2011-10-01 12:00 - Messages

Factors affecting return to work after carpal tunnel syndrome surgery in a large French cohort

Parot-Schinkel, E. et coll. (2011). Factors affecting return to work after carpal tunnel syndrome surgery in a large French cohort. Archives of Physical Medicine & Rehabilitation, 92 (11) :1863-1869.

OBJECTIVE: To evaluate occupational outcomes after surgical release of the median nerve in carpal tunnel syndrome (CTS). DESIGN: Retrospective study 12 to 24 months after surgery. SETTING: Hand centers (N=3) in 2 different areas. PARTICIPANTS: Patients who had undergone surgical release of the median nerve in 2002 to 2003. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Duration of sick leave after surgery and associated factors were analyzed by using bivariate (log rank) and multivariate analyses of survival (Cox model). RESULTS: Questionnaires mailed in 2004 regarding medical condition (history and surgery), employment (occupational category codes in 1 digit), and compensation were returned (N=1248; 62%), with 253 men and 682 women stating they were employed at the time of surgery (N=935). Most were working at the time of the study (n=851; 91.0%). Median duration of sick leave before returning to work was 60 days. The main factors associated with adverse occupational outcome (long duration of sick leave) were simultaneous intervention for another upper-extremity musculoskeletal disorder, belief (by the patient) in an occupational cause, and "blue-collar worker" occupational category (the strongest determinant). CONCLUSION:  This study emphasizes the multifactorial nature of the occupational outcome of CTS after surgery, including occupational category. The probability of return to work for each risk factor provides a fair description of prognosis for physicians and patients.

Source: http://www.archives-pmr.org/article/S0003-9993(11)00359-5/abstract

Retour au travail après une absence pour un problème de santé mentale

Les problèmes de santé mentale au travail représentent actuellement l’une des plus importantes causes d’absence au travail, et ce phénomène a connu une croissance marquée au cours des deux dernières décennies. Les travaux entrepris dans le domaine de la réadaptation professionnelle et de la santé mentale au travail ont permis de mettre en évidence l’importance d’une démarche de collaboration entre les acteurs concernés par le processus de retour au travail. Toutefois, si quelques études ont porté précisément sur la réintégration professionnelle de travailleurs déjà insérés en emploi et qui se sont absentés en raison d’un problème de santé mentale, très peu d’entre elles ont porté sur la conception et l’implantation de programmes de retour au travail. Ce document porte sur la conception, l’implantation et l’évaluation d’un programme intégré de pratiques de soutien au retour au travail à la suite d’une absence en raison d’un problème de
santé mentale. Ce programme pourrait prévenir l’augmentation de l’absentéisme pour des problèmes de santé psychologique et favoriser la réinsertion professionnelle durable des personnes touchées.

Source : http://www.irsst.qc.ca/media/documents/PubIRSST/R-706.pdf

Travailleurs exposés à une surcharge : analyse cinématique du genou lors de la marche

L'exposition à une surcharge peut-elle entraîner des changements dans la cinématique du genou et contribuer au développement de la gonarthrose ? L'ostéoarthrose du genou, communément appelé gonarthrose, est la plus susceptible de causer des incapacités fonctionnelles ou occupationnelles chroniques lorsque comparée à d'autres articulations. Une forte prévalence de gonarthrose est rapportée chez les travailleurs qui occupent un emploi soumettant les genoux à une surcharge mécanique. Dans cette étude pilote, la marche de travailleurs exposés à un travail soumettant les genoux à une surcharge a été comparée à celle de travailleurs non exposés à une telle surcharge. L'objectif du projet est d'étudier si l'exposition à une surcharge peut entraîner des changements dans la cinématique du genou qui pourraient contribuer au développement de la gonarthrose.


Source :http://www.irsst.qc.ca/media/documents/PubIRSST/R-702.pdf

Facilitation of appropriate return to work: a case study of a carpenter-a success story

Allen, L. I. (2011). Facilitation of appropriate return to work: a case study of a carpenter-a success story. Professional Case Management, 16 (6): 320.

Il s'agit d'une brève étude de cas d'un travailleur pour qui le processus de retour et de maintien au travail a été un succès. À travers un portrait descriptif du parcours de réadaptation au travail, le rôle du coordonateur, l'intervention précoce, le maintien du lien d'emploi et la pratique de l'assignation temporaire apparaissent comme des facteurs déterminants du retour au travail.

Source: http://ovidsp.tx.ovid.com/sp-3.4.2a/ovidweb.cgi?QS2=434f4e1a73d37e8cf27460a31211c9bc31805a3b435e1cf920f3168e77dbdd01b073f21f38ff6c9d48208bee0295a2a9c9afa26649d8d5f4aff68eda29629b6a7c7fa5249d1beb1885820db7fdb08bcec998043718482b726e29e83e1ec7370d627821fa386c35c2dd50ff2eae5adc454bb631e34dc1fb50b398a8ab3be8d2e6fa18effdfb23e8cf8480332ca0e2363d46611b05b75017c37ba1472f59407fbc5f45e90531dad917f181935f77c8730d82276cb2cf01a8257d466282a874a24aac9ae43c677cc1395d246e514073639f7747a3cfbd3ffd1ddf16baa1f2d8d268a967a8cd2a09326fbfcfeb6ccd6f84c157d48a34234b4480aa589ba29b37f78cb29612f69ccab3128a0fa28be2ef2652542d250529a7da7f75a4b9dbd9385b8b9850278312bbed7cb754b534733544e07daabce566f6687dbd157b5ccfaf3bbcf6e2a6b2f958a8a0a3485c8778867b77da250bd9be8cbc486291f93ee5f983ec7c3ce1afe4220383b1dfb2714146db746f234139967827c94986e8c2743521ba11d1f1be0ab5cae7c9ae68b5a6a65713a2e6ecdeae136565463949b879a2cc990b9e526bc1795bfc07fc9da5345328e15bf20e73a27d8265116f6ee360feced4d12c757fcd8ea091

The social interaction of return to work explored from co-workers experiences
The social interaction of return to work explored from co-workers experiences



Read More: http://informahealthcare.com/doi/abs/10.3109/09638288.2011.553708

Tjulin, Åsa et coll. (2011). The social interaction of return to work explored from co-workers experiences. Disability & Rehabilitation, 33 (21-22) : 1979-1989.

Purpose.The objective was to explore the role and contribution of co-workers in the return-to-work process. The social interaction of co-workers in the return-to-work process are analysed within the framework of the Swedish national and local employer organisational return-to-work policies. Methods. An exploratory qualitative method was used, consisting of open-ended interviews with 33 workplace actors across seven work units. Organisational return-to-work policies were collected from the three public sector employers. Results.The key findings that emerged during analysis showed that some co-workers have a more work-task oriented approach towards the return-to-work process, whilst others had a more social relational approach. In both situations, the social relations worked hand in hand with job tasks (how task were allocated, and how returning workers were supported by others) and could make or break the return-to-work process. Conclusion.A suggestion for improvement of return-to-work models and policies is the need to take into account the social relations amongst workplace actors, especially involving co-workers when planning for return-to-work interventions. Otherwise the proper attention to work arrangements, social communication and the role of co-workers in the return-to-work process might not be seen.

Source: http://informahealthcare.com/doi/abs/10.3109/09638288.2011.553708

Evaluating Common Outcomes for Measuring Treatment Success for Chronic Low Back Pain

Chapman,  J. R. et coll. (2011). Evaluating Common Outcomes for Measuring Treatment Success for Chronic Low Back Pain. Spine, 36 (21 Suppl): S54-S68.

STUDY DESIGN.: Systematic review. OBJECTIVE.: To identify, describe, and evaluate common outcome measures in patients with chronic low back pain (CLBP). SUMMARY OF BACKGROUND DATA.: The treatment of CLBP has been associated with multiple clinical challenges. Further complicating this is the myriad of outcome scores used to assess treatment of CLBP. These scores have been used to examine different domains of patient satisfaction and quality of life in the literature. Critical assessment of the frequency, parity, and the quality of these outcomes are essential to improve our understanding of CLBP. METHODS.: A systematic review of the English-language literature was undertaken for articles published from January 2001 through December 31, 2010. Electronic databases and reference lists of key articles were searched to identify measures used to evaluate outcomes in six different domains in patients with CLBP. The titles and abstracts of the peer-reviewed literature of LBP were searched to determine which of these measures were most commonly reported in the literature and which have been validated in populations with CLBP. RESULTS.: We identified 75 outcome measures cited to evaluate CLBP. Twenty-nine of these outcome measures were excluded because of only a single citation leaving 46 measures for the evaluation. The most commonly used functional outcomes were the Oswestry Disability Index, Roland Morris Disability Index, and range of motion. For pain, the Numeric Pain Rating Scale, Brief Pain Inventory, Pain Disability Index, McGill Pain Questionnaire, and visual analog scale were most commonly cited. For psychosocial function, the Fear Avoidance Beliefs Questionnaire, Tampa Scale for Kinesiophobia, and Beck Depression Inventory were most commonly used. For generic quality of life, short form 36, Nottingham Health Profile, short form 12, and Sickness Impact Profile were the most common measures. For objective measures, the work status/return to work, complications or adverse events, and medications used were the most commonly cited. For preference-based measures, the Euro-Quol 5 dimensions and short form 6 dimensions were most commonly cited. The validity, reliability, responsiveness, universality, and potential proprietary requirements are summarized for each. CONCLUSION.: Outcome measures should be routinely assessed in patients with CLBP. The choice of appropriate outcome measure should be influenced by the study objectives and design, as well as properties of the particular measure within the context of CLBP. CLINICAL RECOMMENDATIONS.: Recommendation 1: When selecting the appropriate outcome measures for clinical or research purposes, consider domains that best measure what are most important to patients. Measures that are valid, reliable, and responsive to change should be considered first. Other considerations include the number of items required (especially in the context of multiple measures), whether the measure is validated in the relevant language, and the associated costs or fees. Strength: StrongRecommendation 2: Domains of greatest importance include pain, function, and quality of life. If cost utilization is a priority, then preference-based measures should be considered. For pain, we recommend the VAS and NRPS because of their ease of administration and responsiveness. For function, we recommend the ODI and RMDQ. The SF-36 and its shorter versions are most commonly used and should be considered if quality of life is important. If cost utility is important, consider the EQ-5D or SF-6D. Psychosocial tests are best used as screening tools prior to surgery because of their lack of responsiveness. Complications should always be assessed as a standard of clinical practice. Return to work and medication use are complicated outcome measures and not recommended unless the specific study question is focused on these domains. Consider staff and patient burden when prioritizing one's battery of measures.

Source: http://ovidsp.tx.ovid.com/sp-3.4.2a/ovidweb.cgi?&S=KDFKFPEKENDDDHIGNCBLHFFBOBDNAA00&Link+Set=S.sh.15.16.19%7c5%7csl_10

Organizational Return to Work Support and Sick Leave Duration: A Cohort of Spanish Workers With a Long-Term Non–Work-Related Sick Leave Episode
Sampere, Maite (2011). Organizational Return to Work Support and Sick Leave Duration: A Cohort of Spanish Workers With a Long-Term Non–Work-Related Sick Leave Episode. Journal of Occupational and Environmental Medicine, 53(6):674-9.

OBJECTIVE: To analyze the association between organizational support and time to return to work (RTW) in workers with long-term non-work-related sick leave. METHODS: Cohort participants were 571 workers, with a non-work-related sick leave episode of more than 15 days, recruited during the first visit in a health insurance company (mutua). Workers completed a baseline questionnaire regarding organizational RTW support measures and were followed until the end of the episodes. Return to work and time to RTW were established on the basis of the mutua's register. Multivariate Cox regression models were used. RESULTS: Workers in companies with an overall high organizational RTW support returned to work earlier. This effect was mainly due to workers in companies that provided specific RTW programs. CONCLUSIONS: Our findings suggest that companies play an important role in facilitating RTW for workers with long-term non-work-related sick leave episodes.

Source: http://ovidsp.tx.ovid.com/sp-3.4.2a/ovidweb.cgi?QS2=434f4e1a73d37e8cf27460a31211c9bcf74984c4516711f9a067f5b8d1e9d9fc10dd001f8e994de37dfd753e3e3f4c3b095137f39a2feeb327184ad3b1422393892f2faf2d53d0fce505774b1e3187c87082352f9c727092741ee3878ddd147e6178c348fe63de6c772caac3e10a6c8299fa01e539ce06eb6990f72e6b312e38317d849630b62721737517e4cdff822098317483a371f4e0201c638dc0d4c3ef75bd563c62f5c4e6fd980cc23dfd7489218f5ed1bed0127e5499de622e8eabea3cc2ba350950681ae2afc094c62f5536971097b891c1acc05543304794da5fc1ccfea3a1d037f8f158bbf096b1433992c7311bba171ecd6af348fcb6369e12fa48e34e9ee3e3fdbd7b05cf9a4574f6aa61de632671c36df35fc5af66fc3d6a61842a40e2c50927abc19954eaae8e097f9eab0fc3577999e44d83c3144df8040de2fb03197be7a2127d979f22c10faf07fefb1606f130aa69b8669b062e4b14fd3fcda9e7564705a2545cfba470e29ad8ae70318c5bcc8cba4b027cf78c5201fd06b6279702085227ad6c8d822eec451a68a91d8b329620290b688bb9e0e284ce7f36a9676194f28b241b45585d103ced72e721da477e8c97e300ed7f8d0472b8be0d41da2973b298

Examining functional content in widely used Health-Related Quality of Life scales

Hall, Trevor et coll. (2011). Examining functional content in widely used Health-Related Quality of Life scales. Rehabilitation Psychology, 56 (2): 94-99.

Purpose: Assess extent to which generic Quality of Life (QOL) and Health-Related Quality of Life (HRQOL) scales include function in assessment of health, and identify health assessment items that are free of functional content. Methods: An expert panel on measurement of health and disability reached consensus on definitions of health, disability, and function. They assessed all items of all generic (non-condition-specific) scales in the 2006 ProQolid database for being important to measuring health as distinct from function. Ratings were summarized as content validity ratios. Retained items were written into standard format and reviewed again by the expert panel and a validity panel with expertise in specific disabilities. Results: Of 85 scales, 21 were retained as containing items important for assessing health. Scales ranged from 100% (BRFSS HRQOL, WHO-5) to only 4% of items rated as important. In further review of “important” items, functional content was identified in many of the items, particularly with regard to mental functioning. Conclusions: Popular generic scales of QOL and HRQOL vary greatly in the degree to which they include content on function. A pool of items can be identified that are relatively free of function. Distinguishing measurement of function and health is particularly important for people with long-standing functional limitations and for assessing the relationship of health with function.

Source: http://psycnet.apa.org/journals/rep/56/2/

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