2011-11-01 12:00 - Messages
Coutu, MF; Baril, R; Durand, MJ; Côté, D; Cadieux, G. (2011). Health and illness representations of workers with a musculoskeletal disorder-related work disability during work rehabilitation: a qualitative study. Journal of Occupational Rehabilitation, 21(4):591-600.
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.
Cet ouvrage collectif, dirigé par deux professeurs-chercheurs engagés dans le domaine de la réadaptation au travail, propose de passer en revue les éléments essentiels à une bonne compréhension du retour et de la réintégration au travail de personnes aux prises avec un trouble mental. Au sein de notre société moderne, notamment dans les organisations, les troubles mentaux constituent désormais une problématique qui préoccupe les acteurs concernés par le retour et la réintégration au travail, tels que l’employeur, le supérieur immédiat, le représentant syndical, le représentant du système d’assurance, le professionnel de la santé et l’intervenant qui facilite le retour au travail, sans oublier les personnes significatives de l’environnement immédiat de l’individu souffrant d’un trouble mental.
Corbière, Marc, et Marie-Josée Durand. Du trouble mental à l'incapacité au travail : une perspective transdisciplinaire qui vise à mieux saisir cette problématique et à offrir des pistes d'intervention. Québec : Presses de l'Université du Québec, 2011. 408 p.
Eklund, Mona et Lena-Karin Erlandsson (2011). Return to Work Outcomes of the Redesigning Daily Occupations (ReDO) Program for Women with Stress-Related Disorders—A Comparative Study. Women & Health, 11(7): 676-692. (Article en libre accès)
Stress-related disorders are a frequent cause for sick leave, with consequences such as great distress and adverse economic effects for the affected person and substantial costs for society. Identifying effective interventions that facilitate return to work is thus important. The aim of this study was to evaluate the effectiveness of the 16-week Redesigning Daily Occupations program as a work rehabilitation method for Swedish women with stress-related disorders. The authors of this study hypothesized that, compared to women who got Care as Usual, 12 months after completed rehabilitation a larger proportion of the Redesigning Daily Occupations women would have returned to work, and they would have less sick leave, perceive less stress, and have greater self-esteem. Forty-two women entered the Redesigning Daily Occupations intervention and a matched comparison group received Care as Usual. The data, collected between 2007 and 2010, consisted of registry information and questionnaires targeting socio-demographics, perceived stress, and self-esteem. The findings partly verified the hypotheses. A larger proportion of the Redesigning Daily Occupations women returned to work and they decreased their sick leave and increased their self-esteem more than the Care as Usual group, but the groups did not differ in stress reduction. Thus, the Redesigning Daily Occupations seems to be a promising work rehabilitation method for women with stress-related disorders.
Baldwin, Cathryn et Natasha K. Brusco (2011). The Effect of Vocational Rehabilitation on Return-to-Work Rates Post Stroke: A Systematic Review. Topics in Stroke Rehabilitation, 18(5): 562-572.
Purpose: Returning to work has been identified as an important rehabilitation goal following stroke. Twenty percent of stroke survivors are of working age. The purpose of this systematic review was to determine the effect of vocational rehabilitation programs on return-to-work rates post stroke. Method: Searches were performed in electronic databases and Web-based sites. Studies were eligible for inclusion if they included an adult population of working age (18 to 65 years) who had survived a stroke and had participated in a vocational rehabilitation program. The exclusion criteria included any other type of rehabilitation that did not specifically address vocation, other diagnostic groups or studies where stroke population results were not reported independently, as well as publications not translated to English. The primary outcome was return-to-work rates. Results: Six studies, involving a total of 462 participants, were included in this review. All studies were a retrospective single cohort design. The rates of employment following these vocational rehabilitation programs ranged from 12% to 49%. Conclusion: There was not an adequate number of high-quality trials to make recommendations that support or refute the use of specific vocational rehabilitation programs to increase return-to-work rates following a stroke. Standardized terminology definitions as well as quality, randomized controlled trials are required before conclusions can be made about the effect of vocational rehabilitation programs on the return-to-work rates for stroke survivors.
What factors affect how long it will take workers to return to work following an episode of acute low-back pain? A just-completed systematic review from the Institute for Work & Health points to a number of them, including workers’ recovery expectations and their interactions with health-care practitioners. It began with a question: “What influences return to work among workers in the early phase of a disability due to low-back pain?” It ended with some concrete answers, and then took one step further: a workshop to see if the answers rang true for case managers, medical examiners and clinicians.The “it” is a systematic review led by Institute for Work & Health Associate Scientist Dr. Ivan Steenstra. Completed in September, the review updated an earlier version in 2005. The newest review identified a number of factors present at the beginning of a work absence due to low-back pain that affect the length of time before return to work (RTW).“By identifying these factors, we can potentially use them to screen those workers at high risk of long-term disability,” says Steenstra. “We can also try to modify those practices or factors that are shown to negatively affect return to work in order to improve outcomes.”The research team hypothesized that certain factors present at the beginning of a sick-leave absence, for acute low-back pain, would affect the duration of the leave. The team searched the literature for studies that reported on low-back pain and sick leave that lasted more than one day but less than six weeks. In the end, the team identfied 30 relevant publications from 25 studies.