2009-10-01 12:00 - Messages

Exploring Workplace Actors Experiences of the Social Organization of Return-to-Work

Introduction There is a limited body of research on how the actual social exchange among workplace actors influences the practice of return-to-work. The objective of this study was to explore how workplace actors experience social relations at the workplace and how organizational dynamics in workplace-based return-to-work extends before and beyond the initial return of the sick listed worker to the workplace. Method An exploratory qualitative method approach was used, consisting of individual open-ended interviews with 33 workplace actors at seven worksites that had re-entering workers. The workplace actors represented in these interviews include: re-entering workers, supervisors, co-workers, and human resource managers. Results The analysis identified three distinct phases in the return to work process: while the worker is off work, when the worker returns back to work, and once back at work during the phase of sustainability of work ability. The two prominent themes that emerged across these phases include the theme of invisibility in relation to return-to-work effort and uncertainty, particularly, about how and when to enact return-to-work. Conclusion The findings strengthen the notion that workplace-based return-to-work interventions need to take social relations amongst workplace actors into account. They also highlight the importance and relevance of the varied roles of different workplace actors during two relatively unseen or grey areas, of return-to-work: the pre-return and the post-return sustainability phase. Attention to the invisibility of return-to-work efforts of some actors and uncertainty about how and when to enact return-to-work between workplace actors can promote successful and sustainable work ability for the re-entering worker.

Source: http://www.springerlink.com/content/c481611270068645/

Review of sickness absence data in the waste and recycling industry

While injury rates have been calculated and reduced in the waste and recycling industry in recent years (HSE Research Report 701), little is known about the prevalence of ill health for this industry. The main objective of this project was to review sickness absence data for the industry and provide estimates of the occupational ill health rate and the annual number of days absent from work.

Source: http://news.hse.gov.uk/2009/10/22/rr750-review-of-sickness-absence-data-in-the-waste-and-recycling-industry/?rss=

What are the Management Standards for work-related stress?

The Management Standards define the characteristics, or culture, of an organisation where the risks from work-related stress are being effectively managed and controlled. The Management Standards cover six key areas of work design that, if not properly managed, are associated with poor health and well-being, lower productivity and increased sickness absence. In other words, the six Management Standards cover the primary sources of stress at work. The Management Standards represent a set of conditions that, if present, reflect a high level of health well-being and organisational performance.

Source: http://www.hse.gov.uk/stress/standards/index.htm

Return-to-work experiences: Prior to receiving vocational services

Methods. Semi-structured interviews inquiring about participant's (N = 150) return-to-work experiences following an occupational injury resulting in an impairment that limited their ability to perform their past work. Results. Findings indicate that although reasons cited for the loss of employment gains included physiological body function, the ability to perform work-related tasks and actions and personal factors, the most commonly referenced barriers by far were environmental in nature. Depending on where the worker was within the return-to-work process, the regularity with which each of the types of environmental factors was mentioned varied considerably. Conclusions. The finding that environmental factors are considered the most common stumbling blocks is positive in that these are arguably some of the most amenable to intervention.

Source: http://www.informaworld.com/smpp/content~content=a916113870~db=all~jumptype=rss

Vulnerable workers more likely to receive no income for work-related absence

This study aimed to find out the percentage of employees in Canada who receive workers' compensation benefits or other replacement wages after a work-related injury or illness lasting one week or longer. In particular, the researchers wanted to determine if some groups of workers were more or less likely to receive income-replacement payments following a work injury.

Source: http://www.iwh.on.ca/highlights/vulnerable-workers-more-likely-to-receive-no-income-for-work-related-absence

Intervention mapping for development of a participatory return-to-work intervention for temporary agency workers and unemployed workers sick-listed due to musculoskeletal disorders

In the past decade in activities aiming at return-to-work (RTW), there has been a growing awareness to change the focus from sickness and work disability to recovery and work ability. To date, this process in occupational health care (OHC) has mainly been directed towards employees. However, within the working population there are two vulnerable groups: temporary agency workers and unemployed workers, since they have no workplace/employer to return to, when sick-listed. For this group there is a need for tailored RTW strategies and interventions. Therefore, this paper aims to describe the structured and stepwise process of development, implementation and evaluation of a theory- and practise-based participatory RTW program for temporary agency workers and unemployed workers, sick-listed due to musculoskeletal disorders (MSD). This program is based on the already developed and cost-effective RTW program for employees, sick-listed due to low back pain. Methods: The Intervention Mapping (IM) protocol was used to develop a tailor-made RTW program for temporary agency workers and unemployed workers, sick-listed due to MSD. The Attitude-Social influence-self-Efficacy (ASE) model was used as a theoretical framework for determinants of behaviour regarding RTW of the sick-listed worker and development of the intervention. To ensure participation and facilitate successful adoption and implementation, important stakeholders were involved in all steps of program development and implementation. Results of semi-structured interviews and 'fine-tuning' meetings were used to design the final participatory RTW program. Results: A structured stepwise RTW program was developed, aimed at making a consensus-based RTW implementation plan. The new program starts with identifying obstacles for RTW, followed by a brainstorm session in which the sick-listed worker and the labour expert of the Social Security Agency (SSA) formulate solutions/possibilities for suitable (therapeutic) work. This process is guided by an independent RTW coordinator to achieve consensus. Based on the resulting RTW implementation plan, to create an actual RTW perspective, a vocational rehabilitation agency is assigned to find a matching (therapeutic) workplace. The cost-effectiveness of this participatory RTW program will be evaluated in a randomised controlled trial. Conclusion: IM is a promising tool for the development of tailor-made OHC interventions for the vulnerable working population.

Source: http://www.biomedcentral.com/1471-2458/9/216

Adjusting Rehabilitation Costs and Benefits for Health Capital: The Case of Low Back Occupational Injuries

Introduction Case-mix adjustments for treatment/rehabilitation costs and benefits of non-traumatic injuries, such as occupational back pain, are much more difficult than adjustments for traumatic injuries. We present a new method for adjusting for severity differences in the costs and benefits of treating occupational low back injuries. Methods Using initial post-injury differences in the health capital of prospective sample of 1,831 occupational related back pain patients, we combine survey data with workers' compensation claim files and medical billing information to adjust the costs and benefits of treatment using multivariate techniques. Results We find that large differences in the net benefits of treatment between the three lowest cost provider groups virtually disappear once adjustments are made for worker's health capital (injury severity) at entry into treatment. Conclusions Once adjustments are made for initial health capital immediately after injury, the net benefits of treating occupational low back pain are virtually identical for physician only care, physician plus physical therapy care, and chiropractic care. Net benefits of care are lower for combined physician/chiropractic care, and lowest for all other forms of care (principally, treatment by orthopedic surgeons). Our method is readily adapted for comparisons among individual health care/occupational rehabilitation professionals or among group practices and other health care organizations.

Source: http://www.springerlink.com/content/v3561850775x4663/

Work Disability, Work, and Justification Bias in Europe and the U.S.

To analyze the effect of health on work, many studies use a simple self-assessed health measure based upon a question such as “do you have an impairment or health problem limiting the kind or amount of work you can do?” A possible drawback of such a measure is the possibility that different groups of respondents may use different response scales. This is commonly referred to as “differential item functioning” (DIF). A specific form of DIF is justification bias: to justify the fact that they don't work, non-working respondents may classify a given health problem as a more serious work limitation than working respondents. In this paper we use anchoring vignettes to identify justification bias and other forms of DIF across countries and socio-economic groups among older workers in the U.S. and Europe. Generally, we find differences in response scales across countries, partly related to social insurance generosity and employment protection. Furthermore, we find significant evidence of justification bias in the U.S. but not in Europe, suggesting differences in social norms concerning work.

Source: http://ftp.iza.org/dp4388.pdf

Using reflective learning to improve the impact of continuing education in the context of work rehabilitation

Reflective learning has been described as a promising approach for ameliorating the impact of continuing education (CE) programs. However, there are still very few studies that have investigated how occupational therapists use reflection to improve the integration of CE program content in their decision-making processes. The study objectives were to describe how these professionals, working in the sector of work rehabilitation, used reflective learning to integrate research evidence into their clinical decision-making process and to identify the factors that influenced the reflective learning process. A collaborative research study was conducted. Eight occupational therapists were recruited to participate to the group that was convened for 12 meetings and held during a 15-month period. The strategies used were critical analysis of ill-structured and authentic clinical situations, peer support, reflective journal writing and complementary reading. The group facilitator acted as a research evidence mentor and guided the group process. The data collected was analyzed using the grounded theory method. The reflective learning process, used by the participants, enabled them to change their perspective at six different stages in their decision-making process. The participants developed their ability to use different types of reflective thinking: introspection, concept attainment, self-attribution, problem solving, action planning and reorganization. The factors that most influenced learning were: ease in sharing experience, normative beliefs, coping with negative emotions, perceived self-efficacy, social support and risk taking. Results led to the development of the Model of Research Utilization Grounded in Critical Reflection.

Source: http://www.springerlink.com/content/u5170140104n0476/

"If I Don’t Have to Work Anymore,Who Am I?": Job Loss and Collaborative Self-Concept Repair

Previous research on unemployment among managers and professionals has documented the experience of job loss as stressful because of both economic strain and the damage it does to valued identities and self-conceptions. Little research, however, has examined the processes through which displaced workers collectively attempt to repair this damage. Data from participant observation in four support groups, plus intensive interviews with twenty-two group members, are used to develop an analysis of the self-concept repair strategies used by these relatively privileged workers. Five main strategies are identified: (1) redefining the meaning of unemployment, (2) realizing accomplishment, (3) restructuring time, (4) forming accountability partnerships, and (5) helping others.These findings suggest that our understandings of how people cope with stressful life events need to take into account the social capital available to different groups. A second implication concerns our understanding of how the self-concept operates as a source of motivation.

Source: http://jce.sagepub.com/cgi/content/abstract/38/5/547

A Matter of Trust? A Study of Coordination of Swedish Stakeholders in Return-to-Work

Introduction Stakeholder cooperation in return-to-work has been increasingly emphasized over the last years. However, there is a lack of empirical studies on the subject. This study explores different public stakeholders' experiences of participating in Coordination Associations (CAs), a Swedish form of structured cooperation in return-to-work. The aim of the study is to determine the impact of stakeholder interests on the prerequisites for cooperation. Methods Thirty-five representatives from two CAs in eastern Sweden were interviewed regarding the aim, structure and strategies for their common work. Results Stakeholders' actions are to a high degree determined by their institutional preferences and self-interest. In the CAs, the motives for cooperation differ, and although these differences supposedly could be overcome, they are in fact not. One of the stakeholders, the Public Employment Service, limit its interest to coordinating resources, while the other three wishes to engage in elaborated cooperative work forms, implying the crossing of organizational borders. This discrepancy can largely be attributed to the difficulties for representatives from state authorities in changing their priorities in order to make cooperation work. Conclusions Stakeholders' interests have a high impact on the prerequisites for cooperation in return-to-work. By referring to organizational goals, stakeholders engage in non-cooperative behaviour, which threatens to spoil cooperative initiatives and to develop distrust in cooperative work forms. The results of this study expose the complexity of and threats to cooperation, and its conclusions may be used by return-to-work stakeholders in different jurisdictions to improve the possibilities for the development of cooperative structures.

Source: http://www.springerlink.com/content/62622hp243q7853t/

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