2011-04-01 12:00 - Messages
Johnsson, Aina et al. (2011). Work status and life changes in the first year after breast cancer diagnosis. Work 38 (4): 337-346.
Objective: The aims of this study were to generate new knowledge about factors predicting return to work (RTW) among women treated for early-stage breast cancer, and about changes in life satisfaction, and coping, and to examine the association between these concepts and RTW. Methods and Participants: A cohort of 102 women aged 18–64 were assessed six weeks, six months, and ten months after surgery using data from questionnaires and medical files. Results: Factors independently predicting no RTW at six months were: chemotherapy, > 30 days of sick leave during the previous 12 months, low satisfaction with activities of daily living, and not having been born in Sweden. No RTW at ten months was predicted by irradiation to breast/chest wall and regional nodes, and low satisfaction with vocational situation. Global life satisfaction was higher among the working women, both six months after surgery and ten months after surgery. The working women used more positive coping resources as compared to the sick-listed women, particularly sick-listed women treated with chemotherapy. Conclusion: Factors associated with RTW appear to include not only treatment-related factors such as chemotherapy and irradiation, but also psychosocial factors such as life satisfaction and coping resources. With increased understanding of the complex factors related to RTW after a breast cancer diagnosis, it will be possible to identify and support survivors who are at risk of being marginalized from the labor market.
Alexopoulos, Evangelos C. et al. (2011). Knee and low back complaints in professional hospital nurses: Occurrence, chronicity, care seeking and absenteeism. Work 38 (4): 329-335.
Objective: To investigate the relationships between physical, psychosocial, and individual characteristics and occurrence, chronicity, care seeking and absenteeism due to musculoskeletal complaints of the lower back and knee. Methods and Participants: This was a cross-sectional study among 350 nursing personnel in six hospitals in South-West Greece. Data related to physical and psychosocial workload, need for recovery, perceived general health and other risk factors for occurrence of low-back and knee complaints were collected. Odds ratios (ORs) were estimated for all relevant risk factors. Results: Low-back and knee pain were reported by 51% and 23% of the subjects, respectively. A high perceived physical exertion and a moderate/bad perceived general health were the strongest risk factor for low-back and knee pain. With regard to care seeking a moderate/bad perceived general health was risk factor for both, low back and knee pain (OR=3.45 and OR=2.28; respectively). Perceived moderate/bad general health (OR=2.90) and high need for recovery (OR=2.78) were risk factors for absenteeism due to low-back pain, whereas organizational factors, high job demands (OR=4.60) and low co workers support (OR=3.13) for absenteeism due to knee pain. Age exhibited a positive relation with the disability and care seeking for both complaints although far stronger for knee. Conclusions: Compared to the well-studied work related low back pain, knee complaints have been shown to cause significant burden in nursing staff. Besides general health status of individual workers, work-related psychosocial factors, like support and demand, are related with the disability and care seeking for knee complaints.
McGorry, R.W. et al. (2011). Correlations between pain and function in a longitudinal low back pain cohort. Disability & Rehabilitation, 33 (11): 945-952.
Purpose. Most studies of low back pain (LBP) and functional limitation have been cross-sectional, and show only modest correlations between pain and function. Though functional limitation may be superior for predicting disability outcomes, there is a need to understand better the gap between pain and function. This study analysed changes in intra-individual correlations between pain and function over time. Method. Seventeen men and 16 women currently experiencing LBP provided self-reports of LBP (0-to-10 scale) and functional status (Back Pain Functional Scale) for a maximum of 8 weeks. Spearman correlation coefficients between pain and function scores were calculated for each individual. The effects of pain history, pain intensity, variability and trends over time on pain–function correlations were assessed. Results. There were no significant differences in correlation due to gender, age or pain intensity (low versus high). Participants with steeper slopes in change in pain score over the study period had significantly stronger correlations to function than those with weaker trends, r = −0.91 and r = −0.45, respectively. Participants with at least one pain-free score during the reporting period had significantly stronger correlations than those with no pain-free reports, r = −0.80 and r = −0.51, respectively. Participants having the first episode LBP had stronger correlations (r = −0.85) than those with persistent symptoms of LBP (r = −0.62). Conclusions. The results suggest that over the course of LBP, within-person pain–function correlations are stronger than those reported in cross-sectional, population-based studies. Changes in pain ratings over time may have more clinical relevance than differences in pain levels between individuals. Among those with more long-standing pain, factors other than pain intensity, such as pain catastrophising or fear avoidant beliefs, may have a greater effect on day-to-day perceptions of functional limitation.
Cifuentes, Manuel et al. (2011). Health Maintenance Care in Work-Related Low Back Pain and Its Association With Disability Recurrence. Journal of Occupational & Environmental Medicine, 53 (4): 396–404.
Objectives: To compare occurrence of repeated disability episodes across types of health care providers who treat claimants with new episodes of work-related low back pain (LBP). Method: A total of 894 cases followed 1 year using workers’ compensation claims data. Provider types were defined for the initial episode of disability and subsequent episode of health maintenance care. Results: Controlling for demographics and severity, the hazard ratio [HR] of disability recurrence for patients of physical therapists (HR = 2.0; 95% confidence interval [CI] = 1.0 to 3.9) or physicians (HR = 1.6; 95% CI = 0.9 to 6.2) was higher than that of chiropractor (referent, HR = 1.0), which was similar to that of the patients non-treated after return to work (HR = 1.2; 95% CI = 0.4 to 3.8). Conclusions: In work-related nonspecific LBP, the use of health maintenance care provided by physical therapist or physician services was associated with a higher disability recurrence than in chiropractic services or no treatment.
Cette étude avait pour objectif principal d'évaluer le lien entre les symptômes de dépression et les résultats de la réadaptation chez des personnes ayant subi des lésions musculo-squelettiques au travail. Les résultats de cette étude indiquent que la dépression agit négativement sur la réponse d’un patient à la réadaptation et sur son retour au travail. Dans ce document, les auteurs de l’étude discutent des processus à travers lesquels la dépression pourrait influencer l'incapacité
chronique et les résultats d’un programme de réadaptation. Ils traitent également des implications cliniques des résultats obtenus.
Source : http://www.irsst.qc.ca/media/documents/PubIRSST/R-686.pdf
Dong, Xiuwen Sue et al. (2011). Chronic Diseases and Functional Limitations Among Older Construction Workers in the United States: A 10-Year Follow-up Study. Journal of Occupational & Environmental Medicine, 53 (4): 372–380.
Objectives: To examine the health status of older construction workers in the United States, and how occupation and the aging process affect health in workers' later years. Methods: We analyzed six waves (1998 to 2008) of the Health and Retirement Study, a longitudinal survey of US residents age 50+. The study sample totaled 7200 male workers (510 in construction trades) in the baseline. Multiple logistic regression and paired t tests were conducted to compare health outcomes across occupations and within individuals over time. Results: Compared with white-collar workers, construction workers had increased odds of arthritis, back problems, chronic lung disease, functional limitations, work disability, and work-related injuries after controlling for possible confounders. Conclusions: Safety and health interventions, as well as retirement and pension policy, should meet the needs of older construction workers, who face increasingly chronic health conditions over time.
Koji, Yamashiro et al. (2011). A Multidimensional Measure of Pain Interference: Reliability and Validity of the Pain Disability Assessment Scale. Clinical Journal of Pain 27 (4): 338–343.
Measuring outcomes across multiple domains is essential for an adequate understanding of chronic pain and the effects of pain treatment. Pain interference reflects the negative effects of pain on functioning, and is recognized as a critical outcome domain. The Pain Disability Assessment Scale (PDAS) contains items that assess the negative effects of pain on broad spectrum pain interference domains. The purpose of this study was to examine the factor structure, reliability, and validity of the PDAS. Methods: One hundred sixty-four Japanese patients with chronic pain were administered the PDAS, the Brief Pain Inventory, and the Hospital Anxiety and Depression Scale. Results: The findings support a 3 factor structure of the PDAS items, as well as a high level of internal consistency of the scales created from these factors (Cronbach α's range: 0.87 to 0.95). Validity of the 3 scales was supported through their significant associations, in hypothesized directions, with measures of pain intensity, anxiety, depression, and another established measure of pain interference, as well as differences in PDAS scores between patients with versus without back pain. Conclusions: The PDAS may be useful when researchers or clinicians require a multidimensional measure of the effects of pain on a patient's life.
Hogh, Annie et al. (2011). Are immigrants in the nursing industry at increased risk of bullying at work? A one-year follow-up study. Scandinavian Journal of Psychology, 52 (1) : 49-58.
The purpose of this study was to explore whether (a) immigrant health care workers (HCW) are more at risk of bullying at work than Danish staff members, (b) this association is increased by previous exposure to bullying and (c) immigrants experience more bullying from supervisors, colleagues and clients/residents. We analyzed cross-sectional baseline data from 5,635 health care students of whom 10.4% were immigrants, and conducted a prospective analysis by following 3,109 of these respondents during their first year of employment. More than a third of the respondents had previous experiences with bullying. The baseline analyses showed that immigrants are more at risk of being bullied during both their theoretical education and trainee periods than their Danish co-students. At follow-up we found that 9.1% of the total cohort had been exposed to bullying at work during their first year of employment, hereof 1.8% frequently. “Non-Western” immigrants had a significantly higher risk of exposure to bullying at work during follow-up than the Danish respondents independent of previous experience with bullying. Danish and immigrant health care workers were more exposed to bullying from co-workers than from supervisors with no statistically significant difference between the Danes and the immigrant groups. Both “Western” and “non-Western” respondents were more at risk of bullying from clients/residents than the Danish respondents.
Hoedeman, Rob et al. (2010). Sick-listed employees with severe medically unexplained physical symptoms: burden or routine for the occupational health physician? A cross sectional study. BioMedCentral, 10 (305) (article en libre accès)
The two primary objectives of this study were to the assess consultation load of occupational health physicians (OHPs), and their difficulties and needs with regard to their sickness certification tasks in sick-listed employees with severe medical unexplained physical symptoms (MUPS). Third objective was to determine which disease-, patient-, doctor- and practice-related factors are associated with the difficulties and needs of the OHPs. Methods: In this cross-sectional study, 43 participating OHPs from 5 group practices assessed 489 sick-listed employees with and without severe MUPS. The OHPs filled in a questionnaire about difficulties concerning sickness certification tasks, consultation time, their needs with regard to consultation with or referral to a psychiatrist or psychologist, and communication with GPs. The OHPs also completed a questionnaire about their personal characteristics. Results: OHPs only experienced task difficulties in employees with severe MUPS in relation to their communication with the treating physician. This only occured in cases in which the OHP attributed the physical symptoms to somatoform causes. If they attributed the physical symptoms to mental causes, the OHPs reported a need to consultate a psychiatrist about the diagnosis and treatment. Conclusions: OHPs experience few difficulties with their sickness certification tasks and consultation load concerning employees with severe MUPS. However, they encounter problems if the diagnostic uncertainties of the treating physician interfere with the return to work process. OHPs have a need for psychiatric expertise whenever they are uncertain about the psychiatric causes of a delayed return to work process. We recommend further training programs for OHPs. They should also have more opportunity for consultation and referral to a psychiatrist, and their communication with treating physicians should be improved.
Kronström, Kim et al. (2011). Journal of Affective Disorders,130 (1-2): 294-299
Personality characteristics are assumed to affect to the vulnerability to depression and its outcomes. The aim of this study was to examine optimism and pessimism as predictors of depression-related work disability and subsequent return to work. Methods: We conducted a prospective cohort study of 38,214 public sector employees with no record of diagnosed depression. Optimism and pessimism were measured using the Revised Life Orientation Test (LOT-R). Records of long-term (> 90 days) work disability with a diagnosis of depression and subsequent return to work until the end of 2005 were obtained from the national health registers. Results: During the mean follow-up of 4.0 (SD = 2.3) years, 287 employees encountered work disability with a diagnosis of depression. Of them, 164 (57%) returned to work during the follow-up. One unit increase in the optimism mean score (range 1–4) was associated with a 25% lower risk of work disability due to depression and a 37% higher probability of returning to work after a work disability period when adjusted for age and sex. In the fully-adjusted model hazard ratios per one unit increase in optimism were 0.79 (95% CI 0.66–0.96) for work disability and 1.30 (95% CI 1.01–1.66) for return to work. The pessimism mean score (range 1–4) was only associated with a lower probability of returning to work (fully-adjusted HR per one unit increase 0.66, 95% Cl 0.49–0.88). The level of optimism was a stronger predictor of work disability with a diagnosis of depression than the level of pessimism, while both optimism and pessimism predicted returning to work.
Gómez-Pérez, Lydia et López-Martínez, Alicia E. (2011). Psychometric Properties of the Spanish Version of the Tampa Scale for Kinesiophobia (TSK). Journal of Pain, 12 (4): 425-435.
The Tampa Scale for Kinesiophobia (TSK) is one of the most frequently employed measures for assessing pain-related fear in pain patients. Although the TSK has been translated into different languages, a Spanish version of the TSK has not been available, up to now. Thus, the aim of this study was to validate the Spanish version of the TSK in 2 different pain samples: A heterogeneous chronic pain sample (n = 125) and a musculoskeletal acute pain sample (n = 86). Factor analysis revealed a 2-factor model of 11 items replicated on both samples, named TSK-11. The instrument obtained shows good reliability (internal consistency and stability) and validity (convergent and predictive), with the advantage of brevity. Evidence is provided on discriminant validity between both TSK factors (called Activity Avoidance and Harm). The Harm factor shows the best predictive validity, as it predicts pain persistence, catastrophizing, depression, and pain intensity scores after 6 months. Changes in the Activity Avoidance factor are positively correlated with changes in catastrophizing and anxiety, and negatively associated with changes in functional status. The results of this study point to the relative contribution of both components of pain-related fear to pain adjustment.
Mallen, Christian D. et al. (2011). Sickness certification for mental health problems: an analysis of a general practice consultation database. Primary Health Care Research & Development, 12 (2): 179-182.
Background Although mental illness remains the leading cause of both sickness absence and incapacity benefit in most high-income countries, little is known about how frequently patients with mental ill-health receive sickness certificates and what conditions are most commonly certified for. This study aims to use general practice consultation data to determine the rate of sickness certification for common mental health problems. Methods Analysis of a general practice consultation database rates of certification are presented for people consulting with a mental health problem, along with the proportion of these consultations in which a certificate was issued. Results The highest rates of certification among those consulting with mental health problems occurred for depression, stress-related problems and bereavement. Almost two-thirds of the consultations for bereavement resulted in a sickness certificate being issued. At least one in three mental health consultations resulted in a sickness certificate being issued. Conclusions Consultation for mental health problems in primary care frequently results in the issuing of a sickness certificate. Further study is urgently needed to provide adequate support systems to enable patients to return to work whenever possible.
There are more people living with chronic pain than cardiovascular disease and cancer combined. Many people with chronic pain do not seek help from health professionals and suffer in silence for many years. Untreated chronic pain can lead to increased disability, increased risk of fall, depression, sleep deprivation, reduced quality of life and social isolation. The aim of this review is to determine the factors associated with help-seeking for chronic pain in an effort to highlight potential reasons why help may or may not be sought. A total of 23 studies were included in the review. On the whole the review has demonstrated that the most significant demographic and clinical factors associated with help-seeking were increasing age, female gender, pain severity and disability. Psychosocial factors included past help seeking, outcome expectancy, age-related beliefs, social cost and social influence. While the evidence presented appears promising, some conflicting results were found and methodological limitations were noted. Further research needs to examine the underlying determinants of help-seeking behaviour for chronic pain underpinned by theory. The information derived from such research will augment the development of a complex nursing intervention to improve help-seeking for chronic pain.
Nicola Cornally, Geraldine McCarthy
British Journal of Community Nursing 16(2): 90 - 98 (Feb 2011)
Il ressort de cette étude que les perceptions et les représentations des travailleurs, les facteurs de l'organisation et de l'environnement du travail ainsi que les facteurs liés au régime d'assurance agissent en synergie pour favoriser ou nuire au retour au travail des individus. Afin de faciliter le dépistage systématique de ces facteurs, les chercheurs ont développé un outil qui permettra d'améliorer l'intervention auprès des travailleurs.
Source : http://www.irsst.qc.ca/media/documents/PubIRSST/R-679.pdf
Introduction Several studies have been conducted in the West showing that return to work (RTW) coordination is a key element to facilitate RTW of injured workers and to prevent work disabilities. However, no study has been carried out to investigate the scope of RTW activities in China. The purpose of this study was to explore the views of key RTW stakeholders on necessary activities for RTW coordination. Methods A cross-sectional survey was conducted in Guangdong province of China. A three-tiered approach including focus group discussions and panel reviews was used to collect RTW activities, analyze the content validity, and classify domains. Descriptive statistics and intra-class correlation (ICC) were used to describe the importance of RTW activities and the degree of agreement on the classification of different domains. A Kruskal–Wallis test with subsequent post-hoc analysis using multiple Mann–Whitney U tests was carried out to check for any differences in the domains of different RTW activities among RTW stakeholders. Results The domains of RTW activities in China were similar to those in the West and included workplace assessment and mediation, social problem solving, role and liability clarification, and medical advice. Good agreement (ICC: 0.729–0.844) on the classification of RTW activities into different domains was found. The domains of the RTW activities of healthcare providers differed from those of employers (P = 0.002) and injured workers (P = 0.001). However, there was no significant difference between employers and injured workers. Conclusions This study indicated that differences among stakeholders were observed in terms of areas of relative priority. There is a clear need for research and training in China to establish a nation-wide terminology for RTW coordination, facilitate cross-provincial studies and work toward a more integrated system addressing the diverse perspectives of stakeholders involved in the RTW process.