies of most provinces and territories and there are increased efforts to give patients more access to their electronic health records. However, patient and public engagement (PPE) reform in health programs and governance remains an exception, and continuing centralization of governance structures may reduce their responsiveness to patient priorities. In a 2018 survey, 47.2% of respondents reported that they were not told by their health professional that they had a choice about treatment. Nonetheless, decision aids and decision coaching are increasingly available for health-related decisions and the Ottawa Hospital Research Institute's decision aid inventory has ensured continued leadership in this area. Diverse jurisdictions are starting to embed decision aids into care pathways, with some decision aids being included in clinical practice guidelines. The COVID-19 pandemic may have had a negative impact on SDM by removing decision choices due to emergency public health mandates, but stimulated new research and decision aids. Canada continues to assign health research funding to SDM and PCC, and a program dedicated to patient-oriented research is central to this effort. Guides and frameworks are increasingly available for planning and evaluating PPE. Finally, various initiatives are attempting to involve and empower Indigenous peoples through PPE and SDM.
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Affiliation(s)
- France Légaré
- VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et services sociaux (CIUSSS) de la Capitale-Nationale, Quebec City, Canada; Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Pavillon Ferdinand-Vandry, Quebec City, Canada; Research Centre of the Centre Hospitalier Universitaire de Québec, Quebec City, Canada.
| | - Dawn Stacey
- Faculty of Health Sciences, University of Ottawa, Ottawa, Canada; Ottawa Hospital Research Institute, Ottawa, Canada
| | | | - Patrick Archambault
- VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et services sociaux (CIUSSS) de la Capitale-Nationale, Quebec City, Canada; Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Pavillon Ferdinand-Vandry, Quebec City, Canada; Research Centre of the Centre Hospitalier Universitaire de Québec, Quebec City, Canada; Centre de recherche intégrée pour un système apprenant en santé et services sociaux, Centre intégré de santé et services sociaux de Chaudière-Appalaches, Lévis, Canada; Department of Anesthesiology and Intensive Care Medicine, Université Laval, Pavillon Ferdinand-Vandry, Quebec City, Canada
| | - Laura Boland
- Faculty of Health Sciences, University of Ottawa, Ottawa, Canada; Ottawa Hospital Research Institute, Ottawa, Canada
| | - Marie-France Coutu
- Centre for Action in Work Disability Prevention and Rehabilitation affiliated with Hôpital Charles-Lemoyne Research Center, Rehabilitation School, Longueuil Campus - Université de Sherbrooke, Longueuil, Canada
| | - Anik M C Giguère
- VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et services sociaux (CIUSSS) de la Capitale-Nationale, Quebec City, Canada; Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Pavillon Ferdinand-Vandry, Quebec City, Canada; Office of Education and Continuing Development, Faculty of Medicine, Université Laval, Pavillon Ferdinand-Vandry, Quebec City, Canada
| | - Annie LeBlanc
- VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et services sociaux (CIUSSS) de la Capitale-Nationale, Quebec City, Canada; Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Pavillon Ferdinand-Vandry, Quebec City, Canada
| | - Krystina B Lewis
- Faculty of Health Sciences, University of Ottawa, Ottawa, Canada; University of Ottawa Heart Institute, Ottawa, Canada
| | - Holly O Witteman
- VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et services sociaux (CIUSSS) de la Capitale-Nationale, Quebec City, Canada; Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Pavillon Ferdinand-Vandry, Quebec City, Canada; Research Centre of the Centre Hospitalier Universitaire de Québec, Quebec City, Canada; Ottawa Hospital Research Institute, Ottawa, Canada; Office of Education and Continuing Development, Faculty of Medicine, Université Laval, Pavillon Ferdinand-Vandry, Quebec City, Canada
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11
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Larivière C, Rabhi K, Preuss R, Coutu MF, Roy N, Henry SM. Derivation of clinical prediction rules for identifying patients with non-acute low back pain who respond best to a lumbar stabilization exercise program at post-treatment and six-month follow-up. PLoS One 2022; 17:e0265970. [PMID: 35476707 PMCID: PMC9045609 DOI: 10.1371/journal.pone.0265970] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 03/10/2022] [Indexed: 11/19/2022] Open
Abstract
Low back pain (LBP) remains one of the most common and incapacitating health conditions worldwide. Clinical guidelines recommend exercise programs after the acute phase, but clinical effects are modest when assessed at a population level. Research needs to determine who is likely to benefit from specific exercise interventions, based on clinical presentation. This study aimed to derive clinical prediction rules (CPRs) for treatment success, using a lumbar stabilization exercise program (LSEP), at the end of treatment and at six-month follow-up. The eight-week LSEP, including clinical sessions and home exercises, was completed by 110 participants with non-acute LBP, with 100 retained at the six-month follow-up. Physical (lumbar segmental instability, motor control impairments, posture and range of motion, trunk muscle endurance and physical performance tests) and psychological (related to fear-avoidance and home-exercise adherence) measures were collected at a baseline clinical exam. Multivariate logistic regression models were used to predict clinical success, as defined by ≥50% decrease in the Oswestry Disability Index. CPRs were derived for success at program completion (T8) and six-month follow-up (T34), negotiating between predictive ability and clinical usability. The chosen CPRs contained four (T8) and three (T34) clinical tests, all theoretically related to spinal instability, making these CPRs specific to the treatment provided (LSEP). The chosen CPRs provided a positive likelihood ratio of 17.9 (T8) and 8.2 (T34), when two or more tests were positive. When applying these CPRs, the probability of treatment success rose from 49% to 96% at T8 and from 53% to 92% at T34. These results support the further development of these CPRs by proceeding to the validation stage.
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Affiliation(s)
- Christian Larivière
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), Montréal, Québec, Canada
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal (IURDPM), Centre Intégré Universitaire de Santé et de Services Sociaux du Centre-Sud-de-l’Ile-de-Montréal (CCSMTL), Montréal, Québec, Canada
- * E-mail:
| | - Khalil Rabhi
- Independent Statistician Consultant, Montréal, Québec, Canada
| | - Richard Preuss
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal (IURDPM), Centre Intégré Universitaire de Santé et de Services Sociaux du Centre-Sud-de-l’Ile-de-Montréal (CCSMTL), Montréal, Québec, Canada
- School of Physical & Occupational Therapy, McGill University, Montréal, Québec, Canada
| | - Marie-France Coutu
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal (IURDPM), Centre Intégré Universitaire de Santé et de Services Sociaux du Centre-Sud-de-l’Ile-de-Montréal (CCSMTL), Montréal, Québec, Canada
- Charles-Le Moyne Hospital Research Centre, Université de Sherbrooke, Longueuil, Quebec, Canada
| | - Nicolas Roy
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal (IURDPM), Centre Intégré Universitaire de Santé et de Services Sociaux du Centre-Sud-de-l’Ile-de-Montréal (CCSMTL), Montréal, Québec, Canada
| | - Sharon M. Henry
- Department of Neurological Sciences, University of Vermont, Burlington, Vermont, United States of America
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12
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Gouin MM, Coutu MF, Durand MJ. 727 Stakeholders’ negotiation during the return to work of disabled workers: a scoping review. Saf Health Work 2022. [DOI: 10.1016/s2093-7911(22)00105-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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13
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Coutu MF, Durand MJ, Coté D, Tremblay D, Sylvain C, Gouin MM, Bilodeau K, Nastasia I, Paquette MA. How does Gender Influence Sustainable Return to Work Following Prolonged Work Disability? An Interpretive Description Study. J Occup Rehabil 2021; 31:552-569. [PMID: 33394267 DOI: 10.1007/s10926-020-09953-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/07/2020] [Indexed: 06/12/2023]
Abstract
PURPOSE A sustainable return to work (S-RTW) following prolonged work disability poses different challenges, depending on gender. This article provides a synthesis of gender differences in the issues and factors influencing the S-RTW of workers following such a disability. METHODS Using an interpretive description method, an integrative review was conducted of the literature on gender differences in S-RTW issues and factors associated with four major causes of work disability. The initial review concerned the 2000-2016 literature; it was subsequently updated for November 2016-March 2020. To explore and contextualise the results, four focus groups were held with stakeholders representing the workplace, insurance, and healthcare systems and workers. Qualitative thematic analysis was performed. RESULTS A total of 47 articles were reviewed, and 35 stakeholders participated in the focus groups. The prevailing traditional gender roles were found to have a major gender-specific influence on the attitudes, behaviours, processes and outcomes associated with S-RTW. These differences related to the (1) cumulative workload, (2) work engagement, and (3) expressed and addressed needs. CONCLUSIONS The results highlight the importance of taking into account both professional and personal aspects when integrating gender issues into the assessment of workers' needs and subsequently into interventions.
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Affiliation(s)
- Marie-France Coutu
- Centre d'action en Prévention et réadaptation des Incapacités au Travail (CAPRIT), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada.
- Centre de Recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean Sur Les Innovations en Santé (CR-CSIS), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada.
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada.
| | - Marie-José Durand
- Centre d'action en Prévention et réadaptation des Incapacités au Travail (CAPRIT), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- Centre de Recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean Sur Les Innovations en Santé (CR-CSIS), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
| | - Daniel Coté
- Institut de Recherche Robert-Sauvé en Santé et en Sécurité du Travail (IRSST), 505 Boulevard De Maisonneuve West, Montreal, QC, H3A 3C2, Canada
| | - Dominique Tremblay
- Centre de Recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean Sur Les Innovations en Santé (CR-CSIS), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- School of Nursing, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles-Le Moyne, Longueuil, QC, J4K 0A8, Canada
| | - Chantal Sylvain
- Centre d'action en Prévention et réadaptation des Incapacités au Travail (CAPRIT), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- Centre de Recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean Sur Les Innovations en Santé (CR-CSIS), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
| | - Marie-Michelle Gouin
- Department of Management and Human Resource Management, School of Management, Université de Sherbrooke, 2500 Boulevard de l'Université, Sherbrooke, QC, J1K 2R1, Canada
| | - Karine Bilodeau
- Faculty of Nursing, Université de Montréal, Station Centre-ville, PO Box 6128, Montreal, QC, H3C 3J7, Canada
| | - Iuliana Nastasia
- Institut de Recherche Robert-Sauvé en Santé et en Sécurité du Travail (IRSST), 505 Boulevard De Maisonneuve West, Montreal, QC, H3A 3C2, Canada
| | - Marie-Andrée Paquette
- Centre d'action en Prévention et réadaptation des Incapacités au Travail (CAPRIT), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- Centre de Recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean Sur Les Innovations en Santé (CR-CSIS), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
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14
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Nastasia I, Coutu MF, Rives R, Dubé J, Gaspard S, Quilicot A. Role and Responsibilities of Supervisors in the Sustainable Return to Work of Workers Following a Work-Related Musculoskeletal Disorder. J Occup Rehabil 2021; 31:107-118. [PMID: 32681441 DOI: 10.1007/s10926-020-09896-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose Supervisors play an important role during the return to work (RTW) of injured workers. Yet little research has been done on the actions associated with this role or the contexts in which they are taken. The purpose of this study was to develop courses of action to promote supervisors' involvement in the process aimed at achieving sustainable RTW for workers following a work-related musculoskeletal disorder (MSD), and to verify their pertinence, feasibility, and applicability in practice. Methods A two-phase qualitative method was used. (1) Secondary content analysis of 46 interviews of 14 workers post-MSD and 32 other actors in the RTW process, conducted during a prior case study, yielded proposals for courses of action composed of specific actions for supervisors. (2) The pertinence, feasibility, and applicability of these courses of action and specific actions were explored, first, through a self-administered questionnaire to initiate individual reflection, and later in greater depth through focus groups to identify the different contexts in which they might be applicable. Thematic analysis was performed for each phase. Results Eight proposed courses of action, including specific concrete actions and conditions influencing supervisors' involvement, were developed by the researchers and generally perceived as pertinent and feasible by the participants. Several aspects of the organizational context appeared to influence implementation of these courses of action within the organizations. Conclusion Organizational context appears to influence the application of these courses of action, as do the conditions under which they are implemented.
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Affiliation(s)
- Iuliana Nastasia
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail, OHS Prevention and Rehabilitation, 505 De Maisonneuve Blvd. West, Montreal, QC, H3A 3C2, Canada.
| | - Marie-France Coutu
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Canada
| | - Romain Rives
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Canada
| | - Jessica Dubé
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail, OHS Prevention and Rehabilitation, 505 De Maisonneuve Blvd. West, Montreal, QC, H3A 3C2, Canada
| | - Sarah Gaspard
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Canada
| | - Audrey Quilicot
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Canada
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Abstract
Purpose The Work Disability Diagnosis Interview (WoDDI) consists of a semi-structured interview designed to help clinicians systematically identify the factors contributing to a work disability. The aim was to validate two versions of the WoDDI (construct validity, internal consistency, interrater reliability) developed for individuals absent from work due to a musculoskeletal disorder (MSD) or common mental disorder (CMD). Methods A convenience sample of workers absent from work for at least three months due to an MSD or a CMD and enrolled in a rehabilitation program was recruited. To assess interrater reliability for the MSD and CMD versions, six occupational therapists by sub-group scored the WoDDI based on case histories. Results A total of 290 male and female workers (140 MSD, 150 CMD) were recruited. Exploratory factor analysis revealed similar dimensions in both versions, specifically, illness representation, clinical judgment of the complexity of the medical condition, and high level of work demands. It allowed items to be reduced by approximately 20 and 40% respectively for the CMD and MSD versions. Internal consistency (Cronbach's alpha) varied from 0.40 to 0.75 and 0.75 to 0.80 for the CMD and MSD versions respectively, while interrater reliability (Cohen's kappa coefficients) varied from 0.51 to 0.57 and 0.27 to 0.44 for the two versions respectively. Conclusion Despite some limitations, the WoDDI's factors correspond to those in the current scientific literature. The varying results for internal consistency suggest limitations mainly for the CMD version. Interrater reliability was found overall to be fair. The next step will be to revise and retest this version.
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Affiliation(s)
- Marie-José Durand
- Centre d'action en prévention et réadaptation de l'incapacité au travail (CAPRIT), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada.
- Centre de recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada.
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada.
| | - Marie-France Coutu
- Centre d'action en prévention et réadaptation de l'incapacité au travail (CAPRIT), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- Centre de recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
| | - Djamal Berbiche
- Centre de recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
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16
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Durand MJ, Coutu MF, Tremblay D, Sylvain C, Gouin MM, Bilodeau K, Kirouac L, Paquette MA, Nastasia I, Coté D. Insights into the Sustainable Return to Work of Aging Workers with a Work Disability: An Interpretative Description Study. J Occup Rehabil 2021; 31:92-106. [PMID: 32347441 DOI: 10.1007/s10926-020-09894-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose A sustainable return to work (S-RTW) following prolonged work disability poses particular challenges as workers age. This article provides a synthesis of the factors and issues involved in a S-RTW process for aging workers following such a disability. Methods Using interpretive description methods, a critical review was conducted of the literature specifying return-to-work factors and issues for aging workers with regard to four major causes of work disability (musculoskeletal disorders, common mental disorders, cancer or other chronic diseases). The initial review concerned the 2000-2016 literature, and was subsequently updated for November 2016-December 2018. To further explore and contextualise the results of this literature review, four focus groups were held with stakeholders, representing the workplace, insurance, and healthcare systems and workers. Qualitative thematic analysis was performed. Results Fifty-five articles were reviewed and 35 stakeholders participated in the focus groups. Returning to work and staying at work appear to be particularly challenging for aging workers, who face notable issues and stigma concerning their ability to meet work demands, as well as their mobilisation and engagement in these processes. Such findings echo in many ways the main assertions of the literature on aging at work, except those regarding the transformation of capacities with aging, which is not mentioned in relation to workers with a work disability. The influence of healthcare and compensation systems on the S-RTW of aging work-disabled workers has also received little attention to date. Conclusions The results underscore that aging workers with a disability are frequently vulnerable in terms of their health or their jobs. Intersectoral efforts are needed to remedy this situation to keep them at work.
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Affiliation(s)
- Marie-José Durand
- Centre d'action en prévention et réadaptation des incapacités au travail (CAPRIT), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada.
- Centre de recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada.
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada.
| | - Marie-France Coutu
- Centre d'action en prévention et réadaptation des incapacités au travail (CAPRIT), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- Centre de recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
| | - Dominique Tremblay
- Centre de recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- School of Nursing, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles-Le Moyne, Longueuil, QC, J4K 0A8, Canada
| | - Chantal Sylvain
- Centre d'action en prévention et réadaptation des incapacités au travail (CAPRIT), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- Centre de recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
| | - Marie-Michelle Gouin
- Department of Management and Human Resource Management, School of Management, Université de Sherbrooke, 2500 Boulevard de l'Université, Sherbrooke, QC, J1K 2R1, Canada
| | - Karine Bilodeau
- Faculty of Nursing, Université de Montréal, Station Centre-ville, PO Box 6128, Montreal, QC, H3C 3J7, Canada
| | - Laurie Kirouac
- Department of Industrial Relations, Université Laval, 1025 avenue des Sciences-Humaines, Québec, QC, G1V 0A6, Canada
| | - Marie-Andrée Paquette
- Centre d'action en prévention et réadaptation des incapacités au travail (CAPRIT), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
- Centre de recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Université de Sherbrooke, 150 Place Charles-Le Moyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
| | - Iuliana Nastasia
- Institut de Recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), 505 Boulevard De Maisonneuve West, Montreal, QC, H3A 3C2, Canada
| | - Daniel Coté
- Institut de Recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), 505 Boulevard De Maisonneuve West, Montreal, QC, H3A 3C2, Canada
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Coutu MF, Gaudreault N, Major ME, Nastasia I, Dumais R, Deshaies A, Pettigrew S, Labrecque ME, Desmeules F, Maillette P. Return to work following total knee arthroplasty: A multiple case study of stakeholder perspectives. Clin Rehabil 2020; 35:920-934. [PMID: 33371735 DOI: 10.1177/0269215520984319] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The study's aim was to gain insights into factors influencing sustainable return to work following total knee arthroplasty (TKA). DESIGN A descriptive multiple-case design was used. A case was defined as a worker's following TKA work disability situation. SETTINGS The cases came from public hospitals in urban and semi-urban areas in Quebec (Canada) and involved mostly non-work-related TKAs. SUBJECTS Workers had to be between 6 and 12 months post-TKA, have physical/manual jobs and currently employed. Their rehabilitation professionals and workplace representatives (employer and/or union) were also recruited, based on the work disability paradigm. MAIN MEASURES Semi-structured interviews, questionnaires on pain, physical work demands (workers only), and observation of the work activities of those workers back at work were used. Cases were compared and categorized for worker-perceived levels of difficulty in returning to or staying at work: little or no difficulty (n = 8); some difficulty (n = 5); not back at work due to excessive difficulty with their knee (n = 4). RESULTS A total of 17 cases were constituted. In only one case, the worker benefitted from an interdisciplinary work rehabilitation approach. Results highlight the interplay among these factors: (1) the workers' perceptions of their residual symptoms and ability to manage them, (2) the interaction between work adjustments and tools offered by the employers and the workers' own strategies, and (3) perceptions of the workers' physical capacities. CONCLUSION Workers' who face high levels of work demands/difficulties and who have limited access to work adjustments and tools should be referred for work rehabilitation.
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Affiliation(s)
- Marie-France Coutu
- Université de Sherbrooke, School of Rehabiliation, Sherbrooke, QC, Canada
| | - Nathaly Gaudreault
- Université de Sherbrooke, School of Rehabiliation, Sherbrooke, QC, Canada
| | - Marie-Eve Major
- Université de Sherbrooke, Faculty of Physical Activity Sciences, Sherbrooke, QC, Canada
| | - Iuliana Nastasia
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), Research and expertise division, Montreal, QC, Canada
| | - Réjean Dumais
- CIUSSS de l'Estrie-CHUS (Estrie-CHUS University Integrated Health and Social Services Centre), Orthopedics Department, Sherbrooke, QC, Canada
| | - Annie Deshaies
- CIUSSS de l'Estrie-CHUS (Estrie-CHUS University Integrated Health and Social Services Centre), Orthopedics Department, Sherbrooke, QC, Canada
| | - Sara Pettigrew
- Université de Sherbrooke, School of Rehabiliation, Sherbrooke, QC, Canada
| | | | - François Desmeules
- Maisonneuve-Rosemont Hospital Research Centre, Université de Montréal Affiliated Research Centre, Montreal, QC, Canada.,School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Pascale Maillette
- Université de Sherbrooke, School of Rehabiliation, Sherbrooke, QC, Canada
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Marois E, Coutu MF, Durand MJ. Feasibility evaluation of a return-to-work program for workers with common mental disorders: Stakeholders' perspectives. Work 2020; 67:331-343. [PMID: 33044214 DOI: 10.3233/wor-203283] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE This study aimed to evaluate the feasibility of a newly developed return-to-work program for workers with common mental disorders from the perspective of stakeholders (insurers, employers, unions, and workers). METHODS We used a sequential mixed design. First, we conducted a survey to evaluate the levels of stakeholder agreement with the program's feasibility. Second, we conducted a number of independent, homogeneous-group discussions or individual interviews to deepen stakeholders' reflections and allow co-construction of a shared perspective of the program's feasibility. RESULTS Overall, the stakeholders (insurers (n = 6), employers (n = 7), unions (n = 8), and workers (n = 3)), agreed partly to totally with the feasibility of the specific/intermediate objectives, components/tasks, and duration of the components. They identified obstacles that could hinder program implementation. These obstacles pertained mainly to employers' contexts, e.g., difficulty/impossibility of offering job accommodations. They also proposed facilitators to counteract most of these obstacles. Diverging views were found regarding both the role of union representatives and health professionals in the program, and for the duration of the components. CONCLUSION Overall, the program was perceived as feasible to implement, provided that the potential factors discussed are taken into account. The next step will be to evaluate its implementation in real practice settings.
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Affiliation(s)
- Elyse Marois
- Université de Sherbrooke, Health Sciences Program - Faculty of Medicine and Health Sciences, Sherbrooke, Quebec, Canada.,Center for Action in Work Disability Prevention and Rehabilitation (CAPRIT) affiliated with the Charles-Le Moyne - Saguenay-Lac-Saint-Jean Research Center on Health Innovations (CR-CSIS), Quebec, Canada
| | - Marie-France Coutu
- Center for Action in Work Disability Prevention and Rehabilitation (CAPRIT) affiliated with the Charles-Le Moyne - Saguenay-Lac-Saint-Jean Research Center on Health Innovations (CR-CSIS), Quebec, Canada.,Université de Sherbrooke - School of Rehabilitation, Longueuil, Quebec, Canada
| | - Marie-José Durand
- Center for Action in Work Disability Prevention and Rehabilitation (CAPRIT) affiliated with the Charles-Le Moyne - Saguenay-Lac-Saint-Jean Research Center on Health Innovations (CR-CSIS), Quebec, Canada.,Université de Sherbrooke - School of Rehabilitation, Longueuil, Quebec, Canada
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Longtin C, Tousignant-Laflamme Y, Coutu MF. A logic model for a self-management program designed to help workers with persistent and disabling low back pain stay at work. Work 2020; 67:395-406. [PMID: 33044220 DOI: 10.3233/wor-203289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Workers with persistent disabling low back pain (LBP) often encounter difficulty staying at work. Self-management (SM) programs can offer interesting avenues to help workers stay at work. OBJECTIVE To establish the plausibility of a logic model operationalizing a SM program designed to help workers with persistent disabling LBP stay at work. METHODS We used a qualitative design. A preliminary version of the logic model was developed based on the literature and McLaughlin et al.'s framework for logic models. Clinicians in work rehabilitation completed an online survey on the plausibility of the logic model and proposed modifications, which were discussed in a focus group. Thematic analyses were performed. RESULTS Participants (n = 11) found the model plausible, contingent upon a few modifications. They raised the importance of making more explicit the margin of maneuver or "job leeway" for a worker who is trying to stay at work and suggested emphasizing a capability approach. Enhancing the workers' perceived self-efficacy and communication skills were deemed essential tasks of the model. CONCLUSION A plausible logic model for a SM program designed for workers with disabling LBP stay at work was developed. The next step will be to assess its acceptability with potential users.
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Affiliation(s)
- Christian Longtin
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, QC, Canada.,Center for Action in Work Disability Prevention and Rehabilitation (CAPRIT) affiliated with the Charles-Le Moyne - Saguenay-Lac-Saint-Jean Research Center on Health Innovations (CR-CSIS), Quebec, Canada
| | - Yannick Tousignant-Laflamme
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, QC, Canada.,Research Centre of the CHUS, CIUSSS de l'Estrie-CHUS, Sherbrooke, QC, Canada
| | - Marie-France Coutu
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, QC, Canada.,Center for Action in Work Disability Prevention and Rehabilitation (CAPRIT) affiliated with the Charles-Le Moyne - Saguenay-Lac-Saint-Jean Research Center on Health Innovations (CR-CSIS), Quebec, Canada
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20
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Marois E, Durand MJ, Coutu MF. Logic models for the Therapeutic Return-to-Work Program as adapted for common mental disorders: A guide for health professionals. Work 2020; 67:345-358. [PMID: 33044215 DOI: 10.3233/wor-203284] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Workplace interventions are recommended for workers with common mental disorders, but knowledge of their action mechanisms and operationalization remains limited. The Therapeutic Return-to-Work Program, developed for workers with musculoskeletal disorders, is recommended for common mental disorders. OBJECTIVE Our objective was to adapt this program's logic models to common mental disorders. METHODS A program logic analysis was conducted using a literature review and a two-phase group consensus method. We submitted a preliminary adapted version of the program's logic models and two questionnaires to health professional experts who participated in two group sessions, ultimately to produce the final version of the models. RESULTS We consulted 86 publications. The health professional experts (N = 7) had overall mean agreement scores of respectively 4.10/5 and 3.89/5 for questions on the program's theoretical and operational models. The final version of the logic models adapted for common mental disorders included four specific and 15 intermediate objectives, three main components, one optional component, four key processes, and 44 tasks. CONCLUSION The adapted logic models for the Therapeutic Return-to-Work Program show the relevance of the original objectives and components for common mental disorders. The next step will involve evaluating its feasibility with other stakeholders (insurers, employers, unions, workers).
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Affiliation(s)
- Elyse Marois
- Université de Sherbrooke, Health Sciences Program -Faculty of Medicine and Health Sciences, Sherbrooke, Quebec, Canada.,Center for Action in Work Disability Prevention and Rehabilitation (CAPRIT) affiliated with the Charles-Le Moyne - Saguenay-Lac-Saint-Jean Research Center on Health Innovations (CR-CSIS), Quebec, Canada
| | - Marie-José Durand
- Center for Action in Work Disability Prevention and Rehabilitation (CAPRIT) affiliated with the Charles-Le Moyne - Saguenay-Lac-Saint-Jean Research Center on Health Innovations (CR-CSIS), Quebec, Canada.,Université de Sherbrooke -School of Rehabilitation, Longueuil, Quebec, Canada
| | - Marie-France Coutu
- Center for Action in Work Disability Prevention and Rehabilitation (CAPRIT) affiliated with the Charles-Le Moyne - Saguenay-Lac-Saint-Jean Research Center on Health Innovations (CR-CSIS), Quebec, Canada.,Université de Sherbrooke -School of Rehabilitation, Longueuil, Quebec, Canada
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21
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Tousignant-Laflamme Y, Longtin C, Coutu MF, Gaudreault N, Kairy D, Nastasia I, Leonard G. What are the essential components of a self-management program designed to help workers with chronic low back pain stay at work? A mapping review. European Journal of Physiotherapy 2020. [DOI: 10.1080/21679169.2020.1822443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Yannick Tousignant-Laflamme
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Canada
- Research Centre of the CHUS, CIUSSS de l’Estrie-CHUS, Sherbrooke, Canada
| | - Christian Longtin
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Canada
| | - Marie-France Coutu
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Canada
- Centre for Action in Work Disability Prevention and Rehabilitation (CAPRIT) affiliated with the Centre de recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean Research Center on Health Innovations (CR-CSIS), Université de Sherbrooke, Longueuil, Canada
| | - Nathaly Gaudreault
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Canada
- Research Centre of the CHUS, CIUSSS de l’Estrie-CHUS, Sherbrooke, Canada
| | - Dahlia Kairy
- Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM) du Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l’Ile-de-Montréal, Montreal, Canada
- School of Rehabilitation, Université de Montréal, Montreal, Canada
- Centre de recherche interdisciplinaire en réadaptation, Montreal, Canada
| | - Iuliana Nastasia
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), Montreal, Canada
| | - Guillaume Leonard
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Canada
- Research Center on Aging, CIUSSS de l’Estrie-CHUS, Sherbrooke, Canada
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22
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Dulude E, Coutu MF, Durand MJ. Promoting resilience in work rehabilitation: development of a transdiagnostic intervention. Disabil Rehabil 2020; 43:3652-3662. [PMID: 32228191 DOI: 10.1080/09638288.2020.1744041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE The aim of this study was to develop an operationalized transdiagnostic resilience-based intervention for workers at risk of long-term work disability. METHODS A sequential mixed method design was used. Expert clinicians (n = 10) first answered a questionnaire including closed and open-ended questions on the clarity, applicability, relevance and exhaustiveness of a preliminary resilience intervention developed from evidenced-informed resilience factors to prompt reflection. Second, proposals from the questionnaire were discussed at a consensus group meeting with the same experts, yielding a final and improved intervention. Third, semi-structured interviews with work-disabled workers (n = 6) explored the intervention's acceptability to them. Thematic analysis of the verbatim was performed. RESULTS Experts identified 15 statements on clarity, applicability, relevance or exhaustiveness in the questionnaire that did not achieve consensus and generated 41 modification proposals. The consensus group adopted 15 modifications. The adapted intervention was well-accepted by the workers who had completed a work rehabilitation program. They perceived the intervention as positive, relevant, coherent, useful and consistent with their values. CONCLUSION A new transdiagnostic resilience intervention in work rehabilitation is available and was on exploratory basis seen acceptable by workers. Next step would be to validate it at a larger scale with more workers and other stakeholders.IMPLICATIONS FOR REHABILITATIONPromoting workers resilience in work rehabilitation fosters a holistic approach in clinical practice.Resilience interventions should be integrated into work rehabilitation programs.A new transdiagnostic resilience intervention designed to complement current work rehabilitation programs is available.
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Affiliation(s)
- Eve Dulude
- Centre de recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Université de Sherbrooke ‒ Centre d'action en prévention et réadaptation de l'incapacité au travail (CAPRIT), Longueuil, Canada
| | - Marie-France Coutu
- Centre de recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Université de Sherbrooke ‒ Centre d'action en prévention et réadaptation de l'incapacité au travail (CAPRIT), Longueuil, Canada
| | - Marie-José Durand
- Centre de recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Université de Sherbrooke ‒ Centre d'action en prévention et réadaptation de l'incapacité au travail (CAPRIT), Longueuil, Canada
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Doiron-Cadrin P, Lafrance S, Saulnier M, Cournoyer É, Roy JS, Dyer JO, Frémont P, Dionne C, MacDermid JC, Tousignant M, Rochette A, Lowry V, Bureau NJ, Lamontagne M, Coutu MF, Lavigne P, Desmeules F. Shoulder Rotator Cuff Disorders: A Systematic Review of Clinical Practice Guidelines and Semantic Analyses of Recommendations. Arch Phys Med Rehabil 2020; 101:1233-1242. [PMID: 32007452 DOI: 10.1016/j.apmr.2019.12.017] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 12/12/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVES To perform a systematic review of clinical practice guidelines (CPGs) and semantic analysis of specific clinical recommendations for the management of rotator cuff disorders in adults. DATA SOURCES A systematic bibliographic search was conducted up until May 2018 in Medline, Embase, and Physiotherapy Evidence Database, or PEDro, databases, in addition to 12 clinical guidelines search engines listed on the Appraisal of Guidelines for Research and Evaluation (AGREE) website. STUDY SELECTION Nine CPGs on the management of rotator cuff disorders in adults or workers, available in English or French, and published from January 2008 onward, were included and screened by 2 independent reviewers. DATA EXTRACTION CPG methodology was assessed with the AGREE II checklist. A semantic analysis was performed to compare the strength of similar recommendations based on their formulation. The recommendations were categorized in a standardized manner considering the following 4 levels: "essential," "recommended," "may be recommended," and "not recommended." DATA SYNTHESIS Methodological quality was considered high for 3 CPGs and low for 6. All CPGs recommended active treatment modalities, such as an exercise program in the management of rotator cuff disorders. Acetaminophen or nonsteroidal anti-inflammatory drug prescriptions and corticosteroid injections were presented as modalities that may be recommended to decrease pain. Recommendations related to medical imagery and surgical opinion varied among the guidelines. The most commonly recommended return-to-work strategies included intervening early, use of a multidisciplinary approach, and adaptation of work organization. CONCLUSIONS Only 3 CPGs were of high quality. The development of more rigorous CPGs is warranted.
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Affiliation(s)
- Patrick Doiron-Cadrin
- Maisonneuve-Rosemont Hospital Research Center, University of Montréal Affiliated Research Center, Montréal, Québec, Canada
| | - Simon Lafrance
- Maisonneuve-Rosemont Hospital Research Center, University of Montréal Affiliated Research Center, Montréal, Québec, Canada
| | - Marie Saulnier
- Maisonneuve-Rosemont Hospital Research Center, University of Montréal Affiliated Research Center, Montréal, Québec, Canada
| | - Émie Cournoyer
- Maisonneuve-Rosemont Hospital Research Center, University of Montréal Affiliated Research Center, Montréal, Québec, Canada
| | - Jean-Sébastien Roy
- Department of Rehabilitation, Faculty of Medicine, Laval University, Québec City, Québec, Canada; Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Québec City, Québec, Canada
| | - Joseph-Omer Dyer
- School of Rehabilitation, Faculty of Medicine, University of Montréal, Montréal, Québec, Canada
| | - Pierre Frémont
- Department of Rehabilitation, Faculty of Medicine, Laval University, Québec City, Québec, Canada
| | - Clermont Dionne
- Department of Rehabilitation, Faculty of Medicine, Laval University, Québec City, Québec, Canada; Laval University Hospital Center of Research, Québec City, Québec, Canada
| | - Joy C MacDermid
- School of Physical Therapy, Western University, London, Ontario, Canada
| | - Michel Tousignant
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Sherbrooke University, Sherbrooke, Québec, Canada
| | - Annie Rochette
- School of Rehabilitation, Faculty of Medicine, University of Montréal, Montréal, Québec, Canada; Center for Interdisciplinary Research in Rehabilitation of Greater Montréal, Montréal, Québec, Canada
| | - Véronique Lowry
- Maisonneuve-Rosemont Hospital Research Center, University of Montréal Affiliated Research Center, Montréal, Québec, Canada
| | - Nathalie J Bureau
- Department of Radiology, Oncology and Nuclear Medicine, Faculty of Medicine, University of Montréal, Montréal, Québec, Canada; University of Montréal Hospital Research Center (CHUM), Montréal, Québec, Canada
| | - Martin Lamontagne
- Department of Medicine, Faculty of Medicine, University of Montréal, Montréal, Québec, Canada
| | - Marie-France Coutu
- Centre for Work Disability Prevention and Rehabilitation, Charles Le Moyne Hospital Research Centre affiliated with Sherbrooke University, Longueuil, Canada
| | - Patrick Lavigne
- Maisonneuve-Rosemont Hospital Research Center, University of Montréal Affiliated Research Center, Montréal, Québec, Canada; Department of Surgery, Faculty of Medicine, University of Montréal, Montréal, Québec, Canada
| | - François Desmeules
- Maisonneuve-Rosemont Hospital Research Center, University of Montréal Affiliated Research Center, Montréal, Québec, Canada; School of Rehabilitation, Faculty of Medicine, University of Montréal, Montréal, Québec, Canada.
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Longtin C, Coutu MF, Tousignant-Laflamme Y. Deciphering programs for optimal self-management of persistent musculoskeletal-related pain and disability - Clinical implications for PTs. Physiother Theory Pract 2019; 37:1264-1272. [PMID: 31793371 DOI: 10.1080/09593985.2019.1698083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The prolonged disability associated with musculoskeletal (MSK) pain represents an enormous health burden, for individuals as well as society. Promoting pain and disability management for patients with persistent MSK-related conditions can be very challenging for rehabilitation professionals. These often-complex conditions require the adoption of a biopsychosocial perspective in order to assess and address a vast array of potential factors affecting the patient. Fortunately, a self-management (SM) approach has been deemed effective in enhancing patients' control over their symptoms and disabilities. However, given the many different existing SM approaches, rehabilitation professionals would benefit from a clearer definition of SM and a better understanding of the basics of a SM program in order to facilitate their patients' development of SM skills, as this can lead to better outcomes. This narrative review explores the various components of an intervention program intended to facilitate patients' SM of their symptoms and disabilities resulting from a persistent MSK condition. It does so by drawing on a body of published work on pain and disability management, conceptual frameworks underlying SM programs, essential skills associated with optimal SM, and examples from the persistent low back pain (LBP) literature.
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Affiliation(s)
- Christian Longtin
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Marie-France Coutu
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada.,Charles-Le Moyne-Saguenay-Lac-Saint-Jean Research Center on Health Innovations (CR-CSIS), Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Yannick Tousignant-Laflamme
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada.,Clinical Research Centre of the CHUS, CIUSSS de l'Estrie-CHUS, Sherbrooke, QC, Canada
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Bouffard J, Durand MJ, Coutu MF. Adaptation of a Guide to Equip Employers to Manage the Gradual Return to Work of Individuals with a Musculoskeletal Disorder. J Occup Rehabil 2019; 29:625-635. [PMID: 30661156 DOI: 10.1007/s10926-019-09827-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Purpose The gradual return to work (GRTW) of injured workers poses numerous challenges for workplaces. The aim of this study was to provide employers with an adapted tool to support them in managing GRTWs following a musculoskeletal disorder (MSD), by adapting the Guide for estimation of margin of manoeuvre (Durand et al. in 7th international scientific conference on prevention of work-related musculoskeletal disorders, 2010) and then evaluating the acceptability of the adapted version. Methods A mixed methods design was used. Content experts were surveyed about the content and form of a first version of the adapted tool. Proposed modifications were then discussed in a group meeting until consensus was reached on the changes to be made. The acceptability of the new version was determined by conducting semi-structured interviews of potential users. A thematic analysis of the verbatim transcript was performed. Results Nine experts reached a consensus on 20 modifications, which yielded a tool comprising an instruction guide and a planning worksheet. The eight companies consulted found the tool acceptable, useful, and pertinent, but also identified a few changes to be made. Conclusion The use of original methods made it possible to adapt the content of the tool while taking evidence-based data and user needs into account, all of which contributed to its acceptance. The tool will support employers and standardize management of GRTWs following MSD-related sick leaves. Possible avenues for future research emerged from this study: evaluate the acceptability of new formats and a transdiagnostic version of the tool, and consult workers.
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Affiliation(s)
- Julie Bouffard
- Centre for Action in Work Disability Prevention and Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles LeMoyne, Suite 200, Longueuil, QC, J4K 0A8, Canada.
| | - Marie-José Durand
- Centre for Action in Work Disability Prevention and Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles LeMoyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
| | - Marie-France Coutu
- Centre for Action in Work Disability Prevention and Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles LeMoyne, Suite 200, Longueuil, QC, J4K 0A8, Canada
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L’Heureux J, Coutu MF, Berbiche D, Larivière C. Adherence to a home exercise programme following a clinical programme for non-acute non-specific low back pain: an exploratory study. European Journal of Physiotherapy 2019. [DOI: 10.1080/21679169.2019.1617777] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Judith L’Heureux
- Université de Sherbrooke, Longueuil, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada
| | - Marie-France Coutu
- Université de Sherbrooke, Longueuil, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada
- Charles-LeMoyne Hospital Research Centre, Longueuil, Canada
| | - Djamal Berbiche
- Université de Sherbrooke, Longueuil, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada
| | - Christian Larivière
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada
- Institut Robert-Sauvé en santé et en sécurité du travail (IRSST), Montréal, Canada
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Tremblay D, Bilodeau K, Durand MJ, Coutu MF. Translation and perceptions of the French version of the Cancer Survivor Profile-Breast Cancer (CSPro-BC): a tool to identify and manage unmet needs. J Cancer Surviv 2019; 13:306-315. [PMID: 30904981 DOI: 10.1007/s11764-019-00752-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 03/13/2019] [Indexed: 12/12/2022]
Abstract
PURPOSE Worldwide healthcare systems continue to struggle to reduce the unmet needs of a growing population of breast cancer survivors (BCSs). The Cancer Survivor Profile-Breast Cancer (CSPro-BC) survey was developed to address BCS's specific needs. This study aims to produce a culturally adapted French version of the CSPro-BC. METHODS The CSPro-BC(French) was developed through five steps including back translation, use of a multidisciplinary committee, and pretest with BCS (n = 22). Healthcare providers (HCP) (n = 7) from cancer and primary care settings were also interviewed to obtain perceptions of facilitators and barriers to utilization in daily practice. RESULTS BCS were 40-69 years old (50%), ≥ 5 years post-diagnosis (45%), received chemotherapy alone or in combination (73%). Questionnaire instructions were perceived as clear, the number of questions (n = 73) acceptable, the questions non-intrusive and not complicated. Clarity of questions (min = 1; max = 7) ranged from 4 to 7 with a mean score of 5.9 out of 7. HCP perceived the CSPro-BC(French) as useful for improving communication with BCS. However, HCP stressed implementation concerns regarding competencies, BCS acceptability, and limited resources in the healthcare system to meet the identified concerns. CONCLUSIONS CSPro-BC(French) is a credible tool for assessment in Francophone nations. Our study provides an important perspective in the translation method, including both survivors and HCP perspectives. Further research is required to evaluate its psychometric qualities, sensitivity to change and its clinical signification. IMPLICATIONS FOR CANCER SURVIVORS Access to assessment tools specific to French-speaking cancer survivors having a potential to improve support from HCP and self-management capacity for BCS.
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Affiliation(s)
- Dominique Tremblay
- Centre de recherche Charles-Le Moyne - Saguenay-Lac-Saint-Jean sur les innovations en santé, 150 Place Charles-Le Moyne, Longueuil, Québec, J4K 0A8, Canada. .,Faculté de médecine et des sciences de la santé, Université de Sherbrooke, 150 Place Charles-Le Moyne, Longueuil, Québec, J4K 0A8, Canada.
| | - Karine Bilodeau
- Faculté des sciences infirmières, Université de Montréal, 2375 chemin Côte-Ste-Catherine, Montreal, Québec, H3T 1A8, Canada
| | - Marie-José Durand
- Centre de recherche Charles-Le Moyne - Saguenay-Lac-Saint-Jean sur les innovations en santé, 150 Place Charles-Le Moyne, Longueuil, Québec, J4K 0A8, Canada.,Faculté de médecine et des sciences de la santé, Université de Sherbrooke, 150 Place Charles-Le Moyne, Longueuil, Québec, J4K 0A8, Canada
| | - Marie-France Coutu
- Centre de recherche Charles-Le Moyne - Saguenay-Lac-Saint-Jean sur les innovations en santé, 150 Place Charles-Le Moyne, Longueuil, Québec, J4K 0A8, Canada.,Faculté de médecine et des sciences de la santé, Université de Sherbrooke, 150 Place Charles-Le Moyne, Longueuil, Québec, J4K 0A8, Canada
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Coutu MF, Légaré F, Durand MJ, Stacey D, Labrecque ME, Corbière M, Bainbridge L. Acceptability and Feasibility of a Shared Decision-Making Model in Work Rehabilitation: A Mixed-Methods Study of Stakeholders' Perspectives. J Occup Rehabil 2019; 29:128-139. [PMID: 29663111 DOI: 10.1007/s10926-018-9770-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Purpose To establish the acceptability and feasibility of implementing a shared decision-making (SDM) model in work rehabilitation. Methods We used a sequential mixed-methods design with diverse stakeholder groups (representatives of private and public employers, insurers, and unions, as well as workers having participated in a work rehabilitation program). First, a survey using a self-administered questionnaire enabled stakeholders to rate their level of agreement with the model's acceptability and feasibility and propose modifications, if necessary. Second, eight focus groups representing key stakeholders (n = 34) and four one-on-one interviews with workers were conducted, based on the questionnaire results. For each stakeholder group, we computed the percentage of agreement with the model's acceptability and feasibility and performed thematic analyses of the transcripts. Results Less than 50% of each stakeholder group initially agreed with the overall acceptability and feasibility of the model. Stakeholders proposed 37 modifications to the objectives, 17 to the activities, and 39 to improve the model's feasibility. Based on in-depth analysis of the transcripts, indicators were added to one objective, an interview guide was added as proposed by insurers to ensure compliance of the SDM process with insurance contract requirements, and one objective was reformulated. Conclusion Despite initially low agreement with the model's acceptability on the survey, subsequent discussions led to three minor changes and contributed to the model's ultimate acceptability and feasibility. Later steps will involve assessing the extent of implementation of the model in real rehabilitation settings to see if other modifications are necessary before assessing its impact.
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Affiliation(s)
- Marie-France Coutu
- CAPRIT and School of Rehabilitation, Université de Sherbrooke, Longueuil, QC, Canada.
- Charles-Le Moyne Hospital Research Centre, 150 Place Charles-Le Moyne, Room 200, Longueuil, QC, J4K 0A8, Canada.
| | - France Légaré
- Research Center of Centre hospitalier universitaire de Québec, St-François d'Assise Hospital, Quebec, QC, Canada
| | - Marie-José Durand
- CAPRIT and School of Rehabilitation, Université de Sherbrooke, Longueuil, QC, Canada
- Charles-Le Moyne Hospital Research Centre, 150 Place Charles-Le Moyne, Room 200, Longueuil, QC, J4K 0A8, Canada
| | - Dawn Stacey
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Marie-Elise Labrecque
- CAPRIT and School of Rehabilitation, Université de Sherbrooke, Longueuil, QC, Canada
| | - Marc Corbière
- Université du Québec à Montréal, Montreal, QC, Canada
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montreal, QC, Canada
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Negrini A, Corbière M, Lecomte T, Coutu MF, Nieuwenhuijsen K, St-Arnaud L, Durand MJ, Gragnano A, Berbiche D. How Can Supervisors Contribute to the Return to Work of Employees Who have Experienced Depression? J Occup Rehabil 2018; 28:279-288. [PMID: 28660364 DOI: 10.1007/s10926-017-9715-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Background In Western countries, work disability due to depression is a widespread problem that generates enormous costs. Objective The goal of this study was to determine the types and prevalence of supervisor contributions during the different phases of the return-to-work (RTW) process (before and during the sick-leave absence, and during the RTW preparations) of employees diagnosed with depression. Moreover, we sought to determine which contributions actually facilitate employees' RTW, and to identify the work accommodations most frequently implemented by supervisors at the actual time of their employee's RTW. Methods Telephone interviews were conducted in Québec (Canada) with 74 supervisors working with employees who were already back at work or still on sick leave due to depression. A sub-sample of 46 supervisors who had already taken measures to facilitate their employees' RTW was questioned about the work accommodations implemented. Results Most of the supervisors got along well with their employees before their sick leave and 72% stayed in contact with them during their leave. Nearly 90% of the supervisors encouraged their employees to focus primarily on their recovery before their RTW, but 43% pressured their employees to RTW as soon as possible. Cox regression analyses performed for the entire sample revealed that "the supervisors' intention to take measures to facilitate their employees' RTW" was the only significant predictor of the RTW at the time of the interview. The Kaplan-Meier survival curve showed that 50% of the employees were expected to RTW within the first 8 months of absence. Four of the most frequently implemented work accommodations were actions directly involving the supervisor (i.e. providing assistance, feedback, recognition, and emotional support to the employee). Conclusions This study shed light on the less explored point of view of the supervisor involved in the RTW process of employees post-depression. It highlighted the most frequent and effective supervisor contributions to the process. These results can be used to develop concrete action plans for training supervisors to contribute to the sustainable RTW of employees on sick leave due to depression.
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Affiliation(s)
- Alessia Negrini
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), 505 boul. de Maisonneuve Ouest, Montreal, QC, H3A 3C2, Canada.
| | - Marc Corbière
- Faculty of Educational Sciences, Université du Québec à Montréal, 1205 rue Saint-Denis, Montreal, QC, H2X 3R9, Canada
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, 7401 Rue Hochelaga, Montreal, QC, H1N 3M5, Canada
| | - Tania Lecomte
- Faculty of Arts and Sciences, Université de Montréal, 90 avenue Vincent d'Indy, Pavillon Marie-Victorin, succ. Centre-Ville, CP6128, Montreal, QC, H2C 3J7, Canada
| | - Marie-France Coutu
- Centre for Action in Work Disability Prevention and Rehabilitation (CAPRIT), School of Rehabilitation, Université de Sherbrooke, 150 Place Charles LeMoyne, Longueuil, QC, J4K 0A8, Canada
| | - Karen Nieuwenhuijsen
- Coronel Institute of Occupational Health, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam-Zuidoost, The Netherlands
| | - Louise St-Arnaud
- Faculty of Education, Centre de recherche et d'intervention sur l'éducation et la vie au travail (CRIEVAT), Université Laval, 2320 rue des Bibliothèques, Quebec, QC, G1V 0A6, Canada
| | - Marie-José Durand
- Centre for Action in Work Disability Prevention and Rehabilitation (CAPRIT), School of Rehabilitation, Université de Sherbrooke, 150 Place Charles LeMoyne, Longueuil, QC, J4K 0A8, Canada
| | - Andrea Gragnano
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), 505 boul. de Maisonneuve Ouest, Montreal, QC, H3A 3C2, Canada
- Faculty of Educational Sciences, Université du Québec à Montréal, 1205 rue Saint-Denis, Montreal, QC, H2X 3R9, Canada
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, 7401 Rue Hochelaga, Montreal, QC, H1N 3M5, Canada
| | - Djamal Berbiche
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, 150 Place Charles LeMoyne, Longueuil, QC, J4K 0A8, Canada
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Hong QN, Coutu MF, Berbiche D. Evaluating the validity of the Work Role Functioning Questionnaire (Canadian French version) using classical test theory and item response theory. Work 2018; 57:501-515. [PMID: 28826198 DOI: 10.3233/wor-172585] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The Work Role Functioning Questionnaire (WRFQ) was developed to assess workers' perceived ability to perform job demands and is used to monitor presenteeism. Still few studies on its validity can be found in the literature. OBJECTIVE The purpose of this study was to assess the items and factorial composition of the Canadian French version of the WRFQ (WRFQ-CF). METHODS Two measurement approaches were used to test the WRFQ-CF: Classical Test Theory (CTT) and non-parametric Item Response Theory (IRT). RESULTS A total of 352 completed questionnaires were analyzed. A four-factor and three-factor model models were tested and shown respectively good fit with 14 items (Root Mean Square Error of Approximation (RMSEA) = 0.06, Standardized Root Mean Square Residual (SRMR) = 0.04, Bentler Comparative Fit Index (CFI) = 0.98) and with 17 items (RMSEA = 0.059, SRMR = 0.048, CFI = 0.98). Using IRT, 13 problematic items were identified, of which 9 were common with CTT. CONCLUSIONS This study tested different models with fewer problematic items found in a three-factor model. Using a non-parametric IRT and CTT for item purification gave complementary results. IRT is still scarcely used and can be an interesting alternative method to enhance the quality of a measurement instrument. More studies are needed on the WRFQ-CF to refine its items and factorial composition.
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Affiliation(s)
- Quan Nha Hong
- Department of Family Medicine, McGill University, Montréal, QC, Canada
| | - Marie-France Coutu
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, QC, Canada.,Hôpital Charles-LeMoyne Research Center - CISSS Montérégie-Centre, Longueuil, QC, Canada
| | - Djamal Berbiche
- Hôpital Charles-LeMoyne Research Center - CISSS Montérégie-Centre, Longueuil, QC, Canada
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Corbière M, Lecomte T, Lachance JP, Coutu MF, Negrini A, Laberon S. Stratégies de retour au travail d’employés ayant fait l’expérience d’une dépression : perspectives des employeurs et des cadres des ressources humaines. smq 2017. [DOI: 10.7202/1041922ar] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
La dépression majeure est l’une des premières causes d’incapacité au travail dans le monde et a de nombreuses conséquences tant sur l’employé concerné qu’auprès des acteurs du milieu de travail.ObjectifNous visons à documenter, selon la perspective des employeurs et des cadres des ressources humaines, les stratégies que ces acteurs préconisent dans leur organisation pour faciliter le retour au travail (RaT) d’employés en absence maladie due à une dépression.MéthodeDeux cent dix-neuf employeurs et cadres de ressources humaines (n = 219) ont accepté de répondre à une entrevue semi-structurée téléphonique. La question abordée dans cet article était : « Selon vous, quelles sont les stratégies les plus efficaces pour aider un employé ayant reçu un diagnostic de dépression à retourner au travail ? » La codification duverbatima été effectuée à partir d’études empiriques et de théories existantes.RésultatsTrente-quatre (34) stratégies réparties sur six grands principes ont émergé : 1) Contact avec l’employé en absence maladie (10 stratégies) ; 2) Évaluation et planification du RaT sans précipitation (6) ; 3) Formation des gestionnaires et du collectif de travail à la problématique de la santé mentale au travail (4) ; 4) Concertation des acteurs clés du RaT (4) ; 5) RaT progressif avec aménagements (4) ; 6) Suivi de la santé de l’employé et de son travail (6).ConclusionCes principes articulés autour de 34 stratégies du RaT vont au-delà d’un processus étapiste de nature chronologique. Articulés dans un programme de RaT, ils devront être testés afin d’évaluer leurs retombées dans les organisations, notamment sur la gestion de l’incapacité au travail.
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Affiliation(s)
- Marc Corbière
- Professeur titulaire du Département d’éducation et pédagogie – Counseling de carrière, Université du Québec à Montréal – Chercheur au Centre de recherche de l’Institut universitaire en santé mentale de Montréal (CR-IUSMM) – Titulaire de la Chaire de recherche en santé mentale et travail, Fondation de l’IUSMM
| | - Tania Lecomte
- Professeur titulaire du Département de psychologie, Université de Montréal – Chercheuse au Centre de recherche de l’Institut universitaire en santé mentale de Montréal (CR-IUSMM)
| | - Jean-Philippe Lachance
- Étudiant au doctorat interdisciplinaire santé et société, Université du Québec à Montréal ; Coordonnateur de projets de recherche au Centre de recherche de l’Institut universitaire en santé mentale de Montréal (CR-IUSMM)
| | - Marie-France Coutu
- Professeure titulaire de l’École de réadaptation, campus de Longueuil, Université de Sherbrooke ; Chercheuse du CAPRIT intégré au centre de recherche – Hôpital Charles Le Moyne
| | - Alessia Negrini
- Chercheuse en santé psychologique au travail à l’Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST)
| | - Sonia Laberon
- Maître de conférences en psychologie du travail et des organisations, Faculté de psychologie, Laboratoire de psychologie EA4139, Université de Bordeaux, France
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Gouin MM, Coutu MF, Durand MJ. Return-to-work success despite conflicts: an exploration of decision-making during a work rehabilitation program. Disabil Rehabil 2017; 41:523-533. [DOI: 10.1080/09638288.2017.1400592] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Marie-Michelle Gouin
- Department of Management and Human Resource Management, Management school, Université de Sherbrooke, Longueuil, Canada
| | - Marie-France Coutu
- Centre for Work Disability Prevention and Rehabilitation (CAPRIT), Charles-Le Moyne Hospital Research Centre affiliated with Université de Sherbrooke, Longueuil, Canada
| | - Marie-José Durand
- Centre for Work Disability Prevention and Rehabilitation (CAPRIT), Charles-Le Moyne Hospital Research Centre affiliated with Université de Sherbrooke, Longueuil, Canada
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Maillette P, Coutu MF, Gaudreault N. Workers’ perspectives on return to work after total knee arthroplasty. Ann Phys Rehabil Med 2017; 60:299-305. [DOI: 10.1016/j.rehab.2017.01.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 01/18/2017] [Accepted: 01/19/2017] [Indexed: 11/28/2022]
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Légaré F, Stacey D, Forest PG, Coutu MF, Archambault P, Boland L, Witteman HO, LeBlanc A, Lewis KB, Giguere AMC. Milestones, barriers and beacons: Shared decision making in Canada inches ahead. Z Evid Fortbild Qual Gesundhwes 2017; 123-124:23-27. [PMID: 28532628 DOI: 10.1016/j.zefq.2017.05.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Canada's approach to shared decision making (SDM) remains as disparate as its healthcare system; a conglomerate of 14 public plans - ten provincial, three territorial and one federal. The healthcare research funding environment has been largely positive for SDM because there was funding for knowledge translation research which also encompassed SDM. The funding climate currently places new emphasis on patient involvement in research and on patient empowerment in healthcare. SDM fields have expanded from primary care to elder care, paediatrics, emergency and critical care medicine, cardiology, nutrition, occupational therapy and workplace rehabilitation. Also, SDM has reached out to embrace other health-related decisions including about home care and social care and has been adapted to Aboriginal decision making needs. Canadian researchers have developed new interprofessional SDM models that are being used worldwide. Professional interest in SDM in Canada is not yet widespread, but there are provincial initiatives in Alberta, British Columbia, Ontario, Quebec and Saskatchewan. Decision aids are routinely used in some areas, for example for prostate cancer in Saskatchewan, and many others are available for online consultation. The Patient Decision Aids Research Group in Ottawa, Ontario maintains an international inventory of decision aids appraised with the International Patient Decision Aid Standards. The Canada Research Chair in SDM and Knowledge Translation in Quebec City maintains a website of SDM training programs available worldwide. These initiatives are positive, but the future of SDM in Canada depends on whether health policies, health professionals and the public culture fully embrace it.
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Affiliation(s)
- France Légaré
- Research Centre of the Centre Hospitalier Universitaire de Québec, Quebec, QC, Canada; Department of Family Medicine and Emergency Medicine, Université Laval, Quebec, QC, Canada; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Université Laval Research Institute for Primary Care and Health Services (CERSSPL-UL), Quebec, QC, Canada.
| | - Dawn Stacey
- Faculty of Health Sciences University of Ottawa, Ottawa, Ontario, Canada; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | | | - Marie-France Coutu
- Centre for Action in Work Disability Prevention and Rehabilitation affiliated with Hôpital Charles LeMoyne Research Center, Rehabilitation Department, Université de Sherbrooke, Longueuil, Longueuil, QC, Canada
| | - Patrick Archambault
- Research Centre of the Centre Hospitalier Universitaire de Québec, Quebec, QC, Canada; Department of Family Medicine and Emergency Medicine, Université Laval, Quebec, QC, Canada; Centre intégré de santé et services sociaux de Chaudière-Appalaches, Hôtel-Dieu de Lévis, Lévis, QC, Canada; Department of Anesthesiology and Critical Care Medicine, Division of Critical Care Medicine, Université Laval, Quebec, QC, Canada
| | - Laura Boland
- Faculty of Health Sciences University of Ottawa, Ottawa, Ontario, Canada; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Holly O Witteman
- Research Centre of the Centre Hospitalier Universitaire de Québec, Quebec, QC, Canada; Department of Family Medicine and Emergency Medicine, Université Laval, Quebec, QC, Canada; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Université Laval Research Institute for Primary Care and Health Services (CERSSPL-UL), Quebec, QC, Canada; Office of Education and Continuing Development, Faculty of Medicine, Université Laval, Quebec, QC, Canada
| | - Annie LeBlanc
- Research Centre of the Centre Hospitalier Universitaire de Québec, Quebec, QC, Canada; Department of Family Medicine and Emergency Medicine, Université Laval, Quebec, QC, Canada; Université Laval Research Institute for Primary Care and Health Services (CERSSPL-UL), Quebec, QC, Canada
| | - Krystina B Lewis
- Faculty of Health Sciences University of Ottawa, Ottawa, Ontario, Canada
| | - Anik M C Giguere
- Research Centre of the Centre Hospitalier Universitaire de Québec, Quebec, QC, Canada; Department of Family Medicine and Emergency Medicine, Université Laval, Quebec, QC, Canada; Université Laval Research Institute for Primary Care and Health Services (CERSSPL-UL), Quebec, QC, Canada; Office of Education and Continuing Development, Faculty of Medicine, Université Laval, Quebec, QC, Canada
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Abstract
Purpose Although the role of return-to-work coordinators (RTW coordinators) is associated with reducing long-term disabilities, little has been written about their practices. The objective of this study was to clearly identify their tasks and activities and the stakeholders with whom they collaborate. Methods A cross-sectional survey was conducted using a web-based self-administered questionnaire. Participant inclusion criteria were as follows: (1) working for a large organization with 500 or more employees; (2) being responsible for managing disabilities and coordinating the return-to-work process; and (3) having been involved in coordinating the return to work of at least one person in the past year. Results 195 RTW coordinators completed the questionnaire. The three tasks or activities rated as most important were applying laws, policies, and regulations related to work absences and return to work; contacting the absent worker; and planning the return to work. A nursing or occupational health and safety training background significantly influenced the RTW coordinators' practices. In addition, RTW coordinators collaborated mainly with workers and their supervisors. Conclusion Despite a wide variety of contexts and diverging definitions of competencies, a set of common RTW coordination practices appears to exist across industrialized countries. RTW coordinators with a training background in the health field seem better able to assimilate the various dimensions of work disability. Moreover, concerted action was found to be minimal and a far cry from recommendations. The practices defined could serve as a benchmark for describing RTW coordinators' responsibilities in greater detail and allow for cross-organization and cross-country comparisons.
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Affiliation(s)
- Marie-José Durand
- Centre for Action in Work Disability Prevention and Rehabilitation, School of Rehabilitation, Université de Sherbrooke, 150 Place Charles LeMoyne, Longueuil, QC, J4K 0A8, Canada.
| | - Iuliana Nastasia
- Institut de Recherche Robert Sauvé en Santé et en Sécurité du Travail, 505 Boulevard de Maisonneuve O, Montréal, QC, Canada
| | - Marie-France Coutu
- Centre for Action in Work Disability Prevention and Rehabilitation, School of Rehabilitation, Université de Sherbrooke, 150 Place Charles LeMoyne, Longueuil, QC, J4K 0A8, Canada
| | - Michael Bernier
- Centre for Action in Work Disability Prevention and Rehabilitation, School of Rehabilitation, Université de Sherbrooke, 150 Place Charles LeMoyne, Longueuil, QC, J4K 0A8, Canada
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Corbière M, Lecomte T, Lachance JP, Coutu MF, Negrini A, Laberon S. [Return to Work Strategies of Employees who Experienced Depression: Employers and HR's Perspectives]. Sante Ment Que 2017; 42:173-196. [PMID: 29267420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Major depression is one of the leading causes of work disability across the world. In Canada, the lifetime prevalence of depression varies from 10 to 12%. Depression impacts not only the employee who is often stigmatized and can lose his professional identity, but also has consequences on colleagues and supervisors in organizations. In the literature, four models are described from which employers and managers use in their organizations to make decisions regarding the work disability of employees on sick leave: biomedical, financial management, personnel management, and organizational development. These models can also be supported by economic, legal and ethical interests. Even though these models are essential to better understand the decision of employers and HR regarding work disability, information remains scarce regarding the concrete strategies used by these stakeholders to facilitate the return to work for employees on sick leave due to depression.Objectives the aim of this paper is to document, considering employers' and human resources' perspectives, the best strategies to put in place to facilitate the return to work of employees on sick leave due to depression.Method This study was part of a larger study carried out in Canada to assess factors influencing the return to work after a depression-related sick leave, taking into account the viewpoint of four types of stakeholders: employers/human resources, supervisors, unions and people diagnosed with depression. 219 employers (68.5%) and human resources directors (31.5%) from 82.6% organizations having more than 100 employees accepted to answer a telephone semi-structured interview. The question of interest in this study is: In your opinion, what are the best strategies to help an employee who has had a depression to return to work? Coding was influenced by empirical findings and theories related to psychosocial risk factors that the authors use in their respective disciplines as well as return to work principles/steps mentioned in the literature. The main objective was to keep all the strategies mentioned by participants, and analyzing them with major principles of return to work.Results 24 return to work strategies spread on six principles emerged: 1) Contact with the employee during his sick leave (10 strategies); 2) Evaluate and plan the return to work without precipitating it (6); 3) Training for managers and colleagues regarding mental health in the workplace (4); 4) Concertation between key return to work stakeholders (4); 5) Progressive return to work with work accommodations (4); 6) Health and work follow-up regarding the employee (6).Conclusion These six principles including 34 strategies are usually related to the timeframe process of the return to work, though they can be implemented sometimes in parallel. This possible overlap reinforces the idea to consider the return to work as sustainable in order to prevent potential relapses and improve the performance at work. Next steps will be to systematically implement these principles and strategies in organizations in order to evaluate their impact on return to work of employees on sick leave due to depression.
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Affiliation(s)
- Marc Corbière
- Département d'éducation et pédagogie, Université du Québec à Montréal; Centre de recherche de l'Institut universitaire en santé mentale de Montréal (CR-IUSMM); Chaire de recherche en santé mentale et travail, Fondation de l'IUSMM
| | - Tania Lecomte
- Département de psychologie, Université de Montréal; Centre de recherche de l'Institut universitaire en santé mentale de Montréal (CR-IUSMM)
| | - Jean-Philippe Lachance
- Université du Québec à Montréal; Projets de recherche, Centre de recherche de l'Institut universitaire en santé mentale de Montréal (CR-IUSMM)
| | - Marie-France Coutu
- École de réadaptation, campus de Longueuil, Université de Sherbrooke; Hôpital Charles Le Moyne
| | - Alessia Negrini
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST)
| | - Sonia Laberon
- Faculté de psychologie, Laboratoire de psychologie EA4139, Université de Bordeaux, France
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Durand MJ, Coutu MF, Nastasia I. Pratiques de retour au travail dans de grandes entreprises au Québec. ARCH MAL PROF ENVIRO 2016. [DOI: 10.1016/j.admp.2016.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Labrecque ME, Coutu MF, Durand MJ, Fassier JB, Loisel P. Using Cartoons to Transfer Knowledge Concerning the Principles of Work Disability Prevention Among Stakeholders. J Occup Rehabil 2016; 26:141-149. [PMID: 26149618 DOI: 10.1007/s10926-015-9595-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Purpose This study assesses how well two cartoons transfer knowledge of principles of work disability prevention among stakeholders, according to their level of experience. We also document stakeholders' perceptions of the usefulness of the cartoons. Method We performed a descriptive study. Two groups of stakeholders were recruited: (1) experienced (working for more than 2 years in work disability), (2) non-experienced (in training). A self-administered questionnaire with open-ended questions documented stakeholders' understanding of each cartoon box and their perception of the possible usefulness of the cartoons. We transformed qualitative responses into quantitative responses for descriptive purposes. We performed independent t tests to compare the groups' level of understanding, and content analysis for the perception of usefulness. Results Overall, 149 stakeholders (50 experienced and 99 non-experienced) participated and identified 79.4 and 61.4 % of all principles presented in each of the two cartoons respectively. Experienced stakeholders identified more principles compared to non-experienced stakeholders (p = 0.007). Both cartoons were perceived to be useful for knowledge transfer. Conclusions Principles were generally well identified in the cartoons by all participants. Cartoons can be used as an effective tool among stakeholders to achieve a common understanding in order to coordinate their actions.
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Affiliation(s)
- Marie-Elise Labrecque
- Hopital Charles-LeMoyne Research Center and School of Rehabilitation, Université de Sherbrooke, 150 Place Charles-lemoyne, Longueuil, QC, J4K 0A8, Canada
| | - Marie-France Coutu
- Hopital Charles-LeMoyne Research Center and School of Rehabilitation, Université de Sherbrooke, 150 Place Charles-lemoyne, Longueuil, QC, J4K 0A8, Canada.
| | - Marie-José Durand
- Hopital Charles-LeMoyne Research Center and School of Rehabilitation, Université de Sherbrooke, 150 Place Charles-lemoyne, Longueuil, QC, J4K 0A8, Canada
| | - Jean-Baptiste Fassier
- Hopital Charles-LeMoyne Research Center and School of Rehabilitation, Université de Sherbrooke, 150 Place Charles-lemoyne, Longueuil, QC, J4K 0A8, Canada
- Hospices Civils de Lyon/UMRESTTE, Université Claude Bernard Lyon 1, Lyon, France
| | - Patrick Loisel
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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Durand MJ, Corbière M, Coutu MF, Reinharz D, Albert V. A review of best work-absence management and return-to-work practices for workers with musculoskeletal or common mental disorders. Work 2016; 48:579-89. [PMID: 24990281 DOI: 10.3233/wor-141914] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Workplace absenteeism is still a curse for developed countries, and more systematic practices need to be adopted to address this issue. OBJECTIVE To review the literature on best practices for managing work absences related to musculoskeletal or common mental disorders. METHODS A review was conducted by performing a search in bibliographic databases and on work-disability research institute websites. Recommendations regarding work-absence management and return-to-work practices were extracted from all the retained documents and organized within a chronological framework. RESULTS In total, 17 documents were analyzed, leading to identification of common work-absence management and return-to-work practices, the importance of a worker support approach, and recommended roles and responsibilities for stakeholders. These practices were then integrated into a six-step process: (1) time off and recovery period; (2) initial contact with the worker; (3) evaluation of the worker and his job tasks; (4) development of a return-to-work plan with accommodations; (5) work resumption, and (6) follow-up of the return-to-work process. CONCLUSIONS Based on this review, we constructed a comprehensive work-absence management and return-to-work process designed to assist organizations. Our results indicate that such a process must be included within a broader policy of health promotion and job retention. Adaptations will be required for implementation in the workplace.
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Affiliation(s)
- Marie-José Durand
- University of Sherbrooke, Center for Action in Work Disability Prevention and Rehabilitation, Hôpital Charles-LeMoyne Research Center, Longueuil, QC, Canada
| | - Marc Corbière
- University of Sherbrooke, Center for Action in Work Disability Prevention and Rehabilitation, Hôpital Charles-LeMoyne Research Center, Longueuil, QC, Canada
| | - Marie-France Coutu
- University of Sherbrooke, Center for Action in Work Disability Prevention and Rehabilitation, Hôpital Charles-LeMoyne Research Center, Longueuil, QC, Canada
| | - Daniel Reinharz
- Laval University, Social and Preventive Medicine, Pavillon Ferdinand-Vandry, QC, Canada
| | - Valérie Albert
- University of Sherbrooke, Center for Action in Work Disability Prevention and Rehabilitation, Hôpital Charles-LeMoyne Research Center, Longueuil, QC, Canada
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Coutu MF, Légaré F, Stacey D, Durand MJ, Corbière M, Bainbridge L, Labrecque ME. Occupational therapists' shared decision-making behaviors with patients having persistent pain in a work rehabilitation context: A cross-sectional study. Patient Educ Couns 2015; 98:864-870. [PMID: 25850756 DOI: 10.1016/j.pec.2015.03.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 03/13/2015] [Accepted: 03/14/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE In a work rehabilitation context, we assessed occupational therapists' (OTs) shared decision-making (SDM) behaviors with individuals having persistent pain and explored factors influencing SDM behaviors. METHODS A cross-sectional study that used audio-recordings of work rehabilitation consultations between OTs trained in SDM and a convenient sample of patients. Eligible patients were: off work for ≥12 weeks due to persistent pain associated with a musculoskeletal disorder, starting a work rehabilitation program, and French speaking. Transcripts were analyzed using the Observing Patient Involvement in Shared Decision Making (OPTION) instrument and assessed patients' decisional conflict and socioeconomic status. RESULTS Of 15 OTs trained in SDM, 11 (90% female), provided audiotaped SDM meetings with 37 patients (40.5% female; aged 18-62 years). Their average OPTION score was 53.94 out of 100 (SD=9.68; range 35.42-70.83), indicating basic skills. Significant factors associated with OPTION scores (R (2)adjusted=21.7%) were the interview length (p=0.008) and level of patient education (p=0.038). CONCLUSION Basic SDM behaviors were integrated in the practice of OTs trained in SDM. PRACTICE IMPLICATIONS Evaluating SDM behaviors is a step toward providing OTs with performance feedback toward achieving client-centered care.
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Affiliation(s)
- Marie-France Coutu
- Hôpital CharlesLeMoyne Research Center and School of Rehabilitation, Université de Sherbrooke, Longueuil, Canada.
| | - France Légaré
- Centre Hospitalier Universitaire de Québec Research Center, Hospital St-François d'Assise, Québec, Canada
| | - Dawn Stacey
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Marie-José Durand
- Hôpital CharlesLeMoyne Research Center and School of Rehabilitation, Université de Sherbrooke, Longueuil, Canada
| | - Marc Corbière
- Hôpital CharlesLeMoyne Research Center and School of Rehabilitation, Université de Sherbrooke, Longueuil, Canada
| | | | - Marie-Elise Labrecque
- Hôpital CharlesLeMoyne Research Center and School of Rehabilitation, Université de Sherbrooke, Longueuil, Canada
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Corbière M, Renard M, St-Arnaud L, Coutu MF, Negrini A, Sauvé G, Lecomte T. Union perceptions of factors related to the return to work of employees with depression. J Occup Rehabil 2015; 25:335-347. [PMID: 25261388 DOI: 10.1007/s10926-014-9542-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE Between 30 and 60% of the societal cost of depression is due to losses related to decreased work productivity. To date, only a few studies have focused on union perspectives related to factors influencing the return-to-work of employees absent due to depression, despite evidence of the importance of these perspectives. The purpose of this study is to develop a better understanding of union perspectives on the factors surrounding the return-to-work of employees who were absent from work due to depression. METHODS In this qualitative study, conducted in Canada (Québec), 23 individuals (union representatives and peer workers) from the three largest unions (mixed industries) in Quebec took part in one of three focus groups. RESULTS Fourteen emerging themes (e.g., work environment, attitudes toward depression) were distributed over five categories of stakeholders involved in the return-to-work of employees on sick leave (i.e., employers and immediate supervisors, co-workers, employees on sick leave due to depression, general physicians, and unions). We observed four major cross-cutting themes that arose beyond these five categories: (1) organizational culture in which mental health issues and human aspects of work are central, (2) support and follow-up during the work absence and the return-to-work, (3) lack of resources to assist the employee in the return-to-work, and (4) stakeholders' prejudices and discomfort regarding depression. CONCLUSIONS Our results clarify the factors, from a union perspective, that may facilitate or hinder the return-to-work of employees absent from work due to depression.
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Affiliation(s)
- Marc Corbière
- Centre for Action in Work Disability Prevention and Rehabilitation (CAPRIT), School of Rehabilitation, Université de Sherbrooke, 150 Place Charles Le Moyne, Bureau 200, Longueuil, QC, J4K 0A8, Canada,
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Corbière M, Samson E, Negrini A, St-Arnaud L, Durand MJ, Coutu MF, Sauvé G, Lecomte T. Factors perceived by employees regarding their sick leave due to depression. Disabil Rehabil 2015; 38:511-9. [DOI: 10.3109/09638288.2015.1046564] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Coutu MF, Légaré F, Durand MJ, Corbière M, Stacey D, Bainbridge L, Labrecque ME. Operationalizing a shared decision making model for work rehabilitation programs: a consensus process. J Occup Rehabil 2015; 25:141-152. [PMID: 25001070 DOI: 10.1007/s10926-014-9532-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE The objective of this study was to design and operationalize shared decision making (SDM) rehabilitation model for worker rehabilitation programs. SDM has previously been shown to improve decision outcomes in patient-health care professional relationships. To date, SDM has not yet been adapted to work rehabilitation, although it could be a valuable approach to better understand and agree on return-to-work decisions. METHODS We designed a preliminary model for return-to-work decisions for workers suffering from pain due to musculoskeletal injuries. We submitted the preliminary model and a questionnaire to expert health care professionals. Using the Technique for Research of Information by Animation of a Group of Experts method, a group consensus process was used to discuss and refine the experts' responses to operationalize a model adapted for rehabilitation. RESULTS Eleven occupational therapists (three were clinical coordinators) and four psychologists participated in three group consensus sessions. The final version of the model included one general longitudinal objective (the maintenance of a working alliance and assuring mutual comprehension among all stakeholders), and 11 specific objectives: establishing a working alliance, seven in the deliberation phase of the SDM process, and three in the implementation of the decision. Participants also reached consensus on between 1 and 8 indicators per objective. CONCLUSION We developed and operationalized an SDM rehabilitation model intended for a return-to-work implementation plan. The next step will be to document its feasibility among the main stakeholders (employer, union, insurer and worker) taking part in decisions about return to work.
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Affiliation(s)
- Marie-France Coutu
- Research Center - Hôpital Charles-Le Moyne, Université de Sherbrooke, 150, Place Charles LeMoyne, Longueuil, QC, J4K 0A8, Canada,
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Nastasia I, Coutu MF, Tcaciuc R. Topics and trends in research on non-clinical interventions aimed at preventing prolonged work disability in workers compensated for work-related musculoskeletal disorders (WRMSDs): a systematic, comprehensive literature review. Disabil Rehabil 2014; 36:1841-56. [PMID: 24472007 DOI: 10.3109/09638288.2014.882418] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE This study sought to provide an overview of the main topics and trends in contemporary research on successful non-clinical interventions for preventing prolonged work disability in workers compensated for work-related musculoskeletal disorders (WRMSDs). METHODS A systematic electronic search (English and French) was performed in ten scientific databases using keywords and descriptors. After screening the identified titles and abstracts using specific sets of criteria, categorical and thematic analyses were performed on the retained articles. RESULTS Five main topics appear to dominate the research: (1) risk factors and determinants; (2) effectiveness of interventions (programmes, specific components, strategies and policies); (3) viewpoints, experiences and perceptions of specific actors involved in the intervention process; (4) compensation issues; and (5) measurement issues. A currently widespread trend is early screening to identify risks factors for appropriate intervention and multidisciplinary, multimodal approaches. Morover, workplace-related psychosocial and ergonomic factors are considered vital to the success and sustainability of return-to-work (RTW) interventions. Finally, involving workplace actors, and more specifically, affected workers, in the RTW process appears to be a powerful force in improving the chances of moving workers away from disabled status. CONCLUSIONS The findings of this literature review provide with information about the main topics and trends in research on rehabilitation interventions, revealing some successful modalities of intervention aimed at preventing prolonged work disability. IMPLICATIONS FOR REHABILITATION Successful intervention for preventing prolonged work disability in workers compensated for WRMSDs address workplace issues: physical and psychosocial demands at work, ability of the workers to fill these demands, work organization and support of the worker, and worker' beliefs and attitudes related to work. Successful intervention promotes collaboration, coordination between all actors and stakeholders involved in the process of rehabilitation. Strategies able to mobilize the employees, employers, insurers and health care providers are still needed to be implemented.
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Affiliation(s)
- Iuliana Nastasia
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST) , Montreal, Quebec , Canada and
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Coutu MF, Baril R, Durand MJ, Côté D, Cadieux G. Clinician-patient agreement about the work disability problem of patients having persistent pain: why it matters. J Occup Rehabil 2013; 23:82-92. [PMID: 22996342 DOI: 10.1007/s10926-012-9387-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
BACKGROUND Studies from different fields documenting the differences between clinicians' and workers' representations have not elucidated where the differences exist or how they can be resolved. PURPOSE To define and describe scenarios depicting the differences between clinical judgment, workers' representations about their disability and clinicians' interpretations of these representations. METHODS A multiple case-study design was used. Semi-structured prospective interviews were conducted at four points in time, with five clinicians managing 12 cases of workers having persistent pain and participating in an evidence-based work rehabilitation program. RESULTS Four scenarios depicting differences in representations were found, but not all the differences necessarily had a negative impact on the program outcomes. For the clinicians, clear identification of the problem was important to allow for the use of concrete, pragmatic strategies. For the workers, congruence between the proposed strategy and their representations was crucial. CONCLUSION During rehabilitation, the objectives must be acceptable to both parties or the proposed strategy must, at least, make sense to the patient.
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Affiliation(s)
- Marie-France Coutu
- Centre for Action in Work Disability Prevention and Rehabilitation, School of Rehabilitation, Université de Sherbrooke, 150 Place Charles LeMoyne, Longueuil, QC, J4K 0A8, Canada.
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Coutu MF, Durand MJ, Marchand A, Labrecque ME, Berbiche D, Cadieux G. Factors associated with generalized anxiety in workers undergoing work rehabilitation for persistent musculoskeletal pain. Disabil Rehabil 2013; 35:1599-607. [PMID: 23294407 DOI: 10.3109/09638288.2012.748833] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To document in workers having a work disability due to a musculoskeletal disorder (MSD), the presence and variation over time of their intolerance of uncertainty and its maintenance factors as defined in Dugas et al.'s generalized anxiety disorder (GAD) model, i.e. worries, negative problem orientation, beliefs about the usefulness of worrying, cognitive avoidance and their consequences on depressive symptoms. METHODS An observational, prospective repeated-measures design was retained. Thirty-nine workers with an MSD having caused a work absence of over three months and who were beginning a work rehabilitation program were recruited and evaluated at four moments (beginning of rehabilitation program, first hours of work exposure, 50% of regular working hours and end of rehabilitation program). Validated self-report questionnaires measuring intolerance of uncertainty and its maintenance factors were administered. Finally, the Worry and Anxiety Questionnaire measured the presence and intensity of GAD symptoms as defined in the DSM-IV-TR. RESULTS Fifty percent of the workers initially exhibited GAD symptoms. Concerning the variation over time, improvements were noted in all GAD-related factors during the program, particularly with the first hours of work exposure. At the end of rehabilitation, only 21% of the participants still met GAD diagnostic criteria. CONCLUSION Workers with an MSD causing a work disability averaging one year in length and enrolled in a work rehabilitation program exhibited a high level of anxiety at the beginning of the work rehabilitation program. Workers perceived a usefulness in worrying and presented some intolerance of uncertainty and some cognitive avoidance strategies. According to Dugas et al.'s GAD model, the intensity of the symptoms associated with GAD development and maintenance factors was, however, not typical of a GAD. IMPLICATION FOR REHABILITATION: A reconceptualization of the problem in terms of reducing the work disability rather than reducing pain may constitute a promising avenue to reduce anxiety symptoms. Future studies should look at the specific impact of work exposure, not only on pain symptoms but also on worries. The high level of anxiety and the reported worries by workers stresses the importance of studying the hypothesis of a workplace phobia in order to improve clinical practice guidelines.
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Affiliation(s)
- Marie-France Coutu
- CAPRIT and School of Rehabilitation, Université de Sherbrooke, Longueuil QC, Canada.
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Albert V, Coutu MF, Durand MJ. Internal consistency and construct validity of the Revised Illness Perception Questionnaire adapted for work disability following a musculoskeletal disorder. Disabil Rehabil 2012; 35:557-65. [DOI: 10.3109/09638288.2012.702849] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abstract
INTRODUCTION Research into work reintegration following cardiovascular disease onset is limited in its clinical and individual focus. There is no research examining worker experience in context during the return to work process. METHODS Qualitative case study method informed by applied ethnography. Worker experience was assessed through longitudinal in-depth interviews with 12 workers returning to work following disabling cardiac illness. Workplace context (Canadian auto manufacturing plant) was assessed through site visits and meetings with stakeholders including occupational health personnel. Data was analyzed using constant comparison and progressive coding. RESULTS Twelve men (43-63 years) participated in the study. Results revealed that unyielding production demands and performance monitoring pushed worker capacities and caused "insidious stress". Medical reassurance was important in the workers' decisions to return to work and stay on the job but medical restrictions were viewed as having limited relevance owing to limited understanding of work demands. Medical sanction was important for transient absence from the workplace as well as permanent disability. Cardiac rehabilitation programs were beneficial for lifestyle modification and building exercise capacity, but had limited benefit on work reintegration. Occupational health provided monitoring and support during work reintegration. CONCLUSIONS Medical reassurance can be an important influence on worker representations of disease threat. Medical advice as it pertained to work activities was less valued as it lacked considerations of work conditions. Cardiac rehabilitation lacked intensity and relevance to work demands. Occupational health was reassuring for workers and played an important role in developing return to work plans.
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Affiliation(s)
- F T O'Hagan
- Department of Psychology, Trent University, Peterborough, ON, K9J 7B8, Canada.
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Albert V, Coutu MF, Durand MJ. [Psychometrics of the Eschelle questionnaire to measure self efficacy in work capacity]. Can J Occup Ther 2012; 78:311-7. [PMID: 22338298 DOI: 10.2182/cjot.2011.78.5.6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Self-efficacy with regard to work capacity is one of the determinants of return to work among workers with musculoskeletal disorders (MSDs). To our knowledge, the self-administered questionnaire named Echelle de mesure du sentiment d'efficacité personnelle is the only work-specific scale available in French; however its psychometric properties have not been extensively studied. PURPOSE To estimate the internal consistency and factorial structure of the scale. METHODS The questionnaire has been administered to 36 workers in prolonged work disability due to a musculoskeletal injury during the chronic pain phase. RESULTS Internal consistency is satisfactory (Cronbach's alpha: 0.925). Factor analysis reveals a one-dimensional structure that explains 65.5% of the variance. PRACTICE IMPLICATIONS The results support the use of the scale for clinical practice and research. However, the evaluation of self-efficacy concerning work capacity still requires triangulation with other observations to increase conclusion accuracy.
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Affiliation(s)
- Valérie Albert
- Programme des sciences cliniques de I'Université de Sherbrooke, Centre d'Action en Prévention et Réadaptation de I'Incapacité au Travail (CAPRIT), Campus de Longueuil--Université de Sherbrooke, 150 place Charles-Le Moyne, 9e étage, Longueuil (Qc) J4K 0A8.
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Coutu MF, Baril R, Durand MJ, Côté D, Cadieux G. Health and illness representations of workers with a musculoskeletal disorder-related work disability during work rehabilitation: a qualitative study. J Occup Rehabil 2011; 21:591-600. [PMID: 21544669 DOI: 10.1007/s10926-011-9311-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
INTRODUCTION Distinctions between disease and illness have been criticized for being too theoretical. In practice, however, it may help explain gaps in understanding and miscommunication between health care professionals and patients/injured workers, since each has their own perception of reality. To reduce the gap between health care professionals and patients in understanding the definition of disease, this paper documents general representations of health, illness and work-related musculoskeletal disorders and their influence on the work rehabilitation program. METHODS A qualitative methodology was used. Semi-structured interviews were conducted with 16 participants (male, female) recruited when they were starting an intensive interdisciplinary work rehabilitation program for chronic pain due to a musculoskeletal disorder. Interviews were performed at three points during the program and 1 month after discharge. RESULTS First, participants described health and illness in terms of: (1) illness prototype; (2) the absence or presence of symptoms; (3) physical health and capacities; (4) engaging in a healthy lifestyle; (5) maintaining independence; (6) preserving mental well-being; and (7) healing from accidents or injuries. A second observation was that rehabilitation success depended on workers transitioning from a less mechanistic to a more functional view of health. CONCLUSION This study highlights the importance of identifying and acknowledging workers' health, illness and WRMSD representations to facilitate their return to work.
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Affiliation(s)
- Marie-France Coutu
- Centre for Action in Work Disability Prevention and Rehabilitation, School of Rehabilitation, Université de Sherbrooke, 1111 St-Charles Street West, Longueuil, Quebec, Canada.
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