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Models of care for the management of persistent musculoskeletal pain and/or depression
Musculoskeletal pain can occur following damage to the muscles, ligaments, tendons, and bones. The three main causes of musculoskeletal pain are unusual or repetitive strain on the system, trauma to a specific area from a fall, sprain or blow, and certain musculoskeletal diseases.1 Many Australians experience musculoskeletal pain, however for a few, this becomes chronic or persistent. 2 Persistent musculoskeletal pain is often associated with depression and anxiety.3 Persistent musculoskeletal pain is a major cause of disability in older age and a major cause of work absence in the working age...
Return to Work in Patients with Chronic Musculoskeletal Pain: Multidisciplinary Intervention Versus Brief Intervention
A Randomized Clinical Trial Objective: This randomized clinical trial was performed to compare the effect of a new multidisciplinary intervention (MI) programme to a brief intervention (BI) programme on return to work (RTW), fully and partly, at a 12-month and 24-month follow-up in patients on long-term sick leave due to musculoskeletal pain. Methods: Patients (n = 284, mean age 41.3 years, 53.9 % women) who were sick-listed with musculoskeletal pain and referred to a specialist clinic in physical rehabilitation were randomized to MI (n = 141) or BI (n = 143). The MI included the use of a visual...
Pratiques des grandes organisations au Québec en regard de la coordination du retour au travail
L'objectif général de cette étude consistait à décrire les pratiques des personnes impliquées dans la coordination du retour au travail dans de grandes organisations privées et publiques au Québec. Le premier objectif spécifique était de décrire les personnes impliquées dans la coordination du retour au travail, ainsi que les organisations pour lesquelles elles travaillent. Le deuxième objectif spécifique était de décrire les tâches et activités réalisées...
Travailleurs avec déchirure de la coiffe des rotateurs et asymptomatiques
Corrélation entre des paramètres morphoanthropométriques et d'imagerie diagnostique et la fonction de l'épaule L'objectif général du présent projet est de faire des analyses de corrélation entre différents paramètres d'imagerie diagnostique, morphologiques, posturaux et de pseudo-cinématique et la fonction de l'épaule chez deux groupes de travailleurs avec et sans rupture de la coiffe pour tenter d'établir les déterminants de la fonction de l'épaule. Source: http...
Manual therapy for tension-type headache related to quality of work life and work presenteeism
Secondary analysis of a randomized controlled trial OBJECTIVE: The objective of this research is to evaluate the efficacy of manual therapy for tension-type headache (TTH) in restoring workers quality of work life, and how work presenteeism affects this relation. DESIGN: This study is a secondary analysis of a factorial, randomized clinical trial on manual therapy interventions. Altogether, 80 patients (85% women) with TTH and without current symptoms of any other concomitant disease participated. INTERVENTIONS: An experienced therapist delivered the treatment: myofascial inhibitory technique ...
Seven “Principles” for Successful Return to Work
What do employers need to do to enhance a worker's return to work (RTW) after an injury or illness? These evidence-based guidelines have the answers. They are based on an IWH review of RTW studies, which identified the elements contributing to a successful return to work. This document is essential for all workplaces and RTW professionals. Source: http://www.iwh.on.ca/seven-principles-for-rtw
Effect of the Danish return-to-work program on long-term sickness absence
Results from a randomized controlled trial in three municipalities Objectives : The aim of this study was to evaluate the effect of the Danish return-to-work (RTW) program on long-term sickness absence in a randomized controlled trial in three municipalities. Methods : The intervention group comprised 1948 participants while the control group comprised 1157 participant receiving ordinary sickness benefit management (OSM). Study participants were working-age adults receiving long-term (≥8 weeks or more) benefits, included regardless of reason for sickness absence or employment status. Each beneficiary...
Maladies chroniques et travail : l'exemple danois du programme "Return To Work"
Les maladies chroniques évolutives posent un challenge majeur en matière de santé en Europe. Mais elles ont aussi un impact substantiel sur le marché du travail et la vie professionnelle. Des actions sur l’organisation du travail peuvent pourtant être menées pour améliorer la situation des salariés et celle des entreprises. Le réseau Anact est l'opérateur pour la France d'un projet réunissant 18 pays de l'Union sur ce sujet. Retour d'expérience sur une initiative danoise Source : http://www...
Return-to-work program for workers on sick leave due to common mental disorders
In case of long-term sick leave, gradually increasing workload appears to be an effective component of work-directed interventions to reduce sick leave due to common mental disorders (CMD). We developed an exposure-based return-to-work (RTW-E) intervention and evaluated the effect on time-to-full return to work (RTW) among workers who were on sick leave due to CMD in comparison to those treated with care-as-usual (CAU). CAU is guideline-directed and consists of problem-solving strategies and graded activities. The median time-to-full RTW differed significantly between groups [hazard ratio (HR)...
Intervention Characteristics that Facilitate Return to Work After Sickness Absence: A Systematic Literature Review
Hoefsmit, Nicole, Houkes, Inge et Nijhuis, Frans J. N. (2012). Intervention Characteristics that Facilitate Return to Work After Sickness Absence: A Systematic Literature Review. Journal of Occupational Rehabilitatin . Introduction In many Western countries, a vast amount of interventions exist that aim to facilitate return to work (RTW) after sickness absence. These interventions are usually focused on specific target populations such as employees with low back pain, stress-related complaints or adjustment disorders. The aim of the present study is to detect and identify characteristics of RTW...
Rehabilitation Interventions for Pain and Disability in Osteoarthritis...
Iversen, Maura Daly (2012). Rehabilitation Interventions for Pain and Disability in Osteoarthritis: A review of interventions including exercise, manual techniques, and assistive devices. Orthopaedic Nursing 31(8): 103-108. OVERVIEW: Osteoarthritis (OA) results in progressive destruction of articular cartilage and bone at the joint margins, leading to impairments extending far beyond the synovial joint. Rehabilitation interventions that target specific impairments and activity restrictions can help restore independence and promote healthy living. Such interventions include exercise, physical modalities...
Work-focused treatment of common mental disorders and return to work
A comparative outcome study The aim of this study was to compare the effectiveness of two individual-level psychotherapy interventions: (a) treatment as usual consisting of cognitive–behavioral therapy (CBT) and (b) work-focused CBT (W-CBT) that integrated work aspects early into the treatment. Both interventions were carried out by psychotherapists with employees on sick leave because of common mental disorders (depression, anxiety, or adjustment disorder). In a quasi-experimental design, 12-month follow-up data of 168 employees were collected. The CBT group consisted of 79 clients, the...
The Danish national return-to-work program
The Danish national return-to-work (RTW) program aims to improve the management of municipal sickness benefit in Denmark. A study is currently ongoing to evaluate the RTW program. The purpose of this article is to describe the study protocol. The program includes 21 municipalities encompassing approximately 19 500 working-age adults on long-term sickness absence, regardless of reason for sickness absence or employment status. It consists of three core elements: (i) establishment of multidisciplinary RTW teams, (ii) introduction of standardized workability assessments and sickness absence management...
Colloque du 4 novembre 2011 en réadaptation au travail et les 25 ans de "rapport Spitzer": accès aux diapositives
Le 4 novembre dernier, s'est tenu à l'Institut de réadaptation Gingras-Lindsay-de-Montréal, le Colloque sur la réadaptation au travail: du "Rapport Spitzer" à nos jours - 24 ans plus tard! organisé par l'IRSST en collaboration avec le REPAR. Ce colloque a été un grand succès avec plus de 130 participants à la journée. Vous pouvez accéder aux présentations et vidéos de la journée en suivant le lien: http://www.irsst.qc.ca/conferenciers-Spitzer-a-nos-jours-4-novembre-2011...
Return to Work Outcomes of the Redesigning Daily Occupations (ReDO) Program for Women with Stress-Related Disorders—A Comparative Study
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...
Publication d’un guide de pratique pour les ergothérapeutes
L'Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST) vient de publier un guide de pratique à l'intention des ergothérapeutes. Mis à la disposition des cliniciens, ce guide fournit les données scientifiques nécessaires pour éclairer leur décision en matière d'évaluation des capacités reliées au travail des personnes présentant une déficience physique. La pratique professionnelle est très variable, ce qui suscite un questionnement sur...
Motor performance in chronic low back pain: is there an influence of pain-related cognitions? A pilot study
Kusters, Dymphy et coll. (2011). Motor performance in chronic low back pain: is there an influence of pain-related cognitions? A pilot study. BMC Musculoskeletal Disorders 2011, 12:211. (article en libre accès) Backgroundf: Chronic low back pain (CLBP) is often accompanied by an abnormal motor performance. However, it has not been clarified yet whether these deviations also occur during motor tasks not involving the back and whether the performance is influenced by pain and pain-related cognitions. Therefore, the aim of the present study is to get insight in the contribution of both pain...
Swedish rehabilitation professionals' perspectives on work ability assessments in a changing sickness insurance system
Stååhl, Christian et al. (2011). Swedish rehabilitation professionals' perspectives on work ability assessments in a changing sickness insurance system. Disability & Rehabilitation , 33 (15-16): 1373-1382. Purpose . Changes in the Swedish sickness insurance system shifts focus from return-to-work to labour market reintegration. This article analyses Swedish rehabilitation professionals' perspectives on how the changed regulations affect practice, with a special focus on work ability assessments. Methods . Two groups of representatives (( n == 15)) from organizations...
Occupational therapy practitioners’ perspectives regarding international cross-cultural work
Humbert, T. K. et al. (2011). Occupational therapy practitioners' perspectives regarding international cross-cultural work. Australian Occupational Therapy Journal , 58 (4): 300-309. Aim:  The purpose of this study was to investigate the perspectives of occupational therapy practitioners who have engaged in cross-cultural work experiences. The research question was how do occupational therapy practitioners make meaning of their lived cross-cultural experiences. Methods:  This study utilised a qualitative, phenomenological design. Eleven open-ended, semi-structured interviews were...
Promoting Culturally Competent Chronic Pain Management Using the Clinically Relevant Continuum Model
Monsivais, Diane B. (2011). Promoting Culturally Competent Chronic Pain Management Using the Clinically Relevant Continuum Model. Nursing Clinics of North America , 46(2): 163-169. This article reviews the culture of biomedicine and current practices in pain management education, which often merge to create a hostile environment for effective chronic pain care. Areas of cultural tensions in chronic pain frequently involve the struggle to achieve credibility regarding one's complaints of pain (or being believed that the pain is real) and complying with pain medication protocols. The clinically...
The Practical Application of Theory and Research for Preventing Work Disability: A New Paradigm for Occupational Rehabilitation Services in China?
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 trajectory of chronic pain: Can a community-based exercise/education program soften the ride?
(accès restreint) The entire primary care record of six patients attending a community-based education/exercise self-management program for chronic noncancer pain (YMCA Pain Exercise/Education Program [Y-PEP]) was reviewed. Medical visits, consultations and hospital admissions were coded as related or unrelated to their pain diagnoses. Mood disruption, financial concerns, conflicts with employers/insurers, analgesic doses, medication side effects and major life events were also recorded. The 'chronic pain trajectory' resembled a roller coaster with increased health care visits at...
The meaning of the experiences of persons with chronic pain in their encounters with the health service
Chronic pain causes great suffering for those affected and treating it is one of the most common assignments in the health service. The aim of the study was to investigate the meaning of the experiences of persons with chronic pain in their encounters with health service staff. The study had a descriptive design with a phenomenological approach based on the perspective of caring science. Interviews were carried out with eight patients. The study showed that patients experienced a positive approach and that the staff had understood the serious nature of the situation. A positive approach can communicate...
Community occupational therapists' clinical reasoning: Identifying tacit knowledge
Occupational therapy interventions in the community, a fast expanding practice setting, are central to an important social priority, the ability to live at home. These interventions generally involve only a small number of home visits, which aim at maximising the safety and autonomy of community-dwelling clients. Knowing how community occupational therapists determine their interventions, i.e. their clinical reasoning, can improve intervention efficacy. However, occupational therapists are often uninformed about and neglect the importance of clinical reasoning, which could underoptimise their interventions...
Disability Management Outcomes in the Ontario Long-Term Care Sector
Optimal disability management practices supporting early and safe return-to-work involve the workplace adoption of formal policies and procedures to ensure the quality of disability management outcomes. In the Canadian province of Ontario, there are approximately 60,000 health care workers in 600 licensed facilities providing long-term residential care to approximately 75,000 elderly residents. Workers in this sector are exposed to high biomechanical demands arising from care-giving tasks and have a substantial risk of work-related disability. Over the period 2000–2006, many long-term care...
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