2013-07-01 12:00 - Messages

Introduction to the Special Section: Sustainability of Work with Chronic Health Conditions

Background The increasing prevalence of older workers and chronic health conditions represents a growing occupational health concern. More research is needed to understand risk factors, apply and adapt theories, and test workplace-focused interventions that might prevent work disability and disengagement among chronically ill workers. Methods A 2-h roundtable symposium involving 28 participants was held at an international conference (Second Scientific Conference on Work Disability Prevention & Integration, Groningen, The Netherlands) in October 2012. In that symposium, small groups of participants were invited to discuss theoretical, methodological, and implementation considerations for studying workplace function and well-being among workers with chronic health conditions. As a follow-up to the symposium, the organizers invited authors to submit original articles to a Special Section of the Journal of Occupational Rehabilitation for peer review and publication. Results Results of the symposium reflected the need to address social, not just physical, aspects of the workplace, to include both individual-level and organizational interventions, and to integrate employer perspectives and operational models. Contributions to the Special Issue focus on outcome measurement, symptom self-management at work, job accommodations, prognostic factors for disability escalation, and the perceived needs of affected workers. Conclusions The content of the Special Section reflects an evolving body of research that continues to grapple with basic issues around choice of outcome measures, level of intervention, and the optimal ways to meet the needs of workers with chronic health conditions, including supporting efforts to manage symptoms and function at work. Future research should focus on integrating organizational and individual-level interventions. 

Source : Source: Shaw, William; Tveito, Torill; Boot, Cécile, Journal of Occupational Rehabilitation, vol. 23, no 2, June 2013 , p. 157-161(5). http://dx.doi.org/10.1007/s10926-013-9448-7

 

Disability Employment Services in Australia: A Brief Primer

This review aims to highlight how the chronic condition self-management support (CCSMS) field might inform and enhance the skills of the disability employment services (DES) workforce, particularly in its interactions with clients with complex disability needs. The approach we have taken involves a consideration of current education and training, recruitment of staff into DES and issues of concern arising from these processes. The main findings of our review are that the current DES workforce may not have the required skills to fully meet the needs of the populations they serve given the growing burden of chronic conditions, generally. We conclude by calling for greater consideration of CCSMS education and training as core required skills for the DES workforce, so that they might integrate their practice more collaboratively alongside other support providers.
Keywords:
disability; employment; training; competencies; chronic condition management
Source : Catherine Byrnes and Sharon Lawn (2013). Disability Employment Services in Australia: A Brief Primer. The Australian Journal of Rehabilitation Counselling, 19, pp 46-56. http://dx.doi.org/10.1017/jrc.2013.4.

 

Workplace Rehabilitation and Supportive Conditions at Work: A Prospective Study

Purpose To investigate the impact of rehabilitation measures on work ability and return to work (RTW), specifically the association between workplace rehabilitation/supportive conditions at work and work ability and RTW over time, among women on long-term sick leave. Methods Questionnaire data were collected (baseline, 6 and 12 months) from a cohort of women (n = 324). Linear mixed models were used for longitudinal analysis of the repeated measurements of work ability index (WAI), work ability score and working degree. These analyses were performed with different models; the explanatory variables for each model were workplace rehabilitation, supportive conditions at work and time. Results The individuals provided with workplace rehabilitation and supportive conditions (e.g. influence at work, possibilities for development, degree of freedom at work, meaning of work, quality of leadership, social support, sense of community and work satisfaction) had significantly increased WAI and work ability score over time. These individuals scored higher work ability compared to those individuals having workplace rehabilitation without supportive conditions, or neither. Additionally, among the individuals provided with workplace rehabilitation and supportive conditions, working degree increased significantly more over time compared to those individuals with no workplace rehabilitation and no supportive conditions. Conclusion The results highlight the importance of integrating workplace rehabilitation with supportive conditions at work in order to increase work ability and improve the RTW process for women on long-term sick leave.

Source: Ahlstrom, Linda; Hagberg, Mats; Dellve, Lotta, Journal of Occupational Rehabilitation, vol. 23, no 2, June 2013, p. 248-260.
http://dx.doi.org/10.1007/s10926-012-9391-z

Employers' Attitudes Towards Hiring and Retaining People with Disabilities: A Review of the Literature

This selective review provides an overview of salient research findings related to employers' attitudes towards disability and prospective influences on employers to improve employment outcomes of people with disabilities. Research studies included for review are mainly those which investigated employer attitudes towards disability as predispositions to hiring people with disability. Selected studies were classified into three categories including hiring and accommodating employees with disabilities, work performance, and affective reactions and behavioural intentions of employers. Excluded from the review were studies that investigated other factors influencing employer attitudes toward disability. Altogether 34 research studies from the period of 1987 until 2012 were included in the review. Primary databases for the review included ProQuest, Ebscohost, Lexus Nexus, ERICK Database and the Sage Sociology Collection. This review of the demand-side employment literature suggests employers hold relatively positive attitudes regarding individuals with disabilities. However, employer affective reactions and behavioural intentions of employers towards disability in the work setting were less positive and negatively impact hiring decisions, provision of accommodations and work performance appraisals. Employer attitudes represent an important demand-side factor impacting full participation in competitive employment for individuals with disabilities. While employers report generally positive attitudes toward disability, hiring practices may still be discriminatory. Use by rehabilitation professionals of demand-side strategies with employers would likely result in higher rates of work participation by people with disabilities.

Source : Jana Burke, Jill Bezyak, Robert T. Fraser, Joseph Pete, Nicole Ditchman and Fong Chan (2013). Employers' Attitudes Towards Hiring and Retaining People with Disabilities: A Review of the Literature. The Australian Journal of Rehabilitation Counselling, 19, p. 21-38. http://dx.doi.org/10.1017/jrc.2013.2.

Personal Resources and Support When Regaining the Ability to Work: An Interview Study with Exhaustion Disorder Patients

Purpose The aim of the study was to explore experiences and thoughts in the process of returning to work in employed patients with Exhaustion Disorder. Methods Twelve patients with Exhaustion Disorder (burnout) who had been referred to a Stress Rehabilitation Clinic were interviewed. All patients were employed but a majority was on full or part-time sick leave. Grounded Theory was used as the qualitative method. Results A core category, regaining the ability to work, was developed. Alongside, two categories, internal resources and the external support system, were experienced as being important to the process. The internal resources were expressed through three key features (sub-categories), perceived validation, insights and adaptive coping abilities. The external support system was diverse and described by the sub-categories practical/structural and/or emotional support. Four external support actors were identified; the workplace, health care, the Social Insurance Agency, and the union. The supervisor was described as the most important external actor. Conclusions Internal and external resources are intertwined in the process of regaining the ability to work. The internal resources and external support can directly increase the probability to regain the ability to work. Moreover, these resources can affect each other and thus indirectly have an effect on the process. 

 Source: Norlund, Sofia; Fjellman-Wiklund, Anncristine; Nordin, Maria; Stenlund, Therese; Ahlgren, Christina, Journal of Occupational Rehabilitation, vol. 23, no 2, June 2013 , p. 270-279. http://dx.doi.org/10.1007/s10926-012-9396-7

Disability Accommodation in Nonstandard and Precarious Employment Arrangements

This study, based on data from a large nationally representative sample of Canadian workers with disabilities, examines the relationship between employment arrangements and the accommodation of disability in the workplace. We address whether workers with disabilities in nonstandard arrangements are more likely to have unmet accommodation needs and if other key dimensions of precarious employment mediate the relationship between nonstandard work and accommodation. Results from multivariate models suggest that despite disability legislation, practices of workplace disability accommodation parallel the unequal distribution of other labor market protections, with workers in more precarious arrangements (i.e. those in nonpermanent, low-wage, and nonunion jobs) at greater risk of having unmet needs.

Source : Work and Occupations May 2013 40: 174-205, http://dx.doi.org/10.1177/0730888413481030

Obstacles to and Facilitators of Return to Work After Work-Disabling Back Pain: The Workers' Perspective

Introduction Back pain entails considerable costs, particularly because many injured workers are absent from work for long periods. Factors that influence return to work among workers with back pain are still, however, not well understood. This qualitative study aimed at documenting affected workers' perspective on the: 1-difficulties caused by back pain, and 2-most important obstacles to and facilitators of return to work. Methods Two focus groups composed of workers having suffered from work-disabling back pain were held: a group of participants who had returned to work (n = 9) and a group of participants who had not returned or had recently returned to work (n = 10). The verbatim accounts of the discussions were transcribed and a content analysis was carried out that included a ranking of items. Results Difficulties caused by back pain were related to: (1) personal, (2) family, (3) social, (4) occupational, and (5) financial factors, and (6) health services. Obstacles to and facilitators of return to work were of 4 different types: (1) occupational factors, (2) factors associated with the utilization of health services, (3) clinical, and (4) personal factors. Persistent pain, lack of access to information or support groups, and lack of collaboration and understanding from employer were the most important obstacles identified, whereas knowledge of one's limits and physical training were perceived to be the most important facilitators of return to work, ahead of work-related factors. Differences between groups' perceptions were attributed mainly to control beliefs. Conclusions Personal, clinical, occupational and health services factors are perceived by workers with back pain to play a crucial role in determining whether they return to work or not. 

Source : Dionne, Clermont; Bourbonnais, Renée; Frémont, Pierre; Rossignol, Michel; Stock, Susan; Laperrière, Ève, Journal of Occupational Rehabilitation, vol. 23, no 2, June 2013 , p. 280-289(10).  http://dx.doi.org/10.1007/s10926-012-9399-4

 

Are the predictors of work absence following a work-related injury similar for musculoskeletal and mental health claims?

Objective To examine if the factors associated with days of absence following a work-related injury are similar for mental health versus musculoskeletal (MSK) conditions. Methods A secondary analysis of wage replacement workers' compensation claims in the state of Victoria, Australia. We examined the relationship between individual, injury, occupational and workplace variables with days of wage replacement over the 2-year period following first day of absence from work separately for mental health claims and MSK claims using negative binomial regression models. Results Mental health conditions were associated with a greater number of days of absence over the 2 years following first incapacity compared to MSK conditions. Differences were observed in employment, injury and industry variables on absence from work for mental claims compared to MSK claims. Working in the agriculture, forestry, fishing and mining industries and employment with a small organisation were more strongly associated with the number of days of wage-replacement among MSK compared to mental health claims, and working in the public administration and safety, or education and training industries or being employed in a position with high time pressure were associated with greater days of wage-replacement among mental health compared to MSK claims. Conclusions Predictors of days away from work in the 2 years following an injury differ for mental health versus MSK claims. Given the increasing number of mental health claims in Australia more research is required to understand differences in return-to-work for this group of claimants compared to those with physical injuries.

Source : Smith PM, Black O, Keegel T, Collie A. J. Occup. Rehabil. 2013; ePub. http://dx.doi.org/10.1007/s10926-013-9455-8

Confirmatory Factor Analysis of the Work Limitations Questionnaire (WLQ-25) in Workers' Compensation Claimants with Chronic Upper-Limb Disorders

Purpose: To examine the factorial validity of the Work Limitations Questionnaire (WLQ-25) among workers' compensation claimants with chronic upper-limb disorders. Methods: Attendees of the WSIB Shoulder and Elbow Specialty clinic in Toronto, Ontario, Canada, completed a survey that includes the WLQ-25 [4 subscales: time-management (TM), physical demands (PD), mental-interpersonal (MI), and output demands (OD)]. Confirmatory factor analyses (n = 2262) were conducted to evaluate and compare alternative 4- and 5-factor WLQ-25 structures [MI subscale intact vs. separated into mental demands (MD) and interpersonal demands (IP) subscales]. Model fit indices, saliency of factor loadings, and convergent/divergent validity of latent factors (r = 0.4 − 0.85 expected) were concurrently assessed. Results: The 4-factor WLQ-25 showed acceptable model fit after allowing the residuals of a pair of PD items to correlate (CFI = 0.924, TLI = 0.915, RMSEA = 0.057, SRMR = 0.054); however, significantly lower-than-expected correlations between the PD factor and all other factors (r = −0.11 - −0.03) were also observed. Model fit for the 5-factor WLQ-25 was even more optimal (CFI = 0.934, TLI = 0.925, RMSEA = 0.053, SRMR = 0.051), with MD and IP factors correlating at r = 0.83. Conclusions: Evidence of factorial validity was demonstrated by the WLQ-25; however, users should be attentive of an instrumentation issue that could be directly related to the psychometric performance of its PD subscale.

Source : Tang, Kenneth; Beaton, Dorcas; Amick, Benjamin; Hogg-Johnson, Sheilah; Côté, Pierre; Loisel, Patrick, Journal of Occupational Rehabilitation, vol. 23, no 2, June 2013, p. 228-238. http://dx.doi.org/10.1007/s10926-012-9397-6

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